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Volume 6

October 2021

Volume 6, Issue 1

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Volume 5

December, 2020

Volume 5, Issue 1

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Volume 4

December, 2019

Volume 4, Issue 1

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Volume 3

December, 2018

Volume 3, Issue 1

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Volume 2

December, 2017

Volume 2, Issue 1

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Volume 1

May, 2016

Volume 1, Issue 1

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Article in press

  • 2022, January

    opinion

    Coronavirus Disease-2019 Conspiracy Theories are Alive and Breathing on the InternetOpen Access

    John Boos*
    DOI: https://dx.doi.org/10.17140/EPOJ-7-126
    Provisional PDF269.25 KB 269.25 KB
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  • 2022, January

    observational study

    Epidemiological Profile of Children with Neurodevelopmental Disorders in a Diagnostic Center in Southern Puerto Rico, 2006-2017Open Access

    María Pacheco, Laura D. Bauzá, Iris Martínez and Luisa M. M. Torres*
    DOI: https://dx.doi.org/10.17140/EPOJ-7-127
    Provisional PDF426.46 KB 426.46 KB
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    Abstract [+]

    Objective
    This study has the purpose of developing an epidemiological profile of children with neurodevelopmental disorders in southern Puerto Rico.
    Methods
    This is an exploratory study with a mixed design that was carried out in a diagnostic center located in Ponce, Puerto Rico. The population under study were children within 0-18-years-old of both sexes diagnosed with a neurodevelopmental disorder using the diagnostic and statistical manual of mental disorders (DSM-4) and DSM-5 criteria. The sample under investigation were all the children in the secondary database of children who received health services in the diagnostic center during 2016-2017. Additionally, to the data from the secondary database, a hand-writing record review was performed to obtain data related to comorbidities and family history. The bivariate and multivariate analysis evaluated the association between each neurodevelopmental disorder, and each disease reported in the family history of diseases. Also bivariate, and multivariate analysis assessed the association between each neurodevelopmental disorder, and each comorbidity reported.
    Results and Conclusion
    The mean age and standard deviation of the sample were 5.2±3.20, and 80.5% were males. Most of the children lived in Ponce, Puerto Rico. The sample size did not have normal distribution because the sample size was too small and selected by non-probabilistic methods. Furthermore, 88.2% of the children received a previous evaluation related to the problem, and 70.5% received treatment for the symptoms. The results revealed that neurodevelopmental disorders frequently co-occurred. Also, other comorbidities commonly co-occurred with these disorders. Mental disorders were commonly reported with autism, attention deficit and hyperactivity disorder (ADHD) and communication disorders. Autism was also linked to a family history of mental disorders.
    Keywords
    Childhood; Neurodevelopmental disorder; Disabilities; Developmental delays.


  • 2022, April

    retrospective study

    Trends in Spatiotemporal Exposure to Air Pollutants and Adult Cardiovascular Emergency Room Visits in the Greater Pittsburgh, Pennsylvania, USAOpen Access

    Chunzhe Duan, Richard A. Bilonick, Judith R. Rager, Tao Xue and Evelyn O. Talbott*
    DOI: https://dx.doi.org/10.17140/EPOJ-7-128
    Provisional PDF1.44 MB 1.44 MB
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    Abstract [+]

    Introduction
    The acute effects of air pollution and cardiovascular disease (CVD) have been studied, but very few studies have focused on spatiotemporally modeled exposure to air pollutants at the population level. This study aims to examine the short-term association of fine particulate matter (PM2.5), Ozone (O3), Nitrogen Dioxide (NO2) and Sulfur Dioxide (SO2) and CVD emergency room visits (ERV) in Allegheny County for a 13-year period using a case-crossover study design.
    Aim
    We sought to estimate the effects of acute exposure to these four pollutants adjusting for temperature on CVD ERV and to compare outcomes in 1999-2005 compared to 2006-2011.
    Methods
    Land-use regression was used to model the ground level exposures to PM2.5, O3, NO2 and SO2. CVD ER visits were requested from the local hospitals of the two health networks in Allegheny County, which operate the majority of the ER services. The discharge International Classification of Diseases-9 (ICD-9) codes were used to identify the CVD cases and CVD subgroups. We linked the Zone Improvement Plan (ZIP) code level air pollution data with the patients’ ZIP code (residence) to determine the individual level exposure estimation of both case days and control days. Conditional logistic regression with multi-pollutant and distributed lags of 0-3-days was applied to estimate the effect of acute exposure of these pollutants to CVD ER visits (ERV), adjusting for temperature.
    Results
    In the overall analyses, for every interquartile increase of O3 exposure (25.52 ppb), there was a 6.6% (95% CI: 0.8%-12.7%) increase in the odds of an acute myocardial infarction ERV. This was consistent across both time periods. Among women and Black ERV, we observed an association of PM2.5 with acute myocardial infarction, and with ischemic heart disease. Some of these associations persisted in the later years of the study period. The gaseous pollutants (NO2, SO2 and O3) were shown to increase risk of cardiovascular events in both time periods.
    Conclusion
    We found an association of PM2.5 and NO2 with CVD ER visits, and this association persisted in the stratified analyses, as well as in the later years with lower exposure levels. The findings suggest that further actions to reduce the pollution level in this area should be taken. Ozone and NO2 were related to increased risk for all CVD, ischemic heart disease (IHD) and acute myocardial infarction (AMI) underscoring the importance of gaseous pollutants and their effect on coronary heart disease (CHD) risk.
    Keywords
    Multi-pollutants; Cardiovascular emergency room visits; Spatiotemporal; Acute; Case-crossover.


  • 2022, May

    editorial

    Unintended Effects of Coronavirus Disease-2019Open Access

    James M. Wesson*
    DOI: https://dx.doi.org/10.17140/EPOJ-7-e003
    Provisional PDF268.21 KB 268.21 KB
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NOTE: The DOIs of the In-Press Articles will only function after the final publication of the articles and once they are uploaded to the Current Issues.
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Current Issue

  • 2021, January

    editorial

    Nothing is SimpleOpen Access

    Mark Wesson*
    DOI: https://dx.doi.org/10.17140/EPOJ-6-e002
    PDF198.30 KB 198.30 KB
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  • 2021, July

    review

    Strategies and Challenges in the Development of Coronavirus Disease-2019 VaccineOpen Access

    Pratibha Gupta*
    DOI: https://dx.doi.org/10.17140/EPOJ-6-122
    PDF579.07 KB 579.07 KB
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    Abstract [+]

    The novel coronavirus infection (coronavirus disease-2019 (COVID-19)) emerged from Wuhan in the Hubei Province of China in late 2019. Millions of people were infected with COVID-19 pandemic due to the long incubation period of the virus inside the human body and the dearth of available treatments or vaccines. High transmission rates created havoc, which highlighted the urgent need for effective interventions to stop the spread and clinical impact of the virus on patients and populations. Previous research on severe acute respiratory syndrome coronavirus (SARS-CoV) provides information on vaccination strategies that could inform how governments approach the elimination of this novel coronavirus. Numerous efforts have been made to develop vaccines against Middle East respiratory syndrome (MERS) and SARS. The spike glycoprotein or S protein is the critical target for most of the drugs and vaccines against coronavirus. The virus uses the spike (S) protein for entering the host cell, by interacting
    with the receptor called angiotensin converting enzyme-2 (ACE2). Various vaccine platforms are available such as nucleic acid vaccine, protein-based vaccines, virus-vectored vaccines and live or attenuated vaccines, with each having their advantages and disadvantages. This review focuses on the overview of different vaccine candidates used, those currently in development, and the challenges encountered while developing effective vaccines.
    Keywords
    SARS-CoV-2; Vaccine development; Clinical trials.


  • 2021, August

    original research

    Using MapMCDA Tool for the Spatial Epidemiology of Animal Rabies in Morocco: How to Improve the Rationality of a Qualitative Risk AssessmentOpen Access

    Mounir Khayli*, Mehdi Kechna, Khalil Zro, Faouzi Kichou, Jaouad Berradae and Mohammed Bouslikhane
    DOI: https://dx.doi.org/10.17140/EPOJ-6-123
    PDF717.45 KB 717.45 KB
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    Abstract [+]

    Objective
    The objective behind this article is to better characterize spatial distribution of animal rabies in Morocco through qualitative risk assessment framework. In Morocco, the occurrence of the disease is neither clearly distributed nor complete. Therefore, risk assessment methods become strongly recommended to cope with distorted geographic patterns.
    Methods
    Based on data collection set from 168 counties, qualitative changes on spatial epidemiology of rabies were analysed by mapMCDA tool covering a period from 2004 to 2017 and including information on determinants of the geographic distribution of animal rabies in Morocco defined in previous work.
    Results
    To validate the risk assessment model, the results were compared to rabies cases reported during the study period. The clustering of the rabies risk estimates is decisive and highly reliable. A significant alignment was shown between the very high and high-risk estimates.
    Conclusion
    This study is the first attempt that has been made for using MapMCDA for rabies. For a normative process aiming to avoid subjectivity related to expert-opinions, authors suggest conducting initially a statistical multiple component analysis that will provide quantified estimates of risk factors. It would be an advisable decision-making tool that helps to design oriented surveillance and allows better referral of actions to control the disease.
    Keywords
    Animal rabies; Canine rabies; Spatial epidemiology; Qualitative risk assessment; MapMCDA; Veterinary science; Public health; Morocco.


  • 2021, September

    original research

    Factors Affecting Access to E-Learning during the Coronavirus Disease 2019 Pandemic Among Rural-Based Pharmacy Students in Zambia: A Qualitative StudyOpen Access

    Kennedy Mwila*, Steward Mudenda, Martin Kampamba, Webrod Mufwambi, Enala S. Lufungulo, Margaret Phiri and Christabel N. Hikaambo
    DOI: https://dx.doi.org/10.17140/EPOJ-6-124
    PDF828.58 KB 828.58 KB
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    Abstract [+]

    Background
    The coronavirus disease 2019 (COVID-19) pandemic has negatively affected the education sector globally. This has resulted in learning institutions adopting e-learning techniques. E-learning implementation in higher education continues to gain prominence in both developed and developing countries. Most universities are exploring different ways of using information and
    communications technology (ICT). However, ICT remains a challenge more especially for students who come from rural areas.
    Aim
    This study was aimed at exploring the factors that affect access to e-learning among rural-based pharmacy students in Zambia.
    Methods
    A qualitative case study was conducted among ten (10) purposively sampled pharmacy students at the University of Zambia. The study participants were from the Manying, a district of North-Western Province, the Sinda district of Eastern Province, the Nalolo district of Western Province, the Chipili district of Luapula Province and the Mbala district of Northern Province. Semistructured interviews were used to collect data from the respondents. Data were analyzed using the framework analysis. The sociodemographic characteristics indicate that ten (10) respondents were drawn from Zambia’s five (5) provinces. Six qualitative themes were generated these included devices used for e-learning; the effectiveness of the devices; student performance; internet connectivity; and electrification of the houses. Key findings suggest that the most commonly used device was a smartphone, which posed challenges to effective learner participation in e-learning. Poor internet connectivity, non-electrification of students’ houses, electricity outages, and costs-associated with internet use negatively affected students in accessing online learning and could adversely affect their academic activities and performance.
    Conclusion
    The COVID-19 pandemic has negatively affected access to e-learning among rural pharmacy students in Zambia. The implications of the challenges faced by the rural pharmacy students are that their academic activities and performance were negatively affected. Therefore, this posed a threat to the rights to universal access to education of the rural students who were mostly venerable.
    Keywords
    Academic performance; COVID-19; Coronavirus disease; E-Learning; Online learning; Pandemic; Pharmacy students.


  • 2021, October

    narrative review

    A Review of the Antiviral Activity of Ivermectin and Its Use in the Treatment of Coronavirus Disease-2019Open Access

    Christabel N. Hikaambo*, Martin Kampamba, Fernando Bwalya, Mutenje Mweemba, Chipo Siamutwe, Webrod Mufwambi, Tadious Chimombe, Michelo Banda and Steward Mudenda
    DOI: https://dx.doi.org/10.17140/EPOJ-6-125
    PDF402.93 KB 402.93 KB
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    Abstract [+]

    Background
    The coronavirus disease-2019 (COVID-19) originated in China and was declared a pandemic by the World Health Organization (WHO) on 11th March 2020. Since its emergence in December 2019, worldwide, we have developed preventive vaccines but no definitive treatment directed at the virus itself. Currently, the treatments for COVID-19 include symptomatic treatments, supportive therapy, antiviral drugs, immunotherapy and cellular therapy. However, most of the treatments are still under investigation and development and treatment guidelines vary according to countries or regions. Ivermectin is one of the drugs that are being used as part of treatment guidelines in certain countries like the Republic of Peru. However, the WHO advices that ivermectin only be used in clinical trials.
    Aim
    The authors conducted this review to explore published studies on the possible therapeutic effects of ivermectin against active infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a causative agent of COVID-19.
    Methods
    A literature search was conducted using Google Scholar, PubMed and EMBASE for articles published from 2010 to 2021. Search words used included ivermectin, antiviral, COVID-19, efficacy, safety, dosing, lower mortality rate, hospitalised patients and the Boolean operator ‘AND’.
    Results
    A few clinical trials have shown that ivermectin is safe for use in humans at specific doses and reduces the severity of the infection. Ivermectin was seen to reduce the signs and symptoms associated with COVID-19 in some studies while others showed no significant reduction. However, more studies must be conducted to ascertain its use in treating COVID-19.
    Conclusion
    Since many clinical trials are being conducted on the use of ivermectin to treat COVID-19, full evidence will be used to support its use in humans. Currently, some countries that are using ivermectin for treating COVID-19 have reported it to be effective and reduce morbidity and mortality associated with the disease. Therefore, countries should collaborate and provide full evidence for the use of ivermectin in humans to manage COVID-19.
    Keywords
    Ivermectin; COVID-19; SARS-CoV-2; Clinical trials; Antiviral.


×

Previous Issue

  • 2020, February

    review

    Better Together: Evolving Social Process between Bystanders and First Responders is a Force Multiplier for Effective Emergency ResponseOpen Access

    Carmit Rapaport* and Isaac Ashkenazi
    DOI: https://dx.doi.org/10.17140/EPOJ-5-117
    PDF433.98 KB 433.98 KB
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    Abstract [+]

    Bystanders are an integral part of an emergency scene. Their presence on site makes them the immediate potential responders, who can provide life-saving assistance as well as various rescue actions. Research has shown that bystanders are willing to and are capable of helping, especially (but not limited to) when a leader emerges, as the help is rooted in a collective action. In this article, we suggest a new framework for understanding the effectiveness of bystanders help, based on the evolving social process between bystanders and first responders. As we show, the transition from no help, at the very first moment right after the emergency has occurred, to an effective coordinated response where first responders and bystanders act together, goes through engagement of bystanders. Further, first responders should acknowledge the social organization of bystanders, utilize and leverage it in order to optimize their efforts. This framework has important insights for policy makers when managing emergency and disaster situations with limited resources.

    Keywords

    Bystanders; First responders; Mass casualty incident; Help; Emergency; Cardio-pulmonary resuscitation (CPR).


  • 2020, July

    review

    The Potential of Amniotic Fluid-Derived Extracellular Vesicles to Treat Severe Acute Respiratory Syndrome Coronavirus 2 Infection Versus Hydroxychloroquine in Human PatientsOpen Access

    Ian A. White*
    DOI: https://dx.doi.org/10.17140/EPOJ-5-118
    PDF395.85 KB 395.85 KB
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    Abstract [+]

    Recently a lot of attention has been focused on fast-tracking repurposed drugs for the treatment of a novel coronavirus; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent leading to the devastating coronavirus disease-2019 (Covid-19). One of the first and most well-known examples is hydroxychloroquine (HCQ), which has been used for years as a treatment for malaria, rheumatoid arthritis and lupus. HCQ was rolled out as a miracle treatment for Covid-19, which was inexpensive, effective and causing few side-effects. However, its effectiveness in treating Covid-19 has recently been questioned leaving doctors and patients confused and desperate. Here the proposed mechanisms of action of HCQ are discussed and compared with an inexpensive, safe and effective alternative, which is derived from natural, healthy amniotic fluid.
    Keywords
    Covid-19; SARS-CoV-2; Amniotic fluid; CytoSomes.


  • 2020, October

    mini review

    Halting Coronavirus ReplicationOpen Access

    Kira Smith*
    DOI: https://dx.doi.org/10.17140/EPOJ-5-119
    PDF318.44 KB 318.44 KB
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    Abstract [+]

    Sirtuin 1 (SIRT1) inhibitors can reduce replication of many viruses with certain characteristics similar to those of coronaviruses, while the p53 protein is another important factor in the down-regulation of viral growth. Tenovin is a class of small molecules that inhibit Sirtuin 1 and 2, in addition to activating the p53 protein, by means of regulating the interactions used by coronaviruses as a self-defense mechanism. By blocking virus growth and continuous replication, with already tested antiviral medicines, the promise of coronavirus disease 2019 (COVID-19) eradication exists.
    Keywords
    COVID-19; Coronavirus replication; SIRT1 inhibitors; p53; Tenovin.


  • 2020, November

    letter to the editor

    Review of the article on “The Rate of Underascertainment of Novel Coronavirus (2019-nCoV) Infection: Estimation Using Japanese Passergers Data On Evacuation Flights”Open Access

    Eric Lin*
    DOI: https://dx.doi.org/10.17140/EPOJ-5-120
    PDF282.30 KB 282.30 KB
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  • 2020, November

    commentary

    Challenges Related to Antimalarial Abuse in Coronavirus Disease-2019 Treatment in the Democratic Republic of CongoOpen Access

    Anselme Manyong* and Ange Landela
    DOI: https://dx.doi.org/10.17140/EPOJ-5-121
    PDF256.33 KB 256.33 KB
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    Abstract [+]

    Malaria is endemic to many African countries and geographies and remains the leading cause of morbidity and mortality on the continent. Ongoing efforts by health authorities to reverse the scale of malaria are often faced to the challenges of drug resistance often generated by therapeutic abuses relating to self-medication, sub-therapeutic under dosages and poor storage and handling of drugs throughout the pharmacy supply chain system.
    Keywords
    Malaria; Covid-19; Morbidity and mortality; Abuse antimalarial; Drug resistance.


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    Editor-in-Chief

    Pi Guo, MD, PhD


    Associate Professor
    Department of Public Health
    Shantou University
    No. 22 Xinling Road
    Shantou, China

    Associate Editors

    Scott Lee, MD, MPH, FACS


    Lecturer
    School of Public Health
    University of California
    Berkeley, CA, USA

    Evelyn O. Talbott, MPH, Dr.PH


    Professor of Epidemiology
    University of Pittsburgh
    Graduate School of Public Health
    130 DeSoto Street, A526 Crabtree Hall
    Pittsburgh, PA 15261, USA

    Our editorial team


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