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An outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in Jordan in 2015 involved a variant virus that acquired distinctive deletions in the accessory open reading frames. We conducted a molecular and seroepidemiologic investigation to describe the deletion variant's transmission patterns and epidemiology. We reviewed epidemiologic and medical chart data and analyzed viral genome sequences from respiratory specimens of MERS-CoV cases. In early 2016, sera and standardized interviews were obtained from MERS-CoV cases and their contacts. Sera were evaluated by nucleocapsid and spike protein enzyme immunoassays and microneutralization. Among 16 cases, 11 (69%) had health care exposure and 5 (31%) were relatives of a known case; 13 (81%) were symptomatic, and 7 (44%) died. Genome sequencing of MERS-CoV from 13 cases revealed 3 transmissible deletions associated with clinical illness during the outbreak. Deletion variant sequences were epidemiologically clustered and linked to a common transmission chain. Interviews and sera were collected from 2 surviving cases, 23 household contacts, and 278 health care contacts; 1 (50%) case, 2 (9%) household contacts, and 3 (1%) health care contacts tested seropositive. The MERS-CoV deletion variants retained human-to-human transmissibility and caused clinical illness in infected persons despite accumulated mutations. Serology suggested limited transmission beyond that detected during the initial outbreak investigation.

Despite under-reporting, health workers (HWs) accounted for 2 to 30% of the reported COVID-19 cases worldwide. In line with data from other countries, Jordan recorded multiple case surges among HWs. Based on the standardized WHO UNITY case-control study protocol on assessing risk factors for SARS-CoV-2 infection in HWs, HWs with confirmed COVID-19 were recruited as cases from eight hospitals in Jordan. HWs exposed to COVID-19 patients in the same setting but without infection were recruited as controls. The study lasted approximately two months (from early January to early March 2021). Regression models were used to analyse exposure risk factors for SARS-CoV-2 infection in HWs; conditional logistic regressions were utilized to estimate odds ratios (ORs) adjusted for the confounding variables. A total of 358 (102 cases and 256 controls) participants were included in the analysis. The multivariate analysis showed that being exposed to COVID-19 patients within 1 metre for more than 15 minutes increased three-fold the odds of infection (OR 2.92, 95% CI 1.25-6.86). Following IPC standard precautions when in contact with patients was a significant protective factor. The multivariate analysis showed that suboptimal adherence to hand hygiene increased the odds of infection by three times (OR 3.18; 95% CI 1.25-8.08). Study findings confirmed the role of hand hygiene as one of the most cost-effective measures to combat the spreading of viral infections. Future studies based on the same protocol will enable additional interpretations and confirmation of the Jordan experience.

Population-based serosurveillance is a cornerstone to furthering our understanding of the COVID-19 pandemic at the community levels. In Jordan, four waves (phases) of seroprevalence epidemiological investigations were conducted using representative population-based national samples. This study aims to estimate the population-based seropositivity, herd immunity, and vaccination coverage at the fourth wave. Multistage sampling technique was implemented to recruit a nationally representative sample for the fourth wave of the seroprevalence investigation (June to August 2021). Electronically collected data utilized a questionnaire on background demographics, chronic diseases, and COVID-19 vaccination history. Also, blood samples were collected to detect the presence of total Anti-SARS-CoV-2 IgM and IgG using Wantai/ELISA assays. Prevalence estimates were presented using percentage and 95% Confidence Intervals (C.I.). There were 8821 participants included in this study, with a mean age of 31.3 years, and 61.7% were females. COVID-19 national seroprevalence and vaccination coverage estimates were 74.1% (95% C.I.: 73.1-74.9%) and 38.4% (95% C.I.: 37.1-39.6%), respectively. Among children, seroprevalence estimates were similar to unvaccinated adults. Among COVID-19 adults, 57.2% were vaccinated. Among vaccinated participants, 91.5% were seropositive, while among unvaccinated, 63.2% were seropositive. By age group, seroprevalence ranged between 53.0% and 86.9%. Seroprevalence estimates were significantly different by gender, vaccination status and dose, and residence. The reported interplay between seropositivity and vaccination coverage estimate seems insufficient to provide herd immunity levels to combat new variants of SARS-CoV-2. Children and healthcare workers seem to be an epidemiologically influential group in spreading COVID-19. As the globe is still grappling with SARS-CoV-2 infection, national seroepidemiological evidence from Jordan calls for more focus on vaccination coverage, especially among epidemiologically vulnerable groups, to optimize herd immunity.

Influenza illness burden is substantial, particularly among young children, older adults, and those with underlying conditions. Initiatives are underway to develop better global estimates for influenza-associated hospitalizations and deaths. Knowledge gaps remain regarding the role of influenza viruses in severe respiratory disease and hospitalizations among adults, particularly in lower-income settings. We aggregated published data from a systematic review and unpublished data from surveillance platforms to generate global meta-analytic estimates for the proportion of acute respiratory hospitalizations associated with influenza viruses among adults. We searched 9 online databases (Medline, Embase, CINAHL, Cochrane Library, Scopus, Global Health, LILACS, WHOLIS, and CNKI; 1 January 1996-31 December 2016) to identify observational studies of influenza-associated hospitalizations in adults, and assessed eligible papers for bias using a simplified Newcastle-Ottawa scale for observational data. We applied meta-analytic proportions to global estimates of lower respiratory infections (LRIs) and hospitalizations from the Global Burden of Disease study in adults ≥20 years and by age groups (20-64 years and ≥65 years) to obtain the number of influenza-associated LRI episodes and hospitalizations for 2016. Data from 63 sources showed that influenza was associated with 14.1% (95% CI 12.1%-16.5%) of acute respiratory hospitalizations among all adults, with no significant differences by age group. The 63 data sources represent published observational studies (n = 28) and unpublished surveillance data (n = 35), from all World Health Organization regions (Africa, n = 8; Americas, n = 11; Eastern Mediterranean, n = 7; Europe, n = 8; Southeast Asia, n = 11; Western Pacific, n = 18). Data quality for published data sources was predominantly moderate or high (75%, n = 56/75). We estimate 32,126,000 (95% CI 20,484,000-46,129,000) influenza-associated LRI episodes and 5,678,000 (95% CI 3,205,000-9,432,000) LRI hospitalizations occur each year among adults. While adults <65 years contribute most influenza-associated LRI hospitalizations and episodes (3,464,000 [95% CI 1,885,000-5,978,000] LRI hospitalizations and 31,087,000 [95% CI 19,987,000-44,444,000] LRI episodes), hospitalization rates were highest in those ≥65 years (437/100,000 person-years [95% CI 265-612/100,000 person-years]). For this analysis, published articles were limited in their inclusion of stratified testing data by year and age group. Lack of information regarding influenza vaccination of the study population was also a limitation across both types of data sources. In this meta-analysis, we estimated that influenza viruses are associated with over 5 million hospitalizations worldwide per year. Inclusion of both published and unpublished findings allowed for increased power to generate stratified estimates, and improved representation from lower-income countries. Together, the available data demonstrate the importance of influenza viruses as a cause of severe disease and hospitalizations in younger and older adults worldwide.

An alarming elevation of anthropogenic carbon dioxide (CO 2 ), primarily responsible for global warming and its drastic effects on climatic conditions, must be challenged on a priority basis. Various types of absorbents capture as much CO 2 as possible to minimize the harsh effects of environmental and climatic changes. In this study, one such compound, methyltrioctylammonium trifluoromethanesulfonate ionic liquid (IL), was analyzed experimentally and theoretically. The COSMO‐RS, a type of conductor‐like screening model, is an advanced fast method to predict the thermo‐physical properties of IL. It depends upon unimolecular, statistical thermodynamics, molecular structure, and conformation, which provides the required information for estimating interactions in ILs. The COSMO‐RS, not dependent on data, coefficients, or parameters, was used to calculate the sigma surface, profile, and potential. These parameters are crucial for predicting high‐absorbing CO 2 materials, such as ILILs. Spectroscopic methods, such as Fourier transform infrared spectroscopy (FTIR), proton nuclear magnetic resonance ( 1 H NMR), and carbon‐13 NMR ( 13 C NMR), verified the structure confirmation. In addition, spectrochemical characterization of the IL was performed using FTIR, NMR, ultraviolet–visible (UV–Vis) spectroscopy, and fluorescence. The thermal integrity of IL was measured by thermogravimetric–differential thermal analysis (TGA‐DTA) over the temperature range of 323–773 K in an oxygen ambiance with a ramp rate of 283 K/min. Due to its high potential for gas absorption, as confirmed by COSMO‐RS calculations, IL was investigated for CO 2 absorption and desorption studies at 298 K and 4.5 MPa. The maximum CO 2 absorption obtained was ~ 6.0 mmol/g, performed at similar experimental conditions. The high uptake of CO 2 might be due to fluorinated anions, as CO 2 has a high affinity for fluoroalkyl groups. According to a hysteresis‐based classification, the hysteresis formation during CO 2 absorption and desorption follows type H3, indicating the presence of both microporous and mesoporous characteristics in the sample. A detailed study of the excess Gibbs energy of sorption and the activity coefficient of the IL indicates a strong sorption capacity under moderate conditions.

Breast cancer is the most prevalent and lethal form of cancer being the utmost common medical concern of women. Breast cancer etiology implicates numerous cellular protein receptors such as estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor/receptor 2 (HER2) which turn on oncogenic cascade often attributed to certain genetic variations. Breast Cancer is thus classified into ER + /-, PR + /-, HER2 ± and Triple Negative types. This study seeks to build upon our current knowledge of HER2 + and TNBC BC types to discover novel patterns for diagnosis and prognosis. The study exploits wealth of HER2 + and TNBC transcriptome (RNA Seq) data to elucidate the key hub genes, their associated networks, pathways, stage-wise expression profile, role in prognosis and survival expectancy, and regulatory transcription factors. The study also employs machine learning models including support vector machine (SVM), XGBoost , Random Forest, k nearest neighbor (kNN), Naïve Bayes and Voting Classifier to distinguish between HER2 + and TNBC transcriptomes which is a key variable for early detection and choice of therapeutic alternatives. RNA Seq datasets consisting of 49 HER2 + and 44 TNBC breast tumor samples were retrieved and pre-processed. Differentially Expressed Genes (DEGs) along with their logFC and p-values were fetched. The KEGG (Kyoto Encyclopedia of Genes and Genomes) and GO (Gene Ontology) analyses of DEGs were conducted on DAVID (the Database for Annotation, Visualization and Integrated Discovery) and interaction network was constructed through Cytoscape. Ten hub genes were obtained based on maximum clique centrality (MCC), maximum neighborhood component (MNC), degree, closeness and betweenness using cytoHubba which included ACTB, ATM, ESR1, GAPDH, HNRNPK, KRAS, MDM2, SIRT1, TP53, and H3F3C (H3-5). These hub genes were found to be associated with cell proliferation, invasion and migration. Transcription factors and association of the expression profile of these hub genes with survival expectancy was also determined. Among the ML models, SVM stood out, exhibiting classification success between HER2 + and TNBC transcriptomes with an accuracy of 90%. The findings of this study can therefore effectively aid in tracing the initial prognosis of BC and identify biomarkers for the personalized prevention, prediction, diagnosis, and treatment of BC.

Tricuspid valve disorder (TVD), a critical aspect of valvular heart disease (VHD), significantly impacts cardiovascular health, yet its mortality trends are not well understood. This study aimed to investigate demographic and geographic disparities in TVD-related mortality across the United States from 1999 to 2023. Using data from the CDC WONDER database, death certificates were analyzed to identify TVD-related fatalities, and age-adjusted mortality rates (AAMRs) were calculated per 1,000,000 individuals. Joinpoint regression analysis was conducted to assess annual percent changes (APCs) in mortality rates. A total of 72,805 deaths were attributed to TVD. An initial steep increase in mortality rate from 1999 to 2003 (APC: 7.9%; 95% CI: 3.9 to 14.1) followed by a stable period from 2003 to 2014 (APC: 0.1%; 95% CI: -2.7 to 1.0) and a sharp increase in AAMR from 2014 to 2023 (APC: 6.5%; 95% CI: 5.2 to 8.4). Females consistently had higher mortality rates than males, with a sharper increase after 2012. Racial and ethnic disparities were evident, with American Indian and white populations experiencing higher mortality rates than black populations. Geographic disparities were also noted, with states like Oregon, Minnesota, and Vermont, as well as the West census region, showing significantly higher mortality rates. Rural areas had higher mortality rates compared to urban areas. TVD-related mortality trends have followed a complex trajectory, with marked disparities across demographic and geographic factors. Further research is required to fully understand the factors driving these trends and their public health implications.

(1) Background: COVID-19 caused the worst international public health crisis, accompanied by major global economic downturns and mass-scale job losses, which impacted the psychosocial wellbeing of the worldwide population, including Saudi Arabia. Evidence of the high-risk groups impacted by the pandemic has been non-existent in Saudi Arabia. Therefore, this study examined factors associated with psychosocial distress, fear of COVID-19 and coping strategies among the general population in Saudi Arabia. (2) Methods: A cross-sectional study was conducted in healthcare and community settings in the Saudi Arabia using an anonymous online questionnaire. The Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale (FCV-19S) and Brief Resilient Coping Scale (BRCS) were used to assess psychological distress, fear and coping strategies, respectively. Multivariate logistic regressions were used, and an Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CIs) was reported. (3) Results: Among 803 participants, 70% (n = 556) were females, and the median age was 27 years; 35% (n = 278) were frontline or essential service workers; and 24% (n = 195) reported comorbid conditions including mental health illness. Of the respondents, 175 (21.8%) and 207 (25.8%) reported high and very high psychological distress, respectively. Factors associated with moderate to high levels of psychological distress were: youth, females, non-Saudi nationals, those experiencing a change in employment or a negative financial impact, having comorbidities, and current smoking. A high level of fear was reported by 89 participants (11.1%), and this was associated with being ex-smokers (3.72, 1.14–12.14, 0.029) and changes in employment (3.42, 1.91–6.11, 0.000). A high resilience was reported by 115 participants (14.3%), and 333 participants (41.5%) had medium resilience. Financial impact and contact with known/suspected cases (1.63, 1.12–2.38, 0.011) were associated with low, medium, to high resilient coping. (4) Conclusions: People in Saudi Arabia were at a higher risk of psychosocial distress along with medium-high resilience during the COVID-19 pandemic, warranting urgent attention from healthcare providers and policymakers to provide specific mental health support strategies for their current wellbeing and to avoid a post-pandemic mental health crisis.

Medicinal plants are highly used in the ethnoveterinary practice as considerable livestock resources in remote areas. The aim of the present study is to explore the ethnoveterinary medicinal practices in three different communities and discuss the cross‐cultural consensus on the usage of medicinal plants for the treatment of animals. The field survey was conducted by the animal healers of the area during the different seasons of plant growth. A total of 83 informants were interviewed through Semi‐structured interview involving experts of traditional knowledge in 21 localities of the three regions (Zhob, D. I. Khan and Mianwali) were conducted. Findings of the study were quantitatively analyzed through the informant consensus factors to identify the homogeneity information provided by the informants. Furthermore, cross‐culture consensuses were analyzed and recorded data were represented in a tabulated and Venn diagrams. In particularly, 59 species of plants were documented in the comparative analysis. Among them, 32 plant species were recorded in Pashto community, while Punjabi and Sarakai communities exhibited nine and four plant species, respectively. Whereas cross‐cultural analysis showed 14 medicinal plants that were commonly utilized by three different ethnic communities, that indicated low interregional consensus in regard to ethnoveterinary practices of medicinal plants. The current study showed that different communities and ethnic groups sharing some traditional knowledge and cross‐culturally approaches have been reported from traditional uses of plants against livestock's diseases. Therefore, current findings are the opportunities to scrutinize the plants for the discovery of new drug sources for humans and animals. This research work provides the cross‐cultural information about medicinal plants in different communities of three different regions in the Southwest Pakistan. Cross‐cultural analysis showed medicinal plants was commonly used among three ethnic communities that indicates a low interregional consensus with regard to the ethnoveterinary practices of medicinal plants.