2022 Monkeypox outbreak:Why is it a public health emergency of international concern?What can we do to control it?

The World Health Organization(WHO) called the recent monkeypox(MPX)outbreak a Public Health Emergency of International Concern on July 23,2022.The United States of America(US) alarmed the recent MPX outbreak as the US public health emergency on August 4,2022.Since early May 2022,more than 35000 MPX cases and 12 deaths had been reported to WHO from 92 countries and territories by August 17,2022,and MPX cases continue rising rapidly with improved surveillance,access to diagnosis,and continuous virus spreading globally.Approximately 99% MPX cases are men,of which 95% cases are men who have sex with man.No evidence of MPX being sexually transmitted infections(STIs) is found;however,a high percentage(25%) of concurrent STIs and frequent anogenital symptoms suggest transmission through local inoculation during close intimate contact or sexual activity.Many approaches including a comprehensive international vaccination strategy and adequate supplies are mandatory to prevent MPX pandemic.Education,vaccination,MPX scrutiny and careful monitoring,and crossborder collaborations with international sectors are practical strategy to contain MPX outbreaks.People are educated to reduce the risk of exposure and to reduce the number of sexual partners especially new ones,to avoid contacting travelers from epidemic regions or animals that may carry MPX virus,and avoid traveling to endemic areas.

Rehabilitation of shoulder paresis caused by herpes zoster according to the International Classification of Functioning, Disability and Health A case report

We describe the case of a 73-year-old man with left shoulder paresis caused by a herpes zoster infection of the left C5 dermatomes. The patient had been affected by pain for 10 days, a skin rash on his left shoulder and back for 5 days, and weakness of his left shoulder for 2 days before admission. Eiectromyography revealed denervation discharges from the left supraspinatus, infraspinatus and deltoid muscles, which was compatible with radiculopathy showing after zoster infection. The patient was examined in accordance with the International Classification of Functioning, Disability and Health, and treated with range-of-movement and strengthening exercises as well as activities of daily living and social participation. At 14 months after the onset of the condition, muscle strength had returned to normal. Electromyography revealed that motor unit action potentials were largely normal. These results indicate that the rehabilitation of paresis caused by herpes zoster can obtain positive results with suitable movement training.

INTERNATIONAL FORUM FOR PUBLIC HEALTH,SHANGHAI 2007 Second announcement

Conference Time and Venue 1.Registration Time Dec 11,2007;Scientific Program Dec 12-14,2007 2.Venue Skyway Landis Hotel,Shanghai Address:15 Dapu Road,Luwan District,Shanghai;Zip Code:200023; Tel:86-21-33189988,Fax:86-21-53010000;Homepage:http://www.skywaylandis.

Introduction to the International Symposium on Lipid Science and Health and research progress in lipid science and health

The International Symposium on Lipid Science and Health(ISLSH),which was organized annually by Oil Crops Research Institute of Chinese Academy of Agricultural Sciences(OCRI-CAAS)since 2016,has gained a strong reputation and attracted hundreds of delegates from around the world for discussion of lipid research trends and advances every year,to promote research and academic exchanges in the fields of lipid science and health.The 5th International Symposium on lipid Science and Health was successfully held in Wuhan,China,from October 23rd to 25th,2020,to celebrate the 60th anniversary of OCRI-CAAS.The two-day symposium gathered wellknown experts specialized in lipid science to share the current state of lipid research with emphasis on aspects covering:(1)lipid profiling and characterization,(2)lipid preparation and modification,(3)lipid improvement and regulation,and(4)lipid nutrition and health.The symposium was conducted by a combination of on-site and network meeting.More than 250 distinguished delegates from academia and industry participated in the on-site multidisciplinary meeting,and thousands of scholars attended the virtual event.This paper is as a record of the symposium proceedings and a brief summary of the advances and trends in 4 aspects of lipid science and health.

Minimizing the risk of international spread of coronavirus disease 2019 (COVID-19) outbreak by targeting travelers

The Coronavirus Disease-2019 (COVID-19) outbreak has become a global health emergency owing to its magnitude, attributed deaths, and its propensity to spread across the world. In-fact, owing to its quick spread across international boundaries and the resulting caseload, the disease has been declared as a Public Health Emergency of International Concern on 30 January 2020. It is worth noting that out of the 395 cases detected in other nations, 165 (41.8%) have a positive history of travel to China. As of now, the World Health Organization has not recommended for any restrictions on the travel or trade aspects, but has clearly specified that implementation of International Health Regulations should be strictly done at the airports and seaports. In conclusion, the COVID-19 outbreak has created an alarm across the globe as the causative virus is novel in nature. However, strengthening of standard infection control practices and adoption of preventive measures for travelers can significantly minimize the threat of further transmission of the disease.

A One Health approach to fight antimicrobial resistance in Uganda: Implementation experience, results, and lessons learned

Uganda has been implementing the Global Health Security Agenda(GHSA)since 2015 to build its capacity according to World Health Organization(WHO)Benchmarks on International Health Regulations Capacities.The country remains prone to outbreaks,with more than 20 disease outbreaks reported in the past five years,including Ebola virus disease,Crimean-Congo haemorrhagic fever,Marburg haemorrhagic fever,measles,yellow fever,coronavirus disease 2019(COVID-19),and cholera.Antimicrobial resistance(AMR)is an ongoing challenge.Uganda scored capacity level 3 on infection prevention and control(IPC)and antimicrobial stewardship(AMS)in the 2017 Joint External Evaluation(JEE)assessment.Identified gaps were being addressed after a self-assessment in 2021.This paper describes the technical assistance approaches provided to Uganda by the Medicines,Technologies,and Pharmaceutical Services Program,funded by the United States(U.S.)Agency for International Development,and implemented by Management Sciences for Health.The program,through a One Health approach,supported systematic capacity strengthening based on the JEE's capacity advancement framework for global health security,specifically relating to AMR.The program's interventions impacted 32 WHO benchmark actions(7 for AMR multisectoral coordination,16 for IPC,and 9 for AMS),contributing to Uganda's strengthened GHSA capacity.Leveraging success built on the AMR platform,the program trained 745 health workers in IPC for the Ebola virus and provided support for simulation exercises by eight district IPC teams.The program also worked with the Ministry of Health to coordinate IPC for the COVID-19 response in five health regions,covering 45 districts and reaching 5,452 health workers at 858 health facilities.

Ultrasound diagnosis of malaria: examination of the spleen, liver, and optic nerve sheath diameter

BACKGROUND: Over 90% of all cases of malaria worldwide occur in Africa. Current methods of diagnosis are time and labor intensive, and could lead to delayed treatment.METHODS: In this study we investigated the effectiveness of measurements of spleen, liver, and optic nerve sheath diameter(ONSD) in identifying patients with malaria or severe malaria through the use of hand-held ultrasound devices. We recruited 40 adult patients with malaria and 16 adult control subjects at two hospitals in Mwanza, Tanzania. Ultrasonographic diagnosis was compared with rapid antigen diagnostic test and peripheral blood smear as the gold standards. An receiver operating characteristic curve test was performed to determine the most optimal diagnostic threshold for malaria and severe malaria, using each of the measurements for liver size, spleen size, and ONSD. The thresholds were determined to be >12 cm for spleen length and >15.1 cm for liver length, whereas ONSD was not signifi cant in this study.RESULTS: The sensitivities for malaria diagnosis were 66.7% and 58.3% for liver and spleen length respectively, suggesting that these measurements may not be suitable for identifying patients with severe malaria. However, the high specificity of 90.9% for spleen length and the acceptable specifi city of 75.0% for liver length suggest that these measurements can be used as a method to eliminate false-positive diagnoses(i.e. patients who do not have severe malaria but are classifi ed as having it by a test with a high sensitivity), giving a high positive predictive value.CONCLUSIONS: We report a high specifi city for spleen size and a moderate specifi city for liver size in the ultrasonographic diagnosis of severe malaria. Thus when paired with a highly sensitive method of malaria diagnosis, ultrasonographic measurement of spleen and liver size is promising as part of a diagnostic algorithm for malaria. It could be used to stratify risk in patients diagnosed with malaria and assist in their triage. If no sensitive tests are available, ultrasound might be useful to suggest malaria as a cause of a patient's constellation of clinical symptoms.

Application of the international classification of functioning, disability and health in China

Implementation of the International Classification of Functioning, Disability and Health （ICF） started in 2001 with the unanimous endorsement of the classification by the 54th World Health Organization （WHO） as a framework for describing and measuring health and disability. In recent years, the ICF has been increasingly applied to research and development in China, and has influenced the policies of the Chinese Disabled Person Enterprise and Chinese Rehabilitation Career. This paper introduces the translation, training and spread of ICF and its application in the fields of medicine, society and education in China.

Chinese medical students’interest in COVID-19 pandemic

BACKGROUND The outbreak of coronavirus disease 2019(COVID-19)happened in early December and it has affected China in more ways than one.The societal response to the pandemic restricted medical students to their homes.Although students cannot learn about COVID-19 through clinical practice,they can still pay attention to news of COVID-19 through various channels.Although,as suggested by previous studies,some medical students have already volunteered to serve during the COVID-19 pandemic,the overall willingness of Chinese medical students to volunteer for such has not been systematically examined.AIM To study Chinese medical students’interest in the relevant knowledge on COVID-19 and what roles they want to play in the pandemic.METHODS Medical students at Peking Union Medical College were surveyed via a webbased questionnaire to obtain data on the extent of interest in the relevant knowledge on COVID-19,attitude towards volunteerism in the pandemic,and career preference.Logistic regression modeling was used to investigate possible factors that could encourage volunteerism among this group in a pandemic.RESULTS A total of 552 medical students responded.Most medical students showed a huge interest in COVID-19.The extent of students’interest in COVID-19 varied among different student-classes(P<0.05).Senior students had higher scores than the other two classes.The number of people who were‘glad to volunteer’in COVID-19 represented 85.6%of the respondents.What these students expressed willingness to undertake involved direct,indirect,and administrative job activities.Logistic regression analysis identified two factors that negatively influenced volunteering in the pandemic:Student-class and hazards of the voluntary job.Factors that positively influenced volunteering were time to watch COVID-19 news,predictable impact on China,and moral responsibility.CONCLUSION More innovative methods can be explored to increase Chinese medical students’interest in reading about the relevant knowledge on COVID-19 and doing voluntary jobs during the pandemic.

Representation of Specific Diagnosis for Low Back Pain Using the 11^(th) Revision of International Classification of Diseases and Related Health Problems: Perspectives of Conventional Medicine and Traditional Medicine

Background:The 11th revision of the International Classification of Diseases and Related Health Problems(ICD-11)was released on June 18,2018,by the World Health Organization and will come into effect on January 1,2022.Apart from the chapters on the classification of diseases in the conventional medicine(CM),a new chapter,traditional medicine(TM)conditions–Module 1,was added.Low back pain(LBP)is one of the common reasons for the physician visits.The classification codes for LBP in the ICD-11 are vital to documenting accurate clinical diagnoses.Methods:The qualitative case study method was adopted.The secondary use data for 100 patients were randomly selected using the ICD-11 online interface to find the classification codes for both the CM section and the TM Conditions–Module 1(TM1)section for LBP diagnosis.Results:Of the 27 codes obtained from the CM section,six codes were not relevant to LBP,whereas the other 21 codes represented diagnoses of LBP and its related diseases or syndromes.In the TM1 section,six codes for different patterns and disorders represented the diagnoses for LBP from the TM perspective.Conclusion:This study indicates that specific diagnoses of LBP can be represented by the combination of CM classification codes and TM1 classification codes in the ICD-11;the CM codes represent specific and accurate clinical diagnoses for LBP,whereas the TM1 codes add more accuracy to the diagnoses of different patterns from the TM perspective.

Fighting against the common enemy of COVID-19: a practice of building a community with a shared future for mankind

The outbreak of coronavirus disease 2019(COVID-19)has caused more than 80813 confirmed cases in all provinces of China,and 21110 cases reported in 93 countries of six continents as of 7 March 2020 since middle December 2019.Due to biological nature of the novel coronavirus,named severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)with faster spreading and unknown transmission pattern,it makes us in a difficulty position to contain the disease transmission globally.To date,we have found it is one of the greatest challenges to human beings in fighting against COVID-19 in the history,because SARS-CoV-2 is different from SARS-CoV and MERS-CoV in terms of biological features and transmissibility,and also found the containment strategies including the non-pharmaceutical public health measures implemented in China are effective and successful.In order to prevent a potential pandemic-level outbreak of COVID-19,we,as a community of shared future for mankind,recommend for all international leaders to support preparedness in low and middle income countries especially,take strong global interventions by using old approaches or new tools,mobilize global resources to equip hospital facilities and supplies to protect noisome infections and to provide personal protective tools such as facemask to general population,and quickly initiate research projects on drug and vaccine development.We also recommend for the international community to develop better coordination,cooperation,and strong solidarity in the joint efforts of fighting against COVID-19 spreading recommended by the joint mission report of the WHO-China experts,against violating the International Health Regulation(WHO,2005),and against stigmatization,in order to eventually win the battle against our common enemy—COVID-19.

Sustainable strategies for Ebola virus disease outbreak preparedness in Africa:a case study on lessons learnt in countries neighbouring the Democratic Republic of the Congo

Background: From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018–2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions within the various contexts of these countries against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly events.Main text: Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent coronavirus disease 2019 (COVID-19) pandemic. Shortfalls such as lost opportunities for operationalizing cross-border regional preparedness collaboration and better integration of multidisciplinary perspectives, vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during active Ebola virus disease outbreaks for preparedness rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations, the Sustainable Development Goals and advocating global policy for addressing the larger structural determinants underscoring these outbreaks.Conclusions: Despite several international frameworks established at the global level for emergency preparedness, a shortfall exists between global policy and practice in countries at high risk of cross border transmission from persistent Ebola virus disease outbreaks in the Democratic Republic of Congo. With renewed global health commitment for country emergency preparedness resulting from the COVID-19 pandemic and cumulating in a resolution for a pandemic preparedness treaty, the time to review and address these gaps and provide recommendations for more sustainable and integrative approaches to emergency preparedness towards achieving global health security is now.