Development of methods of male contraception: impact of the World Health Organization Task Force

Objective: To give an historical record of the research of the World Health Organization (WHO) Task Force to develop methods of male contraception; to examine the social, political, medical, pharmaceutical, funding, and other factors that influenced progress; and to suggest reasons why such methods are only now becoming available. Design: Review of basic and clinical research over 30 years. Setting: Task force of a multinational agency and collaborating agencies. Conclusion(s): Through the involvement of many international scientists, the WHO Task Force has uniquely contributed to the exploratory phases of the research in male contraception and by its multicenter contraceptive efficacy studies has accelerated progress towards the ideal hormonal method. Despite an adverse climate involving social and political attitudes, funding constraints, and pharmaceutical industry hesitations, WHO formed coalitions with governments and international agencies to sustain research with results that apply to men in culturally diverse populations and thereby to influence activities across the whole range of global reproductive health and family planning.

Simple approach for the histomolecular diagnosis of central nervous system gliomas based on 2021 World Health Organization Classification

The classification of central nervous system(CNS)glioma went through a sequence of developments,between 2006 and 2021,started with only histological approach then has been aided with a major emphasis on molecular signatures in the 4^(th) and 5^(th) editions of the World Health Organization(WHO).The recent reformation in the 5th edition of the WHO classification has focused more on the molecularly defined entities with better characterized natural histories as well as new tumor types and subtypes in the adult and pediatric populations.These new subclassified entities have been incorporated in the 5^(th) edition after the continuous exploration of new genomic,epigenomic and transcriptomic discovery.Indeed,the current guidelines of 2021 WHO classification of CNS tumors and European Association of Neuro-Oncology(EANO)exploited the molecular signatures in the diagnostic approach of CNS gliomas.Our current review presents a practical diagnostic approach for diffuse CNS gliomas and circumscribed astrocytomas using histomolecular criteria adopted by the recent WHO classification.We also describe the treatment strategies for these tumors based on EANO guidelines.

Mental health promotion for elderly populations in World Health Organization South-East Asia Region:Needs and resource gaps

The accelerated population growth of the elderly(individuals aged 60 years or more)across the globe has many indications,including changes in demography,health,the psycho-social milieu,and economic security.This transition has given rise to varied challenges;significant changes have been observed in regard to developing strategies for health care systems across the globe.The World Health Organization(WHO)is also engaging in initiatives and mediating processes.Furthermore,advocacy is being conducted regarding a shift toward the salutogenic model from the pathogenic model.The concept behind this move was to shift from disablement to enablement and from illness to wellness,with the notion of mental health promotion(MHP)being promoted.This article attempts to discuss the MHP of elderly individuals,with special reference to the need to disseminate knowledge and awareness in the community by utilizing the resources of the health sector available in the WHO South-East Asia Region countries.We have tried to present the current knowledge gap by exploring the existing infrastructure,human resources,and financial resources.There is much to do to promote the mental health of the elderly,but inadequate facilities are available.Based on available resources,a roadmap for MHP in elderly individuals is discussed.

The World Health Organization Surgical Safety Checklist Improves Post-Operative Outcomes: A Meta-Analysis and Systematic Review

Background: The incidence of in-hospital adverse events is about 10%, with a majority of these related to surgery, and nearly half considered preventable events. In attempts to improve patient safety, the World Health Organization (WHO) developed a checklist to be used at critical perioperative moments. This meta-analysis examines the impact of the WHO surgical safety checklist (SSC) on various patient outcomes. Methods: A comprehensive search of all published studies assessing the use of the WHO SSC in patients undergoing surgery was conducted. Studies using the WHO SSC in any surgical setting, with pre-implementation and post-implementation outcome data were included. The incidence of patient outcomes (total complications, surgical site infections, unplanned return to the operating room (OR) within 30 days, and overall mortality) and adherence to safety measures were analyzed. Results: 10 studies involving 51,125 patients (27,490 prior to implementation and 23,635 after implementation of the WHO SSC) were analyzed. The implementation of the WHO SSC significantly reduced the risk of total complications by 37.9%, surgical site infections by 45.5%, unplanned return to OR by 32.1%, and mortality by 15.3%. Increased adherence to safety measures including airway evaluation, use of pulse oximetry, prophylactic antibiotics when necessary, confirmation of patient name and surgical site, and sponge count was also observed. Conclusions: The use of the WHO SSC is associated with a significant reduction in post-operative complication rates and mortality. The WHO SSC is a valuable tool that should be universally implemented in all surgical centers and utilized in all surgical patients.

Effect of varicocele on semen characteristics according to the new 2010 World Health Organization criteria： a systematic review and meta-analysis

This study investigated the effects of varicocele on semen parameters in infertile men based on the new 2010 World Health Organization laboratory manual for the examination of human semen. Semen analysis results （volume, sperm count, motility, and morphology） were the primary outcomes. An electronic search to collect the data was conducted using the Medline/PubMed, SJU discover, and Google Scholar databases. We searched articles published from 2010 to August 2015, i.e., after the publication of the 2010 WHO manual. We included only those studies that reported the actual semen parameters of adult infertile men diagnosed with clinical varicocele and contained a control group of either fertile men or normozoospermic men who were not diagnosed with varicocele. Ten studies were included in the meta-analysis, involving 1232 men. Varicocele was associated with reduced sperm count （mean difference： -44.48 x 106 ml-1; 95% Ch -61.45, -27.51 x 106 ml-1; P〈 0.001）, motility （mean difference： -26.67%; 95% Ch -34.27, -19.08; P 〈 0.001）, and morphology （mean difference： -19.68%; 95% Ch -29.28, -10.07; P 〈 0.001） but not semen volume （mean difference： -0.23 ml; 95% CI： -0.64, 0.17）. Subgroup analyses indicated that the magnitude of effect was influenced by control subtype but not WHO laboratory manual edition used for semen assessment. We conclude that varicocele is a significant risk factor that negatively affects semen quality, but the observed pooled effect size on semen parameters does not seem to be affected by the WHO laboratory manual edition. Given most of the studies published after 2010 still utilized the 1999 manual for semen analysis, further research is required to fully understand the clinical implication of the 2010 WHO laboratory manual on the association between varicocele and semen parameters.

Monoclonal B-cell Lymphocytosis in a Patient with Wegener Granulomatosis： A Case Report and Update on 2016 World Health Organization Classification

The association between autoimmune disease and risk of monoclonal malignancy is well studied. Howeven monoclonal B-cell lymphocytosis （MBL） in patients with autoimmune diseases has rarely been reported. The newly published 2016 revision of the World Health Organization （WHO） classification of lymphoid neoplasms has officially accepted MBL as an independent disease entity Herein, we present a case of Wegener granulomatosis （WG） with MBL.

China President XI Jin-ping Met with Dr.Margaret Chan,Director-General of the World Health Organization,and Addressed to Promote Integrative Medicine and Chinese Medicine to Develop in Oversea Countries

China President Xi Jin-ping met with Dr. Margaret Chan, Director-General of the World Health Organization （WHO）, at the Great Hall of the People in Beijing, capital of China, Aug. 20, 2013. XI Jin-ping said that China will continue to improve public health and enhance cooperation with the WHO. The Chinese government always prioritizes its people＇s health and will make unremitting efforts to further implement reform of its public health system, Xi said. He promised that the Chinese government would continue to effectively distribute public health and medical resources in order to achieve full coverage of basic health services to all Chinese people by 2020.

Classificatory updates in verrucous and cuniculatum carcinomas:Insights from the 5^(th) edition of WHO-IARC head and neck tumor classification

The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular updates in this classification accommodate emerging molecular discoveries,advances in immunohistochemical techniques,and evolving clinical insights.The 5th edition of the WHO/IARC classification of head and neck tumors refines the'Oral Cavity and Mobile Tongue'chapter,including sections for non-neoplastic lesions,epithelial tumors,and tumors of uncertain histogenesis.Notably,the epithelial tumors section is rearranged by tumor behavior,starting with benign squamous papillomas and progressing through potentially malignant oral disorders to oral squamous cell carcinoma(OSCC).The section on OSCC reflects recent information on epidemiology,pathogenesis,and histological prognostic factors.Noteworthy is the specific categorization of verrucous carcinoma(VC)and carcinoma cuniculatum(CC),both associated with the oral cavity and distinct in clinical and histologic characteristics.This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck.Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes,elucidating their clinical features,distinct histological characteristics,prevalence,significance,and clinical relevance.By categorizing these subtypes into specific sections,the 5th edition of the WHO classification aims to provide a more nuanced and detailed account,enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors.

Health disparities are associated with gastric cancer mortality-to-incidence ratios in 57 countries

AIM To evaluate the association between mortality-to-incidence ratios(MIRs) and health disparities.METHODS In this study, we used the GLOBOCAN 2012 database to obtain the cancer incidence and mortality data for 57 countries, and combined this information with the World Health Organization(WHO) rankings and total expenditures on health/gross domestic product(e/GDP). The associations between variables and MIRs were analyzed by linear regression analyses and the 57 countries were selected according to their data quality. RESULTS The more developed regions showed high gastric cancer incidence and mortality crude rates, but lower MIR values than the less developed regions(0.64 vs 0.80, respectively). Among six continents, Oceania had the lowest(0.60) and Africa had the highest(0.91) MIR. A good WHO ranking and a high e/GDP were significantly associated with low MIRs(P = 0.001 and P = 0.001, respectively).CONCLUSION The MIR variation for gastric cancer would predict regional health disparities.

Male reproductive health research needs and research agenda:Asian and Chinese perspective

Research that addresses male reproductive health should assist in the development of reproductive healthprogrammes and policy; identify and test new leads in male contraceptive technology; establish effective maleinvolvement initiatives which are likely to have a positive impact on the reproductive health of men and women; guidethe allocation of health care resources to ensure cost-effectiveness of interventions; generate new knowledge, developdiagnostic technology in reproductive health and offer optimal treatment/care regimens. In considering the needs and demands of male reproductive health research in Asia and the Pacific, the followingsix research topics are recommended as the priority research areas: male contraceptive technology; male reproductivehealth behaviour and male adolescent reproductive health; male reproductive aging including male menopause and otherdiseases; male RTIs, STDs, HIV/AIDS; prevalence, management and prevention of male infertility; environment andsemen quality and other male reproductive problems. One of the major challenges now facing us is the elaboration of a comprehensive, yet realistic male reproductivehealth research agenda that reflect the needs and demands of Asian developing countries. To this end, to make use of aninterdisciplinary approach is of strategic importance. The most creative insights and productive leads are likely toemerge from a research team that is interdisciplinary especially in the field of reproductive health.

An Innovative Person-Centered Model for Provision of Mental, Social and Medical Care for People Living with Dementia

Globally there is an increased digitalization going on with an increasing number of people having access to the internet, having smartphones and now also in many countries being expected to access health-related information and schedule appointments through websites, apps or web-based portals. Healthcare providers have also adopted this with an increasing number of public or private organizations providing web-based portals as well as app interfaces to some of the largest electronic healthcare systems. The benefit of this is easier access, more efficient provision of services, increased transparency and improved workflows. This may increase the population’s capability to manage their conditions and reduce the contacts to, thereby burdening healthcare professionals. But not all will be able to benefit from this digital (r)evolution. Those who will not be able to include people with dementia. For people with dementia to also be able to take advantage of digital health tools and services, it will require planning and involvement of caregivers. In 2017, we presented the Epital Care Model as a framework to organize an efficient people-centered cross-disciplinary and cross-sectoral way to organize activities, roles, responsibilities and describe geographical locations and used technologies in response to individuals’ specific diagnoses and everyday changes in their condition. In 2021, an EU-funded project was initiated to investigate how living labs and scaling up could be done building upon the ECM. One of the living labs was organized around an organization providing care to PWD in Netherlands. In the period 2021 to 2024, we have tried to identify ways for how the ECM could be used to digitally enable the services provided by the organization. In 2022, the care organization tanteLouise started a project originally named Daycare Centre2.0 (now called “Van Thuis Uit” meaning “From Home”), together with healthcare insurance company CZ, and developed a model for onboarding people with dementia and introducing them to specific interventions based on their personal goals and needs. We here present how the ECM and the “Van Thuis Uit” can be mapped within each other to create synergy in creating a healthcare setting for people with dementia. This work may serve as a model for other conditions, where individuals are likely to need more intensive support from their informal caregivers due to a relatively rapid progression of the condition or development of severe impairments. Examples here can be neurologic conditions such as multiple sclerosis and amyotrophic lateral sclerosis or the final stage of conditions that require palliation.

International Health Classification Family and International Classification of Functioning

The theoretical framework, terminology and coding of the InternationalClassification of Functioning, Disability and Health for Children andYouth are useful tools for content analysis of physical activity guidelines forchildren and adolescents. The guidelines for physical activity for children andadolescents at home and abroad have their own policy background and healthrelated theoretical basis for healthy development. The formulation and implementation of physical activity guidelines for children and adolescents shouldbe based on the national health policy, propose programs suitable for childrenand adolescents, and guide the implementation of the guidelines. This papersummarizes the use in patients with cerebral palsy and those on the autismspectrum. Based on the theoretical framework and methodological systemof research rehabilitation guidelines based on the World Health OrganizationFamily International Classifications, pay attention to the policy backgroundand theoretical basis, activity mode and amount, benefits and influencingfactors of physical activity guidelines for children and adolescents, and provide theoretical basis and methodological guidance for the formulation andimplementation of relevant guidelines.

Chlorophenols in marine organisms from the southern coast of Hangzhou Bay,China,and an assessment of risks posed to human health

The composition of chlorophenols in marine organisms from the southern coast of Hangzhou Bay, China, was analyzed and the health risks posed to humans assessed. A total of 19 chlorophenols from 16 types of marine organism were analyzed across nine survey sections in Hangzhou Bay. The chlorophenols were analyzed by gas chromatography-mass spectrometry using a DB-5MS quartz capillary column. The concentrations of monochlorophenol, dichlorophenol, trichlorophenol, tetrachlorophenol, and pentachlorophenol ranged from below the detection limit(ND) to 132 μg/kg, ND–51.0 μg/kg, ND–42.5 μg/kg, ND–69.0 μg/kg, and ND–9.06 μg/kg, respectively. Additionally, concentration differences between each type of chlorophenol were not significant( P >0.05). However, significant differences were found between monochlorophenol( F =8.13, P <0.01) and total chlorophenol(F =5.19, P <0.01) concentrations. As the noncarcinogenic risk indices were <0.1(10-5 –10-2) for all of the organisms, no high risk was posed by 2-chlorophenol, 2,4-dichlorophenol, 2,4,6-trichlorophenol, 2,4,5-trichlorophenol, 2,3,4,6-tetrachlorophenol, and pentachlorophenol to humans consuming marine organisms from the study area. Furthermore, the carcinogenic risks posed by 2,4,6-trichlorophenol and pentachlorophenol were lower than limits set by the International Commission on Radiological Protection and the US Environmental Protection Agency. However, the noncarcinogenic and carcinogenic risks posed by chlorophenols in marine organisms from four of the survey sections(Sizaopu, Niluoshan, Longshan Town and Xinhong zha) were higher than the other survey sections.

History,origin,transmission,genome structure,replication,epidemiology,pathogenesis,clinical features,diagnosis,and treatment of COVID-19:A review

In December,2019,pneumonia triggered by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)surfaced in Wuhan,China.An acute respiratory illness named coronavirus disease 2019(COVID-19)is caused by a new coronavirus designated as SARS-CoV-2.COVID-19 has surfaced as a major pandemic in the 21st century as yet.The entire world has been affected by this virus.World Health Organization proclaimed COVID-19 pandemic as a public health emergency of international concern on January 30,2020.SARS-CoV-2 shares the same genome as coronavirus seen in bats.Therefore,bats might be its natural host of this virus.It primarily disseminates by means of the respiratory passage.Evidence revealed human-to-human transmission.Fever,cough,tiredness,and gastrointestinal illness are the manifestations in COVID-19-infected persons.Senior citizens are more vulnerable to infections which can lead to dangerous consequences.Various treatment strategies including antiviral therapies are accessible for the handling of this disease.In this review,we organized the most recent findings on COVID-19 history,origin,transmission,genome structure,replication,epidemiology,pathogenesis,clinical features,diagnosis,and treatment strategies.

Productivity change of national health systems in the WHO Eastern Mediterranean region:application of DEA-based Malmquist productivity index

Background:The pursuit of efficiency and productivity is one of the goals of health systems.In the era of Sustainable Development Goals and particularly the move towards universal health coverage,it is imperative to curb wastage of resources to ensure sustainable access of the population to needed and effective health services without enduring financial hardship.This study aims to assess total factor productivity change of national health systems of 20 countries in the WHO’s Eastern Mediterranean Region.Methods:Data Envelopment Analysis(DEA)-based Malmquist index is used to assess total factor productivity change and its components-efficiency change and technical change.To assess the robustness of the Malmquist index estimates,bootstrapping was performed.Outputs used are life expectancy at birth for both sexes and infant mortality;while total expenditure on health per capita in international dollars(PPP)is used as a measure of input.Panel data for the period 2003-2014 was extracted from databases of the WHO and the World Bank.Results:In all but five countries covered in the study,a decline in the mean total factor productivity is observed during the period 2003-2014.The decline is driven by technical regress.In all countries,the technical change component of the Malmquist TFP index is less than unity(range:0.896 to 0.945).All countries exhibited growth in efficiency(efficiency change exceeding one)except two countries(Djibouti and Iraq).The growth in efficiency was mainly due to change in scale efficiency.Overall,total factor productivity in the region declined by 3.8%.This was due to a 9.1%decline in technical change,which overshadowed the 5.8%increase in efficiency.Three countries-Libya,Qatar and Yemen-showed a marginal growth in total factor productivity.There was no change in total factor productivity in Kuwait and Lebanon.Conclusion:The decline in total factor productivity over the study period is likely to hamper achieving the targets of Sustainable Development Goal 3 of ensuring healthy lives and promoting well-being for all at all ages.It is recommended that country-level studies on efficiency and productivity of health systems be conducted in order to intensively examine the determinants of inefficiency and productivity decline and implement appropriate interventions that could enhance efficiency and productivity.

Pancreatic neuroendocrine neoplasms: Magnetic resonance imaging features according to grade and stage

AIMTo describe magnetic resonance (MR) imaging features of pancreatic neuroendocrine neoplasms (PanNENs) according to their grade and tumor-nodes-metastases stage by comparing them to histopathology and to determine the accuracy of MR imaging features in predicting their biological behavior.METHODSThis study was approved by our institutional review board; requirement for informed patient consent was waived due to the retrospective nature of the study. Preoperative MR examinations of 55 PanNEN patients (29 men, 26 women; mean age of 57.6 years, range 21-83 years) performed between June 2013 and December 2015 were reviewed. Qualitative and quantitative features were compared between tumor grades and stages determined by histopathological analysis.RESULTSIll defined margins were more common in G2-3 and stage III-IV PanNENs than in G1 and low-stage tumors (P < 0.001); this feature had high specificity in the identification of G2-3 and stage III-IV tumors (90.3% and 96%, 95%CI: 73.1-97.5 and 77.7-99.8). The mean apparent diffusion coefficient value was significantly lower in G2-3 and stage III-IV lesions compared to well differentiated and low-stage tumors (1.09 × 10-3 mm2/s vs 1.45 × 10-3 mm2/s and 1.10 × 10-3 mm2/s vs 1.53 × 10-3 mm2/s, P = 0.003 and 0.001). Receiving operator characteristic analysis determined optimal cut-offs of 1.21 and 1.28 × 10-3 mm2/s for the identification of G2-3 and stage III-IV tumors, with sensitivity and specificity values of 70.8/80.7% and 64.5/64% (95%CI: 48.7-86.6/60-92.7 and 45.4-80.2/42.6-81.3).CONCLUSIONMR features of PanNENs vary according to their grade of differentiation and their stage at diagnosis and could predict the biological behavior of these tumors.

Hepatitis B virus: Where do we stand and what is the next step for eradication?

Hepatitis B(HB) virus(HBV) infection, which causes liver cirrhosis and hepatocellular carcinoma, is endemic worldwide. Hepatitis B vaccines became commercially available in the 1980 s. The World Health Organization recommended the integration of the HB vaccine into the national immunisation programs in all countries. HBV prevention strategies are classified into three groups:(1) universal vaccination alone;(2) universal vaccination with screening of pregnant women plus HB immune globulin(HBIG) at birth; and(3) selective vaccination with screening of pregnant women plus HBIG at birth. Most low-income countries have adopted universal vaccine programs without screening of pregnant women. However, HB vaccines are not widely used in low-income countries. The Global Alliance for Vaccine and Immunization was launched in 2000, and by 2012, the global coverage of a three-dose HB vaccine had increased to 79%. The next challenges are to further increase the coverage rate, close the gap between recommendations and routine practices, approach highrisk individuals, screen and treat chronically infected individuals, and prevent breakthrough infections. To eradicate HBV infections, strenuous efforts are required to overcome socioeconomic barriers to the HB vaccine; this task is expected to take several decades to complete.

Pathohistological classification systems in gastric cancer:Diagnostic relevance and prognostic value

Several pathohistological classification systems exist for the diagnosis of gastric cancer. Many studies have investigated the correlation between the pathohistological characteristics in gastric cancer and patient characteristics, disease specific criteria and overall outcome. It is still controversial as to which classification system imparts the most reliable information, and therefore, the choice of system may vary in clinical routine. In addition to the most common classification systems, such as the Laur&#x000e9;n and the World Health Organization (WHO) classifications, other authors have tried to characterize and classify gastric cancer based on the microscopic morphology and in reference to the clinical outcome of the patients. In more than 50 years of systematic classification of the pathohistological characteristics of gastric cancer, there is no sole classification system that is consistently used worldwide in diagnostics and research. However, several national guidelines for the treatment of gastric cancer refer to the Laur&#x000e9;n or the WHO classifications regarding therapeutic decision-making, which underlines the importance of a reliable classification system for gastric cancer. The latest results from gastric cancer studies indicate that it might be useful to integrate DNA- and RNA-based features of gastric cancer into the classification systems to establish prognostic relevance. This article reviews the diagnostic relevance and the prognostic value of different pathohistological classification systems in gastric cancer.

Pathologic research update of colorectal neuroendocrine tumors

Colorectal neuroendocrine tumors (NETs) originate from neuroendocrine cells in the intestinal tract, and represent a small area within oncology, but one which has provided increasing new data during the past years. Although the World Health Organization has determined clinical and histological features to predict prognosis for such tumors, they may not be valid on an individual basis. We aim to give an overview of the recent findings with regard to pathology, molecular genetics and diagnosis of NETs.

Semen analysis standardization： is there any problem in Polish laboratories？

The aim of the study was to determine the degree of compliance of Polish laboratories with World Health Organization （WHO） recommendations, with regard to semen analysis methodology. A survey requesting information about methods of semen analysis was distributed to employees of 55 laboratories. Respondents who had participated in external seminological workshops （31%） were termed certified respondents （CR）, the remaining （69%）--non-certified respondents （NCR）. Only one laboratory （6%） in the CR group and none in the NCR were compliant with WHO guidelines for methods and equipment used to evaluate seminal volume, sperm motility, concentration, vitality and morphology. Most problems were of volume measurement （weighing method was reported by 17% of CR and 10% of NCR） and staining method for sperm morphology （Papanicolau or Diff-Quik were found in 33% of CR and 23% of NCR）. A three- or four-point grading of sperm motility was used by the majority of respondents; however, 17% of CR and 37% of NCR did not use a laboratory counter to tally spermatozoa. Although a haemocytometer method was used by 80% of laboratories in each group, the improved Neubauer chamber was used only by 42% of CR and 19% of NCR. In each group, 24% of laboratories did not perform a vitality test. Procedural errors and the interchangeable utilization of two or even three methods to analyse a given parameter was observed in both groups. The results indicate a need for standardisation of the methods and continuous, unified training in semen analysis in Polish laboratories.