To investigate the genomic properties of HIV-1, we collected 3,081 sequences from the HIV Sequence Database. The sequences were categorized according to sampling region, country, year, subtype, gene name, and sequence and were saved in a database constructed for this study. The relative synonymous codon usage (RSCU) values of matrix, capsid, and gp120 and gp41 genes were calculated using correspondence analysis. The synonymous codon usage patterns based on the geographical regions of African countries showed broad distributions; when all the other regions, including Asia, Europe, and the Americas, were taken into account, the Asian countries tended to be divided into two groups. The sequences were clustered into nine non-CRF subtypes. Among these, subtype C showed the most distinct codon usage pattern. To determine why the codon usage patterns in Asian countries were divided into two groups for four target genes, the sequences of the isolates from the Asian countries were analyzed. As a result, the synonymous codon usage patterns among Asian countries were divided into two groups, the southern Asian countries and the other Asian countries, with subtype 01_AE being the most dominant subtype in southern Asia. In summary, the synonymous codon usage patterns among the individual HIV-1 subtypes reflect genetic variations, and this bioinformatics technique may be useful in conjunction with phylogenetic methods for predicting the evolutionary patterns of pandemic viruses.
HIV-1/*genetics/*isolation & purification ; Gene Expression Regulation, Viral/*genetics ; Europe/epidemiology ; Codon/*genetics ; Asia/epidemiology ; Americas/epidemiology ; Africa/epidemiology

Zika virus (ZIKV) is a vector-borne flavivirus. It was initially identified in Uganda in 1947, and the first human infection was reported in Nigeria in 1953. Since 2015, ZIKV has been spreading rapidly in Brazil and the Americas. Given its general symptoms, ZIKV is considered to be a mild, febrile illness, although it is associated with severe neurologic complications. On February 1, 2016, the World Health Organization (WHO) declared a Public Health Emergency of International Concern (PHEIC). We conducted a review of the literature on the epidemiology and transmission, clinical manifestations, and diagnosis of ZIKV. Additionally, we introduce original literature on the current ZIKV outbreak in this review.
Americas ; Brazil ; Diagnosis ; Emergencies ; Epidemiology ; Flavivirus ; Humans ; Nigeria ; Public Health ; Uganda ; World Health Organization ; Zika Virus*

Bacteria, pigs, rats, pots, plants, words, bones, stones, earrings, diseases, and genetic indicators of all varieties are markers and proxies for the complexity of interweaving trails and stories integral to understanding human movement and knowledge assemblage in Southeast Asia and around the world. Understanding human movement and knowledge assemblage is central to comprehending the genetic basis of disease, especially of a cancer like nasopharyngeal carcinoma. The problem is that the markers and trails, taken in isolation, do not all tell the same story. Human movement and knowledge assemblage are in constant interaction in an adaptive process of co-production with genes, terrain, climate, sea level changes, kinship relations, diet, materials, food and transport technologies, social and cognitive technologies, and knowledge strategies and transmission. Nasopharyngeal carcinoma is the outcome of an adaptive process involving physical, social, and genetic components.
Americas ; epidemiology ; Archaeology ; Asia, Southeastern ; epidemiology ; Biomarkers, Tumor ; analysis ; China ; epidemiology ; Emigration and Immigration ; Humans ; Knowledge ; Nasopharyngeal Neoplasms ; epidemiology ; etiology ; genetics ; Pacific Islands ; epidemiology

PURPOSE: The purpose of this study is to compare and contrast the contents of each state's occupational therapy (OT) regulatory board requirements regarding licensees' acquisition of continuing education units in the United States of America. METHODS: Data related to continuing education requirements from each OT regulatory board of all 50 states and the District of Columbia in the United States were reviewed and categorized by two reviewers. Analysis was conducted based on the categorization of the continuing education requirements and activities required, allowed, and not allowed/not mentioned for continuing education units. RESULTS: Findings revealed non-uniformity and inconsistency of continuing education requirements for licensure renewal between OT regulatory boards and was coupled with lack of specific criteria for various continuing education activities. Continuing education requirements were not tailored to meet the needs of individual licensee's current and anticipated professional role and job responsibilities, with a negative bias towards presentation and publication allowed for continuing education units. Few boards mandated continuing education topics on ethics related to OT practice within each renewal cycle. CONCLUSION: OT regulatory boards should move towards unifying the reporting format of continuing education requirements across all states to reduce ambiguity and to ensure licensees are equipped to provide ethical and competent practice. Efforts could be made to enact continuing education requirements specific to the primary role of a particular licensee. Finally, assigning the amount of continuing education credits to be awarded for different activities should be based on research evidence rather than arbitrary determination.
Americas* ; Awards and Prizes ; Bias (Epidemiology) ; Education, Continuing* ; Ethics ; Licensure ; Occupational Therapy* ; Professional Competence ; Professional Role ; Publications ; United States*

The Korean College of Helicobacter and Upper Gastrointestinal Research proposed revised guidelines for the diagnosis and treatment of Helicobacter pylori infection in 2013. These new guidelines were developed using an adaptation process, and addressed the revised recommendations especially in the changes of indication and treatment of H. pylori infection in Korea. They included 19 statements: 11 on the indications for tests and treatment, four for the diagnosis, and four for the treatment. A critical difference between the new and previous guidelines was that the proposed treatment regimen was more detailed, in consideration of the increasing resistance to antibiotics in Korea. Although clarithromycin-containing triple therapy was proposed as the first-line treatment option, per the previous guidelines, a bismuth-based quadruple regimen was also proposed as an effective alternative. In the case of treatment failure following bismuth quadruple therapy, second-line treatment should be based on two or more antibiotics that had not been used previously. Several overseas guidelines - from America, Europe, Canada, Japan, and the Asia-Pacific region - have been published concerning H. pylori infection; they indicate regional differences in epidemiology, antibiotic susceptibility, and national health insurance systems. This review compares the guidelines for H. pylori infection among these regions.
Americas ; Anti-Bacterial Agents ; Bismuth ; Canada ; Diagnosis* ; Epidemiology ; Europe ; Helicobacter pylori* ; Helicobacter* ; Japan ; Korea ; National Health Programs ; Treatment Failure

OBJECTIVES: Zika virus, which was first discovered in 1947, has become a global threat to human health as it is rapidly spreading through Latin America, the Caribbean, the US and Asia, after causing a large outbreak in the Northeast region of Brazil in 2015. There is ample evidence to support that Zika virus is associated with neurological complications such as microcephaly. The review aims to provide an overview on the complex issues involved in the emergence of Zika virus's neurological disorders and to discuss possible explanations of Zika virus introduction and dissemination in Brazil. We also suggest national and global strategies to adequately respond to the Zika virus emergence. METHODS: We provide an analytical evaluation of the main issues related to the Zika outbreak in Brazil, based on available scientific literature, including government documents, and on epidemiological information from national surveillance databases. RESULTS: The studies on the clinical manifestations of the Zika virus infection coupled with the epidemiological surveillance information in Brazil have provided significant evidence that the Zika virus is associated with neurological disorders such as microcephaly and Guillain-Barré syndrome. Based on phylogenetic and molecular analysis, the hypothesis regarding the introduction of Zika virus in the country is that it took place following international events in 2013 and 2014, when many foreign visitors could have brought Zika virus into Brazil. The immunologically naïve status of populations in the Americas, previous infection with dengue virus, and the increased activity of Aedes aegypti might be the contributing factors for such an outbreak in Brazil. The Zika virus emergence emphasized the importance of cross-disciplinary perspective. Besides the scientific-based vector control strategies, it is important to understand the nature of the evolutionary processes involved in the viral evolution in complex ecosystems and to have social and anthropological knowledge on the conditions related to the spread of the disease in order to properly respond to the spread of the Zika virus. CONCLUSIONS: The experiences of Brazil have demonstrated the significance of multi-disciplinary approach in response to new and resurgent arboviral diseases and provided important lessons that could be applied to other developing countries.
Aedes ; Americas ; Asia ; Brazil* ; Caribbean Region ; Dengue Virus ; Developing Countries ; Ecosystem ; Epidemiology ; Guillain-Barre Syndrome ; Humans ; Latin America ; Microcephaly ; Nervous System Diseases ; Zika Virus ; Zika Virus Infection

Zika virus (ZIKV) was spread to both eastward and westward from Uganda where the virus was identified approximately in 1947 by a group of arbovirus researchers. In 2015, ZIKV reached Americas with major outbreaks in Brazil. Most countries with mosquito transmitted ZIKV infection are located in tropical and subtropical areas, where ZIKV is endemic with other flaviviruses, including JEV, dengue and yellow fever virus. Approximately 40 countries in Central and South Americas and territories in South Pacific Islands and South East Asia show autochthonous ZIKV endemics. American lineage of ZIKV is known significantly to be mutated in susceptibility to host and in pathogenicity from Asian and Asian lineages approximately since 2014. Early and specific identification of ZIKV infection is very important for the effective management of patients. First of all, optimal collection of specimens for the laboratory diagnosis is required for both nucleic acid testing (NAT) and serological tests. Specimens for NAT tests and serological tests should be determined by the available laboratory resources, work-flow in each laboratory and the geographic areas of specimen collected in addition to days after showing symptoms. Testing strategy for specific differentiation among flaviviruses will vary depending on the prevalence of viruses known to be circulating in the area where the patients were exposed. NAT will be employed for the patients presenting with onset of symptoms less than 7 days. Advanced diagnostic technologies should be continuously developed for the increase of specificity and sensitivity of ZIKV diagnosis.
Americas ; Arboviruses ; Asian Continental Ancestry Group ; Biology* ; Brazil ; Clinical Laboratory Techniques* ; Culicidae ; Dengue ; Diagnosis ; Disease Outbreaks ; Epidemiology* ; Far East ; Flavivirus ; Humans ; Pacific Islands ; Prevalence ; Sensitivity and Specificity ; Serologic Tests ; South America ; Uganda ; Virulence ; Yellow fever virus ; Zika Virus*

BACKGROUND: Allergic rhinitis (AR) is a global health problem and is characterised by one or more symptoms, including sneezing, itching, nasal congestion and rhinorrhea. OBJECTIVE: We investigated the features of AR and the physician's approach to the management of AR patients in four geographical regions. METHODS: In this cross-sectional study, a questionnaire survey concerning AR was completed by Honorary and Corresponding Members of the Italian Society of Rhinology from different countries among 4 world geographical regions—Asia, Europe, the Americas, and Africa. RESULTS: The prevalence of AR was reported to be 15%–25%. Children and adolescents, as well as young adults, were the age groups more affected by AR with comorbidities of asthma, sinusitis, conjunctivitis, and nasal polyposis. Nasal symptoms of AR were more intense in the spring (51.92%) and autumn (28.85%). The most common aero-allergens were pollen and mites (67.31%), animal dander and pollutants (23.08%), and fungal allergens (21.15%). Allergen-specific immunotherapy was prescribed for both perennial and seasonal allergens (32.69%) via sublingual swallow (46.15%) and subcutaneous (32.69%) routes. For the AR patients, the most prescribed drugs were intranasal corticosteroids (86.54%) and oral H₁-antihistamines (82.69%). CONCLUSION: A network of experts can improve our knowledge concerning AR epidemiology, and together with guidelines, could assist practitioners and otolaryngologists in standardising the diagnosis and treatment of AR.
Adolescent ; Adrenal Cortex Hormones ; Africa ; Allergens ; Americas ; Animals ; Asthma ; Child ; Comorbidity ; Conjunctivitis ; Cross-Sectional Studies ; Dander ; Diagnosis ; Epidemiology ; Estrogens, Conjugated (USP) ; Europe ; Global Health ; Humans ; Immunotherapy ; Mites ; Pollen ; Prevalence ; Pruritus ; Rhinitis, Allergic ; Seasons ; Sinusitis ; Sneezing ; Sublingual Immunotherapy ; Young Adult