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  1. Yuan B, Nishiura H
    PLoS One, 2018;13(6):e0198734.
    PMID: 29924819 DOI: 10.1371/journal.pone.0198734
    BACKGROUND: Frequent international travel facilitates the global spread of dengue fever. Japan has experienced an increasing number of imported case notifications of dengue virus (DENV) infection, mostly arising from Japanese travelers visiting South and Southeast Asian countries. This has led an autochthonous dengue outbreak in 2014 in Japan. The present study aimed to infer the risk of DENV infection among Japanese travelers to Asian countries, thereby obtaining an actual estimate of the number of DENV infections among travelers.

    METHODOLOGY/PRINCIPAL FINDINGS: For eight destination countries (Indonesia, Philippines, Thailand, India, Malaysia, Vietnam, Sri Lanka, and Singapore), we collected age-dependent seroepidemiological data. We also retrieved the number of imported cases, who were notified to the Japanese government, as well as the total number of travelers to each destination. Using a mathematical model, we estimated the force of infection in each destination country with seroepidemiological data while jointly inferring the reporting coverage of DENV infections among Japanese travelers from datasets of imported cases and travelers. Assuming that travelers had a risk of infection that was identical to that of the local population during travel, the reporting coverage of dengue appeared to range from 0.6% to 4.3%. The risk of infection per journey ranged from 0.02% to 0.44%.

    CONCLUSIONS/SIGNIFICANCE: We found that the actual number of imported cases of DENV infection among Japanese travelers could be more than 20 times the notified number of imported cases. This finding may be attributed to the substantial proportion of asymptomatic and under-ascertained infections.

  2. Ge P, Ong CY, Abdalkareem AE, Khoo BY, Yuan B
    Exp Ther Med, 2021 Feb;21(2):103.
    PMID: 33335566 DOI: 10.3892/etm.2020.9535
    The presence of certain soluble factors may provide a possible selective advantage for a parasite to gradually modify cell proliferation in neighbouring cells, which may result in chronic diseases. These soluble factors present in the conditioned medium also allow the parasite to invade rapidly into more host cells. The present study aimed to determine the levels of a group of type 1 T helper (Th1) cytokines in the conditioned media of host cells infected with parasites and in IL-21-silenced colorectal cancer cells. The conditioned media of human foreskin fibroblasts (HFFs) parasitized with the RH and ME49 strains of Toxoplasma gondii for 10 days were prepared, and subsequently the levels of the Th1 cytokines in the conditioned media were determined by ELISA. HFFs were incubated with the growth media containing selected soluble factors, and cell proliferation markers were subsequently analysed by reverse transcription-quantitative PCR. The mRNA expression level of cell proliferation markers was also examined in IL-21-silenced HCT116 cells, where the levels of soluble factors in the conditioned media were also determined as aforementioned. The results of the present study demonstrated that HFFs parasitized with ME49 released elevated levels of IFN-γ and lower levels of IL-18 into the conditioned medium compared with the controls. These phenomena were not observed in the conditioned medium of HFFs parasitized with RH. Similar levels of these soluble factors were also detected in the conditioned medium of IL-21-silenced HCT116 cells. The results of the present study also revealed that Ki67 and proliferating cell nuclear antigen mRNA expression was altered in host cells incubated with various levels of IFN-γ and IL-18, as well as in IL-21-silenced HCT116 cells compared with the respective controls. In conclusion, the current study provided preliminary evidence on the fundamental molecular mechanisms of host-parasite interactions that result in chronic diseases, which may aid in the treatment of these diseases in the relevant endemic regions.
  3. Prazeres F, Jamoulle M, Kareli A, Collins C, Móczár C, Wong MCS, et al.
    Fam Pract, 2024 Nov 19.
    PMID: 39561247 DOI: 10.1093/fampra/cmae061
    INTRODUCTION: The evolving landscape of general practice (GP)/family medicine (FM) in the post-COVID-19 era, focussing on integrating telemedicine and remote consultations requires a new definition for this specialty. Hence, a broader consensus-based definition of post-COVID-19 GP/FM is warranted.

    METHODS: This study involved a modified electronic Delphi technique involving 27 specialists working in primary care recruited via convenient and snowball sampling. The Delphi survey was conducted online between August 2022 and April 2023, utilizing the Google Forms platform. Descriptive statistics were employed to analyse consensus across Delphi rounds.

    RESULTS: Twenty-six international experts participated in the survey. The retention rate through the second and third Delphi rounds was 96.2% (n = 25). The broader consensus definition emphasizes person-centred care, collaborative patient-physician partnerships, and a holistic approach to health, including managing acute and chronic conditions through in-person or remote access based on patient preferences, medical needs, and local health system organization.

    CONCLUSION: The study highlights the importance of continuity of care, prevention, and coordination with other healthcare professionals as core values of primary care. It also reflects the role of GP/FM in addressing new challenges post-pandemic, such as healthcare delivery beyond standard face-to-face care (e.g. remote consultations) and an increasingly important role in the prevention of infectious diseases. This underscores the need for ongoing research and patient involvement to continually refine and improve primary healthcare delivery in response to changing healthcare landscapes.

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