Journal of the Asian Medical Students Association
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Spatio-Temporal Analysis of Optimal Mortality Temperature Over 10 Years: Results of a Multi-City Study in Iran
No full textIntroduction: Global warming and climate change today is affecting many aspects of lives including Minimum Mortality Temperature (MMT) which has not been well addressed in Iran yet. In this study, we did spatio-temporal analysis of MMT across 60 cities in the country over a 10-year period so that according to this work more attentions would be paid to the global warming.
Methods: Dose-response association was used to determine the MMT. To explain the spatial distribution of MMT, we did cluster analysis using Local Moran’s I test. Also, temporal variation in the impact of space on the MMT was evaluated using Generalized additive model, including both linear and smooth components and a factor by curve interaction function which allows for the interaction between year and MMT.
Results: The MMT was variable from -18.3°C (CI 95%: -18.3, -8.8) in the cities of Chaldoran, the North west to 46°C (CI 95%: 4, 46) in Ramhormoz, the South East of the region. We found four statistically significant clusters with positive autocorrelation. Consistent spatial patterns were approximately observed over the 10 years, with hot clusters primarily located in the southern regions and cold clusters in the northern and central regions. The joint impact of latitude and longitude confirmed that the highest MMTs were seen in areas with low latitudes and high longitudes, corresponding to the hot, arid regions in the southeast of Iran.
Conclusion: The observed spatial autocorrelation and clustering patterns highlight the need for targeted and subnational heat-health adaptation strategies to reflect the spatial and temporal variability in MMT
Developing A Balanced Gut Microbiota For Childhood Obesity Prevention: Systematic Review
No full textBackgrounds: The gut microbiota is crucial for children’s metabolic health, influencing weight regulation, immune function, and nutrient absorption. Imbalances in microbiota can increase childhood obesity risk, leading to long-term health issues. Although evidence increasingly links gut health to metabolism, obesity prevention often overlooks its importance. There is a need to better understand the mechanisms by which early-life gut microbiota composition affects obesity risk and to develop personalized, evidence-based interventions for establishing and maintaining a balanced microbiota in children.
Objective: To conduct a systematic review of literature on early-life gut microbiota and the effectiveness of microbiota-targeted interventions in reducing obesity risk in children.
Methods: A systematic search was conducted in “PubMed” using MeSH terms and keywords. This search identified 580 articles, from which 146 studies met the inclusion criteria: original research on children under 5, focusing on nutrition-related conditions (malnutrition, obesity, etc.), and examining microbiota/microbiome with or without interventions. Data on study design, population, interventions, and microbiome outcomes were qualitatively synthesized to identify microbiome patterns linked to nutritional status.
Results: Evidence suggests gut microbiota influences energy balance by enhancing dietary energy absorption and regulating genes for energy storage and expenditure. Obese children often exhibit a higher Firmicutes/Bacteroidetes ratio, reduced levels of beneficial bacteria like Bifidobacterium and Akkermansia muciniphila, and increased opportunistic pathogens. Interventions with probiotics, prebiotics, fiber, dietary changes, physical activity, and synbiotic supplements show promising effects on weight reduction, metabolic markers, and gut health, particularly in obese children. Probiotic and synbiotic interventions, especially with strains like Lactobacillus and Bifidobacterium, were effective in reducing BMI, waist circumference, and improving insulin sensitivity.
Conclusions: Interventions using probiotics, prebiotics, fiber, and lifestyle changes appear effective for reducing obesity, improving gut health, and modulating metabolic and inflammatory markers in children. Future studies should evaluate these interventions in national programs to assess their broader impact
The Power Plant
No full textOur short film raises awareness of the air pollution and health risks caused by the Taichung Thermal Power Plant in Longjing district, Taichung, Taiwan. This power plant releases tons of particulate matter daily, threatening local residents' health.
A study by Professor Liaw confirms that these pollutants are linked to lung cancer and various respiratory diseases.
While coal burning has decreased, the shift to natural gas still contributes significantly to greenhouse gas emissions, exacerbating global warming.
This issue isn't unique to Taiwan; rising energy consumption worldwide is increasing these harmful emissions.
We explored different countries' strategies to address this problem. A practical solution is to install solar panels on household roofs. Additionally, countries like Germany have successfully utilized wind power.
As global citizens and future doctors, it's our responsibility to advocate for a healthier environment. By learning from each other and adopting effective methods, we can make a meaningful difference
Piecing Together Hope: The Sustainability Puzzle
No full textThe film presents a powerful narrative of resilience and action amidst systemic disasters.
On July 25, Typhoon Gaemi hit Hualien, causing extreme rain, floods, and landslides. The storm intensified over record-warm Pacific waters, a result of climate change. Experiencing these disasters firsthand led us to reflect on how to respond to the growing crisis.
In our interview with disaster relief expert Mr. Hsieh, he shared innovative insights on sustainable living and future preparedness. The video highlights the "Ark Project" as a systemic solution for compound disasters, focusing on green architecture, natural farming, and renewable energy. Inspired by him, we realized that we could build resilience in sustainable living and healthcare. In sustainable living, it requires disaster preparedness and efficient resource management. In healthcare, medical students can engage in research on climate-related health issues and sustainable medical practices, fostering a wholesome healthcare system. The film calls for unity, and stresses self-sufficiency. We must piece together our own sustainability puzzle to systematically face future disasters
Influence of Climate Change on Dengue Fever Incidences in the Asian Region: A Rapid Review
No full textInfluence of Climate Change on Dengue Fever Incidences in the Asian Region: A Rapid Review
Introduction
Dengue fever (DF) is a tropical viral disease transmitted by the Aedes aegypti. DF poses a burden on healthcare systems. Dengue incidence has increased significantly in recent decades, from 505 430 cases in 2000 to 5.2 million in 2019. Temperatures above regional threshold levels are conducive to the life cycle of dengue vectors. Hence, our rapid review aims to synthesize the relationship between climate change, particularly heatwaves and DF incidence in Asia.
Methods
We completed a literature search on 8th March 2024 using the Ovid Medline database. The search strategy included: (“heatwave” OR “extreme weather” OR “climate change” OR “temperature”) AND ("dengue fever” OR “dengue hemorrhagic fever” OR “dengue infection"). Studies classified as time series and cases associated with heatwaves and dengue are included.
Results
Out of 442 studies, 41 studies were included in our final analysis. 31 (75.6%) showed a positive correlation between temperature and dengue incidence. In comparison, 6 studies (14.6%) had a negative correlation while 4 studies (9.8%) showed no significant association. In East Asia, all 14 studies exhibited a positive correlation. In South Asia, a positive correlation was observed in 6 of 8 studies, whereas in Southeast Asia, 11 of 19 studies demonstrated a positive correlation. In 11 studies with relative risk data, dengue incidence increased by 38.9% (95% CI 0.73-3.41) with each 1°C rise in temperature.
Conclusion
In conclusion, dengue incidence increases when temperature increases, primarily in East Asia. This is important in establishing early warning systems that involve interdisciplinary collaboration with health and meteorological departments. Limitations include selection bias in geographical aspects throughout the screening process and other climatic confounding factors. Further studies are needed to determine the climatic causality and to uncover other social determinants affecting dengue incidence.
Keywords
Climate change; Dengue fever; Heatwave; High Temperature; Asia 
Assessing the Efficacy of Air Cleaning Machines in Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review
No full textIntroduction: Chronic Obstructive Pulmonary Disease (COPD) poses a significant medical burden, with a high demand for medication. If effective interventions beyond medication and surgery exist, they can benefit patients and reduce the strain on healthcare resources. One of the major causes of COPD is air pollution, and many researches show global warming is interconnected with air pollution. Air cleaning machines (ACMs) can lower the indoor air pollutants level, so it may offer benefits for COPD patients.
Method: We systematically searched articles from EMBASE, PubMed, and Cochrane Library. Following the PRISMA diagram, we include studies mentioning the effects of ACMs on COPD patients.
Result: Finally, we analysed 6 randomised controlled trials. Two studies indicated significant improvements in the St. George's Respiratory Questionnaire (SGRQ) symptoms, and also in Breathlessness Cough and Sputum Score (BCSS) with air cleaners versus placebo. One study reported lower rates of rescue inhaler use, and fewer moderate exacerbations with air cleaners compared to placebo, but no significant effect on severe exacerbations was found. In addition, one study showed improved autonomic functions with air cleaners compared to placebo measured by Root Mean Square of Successive Differences (RMSSD) and High Frequency (HF). However, studies showed no significant improvement in lung functions and blood pressure with the ACMs.
Conclusion: ACMs may benefit COPD patients by alleviating COPD symptoms, decreasing rates of moderate exacerbation and rescue inhaler use, increasing heart rate variabilities. ACMs could potentially help COPD patients reduce the severity and further lower the healthcare burdens. Due to the limited number of studies included, more studies should be conducted to clarify the effects
Years of Life Lost Attributable to Estimated Air Particle Matter2.5 Using High-Resolution Satellite Data In a Region of Iran
No full textIntroduction: Based on the life changing effect of a clear air and a healthy life In this study, we aimed to investigate the impact of predicted particulates with a diameter of 2.5 micrometers or less (PM2.5) using the satellite data on Years of Life Lost (YLL) as a health burden of air pollution.
Methods: A two-stage methodology was used in order to predict PM2.5 using Aerosol Optical Depth (AOD). The predicted PM was corrected for its bias through Bland-Altman method and observed data. Relative Risk (RR), Attributable Fraction (AF) and Attributable Number (AN) of YLL were estimated as the effect of PM2.5 on health.
Results: Based on the minimum value as the optimum value of PM, statistically a significant cumulative dose-response association was found. The significant association was mainly observed between lags 4 and 13. Also, based on the scenario, the total estimated YLL attributable to air pollution was 74227 years, with an AF of 0.45 which was statistically significant (CI 95%: 0.14, 0.65). Based on the median value as the second scenario, there was not cumulative significant dose-response association. The subgroup analysis revealed that females and the elderly exhibited higher PM2.5-related YLL compared to males and younger, respectively.
Conclusion: Totally, the study revealed that impact of the predicted PM on YLL was significant when we selected the minimum value as reference. While, the impact was insignificant when we changed it to median value. This result highlights the important effect of reference value selection on the interpretation of dose-response and lag-response associations between PM2.5 and YLL which should be addressed in next studies
Developments of Respiratory, Cardiovascular, and Neurological Diseases Associated with Lithium Battery Disposal: A Cross-Sectional Study
No full textIntroduction
With the rapid increase in electric vehicle (EV) production and ownership, disposal of lithium iron phosphate (LFP) batteries [1] has become a critical environmental challenge. These batteries contain chemicals like lithium hexafluorophosphate, and organic carbonates (e.g., ethylene carbonate such as ethylene carbonate, and toxic metals such as cadmium and lead [2]. Inhalation of these substances can lead to asthma, chronic obstructive pulmonary disease (COPD), and pneumonitis. Long-term exposure may increase risks of cardiovascular diseases such as hypertension and arrhythmias as well as neurological conditions such as cognitive impairments and dementia [3][4][5]. The objective of our study is to assess disease outcomes in individuals exposed to heavy metals or toxic chemical byproducts from LFP battery recycling or disposal.
Method
Our study deploys a cross-sectional observational design to assess three health outcomes: respiratory, cardiovascular, and neurological outcomes.
Study population
The exposed group includes workers in lithium battery recycling plants or living within a 3 km radius of such facilities. The control group includes individuals who have no occupational exposure and live at least 10 km away from any battery recycling or disposal facility.
Inclusion criteria:
The study includes 18-60-year-old individuals with no previous history of chronic respiratory, cardiovascular, or neurological conditions before employment or residence in or near battery recycling facilities.
Exclusion criteria:
Individuals with chronic history of respiratory, cardiovascular, or neurological diseases are excluded.
Results
Health outcomes assessment for all three systems
We use spirometry to measure FEV1 and FVC for lung function, blood pressure and electrocardiograms for cardiovascular health, and cognitive tests for neurological status.
Data analysis
Baseline characteristics are summarized for descriptive statistics. Outcome differences across groups are compared using t-tests with multivariable regression for adjusted odds ratios.
Conclusion
Our study emphasizes the need for health surveillance for individuals in proximity to lithium battery recycling
Health Risk Assessment Due to Exposure to Particulate Matter10 and Particulate Matter2.5 Particles in Ardabil City During the Years 2023-2024
No full textIntroduction: PM2.5 and PM10 is two air pollutant agents as a matter of concern. We aimed to investigate their concentration compared to the regulated levels, and evaluate cancerous and non-cancerous risk due exposure to occurred concentrations of the particles in Ardabil ambient air.
Method: Air quality standards pollutants real-time hourly concentrations from January 2023–October 2024 were acquired from Ardabil Environmental Protection Agency. Beta attenuation monitoring (BAM) technique which allows for the detection of PM10 and PM2.5 is used for detection of that particles in Ardabil air quality monitoring stations.
Results: The daily average concentration of PM2.5 and PM10 is higher than WHO daily standards (PM2.5= 15 μg/m3, PM10= 45 μg/m3) [1]. Comparison of PM2.5 monthly average concentration in different months shows the highest PM2.5 values in November and December in both years. The results show PM2.5 annual average concentration (2023) in present study (18.35 ± 4.13) was more than 2024 annual average concentration (18.35 ± 4.13). Considering the World Health Organization standard for particulate matter annual average concentration (PM2.5 = 5 μg/m3, PM10= 15 μg/m3), the annual average concentration of PM2.5 and PM10 are multiplied (2-3 times) more than the standard [2]. The mean of hazard quotient (HQ) for PM2.5 (3.31) and PM10 (1.14) were > 1, which indicates an unacceptably high risk for human health [3]. Also, the mean of Excess Lifetime Cancer Risk (ELCRs) for PM2.5 in 2023 and 2024 varied from 2.21×10-6 to 67.9×10-6 and from 2.35×10-6 to 67.15×10-6, respectively, which exceeds the limit value set by the USEPA and WHO [4].
Conclusion: Based on achieved results, ambient air can be a potential source for exposure to PM10 and PM2.5 and increase the risk of respiratory and cardiovascular diseases among exposed people. Therefore, proper control policies are recommended to protect public health in this metropolitan area
Do Mobile Health Interventions Effectively Improve Malaria Management? A Systematic Review and Meta-Analysis of Randomized Controlled Trials
No full textIntroduction: Climate change is projected to alter the risk of mosquito-borne diseases, including malaria, by increasing transmission suitability for this disease.1 It is estimated that in 2022, malaria cases will reach 249 million globally, resulting in 608,000 deaths across 85 countries.2 Mobile health (mHealth), as an innovative technology, has become a potential solution for improving the management of malaria.3-11 Their potential utilization in malaria-endemic regions is bolstered by increasing mobile phone usage in this area.12 While mHealth presents a promising strategy for improving malaria management, the statistical evidence remains scarce. Thus, this systematic review and meta-analysis aims to analyze the effectiveness of mobile health in enhancing malaria management.
Method: Employing the PRISMA guideline, this study systematically searches literature from PubMed, ScienceDirect, Wiley, and Cochrane Library databases, focusing on publications from 2014 onward. Bias was assessed using the Risk of Bias 2.0 tool, and data were analyzed using Review Manager 5.4.1. Odds Ratio (OR) was calculated with a 95% confidence interval, given p<0.05 as significant.
Results: This meta-analysis of nine randomized controlled trials involving 22,647 patients in Sub-Saharan African countries revealed that various mHealth interventions, including text reminders, AI tools for diagnosis, telehealth platforms, and mobile-based education, have significantly enhanced malaria management. It is demonstrated by a significant effect of mHealth in malaria management, as indicated by the improvement of pharmacoadherence (OR=1.26; p-value=0.01), reduction in case prevalence (OR=3.65; p-value=0.003), and decrease in antibiotic prescription (OR=0.46; p-value<0.00001). Additionally, mHealth interventions were shown to positively affect the accuracy of malaria management (OR=1.78; p-value=0.40).
Conclusion: mHealth interventions are found to be effective in improving malaria management. Henceforth, further research is essential across diverse geographical and social contexts to comprehensively understand their applicability.
Keywords: climate change, malaria, management, mhealth, vector-borne disease