Introduction: The recent multi-nation outbreaks of human monkeypox in non-endemic areas have created an emerging public health issue. Medical students who will become future healthcare providers are directly associated with community people and can easily sensitize the general population, so it is crucial to assess their degree of knowledge and attitudes regarding recently emerging infections or pathogens. However, studies on medical students' perception of the monkeypox virus are scarce in Saudi Arabia. Therefore, the objective of this study was to assess the monkeypox virus-related knowledge and attitudes among medical students in the country. Methods: A cross-sectional study was conducted from May to July 2022 among undergraduate medical students at King Khalid University, Abha, Saudi Arabia. A systematic random sampling technique was applied to select the study participants. A self-administered questionnaire was used to gather data on sociodemographic characteristics, knowledge and attitudes toward the monkeypox virus. Descriptive statistics and Chi-square tests were performed. Results: A total of 314 medical students were recruited for this study. The findings from this study showed that the vast majority of medical students (72%) had poor knowledge about the monkeypox virus. Respondents’ age, grade point average (GPA), fathers’ education level, and training received about the monkeypox virus were significantly associated with the level of knowledge about the monkeypox virus (p < 0.05). Nearly half of the respondents (45.9%) agreed that the monkeypox virus could be transmitted to Saudi Arabia. Overall, this study showed that the awareness levels regarding the monkeypox virus were significantly higher among seniors as compared to junior students. Conclusion: The study found poor knowledge of the monkeypox virus among currently enrolled medical students in the country’s highest-ranked medical school. This finding emphasizes the urgent need to increase their knowledge because controlling outbreaks requires significant cooperation from knowledgeable and skilled healthcare providers.

Atherosclerotic cardiovascular disease remains the leading cause of global morbidity and mortality. Identifying early markers of subclinical atherosclerosis is critical for predicting major adverse cardiovascular events (MACE) and improving prevention strategies. Carotid intima-media thickness (cIMT) is a well-established surrogate marker of atherosclerosis, but the impact of cardiometabolic risk factor burden on cIMT and future MACE risk is not fully understood. To assess the association between cIMT and the risk of MACE, and to evaluate the relationship between a composite cardiometabolic-risk biomarker index and cIMT as well as future MACE risk. Prospective cohort study using data from the UK Biobank, with a median follow-up of 4.3 years. Population-based study of 29,292 participants from the UK Biobank. Men and women aged 40 to 69 years (n=29,292) free from cardiovascular disease at baseline. Exclusions were made for those with prior coronary heart disease, myocardial infarction, and heart failure. Carotid intima-media thickness (cIMT) measured at baseline. A composite cardiometabolic-risk biomarker index (CRBI) was developed using HbA1c, total cholesterol ratio, and blood pressure. The primary outcomes were the risk of MACE, including coronary heart disease (CHD), myocardial infarction (MI), and heart failure (HF). The association between cIMT, CRBI, and the risk of these events was evaluated using hazard ratios (HRs) and adjusted for confounders. Higher cIMT values (>800 µm) were predictive of increased risk for CHD (HR: 2.15 at 800 µm; 95 % CI: 1.07-4.31) and MI (HR: 2.46 at 800 µm; 95 % CI: 0.93-6.53). The cumulative burden of cardiometabolic risk factors, as measured by the CRBI score, was significantly associated with increased cIMT (β=44.38 µm for very high CRBI score; 95 % CI: 38.25-50.51; p < 0.001) and future MI risk (HR: 10.43 for very high CRBI score; 95 % CI: 3.18-34.24). Lifestyle factors such as smoking and physical activity were also correlated with higher cIMT, particularly in males. Carotid intima-media thickness is a strong predictor of coronary heart disease and myocardial infarction. The cumulative cardiometabolic-risk biomarker index offers additional predictive value for subclinical atherosclerosis and future cardiovascular events. These findings underscore the importance of comprehensive cardiometabolic health in CVD prevention strategies.

Sayan Mitra, MBBS, MPH, MPhil; The cumulative effect of insufficient sleep on adolescent obesity: Evidence from a Spanish cohort, European Journal of Preventive

The chronic burden of diabetes on the health of individuals has extensive economic and public health impact on the well-being of any nation. Strategies in place to curtail the growing epidemic challenges mediate their interventions through the informative and preventive programs in place. Research being done to overcome these challenges gives hope towards what one can do at an individual level. The journey towards prevention is a long road once the limitations of the healthcare industry are realized.