Conectar
by Sara Cuesta-Morrondo, Jerson Garita-Cambronero, Jaime Cubero
Xanthomonas arboricola pathovars pruni (Xap), juglandis (Xaj), and corylina (Xac) are phytopathogenic bacteria that infect Prunus spp., walnut, and hazelnut trees, respectively. In this study, the understanding of the differences among these pathovars was improved with the aim of elucidating their host range and uncovering distinct virulence mechanisms. A comparative genomic analysis was conducted focusing on secretion system clusters across high-quality genomes from two strains of each pathovar. The results revealed that the RaxABC type I secretion system was absent in all analyzed strains. However, the HlyDB type I secretion system was present in both Xap and Xac, with a putative HlyDB effector identified in each Xac strain. Additionally, Xap strains contained a putative PctAB type I secretion system, while only one of the Xac harbored a putative PctAB. Notably, the genomic region surrounding pctA and pctB lacked pctP, suggesting the presence of a novel type I secretion system rather than the canonical PctAB. In contrast, Xaj lacked all the studied type I secretion systems. While the core components of type II and type III secretion systems were highly conserved across strains, significant variation was observed in their substrates. Interestingly, only Xap carried two pathovar-specific type III effectors. Regarding type V secretion systems, complete homologs of EstA, YapH, and XadA were found in all strains, except for one Xac strain, which contained a frameshifted YapH. Additionally, homologs of the XacFhaB/XacFhaC system were found in both Xap strains. However, both Xaj strains and one Xac strain carried an incomplete XacFhaB subunit, while the other Xac strain lacked this system entirely. Finally, analysis of the genomic regions surrounding these secretion system clusters strongly suggests that horizontal gene transfer has played a crucial role in their acquisition, likely contributing to the diversification, emergence and specialization of distinct X. arboricola pathovars.by Pornkamol Tiranaprakij, Sahaphume Srisuma, Krongtong Putthipokin, Sirasa Ruangritchankul
BackgroundAnticholinergic medication use is associated with adverse clinical outcomes, especially in older adults. However, few studies have assessed the anticholinergic burden in the Thai geriatric population. Hence, we aimed to evaluate the impact of anticholinergic burden on clinical outcomes in older patients after discharge from the hospital.
MethodsA prospective cohort study was conducted between January 1 to December 31, 2023. The prescribed medications were assessed at admission and discharge to determine the anticholinergic cognitive burden (ACB) scores. Participants were classified into three groups according to the ACB score at discharge: none (score 0), moderate (score 1–2), and severe (score ≥ 3) anticholinergic burden. The Cox proportional hazard model was used to determine the marker risk of high anticholinergic burden to adverse outcomes.
ResultsThis study involved 290 older patients admitted to general internal medicine wards. At discharge, 37.9% (n = 110) of the patients had a high anticholinergic burden (ACB score ≥ 3), and 50% (n = 145) had a higher ACB score than at admission. The three most commonly prescribed anticholinergics at discharge were benzodiazepines (20.3%), corticosteroids (20.0%), and antihistamines (15.9%). During the one-year follow-up period, 16.6% (n = 48) of the patients died. The incidence rate of all-cause mortality in hospitalized older patients with an ACB score ≥ 3 was 0.65 cases per 1000-person day during a one-year follow-up period. After adjusting for potential factors, an ACB score of ≥ 3 at discharge was marginally associated with one-year mortality post discharge [hazard ratio: 2.98, 95% confidence interval (0.96–9.28)].
ConclusionsThe exposure to high anticholinergic burden (ACB scores ≥ 3) at discharge was slightly associated with an increased risk of one-year mortality post discharge. The cautious use of benzodiazepines may assist to reduce the anticholinergic burden in this vulnerable population.
by Mario Gómez-Martínez, Greta Arias-Merino, Juan Benito-Lozano, Ana Villaverde-Hueso, Renata Linertová, Verónica Alonso-Ferreira
Inherited Epidermolysis Bullosa (EB) is a group of rare, genetic skin diseases characterized by extreme fragility of the skin and mucous membranes, leading to blistering and wounds in response to minimal trauma or friction. These clinical manifestations significantly reduce health-related quality of life (HRQoL). The objective of this protocol article is to provide information about the methods planned to be used to assess the measurement properties of HRQoL instruments specifically developed for EB patients of all age groups through a systematic review and meta-analysis. The protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P) guideline. The literature search will be conducted in PubMed, Web of Science (WOS) and EMBASE, including terminology that aligns with the four key elements of the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) research question (construct, target population, measurement properties and type of PROM), as well as the terminology proposed by COSMIN for measurement properties. Studies that include information on measurement properties (specifically, validity and/or reliability) with a sample of patients with inherited EB will be selected. Both title and abstract screening and full text review, will be conducted by two independent reviewers using the Rayyan tool. In addition, the risk of bias will be assessed using the COSMIN-Risk of Bias checklist. The data from each study and each measurement property will be summarized in accordance with the COSMIN guidelines. The evidence gathered will strive to adjudicate data on measurements properties of HRQoL instruments used in EB patients, and the limitations of the future systematic review will be discussed. Ultimately, results of the future systematic review will help develop more personalized guidelines for the assessment of HRQoL in EB patients of all age groups. The protocol is registered in OSF with registration number vrm87: https://osf.io/vrm87/by Yiming Jin, Rong Lu, Mingyuan Wang, Zihao Xu, Zhen Liu, Shuhong Xie, Yu Zhang
ObjectiveIn this study, we aimed to analyze the blood screening detection strategies employed for voluntary blood donation in a specific region of East China and evaluate the efficacy of the blood safety detection system.
Donors and MethodsA total of 539,117 whole blood samples were collected from voluntary blood donors between January 2018 and July 2021, as well as in 2023 and 2024. The samples were screened for hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibodies, human immunodeficiency virus antibodies/antigen (HIV Ab/Ag), and Treponema pallidum (TP) antibodies using enzyme-linked immunosorbent assay (ELISA). Alanine aminotransferase (ALT) levels were measured using a rapid method. Chemiluminescence immunoassay technology was used to detect five hepatitis B virus (HBV) markers. Polymerase chain reaction was employed to detect HBV DNA, HCV RNA, and HIV RNA. The reactivity rates of each marker were analyzed.
ResultsThe overall positivity rate for blood testing among donors in this region was 0.76% (4,078/539,117). The positivity rates for the individual markers were as follows: anti-TP (0.20%)> HBsAg (0.18%)> ALT (0.13%)> anti-HCV (0.085%)> nucleic acid testing (0.080%)> HIV antigen/anti-HIV (0.079%). No significant differences were observed (P > 0.05). Before 2023, the positivity rates for ALT and HBsAg exhibited occasional fluctuations, followed by a significant decline. Conversely, in 2024, a slight upward trend in the HIV positivity rate was noted.
ConclusionThe current multitiered blood screening and detection strategy in this region exhibits complementary advantages, ensuring effective blood safety. However, the observed slight upward trend in the HIV positivity rate among voluntary blood donors highlights the necessity for enhanced pre-donation counseling and risk assessment for key populations.
by Shuangyan Tu, Menglin Jiang, Rong Yang, Zhiqiang Deng, Cairong Zhu, Muke Zhou, Zhangyan Peng, Lihong Zhao
PurposeTo identify the scale that is more suitable for oral health assessment in stroke patient population with indwelling gastric tubes.
MethodsA total of 198 patients with indent gastric tubes were selected from 1250 stroke patients to evaluate their oral health using both the BOAS and the OHAT scales. The scores obtained from both scales were then compared to evaluate the feasibility, reliability, and validity of each scale in assessing oral health among stroke patients with indwelling gastric tubes.
ResultsThe results showed that both the BOAS and OHAT scales exhibited good reliability and validity in stroke patients with indwelling gastric tubes. The Cronbach’s alpha coefficients of BOAS and OHAT in stroke patients with indwelling gastric tubes were 0.89 and 0.91, respectively. In the exploratory factor analysis, one and two common factors were extracted from the two scales, with cumulative variance contributions of 65.89% and 71.85%, respectively. In addition, potential influencing factor correlation analysis found that gender and marital status had a significant correlation with the BOAS score(P Conclusions
The BOAS and OHAT have demonstrated good reliability and validity and in their ability to assess the oral health of stroke patients with indwelling gastric tubes. Therefore, it is recommended that the selection of oral assessment scales should be further refined in different disease stages of stroke patients to assess the oral health status of patients more accurately and personalized.
by Morgan Boncyk, Krystal K. Rampalli, Marian N. Winters, Muskaan K. Makkar, Silver Nanema, Gideon S. Amevinya, Amos Laar, Edward A. Frongillo, Christine E. Blake
Food marketing has increased volume, precision, and reach to influence viewers’ food attitudes, beliefs, and eating behaviors. What and how much people eat has implications for health. While many countries regulate food advertising to protect consumers and encourage healthy eating, Ghana has none. Understanding the content and framing of food and beverage advertisements can inform the development of effective policies and practices that encourage healthier diets. This content analysis examines the foods and beverages advertised, their timing, and marketing techniques on Ghanaian television. From February to May 2020, 486 hours of advertisements were recorded. Advertisements with ≥1 actors were coded for food type, actor characteristics (i.e., body size, gender, age, race), and marketing techniques (i.e., promotional characters, premium offers, goal frames). A total of 607 advertisements with 2,043 actors were analyzed. Two-thirds (66.8%) promoted foods categorized as unhealthy. Sugar-sweetened beverages (22.6%) were most frequent, followed by grains high in sugar and low in fiber (13.2%), recipe additions (13.1%), and supplements (10.2%). Half (52.9%) of advertisements used persuasive marketing strategies. Most actors were classified as underweight (72.1% v. 20.5% normal weight, 7.4% overweight/obese) with a balanced gender distribution (49.1% female). Most advertisements aired during evenings (37.7%) and weekdays (69.5%). Morning advertisements promoted more healthy foods, whereas evening and night advertisements promoted more unhealthy foods. Gain goal frames were most common for healthy foods (pby Weiyong Chen, Zhongrong Yang, Xing Wang, Weiwei Wang
ObjectiveThis study aimed to investigate the demographic characteristics of Men who have Sex with Men (MSM) recruited online and identify the factorsassociated with meeting homosexual partners at fixed offline locations.
MethodsUnivariate and multivariate logistic regression analyses were used to examine the factors that influenced their meeting up with homosexual partners at fixed offline locations.
ResultsA total of 604 MSM were included, with 133 participants (22.02%) meeting homosexual partners at fixed offline locations. Multivariate logistic regression analysis showed that participantswho were willing to engage in commercial sex, engage in behaviors such as alcohol consumption, drug use, or aphrodisiac use during homosexual activities, and hadused HIVPre-Exposure Prophylaxis (PrEP) in the last six months were more likely to meet homosexual partners at fixed offline locations.
ConclusionsThe proportion of participants meeting homosexual partners at fixed offline locations was relatively high, emphasizing the need to increase education and awareness among MSM to reduce relatedbehaviors during homosexual activities. Further promotion of the proper use of PrEP and avoidance of commercial sex are essential for lowering the risk of HIV infection among this population.
by Janaína de Pina Carvalho, Sarah Nascimento Silva, Tália Santana Machado de Assis, Endi Lanza Galvão, Mayra Soares Moreira, Mônica Viegas Andrade, Kenya Valéria Micaela de Souza Noronha, Gláucia Cota
Cutaneous leishmaniasis (CL) is a neglected infectious disease with a global distribution and a known health-related quality of life (HRQoL) impact. However, no utility-based HRQoL assessments for CL patients are available. The aim of this study was to quantitatively assess the health-related quality of life among patients with CL attending a Brazilian reference center. A retrospective interview-based longitudinal study was conducted using the EQ-5D-3L/VAS to assess the current health status during active disease, and retrospectively before the onset of disease symptoms. In addition, socioeconomic data were collected via a standardized questionnaire, and sociodemographic and clinical data were collected directly from medical records. A total of 143 patients with a mean age of 52 (±17) years were included, 73% of whom were men. The mean utility score before the onset of CL symptoms was 0.858. Comparison of responses related to health status before and after disease onset revealed significant losses (pby Xihong Ying, Qiuyan Zhao, Yi Wu, Shasha Deng, Qing Ma, Ronghua Fang
ObjectivesSleep disorders are a common symptom in Ankylosing Spondylitis (AS) patients. In this cross-sectional study, we aimed to understand the current status of sleep disorders in AS patients and to analyze potential factors influencing sleep disorders.
MethodsA total of 205 AS patients were recruited in the survey. The content included the self-designed demographic data questionnaire, The MOS 36-Item Short Form Health Survey (SF-36), Visual Analogue Scale (VAS), Multidimensional Fatigue Inventory (MF-20), Self-Rating Anxiety and Depression Scale, Pittsburgh Sleep Quality Index questionnaire (PSQI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Metrology Index (BASMI). These data were analyzed using chi-square test, independent sample t-test, Mann-Whitney U test, Pearson correlation analysis, single-factor linear regression analysis, and multiple linear stepwise regression analysis.
ResultsThe results showed that the average sleep total score was 8.82 ± 4.146, and the prevalence of sleep disorders was approximately 66.8% in AS patients. Age (F = 29.710, P Conclusion
These findings suggest that medical professionals should pay increased attention to the observed associations between sleep disorders and clinical factors in AS patients, and consider implementing targeted interventions to address sleep-related issues.
by Jeff Ondocsin, Lissa Moran, Daniel Ciccarone, Simon Outram, Dan Werb, Nicole Holm, Emily A. Arnold
BackgroundOverdose deaths have continued to rise in the US despite heightened public attention and resources. Drug checking shows promise for integration into existing services for people who use drugs (PWUD) across North America. Amidst the backdrop of rising overdose deaths and emerging funds for harm reduction initiatives, this manuscript explores the landscape of drug checking services in North America and perspectives on improved integration with a diverse set of PWUD based in San Francisco and North American drug checking experts.
MethodsTwo separate samples of drug checking stakeholders, ‘providers’ and ‘clients’ were recruited. Providers participated in in-depth semi-structured qualitative interviews over Zoom on their experiences advocating for and operating drug checking services in the US and Canada. Clients were people who used drugs and lived in or commuted to the San Francisco Bay Area and participated in semi-structured interviews in November 2022. Interviews were transcribed fully and analyzed using thematic analysis methods.
ResultsProviders and clients identified ongoing instability in the North American drug supply that is exacerbating overdose risk while also identifying groups that would benefit from greater access to drug checking services. Both groups believed the paradoxical impacts of the fentanyl crisis at the core of drug checking services created barriers to the implementation and expansion of these services, hurting PWUD and their providers. Additionally, clients and providers reflected on the social and policy challenges to expansion and improvement of drug checking in their communities.
ConclusionDrug checking remains underleveraged, particularly with respect to the most vulnerable PWUD. Clients and providers contended that these services must become more responsive to an ever changing and dangerous drug supply in North America.
by Pakorn Prakaikietikul, Yutthaphan Wannasopha, Juntima Euathrongchit, Apichat Tantraworasin
ObjectiveTo evaluate the diagnostic value of CT features and histogram analysis in distinguishing between malignant and benign mediastinal lymph nodes in patients with non-small cell lung cancer (NSCLC).
MethodThis retrospective study analyzed non-contrast chest CT images from 40 NSCLC patients, comprising 80 pathology-proven mediastinal lymph nodes (46 benign, 34 metastasis). Morphologic features, including size, shape, margins, and internal composition, were independently assessed by two radiologists. Histogram analysis was conducted using the Synapse Vincent system with six parameters: mean attenuation, mean positive pixel (MPP), standard deviation (SD), skewness, kurtosis, and entropy. Statistical analysis included the Mann-Whitney test for continuous data, Fisher’s exact test for categorical data, and receiver-operating characteristic (ROC) curve analysis to assess diagnostic accuracy, with statistical significance set at p Results
Malignant lymph nodes demonstrated significantly larger sizes (p Conclusion
The combination of morphologic CT features and CT histogram analysis offers a robust method for differentiating malignant from benign mediastinal lymph nodes in NSCLC patients, potentially enhancing diagnostic accuracy and informing treatment strategies.
by Alyssa Kearly, Prontip Saelee, Jonathan Bard, Satrajit Sinha, Anne Satterthwaite, Lee Ann Garrett-Sinha
The levels of transcription factor Ets1 are high in resting B and T cells, but are downregulated by signaling through antigen receptors and Toll-like receptors (TLRs). Loss of Ets1 in mice leads to excessive immune cell activation and development of an autoimmune syndrome and reduced Ets1 expression has been observed in human PBMCs in the context of autoimmune diseases. In B cells, Ets1 serves to prevent premature activation and differentiation to antibody-secreting cells. Given these important roles for Ets1 in the immune response, stringent control of Ets1 gene expression levels is required for homeostasis. However, the genetic regulatory elements that control expression of the Ets1 gene remain relatively unknown. Here we identify a topologically-associating domain (TAD) in the chromatin of B cells that includes the mouse Ets1 gene locus and describe an interaction hub that extends over 100 kb upstream and into the gene body. Additionally, we compile epigenetic datasets to find several putative regulatory elements within the interaction hub by identifying regions of high DNA accessibility and enrichment of active enhancer histone marks. Using reporter constructs, we determine that DNA sequences within this interaction hub are sufficient to direct reporter gene expression in lymphoid tissues of transgenic mice. Further analysis indicates that the reporter construct drives faithful expression of the reporter gene in mouse B cells, but variegated expression in T cells, suggesting the existence of T cell regulatory elements outside this region. To investigate how the downregulation of Ets1 transcription is associated with alterations in the epigenetic landscape of stimulated B cells, we performed ATAC-seq in resting and BCR-stimulated primary B cells and identified four regions within and upstream of the Ets1 locus that undergo changes in chromatin accessibility that correlate to Ets1 gene expression. Interestingly, functional analysis of several putative Ets1 regulatory elements using luciferase constructs suggested a high level of functional redundancy. Taken together our studies reveal a complex network of regulatory elements and transcription factors that coordinate the B cell-specific expression of Ets1.by Mekuriaw Nibret Aweke, Muluken Chanie Agimas, Moges Tadesse Abebe, Tigabu Kidie Tesfie, Meron Asmamaw Alemayehu, Werkneh Melkie Tilahun, Gebrie Getu Alemu, Worku Necho Asferie
BackgroundMixed milk feeding is defined as providing formula and/or animal milk along with breast milk to infants under six months old which is prevalent in many countries. However, this practice is generally not recommended as it can reduce the intake of breast milk, depriving the infant of its optimal nutritional and immunological benefits. Unlike formula, breast milk contains complex bioactive constituents that promote intestinal and pancreatic growth and develop mucosal defenses. The aim of this study was to analyze the spatial distribution and predictors of MMF practices in Ethiopia.
MethodsThis study utilized data from the 2019 Mini-Ethiopian Demographic and Health Survey (MiniEDHS), a nationally representative cross-sectional survey conducted from March to June 2019. The total weighted sample size derived from the data examined in this study amounted to 524 infants. The data analysis used Global Moran’s I for spatial autocorrelation and the Getis-Ord Gi * statistic for local cluster analysis to assess the spatial distribution of mixed milk feeding prevalence across Ethiopia’s administrative regions and cities. Empirical Bayesian Kriging was used for spatial interpolation to estimate mixed milk feeding prevalence in unsampled areas. The analysis utilized a maximum spatial cluster size threshold of 50% of the population to detect clusters of varying sizes. Ordinary least squares regression analysis identified significant spatial predictors. In geographically weighted regression analysis, the effect of predictor variables on the spatial variation of mixed milk feeding was detected using local coefficients.
ResultsThe overall weighted prevalence of Mixed Milk Feeding (MMF) in Ethiopia was 10.12% (95% CI: 7.8, 13.01). This prevalence shows significant regional variations across the country emphasizing regional disparities in prevalence and distribution. The Global Moran’s I statistic was 0.14, with a Z-score of 3.18 and a p-value of Conclusion
The study found significant regional variations in mixed milk feeding practices in Ethiopia. Households with middle wealth index and baby without postnatal check were significant spatial predictors of mixed milk feeding. To reduce mixed milk feeding prevalence, targeted interventions should engage community leaders, enhance breastfeeding education in maternal health services, and integrate counseling into routine healthcare to support informed maternal choices and improve child health outcomes nationwide.
by Luca Ghirotto, Eugenio Paci, Claudia Bricci, Silvia Marini, Valentina Bessi, Matías Eduardo Díaz Crescitelli, Ermanno Rondini, Francesco Pistelli, Giuseppe Gorini, Sandra Bosi, Paolo Giorgi Rossi, the Working Group
BackgroundLung cancer screening (LCS) combined with smoking cessation programs is a critical strategy for reducing lung cancer mortality. Understanding the perspectives of cigarette users and former ones on these interventions is essential for enhancing their acceptability and effectiveness. This study aimed to explore, in Italy, the perceptions and experiences of individuals eligible for LCS within the context of a smoking cessation program.
Methods and findingsThis multicenter qualitative study was conducted in two Italian regions as part of a larger project the Italian League against Cancer promoted. Using purposive sampling, we included (a) cigarette users and former ones who participated in an Italian trial, ITALUNG study, and (b) cigarette users who had been offered individual or group smoking cessation interventions and were theoretically eligible for screening in the following years (aged 50–70, ≥15 pack-years). Data were collected through open-ended semi-structured interviews and focus group meetings and analyzed using reflexive thematic analysis. The data analysis yielded six themes covering participants’ views on the interactions between the two types of interventions (screening and smoking cessation program). Across their data, we generated the following themes: (i) depreciation and fatalism toward the risk of smoking, (ii) self-blaming and ethicality, (iii) ambivalent impact of the screening on smoking, (iv) LCS-related information and concerns, (v) teachable and motivating moments, and (vi) non-stigmatizing communication and testimony by professionals.
ConclusionsOur study underscores the importance of avoiding stigma and respecting the dignity of cigarette users in implementing LCS and smoking cessation programs. Clear communication and supportive interactions with healthcare providers are crucial for enhancing the acceptability and effectiveness of these interventions. Future research should focus on quantifying these findings and exploring additional factors influencing the acceptability and effectiveness of combined LCS and smoking cessation programs.
by Kenneth K.Y. Ting, Hisham M. Ibrahim, Nitya Gulati, Yufeng Wang, Jonathan V. Rocheleau, Myron I. Cybulsky
The formation of macrophage (Mφ) foam cells is a hallmark of atherosclerosis, yet how the process of lipid loading can modulate Mφ inflammatory responses by rewiring their intracellular metabolic circuits is not well understood. Our previous studies have shown that the accumulation of oxidized LDL (oxLDL) or free cholesterol in Mφs impaired their inflammatory response by suppressing HIF-1α-mediated glycolysis and upregulating NRF2 antioxidative response. However, it remains unclear if other metabolic processes are also contributory. In this study, we found that the accumulation of free cholesterol, but not oxLDL, in primary murine thioglycolate-elicited peritoneal Mφs (PMφs) enhanced a PARP1-dependent response associated with repair of DNA damage, which was characterized by poly ADP-ribosylation of proteins, phosphorylation of histone 2A.X and consumption of NAD + . Both oxLDL and cholesterol enhanced the PARP1 response after LPS stimulation. Treatment of PMφs with mitoTEMPO, a specific mitochondrial reactive oxygen species (mtROS) scavenger, alleviated mtROS during cholesterol loading, blocked the PARP1 response and partially restored LPS- induced inflammatory gene expression. In contrast to inhibition of PARP1 enzymatic activity, knockdown of PARP1 expression in RAW264.7 Mφs with siRNA elevated LPS-induced inflammatory gene expression. Overall, our study suggests that cholesterol accumulation triggers a PARP1 response to DNA damage in Mφs and that PARP1 inhibits LPS-mediated inflammation through a non-enzymatic function.by Yu-Xue Feng, Ming-Zhi Tan, Hui-Han Qiu, Jie-Rong Chen, Si-Zhe Wang, Ze-Min Huang, Xu-Guang Guo
Bacterial vaginosis (BV) is a prevalent cause of vaginal symptoms in women of reproductive age. With the widespread of heavy metal pollutants and their harmful function on women’s immune and hormonal systems, it is necessary to explore the association between heavy metal exposure and BV. This study investigates the potential relationship between serum heavy metals and bacterial vaginosis in a cohort of American women. The present study employed a cross-sectional analysis of 2,493 women participating in the 2001–2004 National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression models were utilized in the study to assess the correlation between these variables. A stratified analysis was performed to investigate the relationship among different population groups further, and smooth curve fittings were conducted to intuitively evaluate the correlation. According to the current cross-sectional study results, a significant correlation was identified between the high levels of lead and cadmium in the serum and the likelihood of developing bacterial vaginosis. We found that serum lead (OR = 1.35, 95% CI: 1.06–1.72, p = 0.016) and serum cadmium (OR = 1.41, 95% CI: 1.01–1.98, p = 0.047) increased the risk of bacterial vaginosis by 35% and 41%, respectively, in the highest level group in comparison to the lowest level group in the fully adjusted model. Furthermore, the research discovered no statistically significant association between the levels of total mercury in the serum and a heightened susceptibility to bacterial vaginosis (OR = 0.96, 95% CI: 0.75–1.23, p = 0.763). Results of our study indicated an inverse association between serum heavy metals and bacterial vaginosis risk, including lead and cadmium. Reducing exposure to heavy metals could be vital to preventing and managing bacterial vaginosis.by Bin Li, Jinjin Wang, Jianlong Ge, Meijie Liao, Xiaojun Rong, Jinyan Wang, Yingeng Wang, Zheng Zhang, Chunyuan Wang, Yongxiang Yu
In order to study the optimal use of Lactobacillus plantarum in sea cucumber (Apostichopus japonicus), 49 days feeding trial was conducted to determine the influence of immersion bathing in different concentrations of Lactobacillus plantarum CLY-05 on body weight gain rate and non-specific immune activities. The potential effect of CLY-05 on gut microbiota was also analyzed during the immersion bathing at the optimum concentration. The results showed that the body weight growth rate of all bathing groups was higher than that of control. The highest specific growth rate (4.58%) and weight gain rate (25.35%) was achieved at the bacterial concentration of 1×103 CFU/mL. The activities of non-specific immune enzymes (ACP, AKP, SOD and LZM) of all bathing groups increased after immersion bathing, and the enzyme activities of groups bathed with the bacterium at 1×103 and 1×104 CFU/mL reached the highest. Therefore, 1×103 CFU/mL was considered as the optimum concentration of L. plantarum CLY-05 for A. japonicus pond culture. The results of gut microbiota analysis showed that the gut microbiota changed with the addition of L. plantarum CLY-05, and the richness and diversity of the gut microbiota peaked on day 14 and day 21, respectively. The correlation analysis revealed that the non-specific immune enzyme activities were significantly correlated to some gut bacteria (in the phyla Proteobacteria, Firmicutes) after immersion bathing in L. plantarum CLY-05. These findings provide the theoretical foundation for probiotic application in sea cucumber farming.by Dima Hadid, Rebecca H. Correia, Sarah D. McDonald, Elizabeth K. Darling, David Kirkwood, Aaron Jones, Andrea Carruthers, Cassandra Kuyvenhoven, Michelle Howard, Devon Greyson, Sujane Kandasamy, Meredith Vanstone
ObjectiveGestational diabetes mellitus (GDM) is a common medical complication of pregnancy that leads to adverse outcomes for both infants and pregnant people. Early detection and treatment can mitigate these negative outcomes. The COVID-19 pandemic strained healthcare and laboratory services, including GDM screening programs. Adapted GDM screening guidelines were introduced in many jurisdictions. This study examined changes in uptake, modality, and experiences of GDM screening in Ontario, Canada during the COVID-19 pandemic.
MethodsThis convergent mixed-method study involved a population-based retrospective cohort analysis of Ontario-based health administrative data to describe and compare gestational diabetes screening rates among 85,228 individuals with live, in-hospital births between January 1-March 31 before (2019) and during the COVID-19 pandemic (2021 and 2022). Descriptive analyses were conducted for GDM screening pathways aligning with usual and pandemic-adapted screening guidance. Qualitative descriptive interviews were conducted about experiences and decision-making of GDM screening with 43 Ontario residents who gave birth between May 2020 and December 2021. Data were integrated during the design and interpretation phases.
ResultsThere were small but significant increases in GDM screening during the pandemic; likelihood of screening completion using any modality increased in 2021 and 2022 compared to 2019. Testing modality shifted; the alternate screening strategies introduced during COVID-19 were adopted by clinicians. Interview participants perceived GDM screening to be important and obligatory but accompanied by a degree of stress about potential COVID-19 exposure.
ConclusionDespite health system challenges experienced in Ontario during the COVID-19 pandemic, GDM screening rates increased in the study population, demonstrating the success of adapted GDM screening guidelines. Decisions about screening modalities were driven by clinician expertise, and interview participants were satisfied to provide informed consent to these recommendations.
by Oluwadamilare Akingbade, Ka Yi Hong, Oluwabukola Sharon Ayo, Adetutu Sefinat Alade, Moshood Akinwumi Lawal, Ibironke Elizabeth Somoye, Victoria Adediran, Olamide Sado, Ka Ming Chow
BackgroundBreast cancer (BC) remains a significant health burden globally, with high incidence and mortality rates, particularly in Nigeria. Chemotherapy, a common treatment modality for BC, often leads to various physical and psychological side effects, impacting patients’ quality of life. Despite the growing use of mobile health (mHealth) interventions to provide psychoeducational support, there is a paucity of evidence regarding their feasibility and acceptability among Nigerian women with BC.
ObjectiveTo develop and investigate the feasibility and acceptability of a mHealth psychoeducational intervention (mPEI) named the ChEmo Nurse Breast cancer Application (CENBA) programme.
MethodsA multi-centre, assessor-blinded, parallel-group pilot randomised controlled trial (RCT) was conducted at Lagos State University Teaching Hospital (LASUTH) and Lagos University Teaching Hospital (LUTH). Thirty women newly diagnosed with BC and undergoing chemotherapy were randomly assigned to an intervention or a control group. The intervention group received the CENBA programme, which included BC education, coping skills training, a discussion forum, and nurse-led consultations, delivered via a mobile application and phone calls over six weeks. The control group received standard care. Feasibility was assessed through consent, attrition, and completion rates, while acceptability was explored via qualitative interviews.
ResultsThe completion rate was 93.3%. Qualitative data indicated that participants found the intervention beneficial, particularly appreciating the educational content and the emotional support provided through the discussion forum and nurse consultations.
ConclusionThe CENBA programme was perceived as a feasible and acceptable mHealth intervention for providing psychoeducational support to Nigerian women with BC undergoing chemotherapy. These findings suggest that the CENBA programme could be a valuable tool in addressing the psychoeducational needs of this population, warranting further investigation in a full-scale RCT.
Trial registrationThis manuscript reports a feasibility study preceding the full trial, which was registered with the United States Clinical Trials registry (number NCT05489354).
by Sitthichai Kanokudom, Kittiyod Poovorawan, Pornjarim Nilyanimit, Nungruthai Suntronwong, Ratchadawan Aeemjinda, Sittisak Honsawek, Yong Poovorawan
Hepatitis C virus (HCV) infection can cause acute and chronic hepatitis, leading to liver cirrhosis and hepatocellular carcinoma. The World Health Organization aims to eliminate viral hepatitis by 2030 through extensive screening and treatment. To achieve this goal, comprehensive and widespread screening is essential for diagnosis and treatment. This study aims to evaluate the diagnostic sensitivity and specificity of the Elecsys® HCV Duo immunoassay (Duo-assay), which simultaneously detects anti-HCV antibodies (Duo/anti-HCV) and HCV core antigen (Duo/HCVcAg) in a single sample, compared with initially antibody testing followed by quantitative real-time polymerase chain reaction (qRT-PCR). Additionally, this study aimed to evaluate a relationship between Duo/HCVcAg and qRT-PCR assay in different genotypes. A total of 769 plasma samples were tested using the Duo-assay to further evaluate the test’s performance and conduct Duo/HCVcAg correlation analysis using qRT-PCR for each genotype. Among the active infection group (anti-HCV+/RNA+; n = 473), the Duo-assay showed 100% sensitivity for detecting Duo/anti-HCV and 70.6% for Duo/HCVcAg. In the resolved infection group (anti-HCV+/RNA–; n = 176), the assay showed 100% sensitivity for Duo/anti-HCV and 100% specificity for Duo/HCVcAg. In the non-infected group (anti-HCV–/RNA–; n = 120), the assay showed 100% specificity for both Duo/anti-HCV and Duo/HCVcAg. Moreover, no correlation was observed between the Duo/HCVcAg and HCV RNA tests, irrespective of genotype. These findings indicate that the Duo-assay is highly sensitive for detecting anti-HCV and specifically identifies patients with active infection. Nevertheless, cases with anti-HCV+/HCVcAg–results should undergo additional confirmation with western blot/immunoblot and qRT-PCR to ensure diagnostic accuracy, especially in Blood donation facilities.
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