Reversing Metabolic Dysfunction-Associated Steatotic Liver Disease Promotes Healthy Pediatric Cardiovascular Structures: The PROC Study.

INTRODUCTION: We investigated the impact of metabolic dysfunction-associated steatotic liver disease (MASLD) on cardiovascular structure development in children. METHODS: We followed 1,356 children with the mean age of 6.6 years for 4.5 years in Beijing, China. We assessed the association of MASLD with cardiovascular structure (carotid intima-media thickness and left ventricular mass) outcomes at baseline and follow-up. RESULTS: Over follow-up, 59 children had persistent MASLD, 109 had incident MASLD (progression), and 35 had normalization of liver health. Children with MASLD normalization showed a significantly lower mean development in carotid intima-media thickness (0.161 vs 0.188 mm) and left ventricular mass (4.5 vs 12.4 g) than children with persistent MASLD. DISCUSSION: The control of MASLD was associated with improved cardiovascular structure development.

The emerging role of α7nAChRs/caspase-3/Nrf-2 signaling pathway in citicoline improved autistic behavior induced by thimerosal in mice.

AIMS: Autism spectrum disorder (ASD) is a global concern,affecting around 75 million individuals.Various factors contribute to ASD,including mercury-containing preservatives like thimerosal (Thim) found in some vaccines.This study explored whether citicoline could be a therapeutic option for Thim-induced neuronal damage in a mouse model of ASD.Additionally,the study investigated the effects of citicoline on the α7nAChRs/Akt/Nrf2/caspase-3 pathway,which may be involved in the development of ASD. MATERIALS AND METHODS: The study separated newborn mice into four groups.The control group received saline injections,while the Thim group received intramuscular injections of 3000 µg Hg/kg Thim on days 7,9,11,and 15 after birth.The two citicoline groups were administered Thim followed by intraperitoneal injections of 250 mg/kg or 500 mg/kg citicoline for three weeks.Afterward,various parameters were assessed, including growth,behavior,brain histopathology,oxidative stress,apoptotic,and inflammatory markers. KEY FINDINGS: Untreated Thim-exposed mice exhibited significant brain damage,which was substantially alleviated by citicoline treatment.This beneficial effect was associated with increased expressions and concentrations of brain α7nAChRs and Akt, increased brain content of Nrf2, and the hippocampus contents of acetylcholine. Citicoline treatment decreased the brain levels of oxidative stress markers (MDA and NO),the apoptotic marker caspase-3,and pro-inflammatory markers (NF-κB,TNF-α,and IL-1ß). The drug also increased the brain GPx activity. SIGNIFICANCE: Based on the results of this study,the α7nAChRs pathway appears to be essential for the therapeutic effectiveness of citicoline in treating Thim-induced ASD in mice.

Validation of "Life's Essential 8" Metrics With Cardiovascular Structural Status in Children: The PROC Study in China.

Background Life's Essential 8 (LE8) metrics for cardiovascular health (CVH) aid primordial prevention in US populations. Methods and Results We conducted a child cohort study (PROC [Beijing Child Growth and Health Cohort]) with baseline (2018-2019) and follow-up (2020-2021) assessments, enrolling disease-free 6- to 10-year-old children from 6 elementary schools in Beijing. We collected LE8-assessed components via questionnaire surveys and 3 cardiovascular structural parameters by 2-dimensional M-mode echocardiography: left ventricular mass (LVM), LVM index, and carotid intima-media thickness. Compared with 1914 participants (mean age, 6.6 years) at baseline, we saw lower mean CVH scores at follow-up (n=1789; 8.5 years). Among LE8 components, diet presented the lowest perfect-score prevalence (5.1%). Only 18.6% of participants had physical activity ≥420 min/wk, 55.9% had nicotine exposure, and 25.2% had abnormal sleep duration. Prevalence of overweight/obesity was 26.8% at baseline and 38.2% at follow-up. We noted optimal blood lipid scores in 30.7%, while 12.9% of children had abnormal fasting glucose. Normal BP was 71.6% at baseline and 60.3% at follow-up. LVM (g), LVM index (g/m2.7), and carotid intima-media thickness (mm) were significantly lower in children with high (56.8, 33.2, 0.35) or moderate CVH scores (60.6, 34.6, 0.36), compared with children with low CVH scores (67.9, 37.1, 0.37). Adjusting for age/sex, LVM (ß=11.8 [95% CI, 3.5-20.0]; P=0.005), LVM index (ß=4.4 [95% CI, 0.5-8.3]; P=0.027), and carotid intima-media thickness (ß=0.016 [95% CI, 0.002-0.030]; P=0.028) were higher in the low-CVH group. Conclusions CVH scores were suboptimal, declining with age. LE8 metrics indicated worse CVH in children with abnormal cardiovascular structural measurements, suggesting the validity of LE8 in assessing child CVH. Registration URL: https://www.chictr.org.cn/index.html; Unique identifier: ChiCTR2100044027.

Interplay of Lymphocytes with the Intestinal Microbiota in Children with Nonalcoholic Fatty Liver Disease.

Abnormally high lymphocyte counts are seen in persons with nonalcoholic fatty liver disease (NAFLD). Gut microbiota dysbiosis is a risk factor for NAFLD. We assessed the gut microbiota of 63 healthy children and 63 children with NAFLD using 16S rRNA gene and metagenomic sequencing to explore the relationships. Compared with healthy children (HC group), the Bacteroidetes, Verrucomicrobia, and Akkermansia were less abundant, while the Actinobacteria were more abundant in children with NAFLD (FLD group). To understand the effect of lymphocytes on the gut microbiota of children with NAFLD, we compared the microbiota of 41 children with NAFLD and high numbers of lymphocytes (FLD_HL group) and 22 children with NAFLD and low numbers of lymphocytes (FLD_LL group). The abundances of Bacteroidetes, Verrucobacterium, and Akkermansia increased and Actinobacteria decreased in the FLD_LL group compared to the FLD_HL group. Akkermansia was negatively correlated with lymphocyte count. NAFLD may disturb the gut microbiota in children through reducing the abundance of Akkermansia and increasing the abundance of proinflammatory bacteria, such as Escherichia-Shigella. Conclusions: High lymphocyte counts are associated with disturbances of gut microbiota and emergence of opportunistic pathogens in children with NAFLD.

How coronavirus disease 2019 entered Africa and the Middle East: a case study from Egypt.

BACKGROUND: We report the first person with SARS-CoV-2 in Egypt. METHODS: We interviewed the index case and contacts. RESULTS: The 36-year old man was healthy when he traveled on business to Wuhan, China in January 2020. Upon his return to Cairo, he became ill, went to work, and subsequent autochthonous viral spread occurred. CONCLUSION: We linked SARS-CoV-2 importation to global business travel. The extent to which physical distancing, hand/face/surface hygiene, mask use, viral testing/contact tracing, restricted travel, small gatherings, and/or stay-in-residence mandates will be implemented and limit further spread in the Middle East and North Africa remains to be seen.

Social Media Survey and Web Posting Assessment of the COVID-19 Response in China: Health Worker Attitudes Toward Preparedness and Personal Protective Equipment Shortages.

BACKGROUND: Understanding health worker awareness, attitudes, and self-confidence in the workplace can inform local and global responses toward emerging infectious threats, like the coronavirus disease 2019 (COVID-19) pandemic. Availability of accessible personal protective equipment (PPE) is vital to effective care and prevention. METHODS: We conducted a cross-sectional survey from February 24 to 28, 2020, to assess COVID-19 preparedness among health workers. In addition, we assessed trends from search engine web crawling and text-mining data trending over the Sina Weibo platform from January 1 to March 3, 2020. Data were abstracted on Chinese outbreak preparedness. RESULTS: In the survey, we engaged 6350 persons, of whom 1065 agreed to participate, and after an eligibility logic check, 1052 participated (16.6%). We accessed 412 internet posts as to PPE availability. Health workers who were satisfied with current preparedness to address COVID-19 were more likely to be female, to obtain knowledge about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak from government organizations, and to consider their hospital prepared for outbreak management. Health workers with more confidence in their abilities to respond were those with more faith in their institution's response capacities. Elements of readiness included having airborne infection isolation rooms, visitor control procedures, and training in precautions and PPE use. Both survey and web post assessments suggested that health workers in need were unable to reliably obtain PPE. CONCLUSIONS: Health workers' self-confidence depends on perceived institutional readiness. Failure to maintain available PPE inventory for emerging infectious diseases preparedness suggests a failure to learn key lessons from the 2003-2004 SARS outbreak in China.