Independent and joint associations of cardiometabolic multimorbidity and depression on cognitive function: findings from multi-regional cohorts and generalisation from community to clinic.

Background: Cardiometabolic multimorbidity (CMM) and depression are often co-occurring in older adults and associated with neurodegenerative outcomes. The present study aimed to estimate the independent and joint associations of CMM and depression on cognitive function in multi-regional cohorts, and to validate the generalizability of the findings in additional settings, including clinical. Methods: Data harmonization was performed across 14 longitudinal cohort studies within the Cohort Studies of Memory in an International Consortium (COSMIC) group, spanning North America, South America, Europe, Africa, Asia, and Australia. Three external validation studies with distinct settings were employed for generalization. Participants were eligible for inclusion if they had data for CMM and were free of dementia at baseline. Baseline CMM was defined as: 1) CMM 5, ≥2 among hypertension, hyperlipidemia, diabetes, stroke, and heart disease and 2) CMM 3 (aligned with previous studies), ≥2 among diabetes, stroke, and heart disease. Baseline depression was primarily characterized by binary classification of depressive symptom measurements, employing the Geriatric Depression Scale and the Center for Epidemiological Studies-Depression scale. Global cognition was standardized as z-scores through harmonizing multiple cognitive measures. Longitudinal cognition was calculated as changes in global cognitive z-scores. A pooled individual participant data (IPD) analysis was utilized to estimate the independent and joint associations of CMM and depression on cognitive outcomes in COSMIC studies, both cross-sectionally and longitudinally. Repeated analyses were performed in three external validation studies. Findings: Of the 32,931 older adults in the 14 COSMIC cohorts, we included 30,382 participants with complete data on baseline CMM, depression, and cognitive assessments for cross-sectional analyses. Among them, 22,599 who had at least 1 follow-up cognitive assessment were included in the longitudinal analyses. The three external studies for validation had 1964 participants from 3 multi-ethnic Asian older adult cohorts in different settings (community-based, memory clinic, and post-stroke study). In COSMIC studies, each of CMM and depression was independently associated with cross-sectional and longitudinal cognitive function, without significant interactions between them (Ps > 0.05). Participants with both CMM and depression had lower cross-sectional cognitive performance (e.g. ß = -0.207, 95% CI = (-0.255, -0.159) for CMM5 (+)/depression (+)) and a faster rate of cognitive decline (e.g. ß = -0.040, 95% CI = (-0.047, -0.034) for CMM5 (+)/depression (+)), compared with those without either condition. These associations remained consistent after additional adjustment for APOE genotype and were robust in two-step random-effects IPD analyses. The findings regarding the joint association of CMM and depression on cognitive function were reproduced in the three external validation studies. Interpretation: Our findings highlighted the importance of investigating age-related co-morbidities in a multi-dimensional perspective. Targeting both cardiometabolic and psychological conditions to prevent cognitive decline could enhance effectiveness. Funding: Natural Science Foundation of China and National Institute on Aging/National Institutes of Health.

Toxicity potential of a pyraclostrobin-based fungicide in plant and green microalgae models.

Pyraclostrobin-based fungicides play an effective role in controlling fungal diseases and are extensively used in agriculture. However, there is concern regarding the potential adverse effects attributed to exposure to these fungicides on non-target organisms and consequent influence exerted on ecosystem functioning. Thus, it is essential to conduct studies with model organisms to determine the impacts of these fungicides on different groups of living organisms. The aim of this study was to examine the ecotoxicity associated with exposure to commercial fungicides containing pyraclostrobin. The focus of the analysis involved germination and initial development of seedlings of 4 plant models (Lactuca sativa, Raphanus sativus, Pennisetum glaucum and Triticum aestivum), in addition to determining the population growth rate and total carbohydrate content in microalga Raphidocelis subcapitata. The fungicide pyraclostrobin adversely influenced growth and development of the tested plants, indicating a toxic effect. The fungicide exerted a significant impact on the initial development of seedlings of all model species examined with T. aestivum plants displaying the greatest susceptibility to pyraclostrobin. Plants of this species exhibited inhibitory effects on both aerial parts and roots when treated with a concentration of 4.75 mg/L pyraclostrobin. In addition, the green microalga R. subcapitata was also significantly affected by the fungicide, especially at relatively high concentrations as evidenced by a reduction in total carbohydrate content. This commercial fungicide demonstrated potential phytotoxicity for the tested plant models and was also considered toxic to the selected microalgae, indicating an ecotoxic effect that might affect other organisms in aquatic environments.

Validation of secondary data sources of the retail food environment in the capital of Uruguay, an emerging Latin American country.

Secondary data sources are frequently used for characterizing physical access to food. Although several studies have reported that they tend to show a moderate agreement with field observation in WEIRD (Western Educated Industrialized Rich and Democratic) countries, little is known about their validity in non-WEIRD countries. The aim of the present research was to assess the validity of secondary data sources of the retail food environment in Montevideo, the capital of Uruguay, an emerging Latin American country. A random sample of 106 census tracts was obtained, covering 12% (62 km2) of the city's total area. Two secondary data sources were considered: administrative records and Google Maps. An aggregate database was created by manually removing duplicates. A total of 1051 unique outlets were listed in the database within the census tracts included in the sample. Field validation was performed by six teams of two observers. A total of 1200 food outlets were identified on the ground, including 463 (38.6%) outlets not listed on any database. On the contrary, 297 outlets listed in the databases (28.3%) were not found or were closed at the time of field validation. At the aggregate level, sensitivity and concordance were moderate (0.614 and 0.487, respectively), whereas positive predictive value was substantial (0.701). However, large heterogeneity in the validity of the database across census tracts was found. Sensitivity, positive predictive value, and concordance were positively associated with the socio-economic status index of the census tract. These results suggest that secondary data sources must be used with caution, particularly for the characterization of areas with low socio-economic status.

Trends in land cover and in pollen concentration of Quercus genus in Alentejo, Portugal: effects of climate change and health impacts.

Mediterranean forests dominated by Quercus species are of great ecological and economic value. The Quercus pollen season, peaking in April, varies in concentration due to geographical and climatic factors and has a remarkable allergenic potential. This study investigates Quercus trends in the Alentejo region of Portugal and examines the influence of meteorological parameters on DPC, PSD and SPIn, as well as the impact on allergic respiratory disease. The results show a progressive increase in Quercus Forest area from 1995 to 2018. Temperature and Precipitation are a key factor influencing pollen concentration, especially before peak of pollen season and prior to the pollen season. Particularly prior to the season, the precipitation of t-6 before influence, significantly, the pollen production. On the other hand, Global Srad and RH determine the beginning of the season. Using quartile-based categorization and multivariate statistical analysis, we identified years and scenarios within the IPCC projections where meteorological conditions influence may SPIn production. The study found a statistically significant correlation between high Quercus pollen concentrations in April and increased antihistamine sales. These findings are crucial for enhancing pollen forecast models and early warning systems.

Trem2-expressing multinucleated giant macrophages are a biomarker of good prognosis in head and neck squamous cell carcinoma.

Patients with head and neck squamous cell carcinomas (HNSCC) often have poor outcomes due to suboptimal risk-management and treatment strategies; yet integrating novel prognostic biomarkers into clinical practice is challenging. Here, we report the presence of multinucleated giant cells (MGC) - a type of macrophages - in tumors from patients with HNSCC, which are associated with a favorable prognosis in treatment-naive and preoperative-chemotherapy-treated patients. Importantly, MGC density increased in tumors following preoperative therapy, suggesting a role of these cells in the anti-tumoral response. To enable clinical translation of MGC density as a prognostic marker, we developed a deep-learning model to automate its quantification on routinely stained pathological whole slide images. Finally, we used spatial transcriptomic and proteomic approaches to describe the MGC-related tumor microenvironment and observed an increase in central memory CD4 T cells. We defined an MGC-specific signature resembling to TREM2-expressing mononuclear tumor associated macrophages, which co-localized in keratin tumor niches.

Impact of the improvement of living conditions on tuberculosis mortality in Brazil: an ecological study.

BACKGROUND: The risk of death due to tuberculosis (TB) in Brazil is high and strongly related to living conditions (LC). However, epidemiological studies investigating changes in LC and their impact on TB are lacking. OBJECTIVES: To evaluate the impact of LC on TB mortality in Brazil. DESIGN AND SETTING: This ecological study, using panel data on spatial and temporal aggregates, was conducted in 1,614 municipalities between 2002 and 2015. METHODS: Data were collected from the Mortality Information System and the Brazilian Institute of Geography and Statistics. The proxy variable used for LC was the Urban Health Index (UHI). Negative binomial regression models were used to estimate the effect of the UHI on TB mortality rate. Attributable risk (AR) was used as an impact measure. RESULTS: From 2002 to 2015, TB mortality rate decreased by 23.5%, and LC improved. The continuous model analysis resulted in an RR = 0.89 (95%CI = 0.82-0.96), so the AR was -12.3%. The categorized model showed an effect of 0.92 (95%CI = 0.83-0.95) in municipalities with intermediate LC and of 0.83 (95%CI = 0.82-0.91) in those with low LC, representing an AR for TB mortality of -8.7% and -20.5%, respectively. CONCLUSIONS: Improved LC impacted TB mortality, even when adjusted for other determinants. This impact was greater in the strata of low-LC municipalities.

Are vitamin D intake and serum levels in the mid-trimester of pregnancy associated with preeclampsia? Results from a Brazilian multicentre cohort.

OBJECTIVE: To explore the association between serum levels and food intake of Vitamin D (VD) among healthy women in mid-pregnancy and preeclampsia. STUDY DESIGN: In a Brazilian multicentre cohort of healthy nulliparous pregnant women from five maternity centres we developed a nested case-control analysis comparing cases with and without preeclampsia. Women were enrolled and followed during prenatal care, including only singleton pregnancies, without any fetal malformations or previous chronic maternal disease. We matched 87 cases of preeclampsia to eligible controls randomly selected in a 1:1 ratio, by age and region. MAIN OUTCOME MEASURES: Blood samples from these were collected, and a 24-hour recall of food intake was obtained in mid-pregnancy, between 19 and 21 weeks. VD serum levels (25-hydroxyvitamin D) were measured by liquid chromatography-tandem mass spectrometry and were categorized as deficient, insufficient, and sufficient. The dietary intake of VD was estimated with the 24-hour diet recall applied at the same time and from supplementation. Maternal characteristics and VD levels were compared between cases and controls with OR and respective 95 %CI. Multivariate analysis using the Path method was used to assess relationships among VD, PE, BMI, skin colour/ethnicity, and diet. RESULTS: The maternal characteristics of both groups were similar, except for the higher occurrence of obesity among women with preeclampsia (OR 3.47, 95 %CI 1.48-8.65). Dietary intake of VD was similar in both groups, and most of the women in both groups consumed insufficient VD (82.2 vs 79.3 % in the groups with and without PE). CONCLUSIONS: Levels and dietary intake of VD were not associated with PE in this Brazilian sample of healthy pregnant women; however, BMI and skin colour/ethnicity were associated with PE.

Aedes (Ochlerotatus) scapularis, Aedes japonicus japonicus, and Aedes (Fredwardsius) vittatus (Diptera: Culicidae): Three Neglected Mosquitoes with Potential Global Health Risks.

More than 3550 species of mosquitoes are known worldwide, and only a fraction is involved in the transmission of arboviruses. Mosquitoes in sylvatic and semi-sylvatic habitats may rapidly adapt to urban parks and metropolitan environments, increasing human contact. Many of these mosquitoes have been found naturally infected with arboviruses from the Alphaviridae, Flaviviridae, and Bunyaviridae families, with many being the cause of medically important diseases. However, there is a gap in knowledge about the vector status of newly invasive species and their potential threat to human and domestic animal populations. Due to their rapid distribution, adaptation to urban environments, and anthropophilic habits, some neglected mosquito species may deserve more attention regarding their role as secondary vectors. Taking these factors into account, we focus here on Aedes (Ochlerotatus) scapularis (Rondani), Aedes japonicus japonicus (Theobald), and Aedes (Fredwardsius) vittatus (Bigot) as species that have the potential to become important disease vectors. We further discuss the importance of these neglected mosquitoes and how factors such as urbanization, climate change, and globalization profoundly alter the dynamics of disease transmission and may increase the participation of neglected species in propagating diseases.

Association between Depressive Symptoms and Social Support in a Nationally Representative Sample Of Older Adults (ELSI-Brazil).

OBJECTIVE: To investigate the association between depressive symptoms and social support among a representative sample of the Brazilian population aged 50 years or older. METHODOLOGY: Cross-sectional study, based on 8,074 participants of the second wave of the Brazilian Longitudinal Study on Aging - ELSI-Brasil. Depressive symptoms were screened based on the CES-D8 instrument, and social support was investigated in its structural and functional dimensions. Sociodemographic variables and health conditions were considered for adjustment in investigating the association between social support and depressive symptoms using the Poisson regression model. RESULTS: The prevalence of depressive symptoms was estimated at 19.1% (95% CI:16.7;21.7). In the analysis adjusted for possible confounding factors, depressive symptoms were independently associated with negative social support in the items "not married" (RP=1.24; 95% CI: 1.07-1.44), "not having someone to trust" (RP=1.31; 95% CI: 1.10-1.56) and "not having someone to borrow money or an object from, in case of need" (RP=1.46; 95% CI: 1.21-1.75). CONCLUSION: The present results highlight the importance of social relations in determining the presence of depressive symptoms and reinforce the need to implement public policies aimed at strengthening social networks to minimize this public health problem.

The Influence of Thoracic Ultrasound on the Clinical Practice of Pulmonologists in Portugal.

BACKGROUND: Thoracic ultrasound (TUS) has garnered increased recognition, both in aiding pleural procedures and as a complement to physical examination. Operator ability is essential to obtain reliable findings. This study aimed to inquire pulmonology specialists and residents about their confidence with the technique and to determine future needs. METHODS: A self-administered online survey, including a total of 24 questions, was sent to pulmonology specialists and residents registered as members of the Portuguese Pulmonology Society. Participation was pseudoanonymized and voluntary. RESULTS: One hundred fourteen valid answers were obtained. Most responders had prior TUS training. The primary method for knowledge consolidation was unsupervised practice. The majority had an ultrasound machine available in their daily practice; only 17% performed TUS more than 3 times per week. Overall confidence in TUS usage for diagnostic purposes (median: 7/10), disease monitoring (median: 7/10), and invasive procedures (median: 8/10) were high. There was a significant relation between higher levels of confidence and regularly attending TUS courses and performing TUS more than 3 times per week. The main reasons cited as preventing regular use of TUS were the availability/cost of courses and the availability/cost of equipment. CONCLUSION: Regular TUS training and utilization are essential to boost user's confidence degree. Its use is already a regular feature in the daily practice of pulmonologists in Portugal, but further and better structured training is required to meet the needs of clinicians. The inclusion of mandatory TUS training in residency programs should be considered in the future.

Post-pandemic occupational medicine and telemedicine in Portugal and France: what does the future look like?

Based on personal experience over several years, we carried out a comparative analysis of two different European health systems, in Portugal and France, from a perspective comparing occupational medicine and use of telemedicine in a postpandemic context. This analysis addressed four aspects: Health System; Occupational Medicine; Telemedicine/Telework; and Future and Suggestions. The study employed searches and review of recent articles, guidelines, and recommendations from the authorities responsible for regulation (Medical Doctors Order, Labor Legislation, and Medical Collegiate Recommendations) and analysis of some statistical indicators from recent studies. Three tables on Occupational Health and Medicine present some relevant data and facilitate comparisons. Despite the difficulties of comparison, given the basic differences between these two systems (Beveridge vs. Bismark), it can be concluded that there is a greater acceptance of judicious use of teleconsultation in France (from 15 to 35%). This includes its use by occupational nurses, in the context of the "Visite de Information et Prevention", with good acceptance among employers and employees. There are still some difficulties to be resolved concerning security, conducting biometrics, and objective examinations. We expect that these issues will be overcome with improved biosensing, adequate training, and proper regulation. Given the shortage of occupational physicians and the customary overrunning of legal deadlines, we believe that these possibilities and suggestions should be explored and adopted by the specialty's Collegiates. Certain recommendations to this effect are made.

Com base na experiência pessoal de vários anos, foi realizada uma análise comparativa de dois sistemas de saúde europeus diferentes, de Portugal e da França, em uma perspectiva direcionada a uma comparação da medicina do trabalho e a utilização da telemedicina no contexto pós-pandêmico, em que ela se normalizou. Esta análise comparativa incide em quatro aspectos: sistema de saúde; medicina do trabalho; telemedicina/teletrabalho; e futuro e sugestões. Foram incluídas pesquisa e revisão documental de vários artigos recentes, normativas e recomendações das autoridades responsáveis pela tutela (Recomendações Colegiais, Ordem dos Médicos, Código do Trabalho), e foram feitas comparações de alguns indicadores estatísticos e estudos recentes. Três tabelas sobre a saúde, a medicina do trabalho e a telemedicina apresentam alguns dados relevantes e facilitam a comparação. Apesar da comparação difícil dadas as diferenças de base dos dois sistemas (modelo Beveridge versus Bismarck), parece ser possível concluir que existe uma maior abertura para a utilização criteriosa da teleconsulta na França (entre 15 e 35%), incluindo o seu uso por enfermeiras no contexto da visite d'information et de prévention, com uma boa aceitação pelos empregadores e trabalhadores. Ainda existem dificuldades por resolver, nomeadamente sobre a segurança e as dificuldades na sua utilização ou na realização da biometria ou exame objetivo. Por meio de melhorias no biosensing e de uma formação adequada, essas questões serão ultrapassadas. Dada a falta de médicos do trabalho e a habitual dilação dos prazos legais, essa possibilidade e as sugestões deveriam ser exploradas e enquadradas pelo Colégio da especialidade. Realizam-se algumas sugestões nesse sentido.

New bacterial strains for ibuprofen biodegradation: Drug removal, transformation, and potential catabolic genes.

Ibuprofen (IBU) is a significant contaminant frequently found in wastewater treatment plants due to its widespread use and limited removal during treatment processes. This leads to its discharge into the environment, causing considerable environmental concerns. The use of microorganisms has recently been recognized as a sustainable method for mitigating IBU contamination in wastewater. In this study, new bacteria capable of growing in a solid medium with IBU as the only carbon source and removing IBU from a liquid medium were isolated from environmental samples, including soil, marine, mine, and olive mill wastewater. Four bacterial strains, namely Klebsiella pneumoniae TIBU2.1, Klebsiella variicola LOIBU1.1, Pseudomonas aeruginosa LOIBU1.2, and Mycolicibacterium aubagnense HPB1.1, were identified through 16S rRNA gene sequencing. These strains demonstrated significant IBU removal efficiencies, ranging from 60 to 100% within 14 days, starting from an initial IBU concentration of 5 mg per litre. These bacteria have not been previously reported in the literature as IBU degraders, making this work a valuable contribution to further studies in the field of bioremediation in environments contaminated by IBU. Based on the IBU removal results, the most promising bacteria, K. pneumoniae TIBU2.1 and M. aubagnense HPB1.1, were selected for an in silico analysis to identify genes potentially involved in IBU biodegradation. Interestingly, in the tests with TIBU2.1, a peak of IBU transformation product(s) was detected by high-performance liquid chromatography, while in the tests with HPB1.1, it was not detected. The emerging peak was analysed by liquid chromatography-mass spectrometry, indicating the presence of possible conjugates between intermediates of IBU biodegradation. The proteins encoded on their whole-genome sequences were aligned with proteins involved in an IBU-degrading pathway reported in bacteria with respective catabolic genes. The analysis indicated that strain HPB1.1 possesses genes encoding proteins similar to most enzymes reported associated with the IBU metabolic pathways used as reference bacteria, while strain TIBU2.1 has genes encoding proteins similar to enzymes involved in both the upper and the lower part of that pathway. Notably, in the tests with the strain having more candidate genes encoding IBU-catabolic enzymes, no IBU transformation products were detected, while in the tests with the strain having fewer of these genes, detection occurred.

The Global Impact of Multisystemic Vulnerabilities on Criminal Variety: A Cross-Continental Study in Young Adults.

Previous research has shown a robust association between different childhood and adolescent vulnerabilities and youth offending. However, these investigations have primarily focused on youths from high-income Western countries. Consequently, the generalizability of these findings to better inform global justice policies remains uncertain. This study aimed to address this gap by examining the relationship between individual, familial, and contextual vulnerabilities and criminal versatility during young adulthood, accounting for sociodemographic factors and cross-national differences. Data were derived from a diverse sample of 4,182 young adults (67% female; mean age = 18.96; SD = 0.81) residing in 10 countries across 5 continents who participated in the International Study of Pro/Antisocial Behavior in Young Adults. The Psychosocial and Family Vulnerability Questionnaire and the Adverse Childhood Experiences questionnaire were used to assess social and family adversity, and past-year criminal diversity was measured with the Criminal Variety Index. Results indicate that child maltreatment, substance abuse, and delinquent peers are global risk factors for criminal variety. Moreover, they are independent across males and females and among youths living in countries that are ranked differently on the Human Development Index (HDI). In addition, some childhood vulnerabilities showed different predictive ability across sexes (e.g., school failure), and across countries ranked differently on the HDI (e.g., family dysfunction). These findings suggest that certain childhood factors contribute to criminal behavior through transcultural mechanisms. Moreover, they highlight the importance of developing evidence-based policies that focus on transcultural risk factors to globally prevent criminal behavior.

Preeclampsia in the Context of COVID-19: Mechanisms, Pathophysiology, and Clinical Outcomes.

The emergence of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to the global COVID-19 pandemic, significantly impacting the health of pregnant women. Obstetric populations, already vulnerable, face increased morbidity and mortality related to COVID-19, aggravated by preexisting comorbidities. Recent studies have shed light on the potential correlation between COVID-19 and preeclampsia (PE), a leading cause of maternal and perinatal morbidity worldwide, emphasizing the significance of exploring the relationship between these two conditions. Here, we review the pathophysiological similarities that PE shares with COVID-19, with a particular focus on severe COVID-19 cases and in PE-like syndrome cases related with SARS-CoV-2 infection. We highlight cellular and molecular mechanistic inter-connectivity between these two conditions, for example, regulation of renin-angiotensin system, tight junction and barrier integrity, and the complement system. Finally, we discuss how COVID-19 pandemic dynamics, including the emergence of variants and vaccination efforts, has shaped the clinical scenario and influenced the severity and management of both COVID-19 and PE. Continued research on the mechanisms of SARS-CoV-2 infection during pregnancy and the potential risk of developing PE from previous infections is warranted to delineate the complexities of COVID-19 and PE interactions and to improve clinical management of both conditions.

WEIRD and non-consensual food deserts and swamps: A scoping review of operational definitions.

The aim of the present study was to critically analyze operational definitions of food deserts and food swamps included in empirical studies published in peer-reviewed journals. A scoping review was conducted following the recommendations of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews. A search of the scientific literature was performed on August 2023 to identify empirical studies including operational definitions of food deserts and/or food swamps in three databases: Scopus, PubMed, and Scielo. A total of 932 scientific articles were identified in the three databases, from which 157 articles, published between 2002 and 2023, were included in the review. The included studies were mainly conducted in WEIRD (Western, Educated, Industrilaized, Rich and Democractic) countries. They presented a total of 107 operational definitions of food deserts and 30 operational definitions of food swamps. Large heterogeneity in the operational definitions of food deserts and food swamps was found. Published studies differed in all the elements of the operational definitions analyzed in the present work. Results stress the need for standardization and the development of more objective and multivariate continuous measures of physical food accessibility that reflect the complexity of modern food environments globally. A series of recommendations to advance food environment research are derived.

Prevalence of Anal Human Papillomavirus Infection and Anal High-Grade Squamous Intraepithelial Lesions Among Men Who Have Sex With Men 50 Years and Older Living With or Without HIV.

BACKGROUND: Anal cancer is caused by human papillomavirus (HPV), particularly HPV-16, and is preceded by anal high-grade squamous intraepithelial lesions (HSILs). The incidence of anal cancer is highest among men who have sex with men (MSM) living with HIV (MSMLWH) and increases with age. However, most previous studies of anal HPV infection and anal HSIL were performed on men under 50 years old, and relatively little is known about HSIL among older MSMLWH or MSM not living with HIV (MSM-Not-LWH). SETTING: We enrolled MSM who were aged 50+ during 2018-2022 in San Francisco, CA. METHODS: One hundred twenty-nine MSMLWH and 109 MSM-not-LWH participated. All participants had anal HPV DNA testing (Atila Biosystems) and high-resolution anoscopy with a biopsy of visible lesions. RESULTS: Among MSMLWH, 47% had anal HSIL, 19% had HPV-16, and 51% had other oncogenic anal HPV types (excluding HPV-16). Among MSM-not-LWH, 37% had anal HSIL, 22% had HPV-16, and 34% had other oncogenic anal HPV types. Increasing age was not statistically associated with prevalent HSIL, HPV-16, or other oncogenic HPV infections in MSMLWH or MSM-not-LWH. HPV-16 (odds ratio: 45.1, 95% confidence interval: 15.8-129); other oncogenic HPV types (odds ratio: 5.95, 95% confidence interval: 2.74-12.9) were associated with increased odds of anal HSIL, adjusted for age, income, education, and HIV status. CONCLUSION: The prevalence of oncogenic anal HPV, anal HPV-16, and anal HSIL remains very high in older MSMLWH and MSM-not-LWH. With recent evidence showing that treating anal HSIL prevents anal cancer, MSM aged 50+ should be considered for anal cancer screening.

Quality of Care Transition for COVID-19 Patients in a University Hospital in Southern Brazil.

OBJECTIVE: To assess the quality of care transition from hospital to home for COVID-19 patients. METHOD: A cross-sectional study conducted at a University Hospital in Southern Brazil, involving 78 patients discharged after COVID-19 hospitalization. Data collection was performed via telephone using the Brazilian version of the Care Transitions Measure (CTM-15). Data were analyzed using descriptive and analytical statistics. RESULTS: The mean quality of care transition was 70.8 on a scale ranging from zero to 100, indicating moderate quality of care transition. The highest score was attributed to factor 1, "Preparation for self-management," and the lowest to factor 4, "Care Plan." CONCLUSIONS: It is important to enhance communication and support provided to patients during the transition process, especially regarding understanding prescribed medications and the development of clear care plans.

Enhancing Molecular Characterization of Dissolved Organic Matter by Integrative Direct Infusion and Liquid Chromatography Nontargeted Workflows.

Dissolved organic matter (DOM) in aquatic systems is a highly heterogeneous mixture of water-soluble organic compounds, acting as a major carbon reservoir driving biogeochemical cycles. Understanding DOM molecular composition is thus of vital interest for the health assessment of aquatic ecosystems, yet its characterization poses challenges due to its complex and dynamic chemical profile. Here, we performed a comprehensive chemical analysis of DOM from highly urbanized river and seawater sources and compared it to drinking water. Extensive analyses by nontargeted direct infusion (DI) and liquid chromatography (LC) high-resolution mass spectrometry (HRMS) through Orbitrap were integrated with novel computational workflows to allow molecular- and structural-level characterization of DOM. Across all water samples, over 7000 molecular formulas were calculated using both methods (∼4200 in DI and ∼3600 in LC). While the DI approach was limited to molecular formula calculation, the downstream data processing of MS2 spectral information combining library matching and in silico predictions enabled a comprehensive structural-level characterization of 16% of the molecular space detected by LC-HRMS across all water samples. Both analytical methods proved complementary, covering a broad chemical space that includes more highly polar compounds with DI and more less polar ones with LC. The innovative integration of diverse analytical techniques and computational workflow introduces a robust and largely available framework in the field, providing a widely applicable approach that significantly contributes to understanding the complex molecular composition of DOM.