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1.
Artigo em Inglês | MEDLINE | ID: mdl-38761997

RESUMO

BACKGROUND: Rhinovirus (RV) infections trigger wheeze episodes in children. Thus, understanding of the lung inflammatory response to RV in children with wheeze is important. OBJECTIVES: This study sought to examine the associations of RV on bronchoalveolar lavage (BAL) granulocyte patterns and biomarkers of inflammation with age in children with treatment-refractory, recurrent wheeze (n = 616). METHODS: Children underwent BAL to examine viral nucleic acid sequences, bacterial cultures, granulocyte counts, and phlebotomy for both general and type-2 inflammatory markers. RESULTS: Despite the absence of cold symptoms, RV was the most common pathogen detected (30%), and when present, was accompanied by BAL granulocytosis in 75% of children. Compared to children with no BAL pathogens (n = 341), those with RV alone (n = 127) had greater (P < .05) isolated neutrophilia (43% vs 16%), mixed eosinophils and neutrophils (26% vs 11%), and less pauci-granulocytic (27% vs 61%) BAL. Children with RV alone furthermore had biomarkers of active infection with higher total blood neutrophils and serum C-reactive protein, but no differences in blood eosinophils or total IgE. With advancing age, the log odds of BAL RV alone were lower, 0.82 (5th-95th percentile CI: 0.76-0.88; P < .001), but higher, 1.58 (5th-95th percentile CI: 1.01-2.51; P = .04), with high-dose daily corticosteroid treatment. CONCLUSIONS: Children with severe recurrent wheeze often (22%) have a silent syndrome of lung RV infection with granulocytic bronchoalveolitis and elevated systemic markers of inflammation. The syndrome is less prevalent by school age and is not informed by markers of type-2 inflammation. The investigators speculate that dysregulated mucosal innate antiviral immunity is a responsible mechanism.

2.
PLoS Negl Trop Dis ; 18(5): e0012153, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38768194

RESUMO

Toxoplasma gondii is a parasitic infection that can be transmitted in utero, resulting in fetal chorioretinitis and other long-term neurological outcomes. If diagnosed early, pregnancy-safe chemotherapeutics can prevent vertical transmission. Unfortunately, diagnosis of acute, primary infection among pregnant women remains neglected, particularly in low-and-middle-income countries. Clinically actionable diagnosis is complex due to the commonality of infection during childhood and early adulthood which spawn long-last antibody titers and historically unreliable direct molecular diagnostics. The current study employed a cross-sectional T. gondii perinatal surveillance study using digital PCR, a next generation molecular diagnostic platform, and a maternal-fetal outcomes survey to ascertain the risk of vertical toxoplasmosis transmission in the Western Region of El Salvador. Of 198 enrolled mothers at the time of childbirth, 6.6% had evidence of recent T. gondii infection-85% of these cases were identified using digital PCR. Neonates born to these acutely infected mothers were significantly more likely to meconium aspiration syndrome and mothers were more likely to experience labor and delivery complications. Multivariable logistic regression found higher maternal T. gondii infection odds were associated with the presence of pet cats, the definitive T. gondii host. In closing, this study provides evidence of maternal T. gondii infection, vertical transmission and deleterious fetal outcomes in a vulnerable population near the El Salvador-Guatemala border. Further, this is the first published study to show clinical utility potential of digital PCR for accurate diagnosis of congenital toxoplasmosis cases.


Assuntos
Transmissão Vertical de Doenças Infecciosas , Reação em Cadeia da Polimerase , Toxoplasma , Toxoplasmose , Humanos , Estudos Transversais , Feminino , El Salvador/epidemiologia , Gravidez , Toxoplasma/genética , Toxoplasma/imunologia , Toxoplasma/isolamento & purificação , Adulto , Recém-Nascido , Reação em Cadeia da Polimerase/métodos , Toxoplasmose/diagnóstico , Toxoplasmose/epidemiologia , Toxoplasmose/transmissão , Toxoplasmose/parasitologia , Adulto Jovem , Gatos , Complicações Parasitárias na Gravidez/diagnóstico , Complicações Parasitárias na Gravidez/epidemiologia , Complicações Parasitárias na Gravidez/parasitologia , Animais , Toxoplasmose Congênita/diagnóstico , Toxoplasmose Congênita/epidemiologia , Masculino
3.
J Infect Dis ; 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38820088

RESUMO

BACKGROUND: The outbreak of the COVID-19 pandemic has had a profound impact on the circulation of seasonal respiratory viruses. This study aimed to compare the outcomes of SARS-CoV-2 and seasonal viruses in adults hospitalized with severe acute respiratory infection (SARI) during the COVID-19 pandemic. METHODS: This population-based cohort study included patients aged > 18 years hospitalized for SARI in Brazil between February 2020 and February 2023. The primary outcome was in-hospital mortality. A competing risk analysis was used to account for competing events. RESULTS: In total, 2,159,171 patients were included in the study. SARS-CoV-2 was the predominant virus (98.7%). The cumulative incidence of in-hospital mortality was 33.1%, 31.5%, 21.0%, 18.7%, and 18.6%, for patients positive for SARS-CoV-2, adenovirus, RSV, influenza, and other viruses, respectively. SARS-CoV-2 accounted for 99.3% of the deaths. Older age, male sex, comorbidities, hospitalization in the northern region, and oxygen saturation <95% were the common risk factors for death among all viruses. CONCLUSIONS: In this large cohort study, individuals infected with SARS-CoV-2 or adenovirus had the highest risk of mortality. Irrespective of the virus type, older age, male sex, comorbidities, hospitalization in vulnerable regions, and low oxygen saturation were associated with an increased risk of fatality.

4.
Am J Trop Med Hyg ; 110(6): 1245-1252, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38593790

RESUMO

Tick-borne disease burdens are increasing globally, impacting mostly rural and vulnerable communities. Among the most important emerging tick-borne pathogens are the Rickettsia species within the spotted fever group (SFGR) because of their genetic diversity and high lethality rate. Colombia is highly affected by SFGR despite not being reportable diseases; thus, research and clinical management are neglected. Although some departments have demonstrated high seroprevalence rates, in others, such as Boyacá Department, seroprevalence is unknown. Rickettsioses have not been described in Boyacá since 1943, and conversations with local physicians raised suspicions of recent undiagnosed disease compatible with rickettsiosis in some rural areas of the department, warranting epidemiological investigation. Using biobanked human and canine samples from a previous 2021 vector-borne disease study in Miraflores municipality, Boyacá, we had an opportunity to unearth SFGR's exposure in the region. Samples were evaluated using IgG indirect fluorescent assays against SFGR and complemented by survey questionnaires evaluating associated factors. Findings yielded first-time SFGR serological evidence in Boyacá with a 26.5% seroprevalence among dogs and a 20.4% among humans. Human and dog seroprevalences were positively associated, suggesting the presence of domestic transmission. Owning a greater number of domestic animals (prevalence ratio adjusted for all measured factors [aPR], 1.52) and living near crop fields (aPR, 7.77) were associated with an increased likelihood of household seropositivity. Our findings are consistent with the literature in Colombia, uncovering a suspected region where the disease is endemic. Future studies are warranted to continue defining high-risk areas to determine public health intervention plans.


Assuntos
Anticorpos Antibacterianos , Doenças do Cão , Rickettsia , Rickettsiose do Grupo da Febre Maculosa , Cães , Animais , Estudos Soroepidemiológicos , Humanos , Colômbia/epidemiologia , Estudos Transversais , Doenças do Cão/epidemiologia , Doenças do Cão/microbiologia , Masculino , Feminino , Adulto , Anticorpos Antibacterianos/sangue , Rickettsiose do Grupo da Febre Maculosa/epidemiologia , Rickettsiose do Grupo da Febre Maculosa/microbiologia , Pessoa de Meia-Idade , Rickettsia/imunologia , Adolescente , Adulto Jovem , Idoso , Criança , Imunoglobulina G/sangue
5.
Am J Epidemiol ; 2024 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-38576197

RESUMO

Person-generated health data (PGHD) are valuable to study outcomes relevant to everyday living, to obtain information not otherwise available, for long-term follow-up and in situations where decisions cannot wait for traditional clinical research to be completed. While there is no dispute that these data are subject to bias, insights gained may be better than an information void, provided the biases are understood and acknowledged. People will share information known uniquely to them about exposures that may affect drug tolerance, safety and effectiveness, e.g., using non-prescription and complementary medications, alcohol, tobacco, illicit drugs, exercise, etc. Patients may be the best source of safety information when long-term follow-up is needed, e.g., the 5-15-year follow-up required for some gene therapies. Validation studies must be performed to evaluate what people can accurately report and when supplementary confirmation information is needed. But PGHD has already proven valuable in quantifying and contrasting COVID-19 vaccine benefits and risks, and for evaluating disease transmission and the accuracy of COVID-19 testing. Going forward, PGHD will be used for patient-measured and patient-relevant outcomes, including regulatory purposes, and will be linked to broader health data networks using tokenization, becoming a mainstay for signals about risks and benefits for diverse populations.

6.
Matern Health Neonatol Perinatol ; 10(1): 7, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38561854

RESUMO

BACKGROUND: Despite maternal flavivirus infections' linkage to severe maternal and fetal outcomes, surveillance during pregnancy remains limited globally. Further complicating maternal screening for these potentially teratogenic pathogens is the overwhelming subclinical nature of acute infection. This study aimed to understand perinatal and neonatal risk for poor health outcomes associated with flaviviral infection during pregnancy in El Salvador. METHODS: Banked serologic samples and clinical results obtained from women presenting for labor and delivery at a national referent hospital in western El Salvador March to September 2022 were used for this study. 198 samples were screened for dengue and Zika virus IgM, and statistical analyses analyzed demographic and clinical outcome associations with IgM positivity. RESULTS: This serosurvey revealed a high rate of maternal flavivirus infection-24.2% of women presenting for labor and delivery were dengue or Zika virus IgM positive, suggesting potential infection within pregnancy. Specifically, 20.2% were Zika virus IgM positive, 1.5% were dengue virus IgM positive, and 2.5% were both dengue and Zika virus IgM positive. Women whose home had received mosquito abatement assistance within the last year by the ministry of health were 70% less likely to test IgM positive (aOR = 0.30, 95%CI: 0.10, 0.83). Further, statistical geospatial clustering revealed transmission foci in six primary municipalities. Pregnancy complications and poor birth outcomes were noted among the dengue and/or Zika virus maternal infection group, although these outcomes were not statistically different than the seronegative group. None of the resulting neonates born during this study were diagnosed with congenital Zika syndrome. CONCLUSIONS: The high rate of Zika virus detected among pregnant women and the lack of Zika-specific neonatal outcomes monitoring during a non-outbreak year highlights the need for continued surveillance in Central America and among immigrant mothers presenting for childbirth from these countries. As changing climatic conditions continue to expand the range of the disease vector, asymptomatic screening programs could be vital to early identification of outbreaks and clinical management of cases.

8.
Insects ; 15(3)2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38535366

RESUMO

Spotted fever group Rickettsia spp. (SFGR) are a large group of tick-borne bacteria causing important emerging and re-emerging diseases that affect animals and humans. While SFGR are found worldwide, a lack of surveillance and misdiagnosis particularly affect South American countries. Colombia is a high burdened country in South America, yet rickettsioses are not deemed a nationally reportable condition limiting disease-specific public health resources. As mortality rates are high for one Rickettsia pathogen species, there is a great need to better understand the epidemiological and ecological factors that increase SFGR transmission risk regionally. This literature review provides an overview of Colombia-based SFGR studies connecting knowledge about both vectors and hosts.

9.
Artigo em Inglês | MEDLINE | ID: mdl-38358908

RESUMO

PURPOSE: Laser-created titanium surface topographies enhance soft tissue attachment and implant stability. However, knowledge about the underlying mechanisms governing the tissue-level reaction is lacking. The objective of this study was to examine the behavior and function of human gingival fibroblasts growing on healing abutments with or without laser-textured topography. MATERIALS AND METHODS: Human primary gingival connective tissue fibroblasts were cultured on healing abutments with machined or laser-textured (Laser-Lok, BioHorizons) surfaces. Cellular and molecular responses were evaluated by cell density assay (WST-1), fluorescence microscopy, qRT-PCR, and detachment test. RESULTS: The machined surface showed mono-directional traces and scratches from milling, whereas the laser-textured surface showed a distinct morphology consisting of mono-directional meso-scale channels (15 µm pitch) and woven, oblique micro-ridges formed within the channel. There were no differences in initial fibroblast attachment, subsequent fibroblast proliferation, nor collagen production between the machined and laser-textured surfaces. Fibroblasts growing on laser-textured surface spread mono-directionally along the meso-channels, while cells growing on machined surfaces spread randomly. Fibroblasts on laser-textured surfaces were 1.8-times more resistant to detachment than those on machined surfaces. An adhesive glycoprotein (fibronectin) and trans-membrane adhesion linker gene (integrin beta-1) were upregulated on laser-textured surfaces. CONCLUSIONS: The increased fibroblast retention, uniform growth, increased transcription of cell adhesion proteins compellingly explain the enhanced tissue-level response to laser-created, hybrid textured titanium surfaces. These results provide a cellular and molecular rationale for the tissue reaction to this unique surface and support its extended use from implant fixtures and healing abutments to diverse prosthetic components where enhanced soft tissue responses would be desirable.

10.
Medicine (Baltimore) ; 103(7): e37155, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38363916

RESUMO

Depression is a public mental health problem that can progress to suicidal ideation, literature suggests regular physical activity may ameliorate it. The study assessed the link between physical activity and depression symptoms during the fifth wave of the COVID-19 pandemic and the Academic Staff Union (ASU) strike among undergraduates. Four hundred and eighteen undergraduates were recruited and participated in the study. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and Patient Health Questionnaire-9 (PHQ-9) to measure depression severity. The result on PA showed that about one-third of the participants were inactive, above half were moderately active, while a few achieved high PA levels. Above one-fifth of the participants experienced minimal or no depression while a good percent had mild, moderate, moderately severe, and severe depression. Non-parametric tests between PA total score and depression total score with demographic variables were not significant. Spearman's correlation showed a strong negative relationship between PHQ-9 scores and IPAQ-SF scores. This suggests that a high PA level is associated with lower depression symptoms. The COVID-19 pandemic and the ASU strike experiences resulted in increased depression among undergraduates. The university administration needs to formulate an urgent policy to promote PA among undergraduates and provide treatment for the affected students.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Depressão/epidemiologia , Pandemias/prevenção & controle , Política Pública , Exercício Físico
11.
Parasit Vectors ; 17(1): 33, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38273414

RESUMO

BACKGROUND: Spotted fever group Rickettsia (SFGR) is the largest group of Rickettsia species of clinical and veterinary importance emerging worldwide. Historically, SFGR cases were linked to Rickettsia rickettsii, the causal agent of Rocky Mountain spotted fever; however, recently discovered species Rickettsia parkeri and Rickettsia amblyommatis have been shown to cause a wide range of clinical symptoms. The role of R. amblyommatis in SFGR eco-epidemiology and the possible public health implications remain unknown. METHODS: This study evaluated statewide tick surveillance and land-use classification data to define the eco-epidemiological relationships between R. amblyommatis and R. parkeri among questing and feeding ticks collected across South Carolina between 2021 and 2022. Questing ticks from state parks and feeding ticks from animal shelters were evaluated for R. parkeri and R. amblyommatis using reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) on pooled samples. A Bayesian multivariable logistic regression model for pool testing data was used to assess associations between R. parkeri or R. amblyommatis infection and land-use classification variables among questing ticks. The Spearman correlation was used to evaluate the relationship between the two tested pathogens. RESULTS: The infection prevalence for R. amblyommatis was 24.8% (23.4-26.3%) among questing ticks, and 39.5% (37.4-42.0%) among feeding ticks; conversely, for R. parkeri it was 19.0% (17.6-20.5%) among questing ticks and 22.4% (20.3-24.5%) among feeding ticks. A negative, refractory correlation was found between the species, with ticks significantly more likely to contain one or the other pathogen, but not both simultaneously. The Bayesian analysis revealed that R. amblyommatis infection was positively associated with deciduous, evergreen, and mixed forests, and negatively associated with hay and pasture fields, and emergent herbaceous wetlands. Rickettsia parkeri infection was positively associated with deciduous, mixed, and evergreen forests, herbaceous vegetation, cultivated cropland, woody wetlands, and emergent herbaceous wetlands, and negatively associated with hay and pasture fields. CONCLUSIONS: This is the first study to evaluate the eco-epidemiological factors driving tick pathogenicity in South Carolina. The negative interactions between SFGR species suggest the possible inhibition between the two pathogens tested, which could have important public health implications. Moreover, land-use classification factors revealed environments associated with tick pathogenicity, highlighting the need for tick vector control in these areas.


Assuntos
Ácaros e Carrapatos , Ixodidae , Infecções por Rickettsia , Rickettsia , Carrapatos , Animais , Carrapatos/microbiologia , South Carolina/epidemiologia , Teorema de Bayes , Infecções por Rickettsia/epidemiologia , Infecções por Rickettsia/microbiologia , Ixodidae/microbiologia
12.
Colorectal Dis ; 26(3): 417-427, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38247282

RESUMO

AIM: Sacral neuromodulation (SNM) is a minimally invasive treatment option for functional constipation. Evidence regarding its effectiveness is contradictory, driven by heterogeneous study populations and designs. The aim of this study was to assess the effectiveness, safety and cost-effectiveness of SNM in children and adults with refractory idiopathic slow-transit constipation (STC). METHOD: OVID Medline, OVID Embase, Cochrane Library, the KSR Evidence Database, the NHS Economic Evaluation Database and the International HTA Database were searched up to 25 May 2023. For effectiveness outcomes, randomized controlled trials (RCTs) were selected. For safety outcomes, all study designs were selected. For cost-effectiveness outcomes, trial- and model-based economic evaluations were selected for review. Study selection, risk of bias and quality assessment, and data extraction were independently performed by two reviewers. For the intervention 'sacral neuromodulation' effectiveness outcomes included defaecation frequency and constipation severity. Safety and cost-effectiveness outcomes were, respectively, adverse events and incremental cost-effectiveness ratios. RESULTS: Of 1390 records reviewed, 67 studies were selected for full-text screening. For effectiveness, one cross-over and one parallel-group RCT was included, showing contradictory results. Eleven studies on safety were included (four RCTs, three prospective cohort studies and four retrospective cohort studies). Overall infection rates varied between 0% and 22%, whereas reoperation rates varied between 0% and 29%. One trial-based economic evaluation was included, which concluded that SNM was not cost-effective compared with personalized conservative treatment at a time horizon of 6 months. The review findings are limited by the small number of available studies and the heterogeneity in terms of study populations, definitions of refractory idiopathic STC and study designs. CONCLUSION: Evidence for the (cost-)effectiveness of SNM in children and adults with refractory idiopathic STC is inconclusive. Reoperation rates of up to 29% were reported.


Assuntos
Constipação Intestinal , Terapia por Estimulação Elétrica , Adulto , Criança , Humanos , Análise Custo-Benefício , Sacro , Projetos de Pesquisa , Terapia por Estimulação Elétrica/efeitos adversos , Terapia por Estimulação Elétrica/métodos
13.
J Proteome Res ; 23(2): 834-843, 2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38252705

RESUMO

In shotgun proteomics, the proteome search engine analyzes mass spectra obtained by experiments, and then a peptide-spectra match (PSM) is reported for each spectrum. However, most of the PSMs identified are incorrect, and therefore various postprocessing software have been developed for reranking the peptide identifications. Yet these methods suffer from issues such as dependency on distribution, reliance on shallow models, and limited effectiveness. In this work, we propose AttnPep, a deep learning model for rescoring PSM scores that utilizes the Self-Attention module. This module helps the neural network focus on features relevant to the classification of PSMs and ignore irrelevant features. This allows AttnPep to analyze the output of different search engines and improve PSM discrimination accuracy. We considered a PSM to be correct if it achieves a q-value <0.01 and compared AttnPep with existing mainstream software PeptideProphet, Percolator, and proteoTorch. The results indicated that AttnPep found an average increase in correct PSMs of 9.29% relative to the other methods. Additionally, AttnPep was able to better distinguish between correct and incorrect PSMs and found more synthetic peptides in the complex SWATH data set.


Assuntos
Algoritmos , Aprendizado Profundo , Proteômica/métodos , Espectrometria de Massas em Tandem/métodos , Peptídeos , Software , Bases de Dados de Proteínas
14.
ACS Appl Mater Interfaces ; 16(2): 2180-2192, 2024 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-38174907

RESUMO

Significant interest in the electrocatalytic reduction of molecular nitrogen to ammonia (the nitrogen reduction reaction: NRR) has focused attention on transition metal carbides as possible electrocatalysts. However, a fundamental understanding of carbide surface structure/NRR reactivity relationships is sparse. Herein, electrochemistry, DFT-based calculations, and in situ photoemission studies demonstrate that NbC, deposited by magnetron sputter deposition, is active for NRR at pH 3.2 but only after immersion of an ambient-induced Nb2O5 surface layer in 0.3 M NaOH, which leaves Nb suboxides with niobium in intermediate formal oxidation states. Photoemission data, however, show that polarization to -1.3 V vs Ag/AgCl restores the Nb2O5 overlayer, correlating with electrochemical measurements showing inhibition of NRR activity under these conditions. In contrast, a similar treatment of a sputter-deposited TaC sample in 0.3 M NaOH fails to reduce the ambient-induced Ta2O5 surface layer, and TaC is inactive for NRR at potentials more positive than -1.0 V even though a significant cathodic current is observed. A TaC sample with surface oxide partially reduced by Ar ion sputtering in UHV prior to in situ transfer to UHV exhibits a restored Ta2O5 surface layer after electrochemical polarization to -1.0 V vs Ag/AgCl. The electrochemical and photoemission results are in accord with DFT-based calculations indicating greater N≡N bond activation for N2 bound end-on to Nb(IV) and Nb(III) sites than for N2 bound end-on to Nb(V) sites. Thus, theory and experiment demonstrate that with respect to NbC, the formation and stabilization of intermediate (non-d0) oxidation states for surface transition metal ions is critical for N≡N bond activation and NRR activity. Additionally, the Nb suboxide surface, formed by immersion in 0.3 M NaOH of ambient-exposed NbC, is shown to undergo reoxidation to catalytically inactive Nb2O5 at -1.3 V vs Ag/AgCl, possibly due to hydrolysis or other, as yet not understood, phenomena.

15.
Pediatrics ; 153(2)2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38213278

RESUMO

BACKGROUND AND OBJECTIVES: Understanding how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interacts with other respiratory viruses is crucial for developing effective public health strategies in the postpandemic era. This study aimed to compare the outcomes of SARS-CoV-2 and seasonal viruses in children and adolescents hospitalized with severe acute respiratory infection (SARI). METHODS: This population-based, retrospective cohort study included children and adolescents hospitalized with SARI from February 2020 to February 2023 in Brazil. The main exposure of interest was viral etiology. The primary outcome was in-hospital mortality. Competing risk analysis was used to account for time dependency and competing events. RESULTS: A total of 235 829 patients had available results of the viral tests, with SARS-CoV-2 predominance. According to the competing-risk survival analysis, the estimated probability of a fatal outcome at 30 days of hospitalization according to the viral strain was 6.5%, 3.4%, 2.9%, 2.3%, 2.1%, and 1.8%, for SARS-CoV-2, coinfection, adenovirus, influenza, other viruses, and respiratory syncytial virus, respectively. Individuals with a positive test for SARS-CoV-2 had hazard of death 3 times higher than subjects with a negative test (hazard ratio, 3.3; 95% confidence interval, 3.1-3.5). After adjustment by the competing-risk multivariable analysis, admission in Northeast and North regions, oxygen saturation <95%, and the presence of comorbidities were risk factors for death in all viral strains. CONCLUSIONS: SARS-CoV-2 infection had the highest hazard of in-hospital mortality in this pediatric cohort hospitalized with SARI. Regardless of viral etiology, the presence of underlying medical conditions was a risk factor for death.


Assuntos
COVID-19 , Influenza Humana , Vírus , Adolescente , Humanos , Criança , SARS-CoV-2 , Brasil/epidemiologia , Estudos Retrospectivos , Estações do Ano
16.
Ann Surg ; 279(5): 746-754, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-37991178

RESUMO

OBJECTIVE: Assess the effectiveness of sacral neuromodulation (SNM) versus personalized conservative treatment (PCT) in patients with refractory idiopathic slow-transit constipation (STC). BACKGROUND: Evidence on SNM for idiopathic STC is conflicting and of suboptimal methodological quality. METHODS: The No.2-Trial was a multicenter, open-label, pragmatic, randomized trial performed in 2 Dutch hospitals. Sixty-seven patients with idiopathic STC, a defecation frequency <3 per week and refractory (ie, unresponsive) to maximal conservative (nonoperative) treatment were included. Exclusion criteria included outlet obstruction, rectal prolapse, and previous colon surgery. Patients were randomized (3:2) to SNM (n=41) or PCT (n=26) with randomization minimization between February 21, 2017 and March 12, 2020. In SNM patients, an implantable pulse generator was implanted after a successful 4-week test stimulation. PCT patients received conservative treatment such as laxatives or retrograde colonic irrigation. The primary outcome was treatment success (defined as average defecation frequency ≥3 per week) after 6 months. Secondary outcomes included constipation severity, fatigue, quality of life, and adverse events. Analysis was according to intention-to-treat. RESULTS: After 6 months, 22 (53.7%) patients were successfully treated with SNM versus 1 (3.8%) patient with PCT (odds ratio 36.4, 95% CI 3.4-387.5, P =0.003). At 6 months, SNM patients reported lower constipation severity and fatigue scores ( P <0.001) and improved quality of life compared with PCT ( P <0.001). Eight serious adverse events (6 SNM, 2 PCT) and 78 adverse events (68 SNM, 10 PCT) were reported. CONCLUSIONS: SNM is a promising surgical treatment option in a homogeneous group of adults and adolescents with refractory idiopathic STC. No.2-Trial registered at ClinicalTrials.gov NCT02961582.


Assuntos
Tratamento Conservador , Terapia por Estimulação Elétrica , Adulto , Adolescente , Humanos , Qualidade de Vida , Constipação Intestinal/terapia , Terapia por Estimulação Elétrica/efeitos adversos , Resultado do Tratamento
17.
Ticks Tick Borne Dis ; 15(2): 102288, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38071922

RESUMO

Illness caused by spotted fever group Rickettsia (SFGR) is increasing nationally, with affluent, white residents most likely to be diagnosed. The common under-representativeness of marginalized populations in research studies and these vulnerable populations' health inequities make veritable epidemiologic risk factor profiling challenging, which inhibits equitable public health intervention. The current study leveraged 749 banked sera and associated surveys from a cross-sectional minority-represented COVID-19 study to perform an SFGR seroprevalence investigation. SFGR titers (1:64, 1:128, 1:256, 1:512, and 1:1024) were measured using commercially available indirect fluorescent antibody slides-SFGR positive cases were defined as titers ≥1:128. Multivariable logistic regression and Getis-Ord-Gi* hotspot analyses were used to identify seropositivity-associated factors and determine seropositive clusters. Among a mostly minority and lower socioeconomic population, a 3.4 % SFGR seropositivity was noted at the ≥1:128 titer level. Male gender (Odds Ratio (OR): 3.20; adjusted Odds Ratio (aOR)s: 3.73), age (aOR: 1.05), any frequency of tick bite (OR: 2.29), and spending time working outdoors (OR: 5.05) were associated with SFGR IgG seropositivity. Moreover, the geospatial analysis showed clusters of seropositivity in areas where previous case reports occurred, suggesting potential endemic foci.


Assuntos
Rickettsia , Rickettsiose do Grupo da Febre Maculosa , Humanos , Masculino , Animais , South Carolina , Estudos Soroepidemiológicos , Estudos Transversais , Fatores Epidemiológicos , Rickettsiose do Grupo da Febre Maculosa/microbiologia
18.
Comput Biol Med ; 168: 107793, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38048661

RESUMO

As a prevalent RNA modification, 5-methyluridine (m5U) plays a critical role in diverse biological processes and disease pathogenesis. High-throughput identification of m5U typically relies on labor-intensive biochemical experiments using various sequencing-based techniques, which are not only time-consuming but also expensive. Consequently, there is a pressing need for more efficient and cost-effective computational methods to complement these high-throughput techniques. In this study, we present m5UMCB, a novel approach that harnesses a multi-scale convolutional neural network (CNN) in tandem with bidirectional long short-term memory (BiLSTM) to recognize m5U sites. Our method involves segmenting RNA sequences into smaller fragments based on a 3-mer length and subsequently mapping each fragment to a lower-dimensional vector representation using the global vectors for word representation (GloVe) technique. Through a series of multi-scale convolution and pooling operations, local features are extracted from RNA sequences and transformed into abstract, high-level features. The feature matrix is then inputted into a BiLSTM network, enabling the capture of contextual information and long-term dependencies within the sequence. Ultimately, a fully connected layer is employed to classify m5U sites. The validation results from 5-fold cross-validation (5-fold CV) test indicate that m5UMCB outperforms existing state-of-the-art predictive methods, demonstrating a 1.98% increase in the area under ROC curve (AUC) and significant improvements in relevant evaluation metrics. We are confident that m5UMCB will serve as a valuable tool for m5U prediction.


Assuntos
Redes Neurais de Computação , RNA , RNA/metabolismo , Uridina , Ligação Proteica
19.
Environ Monit Assess ; 196(1): 30, 2023 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-38072841

RESUMO

The occurrence of pathogens in discharged wastewater effluent may constitute potential public health risks. This study assessed the physicochemical and bacteriological characteristics of water samples taken from the Wupa River in Abuja, Nigeria, which receives the final effluent of the Wupa Wastewater Treatment Plant. Sixty sewage/water samples were collected over 12 months from five sampling points. Coliform bacteria and Escherichia coli were simultaneously enumerated using the membrane filtration technique and Chromocult Coliform Agar. HANNA multiparameter metre was used to measure the physicochemical parameters including temperature, pH, electrical conductivity (EC), dissolved oxygen (DO) and total dissolved solids (TDS). Results of the bacteriological analysis showed that impermissible high mean counts of E. coli (≥ 1.2 × 104 CFU/100 ml) and total coliforms (≥ 5.4 × 104 CFU/100 ml) were detected in 95% and 100% of the water samples respectively. These values exceed the acceptable standard limits. The mean values of physicochemical parameters ranged from 6.3 to 8.7, 20.9 to 27.3 °C, 116 to 325.0 µS/cm, 1.3 to 11.4 mg/l and 98.0 to 180.0 mg/l for pH, temperature, EC, DO and TDS respectively, with all conforming to international and national standards. Wupa River seems to have a minor negative environmental impact, per the physicochemical data obtained in this study. However, the high counts of faecal indicator bacteria demonstrated in the effluent samples were higher than those of the river at both upstream and downstream sites, implying that the river microbial load may increase to constitute an unchecked environmental hazard. Adequate disinfection of the Wupa plant effluent before discharge into the Wupa River is imperative.


Assuntos
Monitoramento Ambiental , Purificação da Água , Monitoramento Ambiental/métodos , Escherichia coli , Nigéria , Rios/química , Água
20.
Artigo em Inglês | MEDLINE | ID: mdl-37681764

RESUMO

We investigated the association between discrimination, neighborhood unsafety, and household food insecurity (FI) among Nigerian adults, as well as the gender-specific differences in these associations. Our analysis utilized data from the 2021 Multiple Indicator Cluster Survey (MICS), comprising 56,146 Nigerian adults aged 15-49 (17,346 males and 38,800 females). For bivariate analysis, we employed the Rao-Scott chi-square test to examine the relationship between predictors (discrimination, neighborhood unsafety, and a composite variable of both) and the outcome variable (FI). Food insecurity was assessed using both a dichotomous measure (food insecure vs. food secure) and a multinomial variable (food secure, mild FI, moderate FI, and severe FI). To model the association between predictors and FI while controlling for potential confounding factors, we utilized weighted binary and multinomial logistic regression. Among Nigerian adults, the prevalence of having ever experienced FI was 86.1%, with the prevalence of mild FI, moderate FI, and severe FI being 11.5%, 30.1%, and 44.5%, respectively. In the binary model, experiencing discrimination (OR = 1.36, 95% CI = 1.19-1.55), living in an unsafe neighborhood (OR = 1.33, 95% CI = 1.14-1.54), and facing both discrimination and unsafe neighborhood conditions (OR = 1.97, 95% CI = 1.57-2.48) were significantly associated with FI. In the multinomial model, discrimination, neighborhood unsafety, and experiencing both remained associated with moderate and severe FI. In the gender-specific models, discrimination and neighborhood unsafety were found to be significantly associated with FI in women but not in men. This study underscores the importance of implementing policies and programs that address the underlying causes of food insecurity, with specific attention to discrimination and neighborhood safety concerns, particularly for Nigerian women.


Assuntos
População Negra , Insegurança Alimentar , Alimentos , Características da Vizinhança , Determinantes Sociais da Saúde , Discriminação Social , Adulto , Feminino , Humanos , Masculino , Correlação de Dados , Alimentos/estatística & dados numéricos , Políticas , Características da Vizinhança/estatística & dados numéricos , Discriminação Social/estatística & dados numéricos , Determinantes Sociais da Saúde/estatística & dados numéricos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Nigéria/epidemiologia
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