Disease Prevention Interventions Research Articles

Women's perspectives on mHealth behavior change interventions for the management of overweight, obesity, or gestational diabetes: A qualitative meta-synthesis.

mHealth interventions play an increasingly important role in health behavior change for gestational diabetes or peripartum obesity management. This qualitative systematic review and meta-synthesis aims to explore women's perceptions of mHealth behavior change interventions for gestational diabetes and/or overweight/obesity management during pregnancy and the postpartum period. Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, Excerpta Medica Database (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), and Psychological Information Database (PsycINFO) databases were searched using a Sample, Phenomenon of Interest, Design, Evaluation and Research type (SPIDER) concept framework through to February 2024. Included studies were quality assessed using the Critical Appraisal Skills Programme checklist. Study findings were evaluated using reflexive thematic analysis and GRADE-Confidence in the Evidence from Reviews of Qualitative Research (CERQual) checklist. We identified 29 studies, representing 604 women's views from one upper middle-income and nine high-income countries. Two themes were generated: mHealth as a supportive tool; and mHealth as a personalizable tool. Women highlighted the importance of self-monitoring, information trustworthiness, peer support, motivational tools (goal setting, risk awareness, and problem solving) and convenience in achieving behavior change using mHealth technology. They suggest mHealth programs incorporate these elements to support user engagement and improved health outcomes. Understanding what women want as mHealth users is particularly important for effective interventions in gestational diabetes, weight management, and chronic disease prevention. Creating a better, more woman-centered experience by addressing central engagement issues should result in improved maternal health outcomes.

A systematic review to determine the effect of strategies to sustain chronic disease prevention interventions in clinical and community settings: study protocol

BackgroundThe primary purpose of this review is to synthesise the effect of strategies aiming to sustain the implementation of evidenced-based interventions (EBIs) targeting key health behaviours associated with chronic disease (i.e. physical inactivity, poor diet, harmful alcohol use, and tobacco smoking) in clinical and community settings. The field of implementation science is bereft of an evidence base of effective sustainment strategies, and as such, this review will provide important evidence to advance the field of sustainability research.MethodsThis systematic review protocol is reported in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) checklist. Methods will follow Cochrane gold-standard review methodology. The search will be undertaken across multiple databases, adapting filters previously developed by the research team, data screening and extraction will be performed in duplicate, strategies will be coded using an adapted sustainability-explicit taxonomy, and evidence will be synthesised using appropriate methods (i.e. meta-analytic following Cochrane or non-meta-analytic following SWiM guidelines). We will include any randomised controlled study that targets any staff or volunteers delivering interventions in clinical or community settings. Studies which report on any objective or subjective measure of the sustainment of a health prevention policy, practice, or programme within any of the eligible settings will be included. Article screening, data extraction, risk of bias, and quality assessment will be performed independently by two review authors. Risk of bias will be assessed using Version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2). A random-effect meta-analysis will be conducted to estimate the pooled effect of sustainment strategies separately by setting (i.e. clinical and community). Sub-group analyses will be undertaken to explore possible causes of statistical heterogeneity and may include the following: time period, single or multi-strategy, type of setting, and type of intervention. Differences between sub-groups will be statistically compared.Discussion/conclusionThis will be the first systematic review to determine the effect of strategies designed to support sustainment on sustaining the implementation of EBIs in clinical and community settings. The findings of this review will directly inform the design of future sustainability-focused implementation trials. Further, these findings will inform the development of a sustainability practice guide for public health practitioners.Systematic review registrationPROSPERO CRD42022352333.

A community health worker led approach to cardiovascular disease prevention in the UK-SPICES-Sussex (scaling-up packages of interventions for cardiovascular disease prevention in selected sites in Europe and Sub-saharan Africa): an implementation research project.

This paper describes a UK-based study, SPICES-Sussex, which aimed to co-produce and implement a community-based cardiovascular disease (CVD) risk assessment and reduction intervention to support under-served populations at moderate risk of CVD. The objectives were to enhance stakeholder engagement; to implement the intervention in four research sites and to evaluate the use of Voluntary and Community and Social Enterprises (VCSE) and Community Health Worker (CHW) partnerships in health interventions. A type three hybrid implementation study design was used with mixed methods data. This paper represents the process evaluation of the implementation of the SPICES-Sussex Project. The evaluation was conducted using the RE-AIM framework. Reach: 381 individuals took part in the risk profiling questionnaire and forty-one women, and five men participated in the coaching intervention. Effectiveness: quantitative results from intervention participants showed significant improvements in CVD behavioural risk factors across several measures. Qualitative data indicated high acceptability, with the holistic, personalised, and person-centred approach being valued by participants. Adoption: 50% of VCSEs approached took part in the SPICES programme, The CHWs felt empowered to deliver high-quality and mutually beneficial coaching within a strong project infrastructure that made use of VCSE partnerships. Implementation: Co-design meetings resulted in local adaptations being made to the intervention. 29 (63%) of participants completed the intervention. Practical issues concerned how to embed CHWs in a health service context, how to keep engaging participants, and tensions between research integrity and the needs and expectations of those in the voluntary sector. Maintenance: Several VCSEs expressed an interest in continuing the intervention after the end of the SPICES programme. Community-engagement approaches have the potential to have positively impact the health and wellbeing of certain groups. Furthermore, VCSEs and CHWs represent a significant untapped resource in the UK. However, more work needs to be done to understand how links between the sectors can be bridged to deliver evidence-based effective alternative preventative healthcare. Reaching vulnerable populations remains a challenge despite partnerships with VCSEs which are embedded in the community. By showing what went well and what did not, this project can guide future work in community engagement for health.

Adaptation and qualitative evaluation of the BETTER intervention for chronic disease prevention and screening by public health nurses in low income neighbourhoods: views of community residents

BackgroundThe BETTER intervention is an effective comprehensive evidence-based program for chronic disease prevention and screening (CDPS) delivered by trained prevention practitioners (PPs), a new role in primary care. An adapted program, BETTER HEALTH, delivered by public health nurses as PPs for community residents in low income neighbourhoods, was recently shown to be effective in improving CDPS actions. To obtain a nuanced understanding about the CDPS needs of community residents and how the BETTER HEALTH intervention was perceived by residents, we studied how the intervention was adapted to a public health setting then conducted a post-visit qualitative evaluation by community residents through focus groups and interviews.MethodsWe first used the ADAPT-ITT model to adapt BETTER for a public health setting in Ontario, Canada. For the post-PP visit qualitative evaluation, we asked community residents who had received a PP visit, about steps they had taken to improve their physical and mental health and the BETTER HEALTH intervention. For both phases, we conducted focus groups and interviews; transcripts were analyzed using the constant comparative method.ResultsThirty-eight community residents participated in either adaptation (n = 14, 64% female; average age 54 y) or evaluation (n = 24, 83% female; average age 60 y) phases. In both adaptation and evaluation, residents described significant challenges including poverty, social isolation, and daily stress, making chronic disease prevention a lower priority. Adaptation results indicated that residents valued learning about CDPS and would attend a confidential visit with a public health nurse who was viewed as trustworthy. Despite challenges, many recipients of BETTER HEALTH perceived they had achieved at least one personal CDPS goal post PP visit. Residents described key relational aspects of the visit including feeling valued, listened to and being understood by the PP. The PPs also provided practical suggestions to overcome barriers to meeting prevention goals.ConclusionsResidents living in low income neighbourhoods faced daily stress that reduced their capacity to make preventive lifestyle changes. Key adapted features of BETTER HEALTH such as public health nurses as PPs were highly supported by residents. The intervention was perceived valuable for the community by providing access to disease prevention.Trial registration#NCT03052959, 10/02/2017.

Adapting transformer-based language models for heart disease detection and risk factors extraction

Efficiently treating cardiac patients before the onset of a heart attack relies on the precise prediction of heart disease. Identifying and detecting the risk factors for heart disease such as diabetes mellitus, Coronary Artery Disease (CAD), hyperlipidemia, hypertension, smoking, familial CAD history, obesity, and medications is critical for developing effective preventative and management measures. Although Electronic Health Records (EHRs) have emerged as valuable resources for identifying these risk factors, their unstructured format poses challenges for cardiologists in retrieving relevant information. This research proposed employing transfer learning techniques to automatically extract heart disease risk factors from EHRs. Leveraging transfer learning, a deep learning technique has demonstrated a significant performance in various clinical natural language processing (NLP) applications, particularly in heart disease risk prediction. This study explored the application of transformer-based language models, specifically utilizing pre-trained architectures like BERT (Bidirectional Encoder Representations from Transformers), RoBERTa, BioClinicalBERT, XLNet, and BioBERT for heart disease detection and extraction of related risk factors from clinical notes, using the i2b2 dataset. These transformer models are pre-trained on an extensive corpus of medical literature and clinical records to gain a deep understanding of contextualized language representations. Adapted models are then fine-tuned using annotated datasets specific to heart disease, such as the i2b2 dataset, enabling them to learn patterns and relationships within the domain. These models have demonstrated superior performance in extracting semantic information from EHRs, automating high-performance heart disease risk factor identification, and performing downstream NLP tasks within the clinical domain. This study proposed fine-tuned five widely used transformer-based models, namely BERT, RoBERTa, BioClinicalBERT, XLNet, and BioBERT, using the 2014 i2b2 clinical NLP challenge dataset. The fine-tuned models surpass conventional approaches in predicting the presence of heart disease risk factors with impressive accuracy. The RoBERTa model has achieved the highest performance, with micro F1-scores of 94.27%, while the BERT, BioClinicalBERT, XLNet, and BioBERT models have provided competitive performances with micro F1-scores of 93.73%, 94.03%, 93.97%, and 93.99%, respectively. Finally, a simple ensemble of the five transformer-based models has been proposed, which outperformed the most existing methods in heart disease risk fan, achieving a micro F1-Score of 94.26%. This study demonstrated the efficacy of transfer learning using transformer-based models in enhancing risk prediction and facilitating early intervention for heart disease prevention.

GIS-based Social Vulnerability Integration for Robust Flood Response, Disease Prevention and Community Resilience in Chennai Metropolitan Area post-Cyclone Michaung

The present study outlines a comprehensive strategy for flood response, disease prevention and long-term community resilience in the aftermath of a recent Cyclone Michaung, with the proximity of landfall near Chennai and the increased likelihood of flooding in the CMA. Drawing insights from an existing social vulnerability map, the study addresses the unique challenges posed by flooding and aims to mitigate the heightened risk of waterborne and vector-borne diseases. Objectives encompass assessing social vulnerability, formulating a targeted flood response strategy, implementing healthcare interventions for disease prevention, strengthening information dissemination and advocating for long-term resilience planning. The methodology involves reviewing the existing vulnerability map, identifying vulnerable communities, integrating flood impact data and developing a comprehensive response plan. The study utilizes GIS and Remote Sensing technologies for monitoring and assessing the results. Key findings from the social vulnerability assessment inform prioritized intervention areas for both flood response and disease prevention. The discussion interprets results in the context of strategy effectiveness, emphasizing the significance of a nuanced and inclusive approach. This manuscript serves as a guide for stakeholders in implementing a holistic strategy that addresses immediate concerns, prevents disease outbreaks and fosters long-term community resilience.

Associations between meteorological variation and hospitalisations for rotavirus infections in Kuala Lumpur, Malaysia

ObjectivesRotavirus (RoV) infections have emerged as a significant public health concern around the world. Understanding the relationship between climatic conditions and hospitalisations due to RoV infections can help engage effective prevention strategies. This study aims to investigate the potential associations between meteorological variability and RoV-related hospitalisations in Kuala Lumpur, Malaysia. MethodsHospitalization data from a tertiary teaching hospital in Kuala Lumpur over a twelve-year period were retrospectively collected. Concurrently, meteorological data were obtained from the Malaysian Meteorological Department (MetMalaysia) including variables of temperature, humidity, precipitation, and atmospheric pressure to further demonstrate relationship with RoV-associated hospitalisations. ResultsThe results indicated positive correlations between increased rainfall, rainy days, humidity, and RoV-related hospitalisations, suggesting the influence of environmental factors on the transmission of RoV. ConclusionsThis study highlights positive associations between meteorological variations and hospitalizations for RoV infections in Kuala Lumpur, Malaysia. Further investigations, including national-level data, are needed to deepen our understanding of these associations, particularly within the context of Malaysia and to develop targeted interventions for disease prevention and control.

Avian Influenza A Viruses Modulate the Cellular Cytoskeleton during Infection of Mammalian Hosts.

Influenza is one of the most prevalent causes of death worldwide. Influenza A viruses (IAVs) naturally infect various avian and mammalian hosts, causing seasonal epidemics and periodic pandemics with high morbidity and mortality. The recent SARS-CoV-2 pandemic showed how an animal virus strain could unpredictably acquire the ability to infect humans with high infection transmissibility. Importantly, highly pathogenic avian influenza A viruses (AIVs) may cause human infections with exceptionally high mortality. Because these latter infections pose a pandemic potential, analyzing the ecology and evolution features of host expansion helps to identify new broad-range therapeutic strategies. Although IAVs are the prototypic example of molecular strategies that capitalize on their coding potential, the outcome of infection depends strictly on the complex interactions between viral and host cell factors. Most of the studies have focused on the influenza virus, while the contribution of host factors remains largely unknown. Therefore, a comprehensive understanding of mammals' host response to AIV infection is crucial. This review sheds light on the involvement of the cellular cytoskeleton during the highly pathogenic AIV infection of mammalian hosts, allowing a better understanding of its modulatory role, which may be relevant to therapeutic interventions for fatal disease prevention and pandemic management.

Epithelial recognition and elimination against aberrant cells.

Epithelial cells, which are non-immune cells, not only function as a physical defence barrier but also continuously monitor and eliminate aberrant epithelial cells in their vicinity. In other words, it has become evident that epithelial cells possess immune cell-like functions. In fact, recent research has revealed that epithelial cells recognise the Major Histocompatibility Complex I (MHC-I) of aberrant cells as a mechanism for surveillance. This cellular defence mechanism of epithelial cells probably detects aberrant cells more promptly than the conventional immune response, making it a novel and primary biological defence. Furthermore, there is the potential for this new immune-like biological defence mechanism to establish innovative treatment for disease prevention, leading to increasing anticipation for its future medical applications. In this review, we aim to summarise the recognition and attack mechanisms of aberrant cells by epithelial cells in mammals, with a particular focus on the field of cancer. Additionally, we discuss the potential therapeutic applications of epithelial cell-based defence against cancer, including novel prophylactic treatment methods based on molecular mechanisms.

AI in Healthcare

The integration of Artificial Intelligence (AI) into healthcare systems heralds a transformative era marked by unprecedented advancements in diagnosis, treatment, and patient care. This comprehensive review explores the multifaceted applications of AI in the healthcare domain, offering a synthesized perspective on the current state of knowledge and future implications. By examining the intersection of AI with medical imaging, predictive analytics, personalized medicine, and virtual health assistants, this research illuminates the promising trajectory of AI in reshaping the landscape of healthcare delivery. The initial segment of the review focuses on AI applications in medical imaging and diagnostics. Harnessing machine learning algorithms and deep neural networks, AI demonstrates remarkable capabilities in interpreting complex medical images, such as radiographs, MRIs, and CT scans. The paper evaluates the accuracy and efficiency of AI-driven diagnostic tools, addressing challenges and opportunities for integration into clinical workflows. Moving beyond diagnostics, the second thematic area explores the role of AI in predictive analytics for disease prevention and early intervention. By leveraging patient data, electronic health records, and genomic information, AI models contribute to identifying at-risk populations, predicting disease trajectories, and optimizing preventive strategies. The research assesses the ethical considerations and data privacy implications inherent in deploying predictive AI models within healthcare ecosystems. The third section investigates the paradigm shift towards personalized medicine facilitated by AI technologies. Analyzing patient-specific data, including genetic information and treatment response patterns, AI tailors treatment plans to individual characteristics, optimizing therapeutic outcomes. The review explores case studies and ongoing initiatives in precision medicine to showcase the tangible benefits and challenges associated with personalized healthcare. In the final thematic area, the review delves into the burgeoning field of virtual health assistants and AI-driven patient care. From chatbots offering real-time medical advice to virtual nurses monitoring patient well-being, AI enhances accessibility and engagement in healthcare delivery. The paper examines the potential for AI to improve patient outcomes, increase healthcare accessibility, and alleviate the burden on healthcare professionals. Throughout the review, ethical considerations surrounding patient privacy, algorithmic biases, and the responsible use of AI in clinical decision-making are critically evaluated. The research concludes with a forward-looking perspective, emphasizing the imperative of ongoing collaboration between healthcare professionals, technologists, and policymakers to harness the full potential of AI in fostering a more efficient, accessible, and patient-centric healthcare ecosystem

A qualitative exploration of the health needs and goals of urban women to inform the tailoring and adaptation of Strong Hearts Healthy Communities: a community-based cardiovascular disease prevention intervention

BackgroundIn the United States, cardiovascular diseases (CVD) are the leading cause of death and disability in women. CVD-modifiable risk factors, including poor diet quality and inadequate physical activity, can be addressed through evidence-based interventions (EBIs). Strong Hearts Healthy Communities (SHHC) is an EBI that has demonstrated effectiveness in reducing CVD risk and improving health outcomes among rural white women. The aims of this study were to understand the general health, diet, and physical activity-related needs and goals of women living in an urban community, to inform the tailoring and adaptation of the SHHC EBI to an urban setting and more diverse population.MethodsFocus groups (FGs) were conducted with African American/Black and Hispanic/Latinx women in the Dallas metropolitan area who had a BMI ≥ 25 kg/m2 and engaged in ≤ 150 min per week of moderate physical activity. The data were coded using a team-based, deductive, and thematic analysis approach, that included multiple coders and in-depth discussions.ResultsFour FGs with a total of 18 participants (79% Black and 21% Latinx) were conducted, and three themes were developed: (1) participants had adequate knowledge and positive attitudes towards healthy living but faced many barriers to practicing healthy behaviors; (2) culturally-based beliefs and community practices exerted a strong influence on behaviors related to food and stress, revealing barriers to healthy eating and generational differences in stress and stress management; (3) participants desired a more individualized approach to nutrition and physical activity interventions that included familiar and enjoyable activities and social support centered around shared health goals.ConclusionsThe SHHC intervention and similar health programs for Black/African American and Hispanic/Latinx women in urban settings should emphasize individualized nutrition and practical skills for healthy eating with accessible, familiar, and enjoyable exercises. Additionally, stress management strategies should be culturally and generationally sensitive and social support, whether through family, friends, or other program participants, should be based on shared health goals.

Impact of the circadian clock on cardiovascular physiology and pathophysiology

Circadian rhythms are the innate approximately 24-hour oscillations that orchestrate a multitude of physiological processes encompassing sleep-wake cycles, hormone secretion, thermoregulation, metabolism, and behavioral patterns. Also, those rhythms are intrinsically governed by the suprachiasmatic nucleus (SCN) ensconced in the anterior hypothalamic region. The SCN, synchronized during daylight hours receives and transmits diverse bodily signals to calibrate physiological dynamics, and imbue disturbances with potential repercussions reverberating across a plethora of physiological and behavioral domains. Previous studies have proven that the diurnal changes in the circadian rhythm multiple myocardial processes and have a critical impact on the physiology and pathophysiology of the cardiovascular system. This comprehensive review emphasizes the profound influence of circadian rhythms, orchestrated by the suprachiasmatic nucleus, on cardiovascular health. It reveals that disruptions in circadian rhythms impact blood pressure, myocardial function, platelet responsiveness, and the autonomic nervous system, all of which are critical for cardiovascular well-being. The significance of this research lies in its potential to guide interventions for cardiovascular disease prevention and management, particularly in the context of modern challenges like shift work. Understanding this intricate relationship is crucial for safeguarding cardiovascular health in our fast-paced world.

Profile of sexually transmitted infections among attendees of special clinics (Suraksha) at an apex regional sexually transmitted disease centre in North India – a five-year study

Introduction: Sexually transmitted infections (STIs) present significant global and national health challenges, particularly in India. Objective: To estimate the prevalence and characteristics of STIs among attendees at the Suraksha Clinic in the Apex Regional STD Centre, Safdarjung Hospital. Methods:Retrospective data from January 2018 to December 2022 were statistically analyzed using Excel and SPSS. The study included the examination for diagnosis of various STIs, such as syphilis, human immunodeficiency virus (HIV), gonorrhoea, chlamydiasis, trichomoniasis, candidiasis, bacterial vaginosis, chancroid, and genital herpes. Gender distribution and syndromic diagnoses, including vaginal/cervical discharge and genital ulcers, were also considered. Referrals to Integrated Counseling and Testing Centres for HIV testing were analyzed. Results: The outcomes reveal a substantial burden of STIs, with 3.06% showing reactivity to syphilis, 1.74% testing positive for HIV, 3.36% for gonorrhoea, 11.78% for chlamydiasis, 1.05% for trichomoniasis, 26.24% for candidiasis, 9.97% for bacterial vaginosis, 7.80% for chancroid, 11.64% for herpes genitalis, and 4.01% for other non-STIs. Attendees’ interactions included 34.36% of referrals to Integrated Counseling and Testing Centres for HIV testing. The gender distribution showed 58.92% male and 40.94% female attendees. Conclusion: Syndromic diagnoses, including vaginal/cervical discharge (21.22%) and genital warts (8.00%), highlight prevalent conditions, necessitating routine screening, early detection, and targeted interventions for effective disease control and prevention. These findings underscore the significance of integrated screening, patient education, and proactive strategies to safeguard public health in the face of rising STI rates.

Global Burden of Alzheimer's Disease and Other Dementias Attributed to High Fasting Plasma Glucose from 1990 to 2019.

Burden of Alzheimer's disease (AD) and other dementias have grown rapidly over the decades, and high fasting plasma glucose (HFPG) was one of the well-established risk factors. It is urgently needed to estimate the global burden of AD and other dementias attributable to high fasting plasma glucose between regions, countries, age groups, and sexes to inform development of effective primary disease prevention strategies and intervention policies. The burden of AD and other dementias attributable to HFPG was estimated based on a modeling strategy using the Global Burden of Disease Study 2019 dataset. The disease burden and time trend globally and by region, country, development level, age group, and sex were evaluated. The number of AD and other dementias-related deaths attributable to HFPG increased from 42,998.23 (95% uncertainty interval, UI: 4459.86-163,455.78, the year of 1990) to 159,244.53 deaths (95% UI 18,385.23-583,514.15, the year of 2019). The age-standardized death rate increased from 1.69 (95% UI 0.18-6.54) in 1990 to 2.24 (95% UI 0.26-8.24) in 2019. The burden was higher in more developed regions. The burden in women was double that in men, that HFPG-attributable AD and other dementias caused 99,812.79 deaths (95% UI 9005.67-387,160.60) in women and 59,431.74 deaths (95% UI 5439.02-214,819.23) in men, with age-standardized death rate of 2.27 (95% UI 0.20-8.79) per 100,000 population in women and 2.20 (95% UI 0.20-8.00) in men. Findings from the current study emphasizes the urgent requirement for targeted interventions in high-development regions, as well as the importance of proactive measures in middle-development countries in protection of AD and other dementias. The gender disparity necessitates the integration of gender-specific considerations in targeted approaches in prevention of AD and other dementias.

Vaccine Safety: Assessing the Prevalence and Severity of Adverse Events Following COVID-19 Vaccination amongst Healthcare Workers in Tertiary Health Facilities in Nigeria.

Vaccines, including COVID-19 vaccines, are known to be cost-effective interventions for disease prevention and control. However, adverse events following immunisation (AEFI) may challenge the acceptance of these vaccines. This study assessed the prevalence and severity of COVID-19-related AEFI amongst healthcare workers at tertiary health facilities in Nigeria. This descriptive, cross-sectional study was conducted among healthcare workers who had received the COVID-19 vaccine. A multi-stage sampling technique was used to select participants from six Tertiary Health Facilities in Nigeria. Ethical approval (NHREC/01/01/2007-19/07/2021) was obtained from NHREC. Data were analysed using IBM® SPSS version 25 and categorical variables were presented in tables/charts using frequencies and proportions. A total of 2130 respondents participated in the study, with a mean age of 37.4 ± 9.1 years. Most of the respondents, 1674 (78.6%), had two doses of the vaccine, and the overall prevalence of AEFI was 813 (38.2%). Common among the AEFI reported following the administration of the first dose of the vaccine were fever 649 (30.5%) and pain at the injection site 644 (30.2%), while it was pain at the injection site 216 (10.1%) and fever 173 (8.1%) for second dose. The higher proportions of AEFI were mostly mild to moderate. The study observed a relatively low prevalence of AEFI, with the commonly reported ones being fever and injection site pain. It is crucial that countries continuously collect the data on AEFI and establish causality as a way to improve quality and guarantee vaccine safety.

BMI POLYEPIGENETIC SCORES PREDICT FUTURE CHRONIC CONDITIONS AND CHOLESTEROL

Abstract Body mass index (BMI) is an established risk factor for chronic conditions such as high blood pressure, diabetes, cancer, lung disease, heart condition, stroke, emotional/psychiatric problems, arthritis, and sleep disorders. Poly-Epigenetic Scores (PEGS) have emerged as a promising tool for predicting the risk of chronic diseases. We evaluated the predictive power of BMI PEGS for incident chronic conditions, mortality, and cholesterol levels using data from the Health and Retirement Study, a population representative study of US adults over age 50 years. Three PEGS (Wahl, McCartney, Hamilton) were created from existing epigenome-wide association studies of BMI for participants from the 2016 HRS Venous-Blood study (N=4018). We used element-wise, least-squares regressions to assess the association between each BMI PEG and phenotypes of interest, controlling for demographics, socio-economic status, health-behaviors, and cell type proportions. BMI PEGS were significant predictors of incident chronic conditions in 2020 and these associations were robust to adjustment for covariates. BMI PEGS were also found to be significant predictors of cross-sectional cholesterol levels, a known risk factor for heart disease and stroke. Our study highlights that PEGS can have wide predictive power for future health conditions. These findings can inform personalized interventions for disease prevention and early intervention in the US aging population.

Oat Peptides Alleviate Dextran Sulfate Sodium Salt-Induced Colitis by Maintaining the Intestinal Barrier and Modulating the Keap1-Nrf2 Axis.

The prevalence of inflammatory bowel disease (IBD) is progressively rising each year, emphasizing the significance of implementing rational dietary interventions for disease prevention. Oats, being a staple agricultural product, are abundant in protein content. This study aimed to investigate the protective effects and underlying mechanisms of oat peptides (OPs) in a mouse model of acute colitis induced by dextran sulfate sodium salt (DSS) and a Caco-2 cell model. The findings demonstrated that intervention with OPs effectively mitigated the symptoms associated with DSS-induced colitis. The physicochemical characterization analysis demonstrated that the molecular weight of the OPs was predominantly below 5 kDa, with a predominant composition of 266 peptides. This study provides further evidence of the regulatory impact of OPs on the Keap1-Nrf2 signaling axis and elucidates the potential role of WGVGVRAERDA as the primary bioactive peptide responsible for the functional effects of OPs. Ultimately, the results of this investigation demonstrate that OPs effectively mitigate DSS-induced colitis by preserving the integrity of the intestinal barrier and modulating the Keap1-Nrf2 axis. Consequently, these findings establish a theoretical foundation for the utilization of OPs as dietary supplements to prevent the onset of IBD.

Development and Functionality of a Parsimonious Digital Food Frequency Questionnaire for a Clinical Intervention among an Indigenous Population

Nutrition-related chronic diseases are a major problem among Indigenous populations. Appropriate dietary intake assessment tools are needed for nutritional surveillance and intervention; however, tools designed to measure the habitual dietary intake of Indigenous persons are largely lacking. We developed a digital food frequency questionnaire (FFQ) to measure habitual consumption among Australian Aboriginal adults and support personalized nutrition counseling. The primary contributors to energy, select nutrients, and inter-person variation (83 food groups) were identified from nationally representative 24 h recall (24HR) data, and they accounted for >80% of the total intake and inter-person variation of the nutrients of interest. Based on community input, a meal-based FFQ format was adopted, with a main food/beverage list of 81 items and the capacity to report on >300 additional items via the digital platform. The nutrient database was based on the Australian Food and Nutrient Database. Data for the first 60 study participants (70% female; median age: 48 years) were used to assess the FFQ’s utility. The participants’ median [IQR] reported energy intake (10,042 [6968–12,175] kJ/day) was similar to their median [IQR] estimated energy expenditure (10,197 [8636–11,551] kJ/day). Foods/beverages on the main FFQ list accounted for between 66% and 90% of the participants’ reported energy and nutrient intakes; the remainder came from participant-selected extra items. The digital FFQ platform provides a potentially valuable resource for monitoring habitual dietary intake among Aboriginal adults and supporting chronic disease prevention and management interventions.

Topological properties analysis and identification of mild cognitive impairment based on individual morphological brain network connectome.

Mild cognitive impairment is considered the prodromal stage of Alzheimer's disease. Accurate diagnosis and the exploration of the pathological mechanism of mild cognitive impairment are extremely valuable for targeted Alzheimer's disease prevention and early intervention. In all, 100 mild cognitive impairment patients and 86 normal controls were recruited in this study. We innovatively constructed the individual morphological brain networks and derived multiple brain connectome features based on 3D-T1 structural magnetic resonance imaging with the Jensen-Shannon divergence similarity estimation method. Our results showed that the most distinguishing morphological brain connectome features in mild cognitive impairment patients were consensus connections and nodal graph metrics, mainly located in the frontal, occipital, limbic lobes, and subcortical gray matter nuclei, corresponding to the default mode network. Topological properties analysis revealed that mild cognitive impairment patients exhibited compensatory changes in the frontal lobe, while abnormal cortical-subcortical circuits associated with cognition were present. Moreover, the combination of multidimensional brain connectome features using multiple kernel-support vector machine achieved the best classification performance in distinguishing mild cognitive impairment patients and normal controls, with an accuracy of 84.21%. Therefore, our findings are of significant importance for developing potential brain imaging biomarkers for early detection of Alzheimer's disease and understanding the neuroimaging mechanisms of the disease.

Abstract 18284: Inhibition of Sulfatase-1 Prevents Pulmonary Arterial Hypertension in Animal Models of Disease

Introduction: Sulfatase-1 (Sulf1) is an extracellular enzyme that removes 6-O-sulfate groups from heparan sulfate and is implicated in cardiovascular disease. In human pulmonary artery endothelial cells (HPAECs), Sulf1 mRNA and protein levels are regulated by the fibroproliferative protein NEDD9 involved in PAH. Hypothesis: Sulf1 regulates migration and profibrotic potential of HPAECs and its downregulation prevents the development of PAH. Methods: HPAECs were transfected with Sulf1 siRNA or adenovirus expressing Sulf1 and cell migration was analyzed by scratch assay. In a PAH disease prevention treatment protocol, rats received intratracheal injection of Sulf1 siRNA (si-Sulf1) (1mg/kg of body weight, once a week for 3 weeks) beginning one day following the administration of monocrotaline (MCT). In a disease reversal protocol, injection of si-Sulf1 (1mg/kg of body weight, once every 5 days for a total of 3 doses) began 14 days following initiation of SU-5416/Hypoxia (SU/Hypox) PAH model. Results: Overexpression of Sulf1 in HPAECs resulted in a significant reduction in migration compared to empty vector (wound size 506 ± 39 vs 353 ± 19 μm, P<0.01), whereas transfection with si-Sulf1 increased migration significantly compared to si-Scrambled control (wound size 212 ± 30 vs 295 ± 31 μm, P<0.01). Overexpression of Sulf1 also increased extracellular collagen III deposition in cultured HPAECs compared to empty vector (15.4 ± 5 vs. 7 ± 1 arb. units, P<0.01). Immunostaining of HPAECs for Sulf1 showed strong expression at focal adhesions. In both in vivo PAH models, si-Sulf1 treatment significantly decreased right ventricular (RV) systolic pressure compared to si-Scrambled control (MCT: 41 ± 5 vs 58 ± 6 mm Hg, P<0.05; SU/Hypox: 40 ± 5 vs 75 ± 15 mm Hg, P<0.05) and RV mass measured by Fulton index (MCT: 0.33 ± 0.06 vs 0.56 ± 0.06, P<0.01; SU/Hypox: 0.32 ± 0.02 vs 0.41 ± 0.02, P<0.05). Conclusions: These data demonstrate that pulmonary endothelial expression of Sulf1 is increased at focal adhesions and regulates cellular migration. Inhibition of Sulf1 significantly reduced the severity of PAH in vivo, which, taken together, identifies Sulf1 as a potential therapeutic target by which to improve proliferative vascular remodeling and pulmonary hypertension in PAH.