History Of Exposure Research Articles

Pituitary adenylate cyclase-activating polypeptide (PACAP)+ cells in the paraventricular nucleus of the thalamus: relationship with binge-type eating in male and female mice.

Both the paraventricular nucleus of the thalamus (PVT) and the neuropeptide, pituitary adenylate cyclase-activating polypeptide (PACAP), are thought to be involved in food intake. Importantly, PACAP is expressed in cells of the PVT. To determine if PACAP in cells of the PVT might mediate some of the involvement of the PVT with palatable food intake. In male and female C57BL/6J mice and PACAP-Cre transgenic mice on a C57BL/6J background, limited access to Milk Chocolate Ensure Plus® was used to establish a model of binge-type eating. Next, using quantitative real-time PCR, gene expression of PACAP in the PVT was measured in relation to this binge-type eating. Finally, using chemogenetics in PACAP-Cre transgenic mice, the effect of activation of PVT PACAP+ cells on binge-type eating was determined. Males and females both engaged in binge-type eating with Ensure, although females engaged in this behavior to a greater degree than males. While females also had a higher baseline level of PVT PACAP mRNA than males, only males showed an increase in levels of PACAP after a history of exposure to Ensure, and only males showed a reduction in levels of PACAP immediately prior to a binge session. Conversely, activation of PACAP+ cells in the PVT reduced binge-type eating of Ensure, specifically in male mice. The present findings indicate that PVT PACAP+ cells influence and are influenced by binge-type eating. Thus, PACAP in the PVT might mediate some of the known involvement of the PVT with palatable food intake.

Effects of Mixed Metal Exposure on MRI Metrics in Basal Ganglia.

Welding fumes contain various metals. Past studies, however, mainly focused on Manganese (Mn)-related neurotoxicity. This study investigated welding-related mixed metal exposure effects on MRI metrics in the basal ganglia (BG) and their dose-response relationship. Subjects with (N = 23) and without (N = 24) a welding exposure history were examined. Metal exposure was estimated with exposure history questionnaire and whole blood metal levels. T1 (weighted-intensity and relaxation time; estimates of brain Mn accumulation), diffusion tensor imaging [Axial (AD), mean (MD), radial diffusivity (RD), and fractional anisotropy (FA); estimates of microstructural differences] metrics in BG [caudate nucleus, putamen, and globus pallidus (GP)] and voxel-based morphometry (for volume) were examined and related with metal exposure measures. Compared to controls, welders showed higher GP R1 (1/T1; p = 0.034) but no differences in blood metal and T1-weighted (T1W) values in any ROIs (p's > 0.120). They also had higher AD and MD values in the GP (p's < 0.033) but lower FA values in the putamen (p = 0.039) with no morphologic differences. In welders, higher blood Mn and Vanadium (V) levels predicted higher BG R1 and T1W values (p's < 0.015). There also were significant overall metal mixture effects on GP T1W and R1 values. Moreover, GP AD and MD values showed non-linear associations with BG T1W values: They increased with increasing T1W values only above certain threshold of T1 values. The current findings suggest that Mn and V individually but also metal mixtures jointly predict GP T1 signals that may in turn contribute to altered DTI metrics in the BG after certain exposure threshold levels.

A Rare Case of Occupational Aniline Poisoning: Management in a Limited-Facility Setting

Introduction Cyanosis along with altered mental should bring all the possible ethiologies into her mind in a minimum of time, based on the trauma, medical, environmental, and occupational history of the patient. Poisoning with methemoglobinemia inducing agents is one of the most important differentials especially when a history of occupational exposure to these agents is present. Case Report The patient, a 41-year-old healthy woman and engineer, experienced symptoms after exposure to aniline leading to dizziness and weakness, prompting a visit to the emergency department with cyanosis and low oxygen saturation. Initial vital signs showed decreased oxygen levels and elevated respiratory rate with normal ABG values despite ongoing cyanosis. Patient required intubation, mechanical ventilation, and was diagnosed with ARDS based on chest X-ray findings. Management included IV diuretics, 100% oxygen, and antioxidant treatment in the ICU. Despite treatment, oxygen saturation remained at 88% on the first day. Conclusion This case is a reminder of the importance of taking occupational history and management of aniline toxicity in a setting where methylene blue, the drug of choice for aniline toxicity, is not available in the drug stock.

Tooth loss from the perspective of studies employing a life course approach: a systematic review.

The life course approach scrutinizes factors that shape the development of diseases over time. Tooth loss, which is influenced by social, behavioral and biological factors, can occur at various stages of life and tends to become more prevalent in later years. This systematic review examined the influence of socioeconomic, psychosocial, biological and behavioral adversities in life on the likelihood of tooth loss. Searches were conducted in the Embase, PubMed, Web of Science, Ovid, PsycINFO, Scopus and LILACS databases. Reference management was performed using EndNote online. The risk of bias was appraised using the Newcastle-Ottawa Scale (NOS). The electronic searches yielded 1366 records, 17 of which (13 cohort and four cross-sectional studies) met the inclusion criteria. According to the NOS, all studies had a low risk of bias. Two studies found a link between a lower education and higher incidence of tooth loss and socioeconomic status exerted a significant influence in 47% of the studies. Disadvantaged socioeconomic trajectories and health-related factors, such as smoking, general health perception and oral health behaviors, increased the likelihood of tooth loss. Factors such as dental visits, a history of toothache and exposure to fluoridated water influenced the likelihood of tooth loss. Individuals who experienced adversities in socioeconomic, behavioral and biological aspects throughout their life course were more prone to tooth loss.

A transgenic mouse with a humanised B cell repertoire mounts an antibody response to influenza infection and vaccination.

The development of a universal influenza vaccine likely requires an understanding of previous exposure to influenza virus (through vaccination or infection) and how that shapes the antibody repertoire to vaccination, sometimes called Original Antigenic Sin or antigenic imprinting. Whilst animal models can have a much more defined exposure history, they lack a human B cell repertoire. Transgenic mice with the complete human immunoglobulin locus enable studies of controlled infection history leading to human-like antibody evolution. Here we evaluated responses to influenza in the Intelliselect Transgenic mouse (the Kymouse). We show the Kymouse is susceptible to disease following infection with either H1N1, H3N2 or B/Yam influenza viruses and that it induces a robust binding and neutralising antibody response to all three strains of influenza virus. This study demonstrates that human B cell repertoire mice can be used for influenza virus studies, providing a tool for further interrogation of the antibody response.

Older Adult Family Homicide in Victoria, Australia 2001–2015: A Description of Family and Family Violence Homicide Victimisation

Abstract Purpose This study examined factors present among older adult family homicide victims and their offenders compared to younger adult family homicide using the social-ecological model. Method The study used a population-based single-jurisdiction cross-sectional design of consecutive homicide cases of adults (aged 18 years and older) reported to the coroner in Victoria, Australia for the period 2001–2015. Included were homicides involving an intimate or familial relationship. The data source was the Victorian Homicide Register, maintained by the Coroners Court of Victoria. Descriptive and multivariate analysis was performed to compare the presence of factors between younger and older adult family homicides. Results During the study period 37/283 (13.1%) family homicides occurred among older adult victims (aged 65 years and older) and 246/283 (86.9%) occurred among younger adults (aged 18–64 years). The deceased older adult was often male (57%), with a documented physical illness (54%). Offenders against the older adult were frequently male (68%), non-intimately related (73%), with diagnosed mental illness, a history of substance use and/or historical exposure to violence (all 57%). There were 15 older adult family violence (FV) homicide victims, eight that were previously victims of the homicide offender, primarily enduring emotional, physical and psychological violence as well as the perpetrator assaulting another family member. Seven older adults had perpetrated FV against their offender. Conclusions The history of violence perpetration in the deceased and mental health factors in their offender, as well as the greater proportion of parent-child and other familial relationships offer interesting focal points for future prevention research.

Abstract A045: Pan-viral serological characterization in African Americans and European Americans with Hepatocellular Carcinoma

Abstract Hepatocellular carcinoma (HCC) is often diagnosed at late-stages, particularly among African Americans (AA). Poor screening and diagnosis are key factors that contribute to worse prognoses and disproportionately high mortality rates. We propose investigating viral exposure history as a potential useful screening method. Additionally, by accounting for neighborhood deprivation index (NDI), a metric for differences in socio-economic statuses, we can potentially mitigate this disparity. With NDI and viral exposure history, our study aims to assess HCC prognoses in racially disparate populations. We used a technique called VirScan, which conjugates Phage-Immunoprecipitation (PhIP) and DNA-sequencing, to profile the antibody repertoire against a viral epitope library. Analyzing serum and plasma samples from population controls (PC), individuals at high-risk for developing HCC (HR), and HCC cases, we performed VirScan on 524 AA (272 PC, 205 HR, and 47 HCC) and 342 European Americans (EA) (141 PC, 130 HR, and 71 HCC) participants from the NCI-UMD cohort between 2009-2020 from the greater Baltimore area (NCT00913757; clinicaltrials.gov). We used XGBoost, a machine- learning model, to classify viral features that can discriminate HCC cases from PC group. XGBoost predicted 31 important viral features which distinguish HCC from PC. Of the 31 viral features, 6 viruses were different between AA and EA (FDR &amp;lt; 0.05). To determine the extent to which socio-economic factors contribute to the cancer disparities, we gathered variables from the 1999 census tract as contributors to deprivation. We used Principal Component Analysis (PCA) to determine loadings of these contributor variables; composite of the final variables is derived as NDI. Comparing across groups, we find that average NDI is highest in HR group (x = 0.33), followed by HCC group (x = 0.21), then PC group (x = 0.19). We find that NDI for AA is significantly higher in HCC group (p = 1.3e-09), HR group (p &amp;lt; 2.2e-16), and PC group (p = 5.0e-10) when compared to that of EA. Thus, we demonstrate that both the viral exposure history and NDI of an individual might be useful in prognoses of HCC. This approach could be used to examine the disparities we see in both incidence and mortality of HCC between AA and EA. Citation Format: Theressa Ewa, Whitney Leet, Limin Wang, Marshonna Forgues, Xin Wei Wang. Pan-viral serological characterization in African Americans and European Americans with Hepatocellular Carcinoma [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A045.

The Association between Aminoglycoside Exposure and Ototoxicity in Children with Cystic Fibrosis

Introduction: Pulmonary exacerbations increase the requirement of aminoglycoside (AG) antibiotics in people with cystic fibrosis (pwCF). Several studies have shown that AGs have a cumulative effect on ototoxicity. We aimed to investigate the relationship between AG exposure and ototoxicity by using 3 different methods in patients with CF. Materials/Methods: The multicenter study included 121 pwCF aged between 5 and 18 years with a history of parenteral AG exposure. Standard pure-tone audiometry, extended high-frequency pure-tone audiometry (EHF-PTA), and distortion-product otoacoustic emissions (DPOAE) tests were performed. Mitochondrial mutation analysis for m1555G>A was performed in 61 patients. Results: Median age was 12.85 years and 52.1% (n = 63) were male. 18.2% (n = 22) of the patients had received parenteral AGs more than 5 courses/lifetime. Ototoxicity was detected in at least one of the tests in 56.2% (n = 68) of the patients. Only 10.7% (n = 13) of the patients had reported a symptom indicating ototoxicity. 30.3% (n = 30) of the patients had ototoxicity in the low exposure group, while it was 45.5% (n = 10) in the high exposure group according to EHF-PTA (p > 0.05). Median number of parenteral amikacin courses was significantly higher in the ototoxic group (2 [1.25–5.75] vs. 2 [1–3]; p = 0.045). No m1555A>G mutation was detected in 61 patients who screened for mitochondrial mutation analysis. Conclusion: As AG ototoxicity occurs primarily at high frequencies, EHF-PTA is important in early detecting ototoxicity. EHF-PTA and DPOAE detected ototoxicity in some patients with normal PTA results. All pwCF with a history of AG exposure should be evaluated for hearing loss since symptoms may only be noticed in the late period.

From conceptualising to modelling structural determinants and interventions in HIV transmission dynamics models: a scoping review and methodological framework for evidence-based analyses

Abstract Background Including structural determinants (e.g. criminalisation, stigma, inequitable gender norms) in dynamic HIV transmission models is important to help quantify their population-level impacts and guide implementation of effective interventions that reduce the burden of HIV and inequalities thereof. However, evidence-based modelling of structural determinants is challenging partly due to a limited understanding of their causal pathways and few empirical estimates of their effects on HIV acquisition and transmission. Methods We conducted a scoping review of dynamic HIV transmission modelling studies that evaluated the impacts of structural determinants, published up to August 28, 2023, using Ovid Embase and Medline online databases. We appraised studies on how models represented exposure to structural determinants and causal pathways. Building on this, we developed a new methodological framework and recommendations to support the incorporation of structural determinants in transmission dynamics models and their analyses. We discuss the data and analyses that could strengthen the evidence used to inform these models. Results We identified 17 HIV modelling studies that represented structural determinants and/or interventions, including incarceration of people who inject drugs (number of studies [n] = 5), violence against women (n = 3), HIV stigma (n = 1), and housing instability (n = 1), among others (n = 7). Most studies (n = 10) modelled exposures dynamically. Almost half (8/17 studies) represented multiple exposure histories (e.g. current, recent, non-recent exposure). Structural determinants were often assumed to influence HIV indirectly by influencing mediators such as contact patterns, condom use, and antiretroviral therapy use. However, causal pathways’ assumptions were sometimes simple, with few mediators explicitly represented in the model, and largely based on cross-sectional associations. Although most studies calibrated models using HIV epidemiological data, less than half (7/17) also fitted or cross-validated to data on the prevalence, frequency, or effects of exposure to structural determinants. Conclusions Mathematical models can play a crucial role in elucidating the population-level impacts of structural determinants and interventions on HIV. We recommend the next generation of models reflect exposure to structural determinants dynamically and mechanistically, and reproduce the key causal pathways, based on longitudinal evidence of links between structural determinants, mediators, and HIV. This would improve the validity and usefulness of predictions of the impacts of structural determinants and interventions.

Hysteresis in Water Content of Ultrafine Glassy Organic Aerosol Particles

AbstractWater content of aerosol particles is atmospherically important. Water content of organic aerosol (OA) particles has been estimated by assuming thermodynamic equilibrium. Here, we discovered that the hysteresis phenomenon occurred to water content of glassy ultrafine OA particles, demonstrating that thermodynamically non‐equilibrium states need to be considered. Hygroscopic growth for monodisperse ultrafine particles (sucrose and glucose) was investigated for the temperature range from 252 to 296 K. Hysteresis was not observable at 296 K, consistent with literature data. However, hysteresis in water content was observed at sub‐273 K. The lowest relative humidity (RH), at which hygroscopic growth of particles did not depend on exposure history to water vapor, was defined as threshold RH. Threshold RH for 100 nm particles was approximately the same as the glass transition points when hysteresis clearly happened, demonstrating that water diffusion in a highly viscous matrix of organic aerosols was the key to the phenomenon. Employment of a kinetic multi‐layer model quantitatively predicted threshold RH as a function of temperature, exposure time, and the particle size. Considering the temperature and RH range of Earth's atmosphere, we hypothesize that hysteresis in water content for organic aerosols ubiquitously occurs in the upper troposphere, impacting chemical aging and cloud formation processes.

Analysis of Influencing Risk Factors of Nonsyndromic Unilateral Cleft Lip in South Sulawesi

Abstract Objective This study is to determine the most dominant risk factors for the potential occurrence of nonsyndromic unilateral cleft lip in South Sulawesi, Indonesia. Materials and Methods This is a retrospective study of several hospitals in South Sulawesi, Indonesia. An analysis was performed on the medical records of patients with nonsyndromic unilateral clefts. In the period from January 2018 to December 2022, risk factors include gender, parental education, family history of cleft lip and palate, maternal history of smoking or exposure to secondhand smoke, and consumption of drugs and alcohol during gestational age. The size of the sample is determined using the cluster sampling technique. Statistics uses chi-square test analysis and logistic regression for nominal variables. It uses SPSS Statistics version 25, with a value of p &lt; 0.05. Results The highest risk factor was found in patients with parents with a history of alcohol consumption during pregnancy and in patients with family history of cleft lip and palate, history of smoking or exposure to cigarette smoke, history of drug consumption, and gender. In comparison, parents' education level does not have a significant influence. Conclusion History of alcohol consumption during pregnancy, family history of cleft lip and palate, history of smoking or exposure to cigarette smoke, history of drug consumption, and gender are considered risk factors for nonsyndromic unilateral cleft lip in South Sulawesi, Indonesia.

Correlation of Pseudocholinesterase Level with Clinical, Biochemical Parameters Including Cardiac Profile and the Outcome in Organophosphorus Poisoning.

Poisoning is a significant health hazard and a leading cause of morbidity and mortality worldwide. India, being a predominantly agrarian country, routinely employs organophosphate (OP) pesticides in farming, and they are readily available "over the counter." OPs exert their toxicity by interfering with the normal function of acetylcholine, an essential neurotransmitter throughout the autonomic and central nervous systems. Due to the limited availability of facilities and resources in health-care systems, and economically restraining patients, it is necessary to rely more on clinical features to assess the severity of poisoning and manage the condition properly. It was a hospital-based prospective observational study that included patients aged >13 years in a tertiary care hospital. All patients were clinically evaluated based on their history and examination. The diagnosis was made based on characteristic clinical manifestations or evidence of exposure to organophosphorus compounds (corroborative evidence such as empty containers and the odor of gastric aspirates). Clinical severity was assessed and categorized according to the Peradeniya Organophosphorus Poisoning Scale (POP scale). A score of 0-3 is considered mild poisoning, 4-7 as moderate poisoning, and 8-11 as severe poisoning. Out of the 50 patients enrolled in the study, 17 (34.00%) were aged <20 years, 19 (38%) were in the 20-30 years age group, and 14 (28%) were aged >30 years. Ingestion is the only mode of exposure to poisoning. None of the patients had history of contact or inhalational exposure. Of the 50 cases, 12 (24.0%) were in the mild category, 26 (52.0%) in the moderate category, and 12 (24%) in the severe category on the POP grading. A comparison of the mean serum pseudocholinesterase, troponin-T, and pro-BNP levels with severity was performed. In mild OP poisoning, the mean serum PChE level was 2766.58 ± 1120.44; in moderate, it was 1969.35 ± 1330.07, and in severe, it was 701.83 ± 961.17. Pseudocholinesterase levels decreased progressively with increasing clinical severity from mild-to-severe cases, and this association was statistically significant (P < 0.001). Two-dimensional echocardiography screening done in all patients did not show any significant abnormalities. This study shows that serum PCE is reduced in OP poisoning and correlates with the clinical severity grading done by the POP scale and is also associated with an increase in the duration of intensive care unit stay. No significant evidence of direct cardiac injury was observed in this study. A low Glasgow Coma Scale score and an increased respiratory rate at presentation are associated with poor outcomes.

B - 30 Influence of Military Blast Exposure on Subjective Post-Concussion Symptom Reporting

Abstract Objective Repeated subconcussive blast exposure associated with explosive breaching, mortars, and shoulder-fired artillery weapons is commonly seen in the military/veteran population and has been found to contribute to adverse neurological outcomes; however, the extent is not fully understood. The aim of this study was to assess the effects of blast exposure during military or other training exercises on neurobehavioral symptom endorsement. Method Cross-sectional data from 48 nonclinical post-deployment Operation Enduring Freedom/Operation Iraqi Freedom veterans prospectively-recruited for a study examining posttraumatic stress and cognitive correlates at an urban VA Medical Center were examined (M age = 36.02; SD = 6.12; M years of education = 14.94; SD = 1.84). The sample was 96% male, 41% White, 39% Black, 4% Asian, and 16% Other. The Neurobehavioral Symptom Inventory (NSI) was used to assess self-reported vestibular, somatosensory, cognitive, and affective post-concussion symptoms, and the Boston Assessment of Traumatic Brain Injury-Lifetime semi-structured clinical interview assessed military-related blast exposure. Results There was a significant difference in neurobehavioral symptoms based on blast exposure, F(4,43) = 3.49, p = 0.015; Wilk’s Λ = 0.755, partial η2 = 0.25. Follow-up analyses showed that veterans with history of blast exposure endorsed significantly higher levels of somatosensory (F(1,47) = 7.69, p = 0.008, η2 = 0.143); affective (F(1,47) = 12.66, p &amp;lt; 0.001, η2 = 0.216); cognitive (F(1,47) = 5.97, p = 0.018, η2 = 0.115); and vestibular (F(1,47) = 7.21, p = 0.010, η2 = 0.136) post-concussive symptoms on the NSI compared to those without history of military blast exposure. Conclusion Veterans with blast exposure during military service reported significantly greater levels of post-concussion symptoms. This demonstrates the need to assess history of blast exposure, implement prevention measures through safeguards and decreased exposure when possible, and establish treatment modalities to improve outcomes.

B - 24 Assessing Cognitive Impairment within a High-Blast Risk Military Force

Abstract Objective Explosive Ordinance Disposal (EOD) is a military occupational specialty that is particularly high risk for blast exposures as well as psychologically traumatic combat experiences. We explore cognitive performance, symptom profiles, and blast exposure history of this group. Methods Participants were recruited from an active duty TBI rehabilitation center. Of 123 participants, 12 were EOD (Other N = 111). Learning and memory (HVLT-R), sustained attention (PASAT) and executive functioning (DKEFS) were assessed. A Global Deficit Score (GDS) was calculated to determine impairment. Neurobehavioral symptoms (NSI), PTSD and depressive symptoms (PCL-M and PHQ-8), combat (CES) and blast exposures (BETS) history were also assessed. Results When comparing EOD to Other, age, number of mTBIs, and blast exposures were comparable (p’s &amp;gt; 0.05). There was a trend for EOD to report fewer symptoms and more combat deployments. EOD reported greater exposure to combat (CES p = 0.004, d = 0.90) and performed stronger cognitively. HVLT-R-Total (EOD M = 48.50, SD = 9.46; Other M = 39.13, SD = 11.67; p = 0.008, d = 0.82), HVLT-R-Delayed (EOD M = 45.75, SD = 11.11, Other M = 38.61, SD = 13.76; p = 0.09, d = 0.53) and PASAT (EOD M = 54.10, SD = 7.37; Other M = 46.56, SD = 10.21; p = 0.014, d = 0.76). 50.4% of the overall sample and 16.7% of the EOD sample were determined to have cognitive impairment (GDS p = 0.015). Conclusions Results highlight the importance of baseline assessment for higher functioning specialized populations. EOD performed better than general forces on cognitive measures, including memory domains previously identified to be impacted by blast exposures. EOD presents with greater kinetic combat experiences that expose them to psychologically traumatic events despite reporting fewer symptoms. Most notable is the high rate of cognitive impairment in an active military force.

A - 55 Exploring the Impact of Parental Substance Use Problems and Behavior on Pre-Adolescent Cognitive Performance

Abstract Objective Adults with a parental history of substance use problems (PH+) exhibit deficits in verbal, language, visuomotor, visuospatial, and executive functioning skills. However, findings on whether PH+ affects cognition developmentally is limited. This study explored how PH+ relates to preadolescents’ cognitive performance while controlling for environmental parental factors. Methods We sampled 11,633 participants aged 8–11 (47.74% female) from the Adolescent Brain Cognitive Development Study at baseline. The Family History Assessment evaluated PH+ of alcohol and other drug use problems, with scores ranging from 0–2 parents with problematic use (PH-, PH + 1, PH + 2). PH+ of alcohol (PHA+) and other drugs (PHD+) were assessed separately. The neurocognitive battery included the NIH Toolbox, RAVLT, and Matrix Reasoning. Parental factors assessed included prenatal substance exposure, family conflict, parental warmth, parental monitoring, and parental mental health history. Hierarchical linear mixed-effects models analyzed relationships between PHA+, PHD+, other parental variables of interest, and cognitive outcomes while controlling for demographics. Results PHA+ significantly predicted inhibitory control performance, with PHA + 1 youth performing better than PHA- youth (β = 0.71, p = 0.04), above and beyond other parental behaviors. Conversely, PHD + 1 youth scored lower on immediate (β = −0.3107, p = 0.02) and delayed (β = −3.58, p = 0.01) verbal memory recall, as well as visuospatial memory (β = −1.50, p = 0.003) compared to PHD- youth. Parental factors broadly predicted performance, with parental monitoring and prenatal exposure emerging as the most consistent predictors. Conclusion These findings underscore the complex relationship between PH+, environmental parental factors, and cognition among preadolescents. Future work should explore mechanisms linking parental behaviors to adolescent cognition, given these modifiable factors offer potential for intervention.

Clinical characterization of brucellosis in children from non-pastoral areas: a report of five cases

BackgroundBrucellosis is a global public health concern and occurs mainly in young adults and the elderly, with children having a lower incidence, thus often leading to delayed treatment. This study aimed to describe the epidemiologic features and clinical characteristics of brucellosis in children.MethodsIn this retrospective study, the clinical data of five children diagnosed with brucellosis in Anhui Provincial Children’s Hospital between January 1, 2021 and December 30, 2022 were analyzed.ResultsAll five cases were from non-pastoral areas, among which three have a history of livestock exposure and originated from the countryside. All patients had medium-high grade fever, mostly accompanied by night sweats and malaise, and three had joint pains. Laboratory tests showed that their white blood cell count was normal or mildly raised, with lymphocytes as the predominant cell population. Four patients had anemia, four had aspartate aminotransferase and alanine aminotransferase abnormality, and two had elevated ferritin levels. All blood samples were positive for Brucella culture, one of which had positive bone marrow culture, and all had positive serology test results. All patients were treated with rifampicin, in combination with sulfamethoxazole or doxycycline for 6 weeks following diagnosis. Four children had a good prognosis, but one child had recurrent joint pain.ConclusionsThe epidemiologic history of children from non-pastoral areas with brucellosis is often unclear; clinical manifestations and laboratory tests lack specificity; and they are easily delayed diagnosis. Clinicians should remain vigilant regarding the possibility of this disease in children with fever of unknown origin. The epidemiological history should be investigated in detail to improve the diagnostic ability of brucellosis. We recommend emphasizing serological testing. Children with brucellosis who receive timely diagnosis and standardized treatment can expect a favorable prognosis.

Quantitative matching of forensic evidence fragments using fracture surface topography and statistical learning

The complex jagged trajectory of fractured surfaces of two pieces of forensic evidence is used to recognize a “match” by using comparative microscopy and tactile pattern analysis. The material intrinsic properties and microstructures, as well as the exposure history of external forces on a fragment of forensic evidence have the premise of uniqueness at a relevant microscopic length scale (about 2–3 grains for cleavage fracture), wherein the statistics of the fracture surface become non-self-affine. We utilize these unique features to quantitatively describe the microscopic aspects of fracture surfaces for forensic comparisons, employing spectral analysis of the topography mapped by three-dimensional microscopy. Multivariate statistical learning tools are used to classify articles and result in near-perfect identification of a “match” and “non-match” among candidate forensic specimens. The framework has the potential for forensic application across a broad range of fractured materials and toolmarks, of diverse texture and mechanical properties.

Risk of Hearing Loss in Neonates and Toddlers with in Utero Exposure to SARS-CoV-2.

Given the prevalence of neonatal hearing loss (HL) associated with intrauterine viral exposures, the goal of this study is to provide information on neonatal HL in the context of the COVID-19 pandemic. Data were drawn from the COVID-19 Mother Baby Outcomes (COMBO) Initiative. 1007 participants completed the newborn hearing screen as part of routine clinical care (COMBO-EHR cohort) and 555 completed the National Survey of Children's Health (NSCH) at 2 and/or 3 years of age for research purposes (COMBO-RSCH cohort). Maternal SARS-CoV-2 infection status during pregnancy was determined through electronic health records and maternal-reported questionnaires. In adjusted multivariate logistic regression models covarying for newborn age at assessment, mode of delivery, and gestational age at delivery, there was no significant association between intrauterine SARS-CoV-2 exposure and newborn hearing screening failure (OR = 1.05, 95% CI = 0.39-2.42, p = 0.91) in the COMBO-EHR cohort. In the COMBO-RSCH cohort, there were similar non-significant associations between intrauterine exposure to SARS-CoV-2 and maternal-reported concern for HL on the NSCH (OR = 1.19 [95% CI = 0.30-4.24], p = 0.79). There is no association between intrauterine exposure to SARS-CoV-2 and failed hearing screen in neonates. Similarly, based on the NSCH, there is no association between intrauterine exposure to SARS-CoV-2 and maternal-reported concern for hearing in toddlers. These results offer reassurance given the widespread nature of this pandemic with tens of millions of fetuses having a history of intrauterine exposure. Level 4 Laryngoscope, 2024.

EVALUATION OF NEEDLE STICK INJURY AND ASSOCIATED FACTORS AMONG HEALTHCARE WORKERS IN AL NAJAF CITY/ IRAQ

Introduction:In healthcare-related situations, needle sticks represent a substantial work-related health risk. Healthcare professionals face the danger of contracting blood-borne infections as well as the psychological impact of these wounds. The study aimedtoevaluate the prevalence of needle stick injuries and the associated socio-demographic determinants among healthcare workers.Methods: The research employed a cross-sectional design, with data collection occurring from February 1st, 2023 to February 1st, 2024. 380participants were conveniently selected from different Al-Najaf City/Iraq healthcare institutions. The study sample included a variety of specialists, including anesthetics, surgeons, dentists, surgeon assistants, anesthetics assistants, nurses, physicians, and laboratory workers. A self-administered questionnaire from previously published articles was used for data collection. It covers socio-demographic information, a history of previous exposure to, and the reasons for needle stick injuries.Quantitative variables were summarized with means and standard deviations; descriptive statistics for categorical variables included frequencies and percentages. P ≤ 0.05 indicated statistical significance.Results: Most healthcare workers (85%) were previously exposed to needle sticks. Job category was significantly associated with a history of needle stick exposure (p &lt; 0.001). The anesthetics represent the highest job class exposed to needle sticks (100%). More than one-fifth of participants (21.85%) reported recapping needles followed by bending needles in 16.84% of them as a cause of needle stick injuries. Conclusion: Most healthcare workers are exposed to needle stick injuries; job category is an important risk factor

Antimoniosis: Radiological Insights into a Rare Pneumoconiosis in Miners.

Pneumoconiosis describes diseases caused by the accumulation of inorganic dust particles in the lungs, leading to tissue damage. The diagnosis relies on a history of exposure and compatible radiological findings. We aimed to investigate the radiological findings in individuals exposed to antimony-inert dust relative to their working periods. Fifty-six symptomatic male antimony miners were retrospectively evaluated for demographics and chest computed tomography (CT) scans. The demographic and radiological data of patients with a history of antimony mining, who presented at our pulmonary clinic between June 2017 and June 2023, were analyzed according to the duration of exposure. The study included 56 male patients with a mean age of 58.5±13.02 years and a mean exposure duration of 13.63 ± 6.82 years. CT scans showed that 73.2% (n=41) had upper and middle lung zone involvement, and 55.4% (n=31) had extensive involvement. Micronodules with centriacinar ground-glass opacities were the most common finding (n=37, 66.1%), followed by nodular opacities with irregular margins (n=22, 39.3%) and solid micronodules (n=20, 35.7%). Patients with over 20 years of exposure had significantly higher rates of respiratory and cardiovascular disease (p<0.05). Increased exposure time correlated with more extensive parenchymal involvement and higher rates of calcification in mediastinal lymph nodes, solid micronodules, nodular opacities with irregular margins, honeycombing, and conglomerate mass appearance. Radiological findings in pneumoconiosis generally worsen with longer exposure. Given the scarcity of up-to-date information on antimony pneumoconiosis, further studies focusing on radiological findings and chemical analyses of those exposed to antimony mine dust are essential to identify related pathologies.