Hepatitis A Research Articles

Challenges and global trends in combating enteric hepatitis.

Enteric hepatitis, represented by the hepatitis A virus (HAV) and hepatitis E virus (HEV), remains a significant global public health concern. While much progress has been made, many aspects of the biology and pathophysiology of HAV and HEV are still not fully understood. One of the major challenges is the absence of a reliable system for virus replication. Additionally, the lack of standardized and widely accessible diagnostic tests contributes to the underestimation of the true prevalence of these viruses. Factors such as climate change, environmental shifts, globalization and increased population mobility further complicate the spread of these infections by affecting pathogen transmission, water quality and the distribution of vectors. This review approaches the emergent research challenges and trends of enteric hepatitis and focuses on developing more efficient diagnostic tools, exploring the role of zoonotic transmission and addressing the impact of environmental and climate changes on disease dynamics, underscoring the need for collaborative, interdisciplinary efforts to effectively combat enteric hepatitis in a rapidly changing world.

Thermochemical processing for the sustainable disposal of spent filter waste

High-efficiency particulate air filters are widely used for indoor air purification. Spent filter waste (SFW), which can trap infectious and toxic substances, is primarily treated via incineration. This method causes environmental concerns, particularly regarding the generation of carbon dioxide (CO2) and other air pollutants. To cope with these issues, this work proposes the pyrolysis of SFW using CO2 as a sustainable alternative to conventional incineration. The introduction of CO2 enhanced reactivity during pyrolysis, potentially offering a more sustainable process. The SFW consisted of filtered particles and two distinct filter/support layers, and the presence of toxic chemicals and primary polymer constituents was characterized. While CO2 had a minimal impact on enhancing syngas production, owing to its slow reaction rate during SFW pyrolysis, adding a nickel-based catalyst significantly improved CO2 reactivity. This resulted in a 649.7% increase in carbon monoxide (CO) production compared to that in pyrolysis under N2. The potential of this pyrolysis system for reducing CO2 emissions was evaluated against that of conventional incineration. Overall, this study presents a promising method for the pyrolytic conversion of SFW into combustible gases, particularly CO, while leveraging CO2 utilisation to mitigate global warming.

Fabrication of multilayer cellulose filters isolated from natural biomass for highly efficient air filtration for replacement of synthetic HEPA filters

Indoor air pollution can be extensively reduced by using a molecular air filtration system. However, widely utilized synthetic polymer-based filtration medium can lead to waste management difficulty after use. Consequently, this work aimed to synthesize highly efficient air nano-filters derived from renewable and biodegradable resources namely EFB and Pulp. The study successfully presented an air filter from 100% natural cellulose using a facile physical multilayer filter fabrication method. A combination of chemical and mechanical treatment was applied to prepare nanocellulose. The chemical composition analysis showed that 66-67% nanocellulose yield was efficiently isolated from both raw materials. The highest particle filtration efficiency (PFE) of 97.30% (0.3 μm particle size) greater than that of commercial HEPA filters was achieved from multilayer acid-derived microfiber@mechanically treated nanofibers from EFB with low-pressure drop of 11.56mm H2O. When %PFE and pressure drop were taken into consideration, all single-layer and multilayer-patterned fiber filters in this study provided high quality factor (QF) beyond 0.01Pa−1 which is the target of the air filter. The findings revealed that the pattern-layer filters through TBA-induced freezing-drying technique could achieve the removal of microbial model and Particulate Matters (PM1.0) represented as 0.1 and 0.3 μm particles, at the very low-pressure drop. Therefore, this study not only enhances the value of natural lignocellulosic wastes but also presents inspiring concepts for creating biodegradable cellulose-based air filters that will pave the way to more eco-friendliness and sustainability for synthetic filter replacement.

Composite electrospun membranes from cellulose nanocrystals, castor oil, and poly(ethylene terephthalate): Air permeability, thermal stability, and other relevant properties.

The study examined the use of cellulose nanocrystals (CNCs) in poly(ethylene terephthalate) (PET)/castor oil (CO) electrospun membranes, focusing on how CNCs influenced membrane properties for aerosol filtration applications. PET membranes were fabricated using 5 wt% and 10 wt% of CNCs and 2.5 wt% CO to assess its effectiveness as a compatibilizing agent, under a solution flow rate of 25.5 μL/min, a voltage of 25 kV, and a needle-collector distance of 8 cm. Nonaligned fiber membranes featured a network of ultrafine and nanofibers, while aligned fibers had an average diameter of over 300 nm (ultrafine fibers). The PET membranes permeability parameters were applied to Forchheimer's equation. All membranes presented values of Darcian (k1)/non-Darcian (k2) permeability coefficients in the order of 10-13 m2/10-8 m, respectively, near the range reported for commercial high-efficiency particulate air filters. CNCs acted as reinforcing agents, while CO was a compatibilizing agent, improving the material's mechanical behavior. Nonaligned PET/CO/10 wt% CNC presented a storage modulus (E') 2-fold higher/tensile strength 3-fold higher than pristine PET. Aligned PET/CO/5 wt% CNC, characterized in the preferential direction of fiber alignment, had approximately an E' 42-fold higher/tensile strength 6-fold higher than the same membrane, but tested in the perpendicular alignment direction. The glass transition temperature (Tg) values of PET (90-110 °C) did not exhibit any significant impact from membrane composition or fiber alignment. This study demonstrated the promising capability of PET-CNC bio-based electrospun membranes to be used in aerosol filtration or gas-solid and liquid-solid separations.

Acute hepatitis in children: A wide clinical spectrum

Introduction: Acute hepatitis remains an important health problem in children. viral hepatitis particularly hepatitis A remains the most common cause. Nevertheless, other causes such as non A non B hepatitis and mixed infections like enteric fever are other causes particularly in developing countries like India. The spectrum of acute hepatitis is also varied with many atypical presentations in the form of fever along with icterus as presenting features. Use of lab parameters as prognostic markers for development of acute liver failure (ALF) needs further exploration as it can be used to identify patients who need better monitoring and may be the potential candidates for liver transplantation. In our study we have tried to find a possible association between liver enzyme values and number of children who develop ALF. Methods: Children between 1 and 15 years of age who presented with features of acute hepatitis were enrolled in the study after taking informed consent from their parents. Data was collected about their epidemiological and clinical characteristics in a predesigned study performa. Quantitative data were described as means and standard deviations and qualitative data were computed into frequency (No) and percentages (%). Chi-square (χ2) test was used to determine the statistical difference between the categorical variables, while means were compared using student’s t test. For all statistical analyses, p value < 0.05 was adopted as level of significance. Results: We enrolled 68 patients of acute hepatitis. Most of them were males (78%) and majority were in 6 to 10 years age category. The most common clinical presentation was with abdominal pain followed by fever and icterus. Liver enzymes were raised to the tune of 10 to 20 times in the second week of illness. Serum bilirubin mean value was 5.3. Serum bilirubin values remained almost constant over 3 weeks period while liver enzymes showed a decline. 26% patients presented with ALF. Also, liver enzyme values in the second week showed a positive association with development of ALF with higher values associated with a higher chance of development of ALF. Conclusion: Hepatitis A was the most important cause of acute hepatitis in children and albeit early, a significant proportion of them develop features of ALF. Regular monitoring of liver enzymes can serve as a prognostic marker for development of ALF. It requires larger level studies to use liver enzymes as prognostic markers of ALF in paediatric patients.

Predictive Modelling of Liver Disease Using Biochemical Markers and K-Nearest Neighbors Algorithm

The incidence of liver cirrhosis-related deaths is on the rise due to increased alcohol consumption, chronic hepatitis infections, and obesity-related liver conditions. Early detection is critical for improving patient outcomes; however, female patients often experience delayed diagnosis. This study aims to develop a predictive model for liver disease using biochemical markers and to investigate gender disparities in diagnostic accuracy. A dataset of 584 patient records from NorthEast Andhra Pradesh, India, was utilized, comprising ten variables per patient, including age, gender, total bilirubin, direct bilirubin, alkaline phosphatase, SGPT, SGOT, total proteins, albumin, and the albumin/globulin ratio. The data were pre-processed by encoding categorical variables and scaling numerical features. The K-Nearest Neighbors (K-NN) algorithm was employed for classification, and performance was evaluated using cross-validation. The model demonstrated variable accuracy across different folds, with accuracy ranging from 57.76% to 73.28%, precision from 58.14% to 70.56%, recall from 57.76% to 73.28%, and F1-score from 57.95% to 70.45%. These results indicate the potential of biochemical markers in predicting liver disease and highlight significant gender disparities in diagnostic accuracy. The study's contributions include the development of a practical predictive tool and the identification of gender-specific diagnostic challenges. Future research should focus on larger, more diverse datasets and explore additional machine learning algorithms to enhance predictive accuracy and address gender disparities in liver disease diagnosis.

A Cell-Based Electrochemical Biosensor for the Detection of Infectious Hepatitis A Virus

Hepatitis A virus (HAV), a major cause of acute liver infections, is transmitted through the fecal–oral route and close contact with infected individuals. Current HAV standardized methods rely on the detection of virus antigen or RNA, which do not differentiate between infectious and non-infectious HAV. The objective of this study was to develop a prototype cell-based electrochemical biosensor for detection of infectious HAV. A cell culture-adapted HAV strain (HM175/18f) and its permissive cells (FRhK-4), along with gold nanoparticle-modified screen-printed electrodes, were used to develop the biosensor. Electrochemical impedance spectroscopy was used to quantify the electrical impedance signal. Nyquist plots showed successful fabrication of the cell-based biosensor. The optimum period of HAV incubation with the biosensor was 6 h. A significant linear relationship (R2 = 0.98) was found between the signal and a 6-log range of HAV titers, with a limit of detection of ~5 TCID50/mL (tissue culture infectious dose). The biosensor did not detect non-target viruses such as feline calicivirus and human coronavirus 229E. The biosensor was stable for 3 to 7 days at an abusive temperature (37 °C), retaining ~90 to 60% of the original signal, respectively. In conclusion, this prototype cell-based biosensor is capable of rapidly detecting low levels of infectious HAV.

Viral Hepatitis in Western Patients with Advanced Intrahepatic Cholangiocarcinoma: Retrospective Assessment of Prevalence, Prognostic and Predictive Significance

Despite a biologically established causative role of viral hepatitis (VH), i.e. HBV and HCV infections, on intrahepatic cholangiocarcinoma (ICC), only few large Western cohorts exploring the association between VH and ICC development are available. The prognostic significance of VH in ICC is debated, and no data are available regarding a predictive role for standard first-line CT (CT1), consisting of gemcitabine +/− platinoids. VH-positivity definition is often clinically incomplete and inconsistent among studies. Five different VH conditions, based on laboratory and anamnestic data, were investigated in a multicentric retrospective cohort of advanced ICC cases. Depending on the specific VH condition considered, 139–194 of 472 ICC cases could be categorized according to the presence of the mentioned VH conditions. VH prevalence ranged from 9.3 to 25.3%. No VH condition showed an impact on survival, although a non-significant worse outcome was observed for some HBV-related conditions. HCV-related conditions were associated to lower pre-CT1 biomarkers of inflammation, markedly higher disease control, and numerically longer time-to-progression with CT1. No benefit on time-to-progression was demonstrated for the addition of platinoids to gemcitabine in VH-positive patients (HR 0.77, CI95% 0.41–1.45), at least in HBV-related cases. These findings are clinically relevant and deserve further investigation.

Diagnostic performance of procalcitonin for bacterial infection in severe alcoholic hepatitis compared with C-reactive protein

BackgroundSevere alcoholic hepatitis is a catastrophic disease with a mortality rate of up to 35–50% at 30 days. Bacterial infection is an important prognostic factor in patients with severe alcoholic hepatitis, but it is difficult to detect the presence of infection immediately. Procalcitonin (PCT) is a well-known inflammatory marker that can detect bacterial infections in various diseases early. Therefore, we aimed to evaluate the diagnostic accuracy of PCT for bacterial infection in severe alcoholic hepatitis.MethodsWe prospectively enrolled patients with severe alcoholic hepatitis, defined as modified Maddrey’s Discriminant Function ≥ 32, from 10 medical centers. At admission, we performed an initial evaluation including physical examination, laboratory test, radiology, blood and urine culture, PCT, and C-reactive protein (CRP). We compared the receiver operating characteristic (ROC) curves of PCT and CRP for bacterial infection, systemic inflammatory response syndrome (SIRS), and sepsis among total patients.ResultsA total of 108 patients with severe alcoholic hepatitis were enrolled. The number of bacterial infections, SIRS, and sepsis were 31 (28.7%), 41 (38.0%), and 19 (17.6%), respectively. The patients with bacterial infection had significantly higher MELD scores (24.0 vs. 15.0), PCT levels (1.5 vs. 0.4 ng/mL), and CRP levels (4.9 vs. 2.5 mg/dL) compared to those without bacterial infection. The area under the ROC curve (AUROC) of PCT vs. CRP for bacterial infection was 0.752 and 0.655, respectively (P = 0.113). The AUROC of PCT vs. CRP for SIRS was 0.699 and 0.662, respectively (P = 0.490). The AUROC of PCT vs. CRP for sepsis was 0.780 and 0.630, respectively (P = 0.027).ConclusionsAmong patients with severe alcoholic hepatitis, PCT showed a trend of superior diagnostic performance in the early detection of bacterial infection and sepsis compared to CRP. Although PCT might have better potential to diagnose sepsis in the setting of severe alcoholic hepatitis, it is necessary to find more reliable diagnostic markers.

Hepatovirus translation requires PDGFA-associated protein 1, an eIF4E-binding protein regulating endoplasmic reticulum stress responses.

The overexpression and misfolding of viral proteins in the endoplasmic reticulum (ER) may cause cellular stress, thereby inducing a cytoprotective, proteostatic host response involving phosphorylation of eukaryotic translation initiation factor 2 subunit alpha (eIF2α). Here, we show that hepatitis A virus, a positive-strand RNA virus responsible for infectious hepatitis, adopts a stress-resistant, eIF2α-independent mechanism of translation to ensure the synthesis of viral proteins within the infected liver. Cap-independent translation directed by the hepatovirus internal ribosome entry site and productive hepatovirus infection of mice both require platelet-derived growth factor subunit A (PDGFA)-associated protein 1 (PDAP1), a small phosphoprotein of unknown function with eIF4E-binding activity. PDAP1 also interacts with eIF1A and is essential for translating stress-resistant host messenger RNAs that evade the proteostatic response to ER stress and that encode proteins promoting the survival of stressed cells.

Molecular Basis for the Differential Function of HAVCR1 Mucin Variants.

Background/Objectives: The hepatitis A virus (HAV) cellular receptor 1 (HAVCR1) is a type I integral membrane glycoprotein discovered in monkeys and humans as a HAV receptor. HAVCR1 contains an N-terminal immunoglobulin-like variable domain (IgV) followed by a mucin-like domain (Muc), a transmembrane domain, and a cytoplasmic tail with a canonical tyrosine kinase phosphorylation site. The IgV binds phosphatidylserine on apoptotic cells, extracellular vesicles, and enveloped viruses. Insertions/deletions at position 156 (156ins/del) of the Muc were associated in humans with susceptibility to atopic, autoimmune, and infectious diseases. However, the molecular basis for the differential function of the HAVCR1 variants is not understood. Methods: We used mutagenesis, apoptotic cell binding, and signal transduction analyses to study the role of the 156ins/del in the function of HAVCR1. Results: We found that the HAVCR1 variant without insertions at position 156 (156delPMTTTV, or short-HAVCR1) bound more apoptotic cells than that containing a six amino acid insertion (156insPMTTTV, or long-HAVCR1). Furthermore, short-HAVCR1 induced stronger cell signaling and phagocytosis than long-HAVCR1. Conclusions: Our data indicated that the 156ins/del determine how the IgV is presented at the cell surface and modulate HAVCR1 binding, signaling, and phagocytosis, suggesting that variant-specific targeting could be used as therapeutic interventions to treat immune and infectious diseases.

ASSESSMENT OF BIOLOGICAL RISKS IN INFECTIOUS DISEASES TO ENSURE BIOLOGICAL SAFETY

The territory of the Republic of Kazakhstan is unfavorable for a number of infectious diseases of animals and humans that pose an enzootic biological threat. Such nosological units include anthrax, blackleg, rabies, leukemia, brucellosis, tuberculosis, pasteurellosis, sheep pox, camel pox, CCHF, highly pathogenic avian influenza, foot-and-mouth disease, tick-borne encephalitis, influenza A and B, infectious hepatitis, Newcastle disease, seasonal flu, coronavirus infection COVID-19, etc., some of which affect only animals or humans, and some affect both animals and humans. While some of these diseases are natural focal and pose a constant biological threat, others appear from time to time, penetrating from neighboring countries or develop as a result of movement from the wild - reservoirs and hidden carriers of pathogens. A number of exotic diseases pose a real threat of penetration from outside the country due to interstate movements of people, animals, feed and animal products.

Seasonal Characterization of the Aerobiome in Hematopoietic Stem Cell Transplant Rooms: Potential Risk for Immunosuppressed Patients.

Infections pose a risk for patients undergoing hematopoietic stem cell (HSC) transplants due to their immunosuppression, making them susceptible to opportunistic infections. Therefore, understanding the composition of the aerobiome in this area is vital. The aim of this study was to characterize the aerobiome in an HSC transplant area, evaluating the impact of infrastructure and health personnel operations on air contamination. The environmental parameters and aerobiome of the HSC transplant area at Hospital Juárez de México were quantified over one year. Finally, a double-entry Vester matrix was constructed to classify problems according to their degree of causality. The abundance and taxonomic diversity of the aerobiome were dependent on seasonality, environmental factors, and high-efficiency filtration. Gram-positive bacteria predominated, followed by fungi and Gram-negative bacteria. ANOVA revealed significant differences in the bacterial aerobiome but not in the fungal aerobiome among the transplant rooms. Clinically, fungi such as Aspergillus fumigatus, Alternaria spp., Cladosporium spp., and Penicillium spp. were identified. ESKAPE bacteria typing revealed clonal dispersion. Finally, the Vester matrix highlighted critical problems associated with contamination due to the absence of HEPA filtration and non-adherence in patient management practices. HEPA filtration and positive pressure are essential to improve the air quality and reduce the microbiological load. However, the control areas will depend on patient management and routine activities, such as entry protocols in controlled areas.

Socioeconomic determinants of malaria and hepatitis infections: insights from the Federal Medical Center, Makurdi, North Central, Nigeria

BackgroundMalaria and hepatitis are prevalent public health issues in Nigeria, significantly impacting health outcomes. Given the importance of the Federal Medical Center, Makurdi, as a key healthcare provider in the region, it is crucial to understand the prevalence and factors associated with these diseases within this setting. This study is designed to address this need, aiming to evaluate the prevalence and risk factors of malaria and hepatitis B and C among patients at the Federal Medical Center, Makurdi.MethodologyA cross-sectional study design was employed, involving the meticulous analysis of patient records and diagnostic data from the Federal Medical Center, Makurdi. Data on malaria and hepatitis B and C prevalence were collected from laboratory reports and patient interviews. Socioeconomic information, including income, education level, and healthcare access, was also gathered. Statistical analyses were performed with utmost care to identify associations between disease prevalence and risk factors.ResultsThe study examined 248 patients at the Federal Medical Centre, Makurdi, assessing malaria, Hepatitis B surface antigen (HBsAg), and Hepatitis C virus (HCV). Malaria prevalence was 52.4%, with higher rates in males (57.7%) than females (47.2%). HBsAg prevalence was 6.9%, and HCV was 4.8%, with no significant differences by sex or marital status. Income level impacted HCV rates, with middle-income individuals showing higher prevalence (21.4%). Malaria was most common in the 26–40 age group (35.4%).DiscussionThe findings underscore the need for targeted public health interventions. Enhanced access to preventive measures, such as insecticide-treated nets and safer blood transfusion practices, and educational disease prevention programs, are essential. Addressing socioeconomic disparities is crucial for effective disease control.ConclusionTo mitigate the burden of malaria and hepatitis B and C at the Federal Medical Center, Makurdi, a multifaceted approach is required. Improving preventive measures, healthcare access, and addressing socioeconomic determinants will reduce disease prevalence and improve patient outcomes.

Viral hepatitis A in children: a false prosperity?

The article presents current data on the state of the issue of Hepatitis A (HA) in children in the Russian Federation and describes clinical and epidemiologic features of rare cases of severe course of the disease, as well as pathogenetic mechanisms of liver damage mediated by cell immune response. Objective. To identify clinical and epidemiologic features of the modern course of HA and its outcomes in children of Saint Petersburg within the period of 2018— 2023. Materials and methods. The study included 89 children diagnosed with HA, undergoing treatment at the Children's Research and Clinical Center for Infectious Diseases from 2018 to 2023. The analysis of disease progression in this group of patients was presented using clinical-anamnestic, epidemiologic, biochemical, virologic and instrumental data. Results. The analysis of infection sources showed a high frequency of HA infection within the family (44.9 ± 0.8%) and significantly less in childcare facilities and schools (7.9 ± 1.0%). The frequency of children with unidentified sources of infection remained high (47.2 ± 0.7%). One-third of all disease cases were imported from southern regions. Most hospitalized children had icteric HA (64.0 ± 0.6%) of moderate severity (79.8 ± 0.5%). Severe HA was observed in 6 patients (6.7 ± 1.0%). During the study, 17 patients (19.1 ± 0.9%) had a prolonged, complicated course of the disease, including ascites and aplastic anemia (12.6 ± 2.2%). Ascites was found in 4 patients with severe severity and in 5 patients with moderate severity of HA. Conclusions. Currently, there is an upward trend in the incidence of HA in the Russian Federation and Saint Petersburg, especially among schoolchildren (56.2%). A rather high frequency of severe (6.7%) and complicated forms (19.1%) of the disease is observed, and the growth of ascites and aplastic anemia cases in HA draws particular attention.

Risk of Hepatitis C Virus Infection in Tuberculosis Patients: A Systematic Review and Meta-Analysis.

Tuberculosis (TB) and infection of Hepatitis C virus (HCV) have appeared as major public health problems. The present systematic review and meta-analysis aimed at determining the relationship between TB and the risk of HCV infection. Google Scholar, Embase, Medline, Pubmed, web of sciences (ISI), and Scopus were searched until March 2022. The pooled ORs of HCV in patients with TB were calculated utilizing the random-effect model with a 95% confidence interval (CI). I2 test was utilized for evaluating the heterogeneity. To check publication bias Egger and Beggs' tests were used. From among 1500 articles from 2006 to 2020, 13 studies were examined and analyzed based on the inclusion/exclusion criteria. The overall risk of HCV infection in patients with TB was (OR: 1.34, 95% CI: 1.10-1.63, P=0.001). According to the type of the countries subgroup analysis, the risk of HCV infection in patients with TB in developing countries was (OR: 1.95, 95% CI: 1.00-3.80), which was higher than the risk in developed countries (OR: 1.47, 95% CI: 1.42-1.52). In addition, the risk of hepatitis C infection in men compared to women (OR: 1.84, 95% CI: 1.75-1.94, P=0.001) and in age groups over 65 yr compared to other age groups (OR: 1.46, 95% CI: 0.98-2.16) was significantly higher. The results of this study emphasized the importance of screening HCV in patients with TB. Being aware of the presence or absence of HCV in these patients can contribute to their effective treatment.

Multi-omic molecular characterization and diagnostic biomarkers for occult hepatitis B infection and HBsAg-positive hepatitis B infection.

The pathological and physiological characteristics between HBsAg-positive HBV infection and occult hepatitis B infection (OBI) are currently unclear. This study aimed to explore the immune microenvironment in the peripheral circulation of OBI patients through integration of proteomic and metabolomic sequencing, and to identify molecular biomarkers for clinical diagnosis of HBsAg-positive HBV and OBI. This research involved collection of plasma from 20 patients with OBI (negative for HBsAg but positive for HBV DNA, with HBV DNA levels < 200 IU/mL), 20 patients with HBsAg-positive HBV infection, and 10 healthy individuals. Mass spectrometry-based detection was used to analyze the proteome, while nuclear magnetic resonance spectroscopy was employed to study the metabolomic phenotypes. Differential molecule analysis, pathway enrichment and functional annotation, as well as weighted correlation network analysis (WGCNA), were conducted to uncover the characteristics of HBV-related liver disease. Prognostic biomarkers were identified using machine learning algorithms, and their validity was confirmed in a larger cohort using enzyme linked immunosorbent assay (ELISA). HBsAg-positive HBV individuals showed higher ALT levels (p=0.010) when compared to OBI patients. The influence of HBV infection on metabolic functions and inflammation was evident through the analysis of distinct metabolic pathways in HBsAg-positive HBV and OBI groups. Tissue tracing demonstrated a connection between Kupffer cells and HBsAg-positive HBV infection, as well as between hepatocytes and OBI. Immune profiling revealed the correlation between CD4 Tem cells, memory B cells and OBI, enabling a rapid response to infection reactivation through cytokine secretion and antibody production. A machine learning-constructed and significantly expressed molecule-based diagnostic model effectively differentiated HBsAg-positive and OBI groups (AUC values > 0.8). ELISA assay confirmed the elevation of FGB and FGG in OBI samples, suggesting their potential as biomarkers for distinguishing OBI from HBsAg-positive infection. The immune microenvironment and metabolic status of HBsAg-positive HBV patients and OBI patients vary significantly. The machine learning-based diagnostic model described herein displayed impressive classification accuracy, presenting a non-invasive means of differentiating between OBI and HBsAg-positive HBV infections.

Air Purifiers and Acute Respiratory Infections in Residential Aged Care

The effectiveness of in-room air purification for the reduction of acute respiratory infections (ARIs) in residential aged-care facilities (RACFs) is unknown. To investigate the effectiveness of in-room air purifiers with high-efficiency particulate air (HEPA)-14 filters in reducing the incidence of ARIs among residents of RACFs. This randomized clinical trial used a multicenter, double-blind, 2-period, 2-treatment crossover design for 6 months from April 7 to October 26, 2023, in 3 RACFs with a bed capacity of 50 to 100 in New South Wales, Australia. The purposive sampling approach included permanent residents in private rooms in the enrolled RACFs. Data collection was performed every 2 weeks and required no additional follow-up beyond the final data collection on October 31, 2023. An air purifier containing a HEPA-14 filter was placed in rooms of participants in the intervention group, and an air purifier without a HEPA-14 filter was placed in rooms of the control participants. The groups crossed over after 3 months. The primary outcome was the incidence of ARIs, assessed with logistic mixed-model regression. Among 135 participants randomized (70 to the intervention-first group and 65 to the control-first group), 78 (57.8%) were female; mean (SD) age was 85.2 (8.6) years. In the intention-to-treat analysis, the use of air purifiers with HEPA-14 filters did not reduce ARIs compared with the control (OR, 0.57; 95% CI, 0.32-1.04; P = .07). Among the 104 participants who completed the entire study, the intervention reduced ARI incidence from 35.6% (37 participants) in the control group to 24.0% (25 participants) in the intervention group (OR, 0.53; 95% CI, 0.28-1.00; P = .048). In this clinical trial investigating use of air purifiers with HEPA-14 filters for reducing ARIs, no significant between-group difference was found in the intention-to-treat analysis. However, a significant reduction in ARIs was identified among participants who completed the entire study. These findings may help inform future large-scale studies of respiratory infectious diseases. ANZCTR identification: ACTRN12623000347662.

The correlation between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) with non-alcoholic fatty liver disease: an analysis of the population-based NHANES (2017-2018).

Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of liver disorders, from benign steatosis to more severe conditions like non-alcoholic steatohepatitis, with risks of progressing to fibrosis, cirrhosis, and hepatocellular carcinoma. The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) indicates lipid metabolic dysregulation and is associated with increased risks of various diseases. This study examines the relationship between NHHR and NAFLD to evaluate NHHR as a potential predictive biomarker for NAFLD. Data from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) were used for cross-sectional analysis. After excluding individuals with incomplete data, hepatitis infections, heavy alcohol use, and those under 18, the study included 2,757 adults. The relationship between NHHR and NAFLD was analyzed using multivariable logistic regression, including subgroup analysis and interaction testing. Among the 2,757 participants (mean age 49.91 years), 44.9% had NAFLD. NHHR showed a significant positive association with NAFLD, with an unadjusted odds ratio (OR) of 1.71 and a fully adjusted OR of 1.45. Quartile analysis revealed a 228% higher prevalence of NAFLD in the highest NHHR quartile, with an OR of 3.28. This positive association was consistent across various subgroups. Our findings suggest that elevated NHHR is positively correlated with the prevalence of NAFLD and possesses predictive value. We recommend that future research validate the clinical utility of NHHR, particularly for early detection of high-risk individuals and guiding personalized interventions.

Study of the Microbiological Efficiency of a Hospital Ventilation System With Hepa Filtration in the Prevention of Airborne Pathogens

Objective: To evaluate the microbiological efficiency in air conditioning systems with HEPA filtration in an infectious disease hospital. Theoretical Framework: Air conditioning in intensive care units and wards must consider the spread of microorganisms through respiratory pathways, as both patients and healthcare professionals are exposed to infectious agents transmitted by bioaerosols. Due to the possibility of environmental infection, there is a growing recognition that poorly designed air conditioning systems enhance the transmission of pathogens in areas with constant flow of individuals, particularly immunocompromised patients, who are more susceptible to infections. Air conditioning with HEPA filtration is a hospital engineering technique that shows great potential for filtering airborne contaminants, thereby reducing their dispersion in the environment. Method: Air samples were collected using the active impaction method over a 32-week period in the intensive care unit and wards of a reference hospital for infectious diseases. Results and Discussion: In the hospital environment, 67% of fungi and 33% of bacteria were identified, along with their respective subcategories. The colony-forming unit count exceeded the standards established by current regulations. The study highlights that hospital air is a pathway for the transmission and persistence of pathogenic microorganisms. Research Implications: The importance of ensuring a safe and healthy hospital environment is emphasized. Originality/Value: There are few studies addressing pathogens transmitted by bioaerosols. This study contributes to expanding knowledge on this topic and suggests the need for a review of current regulatory standards.