High Levels Of Disease Research Articles

Equestrianism's social license to operate: assumptions, reality and the future

Horse sports and equestrian activities are high risk to the horses and people undertaking them. Societal views on using animals for human entertainment are changing and there is increased debate on how animal welfare is safeguarded. Traditional management systems that reduce opportunities for expression of normal behaviour and high levels of disease and injury in horses interacting with humans have increased public scrutiny on the use of horses by humans, resulting in equestrianism's social license to operate being questioned. A social license to operate is a virtual license from society to engage in an activity – without this, the future of equestrianism is under threat. This review explores what constitutes a social license to operate and considers how stakeholders in the equestrian sector could work together to generate an effective social license to operate to ensure horses have a good life in all aspects of their relationship with humans.

D-Dimer: A Primer Biomarker in COVID-19

Aim and Objective: To explore risk factors associated with mortality in COVID-19 patients and assess the use of D-dimer as a first line biomarker for disease severity and clinical outcome.
 Materials and Methods: We retrospectively analysed the pathological and radiological characteristics of 2087 consecutive cases of COVID-19 in PSH, Vadodara, Gujarat, from March 2021 to July 2022. Graphically, MS-Excel with median values were used. Correlations of D-dimer upon admission with disease severity and in-hospital mortality were analysed accordingly. Data were collected in MS-Excel with median values.
 Results: 2087 patients having positive RT-PCR and confirm diagnosis of Covid-19 were included upon hospital admission. Whereas, 65.78% (n= 1373) were male and 34.21% (n= 714) were female. Mean age was 52± 4 year. D-dimer level > 250 ng/mL at the time of hospital admission was the only fluctuating value accompanying with increased mortality [(95% CI), P = 0.025]. D-dimer elevation (≥250 ng/mL) was seen in 81.31% patients. Pericardial effusion and Deep vein thrombosis were ruled out in probability of thrombosis based on 2-D echo, X-ray chest and USG. This recommend that hyper-coagulopathy of the fibrin plays a significant role in the occurrence of thromboembolic complications with COVID-19 patients. D-dimer levels was crucially escalated with increasing severity of COVID-19 as determined by clinical improvement (within 5 days of hospital stay) and chest CT staging (CO-RADS score out of 25, P = 0.000). 319 patient were died during above said period and overall in-hospital mortality rate was 15.28%. Additionally, 6.08 % (n=127) patient were on BIPEP and all are died with 100% death ratio. Median D-dimer level in non-survivors (15.29%) was significantly higher than in survivors (84.71%, n = 1768, RR 24.69%). Median elevated D-dimer level was 600.5 ng/ml. Furthermore, the disease activity were higher in the overhead D-dimer level group demonstrated to have anticipating value in differentiating disease severity along with high ESR level and hs-CRP and the fibrinogen level was also upraised indicated seriousness of disease.
 Conclusion: We concluded that D-dimer level was routinely uplifted in patients with COVID-19 disease. D-dimer levels match up with severity of the disease and are a significant definitive prognostic first line marker for in-hospital mortality for COVID-19 disease. Furthermore, a significant association between the high D-dimer level and severity of COVID-19 disease was noted among comorbid patients. Additionally, raced D-dimer level demonstrated with high ESR level and hs-CRP and the fibrinogen level indicated seriousness of disease in comorbid patients.

Muscle Damage, Inflammation, and Muscular Performance following the Physical Ability Test in Professional Firefighters.

Proper monitoring of fatigue and muscular damage may be used to decrease the high levels of cardiovascular disease, overuse musculoskeletal injuries, and workers compensation claims within the profession of firefighting. The purpose of this study was to examine muscle damage, muscular fatigue, and inflammation responses following a typical firefighting shift. Twenty-four professional firefighters completed two Physical Ability Tests to standardize the tasks typically performed in a day of work, and to elicit similar physiological responses. Participants were then monitored for 48 h. Prior to, and 48 h following the Physical Ability Tests, participants were evaluated for changes in strength, power, range-of-motion, as well as blood markers including myoglobin and c-reactive protein. Following the Physical Ability Tests, significant differences in myoglobin (p < 0.05), grip strength (p < 0.05), vertical jump (p < 0.05), and sit-and-reach (p < 0.05) were observed. No difference in c-reactive protein was observed (p > 0.05). After 24 hours following a shift, firefighters exhibited decreased strength, power, and range-of-motion. This may lead to decreases in performance and an increased risk of injury.

Conjoint analysis of transcriptome and metabolome profiles of normal captivity and arch soil free-range in Meishan pigs.

The hygiene hypothesis has been advanced as a potential explanation for the increasingly high levels of atopy and allergic disease in the general human population. In an effort to conduct a more detailed study of the link between immune activity and the hygiene hypothesis, Meishan pigs raised under normal captivity (NC) or arch soil free-range (ASF) conditions were selected as an experimental model system. Cytokine levels were found to differ significantly between these two groups consistent with a difference in cellular immune status. Integrated transcriptomic and metabolomic profiling of duodenal tissue samples from Meishan pigs were then performed, leading to the identification of differentially expressed genes (DEGs), differentially abundant metabolites (DAMs), and key pathways that were able to distinguish the NC and ASF groups. This approach led to the identification of 1,113 DEGs, as well as 577 and 372 DAMs in positive and negative ion modes, respectively. When an interaction network incorporating DEGs and metabolites associated with immune responsivity was constructed, it included factors such as 9-cis-Retinoic acid, (9Z,11E)-(13S)-13-Hydroxyoctadeca-9,11-dienoic acid and (10E,12Z)-(9S)-9-Hydroxyoctadeca-10,12-dienoic acid. Functional enrichment analyses confirmed that identified DEGs and DAMs were associated with immune-related pathways including the intestinal IgA production and PPAR signaling pathways. Together, these results offer new insight into the roles that particular genes and metabolites enriched in response to environmental stressors in free-range Meishan pigs may play in the regulation of cellular immunity, thus offering a foundation for future efforts to better understand the immunological mechanisms underlying the hygiene hypothesis.

Leishmania Seroprevalence in Dogs: Comparing Shelter and Domestic Communities.

Canine leishmaniosis (CanL) is a chronic, systemic, and often severe disease. The main causative agent of CanL is a protozoan parasite, Leishmania infantum, with phlebotomine sand flies acting as vectors. In Europe and other continents, L. infantum is also responsible for leishmaniosis in other animals, such as cats, horses, and humans. In Portugal, animal and human leishmaniosis is endemic, and high prevalence levels of infections and disease have been reported in dogs. There is a prejudice against stray animals and also those housed in shelters, assuming they have higher levels of infection with vector-borne pathogens, including L. infantum, when compared to domestic animals. In northeastern Portugal, serum samples were obtained from March to May 2022 in three shelters (n = 179) and thirteen veterinary clinics (n = 164), resulting in 343 dogs being analyzed for antibodies to Leishmania spp. by the direct agglutination test (DAT). The overall seroprevalence was 9.9%, with 15.2% seroprevalence in domestic dogs and 5.0% in the shelter ones (p = 0.003). The fact that shelter dogs had a lower seroprevalence could be explained by more regular veterinary care provided in shelters regarding preventive measures, including insecticides with an antifeeding effect, in comparison with domestic dogs.

Insights into Toxic Prymnesium parvum Blooms as a Cause of the Ecological Disaster on the Odra River

In 2022, Poland and Germany experienced a prolonged and extensive mass fish kill in the Odra River. During the period from the end of July to the beginning of September 2022, a high level of incidental disease and mortality was observed in various fish species (dozens of different species were found dead). The fish mortality affected five Polish provinces (Silesia, Opole, Lower Silesia, Lubuskie, and Western Pomerania) and involved reservoir systems covering most of the river (the Odra River is 854 km long, of which 742 km are in Poland). Fatal cases were investigated using toxicological, anatomopathological, and histopathological tests. Water samples were collected to determine nutrient status in the water column, phytoplankton biomass, and community composition. High nutrient concentrations indicated high phytoplankton productivity, with favorable conditions for golden algal blooms. The harmful toxins (prymnesins secreted by Prymnesium parvum habitats) had not been found in Poland before, but it was only a matter of time, especially in the Odra River, whose waters are permanently saline and still used for navigation. The observed fish mortality resulted in a 50% decrease in the fish population in the river and affected mainly cold-blooded species. Histopathological examinations of fish showed acute damage to the most perfused organs (gills, spleen, kidneys). The disruption to hematopoietic processes and damage to the gills were due to the action of hemolytic toxins (prymnesins). An evaluation of the collected hydrological, meteorological, biological, and physico-chemical data on the observed spatio-temporal course of the catastrophe, as well as the detection of three compounds from the group of B-type prymnesins in the analyzed material (the presence of prymnesins was confirmed using an analysis of the fragmentation spectrum and the accurate tandem mass spectrometry (MS/MS) measurement, in combination with high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS), allowed the formulation and subsequent testing of the hypothesis for a direct link between the observed fish mortality and the presence of prymnesins in the Odra River. This article systematizes what is known about the causes of the fish kill in the Odra River in 2022, based on official government reports (one Polish and one German) and the EU technical report by the Joint Research Centre. A review and critical analysis of government findings (Polish and German) on this disaster were conducted in the context of what is known to date about similar cases of mass fish kills.

Myrtus communis in Europe threatened by the pandemic and South African strains of the myrtle rust pathogen Austropuccinia psidii (Sphaerophragmiaceae, Pucciniales)

Austropuccinia psidii, the causal agent of myrtle rust, has emerged as a significant threat to Myrtaceae in planted and natural woody ecosystems. The first detection of A. puccinia in South Africa was from severely infected ornamental Myrtus communis. This raised concern that M. communis, the sole Myrtaceae species native to Europe and an important component of vegetation in Mediterranean regions, could be threatened by the rust. In light of the potential threat to this unique species, seed was collected from 12 Italian provenances of M. communis, including mainland and island (Sardinia and Sicily) populations. We assessed the susceptibility of these provenances to both the pandemic and South African strains of A. psidii. In Colombia, where the pandemic strain of A. psidii is native, seedlings rapidly became infected by natural inoculum. In South Africa, a preliminary screening of seedlings by artificial inoculation with a single-uredinium isolate produced high levels of disease. Finally, plants of each of the 12 provenances were planted and monitored in Florence, Italy. To date, these showed no signs of disease, but will continue to be monitored. This study highlights the significant threat that both the pandemic and South African strains of A. puccinia pose to M. communis in Europe.

Rhizosphere and Root Community Analysis of Oomycetes Associated with Poor Alfalfa (Medicago sativa) Seedling Establishment

Alfalfa ( Medicago sativa) seeds planted in cold, wet soil are prone to seed rot, pre- and postemergence damping-off, and seedling root rot. These diseases reduce initial stand density and affect forage yields and winter survival when root systems are stunted by infection. Successful management depends on identifying the causal agents but isolation in pure culture is time consuming and may fail to recover slow-growing organisms or those requiring special growth conditions. Here, the oomycetes in rhizosphere soil and roots from eight locations with a history of poor alfalfa establishment were identified by amplicon sequence analysis. Seedling bioassays were done with bulk soil and quantitative PCR (qPCR) assays were done using DNA from bulk soil, rhizosphere soil, and the root tissue for Aphanomyces euteiches, Phytophthora medicaginis, Pythium irregulare, P. sylvaticum, and P. ultimum var. ultimum. In the root tissue and rhizosphere, A. euteiches was the dominant taxon, followed by Phytophthora medicaginis and P. sansomeana, a broad-host-range pathogen not previously known to infect alfalfa. Pythium inflatum and Globisporangium perplexum were also significantly overrepresented in roots at five of the eight locations, indicating that these taxa are commonly enriched in alfalfa roots but had not previously been identified as alfalfa pathogens. The qPCR assays of bulk soil showed that A. euteiches and Phytophthora medicaginis were unevenly distributed in the plots and low concentrations of the pathogens led to high levels of root rot disease. These results support development of cultivars with high levels of resistance to the most common oomycete pathogens.

Media Reporting Relating to COVID-19 Vaccination as a Driver of Vaccine Hesitancy Prior to the Second Wave of the COVID-19 Pandemic in India: A Content Analysis of Newspaper and Digital Media Reports.

Background Over 2,40,000 deaths were attributed to the SARS-CoV-2 Delta (B.1.617.2) variant in India during the second wave of the pandemic from April to June 2021 with most deaths occurring in the unvaccinated population. High levels of coronavirus disease 2019 (COVID-19) vaccine hesitancy contributed to significantly reduced vaccination coverage in the eligible population especially among healthcare workers, comorbid and older people. The existing global evidence suggests misinformation through social media to accentuate, while newspaper and mainstream media reporting to be protective against vaccine hesitancy during the COVID-19 pandemic. Content analysis of regular press coverage of COVID-19 vaccination in Indiaduring the period of initial deployment and until the onset of the second wave of the pandemiccan provide useful learnings and strengthen preparedness for addressing potential vaccine hesitancy concerns during future pandemics.Therefore, we conducted this inductive content analysis of press coverage related to the COVID-19 vaccine hesitancy in India prior to the second (Delta) wave of the COVID-19 pandemic. Methods We examined news reports related to COVID-19 vaccination in India for the period from 1st January 2021 to 28 February 2021 from a high circulation English language daily (Hindustan Times), Hindi (vernacular) language daily (Dainik Jagran), and English language news reports from selected digital news portals. The inclusion criterion was any news report related to COVID-19 vaccination including editorials and guest opinion pieces that could potentially generate COVID-19-related vaccine hesitancy.The news items were classified depending on their potential to drive vaccine hesitancy by either avoiding reporting of positive information related to COVID-19 vaccines, or attributing directly or indirectly, negative or misleading commentary relating to vaccine safety or efficacy. Reports with possible risk of increasing vaccine hesitancy were further analyzed based on content, source of information, and the extent of fact-checking. Results Most of the published newspaper reports examined in this study echoed official news sources and views from government health agencies promoting COVID-19 vaccine acceptance and dispelling doubts on concerns regarding vaccine safety. There were eight unique newspaper reports after excluding duplicated bilingual entries and four news items from online digital Indian news sources that met our criterion of reports with possible contribution to vaccine hesitancy. The reports possibly contributed to vaccine hesitancy were grouped into two themes: (i) Doubts on the safety and efficacy of local manufactured vaccines: most of these reports focused on the granting of emergency use authorization for Covaxin (BBV152) in 'clinical trial mode' without the completion and publication of Phase-3 efficacy data (ii). Doubts on vaccine requirement considering high seroprevalence and reduced virus transmission. Conclusions Concerns about the efficacy and safety of Covaxin (BBV152), safety of the Covishield vaccine, and questioning the necessity of immunizing all adults with COVID-19 vaccines were observed in multiple press reports withattempts at politicization of vaccination-related decisions. Thepress reporting with potential for contributing tosignificant COVID-19 vaccine hesitancy since launch and until the Delta wave of the pandemic in India has important lessons in future pandemic preparedness.

Associations of physical function and body mass index with functional brain networks in community-dwelling older adults

Deficits in physical function that occur with aging contribute to declines in quality of life and increased mortality. There has been a growing interest in examining associations between physical function and neurobiology. Whereas high levels of white matter disease have been found in individuals with mobility impairments in structural brain studies, much less is known about the relationship between physical function and functional brain networks. Even less is known about the association between modifiable risk factors such as body mass index (BMI) and functional brain networks. The current study examined baseline functional brain networks in 192 individuals from the Brain Networks and mobility (B-NET) study, an ongoing longitudinal, observational study in community-dwelling adults aged 70 and older. Physical function and BMI were found to be associated with sensorimotor and dorsal attention network connectivity. There was a synergistic interaction such that high physical function and low BMI were associated with the highest network integrity. White matter disease did not modify these relationships. Future work is needed to understand the causal direction of these relationships.

Striving towards access to essential medicines for human and animal health; a situational analysis of access to and use of antifungal medications for histoplasmosis in Ethiopia.

Antifungal medications are vital in combatting fungal diseases that affect over a billion people annually. Antifungal medications for people and equids are scarce in Ethiopia, where lack of resources to treat fungal infection, in particular histoplasmosis, is a major health challenge. Histoplasmosis is endemic within the equine population in Ethiopia, where it is estimated that one in five horses are infected. This disease has far reaching impacts on equine welfare and the socio-economic wellbeing of families. The burden of histoplasmosis in people in Ethiopia is currently unknown, representing a blind spot in public health surveillance. Previous research has identified contact with wildlife, and domestic animal species as possible transmission pathways for histoplasmosis however, questions remain about the role of equids in human histoplasmosis. Given the close proximity of people and animals in this setting, the high level of endemic disease among equids, and the common sources of anti-fungals in Ethiopia, our study adopted a One-Health approach to examine how systemic issues affect access to, and use of antifungals to treat histoplasmosis among people and equids. A qualitative study was conducted in 6 urban regions of Oromia, Ethiopia in December 2018, incorporating semi-structured face-to-face interviews and focus group discussions. Twenty-seven individual interviews were held with doctors (n = 7), pharmacists (n = 12), veterinarians (n = 5), para-veterinarians (n = 2) and an equid owner (n = 1). Eleven focus groups were conducted with equid owners (n = 42), 3 with veterinarians (n = 6), 1 with para-veterinarians (n = 2) and 1 with pharmacists (n = 2). Transcripts were analysed using thematic analysis, and dimensions of key themes conceptualised and compared. Two overarching themes namely, 'Structural', and 'Human factors', summarised the main limitations to access to antifungal medications. 'Structural factors' included the national reliance on importation of medicines or pharmaceutical ingredients, inaccurate demand forecasting due to poor recording of the shortfall within the pharmaceutical supply chain, deficiencies in diagnostic capacity for fungal disease and, a healthcare system funded with a significant component of out-of-pocket expenditure. 'Human factors' that influenced access to antifungals included the perception of the expense of antifungals compared with competing needs such as food and education, the social stigma attached to histoplasmosis that could lead to delays in treatment seeking and, readily available home remedies or alternative treatment options. Furthermore, it was reported that trust in healthcare and veterinary provisions was undermined by a perceived lack of efficacious medications. Access to antifungals remains an urgent public health and animal welfare concern in Ethiopia. Key points within the supply and distribution chain that affect access to anti-fungals are identified, and policies that facilitate anti-fungal procurement and distribution should be reviewed. This paper highlights the structural, socio-economic and cultural factors influencing the management of infection with histoplasmosis, including how it is understood, identified and treated. This study identifies areas where further cross-sectorial work is needed to address these factors to improve disease control and clinical outcomes observed in human and animal histoplasmosis within Ethiopia.

Vector communities under global change may exacerbate and redistribute infectious disease risk.

Vector-borne parasites may be transmitted by multiple vector species, resulting in an increased risk of transmission, potentially at larger spatial scales compared to any single vector species. Additionally, the different abilities of patchily distributed vector species to acquire and transmit parasites will lead to varying degrees of transmission risk. Investigation of how vector community composition and parasite transmission change over space due to variation in environmental conditions may help to explain current patterns in diseases but also informs our understanding of how patterns will change under climate and land-use change. We developed a novel statistical approach using a multi-year, spatially extensive case study involving a vector-borne virus affecting white-tailed deer transmitted by Culicoides midges. We characterized the structure of vector communities, established the ecological gradient controlling change in structure, and related the ecology and structure to the amount of disease reporting observed in host populations. We found that vector species largely occur and replace each other as groups, rather than individual species. Moreover, community structure is primarily controlled by temperature ranges, with certain communities being consistently associated with high levels of disease reporting. These communities are essentially composed of species previously undocumented as potential vectors, whereas communities containing putative vector species were largely associated with low levels, or even absence, of disease reporting. We contend that the application of metacommunity ecology to vector-borne infectious disease ecology can greatly aid the identification of transmission hotspots and an understanding of the ecological drivers of parasite transmission risk both now and in the future.

Impact of virtual supervised tooth brushing on caries experience and quality of life among primary school children: study protocol for a randomized controlled trial

BackgroundDental caries is one of the most common diseases affecting children world widely as well as in the Kingdom of Saudi Arabia. Supervised tooth brushing programs are implemented throughout the world to provide young children’s developing teeth with additional fluoride as a form of dental caries prevention. While school-based supervised tooth brushing programs have been proven to improve young children’s oral health, virtual supervised teeth brushing programs have not been assessed. The purpose of this protocol is to assess the impact of virtual supervised tooth brushing on caries experience and quality of life among primary school students in Riyadh, Saudi Arabia.MethodsThis is a cluster randomized controlled trial comparing a virtual supervised tooth brushing program against no intervention applied. A total of 1192 (596 in each group) 8–9-year-old children in Riyadh primary schools, Saudi Arabia, will be recruited for the trial. Schools (cluster) will be randomly selected and allocated to either group. Clinical assessment for caries experience will be conducted in six points (baseline, + 3 months, + 6 months, + 12 months, + 24 months, + 36 months) by dental hygienists using the World Health Organization criteria. Data on sociodemographic behavioral factors and children’s quality of life will be collected with every clinical assessment through a structured questionnaire. The primary outcome is the change in caries experience (the number of teeth with untreated dental caries, filled and missing teeth) in both primary and permanent teeth over 36 months.DiscussionVirtual education as well as some health consultation through the pandemic period had enabled an effective IT infrastructure in Saudi Arabia. Virtual supervised tooth brushing is a proposed initiative. It is also an opportunity for targeting a large portion of the population with a high level of disease as a quarter of the Saudi population is younger than 15 years. This project should provide high level evidence on the effectiveness of virtual supervised tooth brushing. The findings should potentially inform policies related to the continuation/implementation of school-based programs in Saudi Arabia.Trial registrationClinicalTrials.gov, ID: NCT05217316. Registered on 19 January 2022.

High lipoprotein(a) levels and mitral valve disease: A systematic review

AimsThe role of lipoprotein(a) [Lp(a)] as a possibly causal risk factor for atherosclerotic artery disease and aortic valve stenosis has been well established. However, the information available on the association between Lp(a) levels and mitral valve disease is limited and controversial. The main objective of the present study was to assess the association between Lp(a) levels and mitral valve disease. Data synthesisThis systematic review was performed according to PRISMA guidelines (PROSPERO CRD42022379044). A literature search was performed to detect studies that evaluated the association between Lp(a) levels or single-nucleotide polymorphisms (SNPs) related to high levels of Lp(a) and mitral valve disease, including mitral valve calcification and valve dysfunction. Eight studies including 1,011,520 individuals were considered eligible for this research. The studies that evaluated the association between Lp(a) levels and prevalent mitral valve calcification found predominantly positive results. Similar findings were reported in two studies that evaluated the SNPs related to high levels of Lp(a). Only two studies evaluated the association of Lp(a) and mitral valve dysfunction, showing contradictory results. ConclusionsThis research showed disparate results regarding the association between Lp(a) levels and mitral valve disease. The association between Lp(a) levels and mitral valve calcification seems more robust and is in line with the findings already demonstrated in aortic valve disease. New studies should be developed to clarify this topic.

Deeper habitats and cooler temperaturesmoderate a climate-driven seagrass disease.

Eelgrass creates critical coastal habitats worldwide and fulfills essential ecosystem functions as a foundation seagrass. Climate warming and disease threaten eelgrass, causing mass mortalities and cascading ecological impacts. Subtidal meadows are deeper than intertidal and may also provide refuge from the temperature-sensitive seagrass wasting disease. From cross-boundary surveys of 5761 eelgrass leaves from Alaska to Washington and assisted with a machine-language algorithm, we measured outbreak conditions. Across summers 2017 and 2018, disease prevalence was 16% lower for subtidal than intertidal leaves; in both tidal zones, disease risk was lower for plants in cooler conditions. Even in subtidal meadows, which are more environmentally stable and sheltered from temperature and other stressors common for intertidal eelgrass, we observed high disease levels, with half of the sites exceeding 50% prevalence. Models predicted reduced disease prevalence and severity under cooler conditions, confirming a strong interaction between disease and temperature. At both tidal zones, prevalence was lower in more dense eelgrass meadows, suggesting disease is suppressed in healthy, higher density meadows. These results underscore the value of subtidal eelgrass and meadows in cooler locations as refugia, indicate that cooling can suppress disease, and have implications for eelgrass conservation and management under future climate change scenarios. This article is part of the theme issue 'Infectious disease ecology and evolution in a changing world'.

Prevalence of anxiety and depression symptoms in a sample of outpatients with ATTR cardiac amyloidosis.

Patients with ATTR cardiac amyloidosis (ATTR-CA) face rare disease that could negatively influence psychological well-being with consequences on the course of the disease and quality of life. However, to date, no study analyzed the prevalence of anxiety and depression in patients with ATTR-CA and which clinical and sociodemographic characteristics are linked with these psychopathological conditions. A total of 109 consecutive patients (83% males) aged 62-90 years with ATTR-CA were recruited. In order to better understand the prevalence of anxiety and depression in ATTR-CA, a control group composed by 33 individuals equaling gender, education, and age were recruited. The level of anxiety and depression was measured using the Italian version of the Hospital Anxiety and Depression Scale (HADS). Sociodemographic and clinic characteristics were registered. Almost half of patients (49%) reported a clinical level of depression or anxiety, or both. ATTR-CA patients reported higher levels of anxiety and depression than control group. Results showed that older patients with ATTR-CA, especially females, with more advanced disease could be more at risk to develop an anxious disorder. Furthermore, being a woman, and presenting with a greater severity of symptoms, would appear to be a risk factor for developing a depressive disorder. Overall, these results highlighted the high presence of anxiety and depression in ATTR-CA patients, suggesting to physicians to pay attention to the psychological well-being of ATTR-CA patients. In fact, a psychological support for patients with high level of psychopathological disease could reduce disease burden and improve quality of life in ATTR-CA population.

The association of race/ethnicity in male breast cancer survival within similar comorbidity cohorts.

Concomitant disease is associated with poor breast cancer survival in women and is more prevalent in racial/ethnic minority groups than individuals who are non-Hispanic White. The purpose of this study was to determine if race/ethnicity is associated with survival among men with breast cancer when stratifying analyses by level of comorbidity. We used the California Cancer Registry to identify 1730 cases of men and 259,828 cases of women with breast cancer and documented Charlson Comorbidity Index (CCI). Kaplan-Meier survival and Cox regression analyses were used tocompare breast cancer-specific survival and risk of mortality for African American/Black, Hispanic, and Asian/Pacific Islander men with White women and White men. When compared with White women, Black men with a CCI of 0 (hazard ratio [HR],3.09; 95% CI, 1.10-1.16) and a CCI of 2+, (HR,2.51; 95% CI, 1.42-4.42) had an increased risk of mortality when compared with White women. When compared with White men, African American men with a CCI of 0 (HR,2.36; 95% CI, 1.45-3.85) and 2+ (HR,2.44; 95% CI, 1.26-4.74) had an increased unadjusted risk of mortality, but these disparities were neutralized when controlling for sociodemographic and clinical factors. Black men with both low and high levels of concomitant disease have an increased risk of mortality when compared with both White men and women, but demographic and clinical factors are contributors to this disparity.

PS-C25-6: HYPERTENSIVE RESPONSE TO EXERCISE AS PREDICTOR FOR DEVELOPMENT OF ESSENTIAL HYPERTENSION AND HOSPITALIZATION DUE TO MAJOR ADVERSE CARDIAC EVENT

Objective: The aim of this study was to determine the structural and metabolic factors associated with hypertensive response to exercise (HRE) in non hypertensive patients and role of HRE in predict development of essential hypertension during follow-up and predict hospitalization due to major adverse cardiac event (MACE). Design and method: This study was a cross-sectional retrospective study using cardiac treadmill stress test (TST) data at Sanglah General Hospital, Bali from 2016–2020. Data analysis used SPSS version 21. Subjects were divided into positive HRE and negative HRE. Pearson-chi square test and Mann-Whitney test were used to compare categorical variables based on age, gender, smoking status, nutritional status, alcohol status, dyslipidemia, type 2 diabetes mellitus (T2DM), HbA1C, total cholesterol, LDL, HDL, triglycerides, history of kidney disease, and mean echocardiographic parameters based on the presence of HRE. Development of essential hypertension during follow up and history of hospitalization after cardiac TST due to MACE until April 2022 based on the presence of HRE was evaluated using receiver operating characteristics. Results: We evaluated 202 non hypertensive patients (47,1% with HRE) who underwent cardiac TST. During follow up, 19.8% experienced hospitalization and 26.1% developed hypertension. Obesity (PR1.727; 95%CI = 1.235–2.413), smoking status (PR1.773; 95%CI = 1.170–2.687), T2DM (PR2.29; 95%CI = 1.16–3.37), HbA1C (PR3.13; 95%CI = 2.31–4.22), high LDL level (PR1.853, 95%CI = 1.229–2.794) and history of kidney disease (PR1.985; 95%CI = 1.478–2.665), were significantly associated with positive HRE (all p-value &lt; 0.05). Regarding the clinical outcomes, patients with HRE were associated with an increased risk of developing essential hypertension (PR1.72; 95%CI = 1.235–2.413 p = 0.05) and hospitalization due to MACE (OR2.27, 95% CI = 1.62–3.16, p = 0.0001) during follow up, with sensitivity of 76.7% and specificity of 93.6%. Subjects with HRE had higher LV mass index (82.34 ± 15.05 vs 70.62 ± 9.76), higher E/E ratio (16.31 ± 2.95 vs 16.01 ± 13.23), higher LAVI (39.75 ± 15.21 vs 34.27 ± 11.15) with all p-value were &lt; 0.05. Conclusions: Patients with impaired cardiometabolic and the presence of cardiac remodeling commonly have HRE that could be detected by cardiac TST examination, which may predict the development of essential hypertension and major adverse cardiac events in the future.

Effect of Copper Sulfate Pentahydrate and Cultivar Resistance on Reducing Bacterial Leaf Streak in Hard Red Spring Wheat in North Dakota

Bacterial leaf streak (BLS) is one of the most significant foliar diseases affecting hard red spring wheat (HRSW) production in North Dakota. The most effective management tool for BLS is the use of host resistance; however, the adoption and availability of resistant cultivars is limited for HRSW producers. This has led to questions pertaining to the use of copper-based products to suppress BLS severity in HRSW production. Four field experiments were conducted from 2020 to 2022 in North Dakota to evaluate the efficacy of copper sulfate pentahydrate (CSP) applied at the flag leaf stage on reducing BLS severity and protecting HRSW yield and test weight. Experiments were conducted in a randomized complete block design with a split-plot arrangement with four replications. Three treatments served as the main plots (noninoculated, inoculated, and inoculated + CSP applied at flag leaf). Five HRSW cultivars varying in host resistance served as subplots. A high level of disease occurred across all experiments. A combined analysis suggested that the use of CSP did not provide adequate BLS suppression and did not protect HRSW yield or test weight regardless of HRSW susceptibility. The lowest mean yield loss was associated with the moderately resistant cultivar Boost (9%), and the highest was associated with the susceptible cultivar SY Rockford (19%). Variability in yield loss values among cultivars suggests that more research is needed to strengthen our understanding of BLS in HRSW.

Ankilozan Spondilitli Hastalarda Akut Faz Reaktanlarının Değerlendirilmesi

Objective: To determine the high levels of acute phase reactants (APR) of ankylosing spondylitis (AS) patients at diagnosis and follow-up, and to investigate the relationship between patients’ high levels of APR and patients’ disease activity levels and clinical characteristics.&#x0D; Material and Methods : 948 patients who were diagnosed with AS according to the modified 1984 New York criteria and followed-up at the university rheumatology clinic were included in this study. The patients’ erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels across all visits were retrospectively reviewed through the registry and the hospital’s database.&#x0D; Results: At first visit, high levels of CRP and ESR were observed in 626 (68.5%) and 578 (64.6%) patients respectively. During follow-up 84.6% of patients had high CRP and 69.5% patients had high ESR, however in 10% of patients APRs did not increase at all. There was good correlation between ESR and CRP (r=0.666, p=0.000). A better correlation was observed at first visit between CRP and BASDAI (r=0.81, p=0.23) or ASDAS (r=0.468, p=0.000) compared to ESR and BASDAI (r=0.111, p=0.02) or ASDAS (r=0.334, p=0.000). Compared to BASDAI, ASDAS with either ESR (p=0.00) or CRP (very high disease activity-p=0.000, inactive disease-p=0.001) had better performance in evaluating the activity of the patient in inactive and very high levels of severe disease.&#x0D; Conclusions: Our results showed, high levels of acute phase reactants is not rare in AS patients. APR should be considered the most significant laboratory diagnostics in the evaluation of AS and/or response to the treatment.