Low Prevalence Research Articles

Paediatric Crohn’s disease: histologic findings at initial presentation

BackgroundDiagnosing paediatric Crohn’s disease (CD) based on histology can present challenges. We evaluate the histological spectrum of treatment-naïve biopsies from children with CD and assess these findings’ diagnostic and predictive...

Health literacy and falls among community-dwelling older people in China: is there a sex difference?

Health literacy is one of the important determinants of healthy aging, yet few studies have focused on the association between health literacy and falls. This study aims to explore the relationship between health literacy and falls, with a focus on sex differences among older people in China. This cross-sectional study enrolled 2,144 older people aged ≥ 60 years from Shandong Province, China in 2021. We used general health literacy screening scale to assess health literacy, and collected the incidence of falls in the past year. Logistic regression models were employed to analyze the relationship between health literacy and falls. We investigated the sex differences by subgroup analyses. The prevalence of adequate health literacy and falls was 21.7% (95% CI: 20.0-23.5%) and 25.4% (95% CI: 23.6-27.3%), respectively. In a fully-adjusted model, adequate health literacy was associated with a lower prevalence of falls in older adults (OR = 0.71, 95%CI: 0.52-0.96). Subgroup analysis revealed sex differences in this relationship (Pfor interaction <0.05). Specifically, the female group showed no significant relationship between health literacy and falls (OR = 0.92, 95% CI: 0.59-1.44); however, the male group demonstrated a robust and significant relationship (OR = 0.58, 95% CI: 0.37-0.90). Older people with adequate health literacy have lower prevalence of falls, which appears to differ by sex. This relationship was significant among men but not among women. These findings emphasize the need for policymakers and healthcare providers to consider sex differences when designing and implementing programs aimed at improving health literacy and preventing falls in the older population. Improving health literacy among older women could be a strategic component in bridging sex inequality in falls.

The role of governance in mitigating an epidemic disease: evidence from HIV prevalence in 45 Sub-Saharan African countries, 1996–2019

PurposeThis study proposed a theoretical framework to illustrate how governance can be instrumental in preventing the proliferation of HIV. It decomposed governance into six multidimensional facets and empirically examined their effects on HIV prevalence.Design/methodology/approachThe study utilized panel data from 45 sub-Saharan African countries from 1996 to 2019. HIV prevalence, the dependent variable, was estimated based on the number of adults aged 15–49 years infected with HIV, irrespective of the progression to AIDS symptoms. The independent variables included governance and its six dimensions: voice and accountability, political stability, government effectiveness, regulatory quality, rule of law, and control of corruption. The analysis incorporated the random and fixed effects models while controlling for economic development, economic inequality, foreign aid, sanitation, and population.FindingsThe findings revealed a significant association between good governance and lower HIV prevalence. Improved governance quality in sub-Saharan African countries has led to a reduction in HIV prevalence among adults. Specifically, governance dimensions, such as voice and accountability, political stability, rule of law, and control of corruption, contributed to reducing HIV prevalence. Conversely, government effectiveness and regulatory quality did not show significant impacts on HIV prevalence.Originality/valueThis study underscores the significant role of good governance in effectively curbing the spread of epidemic diseases, highlighting its importance in controlling HIV in sub-Saharan African countries.

Deep Learning to Detect Intracranial Hemorrhage in a National Teleradiology Program and the Impact on Interpretation Time.

"Just Accepted" papers have undergone full peer review and have been accepted for publication in Radiology: Artificial Intelligence. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content. The diagnostic performance of an artificial intelligence (AI) clinical decision support (CDS) solution for acute intracranial hemorrhage (ICH) detection was assessed in a large teleradiology practice. The impact on radiologist read times and system efficiency was also quantified. A total of 61,704 consecutive noncontrast head CTs (NCHCT) were retrospectively evaluated. System performance was calculated along with mean and median read time values for NCHCT pre-AI (baseline; August 2021-May 2022) and post-AI (January 2023-February 2024). The AI solution had a sensitivity of 75.6%, specificity of 92.1%, accuracy of 91.7%, prevalence of 2.70%, and positive predictive value of 21.1%. Of the 56,745 post-AI NCHCT with no bleed identified by a radiologist, examinations falsely flagged as suspected ICH by the AI solution (n = 4,464) took 9min40sec on average/8min7sec median to interpret as compared with 8min25sec average/6min48ec median for unremarkable NCHCT pre-AI (n = 49,007) (P < .001) and 8min38sec average/6min53sec median post-AI when ICH was not suspected by the AI solution (n = 52,281) (P < .001). NCHCT with no bleed identified by the AI but reported as positive for ICH by the radiologist (n = 384) took 14min23sec on average/13min35sec median to interpret as compared with a read time of 13min34sec mean/12min30sec median for NCHCT correctly reported as a bleed by the AI (n = 1192) (P = .04). With lengthened read times for falsely flagged examinations, system inefficiencies may outweigh the potential benefits of using the tool in a high volume, low prevalence environment. ©RSNA, 2024.

Prevalence, diagnostic features, and medical outcomes of females with Turner syndrome with a trisomy X cell line (45,X/47,XXX): Results from the InsighTS Registry.

Turner syndrome (TS) is defined by partial or complete absence of a sex chromosome. Little is known about the phenotype of individuals with TS mosaic with trisomy X (45,X/47,XXX or 45,X/46,XX/47,XXX) (~3% of TS). We compared the diagnostic, perinatal, medical, and neurodevelopmental comorbidities of mosaic 45,X/47,XXX (n = 35, 9.4%) with nonmosaic 45,X (n = 142) and mosaic 45,X/46,XX (n = 66). Females with 45,X/47,XXX had fewer neonatal concerns and lower prevalence of several TS-related diagnoses compared with 45,X; however the prevalence of neurodevelopmental and psychiatric diagnoses were not different. Compared to females with 45,X/46,XX, the 45,X/47,XXX group was significantly more likely to have structural renal anomalies (18% vs. 3%; p = 0.03). They were twice as likely to have congenital heart disease (32% vs. 15%, p = 0.08) and less likely to experience spontaneous menarche (46% vs. 75% of those over age 10, p = 0.06), although not statistically significant. Congenital anomalies, hypertension, and hearing loss were primarily attributable to a higher proportion of 45,X cells, while preserved ovarian function was most associated with a higher proportion of 46,XX cells. In this large TS cohort, 45,X/47,XXX was more common than previously reported, individuals were phenotypically less affected than those with 45,X, but did have trends for several more TS-related diagnoses than individuals with 45,X/46,XX.

Portosystemic Hepatic Encephalopathy Scores (PHES) differ between Danish and German healthy populations despite their geographical and cultural similarities.

Minimal hepatic encephalopathy (MHE) is common in liver cirrhosis and is identified by psychometric tests. The portosystemic hepatic encephalopathy score (PHES) is the most widely used and serves as an inter-study comparator. PHES has not been standardised for use in the Danish population, where German normal values have been applied until now based on the notion that the populations are comparable. This study aimed to evaluate if German PHES normal values can be applied in the Danish population and establish Danish normal values if needed. 200 Danish and 217 German healthy persons underwent Number Connection Test A and B (NCT), Line Tracing Test (LTT), Digit Symbol Test (DST), and Serial Dotting Test (SDT), and based on performance, PHES was calculated. German and Danish PHES performance declined with age in all subtests but more rapidly in Danes. Both German and Danish norms were impacted by gender and education, but to a different extent in the single tests of the test battery. Accordingly, there was a need for specific Danish normal values, which are presented here. Applying the new Danish normal values instead of the German in patients with cirrhosis yielded a lower percentage of out-of-norm performances (58% vs. 66%) and, hence, a lower prevalence of MHE. Danes and Germans perform differently on PHES, and therefore, normal German values cannot be used in Danish patients. Danish normal values are presented here and yield a lower number of 'out of norm' performances.

The Impact of Green Innovation on CO2 Emissions in China: Evidence from Spatial Regression Model

Using data from USPTO, CEADs, the Chinese Statistical Yearbook, and spatial econometric models for the panel of the 30 Chinese provinces for the period 2000∼2019, this study explores and compares the impact of green and non-green innovation on CO2 emissions. The findings reveal a significant spatial correlation in CO2 emissions across provinces, validating the appropriateness of spatial econometric models for this analysis. The results indicate that both green and non-green innovations significantly reduce CO2 emissions, with green innovation having a more pronounced effect despite its lower prevalence. Additionally, patents and their citations notably enhance environmental quality in neighboring provinces through indirect effects. The empirical results highlight that China should focus on: (1) spatial spillover effects of technological, especially green, innovation; (2) removing barriers to green patent invention and citation; (3) transitioning from an energy-driven to a green innovation-driven economy; and (4) enhancing environmental quality by mitigating CO2 emissions.

Effect of Customized Nutritious Breakfast and Nutrition Education on Nutritional Status of Preschool Children in Economically Underdeveloped Multi-Ethnic Areas: A Cluster Randomized Clinical Trial in Linxia, China

The nutritional status of preschool children in economically underdeveloped multi-ethnic areas is a global concern. This study aimed to examine the effect of a 2.2-year cluster randomized clinical trial that provided customized nutritious breakfast and nutrition education to preschool children in Linxia County, China. A total of 578 children aged 3 to 6 years were enrolled. After the intervention, the incidence of undernourishment was significantly lower in the intervention group compared to the control group (8.73% vs. 9.92%, OR = 0.01 [95%CI 0.00, 0.39], p = 0.014). Additionally, children with non-Muslim dietary habits had a lower incidence of undernourishment compared to those with Muslim dietary habits (OR = 0.05 [95%CI 0.00, 0.88]; p = 0.010). The intervention group also had a lower prevalence rate of wasting (OR = 0.02 [95%CI 0.00, 0.40]; p = 0.011) and a higher mean BMI-for-age Z-score (β = 1.05 [95%CI 0.32, 1.77]; p = 0.005) compared to the control group. These findings suggest that providing nutritious breakfast and nutrition education is an effective strategy to improve the nutrition and health of preschool children, particularly in economically disadvantaged regions and among children with Muslim dietary habits.

Genotype and Allele Frequency of Methylenetetrahydrofolate Reductase 677CTmutation in Female Arabs residing in the United Arab Emirates

The MTHFR gene (Methylenetetrahydrofolate reductase), responsible for encoding the MTHFR enzyme, is vital for the body’s methylation processes, which are crucial for DNA synthesis, repair, and overall metabolic functions. Previous studies have shown that mutations in the MTHFR gene are associated with various diseases, including neural tube defects, male infertility, type II diabetes mellitus, cardiovascular diseases, and certain cancers. Additionally, abnormal methylation of the MTHFR gene can suppress other important genes such as methionine synthase, thymidylate synthase, choline kinase, and folate receptor genes. This suppression can result in a deficiency of the MTHFR enzyme, essential for proper cellular function, especially when a 677CT (C to T) transition occurs, leading to reduced enzyme activity. Despite the known implications of MTHFR gene mutations, no studies have probed these mutations in the female Arab population. To fill this gap, a pilot study was conducted to determine the prevalence of the MTHFR C677T gene mutation among 45 healthy Arab individuals in the United Arab Emirates. The study used the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method to detect the mutation. The study found that the mutated T allele had a 6% occurrence rate in the female Arab population. The genotype frequencies were 86.6% for the CC genotype, 13.3% for the CT genotype, and 0% for the TT genotype, indicating a relatively low prevalence of the MTHFR C677T polymorphism in Arab women. These findings provide preliminary data that can form the basis for further research on MTHFR gene mutations in this population, potentially enhancing the understanding and management of related health conditions. J MEDICINE 2024; 25: 141-148

The prevalence of vertical transmission of human immunodeficiency virus and associated factors among exposed infants in Eastern Lake zone and Southern Highland of Tanzania: a cross-sectional study

Background Globally, the rate of antiretroviral therapy coverage for pregnant women living with human immunodeficiency virus (HIV) increased by 38% between 2010 and 2015 but only by 2% between 2016 and 2020. Objectives We aimed to determine the prevalence of vertical transmission of HIV among infants from mothers living with HIV and associated factors in the Eastern Lake Zone and Southern Highland of Tanzania from January to December 2022. Methods This retrospective cross-sectional study extracted data from the Open Laboratory Data Repository database collected from January to December 2022 at 93 health facilities. A total of 1,411 infants exposed to HIV from the Mbeya (851), Songwe (304), and Mara regions (256) were enrolled. Results The prevalence for vertical transmission of HIV was 2.48% (35/1411). We observed a non-significant difference in the prevalence of vertical transmission in children whose first test was done below six weeks of life (1.89%) and other age groups (2.52-2.62%) (p < 0.917). Children not given antiretroviral prophylaxis had eleven times higher odds of acquiring infection (AOR 11.39, 95% CI: 3.61–35.97). Mothers who were not on ART during pregnancy had three times the odds of transmitting HIV to their infants (AOR 3.03, 95%CI: 0.91–10.15). Conclusions We found a low prevalence of vertical transmission of HIV compared to previous studies done in Tanzania. The use of ART prophylaxis for infants exposed to HIV is significantly associated with the low rate of HIV transmission.

Digital Violence in University Student Couples: England vs. Spain

This research studies the prevalence of digital violence exercised through new information and communication technology (ICT) among university couples. A comparative study was carried out in England, United Kingdom, and in Spain with 831 participants. A quantitative methodology was applied with different sampling: in the United Kingdom, 303 (MAge = 22.79; SD; 47.32; 58.7% male) and in Spain, 528 (MAge = 24.29; SD = 21.41; 69.5% female). An ad hoc questionnaire was used, created for the detection, measurement and analysis of digital violence within affective-sexual relationships. The results reveal proportions of 51.04% and 49.82% in the perception of digital violence through electronic devices in dating relationships among young people; 15.84% and 11.05% in the prevalence of digital violence in young couples’ relationships; 9.36% and 6.17% in the prevalence of traditional violence; and 35.78% and 22.43% in the tolerance of digital violence among students, for the English and Spanish samples, respectively. The results also show a slightly lower prevalence of digital violence in the Spanish sample with respect to the English sample, where females scored slightly higher in the perpetration of digital violence. There is a need to develop awareness, training and prevention programs against digital violence in the university context.

Neurexan Prescription Is Associated with Lower Risk of Sleep Disorder Recurrence and Depression Prevalence as Compared to Z-Drugs and Benzodiazepines: A Retrospective Database Analysis in Germany

Real-world evidence on the association between natural medicinal products and the recurrence of sleep disorders is currently limited, particularly when compared to the evidence reported for prescription hypnotics. In a retrospective cohort analysis, we investigated patients with sleep disorders prescribed either the natural medicinal product Neurexan (Nx4), benzodiazepines, or nonbenzodiazepines (Z-drugs) using the IQVIA Disease Analyzer database, which encompasses electronic medical records nationwide in Germany. A 1:1 matching procedure based on age, sex, prevalent depression, anxiety or adjustment disorder, and the number of medical consultations in the past 12 months resulted in four cohorts: patients prescribed Nx4 were matched with those prescribed Z-drugs (two cohorts with 8594 matched patients each), and another cohort of patients prescribed Nx4 were matched with those prescribed benzodiazepines (7779 matched pairs). Results from multivariable-adjusted Cox regression models demonstrated that Nx4 was associated with a significantly lower risk of recurrent sleep disorder diagnosis within 30–365 days after prescription compared to both Z-drugs (HR = 0.65, 95%CI = 0.60–0.70, p &lt; 0.001) and benzodiazepines (HR = 0.85, 95%CI = 0.79–0.93, p &lt; 0.001). Additionally, Nx4 was associated with a lower prevalence of depression compared to Z-drugs (HR = 0.90, 95%CI = 0.83–0.98, p = 0.020) and benzodiazepines (HR = 0.89, 95%CI = 0.82–0.97, p = 0.009). These findings suggest an association between Nx4 and improved sleep and mental health outcomes. However, due to inherent limitations in the study design, the causality of this relationship cannot be stated.

Epidemiological analysis of blood donors from college students in Hefei city.

College students represent a unique demographic group as they are adults no longer under direct parental care, yet often lack the institutional health support available to more established members of society, which can lead to their health needs being neglected, despite their substantial contributions to blood donation. The objective of this study is to shed light on the health status of college students in Hefei, with a specific focus on transfusion-transmitted diseases. Based on the detailed data analysis, the implementation of some constructive strategies will play a good warning role in improving clinical blood safety and promoting better health monitoring of this population in the future. The study aims to achieve two main objectives: On the one hand, to deepen our understanding of college students' participation in blood donation activities. On the other hand, to propose effective strategies for increasing youth involvement. Additionally, such research aims to afford recommendations for ensuring the safety of clinical blood supplies. Although the strategies and suggestions presented are speculative, they are grounded in the logical analysis of data and relevant theoretical frameworks. Therefore, these recommendations serve as a basis for potential future testing and implementation. The evaluation process for blood samples at the Hefei Blood Bank involves thorough serological testing for hepatitis B and C, HIV, and Treponema pallidum using both Enzyme-Linked Immunosorbent Assay (ELISA) and Nucleic Acid Testing (NAT). HIV reactive samples were further confirmed using Western Blot techniques at an external specialized laboratory. To ensure accuracy, each sample was tested with reagents from two different manufacturers. Moreover, any initially reactive sample was retested with the same reagent to eliminate potential false positives. In cases of conflicting results, alternative reagent kits are utilized for further confirmatory tests. Only samples that consistently show reactive results in consecutive tests are considered positive confirmation samples. Upon analysis of the data set, it was found that out of the total 663,105 donors, 177,089 (26.7%) were identified as college students, with the remaining 486,016 categorized as noncollege students. Our study demonstrated a notably lower prevalence of blood-transmitted infections among college students (0.48%) in contrast to the wider donor population (1.23%), underscoring their potential as safe blood donors. To uphold this level of safety and protect public health, it is crucial to increase disease prevention awareness and advocate for responsible donation practices within this specific demographic. Strengthening confidentiality protocols and expanding education on safe sexual behaviors in university settings are vital actions to cultivate an environment that promotes informed and secure blood donation. The overall group had prevalence rates of 0.44% for hepatitis B, 0.15% for hepatitis C, 0.02% for HIV, and 0.42% for Treponema pallidum. When focusing on the student cohort, the prevalence rates were 0.17% for hepatitis B, 0.04% for hepatitis C, 0.02% for HIV, and 0.23% for Treponema pallidum. Transmissibility through blood transfusion All donors (%) Students (%) Non-students (%) Any infection 1.23 0.48 1.51 HbsAg 0.44 0.17 0.54 Anti-HCV 0.15 0.04 0.19 HIV Ag/Ab 0.02 0.02 0.02 Anti-TP 0.42 0.23 0.49 Individuals with two or more infectious agents occur more than once in all categories. While it leads to numerical over-representation, such overlap is minimal and statistically insignificant.

Chronic pelvic pain among transgender men and gender diverse adults assigned female at birth.

There are limited data on pelvic pain among transgender men and gender diverse people, and the impact of testosterone on pelvic pain is poorly understood. Characterize the prevalence and correlates of chronic pelvic pain (CPP) among transgender men and gender diverse people and examine the association between testosterone use and CPP. We used 2020-2022 data from The Population Research in Identity and Disparities for Equality (PRIDE) Study, an online prospective cohort study of sexual and gender minority adults in the United States, to conduct complementary cross-sectional and longitudinal analyses. Our primary outcome was self-reported CPP lasting 3 months or longer measured using the Michigan Body Map. Among 2579 transgender men and gender diverse people assigned female at birth included in our sample, 457 (18%) reported CPP. CPP correlates included: inflammatory bowel disease, irritable bowel syndrome (IBS), kidney stones, pelvic inflammatory disease, polycystic ovary syndrome (PCOS), uterine fibroids, current hormonal intrauterine device use, prior pregnancy, vaginal delivery, hysterectomy, and oophorectomy. Individuals with CPP reported a high prevalence of IBS (37%), PCOS (20%), uterine fibroids (9%), post-traumatic stress disorder (51%), and severe depression and anxiety symptoms (42% and 25%, respectively). Current testosterone use was associated with a 21% lower prevalence of CPP (adjusted prevalence ratio (aPR) 0.79, 95% confidence interval [CI]: 0.65-0.96). In longitudinal analyses (N=79), 15 (19%) participants reported any CPP after initiating testosterone: eight (56%) of whom reported CPP prior to testosterone initiation, and seven (47%) who reported new-onset CPP. The relationship between CPP and testosterone is complex. Although testosterone use was associated with a lower prevalence of CPP, some transgender and gender diverse individuals experienced new-onset pelvic pain after testosterone initiation. Given the significant impact that CPP can have on mental health and quality of life, future research must examine the role of testosterone in specific underlying etiologies of CPP and identify potential therapies.

Social determinants and work-related musculoskeletal disorders in Brazil.

This study aimed to analyze the prevalence of work-related musculoskeletal disorders (WMSD) and their association with individual and contextual factors in the Brazilian population. This quantitative cross-sectional study used secondary data from the Brazilian National Health Survey from August 2013 to February 2014. The dependent variable included WMSD, and independent variables were analyzed as individual and contextual factors. WMSD was mostly prevalent in females, individuals aged 43 to 59 years, with chronic physical or mental disorders, reporting frequent sleep disorders, and performing integrative and complementary health practices, physical exercise or sports, and heavy physical activity or housework. Regarding contextual factors, high social classes and proportion of individuals with formal work were associated with a high prevalence of WMSD, whereas a high Gini index was associated with a low prevalence. Thus, a high prevalence of WMSD in the Brazilian population was associated with individual and contextual factors, which should be the target of health professionals for actions of promotion, prevention, and intervention at individual or collective care levels.

Antibodies to Influenza A Virus in Lesser (Aytha affinis) and Greater Scaup (Aytha marila) in the USA.

Scaup, including both Lesser and Greater (Aythya affinis and Aythya marila, respectively), are a grouping of populous and widespread North American diving ducks. Few influenza type A viruses (IAV) have been reported from these species despite a high prevalence of antibodies to IAV being reported. Existing virologic and serologic data indicate that IAV infection routinely occurs in scaup, yet it is unknown which IAV subtypes are linked to these infections. In this study, we aimed to gain a more complete picture of IAV natural history in Lesser and Greater Scaup from two coastal flyways in North America in 2015-18 (302 samples from California in the Pacific Flyway and 471 samples from Maryland in the Atlantic Flyway). Low prevalence of active IAV infection was detected by real-time reverse-transcription PCR in Lesser Scaup sampled in Maryland and California (2.8% and 8.1%, respectively). A single IAV (H1N1) was isolated in embryonated chicken eggs from a bird sampled in California. Similarly low levels were observed in Greater Scaup in California (3.3%). Antibodies to the nucleoprotein as detected with a commercial blocking ELISA were observed in all species and flyway combinations. Antibody seroprevalence estimates were higher in adult Lesser Scaup than in juveniles at both the ≤0.5 (P<0.001, z=-3.582) and ≤0.7 serum-sample-to-negative-control absorbance thresholds (P=0.003, z=-2.996). Neutralizing antibodies to H1-H12, H14, and H15 were detected using a microtiter virus neutralization assay, with the highest prevalence of antibodies against H1 (38%), H6 (36%), and H11 (35%). The high prevalence of antibodies to IAV and evidence of previous exposure to numerous subtypes are consistent with a high level of population immunity and a low prevalence of infection. These results must be interpreted in the context of season (winter sampling), as results may vary with the annual influx of naïve juvenile birds.

Salmonella spp. in Domestic Ruminants, Evaluation of Antimicrobial Resistance Based on the One Health Approach—A Systematic Review and Meta-Analysis

Salmonella spp. pose a global threat as a leading cause of foodborne illnesses, particularly prevalent in the European Union (EU), where it remains the second cause of foodborne outbreaks. The emergence of antimicrobial resistance (AMR) in Salmonella spp. has become a critical concern, complicating treatment strategies and escalating the risk of severe infections. The study focuses on large and small ruminants, identifying a prevalence of Salmonella spp. in slaughterhouses and revealing varied AMR rates across antimicrobial families throughout a meta-analysis. Also, comparison with AMR in human medicine was carried out by a systematic review. The results of the present meta-analysis displayed a prevalence of Salmonella spp. in large and small ruminants at slaughterhouses of 8.01% (8.31%, cattle; 7.04%, goats; 6.12%, sheep). According to the AMR of Salmonella spp., 20, 14, and 13 out of 62 antimicrobials studied were classified as low (&lt;5%), high (&gt;5% but &lt;10%), and very high (&gt;10%), respectively. Salmonella spp. did not display AMR against aztreonam, mezlocillin, ertapenem, meropenem, cefoxitin, ceftazidime, levofloxacin, tilmicosin, linezolid, fosfomycin, furazolidone, quinupristin, trimethoprim and spectinomycin. In contrast, a prevalence of 100% of AMR has been described against ofloxacin, lincomycin, and cloxacillin. In the context of the main antibiotics used in the treatment of human salmonellosis, azithromycin was shown to have the highest resistance among Salmonella spp. isolates from humans. Regarding cephalosporins, which are also used for the treatment of salmonellosis in humans, the prevalence of Salmonella spp. resistance to this class of antibiotics was similar in both human and animal samples. Concerning quinolones, despite a heightened resistance profile in Salmonella spp. isolates from ruminant samples, there appears to be no discernible compromise to the efficacy of salmonellosis treatment in humans since lower prevalences of AMR in Salmonella spp. isolated from human specimens were observed. Although the resistance of Salmonella spp. indicates some degree of concern, most antibiotics are not used in veterinary medicine. Thus, the contribution of cattle, sheep and goats to the rise of antibiotic resistance of Salmonella spp. and its potential impact on public health appears to be relatively insignificant, due to their low prevalence in carcasses and organs. Nevertheless, the observed low prevalence of Salmonella spp. in ruminants at slaughterhouse and the correspondingly low AMR rates of Salmonella spp. to key antibiotics employed in human medicine do not indicate that ruminant livestock poses a substantial public health risk concerning the transmission of AMR. Thus, the results observed in both the meta-analysis and systematic review suggests that AMR is not solely attributed to veterinary antibiotic use but is also influenced by factors such as animal health management (i.e., biosecurity measures, prophylactic schemes) and human medicine.

Footbathing and Foot Trimming, and No Quarantine: Risks for High Prevalence of Lameness in a Random Sample of 269 Sheep Flocks in England, 2022

Since 2004, the prevalence of lameness in sheep flocks in England has reduced as farmers have adopted evidence-based management practices to control lameness. In 2011, the Farm Animal Welfare Council proposed a target prevalence of &lt;2% lameness in sheep by 2021. This study investigated whether that target had been achieved and determined which practices were associated with prevalence of lameness. A postal questionnaire was sent to 1000 randomly selected farmers to investigate the prevalence of lameness and management practices in 2022. The geometric mean prevalence of lameness was &lt;2% in ewes and lambs, but the median was 3%; approximately 26% flocks had &lt;2% lameness. Data were analysed using robust variable selection with multivariable linear models. Farmers that quarantined ewes for ≥3 weeks and did not use foot bathing or foot trimming to prevent lameness had 40–50% lower prevalence of lameness than those not using these practices. Fewer farmers (19.0%) were always using parenteral antimicrobials to treat footrot, an effective practice, than in previous research (49.7%). We conclude that the target of &lt;2% lameness in England has been achieved by 26% of farmers, and further work is required for more farmers to follow the evidence-based management practices to minimise lameness.

Do parents engage in weight- and health-focused conversations with their emerging adult children and are there cross-sectional associations with weight and well-being outcomes?

BackgroundResearch indicates harmful associations between parental weight-focused conversations and markers of pediatric health and well-being. However, little is known about the prevalence and consequences of parent conversations focused on weight or health behaviors (i.e., physical activity or nutrition) with emerging adult children. MethodsData are from the 2018 follow-up survey of the population-based EAT 2010–2018 (Eating and Activity over Time) in cohort from Minneapolis—St. Paul, MN. Participants were emerging adults at follow-up with ages 18–26. Regression models adjusted for sociodemographic characteristics were conducted. ResultsOver two-thirds (68%) of mothers and 44% of fathers engaged in weight-focused conversations with their emerging adult children; 25% of both parents reported engaging in conversations focused only on health behaviors; and 8% of mothers and 26% of fathers reported not engaging in either type of conversation. Health-focused conversations by both parents were associated with lower body mass index (BMI) and disordered eating behaviors, higher intake of fruit and vegetables, and psychosocial well-being in emerging adult children. Weight-focused conversations with both parents were associated with higher BMI and disordered eating behaviors in emerging adults. There were gender moderated associations of paternal conversations about weight and health with vegetable intake, binge eating, and depressive symptoms. DiscussionThe high prevalence and negative health outcomes associated with weight-focused conversations coupled with the low prevalence and positive health outcomes associated with health-focused conversations by parents suggests the need for public health messaging and intervention development aimed at reducing parental weight talk with emerging adult children.

Life history data of four populations of Triatoma mexicana (Hemiptera: Reduviidae) from Central Mexico.

Triatomine bugs are vectors for the Trypanosoma cruzi Chagas parasites, the etiological agent for Chagas disease. This study evaluated 6 epidemiologically significant behaviors (development time, number of blood meals required for molting to the next instar, mortality rate, aggressiveness, feeding duration, and defecation delay) across 4 populations of Triatoma mexicana Herrich-Schaeffer (Heteroptera: Reduviidae), a major T. cruzi vector in Central Mexico. We collected triatomines from areas characterized by high (HP), medium (MP), medium-high (MHP), and low (LP) prevalence of human T. cruzi infection. The MHP population had the shortest development time, <290 days. Both the HP and MP populations required the most blood meals to molt to the next instar, with a median of 13. Mortality rates varied across all populations, ranging from 44% to 52%. All of the tested populations showed aggressive behavior during feeding. All populations shared similar feeding durations, with most exceeding 13min and increasing with each instar. Quick defecation, during feeding, immediately after or less than 1min after feeding, was observed in most nymphs (78%-90%) from the MP and MHP populations and adults (74%-92%) from HP, MP, and MHP populations. Though most parameters suggest a low potential for T. mexicana to transmit T. cruzi, unique feeding and defecation behaviors in 3 populations (excluding the LP group) could elevate their epidemiological importance. These population-specific differences may contribute to the varying prevalence rates of T. cruzi infection in areas where T. mexicana is found.