Counting Measurements Research Articles

Cumulative HIV viral load and lower CD4 cell count are associated with incident venous thromboembolism in people with HIV.

People with HIV (PWH) have benefited greatly from antiretroviral therapy, but face additional challenges from age-related comorbid conditions, particularly cardiovascular disease including venous thromboembolism (VTE). Little is known about the effect of HIV viremia and immunodeficiency on VTE risk in this population. We assessed incident, centrally adjudicated VTE among 21,507 PWH in care between 1/2009-12/2019 within the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort. We examined the association of three measures of HIV viral load (VL: baseline, current, cumulative) and current CD4 count with VTE. Cumulative VL (copy-days of viremia) was estimated with a time-weighted sum using the trapezoidal rule. We modeled the association between VL and VTE using Cox proportional hazards models (marginal structural Cox models for cumulative), adjusted for demographic and clinical characteristics. We compared the 75th percentile of the VL distribution with the 25th percentile using the hazard function from the model for all PWH with a VTE and those with a pulmonary embolism (PE). During a median of 4.8 years of follow-up, 424 PWH developed VTE. In adjusted analyses, higher cumulative VL (75th percentile vs. 25th percentile), the strongest VL predictor, was associated with a 1.45-fold higher risk of VTE (95%CI:1.22-1.72). Low CD4 cell count <100 cells/mm3 was associated with higher VTE risk (HR: 4.03, 95%CI: 2.76-5.89) as compared to ≥500 cells/mm3. Findings were similar for PWH who had a pulmonary embolism (n = 189). Reducing HIV VL and maintaining CD4 cell count may help mitigate VTE risk in PWH.

Improved representation of soil moisture processes through incorporation of cosmic-ray neutron count measurements in a large-scale hydrologic model

Abstract. Profound knowledge of soil moisture and its variability plays a crucial role in hydrological modelling to support agricultural management, flood and drought monitoring and forecasting, and groundwater recharge estimation. Cosmic-ray neutron sensing (CRNS) has been recognised as a promising tool for soil moisture monitoring due to its hectare-scale footprint and decimetre-scale measurement depth. But since CRNS provides an integral measurement over several soil horizons, a direct comparison of observed and simulated soil moisture products is not possible. This study establishes a framework to assess the accuracy of soil moisture simulated by the mesoscale Hydrologic Model (mHM) by generating simulated neutron counts and comparing these with observed neutron measurements for the first time. We included three different approaches to estimate CRNS neutron counts in the mHM as a function of the simulated soil moisture profiles: two methods based on the Desilets equation and one based on the forward operator COSMIC (COsmic-ray Soil Moisture Interaction Code). For the Desilets method, we tested two different approaches to average the vertical soil moisture profiles: a uniform vs. a non-uniform weighting scheme depending on the CRNS measurement depth. The methods were tested at two agricultural sites, namely one pasture site and one forest site, in Germany. To explore the prior and posterior distributions of the mHM parameters when constrained by CRNS observations, we used a Monte Carlo method based on Latin hypercube sampling with a large sample size (S = 100 000). We found that all three methods performed well, with a Kling–Gupta efficiency &gt; 0.75 and a percent bias &lt; ± 10 % across the majority of investigated sites and for the best 1 % of parameter sets. The performance of the neutron forward models varied slightly across different land cover types. The non-uniform approach generally showed good performance, particularly at the agricultural sites. On the other hand, the COSMIC method performed slightly better at the forest site. The uniform approach showed slightly better results at the grassland site. We also demonstrated for the first time that the incorporation of CRNS measurements into the mHM could improve both the soil moisture and the evapotranspiration products of the mHM. This suggests that CRNS is capable of improving the model parameter space in general and adds a broader perspective on the potential of CRNS to support large-scale hydrological and land surface models.

ON ULTRAPRODUCTS, THE SPECTRAL THEOREM AND RIGGED HILBERT SPACES

Abstract We start by showing how to approximate unitary and bounded self-adjoint operators by operators in finite dimensional spaces. Using ultraproducts we give a precise meaning for the approximation. In this process we see how the spectral measure is obtained as an ultralimit of counting measures that arise naturally from the finite dimensional approximations. Then we see how generalized distributions can be interpreted in the ultraproduct. Finally we study how one can calculate kernels of operators K by calculating them in the finite dimensional approximations and how one needs to interpret Dirac deltas in the ultraproduct in order to get the kernels as propagators $\langle x_{1}|K|x_{0}\rangle $ .

Association Between Dynamic Viral Rebound and Longitudinal Measures of Viral Load/CD4 Counts Among People with HIV in South Carolina.

Monitoring HIV viral rebound (VR) is crucial, as it indicates an increased risk of infection, transmission, disease progression, and drug resistance. This study aims to identify the association between dynamic VR and historical viral load (VL)/CD4 count measures. A 15-year South Carolina population-based electronic health record data were used for the study. VR was defined as the return of detectable levels of VL (>200 copies/mL) after stable viral suppression (VS) (two consecutive VS, i.e., VL ≤200 copies/mL). A generalized linear mixed model was used to evaluate the association between dynamic VR and historical time-dependent predictors, such as nadir CD4 count and comorbidities, within a year prior to each VR. Subgroup analysis for men who have sex with men (MSM) was also conducted. Among 8,185 people with HIV (PWH), 1,173 (14.3%) had a history of VR. Lower nadir CD4 count (≥500 vs. <200 cells/μL; adjusted odds ratio [aOR]: 0.51, 95% confidence interval [CI]: [0.43, 0.60]), younger age (>60 years old vs. 18-30 years old; aOR: 0.43, 95% CI: [0.29, 0.63]), and being Black (Black vs. White; aOR: 1.58, 95% CI: [1.34, 1.85]) were associated with a higher risk of VR, while MSM (MSM vs. heterosexual; aOR: 0.81, 95% CI: [0.67, 0.96]) were associated with decreased VR risk. The rate of VR among PWH in South Carolina is significant. Within-1-year VL/CD4 test is critical for identifying PWH at risk for VR. Tailored interventions are needed for PWH at risk for VR to achieve sustained suppression and better health outcomes.

Predictive Modeling for Inactivation of Escherichia coli Biofilm with Combined Treatment of Thermosonication and Organic Acid on Polystyrene Surface

The present study aimed to evaluate the antibiofilm effect of combined sonication treatment with organic acids on polystyrene surfaces and to develop a predictive model for the inactivation of Escherichia coli biofilms. Polystyrene plates containing E. coli biofilms were subjected to sonication using different inactivation solutions (PBS, lactic acid, and acetic acid) at varying temperatures (20 °C, 40 °C, and 50 °C) and durations (2 and 5 min). The effects of temperature, treatment duration, and inactivation solution on E. coli biofilm removal were statistically significant (p &lt; 0.05). The use of organic acids, along with increased treatment time and temperature, led to a significant reduction in viable cell counts (0.43–6.21 log CFU/mL) and optical density (0.13–0.72 at OD600) of E. coli biofilms (p &lt; 0.05). The highest E. coli biofilm inactivation, with a reduction of 6.21 CFU/mL and 0.72 OD, was achieved by combining organic acid and thermosonication at 50 °C for 5 min. A significant positive correlation was observed between test methods based on viable cell count and optical density (OD) measurements. According to multiple linear regression analysis results, the R2 values of the predictive models for biofilm inactivation, based on viable cell count and OD measurements, were 0.84 and 0.80, respectively. Due to its higher accuracy, the predictive model developed using viable cell count data is recommended for applications in the food industry and processing sectors.

Eksplorasi Udeng Pacul Gowang Sebagai Sumber Belajar EtnomatematikaDi Sekolah Dasar

One of the interesting things about Sidoarjo Regency is the strong heritage of Majapahit culture, including traditional clothing. Part of the traditional clothing complement is the typical Sidoarjo Udeng Pacul Gowang. The aim of this research is to dig deeper into the history of udeng pakul gowang, study the aesthetics of the shape of udeng made by craftsmen, foster a sense of love for culture by instilling a sense of pride and love for local culture, and make mathematics learning more interesting for students by integrating udeng pacul gowang making in mathematics learning. In ethnomathematics, udeng pacul gowang is used as a learning resource that can be linked to mathematics subjects. The method used in this research is descriptive qualitative which focuses on understanding descriptions and interpretations in detail and emphasizes actual conditions without any manipulation. Data collection techniques with research are used to collect in-depth information from various sources, including through (1) interviews, (2) observation, and (3) documentation studies. The results of the research show that through the udeng pacul gowang learning resource, students can learn culture with various mathematical concepts including: counting concepts, algebra, geometry, measurement, and others. Thus, it is hoped that the government and schools will support the development of a curriculum based on local wisdom, so that students can learn mathematics in a context that is more relevant to their culture.

Global trends in CD4 count measurement and distribution at first antiretroviral treatment initiation.

While people with HIV (PWH) start antiretroviral treatment (ART) regardless of CD4 count, CD4 measurement remains crucial for detecting advanced HIV disease and evaluating ART programmes. We explored CD4 measurement (proportion of PWH with a CD4 result available) and prevalence of CD4 <200 cells/µL at ART initiation within the International epidemiology Databases to Evaluate AIDS (IeDEA) global collaboration. We included PWH at participating ART programmes who first initiated ART at age 15-80 years during 2005-2019. We described proportions of PWH (i) with CD4 (measured within 6 months before to 2 weeks after ART initiation); and (ii) among those with a CD4, with CD4 <200; by year of ART initiation and region. We included 1,355,104 PWH from 42 countries in 7 regions; 63% were female. Median (interquartile range) age at ART initiation was 37 (31-44) in men and 32 (26-39) in women. CD4 measurement initially increased, or remained stable over time until around 2013, but then declined to low levels in some regions (Southern Africa, except South Africa: from 54 to 13%; East Africa 85 to 31%; Central Africa 72 to 20%; West Africa: 91 to 53%; and Latin America: 87 to 56%). Prevalence of CD4<200 declined over time in all regions, but plateaued after 2015 at ≥30%. CD4 measurement has declined sharply in recent years, especially in sub-Saharan Africa. Among those with a CD4, the prevalence of CD4 <200 remains concerningly high. Scaling up CD4 testing and securing adequate funding are urgent priorities.

Markers of coagulation and early coronary stent thrombosis

Abstract Background Acute stent thrombosis is a rare but deleterious event after percutaneous coronary intervention (PCI). Hemostatic factors such as D-Dimer, fibrinogen, and platelet count have emerged as potential indicators of increased thrombotic risk. However, data regarding the association with early stent thrombosis (ST) is sparse. Purpose The aim of this study was to investigate whether markers of coagulation are associated with increased risk of early (&amp;lt; 30 days after PCI) ST. Methods Within a prospective single-center registry, we retrospectively analyzed the association between pre-procedural platelet count, plasma levels of fibrinogen and D-Dimer with the occurrence of early ST within 30 days after PCI. Results We included 10,714 consecutive patients who underwent percutaneous coronary intervention (PCI) with implantation of drug-eluting stents (DES). Pre-procedural measurements of platelet count, fibrinogen and D-Dimer was available in 6,337, 6,155 and 956 patients, respectively. The number of definite early ST within 30 days was 58 (0.92 %). Pre-procedural platelet count (p&amp;lt;0.05) and plasma levels of fibrinogen (p&amp;lt;0.05) were significantly higher in patients with early ST as compared to patients without ST. Whereas D-Dimer was not associated with early ST, patients in the fifth quintile of platelet count had a significant increased risk for early ST (HR 2.43; 95% CI 1.43 - 4.14; p=0.001) as compared to patients in the lower four quintiles and patients in the fifth quintile of fibrinogen had a significant increased risk for early ST (HR 1.86; 95% CI 1.07 – 3.26; p&amp;lt;0.05) as compared to patients in the lower four quintiles. These associations were independent of clinical risk factors, the presence of acute coronary syndromes and the number of stents. Conclusions Pre-procedural platelet count and plasma levels of fibrinogen are associated with the risk of early ST in patients after implantation of DES. Device-level risk factors like stent-type or size and procedure-level risk factors like peri-interventional medication and complications during stent apposition are associated with ST. Platelet count and plasma levels of fibrinogen may be additional patient-level risk factors that have to be taken in account in the development of future personalized strategies to prevent these rare but deleterious complications.

Loss of Surfactant Protein A Alters Perinatal Lung Morphology and Susceptibility to Hyperoxia-Induced Bronchopulmonary Dysplasia.

Bronchopulmonary dysplasia (BPD) is a condition of poor alveolar formation that causes chronic breathing impairment in infants born prematurely. Preterm lungs lack surfactant and are vulnerable to oxidative injuries driving the development of BPD. Our recent studies reported that surfactant protein A (SP-A) genetic variants influence susceptibility to neonatal lung disease. SP-A modulates activation of alveolar macrophages and parturition onset in late gestation. We asked whether a lack of SP-A alters alveolarization in a mouse model of hyperoxia-induced BPD. SP-A-deficient and control newborn mice were exposed to either clinically relevant 60% O2 hyperoxia or normoxia for 5-7 days. Alveolar formation was then assessed by mean linear intercept (MLI) and radial alveolar count (RAC) measurements in lung tissue sections. We report that the combination of SP-A deficiency and hyperoxia reduces alveolar growth compared to WT mice. The morphometric analysis of normoxic SP-A-deficient lungs showed lower RAC compared to controls, indicating reduced alveolar number. In the presence of hyperoxia, MLI was higher in SP-A-deficient lungs compared to controls. Differences were statistically significant for female pups. Spatial proteomic profiling of lung tissue sections showed that hyperoxia caused a 4-fold increase in the DNA damage marker γH2Ax in macrophages of SP-A-deficient lungs compared to normoxia. Our short report suggests an important role for SP-A in perinatal lung development and the protection of lung macrophages from oxidant injury. These studies warrant future investigation to discern the temporal interaction of SP-A, gender, oxidant injury, and lung macrophages in perinatal alveolar formation and development of BPD.

Assessment of myeloid response and iron status among Sudanese pediatric ESKD on hemodialysis through reticulocyte parameters and β-globin mRNA expression

BackgroundSudanese children with End-Stage Kidney Disease (ESKD) often show limited improvement in hemoglobin levels despite treatment with recombinant human erythropoietin (rHuEPO). This study aims to assess the response to rHuEPO therapy by analyzing β-globin mRNA expression and reticulocyte parameters. Additionally, it classifies anemia among Sudanese pediatric patients based on iron status, considering age and gender as biological markers for evaluating treatment response.MethodsA prospective observational cohort study was conducted from January 2019 to February 2020 in Khartoum, Sudan, involving 45 anemic children aged 2 to 15 years diagnosed with ESKD. The treatment protocol included rHuEPO injections and maintenance hemodialysis. Laboratory assessments consisted of complete blood count (CBC), absolute reticulocyte count, ferritin, and transferrin measurements. β-globin mRNA expression was quantified using reverse transcription polymerase chain reaction (RT-PCR), and reticulocyte parameters, including Reticulocyte Hemoglobin Content (CHr), percentage of hypochromic reticulocytes (HYPO%), and Immature Reticulocyte Fraction (IRF), were measured via flow cytometry.ResultsSignificant variations in hemoglobin levels were observed across different age groups (p = 0.011). Gender analysis revealed a significant association with IRF, showing a lower IRF in male patients (p = 0.017). However, there were no significant differences in hemoglobin levels between genders (p = 0.999). β-globin mRNA expression showed considerable variability, with a strong positive correlation with hemoglobin levels (r = 0.875, p < 0.0001).ConclusionAge and gender significantly influence treatment responses in children with ESKD, highlighting the need to consider growth physiology in anemia management. This study underscores the variability in β-globin mRNA expression and its association with Flow Cytometry parameters, demonstrating their effectiveness in evaluating iron status and guiding rHuEPO dosage.

Uncovering Integrated Dual-State ESIPT-Conductivity, Redox-Capacity, and Opto-Electronic Responses Toward Hg(II)/ Cr(III) of Aliphatic Fluorescent Polymers.

Excited-state intramolecular proton transfer (ESIPT)-associated dual-state emissive aliphatic dual-light emitting conducting polymers (DLECPs) having oxidation-reduction capacities are prepared polymerizing 2-acrylamido-2-methylpropane-1-sulfonic acid, methacrylic acid, and 2-methyl-3-(N-(2-methyl-1-sulfopropan-2-yl)acrylamido)propanoic acid monomers. Of as-synthesized DLECPs, nuclear magnetic resonance (NMR) and Fourier transform infrared (FTIR) spectroscopies, fluorescent enhancements (I/I0), and computational investigation indicate intriguing photophysical features in DLECP3 (optimum composition). In DLECP3, ─CONH─, ─CON<, and ─COOH subluminophores are recognized by density-functional theory (DFT)/time-dependent-DFT calculations and experimental investigations. ESIPT-associated dual-state emission/conductivity, aggregation-enhanced emissions, selective opto-electronic responses toward Hg(II)/Cr(III) at 437/574nm, and redox properties of DLECP3 are supported by solid-state/solution spectroscopies, time-correlated single photon counting (TCSPC) measurements, dual-state excitation dependent emissions, microscopic images, electrochemical measurements, and DFT calculations. Here, preferential interaction of Hg(II)/Cr(III) with DLECP3 (amide)/DLECP3 (imidol) and reduction/oxidation of Hg(II)/Cr(III) to Hg(I)/Cr(VI) are substantiated by UV-vis, FTIR, and X-ray photoelectron spectroscopies; TCSPC measurements; NMR-titration; electrochemical studies; alongside computational calculations. The proton-electrical conductivities of DLECP3, Hg(II/I)-DLECP3, and Cr(III/VI)-DLECP3 in solids/solutions are 15.27 × 10-5/6.16 × 10-5, 19.60 × 10-5/25.52 × 10-5, and 26.69 × 10-5/27.60 × 10-5 S cm-1, respectively.

Innovative nebulization delivery of lipid nanoparticle-encapsulated siRNA: a therapeutic advance for Staphylococcus aureus-induced pneumonia

BackgroundIntegrin α5β1 plays a crucial role in the invasion of nonphagocytic cells by Staphylococcus aureus (S. aureus), thereby facilitating infection development. Lipid nanoparticles (LNPs) serve as an effective vehicle for delivering small interfering ribonucleic acids (siRNA) that represent a method to knockdown integrin α5β1 in the lungs through nebulization, thereby potentially mitigating the severity of S. aureus pneumonia. The aim of this study was to harness LNP-mediated targeting to precisely knockdown integrin α5β1, thus effectively addressing S. aureus-induced pneumonia.MethodsC57 mice (8 week-old females) infected with S. aureus via an intratracheal nebulizing device were utilized for the experiments. The LNPs were synthesized via microfluidic mixing and characterized by their size, polydispersity index, and encapsulation efficiency. Continuous intratracheal nebulization was employed for consistent siRNA administration, with the pulmonary function metrics affirming biosafety. The therapeutic efficacy of LNP-encapsulated siRNAs against pneumonia was assessed through western blotting, bacterial count measurement, quantitative polymerase chain reaction, and histological analyses.ResultsLNPs, which have an onion-like structure, retained integrity post-nebulization, ensuring prolonged siRNA stability and in vivo safety. Intratracheal nebulization delivery markedly alleviated the severity of S. aureus-induced pneumonia, as indicated by reduced bacterial load and bolstered immune response, thereby localizing the infection to the lungs and averting systemic dissemination.ConclusionsIntratracheal nebulization of LNP-encapsulated siRNAs targeting integrin α5β1 significantly diminished the S. aureus-mediated cellular invasion and disease progression in the lungs, presenting a viable therapeutic approach for respiratory infections.

Comparing Holotranscobalamin and Total Vitamin B12 in Diagnosing Vitamin B12 Deficiency in Megaloblastic Anemia Patients.

Background Megaloblastic anemia is characterized by abnormally large red blood cells caused by a deficiency in either vitamin B12 or folic acid, both of which are essential for DNA synthesis. Vitamin B12 insufficiency can lead to severe neurological damage, making early identification of vitamin B12 deficiency crucial to prevent irreversible harm. Vitamin B12 deficiency results in decreased levels of holotranscobalamin (Holo-TC) and increased levels of methylmalonic acid (MMA). Methylmalonic acid is considered the gold standard for diagnosing B12 deficiency because it is a specific marker that rises when B12 is insufficient, even when serum B12 levels appear normal. Elevated MMA levels reflect impaired B12 metabolism, making it a critical tool for early detection and intervention. Previous research indicates that Holo-TC, the active form of vitamin B12 available to cells, is a more specific diagnostic tool for early vitamin B12 deficiency than total B12. This study aims to determine the diagnostic validity of total vitamin B12 and Holo-TC using MMA as the gold standard in patients with megaloblastic anemia. Methods A total of 95 megaloblastic anemia patients were selected from Jinnah Hospital and Lahore General Hospital, Lahore, Pakistan, after receiving approval from the ethical review committees. This was a cross-sectional study. Whole blood, serum, and urine samples were collected in ethylenediamine tetraacetic acid (EDTA) vials, gel vials, and urine containers, respectively. The EDTA samples were used for complete blood count measurements using a hematology analyzer (Sysmex-XT 1800i, Sysmex America, Inc., Mundelein, IL), while serum and urine samples were employed for the detection of serum folic acid, cobalamin, Holo-TC, and MMA levels through manual enzyme-linked immunosorbent assay (ELISA) techniques. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of Holo-TC and cobalamin were calculated. Results The majority of patients fell within the age group of 20-70 years, with 57% of them being females and 43% males; Holo-TC exhibited a sensitivity of 98.9% and specificity of 50.00%, with a PPV of 98.90% and NPV of 50%. Vitamin B12 demonstrated a sensitivity of 63% and specificity of 50%, with a PPV of 98.33% and NPV of 2.85%. The diagnostic accuracy of Holo-TC and vitamin B12 was observed to be 97.8% and 63%, respectively. Conclusions Between the two, Holo-TC displays higher diagnostic accuracy than vitamin B12 and can serve as the primary test for patients suspected of having vitamin B12 deficiency.

Joint modeling of zero-inflated longitudinal measurements and time-to-event outcomes with applications to dynamic prediction.

In this article, we present a joint modeling approach for zero-inflated longitudinal count measurements and time-to-event outcomes. For the longitudinal sub-model, a mixed effects Hurdle model is utilized, incorporating various distributional assumptions such as zero-inflated Poisson, zero-inflated negative binomial, or zero-inflated generalized Poisson. For the time-to-event sub-model, a Cox proportional hazard model is applied. For the functional form linking the longitudinal outcome history to the hazard of the event, a linear combination is used. This combination is derived from the current values of the linear predictors of Hurdle mixed effects. Some other forms are also considered, including a linear combination of the current slopes of the linear predictors of Hurdle mixed effects as well as the shared random effects. A Markov chain Monte Carlo method is implemented for Bayesian parameter estimation. Dynamic prediction using joint modeling is highly valuable in personalized medicine, as discussed here for joint modeling of zero-inflated longitudinal count measurements and time-to-event outcomes. We assess and demonstrate the effectiveness of the proposed joint models through extensive simulation studies, with a specific emphasis on parameter estimation and dynamic predictions for both over-dispersed and under-dispersed data. We finally apply the joint model to longitudinal microbiome pregnancy and HIV data sets.

Validation of steps countering recorded with a smartwatch.

Activity trackers are becoming increasingly popular in everyday life, sport and research. Accurate measurement of step counts is essential for understanding an individual's daily activity levels and promoting healthier lifestyles. As the sensor technology has become very sophisticated, such a device can be worn on the body for several hours or days without restricting the subject's daily activities. The aim of this study was to evaluate the accuracy of a commercially available wrist-worn pedometer in accurately recording step counts. A total of twenty-one subjects participated in this comparative study by running at various speeds in a laboratory setting while wearing a Garmin Forerunner 245 Music watch (Garmin Ltd, Schaffhausen, Switzerland) on each wrist. Simultaneously, their steps were recorded by a camera system. The step counts recorded by the pedometer were compared with the counts obtained by the camera system. Descriptive statistical analyses such as Pearson correlation and Bland-Altman plots were used to assess the accuracy and reliability of the pedometer. For most settings the results on the treadmills showed a high correlation between the pedometer and the camera system. On the step machine the results showed a low correlation between the pedometer and the camera system, the pedometer showed a systematic bias by consistently overestimating the number of steps. Bland-Altman plots showed that the results were within the limits of agreement. Although pedometers provide a convenient tool for monitoring step count, this study highlights some limitations and potential inaccuracies of a commercially available pedometer. Our study indicates that the Garmin watch is sufficiently accurate to be used as a measurement tool in a treadmill running environment.

Predominantly antibody deficiencies: An important underlying cause of recurrent pneumonia in adults

RATIONALE Limited information exists concerning the causes of recurrent pneumonia in adults, particularly regarding immunodeficiencies or inborn errors of immunity. OBJECTIVES This study aims to evaluate the etiology of recurrent pneumonia in the adult population, with a focus on humoral deficiency and inborn errors of immunity. METHODS A cross-sectional non-interventional study was conducted in Cali, Colombia, from January 2019 to March 2021. Consecutive patients, aged over 14 years but under 65 years, with a history of recurrent pneumonia, were included after providing consent. The study involved a thorough review of their past medical records and radiological studies. All participants underwent complete blood count and serum immunoglobulin level measurements (IgG, IgA, IgM and IgE). Further testing was carried out based on the evaluation of a clinical immunologist. RESULTS Sixty-six (66) individuals, comprising 34 females and 32 males, were enrolled in the study. The onset of symptoms occurred at an average age of 14 years (ranging from 5 to 36 years). The analysis revealed that the most prevalent cause of recurrent pneumonia was inborn errors of immunity (20 cases, 30.3%), followed by idiopathic (9 cases, 13.7%), bronchiectasis (7 cases, 10.7%), primary ciliary dyskinesia (6 cases, 9.0%), asthma (6 cases, 9.0%), and post-tuberculosis complications (5 cases, 7.6%). CONCLUSION Predominantly antibody deficiencies, along with other inborn errors of immunity, were identified as an important factor contributing to recurrent pneumonia in adults. These findings highlight the importance of these conditions as major etiological factors in the context of recurrent pneumonia in the Colombian adult population.

Evaluation of Immuno-Hematological Parameters of Severe and Mild COVID-19 Cases in Babylon Province, Iraq

The hematopoietic system plays a very important role in contracting the corona virus infection. Hematology indicators are among the factors related to the clinical results of patients with covid-19 due to their cost-effectiveness, availability, speed and convenience of testing. The aim of this study was comparing hematological parameters including the number of Red Blood Cells (RBC), hemoglobin, hematocrit, and platelet count among mild and severe COVID-19 patients. Methods: The study was conducted on 100 Iraqi patients COVID-19 patients. Subjects were classified into two groups with mild (n= 50) and severe (n=50) COVID-19 infection symptoms based on the clinical criteria. The hematological parameters measurement included Red Blood Cell (RBC) count, Hemoglobin (Hb) levels, White Blood Cell (WBC) count, Platelet count (PLT), Hematocrit (HCT) levels, Platelet Distribution Width (PDW), and Mean Platelet Volume (MPV). An independent sample T-test was used to compare the means of hematological parameters between two groups. Results: The RBC count was significantly lower in severe group compared to mild group (P ≤ 0.05). HCT levels were significantly reduced in the severe group compared to mild group (P ≤ 0.05). The severe patients had a significantly lower PLT than mild patients (P ≤ 0.05). No significant difference in Hb levels was observed between severe and mild patients. The severe patients had a significantly higher PDW than mild patients (P ≤ 0.05). Additionally, the severe patients had a significantly higher MPV than mild patients (P ≤ 0.05). Conclusion: The findings of this study indicate that complete blood count measurements can be used as useful biomarkers to assess the severity of Covid-19. Early identification of severe COVID-19 patients using these markers can help to better manage and accelerate the treatment process for COVID-19 patients.

COVID-19 and Female Fertility: An Observational Prospective Multicenter Cohort Study: Upholding Reproductive Rights in Emergency Circumstances.

Currently available research data points to COVID-19-related multi-organ system damage. This study aims to evaluate the impact of SARS-CoV-2 on the reproductive health, that is, plasma levels of FSH, LH, estradiol, AMH, and antral follicular count, of women undergoing level II ART techniques. This is a multicenter, prospective, and observational study by the reproductive medicine centers of Palermo's Ospedali Riuniti Villa Sofia-Cervello Hospital and Vanvitelli University. From September 2022 to March 2024, 203 patients aged 24-43 were enrolled, all with diagnosed infertility and a history of SARS-CoV-2 infection. Symptomatic women, patients testing positive for HIV or other liver viruses, and patients with a history of ovarian cancer or who had taken gonadotoxic drugs were excluded. Plasma measurements of FSH, LH, estradiol, AMH, and antral follicular count were performed before and after infection. The analysis accounting for the concentration of anti-Müllerian hormone (AMH) before and after COVID-19 infection shows an average concentration decrease from 1.33 ng/mL before SARS-CoV-2 infection to 0.97 ng/mL after infection. Average decrease after infection was -27.4%; average reduction of 1 follicle (95% CI: from -0.74 to -1.33) was reported following SARS-CoV-2 infection. Levels of E2 before and after SARS-CoV-2 infection did not vary significantly. Average FSH and LH levels before and after SARS-CoV-2 infection pointed to an increase. SARS-CoV-2 infection damages female reproductive health, causing significant reductions in AMH (-27.4%) and AFC (-1 antral follicle) values and an increase in FSH (+13.6%) and LH (+13.4%) values. No effect on E2 levels was reported. The pandemic has also affected the ability of infertile patients to access ART procedures, and that calls for a novel, updated blueprint designed to enhance our preparedness in the event that similar circumstances should occur again.

Smartphone-Based Digital Peer Support for a Walking Intervention Among Public Officers in Kanagawa Prefecture: Single-Arm Pre- and Postintervention Evaluation.

Digital peer support, defined as peer support delivered through technology such as smartphone apps, may be promising to promote activity in the form of step counts. Interactions among users have a positive impact on retention rates, and apps with social elements show significant improvements in daily step count. However, the feasibility of digital peer support in promoting physical activity (PA) is unknown; therefore, its effectiveness on step count and the clinical implications remain unconfirmed. This study aimed to assess the feasibility of digital peer support over a 3-month intervention period using the retention rate as the outcome. Moreover, changes in daily step count and physical measurements were compared between pre- and postintervention. The study design was a 3-month 1-arm intervention with participants from local government offices in Kanagawa, Japan. We used an available smartphone app, Minchalle, as the tool for the group intervention. Participants were required to report their daily step count to a maximum of 5 members composed exclusively of study participants. The primary outcome was the retention rate. Secondary outcomes included daily step count, the rate of achieving daily step goals, physical measurements, and lifestyle characteristics. Descriptive statistics and the Pearson coefficient were used to examine the relationship between goal achievement and step count, as well as changes in step count and various variables including physical measurements. Of the 63 participants, 62 completed the intervention. The retention rate was 98% (62/63). The average daily step count during the intervention was 6993 (SD 2328) steps, an 1182-step increase compared with the count observed 1 week before the intervention began. The rate of achieving the daily step count during the intervention was 53.5% (SD 26.2%). There was a significant correlation (r=0.27, P=.05) between achieving daily step goals and increasing daily step count. Comparative analyses showed that changes in weight (68.56, SD 16.97 kg vs 67.30, SD 16.86 kg; P<.001), BMI (24.82, SD 4.80 kg/m2 vs 24.35, SD 4.73 kg/m2; P<.001), somatic fat rate (28.50%, SD 7.44% vs 26.58%, SD 7.90%; P=.005), systolic blood pressure (130.42, SD 17.92 mm Hg vs 122.00, SD 15.06 mm Hg; P<.001), and diastolic blood pressure (83.24, SD 13.27 mm Hg vs 77.92, SD 11.71 mm Hg; P=.002) were significantly different before and after the intervention. Similarly, the daily amount of PA significantly improved from 5.77 (SD 3.81) metabolic equivalent (MET)-hours per day to 9.85 (SD 7.84) MET-hours per day (P<.001). This study demonstrated that digital peer support is feasible for maintaining a high retention rate and can, therefore, effectively promote PA. It can be a promising tool to improve daily step count, subjective PA, and clinical outcomes, such as weight and somatic fat rate. UMIN Clinical Trials Registry UMIN000042520; https://tinyurl.com/46c4nm8z.

Cross-sectional screening for inflammation in tinnitus with near-normal hearing

Tinnitus is the perception of sound without an external stimulus. Recently, inflammation has been implicated in the pathophysiology of tinnitus. In tinnitus animal models, cytokine levels are increased throughout the whole auditory pathway, and microglia and astrocytes are activated. However, only a few human studies on inflammation in tinnitus were conducted, which generally did not account for confounders such as hearing loss, anxiety and depression. The current study therefore aimed to evaluate the association between inflammation and tinnitus specifically in participants with (near-)normal hearing and without signs of anxiety or depression.In this cross-sectional study, fifty tinnitus participants and fifty healthy controls completed a tinnitus questionnaire and underwent audiometric testing. Complete blood count measures were determined in blood plasma, as well as cytokine concentrations by using the enzyme-linked immunosorbent assay (ELISA) technique.Platelet count and cytokine concentrations of IL-10 and IFN-γ were lower in participants with tinnitus compared to controls, and male sex, lower MCV, lower platelet count, and lower IL-10 and IFN-γ concentrations were significant predictors of tinnitus presence.The current study shows that inflammatory parameters are altered in tinnitus patients after exclusion of important confounders such as hearing loss, anxiety, depression, and inflammatory diseases.