Modulation Research Articles

Potential Zoonotic Infections Transmitted by Free-Ranging Macaques in Human-Monkey Conflict Areas in Thailand.

Nonhuman primates (NHPs) can transmit zoonotic diseases to humans because of their close genetic relationship, facilitating the cross-species transmission of certain pathogens. In Thailand, Macaca is the most common NHP genus and their inhabits area are in close proximity of human, particularly in urban and suburban areas, where frequent interactions with humans increase the risk of pathogen transmission. The risk is influenced by factors such as the type of pathogen, the mode of transmission (e.g. direct contact or vector-borne), and the density of human and macaque populations in the regions. This study aims to investigate potential zoonotic infections in free-ranging macaques residing in human-monkey conflict areas. From 2014 to 2023, 2703 macaques across 29 provinces in Thailand were tested for 18 pathogens using PCR, RT-PCR, or real-time PCR. The associations between disease occurrence, demographic variables, and sample types of macaques were analysed using univariable and multivariable regression. The overall pathogen infection percentage was 35.7% (965/2703). Simian foamy virus (SFV) had the highest infection percentage at 52.5% (759/1446), followed by Herpesviridae at 41.4% (353/852), Plasmodium spp. at 1.8% (14/758), and hepatitis B virus at 0.1% (2/1403). Significant differences were observed among different sampling sites, macaque age groups, and species in infection proportion of SFV, and Herpesviridae. Identifying the pathogens carried by macaques is crucial for preparing for potential disease epidemics and outbreaks.

Determinants of Healthcare Workers' Uptake of Voluntary Counseling and Testing for HIV/AIDS at Meru Teaching and Referral Hospital, Kenya

Aim: To establish determinants to the uptake of VCT services among the healthcare workers at Meru Teaching and Referral Hospital, Kenya. Methods: A descriptive, cross-sectional study was conducted among 193 participants selected through stratified random sampling. Data were collected using a semi-structured questionnaire and analyzed using SPSS version 21. Results were presented using frequency distribution tables, with statistical significance set at p<0.05. Results: There was a high level of uptake of VCT services among the healthcare workers, at 97.9%. Age of the participants had a significant influence (P = .042). Gender (P = .062), profession (P = .15), education (P = .12), and marital status (P = .11) had little or no influence. 100% of the participants recorded to be knowledgeable on modes and methods of HIV prevention and transmission. Knowledge of sexual contact in the transmission and spread of HIV virus proved to be statistically significant (P = .000). The factors highlighted as barriers in this study were found to have less impact in hindering the participation in VCT services. The moderation effect between variables was assessed using the Andrew F. Hayes and confirmed that, availability of guidelines for exposed participants and post-exposure prevention did not moderate the demographic factors, (P = .07). However, the administration's role encouraging the healthcare workers to HIV testing increased the significance of demographic factors. (P=.03). Conclusion: There was a high level of uptake of VCT services, knowledge on the modes of transmission and prevention of HIV virus among the healthcare providers. Government policies and institutional guidelines on HIV VCT protocols, medical ethics and consistent efforts are needed to promote the uptake of VCT services among the healthcare workers.

Psychiatric nurses’ knowledge of COVID-19 within a patient care context: A qualitative study

Background: Coronavirus disease 2019 (COVID-19) infection caused unparalleled hastening of the transmission of infection worldwide, commonly affecting healthcare workers’ well-being. Nursing staff spend most hours caring for patients and are the first contact that patients utilise when reporting symptoms or receiving treatment.Aim: This study aims to evaluate the knowledge of COVID-19 among psychiatric nurses at a tertiary psychiatric hospital.Setting: Weskoppies Hospital, Gauteng, South Africa.Methods: We conducted a qualitative study comprising 14 semi-structured interviews with nurses working at Weskoppies Hospital in South Africa. We used open-ended questions to facilitate the discussion and provide some structure for the interview while still allowing the participants to elaborate freely. The recordings were later transcribed into text.Results: Twenty nurses working full time at the hospital, were recruited for the study. The nurses’ knowledge about COVID-19 was summarised into five major themes, each with subthemes: signs and symptoms of COVID-19, risk of contracting the virus, the spread of COVID-19, prevention, and complications. In this study, the majority of participants had relatively good knowledge regarding COVID-19.Conclusion: The majority of nurses at the hospital had adequate knowledge about COVID-19 but limited knowledge about the mode of transmission of the infection. Consistently improving healthcare workers’ knowledge about infection control measures through training, supplying information and identifying areas for improvement can ultimately enhance patient care and outcomes.Contribution: This study sheds light on the value of nurses’ understanding of COVID-19, particularly in a psychiatric setting.

Den Use Patterns of Endangered San Joaquin Kit Foxes in Urban Environments May Facilitate Disease Transmission.

A robust population of endangered San Joaquin kit foxes (Vulpes macrotis mutica; SJKFs) occurs in the city of Bakersfield, CA. In 2013, sarcoptic mange was detected and significantly reduced SJKF abundance. Dens may be a mode of mange mite transmission. Kit foxes use dens daily and sometimes share dens. Also, mange mites are able to live off-host in den soil for multiple days. We monitored den use patterns of 37 marked kit foxes. Radio-collared foxes were tracked to dens and then those dens were monitored with cameras for 7-day sessions, the period of time mites might persist in the dens. Other foxes used the same den as a collared fox during 89.0% of sessions and the mean number was 2.5 foxes. An average of 1.8 foxes used a den concurrently with the collared fox. During 120-day intervals, the minimum survival time for kit foxes contracting mange, collared foxes used a mean of 7.6 dens, 9.8 other foxes used the same dens, and 7.3 foxes used the dens concurrently with the collared foxes. Thus, the potential for kit foxes to transmit mange through den sharing in the urban environment is considerable and may explain the rapid spread of mange throughout this population.

Public Health Evaluation of Prisoners' Demographics and Awareness of Communicable Diseases in Correction Center in South-South Nigeria

Communicable diseases are a significant public health concern in Nigerian custodial centers. This study evaluated the public health implications of prisoners’ demographics and their awareness of communicable diseases in a correctional center in South-South Nigeria. A structured questionnaire was used to gather data on inmates' demographic characteristics and knowledge of six communicable diseases. Two hundred and nine (209) inmates who consented were randomly selected and self-administered the questionnaire. The data were tabulated and analyzed descriptively. Demographic data, including age, sex, marital and educational status, pre-incarceration occupation, residence, and duration in prison, aligned with the prison registry. Results indicated that all inmates (100.0%) were aware of communicable diseases. Information sources included hospitals/health workers (48.3%), family/friends/inmates (37.3%), books/magazines/newspapers (11.0%), and radio/TV/internet (3.3%). Inmates demonstrated good knowledge of communicable diseases, with 87.1% identifying causes and 56.6% recognizing modes of transmission. Awareness levels were high for HIV/AIDS (100.0%), hepatitis (81.3%), COVID-19 (100.0%), malaria (100.0%), human intestinal parasite infections (66.0%), and tuberculosis (73.2%). Most respondents correctly identified the etiologic agents, though some incorrectly attributed HIV/AIDS (9.3%) and hepatitis (17.1%) to spiritual causes. Regarding prevention, all inmates (100.0%) knew the methods for HIV/AIDS, COVID-19, and malaria. Awareness of hepatitis B prevention was 81.3%, while 66.0% and 73.2% identified preventive methods for human intestinal parasite infections and tuberculosis, respectively. This study highlights commendable awareness of communicable diseases among inmates, however, it revealed some misconceptions about its causes, control, and prevention., offering valuable insights for public health programs in correctional facilities.

Summary of the National Advisory Committee on Immunization (NACI) Statement-Updated guidance on Imvamune in the context of a routine immunization program.

Mpox is a viral illness related to smallpox. It can cause flu-like symptoms and a rash, and in severe cases, can lead to hospitalization or death. The Imvamune® vaccine offers protection against mpox. Consistent with global trends, mpox cases in Canada have been reported primarily among men who have sex with men (MSM), with sexual contact as the predominantly reported mode of transmission. While the incidence of mpox in Canada has significantly declined since the fall of 2022, mpox remains an important public health concern with the potential for future resurgence. The National Advisory Committee on Immunization (NACI) reviewed available evidence on the clinical benefits and risks of Imvamune. This evidence included studies assessing the vaccine effectiveness estimates from real-world evidence, as well as pre- and post-market licensure safety data. NACI has also considered additional factors including ethics, equity, feasibility and acceptability. Guidance on the use of Imvamune in the context of international travel was developed in collaboration with the Canadian Committee to Advise on Tropical Medicine and Travel (CATMAT). NACI concluded that available evidence supported the vaccine's effectiveness and safety in preventing mpox infection. Building on previous interim guidance from NACI recommending the use of Imvamune for pre-exposure vaccination in the context of ongoing mpox outbreaks, NACI now recommends that Imvamune be used in the context of a focused routine immunization program. Individuals at high risk of mpox, including MSM who meet high-risk criteria such as having more than one sexual partner, should receive two doses of Imvamune administered by subcutaneous injection at least 28 days apart.

Knowledge, practices, and human seroprevalence of brucellosis in the central dairy-producing area of Cochabamba, BoliviaConhecimentos, práticas e soroprevalência humana de brucelose na área central de produção de laticínios de Cochabamba, Bolívia

To validate the applicability of the Rose Bengal (RB) test, indirect IgG or IgM enzyme-linked immunosorbent assay (ELISA), and the Brucellacapt test® to the local context, determine the seroprevalence of brucellosis, and evaluate knowledge of the disease in people at risk in a dairy-producing area of La Maica, Cochabamba (Plurinational State of Bolivia). The tests were initially validated with a group of 76 people; the final study population was 330 people, who also participated in a socio-epidemiological survey. Of 330 samples tested, 12.7% were positive, using either the RB or Brucellacapt test®. The indirect IgG ELISA gave false positive results, indicating that the cut-off point should be adapted to the local epidemiological situation. Almost all RB-positive cases were asymptomatic. The socio-epidemiological survey highlights a lack of information and awareness about brucellosis, with regard to its zoonotic nature, mode of transmission, and symptoms. This study revealed a high seroprevalence of brucellosis in the La Maica dairy-producing area in Cochabamba (Plurinational State of Bolivia), with many asymptomatic cases and a high number of false positives from IgG indirect ELISA. It is recommended to conduct awareness-raising campaigns on the risks of this disease and to discourage the consumption of raw milk.

Acute Bartonellosis caused by bartonella quintana in a sheep farmer- an unidentified mode of transmission for ‘trench fever’

Acute Bartonellosis caused by bartonella quintana in a sheep farmer- an unidentified mode of transmission for ‘trench fever’

Glycosylation Patterns in Meccus (Triatoma) pallidipennis Gut: Implications for the Development of Vector Control Strategies.

The primary mode of transmission for Chagas disease is vector-borne transmission, spread by hematophagous insects of the Triatominae subfamily. In Mexico, the triatomine Meccus pallidipennis is particularly significant in the transmission of Trypanosoma cruzi. This study focused on analyzing protein expression and modifications by glycosylation in different regions of the digestive tract of fifth-instar nymphs of M. pallidipennis. Two gut sections were dissected and extracted: the anterior midgut (AMG) and the proctodeum or rectum (RE). Proteins were extracted from each tissue sample and profiled by one- and two-dimensional electrophoresis; protein glycosylation was analyzed by lectin affinity. Our results showed significant differences in protein expression and glycosylation between both gut regions, with modifications being more frequent in the RE. The proteins HSP70, actin, and tubulin were analyzed, finding a differential expression of the latter two between AMG and RE. Understanding glycosylation patterns provides critical insights into vector-pathogen interactions that could eventually inform novel control approaches. Furthermore, the potential use of lectins as insecticidal agents highlights the broader implications of glycoprotein research in the future development of strategies on vector control to disrupt T. cruzi transmission.

Descriptions of Adolescent Holistic Knowledge About HIV/AIDS at State Islamic Junior High School 2 Jember

HIV/AIDS is a global health issue, with the number of sufferers tending to increase each year. In 2015, there were 30,935 new HIV cases, and by 2020, this number had risen to 41,987 cases, indicating a 35.77 percent increase in new cases between 2015 and 2020. Adolescents constitute one of the groups vulnerable to HIV/AIDS due to a lack of holistic knowledge on the subject. Knowledge related to HIV/AIDS is crucial for adolescents, as the adolescent phase is characterized by an increase in hormone production, which may trigger risky sexual behavior. This study used a qualitative descriptive method with Focus Group Discussion (FGD) with 22 respondents at State Islamic Junior High School 2 Jember grades 7 and 8. The five indicators of knowledge asked respondents include definition, mode of transmission, characteristics of people affected, prevention and treatment of HIV/AIDS classified as less. Based on research results, knowledge about HIV/AIDS among adolescents is still relatively low, despite the respondents being organizational activists at school. As adolescents active in their organizations, they play an important role in disseminating appropriate information about HIV/AIDS to their peers. To address this issue, it is recommended that schools and other relevant stakeholders provide comprehensive sexual education for adolescents. Integrating education on sexual health into school subjects can help adolescents understand this disease comprehensively and realize the importance of sexual health and HIV/AIDS prevention.

Knowledge, attitude and perception towards Human Papillomavirus and its vaccination: A cross-sectional survey of female university students enrolled in health and non-health related programs

Understanding the human papillomavirus (HPV) and its vaccination is critical due to the global HPV- related disease burden and related costs. This study was based on a cross-sectional design to survey female students enrolled at the Universiti Teknologi MARA Puncak Alam Campus, Selangor, Malaysia. Our study aimed to examine the knowledge, attitude, and perception towards HPV and its vaccine among groups of university students from health and non-health-related programs. Link to validated questionnaires in the form of Google Forms were distributed through course heads. Intentionally, an equal number of sample sizes were obtained from the two groups. Two hundred out of 240 questionnaires targeted were collected (response rate equal 83%). Healthcare providers were the most common source of information. Age, education level, faculty and year of study were significant contributing factors to knowledge. 29% had already completed their immunisation schedule of 3 shots, while 40% had not received the vaccine and had not scheduled an appointment either. A Mann-Whitney test was done on the level of knowledge, which was low and moderate, regarding health issues, mode of transmission, prevention of HPV, vaccine benefits and side effects, which favoured the health-related students (median = 6.50) over the non-health-related students (median = 1.50), (p-value = 0.0001). Significant differences were observed regarding answers on attitudes toward vaccine benefits, perception of vaccination behaviour and external influences. Public health initiatives in developing education policies to equip university students, particularly those in non-health- related programs, with the knowledge, right attitude and perception are imperative to increase their vaccination uptake.

Evaluation of Awareness, Knowledge, Attitude and Practices Related to Toxoplasmosis Among Females in Algeria.

Toxoplasmosis is a major veterinary and public health issue affecting humans and animals, where felids represent the definitive hosts of the causative agent Toxoplasma gondii. While the infections are mostly asymptomatic, the disease could be severe in immune-compromised patients and pregnant women. This study was conducted to evaluate the level of knowledge, practice, and attitude toward this disease among a sample of Algerian women. A cross-sectional poll was conducted between 25 March and 28 August 2024, using a self-administered questionnaire. Results showed that only 53% of the 545 respondents heard of the disease before this survey, and being married increased the odds of awareness (AOR: 3.597 95% CI: 1.598-8.099). Among those who heard of the disease (288 women), 52.7% correct responses were obtained with varied frequencies regarding the mode of transmission and symptoms. The participants were aware of the role of cats as a source of contamination for humans (83.3%) and the common routes of transmission, including contact with cat feces (83.7%) and the consumption of undercooked meat (75%), but the role of unpasteurized milk from infected animals (40.3%), untreated water (35.8%), and blood transfusions (26.4%) was not well understood. The majority of participants ignored symptoms such as skin rashes (29.2%) and swollen lymph nodes (36.5%), as well as sequelae including mental impairment (32.3%) and eyesight issues (35.1%). Results showed also a high rate of appropriate practices and positive attitudes, where 90.3% of the participants said they were in favor of any action that intended to control toxoplasmosis. These results suggest the need to increase the level of awareness of Algerian women regarding this disease.

Pre–Human Immunodeficiency Virus (HIV) α4β7hi CD4+ T Cells and HIV Risk Among Heterosexual Individuals in Africa

Abstract Background CD4+ T cells expressing α4β7 are optimal targets for human immunodeficiency virus (HIV) infections, with higher pre-HIV α4β7hi expression linked to increased HIV acquisition and progression in South African women. However, similar associations were not observed in men who have sex with men or people who inject drugs in the Americas, indicating need for further research. Methods This retrospective case-control study enrolled heterosexual men and women from South Africa (HIV Vaccine Trials Network [HVTN] 503) and East Africa (Partners Preexposure Prophylaxis/Couples’ Observational Study [PP/COS]), quantifying α4β7 expression on CD4+ T cells as a predictor of subsequent HIV risk using flow cytometry analyses. Results Associations between α4β7hi expression and HIV acquisition varied across cohorts. In HVTN 503, women had a higher risk estimate compared to men, but this was not significant. In PP/COS, α4β7hi expression was generally protective, particularly in Ugandans. Additionally, α4β7hi expression inversely correlated with peak viral load in PP/COS but not in HVTN 503; in the latter cohort, α4β7hi expression was inversely correlated with the CD4/CD8 ratio and predicted rapid CD4+ T-cell decline, similar to what was observed previously in South Africa. Conclusions These findings suggest that α4β7hi expression on CD4+ T cells may not predict HIV acquisition and progression in all contexts, which may be due to cohort effects, modes of transmission, viral clade, or other factors.

The application of environmental health assessment strategies to detect Streptococcus pyogenes in Kimberley school classrooms.

Children spend almost one-third of their waking hours at school. Streptococcus pyogenes (Strep A) is a common childhood bacterial infection that can progress to causing serious disease. We aimed to detect Strep A in classrooms by using environmental settle plates and swabbing of high-touch surfaces in two remote schools in the Kimberley, Western Australia. Twelve classrooms in two schools participated in 2021 and 2022. Seven horse-blood agar plates containing colistin and nalidixic acid (HBA-CNA) were placed in each occupied classroom at varied heights for 4h, and 20 high-touch items were swabbed and later cultured on HBA-CNA plates. The primary outcome of each sample was presence or absence of Strep A. Identified Strep A isolates were whole genome sequenced (WGS) to assess for similarity between host-derived and environmental strains. During two visits to each participating Kimberley school in June 2021 and September 2022, the point prevalence of Strep A positive throat swab ranged between 3/34 (8.8%) and 5/21 (23.8%); Strep A impetigo was lower at between 0/43 (0%) and 2/23 (8.7%). Strep A was detected from 4/240 (2%) environmental swabs collected across 3/12 (25%) classrooms but not cultured from any of the classroom settle plates. Whole genome sequencing identified environmental emm types to also be those strains in circulation. There was little evidence to support fomite, droplet or airborne Strep A in classrooms as major modes of transmission among children. Further work is required to determine if classrooms play a role in the transmission of Strep A between students.

Integrated computational biophysics approach for drug discovery against Nipah virus.

The Nipah virus (NiV) poses a pressing global threat to public health due to its high mortality rate, multiple modes of transmission, and lack of effective treatments. NiV glycoprotein G (NiV-G) emerges as a promising target for the discovery of NiV drugs because of its essential role in viral entry and membrane fusion. Therefore, in this study, we applied an integrated computational and biophysics approach to identify potential inhibitors of NiV-G within a curated dataset of Peruvian phytochemicals. The virtual screening results indicated that these compounds could represent a natural source of potential NiV-G inhibitors with ΔG values ranging from -8 to -11 kcal/mol. Among them, procyanidin B2, B3, B7, and C1 exhibited the highest binding affinities and formed the most molecular interactions with NiV-G. Molecular dynamics simulations revealed the induced-fit mechanism of NiV-G pocket interaction with these procyanidins, primarily driven by its hydrophobic nature. Non-equilibrium free energy calculations were used to determine binding affinities, highlighting Procyanidin B3 and B2 as the ligands with the most substantial interactions. In general, this work underscores the potential of Peruvian phytochemicals, particularly procyanidins B2, B3, B7, and C1, as lead compounds for developing anti-NiV drugs through an integrated computational biophysics approach.

The Temporal Order of Mixed Viral Infections Matters: Common Events That Are Neglected in Plant Viral Diseases.

Mixed infections of plant viruses are common in crops and represent a critical biotic factor with substantial epidemiological implications for plant viral diseases. Compared to single-virus infections, mixed infections arise from simultaneous or sequential infections, which can inevitably affect the ecology and evolution of the diseases. These infections can either exacerbate or ameliorate symptom severity, including virus-virus interactions within the same host that may influence a range of viral traits associated with disease emergence. This underscores the need for a more comprehensive understanding of how the order of virus arrival to the host can impact plant disease dynamics. From this perspective, we reviewed the current evidence regarding the impact of mixed infections within the framework of simultaneous and sequential infections in plants, considering the mode of viral transmission. We also examined how the temporal order of mixed infections could affect the dynamics of viral populations and present a case study of two aphid-transmitted viruses infecting melon plants, suggesting that the order of virus arrival significantly affects viral load and disease outcomes. Finally, we anticipate future research that reconciles molecular epidemiology and evolutionary ecology, underlining the importance of biotic interactions in shaping viral epidemiology and plant disease dynamics in agroecosystems.

Epidemiological Characteristics of Hepatitis C Patients Attending a Tertiary Care Hospital

Background: Hepatitis C infection is a major public health concern in Nepal. Epidemiological information on hepatitis C virus along with the status of co-infection with hepatitis B virus and human immunodeficiency virus is essential to controlling the hepatitis C burden. The objective of this study was to determine the sero-prevalence of hepatitis C virus infections, proportions of co-infections with human immunodeficiency virus and hepatitis B virus, and identify the demographic characters, and routes of transmission.Methods: A cross-sectional study was conducted from December 2019 to February 2024 at Tribhuvan University Teaching Hospital. The serological tests were performed by enzyme-linked immunosorbent assays from 25133 patients’ serum in four years.Results: The sero-prevalence of hepatitis C virus -infected patients was 0.8% (211/25133). Among them, 6.6% (14/211) were co-infected with human immunodeficiency virus and 1.4% (3/211) with hepatitis B virus. Among 211 hepatitis C virus patients, 174 (82.5%) were male, 156 (73.9%) were young aged 15–47 years with various professions, 167 (79.1%) were literate, and almost one-third of the patients (33.2%, 70/211) were regular alcoholics. Needle sharing among intravenous drug users (45.5%, 96/211) and sexual intercourse (28%, 59/211) were the most common modes of transmission. Conclusions: Although the prevalence of hepatitis C infections is less than 1%, it is more common among young male intravenous drug users. Awareness of the spread of hepatitis C infections among this population needs to be emphasized to control hepatitis C in Nepal.Keywords: characters; co-infection; hepatitis C, sero-prevalence.

Knowledge, attitudes and practices of the general population towards Marburg virus disease in sub-Saharan African countries: a cross-sectional study.

Marburg virus disease (MVD) is categorized among viral hemorrhagic fevers. MVD is associated with high rates of morbidity and mortality. This study aimed to identify factors affecting MVD knowledge, attitudes and practices in sub-Saharan African countries. Using a validated questionnaire, a cross-sectional survey was conducted from 21 April to 23 May 2023 in eight English-speaking sub-Saharan African countries (Ethiopia, Ghana, Kenya, Lesotho, Nigeria, Senegal, South Africa and Tanzania). Of 3142 participants, 51% were males, 66.0% were aged 18-29 y, 74.4% were living in urban areas, 47.9% completed their university education and 21.7% were healthcare workers (HCWs). Tanzanians had the highest good knowledge (89%), while Kenyans had the lowest (26%). Tanzanians had the highest positive attitude (82%), while Nigerians had the highest negative attitude (95%). The best practices exhibited were by Ethiopians (70%), and the poorest practices exhibited were by Ghanaians (94%). The predictors of good knowledge were marital status (adjusted OR [aOR]=0.75; 95% CI 0.59 to 0.94; p=0.013), knowing the correct mode of transmission (aOR=18.31; 95% CI 13.31 to 25.66; p<0.001), whether the participant has heard before about MVD (aOR=2.24; 95% CI 1.82 to 2.75; p<0.001), whether they modified their working habits (aOR=2.79; 95% CI 2.12 to 3.67; p<0.001), nationality (p<0.001) and being a HCW (aOR=2.71; 95% CI 2.01 to 3.67; p<0.001). The predictors of good attitude were being female (aOR=0.71; 95% CI 0.60 to 0.85; p<0.001), age (aOR=0.99; 95% CI 0.98 to 0.99; p=0.01), place of residence (aOR=3.13; 95% CI 2.46 to 3.99; p<0.001), level of education (aOR=1.67; 95% CI 1.37 to 2.04; p<0.001), knowing the correct mode of transmission (aOR=1.59; 95% CI 1.28 to 1.98; p<0.001), modification of working habits (aOR=1.30; 95% CI 1.01 to 1.68; p=0.039) and nationality (p<0.001). The predictors of practice were being female (aOR=1.17; 95% CI 1.01 to 1.37; p=0.042), place of residence (aOR=1.23; 95% CI 1.02 to 1.48; p=0.033), marital status (aOR=0.65; 95% CI 0.55 to 0.78; p<0.001), knowing the correct mode of transmission (aOR=0.46; 95% CI 0.38 to 0.56; p<0.001), modification of working habits (aOR=0.40; 95% CI 0.32 to 0.49; p<0.001) and occupation (aOR=0.37; 95% CI 0.30 to 0.46; p<0.001). Different modifiable and non-modifiable risk factors can be targeted to improve population perspectives towards MVD.

Low-loss weakly coupled four-mode hollow-core antiresonant fiber based on centrosymmetric nested structure

Abstract This paper designs a novel centrosymmetric double-layer nested antiresonant fiber (CDNAF) with few-mode transmission characteristics. The cladding structure of the CDNAF incorporates glass plates and multilayer capillaries, effectively mitigating the coupling between various core modes and cladding modes. Simulation results show that the CDNAF can support four modes of low-loss transmission from LP01 to LP02 at 1550 nm. The confinement loss (CL) of the four modes is less than 0.008 dB/km, 0.07 dB/km, 0.42 dB/km, and 4.8 dB/km, respectively, and the CDNAF has a sizeable differential group delay (DGD) and weak bending sensitivity. The loss of high-order modes is much greater than that of the other four transmission modes, ensuring high-purity transmission of the four modes. In the wavelength range of 1200–1700 nm, the CDNAF ensures few-mode characteristics with at least two low-loss transmission modes. Furthermore, the effective refractive index difference (Δneff) between adjacent modes is much greater than 10^(-4), eliminating or significantly reducing the need for multiple-input multiple-output digital signal processing (MIMO-DSP) techniques in optical communication systems. Additionally, the results demonstrate that CDNAF can transmit three modes at an ultimate bending radius of 5 cm and can transmit four modes like a straight fiber at a bending radius of 18 cm, which demonstrates that CDNAF has excellent bending performance. These excellent characteristics give the CDNAF great potential for application in large-capacity optical communication systems.

Characteristics of phage-plasmids and their impact on microbial communities.

Bacteria host various foreign genetic elements, most notably plasmids and bacteriophages (or phages). Historically, these two classes were seen as separate, but recent research has shown considerable interplay between them. Phage-plasmids (P-Ps) exhibit characteristics of both phages and plasmids, allowing them to exist extrachromosomally within bacterial hosts as plasmids, but also to infect and lyse bacteria as phages. This dual functionality enables P-Ps to utilize the modes of transmission of both phage and plasmids, facilitating the rapid dissemination of genetic material, including antibiotic resistance and virulence genes, throughout bacterial populations. Additionally, P-Ps have been found to encode toxin-antitoxin and CRISPR-Cas adaptive immune systems, which enhance bacterial survival under stress and provide immunity against other foreign genetic elements. Despite a growing body of literature on P-Ps, large gaps remain in our understanding of their ecological roles and environmental prevalence. This review aims to synthesise existing knowledge and identify research gaps on the impacts of P-Ps on microbial communities.