Prevalence Patterns Research Articles

Effect of Coping Strategies on Pain Intensity in Patients with Rheumatoid Arthritis

Background Rheumatoid arthritis (RA) is a systemic autoimmune disease that imposes significant challenges globally. This research seeks to contribute valuable insights that can inform the development of targeted interventions, enhancing the quality of care for RA patients and potentially mitigating the broader societal burden associated with this chronic autoimmune condition. Objectives The main objective of the current study is to investigate the demographic, psychosocial, and clinical aspects of RA patients. Materials and Methods The study included 93 RA patients and examined their demographic characteristics, brief-Coping Orientation to Problems Experienced (COPE) strategies, the prevalence of depression and anxiety, pain experiences (Mankoski Pain Scale), and diagnostic markers (Disease Activity Score [DAS-28], Rheumatoid Factor [RF], Anti-Cyclic Citrullinated Peptide [ACCP]). Results The study revealed a bimodal age distribution, with a gender predominance aligning with established RA prevalence patterns. Patients exhibited a tendency toward adaptive coping strategies, notably religious coping, active coping, and positive reframing, with variability in maladaptive strategies. The prevalence of depression (14.0%) and anxiety (18.3%) among RA patients was consistent with documented mental health burdens. Pain experiences exhibited a heterogeneous spectrum, and diagnostic markers indicated elevated disease activity in a substantial proportion of patients, with varied distribution in RF and ACCP subcategories. Conclusion This study provides nuanced insights into RA, emphasizing the importance of personalized coping and pain management strategies. The prevalence of mental health challenges and the spectrum of pain experiences underscore the multidimensional nature of RA, informing holistic approaches to care for enhanced patient outcomes.

Dementia and Alzheimer's Disease Prevalence in Bulgaria During 2018: Nationally Representative Study.

This paper presents data analysis of a large dataset of outpatient records for the purpose of establishing accurate prevalence rates of dementia and Alzheimer's disease in Bulgaria. The research is motivated by the lack of accurate prevalence data as well as statistics about the actual number of people affected by dementia at national level. Health data from pseudonymized outpatient records (1,378,355) of 642,013 unique patients (Male 39.88%, Female 61.67%) with visits to neurologists and psychiatrists in 2018 was mapped to an OMOP CDM relational database. The size of this dataset is one of largest in the EU context. Prevalence of dementia for all age groups [30,100+] years is 1.61% (Male 0.62%, Female 0.99%) and Alzheimer' disease prevalence is 0.39% (Male 0.15%, Female 0.24%), where 24.34% of all the patients with dementia suffer Alzheimer's disease. The mean prevalence rates of dementia and Alzheimer's disease for ages above 64 are 9.52% (CI 95%, [6.98%, 12.04%]) and 1.04 % (CI 95%, [0.84%, 1.27%,]). A comparison with EU statistics yields 0.07% difference for dementia prevalence, while data visualization confirms the known patterns of prevalence with aging and gender specifics These results stimulate further research and support the development of a national strategy for dementia and Alzheimer's disease.

An Integrated Pipeline for Phenotypic Characterization, Clustering and Visualization of Patient Cohorts in a Rare Disease-Oriented Clinical Data Warehouse.

Rare diseases pose significant challenges due to their heterogeneity and lack of knowledge. This study develops a comprehensive pipeline interoperable with a document-oriented clinical data warehouse, integrating cohort characterization, patient clustering and interpretation. Leveraging NLP, semantic similarity, machine learning and visualization, the pipeline enables the identification of prevalent phenotype patterns and patient stratification. To enhance interpretability, discriminant phenotypes characterizing each cluster are provided. Users can visually test hypotheses by marking patients exhibiting specific keywords in the EHR like genes, drugs and procedures. Implemented through a web interface, the pipeline enables clinicians to navigate through different modules, discover intricate patterns and generate interpretable insights that may advance rare diseases understanding, guide decision-making, and ultimately improve patient outcomes.

Seasonal patterns of influenza incidence and the influence of meteorological and air pollution factors in Thailand during 2009–2019

Influenza, an acute respiratory illness, remains a significant public health challenge, contributing substantially to morbidity and mortality worldwide. Its seasonal prevalence exhibits diversity across regions with distinct climates. This study aimed to explore the seasonal patterns of influenza and their correlation with meteorological and air pollution factors across six regions of Thailand. We conducted an analysis of monthly average temperature, relative humidity, precipitation, PM10, NO2, O3 concentrations, and influenza incidence data from 2009 to 2019 using wavelet analysis. Our findings reveal inconsistent biannual influenza prevalence patterns throughout the study period. The biannual pattern emerged during 2010–2012 across all regions but disappeared during 2013–2016. However, post-2016, the biannual cycles resurfaced, with peaks occurring during the rainy and winter seasons in most regions, except for the southern region. Wavelet coherence reveals that relative humidity can be the main influencing factor for influenza incidence over a one-year period in the northern, northeastern, central, Bangkok-metropolitan, and eastern regions, not in the southern region during 2010–2012 and 2016–2018. Similarly, precipitation can drive the influenza incidence at the same period for the northeastern, central, Bangkok-metropolitan, and eastern regions. PM10 concentration can influence influenza incidence over a half-year period in the northeastern, central, Bangkok-metropolitan, and eastern regions of Thailand during certain years. These results enhance our understanding of the temporal dynamics of influenza seasonality influenced by weather conditions and air pollution over the past 11 years. Such knowledge is invaluable for resource allocation in clinical settings and informing public health strategies, particularly in navigating Thailand's climatic complexities.

The Clinical Course of the Late Toxicity of Definitive Radiotherapy in Cervical Cancer.

Background and Objectives: This study aimed to investigate the clinical course and characteristics of late toxicity over time following the completion of definitive radiotherapy (RT) in patients with cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 60 patients with cervical cancer who underwent pelvic external beam radiotherapy followed by intracavitary brachytherapy. Late toxicity was assessed for the lower gastrointestinal (GI) tract and bladder organ at 6, 12, 24, 36, and >36 months post-RT. We examined the onset and prevalence of late toxicity at each time point. Clinical remission and interventions for managing late toxicity were also investigated. Results: The peak onset of lower GI toxicity occurred 12 months after RT completion, with a median symptom duration of 9.9 months (range, 0.1-26.3 months), and exhibited its highest prevalence rate of 15.5% at 24 months post-RT. Most GI toxicities developed and resolved within three years post-RT, with a prevalence rate of 8.1% at three years, followed by a decreasing trend. Bladder toxicity first peaked at 24 months post-RT and continued to occur beyond 36 months, showing the re-increasing pattern in the prevalence rate after 36 months (23.5%). In terms of clinical remission, 66.7% of lower GI toxicities (12 of 18 patients) and 60% of bladder toxicities (9 of 15 patients) achieved complete remission by the last follow-up date. Conclusions: Late toxicities of the GI and bladder following definitive RT in cervical cancer are partially reversible and exhibit distinct patterns of onset and prevalence over time. A systematic follow-up strategy should be established for the early detection and timely intervention of late toxicity by understanding these clinical courses.

Sustained Release Microparticles Inhalation for Tuberculosis Treatment: Present Issues and Prospects

Mycobacterium tuberculosis, the primary cause of tuberculosis in humans, is a transmissible airborne disease. One of the most significant medical advances of the 20th century was the development of medications to cure tuberculosis. It makes sense to create strategies for administering antitubercular medications orally, or through the respiratory system. The pulmonary route lowers systemic toxicity, necessitates a lower dose, and has instantaneous drug release, first pass hepatic metabolism, and side effects. Presently, the most prevalent patterns in study aim to offer the optimal dry powders in the appropriate fraction for inhalation, which can release the medication before it is eliminated through natural mechanisms.

Mutation patterns in colorectal cancer and their relationship with prognosis

BackgroundColorectal cancer (CRC) is a prevalent malignancy and a leading cause of cancer-related mortality. Extensive research into the aetiology of CRC has revealed that somatic mutations in certain genes play a crucial role in CRC development.AIM: In this study, we utilized data from public databases to investigate prevalent mutation patterns in CRC and developed a prognostic predictive model for CRC patients based on mutant genetic characteristics and other relevant clinical features. MethodsWe initially gathered mutation information from CRC patients by analysing data from 15 datasets to identify genes with a mutation frequency of ≥10 %. Next, log-rank analyses were used to determine the relationship between prognosis and the mutational status of the most commonly mutated genes; the SIGnaling database was utilized to generate a protein‒protein interaction network. We consolidated and classified the gene mutation patterns of CRC patients in the database based on frequently mutated genes related to prognosis. A predictive nomogram was constructed, including age, sex, TNM stage, and mutation partner, based on available clinical, mutational, and prognostic information for CRC patients at our institution. Finally, the reliability of the model was verified using time-dependent ROC curve analysis. ResultsThe top 7 genes somatically mutated ≥10 % in 4477 samples from 4255 patients were TP53 (67 %), APC (66 %), KRAS (43 %), PIK3CA (18 %), FBXW7 (14 %), SMAD4 (14 %), and BRAF (10 %). Log-rank analysis demonstrated that the mutation status of 5 genes, namely, TP53, APC, PIK3CA, SMAD4, and BRAF, correlated significantly with prognosis. Protein‒protein interaction analysis confirmed functional interactions between these 5 genes, implicating them in tumorigenesis. We exhaustively enumerated the mutation patterns involving these five genes in 4255 patients, resulting in identification of 32 mutational patterns. After consolidation and classification, these patterns were divided into 3 grades based on patient prognosis. Next, a predictive nomogram based on the clinical, mutational, and prognostic information of 107 CRC patients treated at University Medical Center Rostock was constructed. The area under the curve (AUC) values for the model for predicting 1-, 3-, and 5-year overall survival were 0.779, 0.721, and 0.815, respectively. ConclusionCommon mutational patterns based on frequently mutated genes are associated with prognosis in CRC patients. Our study provides a valuable and concise prognostic predictor for determining outcomes in patients with CRC.

Prevalence and Seasonal Patterns of 16 Common Viral Respiratory Pathogens during the COVID-19 Pandemic in Gauteng Province, South Africa, 2020-2021.

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The COVID-19 pandemic resulted in widespread morbidity and mortality, but generally, the diagnosis of other respiratory viruses was limited. This study aimed to assess the prevalence of other respiratory viruses during the 2020/2021 pandemic among patients of all ages who accessed care at public healthcare facilities in Gauteng Province, South Africa. Laboratory diagnosis for respiratory viruses, with or without SARS-CoV-2, was conducted via multiplex real-time polymerase chain reactions using respiratory specimens. A total of 1776 patients were included from 1 April 2020 to 31 March 2021, of which 766 (43.1%) were positive for respiratory viruses other than SARS-CoV-2. RV (368/1776; 20.7%) was the most prevalent, followed by RSV (304/1776; 17.1%), AdV (112/1776; 6.3%) and EV (105/1776; 5.9%). hCoV-OC43 (39/1776; 2.2%) was the most prevalent common coronavirus. SARS-CoV-2 co-infections were detected in 4.8% (24/500) of patients. Only 27.1% (482/1776) of patients were admitted to high-care or intensive care units. A decrease in respiratory virus detections was observed, except for RSV, EV and hCoV-OC43. RSV prevalence increased in 2021, while influenza A/B viruses remained undetected.

Analyses of Osteogenesis Imperfecta in South Korea Using the Nationwide Health Insurance Service Claim Data: A Propensity Score-Matched Study.

Osteogenesis imperfecta (OI) is the most common inherited form of bone fragility and includes a heterogeneous group of genetic disorders that most commonly result from defects associated with type I collagen. Although genetic analyses have been developed, nationwide research on the incidence and associated fractures in OI is lacking. This study aimed to investigate the patterns of OI prevalence, incidence, fracture rate, etc. in South Korea using National Health Insurance Service (NHIS) claims data. We found 1596 patients newly diagnosed with OI between March 2002 and February 2020. We evaluated the incidence, prevalence, and history of fractures, fracture site, prescription of anti-osteoporosis drugs, etc. To compare medical costs, fracture rates, and scoliosis rates, we created a control group comprising patients without OI using 1:1 propensity score matching. The prevalence of OI increased slightly each year, with an annual incidence of 20.20 per 100,000 live births. Mean fracture frequency in OI patients was 17 (2-32) times per patient and the most frequent fracture site was the lower leg. A total of 21.4% patients were prescribed anti-osteoporosis drugs, and the most popular drug was pamidronate. After 1:1 propensity score matching, in terms of scoliosis, OI patients had a 3.91 times higher prevalence of scoliosis than in healthy patients which was statistically significant. The sum of medical care expenses for patients with OI was 3.5 times higher than that for patients without OI. We identified nationwide trends in OI occurrence, fractures, and medication use. This study also highlighted the real-world data of scoliosis and medical costs compared to the control group.

Descriptive Epidemiology of Gastric Cancer: A Population-Based Study From Georgia.

Background Gastric cancer (GC) remains a significant public health issue in many countries globally due to its high morbidity and mortality rates. In Georgia, the incidence of GC reflects the prevalence patterns of established risk factors. To develop appropriate prevention and treatment strategies, GC requires a comprehensive approach and research. This study aims to review and describe GC epidemiologic characteristics in the country. Methodology We conducted a descriptive analysis utilizing data from the national population-based cancer registry. All patients diagnosed with invasive GC between 2015 and 2022 were eligible for inclusion in the analysis. To calculate age-standardized incidence (ASIR) and mortality (ASMR) rates we used a direct method, standardized to the World (WHO 2000-2025) standard population. Trends in Incidence and mortality were assessed using standardized rate ratios (SRRs). The mortality-to-incidence ratio (MIR) was defined as the ratio of the ASMR to the ASIR for the corresponding year. The Kaplan-Meier method was utilized to construct survival curves with survival comparisons performed using the log-rank test. Results A total of 2,707 GC cases with 62% (n = 1,668) of patients being male were enrolled in this descriptive study. The median age at diagnosis was 65 years, and about 70% (n = 1,893) of cases were detected at advanced (III and IV) stages. Over the study period, the ASIR per 100,000 population for both sexes decreased from 8.4 to 7.3.The SRR and 95% confidence interval indicated no significant change in ASIR for males but it decreased for females in 2022 compared to 2015. In 2022, the ASMR decreased compared to 2015 for males (from 10.5 to 7.3/100,00) and for females (from 5.8 to 3.0/100,000) as well. However, the MIR ​​indicated an unstable reduction in mortality, fluctuating over the observation period. The five-year survival rate was around 22.0%. Conclusions This study provides a comprehensive overview of GC epidemiology in Georgia between 2015 and 2022. GC remains a significant public health challenge, characterized by the high proportion of late-stage diagnoses and high mortality rates. The implementation of prevention and early diagnosis strategies is crucial to reduce the burden of GC in the country.

Transmission patterns of malignant catarrhal fever in sheep and cattle in Karnataka, India.

Malignant catarrhal fever (MCF) presents a sporadic yet significant threat to livestock and wildlife. A comprehensive investigation in Karnataka, India into the prevalence and transmission patterns of sheep-associated MCF (SA-MCF) was conducted. A total of 507 sheep peripheral blood leukocyte samples from 13 districts along with 27 cows and 10 buffalo samples from various regions in Karnataka were tested for SA-MCF infection i.e. Ovine gammaherpesvirus 2 (OvHV-2) using heminested PCR. Furthermore, serum samples collected from 73 cows and 15 buffalo suspected of MCF were tested using a commercially available ELISA kit. Additionally, histopathological examinations of affected tissues and phylogenetic analysis of viral tegument protein sequences were conducted. Our findings indicated a 20.11%, 33.33% and 20% positivity for OvHV-2 in sheep, cows and buffalo respectively by PCR. Statistical analysis revealed a significant association between the age of sheep and the detection of OvHV-2. Seven cows and one buffalo serum samples tested positive for ELISA. Clinical findings in bovids were consistent with typical MCF signs, and histopathological results revealed multi-organ involvement characterised by necrotising vasculitis and lymphoid hyperplasia. The nucleotide pairwise identity matrix revealed 99.5% identity between the sequences obtained in the study with sequences from other states. The phylogenetic analysis of partial tegument protein sequences from bovid and sheep samples suggested a close genetic relationship between the local OvHV-2 strains and those from various global regions. Crucially, this study underscores the widespread presence of SA-MCF in Karnataka, with significant implications for both livestock management and wildlife conservation.

A visualized and bibliometric analysis of nursing research during the COVID-19 pandemic.

The global spread of Coronavirus disease 2019 (COVID-19) has been increasing since December 2019. A total of 8460 publications were obtained from the Web of Science Core Collection from 2019 to 2023, providing insights into the progress of nursing research throughout the COVID-19 pandemic. Bibliometric analysis was conducted on these articles using CiteSpace. The analysis focused on examining the distribution of these publications in terms of space and time, distribution of authors, subject categories, distribution of topics, and cited references. These results may be explained from 3 perspectives. Initially, the number of yearly publications on nursing research consistently increased during the COVID-19 pandemic. Furthermore, a co-occurrence analysis of the countries and the authors revealed that certain countries, including the United States, China, and England, have successfully implemented organized and standardized nursing models. These countries also have well-developed and established nursing research systems. Notably, academic communities in specific regions, such as the team led by MD Stefan Gravenstein, Mor Vincent, and White Elizabeth at Brown University in the United States, have emerged as leaders in this field. Furthermore, examining the papers' subject categories and topic distribution indicate that nursing during the COVID-19 pandemic has been predominantly interdisciplinary, encompassing various disciplines such as clinical medicine, essential medicine, psychology, public health management, and even telematics science. Our study provided valuable insights into acquiring knowledge on nursing research during the COVID-19 pandemic, pinpointed possible partners for researchers interested in nursing, and uncovered prevalent research patterns and popular subjects.

Understanding spatial inequalities and stratification in transportation accessibility to social infrastructures in South Korea: multi-dimensional planning insights

This research investigated spatial inequalities in transportation accessibility to social infrastructures (SIs) in South Korea, using a multi-dimensional methodological approach, including descriptive/bivariate analysis, explanatory factor analysis (EFA), K-Mean cluster analysis, and multinomial logit model (MNL). Our study confirmed pronounced spatial disparities in transportation accessibility to SIs, highlighting significantly lower access in rural and remote regions compared to urban centers and densely populated areas, consistent with existing literature. Building on prior findings, several additional findings were identified. First, we uncovered significant positive correlations among accessibility to different types of SIs in four critical categories: green and recreation spaces, health and aged care facilities, educational institutions, and justice and emergency services, revealing prevalent spatial inequality patterns. Second, we identified three distinct accessibility clusters (High, Middle, and Low) across the critical SI categories. Specifically, residents within the High cluster benefited from the closest average network distances to all SIs, while those in the Low cluster faced significant accessibility burdens (e.g., 22.9 km for welfare facilities, 20.1 km for hospitals, and 19.2 km for elderly care facilities). Third, MNL identified factors such as population density and housing prices as pivotal in spatial stratification of accessibility. Specifically, areas with lower SI accessibility tended to have a higher proportion of elderly residents. Also, decreased accessibility correlated with diminished traffic volumes across all transportation modes, particularly public transportation. This research contributes to enhancing our understanding of spatial inequalities in transportation accessibility to SIs and offers insights crucial for transportation and urban planning.

An update on tinea capitis in children.

Tinea capitis presents a significant public health care challenge due to its contagious nature, and potential long-term consequences if unrecognized and untreated. This review explores the prevalence, risk factors, diagnostic methods, prevention strategies, impact on quality of life, and treatment options for pediatric tinea capitis. Epidemiological analysis spanning from 1990 to 1993 and 2020 to 2023 reveals prevalence patterns of pediatric tinea capitis influenced by geographic, demographic, and environmental factors. Notably, Trichophyton species is most prevalent in North America; however, Microsporum species remain the primary causative agent globally, with regional variations. Risk factors include close contact and environmental conditions, emphasizing the importance of preventive measures. Accurate diagnosis relies on clinical evaluation, microscopic examination, and fungal culture. Various treatment modalities including systemic antifungals show efficacy, with terbinafine demonstrating superior mycological cure rates particularly for Trichophyton species. Recurrent infections and the potential development of resistance can pose challenges. Therefore, confirming the diagnosis, appropriately educating the patient/caregiver, accurate drug and dose utilization, and compliance are important components of clinical cure. Untreated or poorly treated tinea capitis can lead to chronic infection, social stigma, and psychological distress in affected children. Prevention strategies focus on early detection and healthy lifestyle habits. Collaborative efforts between healthcare providers and public health agencies are important in treating pediatric tinea capitis and improving patient outcomes. Education and awareness initiatives play a vital role in prevention and community-level intervention to minimize spread of infection. Future research should explore diagnostic advances, novel treatments, and resistance mechanisms in order to mitigate the disease burden effectively.

Association of food insecurity with MASLD prevalence and liver-related mortality

BackgroundThe burden of MASLD is growing across the globe. This study explores association of food insecurity with MASLD prevalence and liver-related mortality (LRM) across the globe. MethodsThe study combines United Nations’ country-level food security data with the MASLD data from Global Burden of Disease-2021. Mixed-effects linear regression (MELR) models, accounting for country-level random effects, were used to assess associations of food security indicators with MASLD prevalence and LRM. The analyses were performed according to each country’s Socioeconomic Development Index (SDI) status. ResultsIn 2021, the median prevalence and LRM of MASLD across 204 countries was 21.77% (14.14%-48.18%) and 2.92 per 100,000 (0.42-10.79) with the highest MASLD prevalence located in North Africa & Middle East (41.70%) and the lowest prevalence in high-income countries (17.31%). After adjustments for age, gender and SDI, higher MASLD prevalence was associated with increasing rates of obesity, type 2 diabetes (T2D) and low physical activity (p<0.001). When analyses were performed based on SDI status, divergent patterns of MASLD prevalence were observed. In high SDI countries (socioeconomically more developed), MASLD prevalence was significantly higher in those in the top tertile of food insecurity as compared to the bottom tertile (mean, 26.73% vs. 18.87%, p=0.0001). In contrast, in low SDI countries (socioeconomically less developed), the opposite was true (19.45% vs. 24.96%, p=0.0008). MASLD-LRM was associated with older age, obesity, and metabolic risks (p<0.001). ConclusionsAnd Relevance: MASLD prevalence and LRM exhibit significant geographical variability across the globe which can be influenced by clinic-demographic, and food insecurity. Targeted public health strategies which considers socio-economic realities of each region are essential for mitigating the global burden of MASLD.

Neighborhood-Level Disparities in Hypertension Prevalence and Treatment Among Middle-Aged Adults

Hypertension in middle-aged adults (35-50 years) is associated with poorer health outcomes in late life. Understanding how hypertension varies by race and ethnicity across levels of neighborhood disadvantage may allow for better characterization of persistent disparities. To evaluate spatial patterns of hypertension diagnosis and treatment by neighborhood socioeconomic position and racial and ethnic composition. In this cross-sectional study of middle-aged adults in Cuyahoga County, Ohio, who encountered primary care in 2019, geocoded electronic health record data were linked to the area deprivation index (ADI), a neighborhood disadvantage measure, at the US Census Block Group level (ie, neighborhood). Neighborhoods were stratified by ADI quintiles, with the highest quintile indicating the most disadvantage. Data were analyzed between August 7, 2023, and June 1, 2024. Essential hypertension. The primary outcome was a clinician diagnosis of essential hypertension. Spatial analysis was used to characterize neighborhood-level patterns of hypertension prevalence and treatment. Interaction analysis was used to compare hypertension prevalence by racial and ethnic group within similar ADI quintiles. A total of 56 387 adults (median [IQR] age, 43.1 [39.1-46.9] years; 59.8% female) across 1157 neighborhoods, which comprised 3.4% Asian, 31.1% Black, 5.5% Hispanic, and 60.0% White patients, were analyzed. A gradient of hypertension prevalence across ADI quintiles was observed, with the highest vs lowest ADI quintile neighborhoods having a higher hypertension rate (50.7% vs 25.5%) and a lower treatment rate (61.3% vs 64.5%). Of the 315 neighborhoods with predominantly Black (>75%) patient populations, 200 (63%) had a hypertension rate greater than 35% combined with a treatment rate of less than 70%; only 31 of 263 neighborhoods (11.8%) comprising 5% or less Black patient populations met this same criterion. Compared with a spatial model without covariates, inclusion of ADI and percentage of Black patients accounted for 91% of variation in hypertension diagnosis prevalence among men and 98% among women. Men had a higher prevalence of hypertension than women across race and ADI quintiles, but the association of ADI and hypertension risk was stronger in women. Sex prevalence differences were smallest between Black men and women, particularly in the highest ADI quintile (1689 [60.0%] and 2592 [56.0%], respectively). These findings show an association between neighborhood deprivation and hypertension prevalence, with disparities observed particularly among Black patients, emphasizing a need for structural interventions to improve community health.

Mangosteen extract reduces the bacterial load of eggshell and improves egg quality

The increasing emergence and spread of antibiotic resistance accelerate the desire for antibiotic alternatives. Plant extracts have emerged as a promising and relatively unexplored area of research as potential substitutes. Herein, we investigated the prevalence and distribution patterns of bacteria on egg surfaces and evaluated the inhibitory effects of mangosteen extract on these surface bacteria. In addition, we examined the antioxidant activity and egg quality in improving the ability of mangosteen extract. The results showed that the predominant bacteria isolated from eggshells were Gram-positive, with Staphylococcus and Micrococcus as the dominant genera. Notably, mangosteen extract exhibited significant bactericidal activity, effectively inhibiting Gram-positive bacteria on the surface of chicken eggshells. Moreover, the supplementation of mangosteen extract in the feed of laying hens yielded a noteworthy improvement in egg quality, accompanied by positively shaped structure and function of microbial communities on the egg surface and in the feces. Collectively, our findings suggested that mangosteen extract was an effective alternative to traditional antibiotics, offering valuable insights for animal husbandry development.

Bloodstream Infections in the Neonatal Intensive Care Unit: A Systematic Review of the Literature.

Bloodstream infections represent a significant concern in neonatal intensive care units (NICUs), constituting a leading cause of morbidity and mortality among neonates. This study aimed to elucidate the etiology, prevalence, and antimicrobial resistance patterns of bloodstream infections in NICU settings. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines using the PubMed database to source relevant studies published between 2019 and 2023. Keywords related to bloodstream infections, neonates in NICUs, pathogens, resistance, and susceptibility were employed. Out of the 73 identified articles, eight met the inclusion criteria. Findings revealed a predominance of late-onset sepsis in hospitalized neonates, with Escherichia coli, Klebsiella pneumoniae, coagulase-negative staphylococci, Group B Streptococcus, Acinetobacter species, Serratia marcescens, Staphylococcus aureus, and Enterobacter cloacae being the most commonly isolated pathogens. Antimicrobial susceptibility profiles demonstrated resistance among bacteria to ampicillin, gentamicin, and penicillin, while fungi exhibited resistance to amphotericin B, fluconazole, flucytosine, itraconazole, and voriconazole. These findings underscore the persistent challenge of bloodstream infections in the NICUs, particularly late-onset sepsis, emphasizing the importance of early detection and appropriate antimicrobial therapy in neonatal care management.

Contemporary prevalence and practice patterns of out-of-sequence kidney allocation

Since 2021, the Organ Procurement and Transplantation Network has reported a nearly 10-fold rise in out-of-sequence (OOS) kidney allocation, generating concern and halting development of continuous distribution policies. We report contemporary (2022-2023) practice patterns in OOS allocation using Organ Procurement and Transplantation Network data. We examined in sequence vs OOS donors with multivariable logistic regression and skipped vs OOS-accepting recipients with conditional logistic regression. Nearly 20% of kidney placements were OOS, varying from 0% to 43% acsoss organ procurement organizations; the 5 highest OOS-organ procurement organizations accounted for 29% of all OOS. Of OOS kidneys, 33% were declined ≥100 times in the standard allocation sequence and 51% were declined by ≥10 centers before OOS allocation began; 4.5% were made without any in-sequence declines. Nearly, all OOS offers were open offers. OOS kidneys were more likely to be from female, Black, older, donation after cardiac death, hypertensive, diabetic, and elevated creatinine donors. Candidates receiving OOS kidneys were more likely female, Asian, and older than skipped candidates. Higher-volume centers and centers with more White, fewer Hispanic, and more educated waiting list patients underwent transplantation disproportionately with more OOS kidneys. These findings suggest that the current, highly variable, discretionary use of OOS might exacerbate disparities, yet the impact of OOS on organ utilization cannot be determined with data now collected.

Prevalence and antimicrobial susceptibility pattern of Vibrio cholerae isolates from cholera outbreak sites in Ethiopia

BackgroundCholera is an acute infectious disease caused by ingestion of contaminated food or water with Vibrio cholerae. Cholera remains a global threat to public health and an indicator of inequity and lack of social development. The aim of this study was to assess the prevalence and antimicrobial susceptibility pattern of V. cholerae from cholera outbreak sites in Ethiopia.MethodsAcross-sectional study was conducted from May 2022 to October 2023 across different regions in Ethiopia: Oromia National Regional State, Amhara National Regional State and Addis Ababa City Administration. A total of 415 fecal samples were collected from the three regions. Two milliliter fecal samples were collected from each study participants. The collected samples were cultured on Blood Agar, MacConkey Agar and Thiosulfate Citrate Bile Salt Sucrose Agar. A series of biochemical tests Oxidase test, String test, Motility, Indole, Citrate, Gas production, H2S production, Urease test were used to identify V. cholerae species. Both polyvalent and monovalent antisera were used for agglutination tests to identify and differentiate V. cholerae serogroup and serotypes. In addition, Kirby-Bauer Disk diffusion antibiotic susceptibility test method was done. Data were registered in epi-enfo version 7 and analyzed by Statistical Package for Social Science version 25. Descriptive statistics were used to determine the prevalence of Vibrio cholerae. Logistic regression model was fitted and p-value < 0.05 was considered as statically significant.ResultsThe prevalence of V. cholerae in the fecal samples was 30.1%. Majority of the isolates were from Oromia National Regional State 43.2% (n = 54) followed by Amhara National Regional State 31.2% (n = 39) and Addis Ababa City Administration 25.6% (n = 32). Most of the V. cholerae isolates were O1 serogroups 90.4% (n = 113) and Ogawa serotypes 86.4% (n = 108). Majority of the isolates were susceptible to ciprofloxacin 100% (n = 125), tetracycline 72% (n = 90) and gentamycin 68% (n = 85). More than half of the isolates were resistant to trimethoprim-sulfamethoxazole 62.4% (n = 78) and ampicillin 56.8% (n = 71). In this study, participants unable to read and write were about four times more at risk for V. cholerae infection (AOR: 3.8, 95% CI: 1.07–13.33). In addition, consumption of river water were about three times more at risk for V. cholerae infection (AOR: 2.8, 95% CI: 1.08–7.08).Conclusionour study revealed a high prevalence of V. cholerae from fecal samples. The predominant serogroups and serotypes were O1 and Ogawa, respectively. Fortunately, the isolates showed susceptible to most tested antibiotics. Drinking water from river were the identified associated risk factor for V. cholerae infection. Protecting the community from drinking of river water and provision of safe and treated water could reduce cholera outbreaks in the study areas.