Tool For Prevention Research Articles

Acute psychological and physiological benefits of exercising with virtual reality.

Exercise is a powerful tool for disease prevention and rehabilitation. Commercially available virtual reality (VR) devices and apps offer an immersive platform to gamify exercise and potentially enhance physiological and psychological benefits. However, no work has compared immersive exercise to closely matched 2D screen-based equivalents with the same visual and auditory stimuli. This study aims to compare the acute effects of an exercise session using a commercial immersive VR workout to the same stimuli and workout presented on a screen. 17 healthy participants (male = 7, female = 10; aged 24.18±4.56 years), completed a 12-minute guided VR boxing exercise session in FitXR™ and a screen-based equivalent. Physiological responses were recorded continuously using a heart rate monitor and telemetricmetabolic cart system. Psychological and perceptual responses were measured using their ratings of perceived exertion, the physical activity enjoyment scale, and the physical activity affect scale. In the immersive VR participants chose to engage in more intense exercise (%VO2max; p = 0.044), showed higher levels of all enjoyment subscales (p<0.05) and reported higher positive affect (p = 0.003) and lower negative affect (p = 0.045) following exercise compared to the screen-based equivalent. However, the design here could not determine which elements of immersive VR contributed to the positive effects. Immersive VR may offer a more efficient alternative to other forms of screen based and exergaming workouts and could be offered as a gateway into exercise.

The effect of novel mosquito bite prevention tools on Anopheles minimus landing and key secondary endpoints: semi-field evaluations in Thailand

BackgroundThe Greater Mekong Subregion (GMS) aims to eliminate all human malaria by 2030 and is making substantial progress toward this goal, with malaria increasingly confined to forest foci. These transmission foci are predominantly inhabited by ethnic minorities, local populations, and rural mobile and migrant populations working in mining and agriculture. The recommendations of the World Health Organization (WHO) on malaria elimination states that small population groups which constitute a large proportion of the malaria transmission reservoir should benefit from targeted strategies to reduce transmission overall. These population groups are exposed to malaria vector bites during the day due to Anopheles daytime biting, and during the night, due to low bed net use and open sleeping structures. Such characteristics limit the effectiveness of the WHO core vector control strategies [indoor residual spraying (IRS), insecticide-treated nets (ITNs)], which target indoor resting and indoor feeding mosquitoes. Interventions that target daytime and outdoor resting or biting mosquitoes, and which complement IRS and ITNs and drug strategies, may hasten a decline in the malaria burden.MethodsThis study evaluated two transfluthrin- and one metofluthrin-based volatile pyrethroid spatial repellents (VPSRs), and etofenprox insecticide-treated clothing (ITC) with and without a topical repellent in a semi-field system (SFS) at two research sites in Thailand, across two trial rounds. The study estimated the protective efficacies of the vector control tools against two pyrethroid-susceptible Anopheles minimus strains in the form of 15 interventions, including a combined VPSR and ITC intervention. The interventions’ modes of action were studied by measuring their impact on mosquito landing, and on key life history traits known to affect vectoral capacity (knockdown, post-exposure blood feeding, and 24-h mortality) using a block-randomized crossover design. The odds ratio (OR) for each intervention compared to the control on each outcome was estimated.ResultsAll interventions substantially reduced An. minimus landings and prevented more than 50% mosquito landings when new (VPSRs) or unwashed (treated clothing). In addition to landing reduction, all interventions decreased post-exposure blood feeding, induced knockdown and increased mortality at 24 h. The VPSR interventions were generally more protective against landing than the treated clothing intervention. The combined intervention (VPSR + ITC) provided the greatest protection overall.ConclusionThis SFS evaluation indicates an effect of these VPSR and ITC interventions in reducing An. minimus landing for the user, and indicates their potential for community protection by secondary modes of action. This study demonstrates the utility of SFS trials in the evaluation of bite prevention tools and emphasizes the need for multiple evaluations at different sites. It also highlights possible sources of biases observed, including the measuring of mosquito landing rather than biting, weather parameters, and low mosquito recapture.

Prioritisation of infectious diseases from a public health perspective: a multi-criteria decision analysis study, France, 2024.

BackgroundWithin the International Health Regulations framework, the French High Council for Public Health was mandated in 2022 by health authorities to establish a list of priority infectious diseases for public health, surveillance and research in mainland and overseas France.AimOur objective was to establish this list.MethodsA multi-criteria decision analysis was used, as recommended by the European Centre for Disease Prevention and Control. A list of 95 entities (infectious diseases or groups of these, including the World Health Organization (WHO)-labelled 'Disease X') was established by 17 infectious disease experts. Ten criteria were defined to score entities: incidence rate, case fatality rate, potential for emergence and spread, impact on the individual, on society, on socially vulnerable groups, on the healthcare system, and need for new preventive tools, new curative therapies, and surveillance. Each criterion was assigned a relative weight by 77 multidisciplinary experts. For each entity, 98 physicians from various specialties rated each criterion against the entity, using a four-class Likert-type scale; the ratings were converted into numeric values with a nonlinear scale and respectively weighted to calculate the entity score.ResultsFifteen entities were ranked as high-priorities, including Disease X and 14 known pathologies (e.g. haemorrhagic fevers, various respiratory viral infections, arboviral infections, multidrug-resistant bacterial infections, invasive meningococcal and pneumococcal diseases, prion diseases, rabies, and tuberculosis).ConclusionThe priority entities agreed with those of the WHO in 2023; almost all were currently covered by the French surveillance and alert system. Repeating this analysis periodically would keep the list updated.

The multifaceted importance of mediterranean pine-tree forests to social cohesion. Energy, resin, grazing, and wildfire management in North Euboea, Greece

Forests are essential not only for their ecological roles but also as invaluable natural resources supporting biodiversity, climate regulation, and human livelihoods. In Mediterranean regions, pine-tree forests are particularly susceptible to intense wildfires, which pose significant challenges to containment and long-term forest health. This study focuses on the pine-tree forests of North Euboea, examining their embedded energy, natural regenerative capacity, and sustainable management approaches. Key aspects investigated include the forest’s contributions to biomass and resin productivity, the social and economic impacts of wildfire events, and the role of managed grazing as a proactive tool in fire prevention and forest stewardship. Our analysis highlights the potential benefits of grazing as a strategic measure to manage forest biomass levels, thereby reducing the fuel load and lowering the intensity of possible future fires. Grazing is also shown to support broader access across the forest landscape, allowing firefighting forces to respond more effectively in case of a fire outbreak. By utilizing grazing to maintain forest ecosystems beyond just the periphery, this approach can enhance both ecological resilience and community cohesion in regions vulnerable to forest fires. The study underscores the need for integrated management practices that balance forest use with conservation, leveraging grazing as a means to sustain the health and accessibility of Mediterranean pine-tree forests.

Machine learning-based prediction model for sports injury risk in biomechanics: A case study of joint injuries in basketball at a university in Xi’an

Basketball players are prone to joint injuries due to the sport’s high intensity and physical demands. Early prediction of injury risk is crucial for implementing effective prevention strategies. Incorporating biomechanics, this study focuses on basketball players at a university in Xi’an, China, aiming to develop a machine learning-based model to predict joint injury risk using easily collectable data such as training load, fatigue levels, and previous injury history. Considering regional differences, we observed that local and northern Chinese students are generally taller, while students from southern China are typically shorter. This anthropometric variation was included in our sampling and analysis. Utilizing data from 100 basketball players, the Random Forest algorithm achieved the best predictive performance with an accuracy of 85%. Key risk factors identified include high training load, elevated subjective fatigue scores, and a history of previous joint injuries. Additionally, biomechanical data were integrated to elucidate the underlying mechanisms of joint injuries, and the cellular responses to injury were explored. The results demonstrate that even with limited data types, machine learning methods can effectively predict joint injury risk among basketball players, providing a valuable tool for injury prevention.

ZnO quantum dots reduce acquisition of huanglongbing pathogen by Diaphorina citri.

Diaphorina citri Kuwayama is the main vector of the Huanglongbing (HLB) pathogen Candidatus Liberibacter asiaticus (CLas). Therefore, reducing CLas acquisition by D. citri is crucial for controlling the spread of HLB. This study aimed to investigate the effect of ZnO quantum dots (ZnO QDs) on CLas acquisition by D. citri. The results showed that ZnO QDs were absorbed by citrus plants and D. citri, inducing reactive oxygen species generation in the intestine and causing intestinal cell apoptosis. The uptake rate of CLas was reduced to 75% and 22.3% after treatment with 2 and 5 mg ∙ mL-1 ZnO QDs, respectively, compared with 100% in the control group. Transcription analysis showed significant changes in the expression of D. citri genes related to apoptosis, oxidative stress, and DNA replication and repair. The results suggested that ZnO QDs could efficiently reduce CLas acquisition by D. citri, providing a safe and reliable tool for HLB prevention and control. © 2024 Society of Chemical Industry.

Amniotic fluid-derived stem cells: potential factories of natural and mimetic strategies for congenital malformations

Background:Mesenchymal stem cells (MSCs) derived from gestational tissues offer a promising avenue for prenatal intervention in congenital malformations although their application is hampered by concerns related to cellular plasticity and the need for invasive, high-risk surgical procedures. Here, we present naturally occurring exosomes (EXOs) isolated from amniotic fluid-derived MSCs (AF-MSCs) and their mimetic analogs (MIMs) as viable, reproducible, and stable alternatives. These nanovesicles present a minimally invasive therapeutic option, addressing the limitations of MSC-based treatments while retaining therapeutic efficacy.Methods:MIMs were generated from AF-MSCs by combining sequential filtration steps through filter membranes with different porosity and size exclusion chromatography columns. A physicochemical, structural, and molecular comparison was conducted with exosomes (EXOs) released from the same batch of cells. Additionally, their distribution patterns in female mice were evaluated following in vivo administration, along with an assessment of their safety profile throughout gestation in a mouse strain predisposed to neural tube defects (NTDs). The possibility to exploit both formulations as mRNA-therapeutics was explored by evaluating cell uptake in two different cell types(fibroblasts, and macrophages) and mRNA functionality overtime in an in vitro experimental setting as well as in an ex vivo, whole embryo culture using pregnant C57BL6 dams.Results:Molecular and physiochemical characterization showed no differences between EXOs and MIMs, with MIMs determining a threefold greater yield. Biodistribution patterns following intraperitoneal administration were comparable between the two particle types, with the uterus being among targeted organs. No toxic effects were observed in the dams during gestation, nor were there any malformations or significant differences in the number of viable versus dead fetuses detected. MIMs delivered a more intense and prolonged expression of mRNA encoding for green fluorescent protein in macrophages and fibroblasts. An ex-vivo whole embryo culture demonstrated that MIMs mainly accumulate at the level of the yolk sac, while EXOs reach the embryo.Conclusions:The present data confirms the potential application of EXOs and MIMs as suitable tools for prevention and treatment of NTDs and proposes MIMs as prospective vehicles to prevent congenital malformations caused by in utero exposure to drugs.

Disease Risk Score Derivation and Validation in Abu Dhabi, United Arab Emirates: A Retrospective Cohort Study.

Cardiovascular disease risk assessment is a key tool in primary prevention. The ADRS (Abu Dhabi Risk Study) is a retrospective cohort study aiming to develop 10-year risk prediction equations for coronary artery disease (CAD), stroke, and atherosclerotic cardiovascular disease (ASCVD), and validate international risk equations. The 8699 participants were examined in the Abu Dhabi cardiovascular screening program from 2011 to 2013 with a subsequent average follow-up of 9.2 years. They were assessed in 2023 for new CAD, admissions for acute coronary syndrome, or stroke. The validation cohort, 2554 subjects, is from the 2016 to 2017 Abu Dhabi community screening program, with 6.67 years average follow-up. Of 8504 ASCVD-free subjects, 250 experienced new CAD events. ASCVD risk factors in this population were age, sex, smoking, high cholesterol/high-density lipoprotein ratio, and diabetes diagnosis, in addition to low vitamin D level and low glomerular filtration rate. Three ADRS prediction models were derived using Cox regression. The ADRS-CAD had a C statistic of 0.899 (0.882-0.916) compared with 0.828 (0.803-0.852) for the Framingham Risk Score in the same sample. ADRS-stroke had a C statistic of 0.904 (0.865-0.944). The ADRS-ASCVD had a C statistic of 0.898 (0.883-0.913) compared with 0.891 (0.875-0.907) of pooled cohort equations and 0.825 (0.802-0.847) for Framingham Risk Score-cardiovascular disease. Applying our formulas to the validation cohort yielded C statistics of 0.825 (0.803-0.846), 0.799 (0.774-0.824), and 0.761 (0.71-0.813) for ASCVD, CAD, and stroke, respectively. The pooled cohort equations in this cohort had a C statistic for ASCVD of 0.824 (0.802-0.846). This study demonstrates the value of tailoring risk assessments to local populations and health care contexts.

Bibliotherapy to prevent bullying. A systematic review

Bullying is a serious social and health problem due to the dimensions it reaches and the consequences it entails. Since the application of bibliotherapy in pediatric and educational social-health interventions has been shown to be effective, it can be assumed that it can also be used as a bullying prevention tool. This paper presents a systematic review of studies on the use of reading books against bullying. In order to carry out the review, a search was conducted, without restriction of language, dates or databases, through BRAIN (acronym in Spanish for Learning and Research Resource Finder) of the King Juan Carlos University of Madrid. Twelve of the 2,604 records initially identified met the established search, selection and inclusion criteria. In this article, these 12 papers are analyzed. The data extracted from the analysis allow us to confirm the validity and usefulness of bibliotherapy to help prevent and address bullying.

A multimedia tool for infection prevention and control practices in the intensive care unit: a participatory interventional before–after study

A multimedia tool for infection prevention and control practices in the intensive care unit: a participatory interventional before–after study

Advances in Factors Affecting ALDH2 Activity and its Mechanisms.

Aldehyde dehydrogenase 2 (ALDH2) is a mitochondrial enzyme primarily involved in the detoxification of alcohol-derived aldehyde and endogenous toxic aldehydes. It exhibits widespread expression across various organs and exerts a broad and significant impact on diverse acute cardiovascular diseases, including acute coronary syndrome, acute aortic dissection, hypoxic pulmonary hypertension, and heart failure. The ALDH2 rs671 variant represents the most prevalent genetic variant in East Asian populations, with carriage rates ranging from 30 to 50% among the Chinese population. Given its widespread presence in the body, the wide range of diseases it affects, and its high rate of variation, it can serve as a crucial tool for the precise prevention and treatment of acute cardiovascular diseases, while offering individualized medication guidance. This review aims to provide a comprehensive overview of the latest advancements in factors affecting ALDH2 activity, encompassing post-transcriptional modifications, modulators of ALDH2, and relevant clinical drugs.

Impact of prescribed fire on fungal communities in Scots pine (Pinus sylvestris) forests in Mediterranean transitional zones

The Mediterranean region is renowned for its natural susceptibility to wildfires. In recent years, this risk has intensified due to various factors, including climate change and rural abandonment. Castilla y Leon stands out as one of the most severely impacted areas grappling with rural exodus. This evolving scenario accentuates the urgency of implementing forest management strategies to mitigate the escalating threat of wildfires, with a primary focus on fuel reduction. Although prescribed fires represent an efficient and cost-effective tool for wildfire prevention, they remain a contentious subject in Europe. Fungi not only contribute significantly to rural economies but also play a pivotal role in maintaining the equilibrium of forest ecosystems. The main objective of this study was to examine the effects of prescribed burning on Pinus sylvestris soils, with a specific focus on the recovery of fungal populations after such fires. To assess the short-term effects of prescribed fires on soil fungal communities, we collected soil samples from both burned and unburned plots 12 months post-burning to perform genomic DNA analyses. Our findings indicate that prescribed burning does not significantly alter fungal diversity or composition, with only litter saprotrophs showing significantly higher levels of abundance in burned areas than in unburned areas. Valuable edible fungi persisted post-burning, suggesting that prescribed burning could be used to reduce wildfire fuel loads while preserving fungal biodiversity and valuable edible fungi. These results advocate for the use of prescribed burning as a viable, myco-friendly forest management practice, offering a balance between fire prevention and ecological conservation.

Men who have sex with men perceiving that sex with women carries the greatest risk of HIV acquisition: results from a mixed-methods systematic review in sub-Saharan Africa.

In sub-Saharan Africa (SSA), men who have sex with men (MSM) often have female sexual partners. Their overall risk of acquiring HIV is higher with male partners. Risk perception is associated with HIV knowledge, sexual risk and preventive behaviours. This synthesis aimed to summarize existing data about HIV knowledge and perceived HIV acquisition risk regarding sex with men and with women in MSM in SSA. We conducted a systematic literature review of MSM's relationships with women in SSA (PROSPERO-CRD42021237836). Quantitative and qualitative data related to MSM's perceived risk from sex with men and with women and HIV knowledge (published up to 2021) were selected and synthesized. Twenty studies were selected. More MSM perceived that the greatest risk of HIV acquisition came from heterosexual/vaginal sex than from homosexual/anal sex (53% vs. 15%; 51% vs. 39%; 42% vs. 8%; 27% vs. 25%; 43% vs. 11%; 23% vs. 13%; 35% vs. 16%, cumulative sample n = 4396, six countries). A higher proportion of MSM received preventive information on heterosexual HIV transmission than on homosexual transmission (79% vs. 22%; 94% vs. 67%; 54% vs. 19%; cumulative sample n = 1199, four countries). The qualitative synthesis (eight studies) highlighted biology- and behaviour-based misconceptions leading MSM to perceive lower or negligible HIV risk from sex with men, compared to sex with women. These misconceptions were partly fuelled by the predominant focus on heterosexual and vaginal HIV transmission in HIV prevention information. Common misconceptions regarding sexual risk between men remain unaddressed by the heteronormative messaging of HIV prevention. Underestimation by MSM of their HIV acquisition risk with male partners can pose significant barriers to effective HIV preventive behaviours and strengthen the transmission risk from MSM to their female partners. Improving access of MSM to tailored HIV prevention information and tools that address their practices with male and female partners is crucial. Integrating messages about anal sex into broader public health initiatives, including sexual health programmes targeting the general population, is essential. Further research in diverse settings in SSA is necessary to gain a greater understanding of the drivers and implications of HIV risk perception in MSM.

Development of an eHealth Intervention Prototype to Prevent Health Risk Behaviors Among Hispanic Adolescents: A User-Centered Formative Study

Health risk behaviors continue to disproportionately affect Hispanic youth. Despite the existence of successful family and school-based interventions, there is a need for developing and testing individually-based preventive interventions that are easily accessed and widely disseminated. Therefore, this study aimed to develop a prototype (proof of concept) for an individual-level mobile application (app), informed by Hispanic parents and adolescents, to prevent/reduce drug use and sexual risk behaviors among Hispanic youth. An iterative user-centered approach was used to inform the development of the app prototype via focus groups with 66 participants (n = 46 adolescents, n = 20 parents). A coding team analyzed data from the focus groups and identified major themes. The coding team summarized interview data into sub-categories that yielded five intervention modules for Hispanic adolescents, three more than originally proposed (i.e., drug use and sexual risk behaviors): (1) effective communication, (2) depression, (3) sexual health, (4) drug use, and (5) mindfulness. A mobile application for health risk behaviors can be used as an additional preventive tool to decrease the existing behavioral health disparities among Hispanic youth. Incorporating a user-centered approach to inform development is important for including the needs and voices of this population.

The epidemiological benefit of pyrethroid–pyrrole insecticide treated nets against malaria: an individual-based malaria transmission dynamics modelling study

Insecticide treated nets (ITNs) are the most important malaria prevention tool in Africa but the rise of pyrethroid resistance in mosquitoes is likely impeding control. WHO has recommended a novel pyrethroid-pyrrole ITN following evidence of epidemiological benefit in two cluster-randomised, controlled trials (CRTs). It remains unclear how effective more costly pyrethroid-pyrrole ITNs are compared with other tools, or whether they should be deployed when budgets are limited. We aimed to compare the epidemiological impact and cost-effectiveness of the mass distribution of pyrethroid-pyrrole ITNs relative to other ITNs over 3 years in different African settings. In this individual-based malaria transmission dynamics modelling study we characterise the entomological impact of ITNs using data from a systematic review of experimental hut trials from across Africa. This African entomological data was used to inform an individual-based malaria transmission dynamics model, which was validated against CRT results from Benin and Tanzania. The full impact of new ITNs was quantified for trial sites and simulation was used to project impact in different settings which were included within an accessible interface (the Malaria Intervention Tool) to support National Malaria Programmes to explore how vector control tools and budgets could be allocated across regions to avert the most cases. The model projects that distributing pyrethroid-pyrrole ITNs averted 65% (95% credible interval 48-74) of cases over 3 years in Tanzania, and 75% (28-93) in Benin. The model indicates that trials might have underestimated the benefits of switching ITNs by 12-16% over 3 years because participants stopped using trial-allocated nets. In moderate endemicity non-trial settings, pyrethroid-pyrrole ITNs are projected to reduce malaria prevalence by 25-60% and switching from pyrethroid-only ITNs is probably highly cost-effective in most locations given current prices, averting an additional 10-30% of cases. The benefit of pyrethroid-pyrrole ITNs varies by setting but is generally the most cost-effective indoor vector control intervention in Africa. National Malaria Programmes can strategise deployment to maximise impact. Entomological data could broadly predict epidemiological impact, although there are some inconsistencies, illustrating the challenge in capturing the dynamics across diverse settings. Unitaid, Bill & Melinda Gates Foundation, the UK Medical Research Council, Wellcome Trust, and the UK Foreign, Commonwealth & Development Office.

Examining Provider Attitudes and Barriers toward Prescribing PrEP within Primary Care Settings in Alabama.

Human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) is an effective HIV prevention tool. Expanding PrEP access and utilization is made possible by incorporating it into primary care practice. This study explored the barriers in and attitudes toward prescribing PrEP to adults among primary care providers (PCPs) in Alabama, a priority HIV jurisdiction with low PrEP uptake. We conducted in-depth interviews grounded in the Health Belief Model with Alabama physicians and advanced practice practitioners in general internal and family medicine, exploring provider experiences in collecting sexual history information from patients and prescribing PrEP. Authors used thematic analysis of transcripts to further investigate the emerging themes. From September 2022 to April 2023, eight PCPs participated in our study. Several themes regarding barriers in and attitudes toward discussing sexual health history emerged: time constraints, knowledge and training, comfort levels, and competing priorities. We identified stigma and knowledge as themes when exploring provider attitudes toward and barriers in prescribing PrEP. When discussing the benefit of PrEP provision in primary care, we also identified themes such as longevity of the patient-provider relationship and accessibility. Participants identified multiple opportunities to increase PrEP provision in primary care beyond provider education and training, such as normalizing the language, consistency in discussing sexual health history, and using streamlined efforts of gathering sexual history information. With barriers hindering PrEP prescribing by Alabama's PCPs, in addition to preexisting healthcare barriers experienced by patients in the US Deep South, immediate attention is warranted. Further exploration into developing policies for streamlining sexual history intake and inclusive medical education and training regarding PrEP is needed in Alabama.

Use of social marketing to address the global burden of disease: Initiatives and effects

Purpose: To assess the use of social marketing interventions to address public health concerns and provide evidence on the effectiveness of the approach as a preventive tool in public health programming. Method: A scoping review framework was used, and articles published between 2000 and 2015 were included. Social marketing interventions were defined as interventions meeting at least six of the eight National Social Marketing Benchmark criteria adapted by French and Blair-Stevens (2006). Results: Sixty-nine (69) social marketing studies were included in the study. Nutrition, physical health and obesity (24.6%), malaria (20.3%), HIV/AIDS (11.6%), and cancer (10.0%) were the most prominent public health topics where social marketing strategies were employed. On the effectiveness of using social marketing in public health results indicated that the use of electronic medical records (EMR) among medical students increased from 13.8% to 54.7% while alcohol-impaired driving decreased from 85.0% to 65.0%, and child’s sugar-sweetened beverages intake reduced from 82.2% to 68.8%. The protective effect of ITN use to prevent malaria yielded OR=0.46 (95% CI: 0.30, 0.71, p=0.236). Limitations: The lack of high-quality data from the evaluation of social marketing interventions poses a major challenge and this needs to be addressed. Originality/value: Though the social marketing framework has gained widespread use in addressing and preventing some public health crises, the use of the framework seems limited to certain health topics, such as malaria and physical activities, nutrition, and obesity.

Multi-omic analyses of a twin pair with mirror image cleft lip identifies pathogenic variant in FGF20 modified by differential methylation upstream of ZFP57.

Disturbances in the intricate processes that control craniofacial morphogenesis can result in birth defects, most common of which are orofacial clefts (OFCs). Nonsyndromic cleft lip (nsCL), one of the phenotypic forms amongst OFCs, has a non-random laterality presentation with the left side being affected twice as often compared to the right side. This study investigates the etiology of nsCL and the factors contributing to its laterality using a pair of monozygotic twins with mirror-image cleft lip. We conducted whole-genome sequencing (WGS) analyses in a female twin pair with mirror image nsCL, their affected mother and unaffected father to identify etiopathogenic variants. Additionally, to identify possible cleft lip laterality modifiers, DNA-methylome analysis was conducted to test for differential methylation patterns between the mirror twins. Lastly, DNA methylation patterns were also analyzed on an independent cohort of female cases with unilateral cleft lip (left=22; right=17) for replication purposes. We identified a protein-altering variant in FGF20 (p.Ile79Val) within the fibroblast growth factor interacting family domain segregating with the nsCL in this family. Concurrently, DNA-methylome analysis identified differential methylation regions (DMRs) upstream of Zinc-finger transcription factor ZFP57 (Δβ > 5%). Replication of these results on an independent cohort, confirmed these DMRs, emphasizing their biological significance (p<0.05). Enrichment analysis indicated that these DMRs are involved in DNA methylation during early embryo development (FDR adjusted p-value = 1.3241E-13). Further bioinformatics analyses showed one of these DMRs acting as a binding site for transcription factor AP2A ( TFAP2A ), a key player in craniofacial development. Interactome analysis also suggested a potential role for ZFP57 in left/right axis specification, thus emphasizing its significance in cleft laterality. This study provides novel insights into the etiology of nsCL and its laterality, suggesting an interplay between etiopathogenic variants and DNA methylation in cleft laterality. Our findings elucidate the intricate mechanisms underlying OFCs development. Understanding these factors may offer new tools for prevention and management of OFCs, alleviating the burden on affected individuals, their families and global health.

Profile of postpartum patients with urinary retention at Koja Regional Hospital, Jakarta, Indonesia

HIGHLIGHTS Maternal age and fetal birth weight are key risk factors for PPUR. Among 300 subjects, 63.7% experienced PPUR, identified using the Suskhan score, with catheterization as a useful tool for prevention and management planning. ABSTRACT Objective: Postpartum urinary retention (PPUR) is a common voiding disorder, defined as the inability to void spontaneously within 6 hours after delivery with a residual bladder volume exceeding 200 mL. High rates of PPUR in Indonesia indicate a need for greater awareness and intervention. This study aims to assess the incidence and potential contributing factors of PPUR among postpartum patients at Koja Regional Hospital in Jakarta, Indonesia. Materials and Methods: A descriptive case-control study was conducted, including women who experienced urinary retention following vaginal delivery at Koja Hospital between September and December 2022. Residual urine volume was measured by catheterization 6 hours after delivery. Data analysis, performed using SPSS version 22, included patient demographics and clinical factors such as maternal age, parity, gestational age, neonatal birth weight, and postvoid residual urine volume. These factors were analyzed to determine their association with PPUR. Results: Out of 300 subjects selected through consecutive random sampling, 63.7% experienced PPUR, while 36.3% had normal urinary function. Patients with a mean age of 26.91 ± 5.02 years (p = 0.000), primiparous status (first-time mothers) (p &lt; 0.001), and a mean neonatal birth weight of 2980.95 ± 450.52 grams (p = 0.000) showed a higher risk of developing PPUR compared to other postpartum patients. Conclusion: The study indicates a significant association between postpartum urinary retention and maternal factors, including younger age, primiparity, and higher neonatal birth weight. Identifying these high-risk factors can enhance PPUR management, allowing healthcare providers to implement targeted monitoring and preventive measures, potentially improving postpartum outcomes in this patient population. This underscores the importance of monitoring these risk factors to better manage and potentially mitigate the incidence of PPUR.

Expanded HPV Genotyping by Single-Tube Nested-Multiplex PCR May Explain HPV-Related Disease Recurrence.

The role of the human papillomavirus (HPV) in the establishment of cervical cancer has driven studies to find more effective methods of viral detection so that early intervention strategies can be performed. However, the methods still have limitations, especially regarding detecting the different genotypes simultaneously. We have developed a high-throughput system using a single-tube nested-multiplex polymerase chain reaction (NMPCR) for the detection of 40 HPV genotypes using capillary electrophoresis. The NMPCR assay was compared to the Hybrid Capture 2 assay (HC2) with 40 women from the Northeast of Brazil (São Luis, MA), a high endemic region, where the HPV positivity was 75% and 37.5%, respectively. These results were validated by performing a molecular epidemiological study on 5223 Brazilian women undergoing gynecological examinations from 2009 to 2017, who presented with an HPV prevalence of 59%. Multiple infections were found in 62.5% and 58% of the patients from the endemic region and from the Brazilian women population, respectively, mostly presenting high-risk genotypes (90.5% and 60%, respectively). Considering cervical intraepithelial neoplasia and adenocarcinomas, the sensitivity and specificity were 97.5% and 100%, respectively. The NMPCR assay was also capable of identifying viral subtypes in cases of multiple infections, even with low viral loads (10-6 ng/µL of HPV DNA). The NMPCR test is a promising and robust tool for HPV diagnostics and a screening tool for prevention of cervical cancer.