Public Health Interest Research Articles

Gauging Medical Students' Interests in Infectious Diseases.

Infectious diseases is a crucial specialty in medicine, yet applications for fellowship have declined even as the United States faces an imminent shortage of infectious disease physicians. Career interests often develop in medical school, but little is known about which interests and experiences are associated with interest in ID. Evaluate interest in ID among medical students and identify factors associated with interest and disinterest in ID careers. We developed a 26-question survey to gauge interest in infectious diseases (ID). All 16 medical schools in Texas were contacted and invited to participate. A total of 262 students across 9 medical school campuses completed the survey. Those interested in ID as a career had a significantly higher interest in public health (p<0.0001) and global (p<0.0003) health. The presence of an ID campus interest group (p<0.0015) and direct experience with the ID profession (p<0.0001) were also associated with interest. The most common reasons for lack of interest were lack of interest in pursuing internal medicine or pediatric residency, lack of compensation, and lack of procedures. Those interested in ID expressed interest in a wide variety of career pathways within ID, the most common being general inpatient and outpatient ID, as well as medical microbiology and global health/tropical medicine/travel medicine. Based on this survey, recruitment efforts for new ID fellows might include focusing on students with interests in public and global health, as well as increasing direct exposure to ID at the medical school level.

Flies as Carriers of Gastrointestinal Protozoa of Interest in Public Health in the Northeast of Brazil.

This study aimed to assess the influence of the presence of synanthropic flies in food preparation environments on the transmission of potentially zoonotic gastrointestinal protozoa. Flies were captured using a glass containing water, fruits, and pieces of protein. Approximately 260 flies from four different species were captured: Musca domestica (76.92%; 200/260), Cochliomyia hominivorax (17.31%; 45/260), Lucilia cuprina (3.85%; 10/260), and Hydrotaea aenescens (1.92%; 5/260). Protozoa were identified through microscopic analysis after macerating these arthropods contained in their respective eppendorfs, using two techniques, namely Mini-FLOTAC® and centrifugal sedimentation with Ziehl-Neelsen staining. The analysis revealed a concerning scenario regarding the epidemiological chain of gastrointestinal protozoa in Sergipe, Northeast Brazil. The positivity rate was 26.92% (14/52) of the pools, with 100.00% (5/5) in Aracaju, 30.00% (3/10) in Nossa Senhora do Socorro, 27.27% (3/11) in Nossa Senhora da Glória, 12.50% (2/16) in Carmópolis, and 10.00% (1/10) in Nossa Senhora das Dores. Two species of protozoa were identified, namely Cryptosporidium spp. (23.08%; 12/52) and Entamoeba spp. (9.62%; 5/52). The involvement of two fly species in the maintenance of the life cycle of these protozoa was noticeable, specifically M. domestica (27.50%; 11/40) and C. hominivorax (22.22%; 2/9). Counties analyzed had an human development index (HDI) considered medium; however, they still faced socioeconomic problems such as absence of sanitation systems, waste accumulation in the streets, and illegal waste disposal, which could favor the proliferation of these vectors and the spread of these gastrointestinal protozoa.

A Cohort Study of Lt. Col. Luke J. Weathers VA Medical Center Patients with Positive FIT and Incomplete GI Evaluation during the COVID-19 Pandemic.

The reasons for and incidence of delay in screening colonoscopies during the coronavirus disease 2019 (COVID-19) pandemic are of major public health interest. The risks and reasons for delay likely vary between public and private institutions. This research sought to analyze data regarding the completion of screening colonoscopies after a positive fecal immunochemical test (FIT) before and during the COVID-19 pandemic and the reasons for a delay in obtaining these results at the Lt. Col. Luke Weathers, Jr. Veterans Affairs Medical Center. The goals were to evaluate the institutional resilience and analyze the problems associated with this major healthcare crisis. This closed cohort study included all positive FITs from our local Veterans Affairs (VA) medical center from October 2019 to January 2020 and July 2020 to May 2021. A total of 115 VA patients with a positive FIT prepandemic and 157 VA patients with a positive FIT during the pandemic were included. Completion rates within 180 days were measured, and charts were reviewed to identify the reasons for lack of completion. Both community and local VA procedures for veterans were included. Univariate and multivariable analyses were applied to calculate odds ratios (ORs). The Pearson χ2 test was applied to calculate P values. VA patients' percentage of timely completion was lower pre-COVID-19 than it was during the pandemic, and the percentage of delayed completion was higher pre-COVID-19 than it was during the pandemic. Comparing patients who completed a colonoscopy with those who did not, increasing age had an OR of 0.947 (95% CI 0.920-0.975), and White race had an OR of 0.504 (95% CI 0.291-0.873). Evaluating delays in colonoscopy completion, VA colonoscopies versus referral to the community had an OR of 4.472 (95% CI 1.602-12.483), and pre-COVID-19 completion versus during COVID-19 had an OR of 4.663 (95% CI 1.727-12.594) with multivariable logistic regression. There was a statistically significant increase in timely colonoscopy completion during the study period when compared with the pre-COVID-19 period. The completion rate was higher at the Lt. Col. Luke Weathers, Jr. VA Medical Center than a large population average in 2020, possibly related to community colonoscopies and an aggressive case management system. In addition, increasing age and White race were associated with decreased colonoscopy completion. Predictors of an increased delay in colonoscopy completion included a pre-COVID-19 positive FIT and colonoscopies performed within the VA rather than being referred to providers in the community. A common reason for delay in all of the groups was patients declining intervention and delay/lack of referral.

Methodological challenges and actionable recommendations in studying the health effects of high-concentration THC products.

In conducting a scoping review on the health effects of high-concentration cannabis products, we have uncovered pervasive methodological shortcomings within the cannabis literature. This paper begins by defining the 'causal effect' of interest for public health and delineating the desirable features of study design that can address crucial questions pertaining to public health and policy. We further delve into the methodological complexities inherent in studying the health effects of high-concentration cannabis products, describing challenges associated with the measurement of exposures and outcomes, confounding, selection bias, and the generalizability of findings. We introduce causal inference methods to mitigate potential biases in observational cannabis use studies. We identify specific areas that necessitate further development and investigation to deepen our understanding of this topic. Finally, this paper extends actionable recommendations, serving as a roadmap for upcoming research initiatives in this domain.

Integrating AI in cause-of-death regular statistical production with human and expert system codings

Abstract Background Cause-of-death (CoD) statistics are key indicators in epidemiology and public health. These statistics are derived from death certificates completed by physicians and are usually coded by official statistics authorities according to the standards of the WHO ICD-10 classification to construct time- and cross-country-comparable statistics. For coding causes of death in free-text format in France according to ICD-10, predictions by deep neural networks (DNNs) are employed in addition to fully automatic batch coding by a rule-based expert system and to interactive coding by the coding team. Methods Seq-to-seq DNNs are trained from scratch on previously coded data to ICD-10 code multiple causes and underlying causes of death. Human coding is focused on certificates with a special public health interest or with low confidence in AI prediction quality to maximize the quality of the overall statistics disseminated when human resources are limited. DNNs also directly predict multiple causes and underlying causes of death for part of the certificates. Hence, the coding campaign aims to optimally allocate a coding mode to a given certificate. Results For deaths in 2021, 63% of the certificates are automatically batch coded by the expert system, 14% by the coding team, and 23% by DNNs. Compared to a traditional campaign that would have relied on automatic batch coding and manual coding, the present campaign reaches an accuracy of 95.7% for ICD-10 coding of the underlying cause (97.3% at the European shortlist level). Conclusions The 3-coding mode approach enables timeliness of dissemination of CoD statistics and may lead in the future to more responsive surveillance. Key messages • Deep neural networks trained on already coded data can be integrated into the regular statistical production of the CoD database in a fully controlled way. • The allocation between the different modes of coding can be optimized to achieve best quality and timeliness under the constraint of limited human resources.

Pharmaceutical Advertising and Public Perceptions in Saudi Arabia

Introduction: As the pharmaceutical advertising landscape evolves with digital advancements, this study examines public awareness and perceptions of medication advertisements in Saudi Arabia. It focuses on the effects of regulatory frameworks and evaluates how they influence public understanding and attitudes toward these advertisements. Method: A cross-sectional study was conducted using an electronic survey in Saudi Arabia in December 2023. The survey was distributed on social media platforms and reached a diverse sample of 440 participants. It covered public perception and attitudes toward drug advertisements, knowledge of regulatory laws, and preferences regarding advertising mediums. Results: Out of the 440 participants in the study, who were primarily employees with bachelor’s degrees, there was a clear awareness of drug advertisements. The average age of the group was 33 years, and a significant portion (71.1%) held a bachelor’s degree, with 51.1% being employed. The findings revealed that 25.5% of participants frequently noticed drug ads, while 22.7% saw them very often. Although many found the ads informative, there were significant concerns about unrealistic expectations and the risk of overmedication; 89.8% believed the ads set unrealistic expectations about the effectiveness of medications. Additionally, 60.7% thought that celebrity endorsements might mislead the audience, and 91.1% felt that ads should provide more detailed information about potential risks and side effects. Regarding preferred advertising platforms, mobile apps and websites were favored (47%), followed closely by social media (46.4%). A striking 93.2% of participants believed that drug ads on social media should be subject to stricter regulations, and 96.4% wanted more proactive monitoring of online advertising. Many also reported using other sources, such as medical review sites, to verify medication information. Conclusions: Pharmaceutical advertising in Saudi Arabia must balance ethical transparency with educational value. The influence of digital platforms underscores the necessity for stricter regulation and accurate information dissemination. A collaborative approach is essential to align advertising practices with public health interests and regulatory standards.

The Canadian platform for research online to investigate health, quality of life, cognition, behaviour, function, and caregiving in aging (CAN-PROTECT): Study protocol, platform description, and preliminary analyses

Background: Preventing or reducing the risk of cognitive decline and dementia is of great public health interest. Longitudinal data from diverse samples are needed to properly inform clinicians, researchers, and policy makers. CAN-PROTECT is a recently launched online observational cohort study that assesses factors contributing to both risk for incident cognitive decline and dementia and resilience against brain aging, in participants across the lifespan. Methods: Measures of cognition, behaviour, and quality of life administered to both participants and study partners were compared using partial Spearman correlations adjusted for participant and study partner age, sex, and education. In participants, relationships between cognition, behaviour, function, and quality of life were examined using adjusted multivariable linear and negative binomial regression models. Results: In the first three-month window, 2150 participants spanning all Canadian provinces enrolled; 637 nominated study partners had already completed assessments. Engagement with the study was excellent, with many optional assessments completed. Initial analyses demonstrated relationships between cognition, behaviour, function, and quality of life. Discussion: These preliminary results speak to the utility and feasibility of CAN-PROTECT to obtain data relevant to brain health, highlighting the public interest in participating in studies on cognition. The online portal facilitated participation of a geographically diverse sample. This group is ideal to study brain aging, dementia prevention, and early detection of neurodegenerative disease. Longitudinal data will provide additional insights. Several features of CAN-PROTECT are important to consider in terms of assessing risk and resilience in Canadians, and for further development and recruitment of a research-ready cohort.

Nutrition in the prevention and treatment of skeletal muscle ageing and sarcopenia: a single nutrient, a whole food, and a whole diet approach.

Loss of skeletal muscle strength and mass (sarcopenia) is common in older adults and associated with an increased risk of disability, frailty, and premature death. Finding cost-effective prevention and treatment strategies for sarcopenia for the growing ageing population is therefore of great public health interest. Although nutrition is considered an important factor in the aetiology of sarcopenia, its potential for sarcopenia prevention and/or treatment is still being evaluated. Nutrition research for sarcopenia utilises three main approaches to understand muscle-nutrition relationships, evaluating: single nutrients, whole foods, and whole diet effects-both alone or combined with exercise. Applying these approaches, we summarise recent evidence from qualitative and quantitative syntheses of findings from observational and intervention studies of healthy older adults, and those with sarcopenia. We consider protein supplements, whole foods (fruits and vegetables), and the Mediterranean diet as exemplars. There is some evidence of beneficial effects of protein supplementation ≥0.8g/kg body weight/day on muscle mass when combined with exercise training in intervention studies of healthy and sarcopenic older adults. In contrast, evidence for effects on muscle function (strength and physical performance) is inconclusive. There is reasonably consistent epidemiological evidence suggesting benefits of higher fruits and vegetables consumption for better physical performance. Similarly, higher adherence to the Mediterranean diet is associated with beneficial effects on muscle function in observational studies. However, intervention studies are lacking. This review discusses how current evidence may inform the development of preventive and intervention strategies for optimal muscle ageing and nutritional public policy aimed at combatting sarcopenia.

Understanding the Politics of Food Regulation and Public Health: An Analysis of Codex Standard-Setting Processes on Food Labelling

Background: The importance of the international food regulatory system to global health, is often overlooked. There are calls to reform this system to promote healthy and sustainable food systems centred on the Codex Alimentarius Commission (Codex), the United Nation’s (UN’s) standard-setting body. Yet this presents a significant political challenge, given Codex has historically prioritized food safety risks over wider harms to public health, and is dominated by powerful food exporting nations and industry groups with a primary interest in trade expansion. To better understand this challenge, we examine who participates and contests Codex standards, using the development of the new Guidelines on Front-of-pack Nutrition Labelling (FOPNL) as a case study. Methods: The study involved: (i) collecting Codex Committee on Food Labelling (CCFL) documents (2016-2023); (ii) identification, categorization, and enumeration of actors involved in the development of the Guidelines; and (iii) guided by a constructivist framework, analysis of how actors framed and contested key provisions of the Guidelines. Results: Country representation was skewed towards high-income (47.9%). Member state delegations were dominated by non-health ministries (59.8%) and industry actors (16.1%). Industry actors comprised the large majority of observers (84.2%) and civil society actors representing public health interests the least (12.2%). Commercial actors used frames supporting positive FOPNL messages (eg, low in salt) opposing negative ones (eg, "high-in" sugar warnings) and called for product exemptions (eg, sports foods and baby foods). Public health actors used frames supporting simplified FOPNL to reduce consumer confusion, that hold up public health goals, and prevent inappropriate marketing. Conclusion: Participation in the Guidelines development process suggests stronger preferences for trade facilitation and commerce over public health. Ambitions to reform the international food regulatory system may require an examination of who participates and how to address this asymmetrical representation of interests. These results suggest the need to greatly strengthen public health representation at Codex.

Ambulance Transports from NCAA Division 1 Football Games.

There is significant public health interest towards providing medical care at mass-gathering events. Furthermore, mass gatherings have the potential to have a detrimental impact on the availability of already-limited municipal Emergency Medical Services (EMS) resources. This study presents a cross-sectional descriptive analysis to report broad trends regarding patients who were transported from National Collegiate Athletic Association (NCAA) Division 1 collegiate football games at a major public university in order to better inform emergency preparedness and resource planning for mass gatherings. Patient care reports (PCRs) from ambulance transports originating from varsity collegiate football games at the University of Minnesota across six years were examined. Pertinent information was abstracted from each PCR. Across the six years of data, there were a total of 73 patient transports originating from NCAA collegiate football games: 45.2% (n = 33) were male, and the median age was 22 years. Alcohol-related chief complaints were involved in 50.7% (n = 37) of transports. In total, 31.5% of patients had an initial Glasgow Coma Scale (GCS) of less than 15. The majority (65.8%; n = 48; 0.11 per 10,000 attendees) were transported by Basic Life Support (BLS) ambulances. The remaining patients (34.2%; n = 25; 0.06 per 10,000 attendees) were transported by Advanced Life Support (ALS) ambulances and were more likely to be older, have abnormal vital signs, and have a lower GCS. This analysis of ambulance transports from NCAA Division 1 collegiate football games emphasizes the prevalence of alcohol-related chief complaints, but also underscores the likelihood of more life-threatening conditions at mass gatherings. These results and additional research will help inform emergency preparedness at mass-gathering events.

Structure-Based Engineering of Monoclonal Antibodies for Improved Binding to Counteract the Effects of Fentanyl and Carfentanil.

The opioid overdose epidemic is a growing and evolving public health crisis fueled by the widespread presence of fentanyl and fentanyl analogues (F/FAs) in both street mixtures and counterfeit pills. To expand current treatment options, drug-targeting monoclonal antibodies (mAbs) offer a viable therapeutic for both pre- and postexposure clinical scenarios. This study reports the isolation, in vitro characterization, and in vivo efficacy of two murine mAb families targeting fentanyl, carfentanil, or both. Because humanization of the mAbs by CDR grafting negatively impacted affinity for both fentanyl and carfentanil, crystal structures of mAbs in complex with fentanyl or carfentanil were analyzed to identify key residues involved in ligand binding in murine versus humanized structures, and site-directed mutagenesis was used to verify their functional importance. The structural analysis identified a framework residue, Tyr36, present in the murine germline sequence of two mAbs, which was critical for binding to fentanyl and carfentanil. These studies emphasize the importance of structural considerations in mAb engineering to optimize mAbs targeting small molecules including opioids and other drugs of public health interest.

Rapid antiretroviral therapy and treatment outcomes among people living with HIV: exploring the mediating roles of medication adherence.

The rapid initiation of antiretroviral therapy (ART) and its impact on treatment outcomes have been a subject of global public health interest. However, the precise mechanisms underlying the effects of rapid ART initiation remain unclear. This retrospective cohort study examined data from 1846 HIV-infected individuals in Jiulongpo District, Chongqing, China, spanning from 2016 to 2022. Logistic regression models and serial mediation analysis were used to explore the influence of rapid ART initiation on treatment outcomes and the role of medication adherence as a mediating factor. The findings revealed a significant association between rapid ART initiation and reduced risk of viral failure (adjusted odds ratio [OR] = 0.320, 95% confidence interval [CI] = [0.161, 0.637]), as well as an increased likelihood of improved adherence (adjusted OR = 2.053, 95% CI = [1.226, 3.438]). Medication adherence was identified as a partial mediator in the relationship between rapid ART initiation and viral failure, explaining 10.5% of the total effect. In conclusion,rapid initiation of antiretroviral therapy was found to enhance treatment outcomes, emphasizing the importance of early adherence education. The study recommends early initiation of ART coupled with adherence education and psychological counseling for HIV-infected individuals.

A scoping review of cultural issues concerning institutional quarantine and isolation during major multi‐country outbreaks in Africa: 2000–2023

AbstractBackground and AimsInfectious disease outbreaks pose significant challenges in Africa due to its ecology, socioeconomic conditions, and weak health systems. Implementing institutional quarantine and isolation (Q&amp;I) measures is crucial for managing major outbreaks. However, the cultural context often determines the success of these measures. This scoping review aims to examine existing evidence on the cultural aspects of institutional Q&amp;I in Africa over the past two decades, focusing on the COVID‐19 pandemic and other major multi‐country disease outbreaks.MethodsThis scoping review's protocol was registered with the Open Science Framework registry. Nine research databases were systematically searched to retrieve all relevant literature, followed by deduplication and a two‐stage screening process using the Rayyan web application. The inclusion of any literature into this review was based on a set of eligibility criteria. Also, manual searching of the reference lists of included literature was done to retrieve any other eligible literature. From the included literature, data were charted, collected, and summarized.FindingsOut of the 787 articles retrieved from the database searches, this review found only one to be eligible for inclusion. Also, no other eligible article was obtained after manual searching of the reference list for this article. The reviewed article presented empirical findings on the impact of COVID‐19 Q&amp;I protocols on traditional burial rites in Ghana. Many Ghanaian families were against their country's protocol because they felt it was insensitive to their traditional values and burial practices. Also, the way the protocol was implemented made some Ghanaian families feel that foreign burial practices were imposed on them, which bred feelings of cultural exclusion and neglect (by the government) among Ghanaians.ConclusionResearch evidence on the cultural implications of Q&amp;I in Africa is very scanty. More research is needed on this topic of public health interest.

Syphilis and pregnancy.

•Although congenital syphilis has a known etiological agent, accessible diagnosis and low-cost, effective treatment with low fetal toxicity, it continues to challenge obstetric and antenatal care services. •The increasing rates of syphilis in the general population have direct repercussions on the increase in cases of congenital syphilis, a situation of objective interest for public health. •Although transforming the recording of syphilis and congenital syphilis into notifiable diseases improved the records and has made it possible to measure the occurrence of these diseases and create solutions, no effects on reducing their frequency have been reached yet. •The failure to control syphilis/congenital syphilis is multifactorial, and associates variables that range from the deficiency in teaching about these diseases in schools and in the training system of the various health professional segments, as well as the lack of rigid policies for quality control from antenatal care until the clinical follow-up of children exposed to Treponema pallidum during pregnancy. •To date, benzathine penicillin is the only antimicrobial accepted as effective by the main health authorities on the planet for the treatment of syphilis in pregnant women. •The fear of anaphylaxis in response to the treatment of syphilis with benzathine penicillin is an important factor hindering the prompt and correct treatment of pregnant women with syphilis, even though health authorities have made efforts to face the problem with solid arguments, still insufficient to resolve the question. •Although specific protocols are published, the failure to control the treatment of syphilis in pregnant women is still observed with high frequency, indicating and reinforcing a failure in the quality control of these care principles. The National Specialized Commission on Infectious Diseases of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) endorses this document. Content production is based on scientific evidence on the proposed topic and the results presented contribute to clinical practice.

Affective symptoms in pregnancy are associated with the vaginal microbiome

BackgroundComposition of the vaginal microbiome in pregnancy is associated with adverse maternal, obstetric, and child health outcomes. Therefore, identifying sources of individual differences in the vaginal microbiome is of considerable clinical and public health interest. The current study tested the hypothesis that vaginal microbiome composition during pregnancy is associated with an individual's experience of affective symptoms and stress exposure. MethodsData were based on a prospective longitudinal study of a medically healthy community sample of 275 mother-infant pairs. Affective symptoms and stress exposure and select measures of associated biomarkers (diurnal salivary cortisol, serum measures of sex hormones) were collected at each trimester; self-report, clinical, and medical records were used to collect detailed data on socio-demographic factors and health behavior, including diet and sleep. Vaginal microbiome samples were collected in the third trimester (34–40 weeks) and characterized by 16S rRNA sequencing. Identified taxa were clustered into three community clusters (CC1–3) based on dissimilarity of vaginal microbiota composition. ResultsResults indicate that depressive symptoms during pregnancy were reliably associated with individual taxa and CC3 in the third trimester. Prediction of functional potential from 16S taxonomy revealed a differential abundance of metabolic pathways in CC1–3 and individual taxa, including biosynthetic pathways for serotonin and dopamine. We did not find robust evidence linking symptom- and stress-related biomarkers and CCs. ConclusionsOur results provide further evidence of how prenatal psychological distress during pregnancy alters the maternal-fetal microbiome ecosystem that may be important for understanding maternal and child health outcomes.

A quantitative content analysis of topical characteristics of the online COVID-19 infodemic in the United States and Japan

BackgroundThe COVID-19 pandemic has spurred the growth of a global infodemic. In order to combat the COVID-19 infodemic, it is necessary to understand what kinds of misinformation are spreading. Furthermore, various local factors influence how the infodemic manifests in different countries. Therefore, understanding how and why infodemics differ between countries is a matter of interest for public health. This study aims to elucidate and compare the types of COVID-19 misinformation produced from the infodemic in the US and Japan.MethodsCOVID-19 fact-checking articles were obtained from the two largest publishers of fact-checking articles in each language. 1,743 US articles and 148 Japanese articles in their respective languages were gathered, with articles published between 23 January 2020 and 4 November 2022. Articles were analyzed using the free text mining software KH Coder. Exploration of frequently-occurring words and groups of related words was carried out. Based on agglomeration plots and prior research, eight categories of misinformation were created. Lastly, coding rules were created for these eight categories, and a chi-squared test was performed to compare the two datasets.ResultsOverall, the most frequent words in both languages were related to health-related terms, but the Japan dataset had more words referring to foreign countries. Among the eight categories, differences with chi-squared p ≤ 0.01 were found after Holm-Bonferroni p value adjustment for the proportions of misinformation regarding statistics (US 40.0% vs. JP 25.7%, ϕ 0.0792); origin of the virus and resultant discrimination (US 7.0% vs. JP 20.3%, ϕ 0.1311); and COVID-19 disease severity, treatment, or testing (US 32.6% vs. JP 45.9%, ϕ 0.0756).ConclusionsLocal contextual factors were found that likely influenced the infodemic in both countries; representations of these factors include societal polarization in the US and the HPV vaccine scare in Japan. It is possible that Japan’s relative resistance to misinformation affects the kinds of misinformation consumed, directing attention away from conspiracy theories and towards health-related issues. However, more studies need to be done to verify whether misinformation resistance affects misinformation consumption patterns this way.

Association of Ultraprocessed Foods Intake with Untargeted Metabolomics Profiles in Adolescents and Young Adults in the DONALD Cohort Study

BackgroundHigh consumption of ultraprocessed foods (UPFs) continues to draw significant public health interest because of the associated negative health outcomes. Metabolomics can contribute to the understanding of the biological mechanisms through which UPFs may influence health. ObjectivesTo investigate urine and plasma metabolomic biomarkers of UPF intake in adolescents and young adults. MethodsWe used data from the Dortmund Nutritional and Anthropometric Longitudinally Designed study to investigate cross-sectional associations of UPF intake with concentrations of urine metabolites in adolescents using 3d weighed dietary records (3d-WDR) and 24-h urine samples (n = 339), and associations of repeatedly assessed UPF intake with concentrations of circulating plasma metabolites in young adults with 3–6 3d-WDRs within 5 y preceding blood measurement (n = 195). Urine and plasma samples were analyzed using mass spectrometry-based metabolomics. Biosample-specific metabolite patterns (MPs) were determined using robust sparse principal components analysis. Multivariable linear regression models were applied to assess the associations of UPF consumption (as a percentage of total food intake in g/d) with concentrations of individual metabolites and MP scores. ResultsThe median proportion of UPF intake was 22.0% [interquartile range (IQR): 12.3, 32.9] in adolescents and 23.2% (IQR: 16.0, 31.6) in young adults. We identified 42 and 6 UPF intake-associated metabolites in urine and plasma samples, respectively. One urinary MP, “xenobiotics and amino acids” [β = 0.042, 95% confidence interval (CI): 0.014, 0.070] and 1 plasma MP, “lipids, xenobiotics, and amino acids” (β = 0.074, 95% CI: 0.031, 0.117) showed positive association with UPF intake. Both patterns shared 29 metabolites, mostly of xenobiotic metabolism. ConclusionsWe identified urine and plasma metabolites associated with UPF intake in adolescents and young adults, which may represent some of the biological mechanisms through which UPFs may influence metabolism and health.

Environmental injustice in the air quality for digital platform delivery workers in Bogotá, Colombia, 2021

Air quality is a matter of interest for public health due to its rapid deterioration in low- and middle-income countries and the effects of polluted air on the health of populations. To explore the air quality conditions in which digital platform delivery workers carry out their work, evaluating the localities of Kennedy and Usaquén in Bogotá, 2021. We developed a mixed parallel convergent study based on four sources of information: 1) Ethnographic observation in five commercial locations of the two localities; 2) Monitoring of PM10 and PM2.5 in 56 delivery routes using a low-cost sensor; 3) Daily logs of the routes to support the device data interpretation, and 4) A semi-structured interview applied to the drivers to explore their danger perception during the routes. We identified elements causing environmental injustice among digital platform delivery workers between the two study locations. The routes made by the delivery drivers in the locality of Kennedy registered higher concentrations of PM10 and PM2.5, compared to the values observed in Usaquén. The sources of air pollution identified by the delivery drivers through ethnographic observation and the router logbook showed the worst parameters in Kennedy. We evidenced that air quality, urban equipment, road infrastructure, mobile sources, and geospatial location are elements that mark the presence of environmental injustice for the digital platform delivery drivers in the studied localities. To reduce this inequity, it is necessary for digital delivery platforms and the district government to implement strategies that reduce the exposure and emission of air pollutants to protect the health of digital platform delivery workers.

Serological evidence of human exposure to foodborne zoonotic parasites in Romanian patients and possible association with food habits and hygiene

Humans may become accidental dead-end hosts for a series of zoonotic foodborne parasites, of which Toxoplasma gondii, Echinococcus spp., Toxocara spp., and Trichinella spiralis are of major public health interest, due to their potential pathological implications. The aims of the study were to evaluate the exposure to these pathogens in north-western Romania, and to investigate their potential association to risk factors. From June 2022 to January 2024, 554 patients admitted to a tertiary hospital in north-western Romania were screened for the presence of IgG antibodies against T. gondii, Echinococcus spp., Toxocara canis, and T. spiralis by ELISA, and potential risks were assessed using a questionnaire. Overall, 225 samples (40.6%) were positive for at least one pathogen. The highest seroprevalence for IgG was found for T. gondii (33.9%), followed by Echinococcus spp. (9.1%), T. spiralis (2.9%), and T. canis (1.1%). For T. spiralis, raw meat consumption was associated with positivity. For T. gondii, increased age, rural environment, contact with cats, consumption of unwashed fruits/vegetables and drinking water from unverified sources were significantly associated to seropositivity. The present study provides new insights into the epidemiological status of zoonotic foodborne parasite in Romania, underlining the need to increase awareness on the importance of water, sanitation and food habits in relation with this neglected pathology.

Wastewater Target Pathogens of Public Health Importance for Expanded Sampling, Houston, Texas, USA.

Building on the success of initiatives put forth during the COVID-19 pandemic response, US health officials are expanding wastewater surveillance programs to track other target pathogens and diseases of public health interest. The Houston Health Department in Houston, Texas, USA, conducted a hypothesis-generating study whereby infectious disease subject matter experts suggested potential targets. This study addressed 2 criteria recommended by the National Academies of Sciences, Engineering, and Medicine for selecting wastewater targets. Results can be used as a basis of a questionnaire for a future population-based study to recommend targets of highest priority to include for expanded wastewater sampling.