Risk Of Illness Research Articles

CLINICAL PROFILE AND OUTCOME AMONG ADULT COVID-19 PATIENTS ADMITTED IN SELECTED LEVEL 1 HOSPITAL IN QUIRINO PROVINCE: A RETROSPECTIVE STUDY

The COVID-19 pandemic has posed unprecedented challenges to healthcare systems worldwide, necessitating a thorough understanding of its impact on patient demographics, clinical presentations, and outcomes. Thus, this study was conducted to investigate the demographic and clinical profiles, as well as outcomes, of COVID-19 patients admitted to Quirino Province Medical Hospital from 2021 to 2022. The patient population exhibited a diverse age distribution, with a concentration in the 58-67 age group, indicating potential higher risks for severe illness among older adults. Respiratory issues were predominant. Also, there were patients experiencing moderate disease severity and facing severe disease. Despite most patients having no comorbidities, cardiovascular conditions led among those with comorbidities, emphasizing the need for cardiac health monitoring. As to clinical outcomes large number of patients were discharged alive, Significant differences in clinical status and outcomes were observed when grouped by age, sex, civil status, and occupation. Age and civil status demonstrated notable associations with disease severity, while sex and occupation had less influence. These findings underscore the importance of tailored healthcare strategies, proactive planning, and early detection to effectively manage COVID-19 patients and promote health equity. Further research is essential to adapt and improve healthcare approaches in this dynamic landscape. KEYWORDS: Clinical Profile, Clinical Outcome, Comorbidity, COVID-19, Severity

Lupus and SARS-CoV-2: What have we learned after the pandemic?

After the end of the COVID-19 public health emergency, we analysed the relationship between Systemic Lupus Erythematosous (SLE) and COVID-19 from the virologist's perspective based on recent findings. SLE and COVID-19 co-morbidity present unique challenges, as individuals with SLE may be at increased risk for severe COVID-19 illness due to immune system abnormalities and ongoing therapies. Effective management of both diseases requires careful monitoring, adherence to vaccination programs, preventive measures and approved and patient-tailored therapies. This review covers various aspects, including the clinical outcome of SLE patients infected by SARS-CoV-2, the impact of this infection on SLE onset or flare-ups and the benefits of vaccination for this population. Furthermore, this review presents the most recent recommendations on clinical management of COVID-19 in rheumatic patients, including those with SLE, discussing the currently available therapeutic options. Finally, we explore the most effective tools for SARS-CoV-2 diagnosis in autoimmune conditions and examine prognostic biomarkers in COVID-19 rheumatic patients with potential implications on their clinical oversight. By adopting a comprehensive approach, we address these complexities from the virologist's perspective, aiming to improve health care for this vulnerable population.

Effects on family functioning and the home environment of a family-based preventive intervention for children of parents with severe mental illness: A randomized controlled trial.

Children of parents with severe mental illness are at increased risk of mental illness throughout their lifespan due to complex gene-environment interactions. Preventive interventions supporting parents and children are warranted. Compared with usual treatment, we tested the effectiveness of a multidisciplinary family-based preventive intervention, VIA Family. We did a parallel randomized controlled superiority trial in Copenhagen, Denmark. A total of 95 families, of 95 parents with either schizophrenia spectrum disorder (n = 12 [12.6%]), bipolar disorder (n = 25 [26.3%]), or recurrent major depressive disorder (n = 58 [61.1%]), participated. A total of 179 coparents and 113 children (6-12 years) participated. Assessments took place at baseline and after 18 months of intervention. We estimated the effects on family functioning with the McMaster Family Assessment Device and on levels of stimulation and support in the home environment with the Home Observation Measurement of the Environment. Effects on family functioning did not differ between the two groups: parents with severe mental illness (0.11; 95% CI [-0.10, 0.31]), p = .296, and coparents (-0.07; 95% CI [-0.27, 0.13]), p = .482. Assessor-rated levels of stimulation and support in the home environment improved in VIA Family, but not significantly compared with usual treatment (Mdiff: 1.79; 95% CI [-0.37, 3.95], p = .104). Sensitivity analyses confirmed our main findings. Effects on family functioning and the home environment did not differ between VIA Family and usual treatment. We cannot rule out a clinically relevant effect of VIA Family on levels of stimulation and support in the home environment. Long-term follow-up will investigate potential preventive effects. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The role of psychotropics on the associations between extreme temperature and heat-related outcomes among people with mental health conditions: population-based study.

The association between heatwave and heat-related outcomes in people with mental health conditions with and without psychotropics was unclear. We identified people with severe mental illness (SMI) and depression, respectively, using Japanese claim data of Ibaraki prefecture during 1/1/2014-31/12/2021. We conducted self-controlled case series to estimate the incidence rate ratio (IRR) of heat-related illness, myocardial infarction and delirium, respectively, during 5-day pre-heatwave, heatwave, and 5-day post-heatwave periods v. all other periods (baseline) within an individual, stratified by periods prescribed psychotropics and periods not prescribed psychotropics, respectively. Among people with SMI, heatwave was associated with an increased rate of heat-related illness v. baseline, with no evidence of a difference in the IRRs between those prescribed v. not prescribed antipsychotics (IRR: 1.48 [95% CI 1.40-1.56]; 1.45 [95% CI 1.35-1.56] respectively, p interaction: 0.53). Among people with depression, heatwave was similarly associated with heat-related illness, with no evidence of a difference in the IRRs between those prescribed v. not prescribed antidepressants (IRR: 1.54 [95% CI 1.46-1.64]; 1.64 [95% CI 1.57-1.71] respectively, p interaction: 0.33). Smaller increased rates of heat-related illness were also observed in pre- and post-heatwave periods, v. baseline in both cohorts. There was weak evidence of an increased risk of MI and delirium associated with heatwave v. baseline. We showed an increased risk of heat-related illness, myocardial infarction and delirium associated with heatwave in people with mental health conditions regardless of whether being prescribed psychotropics. Risks of heat-related illness, myocardial infarction and delirium associated with heatwave might not be factors to influence decisions about the routine use of psychotropics.

Gaps in Heat-Related Knowledge, Practices and Adaptation Strategies Among Coaches in German Outdoor Sports.

Climate change is increasing the risk of heat-related illness in outdoor sports. Coaches have a responsibility to protect the athletes in their care. In this study, the knowledge and practice of German coaches in heat prevention were evaluated nationwide. Coaches (n = 1,200) from the ten largest outdoor sports in Germany were asked about their knowledge using the knowledge of heat-related illness symptoms index (KOSI, range [0-14]). Prevention measures currently implemented by coaches were analyzed in terms of relative compliance with specified recommendations (heat prevention score (HPS), range [0-100]). The KOSI averaged 10.31 ± 1.81 and pointed to clear knowledge deficits: the lowest score values were shown by coaches in skiing (9.85 ± 1.80), soccer (10.07 ± 2.33) and golf (10.09 ± 1.75; pANOVA = 0.015). Heat protection in training was also deficient: The HPS showed a mean value of 62.41 ± 14.89. The greatest deficits existed in tennis (57.71 ± 14.29), mountain sports (58.17 ± 13.08) and soccer (58.70 ± 13.86; pANOVA < 0.001). No correlation between theoretical knowledge and practical prevention was found. In Germany, coaches are insufficiently prepared for the health hazards of heat. Promoting onsite educational programs seems essential to ensure safer sports environments.

A Listeria monocytogenes aptasensor on laser inscribed graphene for food safety monitoring in hydroponic water

AbstractConsumption of fresh produce, such as leafy greens, is often encouraged as part of a healthy diet. Hence, indoor facilities for hydroponic production of leafy greens are increasingly being established. However, fresh produce entails a higher risk of microbial foodborne illnesses than processed foods. Listeria monocytogenes is a major source of fresh produce contamination and is among the leading causes of severe foodborne illnesses in the United States, with a 16% mortality rate. Tools for rapid monitoring are needed for pathogens such as L. monocytogenes to prevent outbreaks. In this manuscript, we have demonstrated the feasibility of a multi-aptamer approach for development of label-free aptasensors targeting L. monocytogenes in irrigation water for lettuce hydroponic production. We use screening studies with surface plasmon resonance to rationally develop mixtures of relevant aptamers for targeting L. monocytogenes. Based on this screening, multiple aptamers targeting extracellular structures on intact L. monocytogenes were tethered to platinum-modified laser inscribed graphene electrodes. This is the first report of a L. monocytogenes biosensor based on laser inscribed graphene. We show that mixing multiple aptamers with varying affinity improves the diagnostic performance over one aptamer alone in complex sample matrices (lettuce hydroponic water). Multi-aptamer biosensors showed high accuracy for L. monocytogenes and were at least three times more selective than Escherichia coli (Crooks, K12, O157:H7) with an accuracy of 85%. The limit of detection (10 CFU/10 mL) is based on data which were significantly different after calibration toward L. monocytogenes or E. coli (Crooks) and validated against gold standard molecular analysis (polymerase chain reaction). Rapid screening of pathogens is a global need to meet food safety and water quality regulations. This study shows the importance of sensors targeting more than one bacterial surface structure in complex samples relevant to the food-water nexus.

Relationship between ABO Blood Groups and Rh Factor with COVID-19 in Nineveh Governorate

ABO blood types and the Rh factor have recently been linked to an increased risk of developing the pandemic coronavirus disease 2019 (COVID-19) in individuals of different ethnic backgrounds. The conducted current study aimed to comprehend the relationship between this polymorphic apparatus and illness risk in Nineveh patients and healthy individuals. Recovery or death and two COVID-19 outcomes were also investigated. Many individuals including COVID-19 Nineveh patients had their ABO blood type and Rh factors determined. Thus, four groups (under therapy, rehabilitative, death, and healthy donors) were created from the research samples. The diagnosis kit RNA (PCR-Fluorescence Probing) was used to diagnose 2019 novel coronavirus (2019nCoV) for patients. The data was gathered from hospital records. The purpose of this study was to highlight significant data related to COVID-19 patients’ infection, symptoms and prognosis with respect to ABO blood type and Rh factor. Results of the current study included links between Rh factor and ABO blood types with increased infection potential, longer incubation times and fatal acute outcomes. Knowing that COVID-19 predisposing factors might help with patient survival, illness treatment and studying viral path physiology. A total of 2480 samples were ،distributed to control group and hospitalized patients with definite COVID-19 infection in isolation in the hospital in Mosul City for the period between 2nd December 2021 and 5th March 2022. The blood samples were obtained from patients and healthy donors by using kit for blood type identification, while the blood types of the deceased were taken from the hospital records. Several statistical tests were also conducted to find out the differences between the aforementioned groups. ANOVA was performed to investigate the correlation of ABO blood types with incidence of COVID-19 patients. The variables adopted in the analysis were age and sex. The study found that the difference between the association of each blood group with that of cases was significantly correlated (p = 0.00001). Out of total 975 patients 30.2% had blood group A, 27.3% had group B, 26.8% had group O and 15.7% had blood group AB. The study found that the number of recovered patients in 18-30 years age group was not significant among male and female population, while number of patients in other age groups in both male and female patients who finally recovered, was significantly lesser among patients with blood groups A and AB. There was a significant number of patients with blood group B in all the age groups except 31-35 years old. The study concluded that blood group B patients were severely affected by COVID-19.

Impact of the COVID-19 Pandemic on the Detection of Leprosy in Micro-Regions with a High Risk of Illness in Minas Gerais, Brazil

Background: Leprosy control remains challenging in Brazil and has been aggravated by the COVID-19 pandemic. Objective: To analyze the impact of the COVID-19 pandemic on the epidemiological scenario of leprosy through the detection rate of new cases, the risk of illness, and the hidden prevalence of leprosy according to high-risk micro-region in Minas Gerais, Brazil. Methods: An ecological study conducted in the health micro-regions of Minas Gerais, using data on new leprosy cases diagnosed between 2015 and 2023. The annual detection rate of new cases, the risk of illness index and the hidden prevalence of leprosy were evaluated. The time trend was evaluated by calculating the annual percentage change (APC) of the detection rate, based on segmented linear regression, considered significant when it showed p &lt; 0.05. Results: The state of Minas Gerais showed a significant negative annual increase between 2015 and 2020 (APC = −7.91; 95%CI −21.76–−1.72), and in 2020 it showed an inflection point, with an annual increase of 9.91 in the period from 2020 to 2023. When evaluating the hidden prevalence of leprosy in Minas Gerais, we observed a reduction in the estimates’ average from 2015–2019 (2.78) to 2020–2023 (2.00). The state as a whole showed an upward trend in the risk of illness, with the average index varying from 0.28 (medium risk) to 0.55 (high risk). Conclusions: The pandemic has had a considerable and heterogeneous impact on the detection of new cases, as well as on the risk of becoming ill and the hidden prevalence of leprosy, with repercussions for the control of the endemic in populations. There is a need to implement public health policies that prioritize the early identification of cases and ensure that vulnerable populations are monitored.

Instrumental variables in the cost of illness featuring type 2 diabetes.

To ascertain how an instrumental variables (IV) model can improve upon the estimates obtained from traditional cost-of-illness (COI) models that treat health conditions as predetermined. A simulation study based on observational data compares the coefficients and average marginal effects from an IV model to a traditional COI model when an unobservable confounder is introduced. The two approaches are then applied to real data, using a kinship-weighted family history as an instrument, and differences are interpreted within the context of the findings from the simulation study. The case study utilizes secondary data on type 2 diabetes mellitus (T2DM) status to examine healthcare costs attributable to the disease. The data come from Utah residents born between 1950 and 1970 with medical insurance coverage whose demographic information is contained in the Utah Population Database. Those data are linked to insurance claims from Utah's All-Payer Claims Database for the analyses. The simulation confirms that estimated T2DM healthcare cost coefficients are biased when traditional COI models do not account for unobserved characteristics that influence both the risk of illness and healthcare costs. This bias can be corrected to a certain extent with instrumental variables. An IV model with a validated instrument estimates that 2014 costs for an individual age 45-64 with T2DM are 27% (95% CI: 2.9% to 51.9%) higher than those for an otherwise comparable individual who does not have T2DM. Researchers studying the COI for chronic diseases should assess the possibility that traditional estimates may be subject to bias because of unobserved characteristics. Doing so may be especially important for prevention and intervention studies that turn to COI studies to assess the cost savings associated with such initiatives.

SEXUAL ABUSE AND RISK OF CHRONIC ILLNESS: A LITERATURE REVIEW

Sexual violence is a traumatic event that often has a long-term impact on physical and mental condition. The existing research primarily focuses on the prevalence and general impacts of sexual violence however, there appears to be a paucity of research investigating the specific long-term effects of sexual violence on women. The aim of this literature review is to described the relation between sexual abuse and the risk of Chronic Illness. This study employs a thematic literature review methodology utilizing the Onwegbuzie &amp; Frels Seven Step model, which is particularly suitable for qualitative research literature reviews; however, it is sufficiently flexible to be applied to other research paradigms. In this study, literature was selected incorporating both qualitative and quantitative studies. Journal articles were identified and selected through the EBSCO and SCOPUS web bases. Twenty papers were then selected according to the following criteria: study conducted on the topic of sexual violence and its effects on chronic illness and health. Due to the thematic methodology employed, articles were subjected to critical appraisal, with particular emphasis on the study's objectives and findings. Three major themes were concluded from the study: the tendency to develop high-risk behaviors; the occurrence of trauma and stress; and the presence of conditions with somatic and physical symptoms that lead to chronic disease. The themes resulting from this study show a link between sexual violence and its relationship with behavioral and lifestyle changes that ultimately have a physical impact.

Development and validation of nomogram models for severe and fatal COVID-19

BackgroundThe coronavirus disease 2019 (COVID-19) has exhibited escalating contagion and resistance to immunity, resulting in a surge in infections and severe cases. This study endeavors to formulate two nomogram predictive models aimed at discerning patients at heightened risk of severe and fatal outcomes upon hospital admission. The primary objective is to enhance clinical management protocols and mitigate the incidence of severe illness and mortality associated with COVID-19.Methods1600 patients diagnosed with COVID-19 and discharged from Fujian Provincial Hospital were chosen as the subjects of this study. These patients were categorized into three groups: mild group (n = 940), severe group (n = 433), and fatal group (n = 227). The patients were randomly divided into training and validation cohorts in a 7:3 ratio. COVID-19 symptoms were treated as dependent variables, and univariate regression analysis was conducted for the laboratory indicators. Risk factors with p-values greater than 0.05 in the univariate regression analysis were eliminated. The remaining risk factors were then analyzed using direct multiple regression analysis to establish an unadjusted model. Subsequently, risk factors with p-values greater than 0.05 were further removed. Clinical characteristics were added to the model as adjustment factors, and the method of multiple stepwise regression analysis was employed to derive the final fully adjusted model. The severe and fatal COVID-19 models were converted into nomograms, respectively. Receiver operating characteristic (ROC) curves were utilized to evaluate the discrimination of the nomogram models. Calibration was assessed using the Hosmer-Lemeshow test and calibration curves. Clinical benefit was evaluated by decision curve analysis.ResultsCompared to the mild group, individuals in the severe COVID-19 group exhibited significant increases in age, neutrophil (NEU), and lactate dehydrogenase (LDH) levels, alongside notable decreases in lymphocyte (LYM) and albumin (ALB) levels. Nomogram model incorporating age, NEU, LDH, LYM, and ALB demonstrated efficacy in predicting the onset of severe COVID-19 (AUC = 0.771). Furthermore, history of cerebral infarction and cancer, LDH and ALB as risk factors for fatal COVID-19 cases compared to the severe group. The nomogram model comprising these factors was capable of early identification of COVID-19 fatalities (AUC = 0.748).ConclusionsElevated age, NEU, and LDH levels, along with decreased LYM and albumin (ALB) levels, are risk factors for severe illness in hospitalized patients with COVID-19. A history of cerebral infarction and tumors, along with elevated LDH and decreased ALB levels, are risk factors for death in critically ill patients. The nomogram model based on these factors can effectively predict the risk of severe or fatal illness from COVID-19, thereby assisting clinicians in timely interventions to reduce the rates of severe illness and mortality among hospitalized patients. However, the model faces challenges in processing longitudinal data and specific points in time, indicating that there is room for improvement.

The use of machine and deep learning to model the relationship between discomfort temperature and labor productivity loss among petrochemical workers

BackgroundWorkplace may not only increase the risk of heat-related illnesses and injuries but also compromise work efficiency, particularly in a warming climate. This study aimed to utilize machine learning (ML) and deep learning (DL) algorithms to quantify the impact of temperature discomfort on productivity loss among petrochemical workers and to identify key influencing factors.MethodsA cross-sectional face-to-face questionnaire survey was conducted among petrochemical workers between May and September 2023 in Fujian Province, China. Initial feature selection was performed using Lasso regression. The dataset was divided into training (70%), validation (20%), and testing (10%) sets. Six predictive models were evaluated: support vector machine (SVM), random forest (RF), extreme gradient boosting (XGBoost), Gaussian Naive Bayes (GNB), multilayer perceptron (MLP), and logistic regression (LR). The most effective model was further analyzed with SHapley Additive exPlanations (SHAP).ResultsAmong the 2393 workers surveyed, 58.4% (1,747) reported productivity loss when working in high temperatures. Lasso regression identified twenty-seven predictive factors such as educational level and smoking. All six models displayed strong prediction accuracy (SVM = 0.775, RF = 0.760, XGBoost = 0.727, GNB = 0.863, MLP = 0.738, LR = 0.680). GNB model showed the best performance, with a cutoff of 0.869, accuracy of 0.863, precision of 0.897, sensitivity of 0.918, specificity of 0.715, and an F1-score of 0.642, indicating its efficacy as a predictive tool. SHAP analysis showed that occupational health training (SHAP value: -3.56), protective measures (-2.61), and less physically demanding jobs (-1.75) were negatively associated with heat-attributed productivity loss, whereas lack of air conditioning (1.92), noise (2.64), vibration (1.15), and dust (0.95) increased the risk of heat-induced productivity loss.ConclusionsTemperature discomfort significantly undermined labor productivity in the petrochemical sector, and this impact may worsen in a warming climate if adaptation and prevention measures are insufficient. To effectively reduce heat-related productivity loss, there is a need to strengthen occupational health training and implement strict controls for occupational hazards, minimizing the potential combined effects of heat with other exposures.

Hidden Spread of Rare Salmonella Serovars Isolated from Healthy Individuals - Yulin City, Guangxi Zhuang Autonomous Region, China, 2013-2022.

The emergence of rare multidrug-resistant Salmonella serovars is increasingly common in developing countries, posing a significant public health risk. This report identified five rare Salmonella serovars in China for the first time and using whole-genome sequencing, identified their hidden spread among healthy individuals. Additionally, antibiotic resistance genes and virulence genes were identified. Healthy individuals, especially food handlers, may be sources of hidden Salmonella dissemination. Therefore, monitoring Salmonella prevalence in healthy individuals is important for understanding and managing the risks of foodborne illness.

Inactivation of deposited bioaerosols on food contact surfaces with UV-C light emitting diode devices.

The airborne transmission of infectious diseases and bioaerosol-induced cross-contamination pose significant challenges in the food, dairy, and pharma industries. This study evaluated the effectiveness of 279 nm UV-C LED irradiation for decontaminating bioaerosols, specifically containing microorganisms such as Escherichia coli (C3040- Kanamycin resistant), Salmonella Enteritidis (ATCC 4931), and Pseudomonas fragi (ATCC 4973), on food contact surfaces. Borosilicate glass, silicon rubber, and stainless steel (316L) surfaces were selected for experimentation for their usage in the food industry. A 50 µL cell suspension was aerosolized at 25 psi pressure using a 4-jet BLAM Nebulizer within a customized glass chamber and then deposited onto the surface of the coupons. The serial dilution approach was used for the microbial enumeration, followed by duplicate plating. With a low Root Mean Square Error (RMSE) and high R2 values, the biphasic kinetic model for UV-C inactivation curves of all three pathogens demonstrated the excellent goodness of fit parameters. At a UV-C dose of 6 mJ cm-2, glass surfaces showed the maximum microbial inactivation (i.e., 2.80, 3.81, and 3.56 log CFU/mL for E. coli, Salmonella, and P. fragi, respectively). Stainless steel and silicon rubber surfaces showed significant microbial inactivation, but log10 reductions observed were consistently lower than glass surface. Our research indicates that UV-C LEDs (279 nm) can effectively disinfect bioaerosols on food contact surfaces.IMPORTANCEFood safety is a major public health concern, with contaminated food causing serious illnesses. UV-C light, used for germicidal action, is effective in disinfecting surfaces and is not subject to the same strict legal restrictions as chemical disinfectants, simplifying compliance with food safety regulations. In this study, we evaluated the efficacy of UV-C (279 nm) LED systems for inactivation of surface-deposited bioaerosols of kanamycin-resistant Escherichia coli (C3040), Salmonella Enteritidis (ATCC 4931), and Pseudomonas fragi (ATCC 4973). The research outcomes can be used to develop UV-based surface disinfection systems to minimize the risk of foodborne illnesses and enhance safety in high-traffic food preparation areas.

Unexplained Illnesses Associated With a Subscription Meal Service, 2022

In recent years, shifting consumer demands have led to changes in the types of foods produced and how consumers obtain them. A growing demand for non–meat-based proteins has led to the development of new plant-based protein products. Simultaneously, there has been an increase in subscription-based meal services. In 2022, a subscription-based meal service, Daily Harvest, launched a new plant-based protein line of products called Crumbles. Shortly, thereafter, consumer complaints of gastrointestinal symptoms were heard, and Daily Harvest recalled the French Lentil and Leek Crumbles, which contained a unique ingredient, tara flour. We obtained case data from the Marler Clark law firm and conducted an epidemiologic investigation of the relationship between illness and consumption of food products distributed by Daily Harvest. We independently reviewed data on 338 people, including 264 people with supplemental food exposure information, and calculated minimal attack rates. Of 264 people who completed the supplemental survey, all (100%) consumed the Lentil and Leek Crumbles. Minimal attack rates were highest for the Lentil and Leek Crumbles (1.4%) followed by the Walnut and Thyme Crumbles (0.45%). Among 213 subscribers, the minimal attack rate was highest for those who purchased three or more units of Lentil and Leek Crumbles (3.7%) compared to those who purchased two units (2.3%) or one unit (1.5%). The strength of the association and the increased risk of illness among persons who consumed Lentil and Leek Crumbles, but not other products that shared ingredients (other than tara flour) with Lentil and Leek Crumbles, suggests that tara flour was likely the source of illness, although a specific etiology remains unknown. This study highlights the value of using nontraditional data to identify sources of illness. Further research is needed to understand the safety of tara flour for human consumption.

Cigarette smoke-induced disordered microbiota aggravates the severity of influenza A virus infection.

Cigarette smoke (CS) promotes the development of chronic pulmonary disease and has been associated with increased risk for influenza-related illness. Here, we directly addressed the impact of CS disordered microbiota on the severity of influenza A virus (IAV) infection. Specific and opportunistic pathogen-free (SOPF) C57BL/6J mice were exposed to CS or room air (RA) for 5.5 months. Each exposed mouse was then cohoused with a group of recipient germ-free (GF) mice for 1 month for microbial transfer. Colonized GF mice were then infected intranasally with IAV and disease development was monitored. Upper and lower airway and fecal microbiota were longitudinally investigated by 16S rRNA gene sequencing and bacterial cultures in donor and recipient mice. The bacterial family Streptococcaceae accounted for the largest difference between CS- and RA-exposed microbiota in the oropharynx. Analysis of the oropharynx and fecal microbiota indicated an efficient transfer to coprophagic recipient mice, which replicated the differences in microbiota composition observed in donor mice. Subsequent IAV infection revealed significantly higher weight loss for CS microbiota recipient mice at 8-10 days post infection (dpi) compared to control recipient mice. In addition, H1N1 infection inflicted substantial changes in the microbiota composition, especially at days 4 and 8 after infection. In conclusion, mice with a CS-associated microbiota suffer from higher disease severity upon IAV infection compared to mice colonized with a normal SOPF microbiota. Our data suggest that independently of CS exposure and concomitant structural lung damage, microbial distortion due to CS exposure may impact the severity of IAV disease course.IMPORTANCEIt has been reported that chronic exposure to CS is associated with a disordered microbiota composition. In this study, we colonized germ-free (GF) mice with the microbiota from SOPF mice which were chronically exposed to CS or RA. This allowed disentangling the effect of the disordered microbiota from the immune-modulating effects of actual CS exposure. We observed a successful transfer of the microbiotas after cohousing including specific microbiota differences induced by CS exposure in formerly GF mice, which were never exposed to CS. We then investigated the effects of IAV infection on the disease course and microbiotas of formerly GF mice. We found that mice with CS-associated microbiota reveal worse disease course compared to the control group. We hypothesize that CS-induced disordering of the microbiota may, indeed, impact the severity of influenza A disease.

Effect of combined treatment with transcranial direct current stimulation and repetitive transcranial magnetic stimulation compared to monotherapy for the treatment of chronic insomnia: a randomised, double-blind, parallel-group, controlled trial

BackgroundChronic insomnia increases the risk of various health problems and mental illness. Existing research suggests promise for both transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) in treating chronic insomnia individually. However, the combined effects of tDCS and rTMS on this condition remain unclear. This study aimed to verify the efficacy and safety of tDCS combined with rTMS for the treatment of adult patients with chronic insomnia.MethodsThis was a randomised double-blind parallel-group controlled study. Overall, 157 participants with chronic insomnia were randomly assigned to one of three neurotherapy regimens: tDCS + rTMS, sham tDCS + rTMS, or tDCS + sham rTMS. All groups received 20 treatment sessions over 4 consecutive weeks. The primary outcome was the change in patients’ sleep as assessed by the Pittsburgh Sleep Quality Index (PSQI) at 2 weeks, 4 weeks, and 3 months of follow-up. The secondary outcome was the assessment of different dimensions of depression and anxiety in patients through the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA), as well as the occurrence of adverse events.ResultsThroughout the intervention and after the 3-month follow-up, the tDCS + rTMS group had significantly reduced total PSQI scores compared with the other two groups [tDCS + rTMS, 9.21 vs. sham tDCS + rTMS, 10.03; difference − 1.10; 95% confidence interval (CI), − 1.82 to − 0.38; p = 0.003; tDCS + rTMS, 9.21 vs. tDCS + sham rTMS, 10.76; difference − 2.14; 95% CI, − 2.90 to − 1.38; p < 0.001; sham tDCS + rTMS, 10.03 vs. tDCS + sham rTMS, 10.76; difference − 1.04; 95% CI, − 1.82 to − 0.26; p = 0.010), indicating improved overall sleep quality. Total HAMD and insomnia factor scores were significantly lower in the tDCS + rTMS group than in the other two groups after treatment (p < 0.05). Notably, no adverse events or serious adverse reactions were observed during the study period.ConclusionsCombining tDCS with rTMS effectively relieved insomnia symptoms, achieving a significant therapeutic effect after 2-week of intervention, and demonstrating the persistence of treatment effects in later follow-up, emphasising the advantages of combination therapy in improving treatment stability and long-term benefits, reflecting the rapid and effective augmentation of combination therapy. This combined therapy may serve as a safe and effective treatment for adults with chronic insomnia.Trial registrationThis study was registered as a clinical trial with the China Clinical Trial Registration Center (ChiCTR2100052681).

Integrated Health Monitoring System using Fingerprint and Disease Risk Prediction

Recent developments in machine learning and biometric systems have had a big influence on healthcare applications. In order to provide a holistic approach to health monitoring, this research introduces a unique method that combines disease risk prediction with fingerprint-based blood group recognition. Based on user-provided health data, the system uses machine learning algorithms to determine the risk of common illnesses including diabetes, cardiovascular disease, and chronic kidney disease (CKD) and convolutional neural networks (CNNs) to identify blood type from fingerprint photos. Through the integration of fingerprint biometric data with health risk modelling, the suggested approach seeks to increase the precision and usability of health forecasts. The system's effectiveness is demonstrated by the evaluation's excellent classification accuracy for blood groups and trustworthy estimates of illness risk.This work demonstrates the possibility of integrating biometric data with predictive health models and offers a promising step toward customized healthcare solutions

Rapid on-site detection of viable Vibrio parahaemolyticus in seafood using cis-diamminedichloroplatinum and colorimetric loop-mediated isothermal amplification (CDDP-LAMP).

Vibrio parahaemolyticus in seafood and marine environments poses significant health risks, causing gastroenteritis worldwide. Current detection methods fail to differentiate live from dead cells, leading to inaccuracies in food safety assessments. This study introduces a novel method combining cis-diamminedichloroplatinum (CDDP) with direct colorimetric loop-mediated isothermal amplification (LAMP) for rapid and accurate detection of viable V. parahaemolyticus cells in seafood samples. CDDP treatment at 37°C for 30min selectively inhibits DNA from dead cells, enhancing the specificity of the assay by ensuring only live cell DNA is amplified. The optimized CDDP-LAMP procedure detects alive V. parahaemolyticus within 1h, with results observable through a color change. The CDDP-LAMP assay demonstrates excellent specificity, identifying live V. parahaemolyticus cells while excluding dead cells and other bacteria. It shows a detection limit of 2.348CFU per reaction and successfully detects V. parahaemolyticus in seafood samples across different food matrices. This study is the first to combine CDDP with colorimetric LAMP for direct detecting viable bacteria in food, enhancing specificity by eliminating signals from dead cells. The CDDP-LAMP assay provides a rapid, accurate process for detecting viable V. parahaemolyticus cells, especially in resource-limited settings. It also gives a model for screening different bacterial pathogens, speeding up and improving foodborne illness risk assessments.

Nirsevimab Effectiveness Against Medically Attended Respiratory Syncytial Virus Illness and Hospitalization Among Alaska Native Children - Yukon-Kuskokwim Delta Region, Alaska, October 2023-June 2024.

Respiratory syncytial virus (RSV) is a leading cause of hospitalization among young children. Historically, American Indian and Alaska Native (AI/AN) children have experienced high rates of RSV-associated hospitalization. In August 2023, a preventive monoclonal antibody (nirsevimab) was recommended for all infants aged <8 months (born during or entering their first RSV season) and for children aged 8-19 months (entering their second RSV season) who have increased risk for severe RSV illness, including all AI/AN children. This evaluation in Alaska's Yukon-Kuskokwim Delta region estimated nirsevimab effectiveness among AI/AN children in their first or second RSV seasons during 2023-2024. Among 472 children with medically attended acute respiratory illness (ARI), 48% overall had received nirsevimab ≥7 days earlier (median=91 days before the ARI-related visit). For children in their first RSV season (292), nirsevimab effectiveness was 76% (95% CI = 42%-90%) against medically attended RSV illness and 89% (95% CI = 32%-98%) against RSV hospitalization. For children in their second RSV season (180), effectiveness against medically attended RSV illness was 88% (95% CI=48%-97%). Nirsevimab is effective for preventing severe RSV illness among infants entering their first RSV season and children entering their second season with increased risk for severe RSV, including all AI/AN children.