Specific Risk Research Articles

Cryptosporidiosis in Human Immunodeficiency Virus Patients in Tripoli Medical Center

Cryptosporidiosis is a leading cause of protracted, life threatening diarrhea in Human Immunodeficiency Virus (HIV) infected patients. The aim of this study was to identify risk factors for transmission of cryptosporidiosis in HIV infected adults and to assess prevalence of Cryptosporidium in HIV patients in Tripoli Medical Center (TMC) Hospital. The study was a descriptive prospective cross sectional study carried out on 65 HIV patients in TMC hospital, only symptomatic (diarrheal) HIV infected patients were screened. All Cryptosporidium spp. positive cases were enrolled in the study and interviewed to record socio-demographic information, water supply and animal contact. The results showed the prevalence of infection with cryptosporidium in HIV infected patients was 5% (5 cases) out of 65 patients. The finding of this study indicates that Cryptosporidium parvum is an important cause of morbidity and mortality in immunocompromised patients in Tripoli, Also pollution of water supply provides an important source of infection. And In addition to that the immune status of the patients play an important role in the infection. From the present study the following are recommended: Periodic examination of patients who are suspected to be in special risk, Improved environmental sanitation as water supply and sanitary sewage disposal system.

Termination of Resuscitation Rules and Survival Among Patients With Out-of-Hospital Cardiac Arrest

Termination of resuscitation (TOR) rules may help guide prehospital decisions to stop resuscitation, with potential effects on patient outcomes and health resource use. Rules with high sensitivity risk increasing inappropriate transport of nonsurvivors, while rules without excellent specificity risk missed survivors. Further examination of the performance of TOR rules in estimating survival of out-of-hospital cardiac arrest (OHCA) is needed. To determine whether TOR rules can accurately identify patients who will not survive an OHCA. For this systematic review and meta-analysis, the MEDLINE, Embase, CINAHL, Cochrane Library, and Web of Science databases were searched from database inception up to January 11, 2024. There were no restrictions on language, publication date, or time frame of the study. Two reviewers independently screened records, first by title and abstract and then by full text. Randomized clinical trials, case-control studies, cohort studies, cross-sectional studies, retrospective analyses, and modeling studies were included. Systematic reviews and meta-analyses were reviewed to identify primary studies. Studies predicting outcomes other than death, in-hospital studies, animal studies, and non-peer-reviewed studies were excluded. Data were extracted by one reviewer and checked by a second. Two reviewers assessed risk of bias using the Revised Quality Assessment Tool for Diagnostic Accuracy Studies. Cochrane Screening and Diagnostic Tests Methods Group recommendations were followed when conducting a bivariate random-effects meta-analysis. This review followed the Preferred Reporting Items for a Systematic Review and Meta-Analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) statement and is registered with the International Prospective Register of Systematic Reviews (CRD42019131010). Sensitivity and specificity tables with 95% CIs and bivariate summary receiver operating characteristic (SROC) curves were produced. Estimates of effects at different prevalence levels were calculated. These estimates were used to evaluate the practical implications of TOR rule use at different prevalence levels. This review included 43 nonrandomized studies published between 1993 and 2023, addressing 29 TOR rules and involving 1 125 587 cases. Fifteen studies reported the derivation of 20 TOR rules. Thirty-three studies reported external data validations of 17 TOR rules. Seven TOR rules had data to facilitate meta-analysis. One clinical study was identified. The universal termination of resuscitation rule had the best performance, with pooled sensitivity of 0.62 (95% CI, 0.54-0.71), pooled specificity of 0.88 (95% CI, 0.82-0.94), and a diagnostic odds ratio of 20.45 (95% CI, 13.15-31.83). In this review, there was insufficient robust evidence to support widespread implementation of TOR rules in clinical practice. These findings suggest that adoption of TOR rules may lead to missed survivors and increased resource utilization.

Vocational counseling for inmates as people from special risk groups

Presented text concerns vocational counseling for persons from special risk groups, based on the example of inmates. Convicts are classified as having a special situation on the labor market. Such people often adopt a passive attitude towards seeking employment. The aim is to show how career counseling is implemented for people from special risk groups on the example of convicts. The method used was a diagnostic survey. The results showed that career counseling is a significant element in the process of professional activation of prisoners. It is a good starting point for further activities, awakens the need to raise qualifications and start work, and can contribute to the effective social readaptation of inmates. Il counseling professionale per i detenuti come persone a rischio. Il presente contributo affronta il tema della consulenza professionale per detenuti, considerati come persone a rischio. I detenuti vengono considerati come persone per le quali si configura una situazione particolare per quanto concerne il loro inserimento lavorativo. Sono persone che spesso adottano un atteggiamento passivo nella ricerca di un lavoro. L’obiettivo del contributo è di illustrare in che modo è svolto il “career counselling” rispetto a persone a rischio, prendendo come oggetto di analisi il cluster delle persone ristrette nella loro libertà. Il metodo utilizzato è stato quello dell’indagine diagnostica. I risultati dello studio dimostrano che il career counselling è una componente significativa nel processo di attivazione professionale dei detenuti. È un buon punto di partenza, risveglia la necessità di migliorare la professionalizzazione, motivare allo svolgimento di una attività lavorativa e può contribuire all’efficace reinserimento sociale dei detenuti.

Correlation between serum HDL/LDL and t-PINP /β-CTX and osteoporotic vertebral fractures in elderly women

To explore high density lipoprotein (HDL)/low density lipoprotein (LDL) and total typeⅠcollagen amino terminal extender peptide (t-PINP)/ C-terminal peptide of typeⅠcollagen β special sequence(β-CTX)and risk of osteoporosis vertebral fractures (OPVFs) in elderly women. The clinical data of 446 female OPVFs patients aged above 60 years old from January 2019 to December 2020 were retrospectively analyzed. According to whether or not fracture, patients were divided into non-fracture group (186 patients) and fracture group(260 patients). Univariate analysis was performed to analysis age, body mass index(BMI), N-terminal mioldle molecular fragment of osteocalcin, N-MID OC), t-PINP, β-CTX, 25-hydroxyvitamin D[25-(OH) VitD], blood sugar (Glu), total cholesterol(TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), Ca, P, Mg, urea (UREA), creatinine (Cr) and Cystatin C(CysC), and correlation between OPVFs and the above indexes and lipid, bone metabolism indexes between two groups;Logistic regression was performed to analyze risk factors and stratification relationship between vertebral fracture and HDL/LDL, t-PINP/β-CTX. Logistic regression was used to analyze risk factors and stratification relationship between OPVFs and HDL/LDL, t-PINP/β-CTX. There were no significant difference in age and BMI between non-fracture group and fracture group (P>0.05). Compared with non-fracture group, contents of HDL, t-PINP/β-CTX and HDL/LDL in fracture group were decreased, and contents of β-CTX were increased (P<0.05). OPVFs was positively correlated with β-CTX (r=0.110, P<0.05), and negatively correlated with HDL, HDL/LDL and t-PINP/β-CTX (r=-0.157, -0.175, -0.181, P<0.05). HDL and HDL/LDL were negatively correlated with β-CTX (r=-0.22, -0.12, P<0.05) and t-PINP (r=-0.13, -0.10, P<0.05). 25-(OH) VitD was positively correlated with TC and HDL (r=0.11, 0.18, P<0.05). HDL/LDL was positively correlated with t-PINP/β-CTX(r=0.11, P=0.02). t-PINP/β-CTX[OR=0.998, 95%CI(0.997, 1.000), P<0.05], HDL/LDL[OR=0.228, 95%CI(0.104, 0.499), P<0.01] were risk factors for vertebral fracture. The lower levels between two tristratified indicators, the higher the vertebral fracture rate. The risk of fracture was 2.5 and 2 times higher in the lowest stratum than in the highest stratum, with an adjusted OR was[2.112, 95%CI(1.310, 3.404)] and [2.331, 95%CI(1.453, 3.739)], respectively. Serum low HDL/LDL and t-PINP /β-CTX are independent risk factors for OPVF in elderly women, and have good predictive value for OPVF risk.

Association of Serum Trimethylamine-N-Oxide Concentration from Childhood to Early Adulthood with Age and Sex.

Primary prevention is the cornerstone of cardiometabolic health. In the randomized, controlled Special Turku Coronary Risk Factor Intervention Project (STRIP), dietary counseling intervention was given to children from infancy to 20 years of age and a follow-up was completed at age 26 years. We investigated the associations of age, sex, gut microbiome, and dietary intervention with the gut metabolite and the cardiac biomarker trimethylamine-N-oxide (TMAO). Overall, 592 healthy participants (females 46%) from STRIP were investigated. Compared to the control group, the intervention group had received dietary counseling between ages 7 months and 20 years focused on low intakes of saturated fat and cholesterol and the promotion of fruit, vegetable, and whole-grain consumption. TMAO serum concentrations were measured by a liquid chromatography-tandem mass spectrometry method at ages 11, 13, 15, 17, 19, and 26 years. Microbiome composition was assessed using 16S rRNA gene sequencing at 26 years of age. TMAO concentrations increased from age 11 to 26 years in both sexes. At all measurement time points, males showed significantly higher serum TMAO concentrations compared to females, but concentrations were similar between the intervention and control groups. A direct association between TMAO concentrations and reported fiber intake was found in females. Gut microbiome analysis did not reveal associations with TMAO. TMAO concentration increased from childhood to early adulthood but was not affected by the given dietary intervention. In females, TMAO concentrations could be directly associated with higher fiber intake suggesting sex-specific differences in TMAO metabolism.

Ovarian Tissue Cryopreservation for Fertility Preservation in Patients with Hemoglobin Disorders: A Comprehensive Review.

Hemoglobin diseases like sickle cell disease (SCD) and β-thalassemia (BT) present fertility challenges for affected patients. SCD and BT result from abnormal hemoglobin production or structure and pose numerous health concerns. Despite medical advancements improving the quality of life or even providing cures, SCD and BT pose unique fertility concerns for women. Young women with these disorders already contend with reduced ovarian reserve and a narrower fertile window, a situation that is compounded by the gonadotoxic effects of treatments like medications, transfusions, stem cell transplants, and gene therapy. While crucial for disease control, these interventions may lead to reproductive health issues, increasing infertility and early menopause risks. Ovarian tissue cryopreservation (OTC) offers potential for future motherhood to women with hemoglobin disorders facing infertility related to curative treatments. OTC involves surgically removing, preparing, and freezing ovarian tissue containing primordial follicles capable of producing mature oocytes, offering advantages over oocyte cryopreservation alone. However, the application of OTC for patients with hemoglobin disorders presents unique challenges, including special health risks, financial barriers, and access to care. This comprehensive literature review delves into the current state of ovarian tissue cryopreservation for fertility preservation in patients with hemoglobin disorders. Empowering patients with informed reproductive choices in the context of their hemoglobin disorders stands as the ultimate goal.

Congenital Long QT Syndrome Unmasked by Albuterol in an Adolescent with Asthma

BackgroundPatients with congenital long QT syndrome (LQTS) are prone to ventricular dysrhythmia but may be initially asymptomatic with a normal QTc interval on resting electrocardiogram (ECG). Albuterol is listed as a medication that poses a “special risk” to patients with congenital LQTS, but its effects have been rarely described. We present a case of previously unknown, asymptomatic congenital LQTS unmasked by albuterol in an adolescent with asthma. Case ReportA 12-year-old girl with a history of asthma presented to the emergency department (ED) with shortness of breath, wheezing, and tachycardia for 24 h, consistent with acute asthma exacerbation. She received two doses of her home albuterol inhaler 2 h prior to presentation. Initial ECG demonstrated a QTc of 619 ms. Her remaining history, clinical examination, and laboratory workup, including electrolytes, were unremarkable. She was observed with cardiac monitoring before being discharged from the ED in stable condition for next-day outpatient pediatric cardiology follow-up. Resting office ECGs revealed QTcs from 440–470 ms. Exercise stress test revealed QTc prolongation of 520 ms and 500 ms at minute-2 and minute-4 of recovery, respectively. Genetic testing revealed heterozygous pathogenic variants in KCNQ1, consistent with type 1 LQTS. Why Should an Emergency Physician Be Aware of This?Albuterol may be a cause of marked QTc prolongation in ED patients with underlying congenital LQTS, which can be a diagnostic clue in previously unidentified patients. Extreme QTc prolongation also serves as an indication in the ED for Cardiology consultation, laboratory evaluation for electrolyte imbalances, and observation with cardiac monitoring.

CORRECTIVE AND DEVELOPMENTAL SUPPORT OF CHILDREN WITH INTELLECTUAL DISABILITIES AT DIFFERENT AGE STAGES OF THEIR DEVELOPMENT

The theoretical review article describes the peculiarities of the organization of correctional and developmental support for children with intellectual disabilities. The types of institutions that provide correctional and developmental services to children with intellectual disabilities at different age periods of their development are structured. At an early age, due to the impossibility of measuring the IQ, children with organic damage to the nervous system are a special risk group. At this age stage of the development of the children of the research group, multidisciplinary correctional and developmental support is supported in the early intervention system. The possibility of receiving correctional and developmental services for preschool children with intellectual disabilities in inclusive preschool educational institutions, inclusive resource centers, and comprehensive rehabilitation centers has been identified. Similarities in the organization of the structure of correctional and developmental support for preschool and school-aged children with intellectual disabilities were observed. It was determined that the correctional and developmental support of school-age children with intellectual disabilities is carried out in the following institutions: inclusive institutions of general secondary education, inclusive resource centers, comprehensive rehabilitation centers. It was determined that the activities of inclusive resource centers and inclusive educational institutions are interdependent. Inclusive resource centers provide comprehensive diagnostic activities, provide correctional and developmental services to children with intellectual disabilities, provide methodical support for pedagogical workers of inclusive educational institutions.

Metagenomic next-generation sequencing as a diagnostic tool in the clinical routine of an infectious diseases department: a retrospective cohort study.

Metagenomic next-generation sequencing (mNGS) of circulating cell-free DNA from plasma is a hypothesis-independent broadband diagnostic method for identification of potential pathogens. So far, it has only been investigated in special risk populations (e.g. patients with neutropenic fever). To investigate the extent to which mNGS (DISQVER® platform) can be used in routine clinical practice. We collected whole blood specimens for mNGS testing, blood cultures (BC), and pathogen-specific PCR diagnostics. Clinical data and pathogen diagnostics were retrospectively reviewed by an infectious disease expert panel regarding the adjustment of anti-infective therapy. In 55 selected patients (median age 53years, 67% male) with heterogeneous diagnoses, a total of 66 different microorganisms and viruses were detected using mNGS (51% viruses, 38% bacteria, 8% fungi, 3% parasites). The overall positivity rate of mNGS was 53% (29/55). Fifty-two out of 66 (79%) potential pathogens detected by mNGS were found in patients with primary or secondary immunodeficiency. The concordance rates of BC and pathogen-specific PCR diagnostics with mNGS testing were 14% (4/28) and 36% (10/28), respectively (p < 0.001). An additional bacterial pathogen (Streptococcus agalactiae) could only be detected by BC. Therapeutic consequences regarding anti-infective therapy were drawn from 23 pathogens (35% of detections), with 18 of these detections occurring in patients with immunodeficiency. We conclude that mNGS is a useful diagnostic tool, but should only be performed selectively in addition to routine diagnostics of infectious diseases. The limited number of patients and the retrospective study design do not allow any further conclusions.

Occupational skin cancer screening: Results of a cross‐sectional study at the city drainage company Munich

AbstractBackgroundSince skin cancer incidence and prevalence are rising steadily, the prevention of skin cancer has gained importance. People with high sun exposure at work are at special risk, and prevention measures by the employer may lower the risk, especially for keratinocyte carcinoma.ObjectivesThe aim of the study was to evaluate the results of a large‐scale skin cancer screening campaign at the city drainage company Munich where the cohort consisted mainly of outdoor workers.MethodsIn 2023, a skin cancer screening campaign was conducted at the city drainage company Munich. Sun exposure and protection measures of each participant were assessed using a questionnaire. Dermatologists identified clinical signs for sun damage and skin cancer by whole‐body skin examination.ResultsA total of 290 participants (72.8% male; mean age 43.7 ± 11.5 years) were enroled. 36.6% showed clinical signs of sun damage correlating with male gender, higher age, and more hours spent outdoors per day. Clinical examination revealed a suspect finding of skin cancer, a preliminary stage, or a lesion requiring clinical control to avoid skin cancer development in 19.3% of participants. Participants with atypical melanocytic lesions were mostly female and showed a high skin cancer awareness. This was concluded from the fewer signs of sun damage, a higher percentage of previous screening participation, and more regular self‐examination.ConclusionsWhole‐body examination for skin cancer screening at work is a valuable tool to encourage participation in this preventive measure. It may help identify people at risk either by clinical signs for sun damage or risk exposure which can be assessed with a simple questionnaire. Based on this result, the screening interval may be adopted individually.

Inequalities in caregiving strain during the COVID-19 pandemic: conceptual framework and review of the empirical evidence

The COVID-19 pandemic poses specific risks to vulnerable population groups. Informal carers for older adults are especially at risk of increased strain, as support from social networks and professional care services is no longer available or in short supply. Already before the pandemic, caring was unequally distributed within societies, with women and people in lower socio-economic status groups bearing a higher risk of caring strain. In this article, we propose a conceptual framework of (unequal) caring strain during the pandemic. We then summarise the state of empirical research, suggest questions for future studies and outline implications for social policy.

Perception and Impact of COVID-19 Pandemic in Psoriasis Patients: Data from the German PsoBest and the CoronaBest Registries.

Limited data are available characterizing the impact of the SARS-CoV-2 pandemic on psoriasis care for patients in Germany. To analyze patient perception and impact of the pandemic on well-being and psoriasis management of German patients with moderate-to-severe psoriasis or psoriasis arthritis under systemic therapies. The CoronaBest registry captures events of SARS-CoV-2 infections and analyzes the impact of the pandemic on patients with psoriasis or psoriasis arthritis. In June 2020, and independently in February 2022, patients with psoriasis or psoriasis arthritis received a standardized questionnaire for current treatment, protective measures, well-being, and individual risks for COVID-19, among others. Included were 4,194 patients in 2020 (mean age of 47.7 years and 41.8% women) and 4,818 patients in 2022 (mean age of 56.4 and 42.9% women). Treatment discontinuations were observed in 2.7% and 1.7% of patients in 2020 and 2022, respectively. In the vast majority of the cases (>92%), no additional measures were taken concerning the management of psoriasis treatments in either 2020 or 2022. Those patients with changes reported most frequently: telephone calls instead of face-to-face visits (80.2%, in 2020 vs 40.5% in 2022) or more frequent controls (27.1%, 2020 vs 22.0%, 2022). A majority (66.7%, 2020, and 70.6%, 2022) did not perceive the virus as a considerable threat. The proportion of patients feeling well informed about COVID-19 by physicians increased from 42.6% in 2020 to 51.8% in 2022. About 81.1% of patients in 2020 and 67.5% in 2022 stated that their overall personal condition was not affected due to the pandemic. Physicians attributed no special risk of contracting SARS-CoV-2 in most of the patients. A high rate of systemic treatment persistence and awareness of risks and protective measures indicate that health care for psoriasis largely followed current national and international recommendations during the COVID-19 pandemic.

Особенности актуального состояния обучающихся в регионе с высокой степенью вовлеченности в последствия боевых действий

&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Objective.&lt;/strong&gt; The study is aimed on estimation of students&amp;rsquo; current state in regions with high degrees of involvement in the consequences of hostilities. &lt;br&gt;&lt;strong&gt;Background.&lt;/strong&gt; Research data, mainly foreign ones, indicate a high prevalence of violations of various degrees of severity, from mild adaptation disorders to symptoms of PTSD, in children either living in military conflict zones or having experience related to their involvement into consequences of hostilities. Such students have a great need for targeted psychological assistance. There is still a gap in domestic studies devoted to the analysis of the impact of involvement into consequences of hostilities on minority. Also, specialists are still experiencing deficits in compact tools allowing comprehensive assessment of children current state and their need for psychological assistance. &lt;br&gt;&lt;strong&gt;Study design.&lt;/strong&gt; We studied features of the students&amp;rsquo; current state in regions highly involved into the consequences of hostilities. using specially developed screening tools designed for students of 9&amp;ndash;11 grades.&lt;br&gt;&lt;strong&gt;Participants.&lt;/strong&gt; 646 students in grades 9&amp;ndash;11 (36% male, 64% female) living in regions experiencing the impact of events related to hostilities, mainly from Lugansk People&amp;rsquo;s Republic. &lt;br&gt;&lt;strong&gt;Measurements.&lt;/strong&gt; The study is based on a questionnaire developed to assess the current state in adolescents including items assessing a) manifestations of socio-psychological and mental maladaptation in various spheres of life, b) symptoms of posttraumatic stress disorder, c) psychological (personal and social) resources for coping with stress. This part of questionnaire includes lists if features among which student must choose those which fit his/her current state on the base of multiple choice. The questionnaire also contains items assessing the subjective well-being of children in life areas mentioned above by the 10-point Likert scale. The questionnaires were presented electronically, using the AnketologBox platform. Results were analyzed using IBM SPSS 27.0. &lt;br&gt;&lt;strong&gt;Results.&lt;/strong&gt; Results were obtained regarding the prevalence and severity of signs of socio-psychological maladaptation, including PTSD symptoms, and subjective estimation of well-being and psychological resources for coping with stress in students of 9&amp;ndash;11 grades. Significant differences were found between students according to the criterion of gender: a significantly higher level of vulnerability of girls compared to boys in the psychophysiological, emotional, behavioral spheres, as well as in relationships with loved ones.&lt;br&gt;&lt;strong&gt;С&lt;/strong&gt;&lt;strong&gt;onclusions.&lt;/strong&gt; The data analysis allowed us to identify the main features of the current state of students in the regions highly involved in the consequences of hostilities: the presence of severe distress in some children in the psychophysiological, cognitive, emotional, communicative and behavioral spheres, the tendency to decrease the level of well-being in these areas with age in secondary school students, the existence of special risk groups, which include female students of 9&amp;ndash;11grades. The proposed diagnostic tool appeared to be sensitive to phenomena under study varying from psychological resources of coping with stress to signs of maladaptation in students living in territories involved into the consequences of hostilities.&lt;/p&gt;

Pediatric tuberculosis in Mexico and the COVID-19 phenomenon: Past and present.

In endemic regions, tuberculosis in children constitutes a bigger fraction of total cases as compared to those in low endemic regions, regardless of the implications, this phenomenon has been historically neglected. Pediatric tuberculosis has an insidious onset and quickly develops into disseminated disease and the young are at a special risk for dissemination. Some studies suggest that measures to contain adult tuberculosis are not enough to manage tuberculosis in children, meaning that pediatric tuberculosis needs dedicated attention. Children are harder to diagnose than adults, because collecting samples is difficult, and their bacterial yield is low. In endemic countries, such as Mexico, where contact with Mycobacterium tuberculosis is common, immunological tests are inconsistent, especially in immunocompromised children. With the disruption of Mexican healthcare services by the COVID-19 pandemic, there is an uncertainty of how the situation has evolved, current data about tuberculosis indicates a drop in the national report of cases: 15.4 per 100,000 persons in 2021, compared with pre-COVID 2019 17.7 per 100,000 persons, a small increase in mortality: 1.7 per 100,000 in 2021 compared with 2019 1.6 per 100,000, a drop in treatment success: 80.4% in 2021 compared with 85.4% in 2019, and a decrease in national vaccination rates: an estimate of 86.6% children between 1 and 2 years-old were vaccinated in 2021 compared with 97.3% reported national rate in 2018-2019. There is a need for new research on regions with high tuberculosis incidence, to clarify the current situation of pediatric tuberculosis and improve epidemiological surveillance.

Early development of infants born prematurely who were conceived through assisted reproductive technologies

ObjectiveThis study aims to determine physical and psychomotor development characteristics during the first 24 months of life in prematurely born children conceived with assistive reproductive technologies and to determine specific risk factors for deviation from typical development. Patients and methodsThe study included 308 prematurely born children (154 conceived with assistive reproductive technologies – ART group and 154 conceived naturally – NC group) hospitalized at the Institute for the Health Care of Children and Adolescents of Vojvodina in Serbia. The physical and psychomotor development was monitored during the first two years of life. ResultsBirth weight was statistically significantly higher in the NC group than in the ART group, and IUGR was more often present in the ART group than in the NC group of newborns. The mean values of body weight, length, and head circumference of children from both groups did not differ statistically significantly at 18 months. At 12 and 18 months, children from the ART group significantly more often had below-average scores on the test for assessment of psychomotor development (corrected GDQ <90) than children from the NC group, but not at 24 months. Logistic regression analysis has shown that at 12 and 18 months, multiple pregnancy is an independent risk factor for lower GDQ. ConclusionAt the age of 12 months, prematurely born children conceived with ART do not differ in physical development from prematurely born children after natural conception. At 12 and 18 months, prematurely born children conceived with ART achieve lower global developmental scores than children conceived naturally, but not at 24 months of age. Multiple pregnancies are an independent risk factor for lower achievement on the test for assessment of psychomotor development in prematurely born children.

A Comprehensive Risk Factor Exploration: Korean Nationwide Cross-Sectional Study of Sarcopenia Obesity in Young-Old Males-Investigating the Prevalence, Somatometric, Biochemical, and Behavioral Traits.

Sarcopenic obesity refers to the coexistence of sarcopenia and obesity. This study assessed the prevalence of and risk factors for sarcopenic obesity in community-dwelling older males in Korea. This cross-sectional study analyzed data from 1060 community-dwelling participants. The participants were screened for sarcopenia and obesity. This study examined various risk factors, composed of somatometric, biochemical, and behavioral traits, including age; height; weight; body mass index; waist circumference; skeletal muscle mass index; fasting glucose, triglycerides, and cholesterol levels; systolic and diastolic blood pressure; and smoking and drinking traits. The prevalence of sarcopenic obesity in men had a weighted value of 9.09% (95% CI: 7.20-11.41). The clinical risk factors included short height, as well as high weight, body mass index, waist circumference, skeletal muscle mass index, triglyceride levels, systolic blood pressure, and diastolic blood pressure. Specific prevalence and clinical risk factors for sarcopenic obesity were found among community-dwelling older men. These findings may be beneficial for primary care clinicians and healthcare professionals for identifying individuals with sarcopenic obesity and referring them for early detection and treatment.

Assessment of psychosocial risks at work in supervisors of clothing stores during the pandemic context

The main objective of this paper is to demonstrate how to carry out a structured, sustained and objective assessment of psychosocial risks at work. Several studies in the literature on this topic are presented as risk assessments, when in fact they reflect the results from worker consultation procedures and/or surveys about the psychosocial work climate. As relevant as these studies are, many are not professional risk assessments. This assessment obeys a set of assumptions that must be strictly respected and performed by duly qualified professionals, as national and European legislation determine. Using a practical case with supervisors of clothing stores evaluated during the pandemic context, it is explained and applied an approach to perform this kind of risk assessment. The data presented show the effectiveness of the methodology applied. Regarding the results obtained in the practical case mobilized, a positive psychosocial work environment, even taking into account the pandemic context, with most risk factors showing acceptable or moderate incidences. It is possible to conclude that the pandemic period, despite creating contextual constraints, was not consider a specific risk factor in these stores and the supervisors felt safe in their workplace, because there was a robust system of preventive measures implemented. However, it is important to underline that exist also dissatisfaction with working conditions in some segments of supervisors, as well as a high level of risk of professional exhaustion, interpersonal conflicts at work and interference of work with personal/family life. For this reason, intervention measures were proposed to the company.

First-In-Human Safety, Tolerability, and Pharmacokinetics of Single and Multiple Doses of AZP2006, A Synthetic Compound for the Treatment of Alzheimer's Disease and Related Diseases.

Alzheimer's disease (AD) and progressive supranuclear palsy (PSP) are major neurodegenerative conditions with tau pathology in common but distinct symptoms-AD involves cognitive decline while PSP affects balance and eye movement. Progranulin (PGRN) is a growth factor implicated in neurodegenerative diseases, including AD and PSP. AZP2006, a synthetic compound, targets tauopathies by stabilizing PGRN levels and reducing tau aggregation and neuroinflammation. Evaluate the safety, tolerability, and pharmacokinetics of AZP2006. A first-in-Human phase 1 study comprised a single ascending dose (SAD) and a multiple ascending dose study (MAD). The SAD study included 64 healthy male volunteers and tested singles oral doses of 3 to 500 mg of AZP2006 free base equivalent or placebo. In the MAD study, 24 healthy male volunteers were administered oral doses of 30, 60, and 120 mg per day of AZP2006 or placebo for 10 days. No serious adverse events were observed. Clinical, biological, and electrocardiogram findings were non-relevant. Nineteen minor adverse events resolved before study completion. The safety profile indicated no specific risks. The multiple ascending dose study was halted, and the optional dose level of 180 mg was not performed due to high levels of M2 metabolite in plasma that necessitated additional preclinical evaluation of M2. Both AZP2006 and its M2 metabolite were quickly absorbed and widely distributed in tissues. Exposure increased more than proportionally with dose. AZP2006 had a favorable safety profile and was rapidly absorbed. Elevated M2 metabolite levels necessitated further studies to clarify excretion and metabolism mechanisms.

Pain sensitivity as a state marker and predictor for adolescent non-suicidal self-injury.

The pain analgesia hypothesis suggests that reduced pain sensitivity (PS) is a specific risk factor for the engagement in non-suicidal self-injury (NSSI). Consistent with this, several studies found reduced PS in adults as well as adolescents with NSSI. Cross-sectional studies in adults with borderline personality disorder (BPD) suggest that PS may (partially) normalize after remission or reduction of BPD symptoms. The objective of the present study was to investigate the development of PS over 1 year in a sample of adolescents with NSSI and to investigate whether PS at baseline predicts longitudinal change in NSSI. N = 66 adolescents who underwent specialized treatment for NSSI disorder participated in baseline and 1-year follow-up assessments, including heat pain stimulation for the measurement of pain threshold and tolerance. Associations between PS and NSSI as well as BPD and depressive symptoms were examined using negative binomial, logistic, and linear regression analyses. We found that a decrease in pain threshold over time was associated with reduced NSSI (incident rate ratio = 2.04, p = 0.047) and that higher pain tolerance at baseline predicted lower probability for NSSI (odds ratio = 0.42, p = 0.016) 1 year later. However, the latter effect did not survive Holm correction (p = 0.059). No associations between PS and BPD or depressive symptoms were observed. Our findings suggest that pain threshold might normalize with a decrease in NSSI frequency and could thus serve as a state marker for NSSI.

Challenges and promising practices in background check systems for firearm purchases

AbstractAimThe U.S. prohibits firearm purchase among individuals with specific risk factors. These prohibitions are operationalized using background checks for firearm purchase. Despite these restrictions, prohibited persons have obtained firearms after passing background checks, sometimes with devastating effects.Materials and MethodsWe conducted a mixed‐methods, descriptive study of the records and record‐keeping practices that underpin background checks for firearm transfers. Sources included key informant interviews with individuals working in a leadership capacity with state record‐keeping systems as well as data from state surveys and administrative records. We analyzed quantitative data using descriptive statistics and qualitative data using a thematic analysis approach to code the data and identify themes. Three investigators coded each interview. We returned to all data sources to develop key findings in an iterative process.ResultsKey informants described major improvements in the collection of specific record types that were previously a “black hole” (e.g. criminal history records housed in military justice systems, and records relating to involuntary commitments for mental illness) and advances in the automation of record transfer across agencies, themes corroborated by administrative data. Key informants also identified potential causes and solutions for challenges relating to missing or incomplete information and delays in resolving ambiguous background check results. Examples include manual processes for confirming relationship status in misdemeanor crimes of domestic violence and discordant practices for processing arrest and court records that result in dispositions that cannot be entered or arrests with no disposition.ConclusionBackground checks are the backbone of many policies designed to prevent firearm harm in the United States. This study highlights actionable ways in which states could make background check practices and policies more robust.