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Nevin Manimala Statistics

Improving occupational health surveillance for enteric infections

Zoonoses Public Health. 2024 Jan 9. doi: 10.1111/zph.13111. Online ahead of print.

ABSTRACT

AIMS: Enteric pathogens with a livestock reservoir pose a unique risk to people in occupations with regular contact with animals. However, public health surveillance of occupational exposures is inadequate, with surveillance for occupation typically focusing on the risk of transmission and the need for worker exclusion, rather than workplace exposures. To improve surveillance for occupational zoonoses, the Colorado Integrated Food Safety Center of Excellence convened a group of subject matter experts who developed a set of variables on occupation, industry, and exposures, which were integrated into Colorado’s surveillance system in 2017. We evaluated the quality and completeness of these new occupational fields for interviewed cases with laboratory-confirmed zoonotic infections and compared occupations to cases with a non-zoonotic infection (Shigella) and to employment data from the Bureau of Labor Statistics.

METHODS AND RESULTS: From March 2017 through December 2019, 3668 domestically acquired, laboratory-confirmed sporadic infections of Campylobacter, Cryptosporidium, Shiga toxin-producing Escherichia coli, and non-typhoidal Salmonella among individuals ≥14 years of age were interviewed by public health. We found asking explicitly about occupational exposure risks and focusing on animal exposures, improved data quality and accuracy. Of the cases who stated that they were employed, 262 (13%) reported working in an occupation with regular animal exposure, and 254 (14%) reported an industry with regular animal exposure. Cases with an animal exposure occupation were more likely to be male and live in a rural or frontier county compared to other occupations. All occupations with regular animal contact were reported at a higher frequency than among Shigella cases or the general population.

CONCLUSIONS: Public health efforts, both in occupational health and communicable disease sectors, should be made to improve surveillance for enteric zoonoses and identify opportunities for prevention strategies.

PMID:38195823 | DOI:10.1111/zph.13111

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Molar incisor hypomineralisation: Teaching and assessment across the undergraduate dental curricula in the UK

Int J Paediatr Dent. 2024 Jan 9. doi: 10.1111/ipd.13158. Online ahead of print.

ABSTRACT

BACKGROUND: No consensus exists on how molar incisor hypomineralisation (MIH) should be covered by the undergraduate dental curricula.

AIM: To assess the current teaching and assessment of MIH in the UK.

DESIGN: A piloted questionnaire regarding the teaching and assessment of MIH was disseminated to paediatric, restorative and orthodontic teaching leads in each UK dental school (n = 16). Data were analysed using descriptive statistics, chi-squared and Kruskal-Wallis tests.

RESULTS: Response rates from paediatric, restorative and orthodontic teams were 75% (n = 12), 44% (n = 7) and 54% (n = 8), respectively. Prevention of caries, preformed metal crowns, anterior resin composites and vital bleaching were taught significantly more by paediatric teams (p = .006). Quality of life and resin infiltration were absent from restorative teaching. Orthodontic teaching focussed on the timing of first permanent molar extractions. Paediatric teams were mainly responsible for assessment. Risk factors, differential diagnoses for MIH and defining clinical features were more likely to be assessed by paediatric teams than by others (p = .006). All specialities reported that students were prepared to manage MIH.

CONCLUSION: Molar incisor hypomineralisation is primarily taught and assessed by paediatric teams. No evidence of multidisciplinary or transitional teaching/assessment existed between specialities. Developing robust guidance regarding MIH learning in the UK undergraduate curricula may help improve consistency.

PMID:38195821 | DOI:10.1111/ipd.13158

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Bovine Herpes Virus Type 1 (BoHV-1) seroprevalence, risk factor and Bovine Viral Diarrhoea (BVD) co-infection analysis from Ireland

Sci Rep. 2024 Jan 9;14(1):867. doi: 10.1038/s41598-023-50433-5.

ABSTRACT

Surveillance of endemic pathogens is essential for disease control, providing an evidence base for policy and advice. Bovine Herpes Virus Type 1 (BoHV-1), the causative agent of Infectious Bovine Rhinotracheitis (IBR), has been found to have high seroprevalence within the Irish cattle population. The aim of the present study was to establish seroprevalence levels for culled cattle in Ireland aged < 30 months and to establish whether BVD exposure and other factors was associated with BoHV-1 exposure. We employed random effects logit models coupled with repeated bootstrap sampling to provide robust estimates. The final dataset contained results for 5273 animals tested over two study years, 2018 and 2020. The animal-level seroprevalence of BoHV-1 was 21.43% (1130/5273; 95%CI: 20.32-22.53%). Univariable analysis suggested that BoHV-1 seropositivity risk was associated with BVDV serodiagnosis status, age, sex, year sampled, herd type, herd-size, and metrics of movement into the herd. Final random-effects multivariable models suggested increased risk associated with increasing herd size of the last herd, movements made by animals during the previous year, and the year the animal was sampled. Despite BVDV status and sex being retained in the final model, repeated bootstrap sampling of the regression model to estimate biased-corrected 95%CI suggested that these associations were not robust. The overall apparent prevalence of BoHV-1 exposure for culled cattle in Ireland declined in 2020 relative to 2018 (from 23.32 to 17.61%). Herd-size and the movement of animals were found to be important factors associated with animal-level risk, but there was less statistical support for sex-based or BVDV status associations.

PMID:38195809 | DOI:10.1038/s41598-023-50433-5

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Physical-chemical analysis of different types of flours available in the Romanian market

Sci Rep. 2024 Jan 9;14(1):881. doi: 10.1038/s41598-023-49535-x.

ABSTRACT

The physical-chemical characteristics of different types of flours are essential for understanding their composition, nutritional value, and functional properties as well. The aim of this research was to identify the variability of the different wheat flours available in Romania. In this study 39 different wheat flours were selected and the following parameters were analyzed in the laboratory: moisture content, ash content, gluten content (wet and dry) and wet gluten spreading. The tested flours were classified into four different classes according to their ash content: 480 (ash content 0.48%) (N = 11), 550 (0.55%) (N = 9), 650 (0.65%) (N = 8), 1100 (1.1%) (N = 11). Mathematical and statistical methods were used to analyze the obtained results: descriptive statistics, box-plot, Spearman correlation and hierarchical cluster analysis. The results revealed that moisture content varied between 9.5 and 11.8%. In terms of ash content, the lowest and highest measured values were 0.427-2.04 g/100 g. The average wet gluten content of the studied flours varied between 30 and 32%, while the average dry gluten content was 12.8%. The findings indicate that the moisture content of all examined flour samples was within permissible levels for extended storage, aligning with established standards. Gluten is a key and essential parameter for bread making because influences the dough mixing and baking properties. The mineral content, represented by ash content, is influenced by cereal type and milling process, with wheat’s ash content ranging between 1.5 and 2%. Flours with high wet gluten content (> 34%) can be used to improve the properties of lower quality flours. Further studies are necessary in order to determine the possible health effects of different cereal varieties.

PMID:38195806 | DOI:10.1038/s41598-023-49535-x

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Association of Red Blood Cell and Platelet Parameters with Metabolic Syndrome: A Systematic Review and Meta-Analysis of 170,000 Patients

Horm Metab Res. 2024 Jan 9. doi: 10.1055/a-2241-5361. Online ahead of print.

ABSTRACT

This systematic review and meta-analysis aims to establish associations between metabolic syndrome (MetS) and erythrocyte and platelet markers, contributing to improved diagnostic tests for identifying individuals at risk. Observational studies and Randomized Controlled Trials (RCTs) were included. The standardized mean difference (SMD) and 95% confidence intervals (CI) of erythrocyte and platelet markers between individuals with and without MetS were used as effect size (inverse variance model). Methodological quality assessment was conducted using the Newcastle-Ottawa scale (NOS) for observational studies and the Cochrane Risk of Bias tool 2.0 for RCTs. The analysis included 51 articles. Compared to controls, individuals with MetS exhibited significantly higher concentrations of mean red blood cell count (Standardized Mean Difference [95% CI]: 0.15 [0.13 – 0.18]; p < 0.00001), hemoglobin (0.24 [0.18 – 0.31]; p < 0.00001), blood platelet count (5.49 [2.78 – 8.20]; p < 0.0001), and red blood cell distribution width (0.55 [0.05 – 1.04]; p = 0.03). Regarding mean platelet volume (0.16 [-0.03 to 0.35]; p = 0.10) and platelet-to-lymphocyte ratio (PLR) (7.48 [-2.85 – 17.81]; p = 0.16), a non-significant difference was observed in patients with MetS. There was no statistically significant difference in hematocrit counts between the two groups (0.47 [-0.40 – 1.34]; p = 0.29). Biomarkers such as mean red blood cell count, hemoglobin, blood platelet count and RDW are associated with higher levels in patients in MetS, whereas mean platelet volume and PLR tend to be lower. These markers can potentially provide new avenues for early diagnosis of MetS.

PMID:38195797 | DOI:10.1055/a-2241-5361

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Meta-Analysis and Network Analysis Differentially Detect Various Pro-Inflammatory Mediators and Risk Factors for Type 2 Diabetes in the Elderly

Horm Metab Res. 2024 Jan 9. doi: 10.1055/a-2241-5281. Online ahead of print.

ABSTRACT

Type 2 diabetes (T2D) has a pathophysiological component that includes inflammation. Inflammation-sensitive marker measurement may be helpful in determining the risk of complications for both older T2D patients and the public. This study aimed to investigate the association between blood pro-inflammatory mediators and the characteristics of elderly patients with T2D using Meta and network analyses. The Web of Science, Scopus, PubMed, and Cochrane Library databases were selected as study methodology. The Quality in Prognosis Studies (QUIPS) tool in the meta-analysis assessed the studies’ methodological quality. The selected studies were statistically analyzed using the META-MAR tool based on the standardized mean difference (SMD). The selected studies included nine examinations involving 6,399 old people [>55 years old, 65.9±4.09 (mean±SD)]. The meta-analysis showed that pro-inflammatory mediators (SMD 0.82) and patient-related variables [risk factors (SMD 0.71)] were significantly associated with T2D (p<0.05). Subgroup analysis revealed that tumor necrosis factor alpha (TNF-α; SMD 1.08), body mass index (SMD 0.64), high-density lipoprotein (HDL; SMD -0.61), body weight (SMD 0.50), and blood pressure (SMD 1.11) were factors significantly associated with T2D (p<0.05). Network analysis revealed that among patient characteristics, diastolic blood pressure and, among inflammatory mediators, leptin were the most closely associated factors with T2D in older adults. Moreover, network analysis showed that TNF-α and systolic blood pressure were most closely associated with leptin. Overall, alternate techniques, such as meta-analysis and network analysis, might identify different markers for T2D in older people. A therapeutic decision-making process needs to consider these differences in advance.

PMID:38195796 | DOI:10.1055/a-2241-5281

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Short-time AOIs-based representative scanpath identification and scanpath aggregation

Behav Res Methods. 2024 Jan 9. doi: 10.3758/s13428-023-02332-w. Online ahead of print.

ABSTRACT

A new algorithm to identify a representative scanpath in a sample is presented and evaluated with eye-tracking data. According to Gestalt theory, each fixation of the scanpath should be on an area of interest (AOI) of the stimuli. As with existing methods, we first identify the AOIs and then extract the fixations of the representative scanpath from the AOIs. In contrast to existing methods, we propose a new concept of short-time AOI and extract the fixations of representative scanpath from the short-time AOIs. Our method outperforms the existing methods on two publicly available datasets. Our method can be applied to arbitrary visual stimuli, including static stimuli without natural segmentation, as well as dynamic stimuli. Our method also provides a solution for issues caused by the selection of scanpath similarity.

PMID:38195788 | DOI:10.3758/s13428-023-02332-w

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East Asian and Southern European craniofacial class III phenotype: two sides of the same coin?

Clin Oral Investig. 2024 Jan 9;28(1):84. doi: 10.1007/s00784-023-05386-4.

ABSTRACT

OBJECTIVES: The skeletal class III phenotype is a heterogeneous condition in populations of different ethnicities. This study aimed to analyse the joint and ethnicity-specific clustering of morphological features in skeletal class III patients of Asian and European origins.

MATERIALS AND METHODS: This cross-sectional study involved South Korean and Spanish participants who fulfilled the cephalometric, clinical, and ethnic-related selection criteria. Radiographic records were standardised, calibrated, and measured. A total of 54 skeletal variables were selected for varimax factorial analysis (VFA). Subsequently, a cluster analysis (CA) was performed (mixed method: k-means and hierarchical clustering). Method error and precision were assessed using ICC, Student’s t-test, and the Dahlberg formula.

RESULTS: A total of 285 Korean and Spanish participants with skeletal class III malocclusions were analysed. After performing VFA and CA, the joint sample revealed three global clusters, and ethnicity-specific analysis revealed four Korean and five Spanish clusters. Cluster_1_global was predominantly Spanish (79.2%) and male (83.01%) and was characterised by a predominantly mesobrachycephalic pattern and a larger cranial base, maxilla, and mandible. Cluster_2_global and Cluster_3_global were mainly South Korean (73.9% and 75.6%, respectively) and depicted opposite phenotypes of mandibular projection and craniofacial pattern.

CONCLUSIONS: A distinct distribution of Spanish and South Korean participants was observed in the global analysis. Interethnic and interethnic differences were observed, primarily in the cranial base and maxilla size, mandible projection, and craniofacial pattern.

CLINICAL RELEVANCE: Accurate phenotyping, reflecting the complexity of skeletal class III phenotype across diverse populations, is critical for improving diagnostic predictability and future personalised treatment protocols.

PMID:38195777 | DOI:10.1007/s00784-023-05386-4

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Global Seroprevalence of Toxocara spp. in Children: A Systematic Review and Meta-analysis

Acta Parasitol. 2024 Jan 9. doi: 10.1007/s11686-023-00772-0. Online ahead of print.

ABSTRACT

BACKGROUND: In the present study, we performed a systematic review and meta-analysis to assess the global and regional seroprevalence of Toxocara spp. and associated risk factors among children.

METHODS: The present systematic review and meta-analysis was followed based on the Preferred Reporting. Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. We searched the online databases (PubMed, Scopus, and Web of Science) and Google Scholar search engine for studies that measured seroprevalence of Toxocara spp. among children, published between 1 January 2000 and 15 January 2022. Accordingly, the pooled seroprevalence and 95% confidence intervals (CI) were estimated using a random-effects meta-analysis model.

RESULTS: A total of 65 articles from 22 countries met the inclusion criteria. The global seroprevalence of Toxocara spp. infection among children was estimated as 25% (95% CI 22-29). Meta-regression analysis showed that the type of population studied (p = 0.002) and year of publication (p = 0.044) it may be the source of heterogeneity. The highest and lowest pooled seroprevalence of Toxocara spp. infection were estimated in Thailand and Colombia as 58.2% (95% CI 50.9-65.5) and 7.04% (95% CI 3.05-11.3), respectively. Male gender was associated with a higher risk of Toxocara spp. compared to females, and this association was statistically significant (OR = 1.24; 95% CI 1.09-1.41, p = 0.001). However, residing in rural areas did not show a statistically significant increase in risk compared to living in urban areas (OR = 1.39; 95% CI 0.88-2.21, p = 0.143).

CONCLUSION: Toxocariasis is common among children, hence, prevention and control scheme of this helminth in children should be considered by health officials and health policymakers, especially in developing countries, where seroprevalence is highest.

PMID:38195773 | DOI:10.1007/s11686-023-00772-0

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Metabolic imaging of human embryos is predictive of ploidy status but is not associated with clinical pregnancy outcomes: a pilot trial

Hum Reprod. 2024 Jan 9:dead268. doi: 10.1093/humrep/dead268. Online ahead of print.

ABSTRACT

STUDY QUESTION: Does fluorescence lifetime imaging microscopy (FLIM)-based metabolic imaging assessment of human blastocysts prior to frozen transfer correlate with pregnancy outcomes?

SUMMARY ANSWER: FLIM failed to distinguish consistent patterns in mitochondrial metabolism between blastocysts leading to pregnancy compared to those that did not.

WHAT IS KNOWN ALREADY: FLIM measurements provide quantitative information on NAD(P)H and flavin adenine dinucleotide (FAD+) concentrations. The metabolism of embryos has long been linked to their viability, suggesting the potential utility of metabolic measurements to aid in selection.

STUDY DESIGN, SIZE, DURATION: This was a pilot trial enrolling 121 IVF couples who consented to have their frozen blastocyst measured using non-invasive metabolic imaging. After being warmed, 105 couples’ good-quality blastocysts underwent a 6-min scan in a controlled temperature and gas environment. FLIM-assessed blastocysts were then transferred without any intervention in management.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Eight metabolic parameters were obtained from each blastocyst (4 for NAD(P)H and 4 for FAD): short and long fluorescence lifetime, fluorescence intensity, and fraction of the molecule engaged with enzyme. The redox ratio (intensity of NAD(P)H)/(intensity of FAD) was also calculated. FLIM data were combined with known metadata and analyzed to quantify the ability of metabolic imaging to differentiate embryos that resulted in pregnancy from embryos that did not. De-identified discarded aneuploid human embryos (n = 158) were also measured to quantify correlations with ploidy status and other factors. Statistical comparisons were performed using logistic regression and receiver operating characteristic (ROC) curves with 5-fold cross-validation averaged over 100 repeats with random sampling. AUC values were used to quantify the ability to distinguish between classes.

MAIN RESULTS AND THE ROLE OF CHANCE: No metabolic imaging parameters showed significant differences between good-quality blastocysts resulting in pregnancy versus those that did not. A logistic regression using metabolic data and metadata produced an ROC AUC of 0.58. In contrast, robust AUCs were obtained when classifying other factors such as comparison of Day 5 (n = 64) versus Day 6 (n = 41) blastocysts (AUC = 0.78), inner cell mass versus trophectoderm (n = 105: AUC = 0.88) and aneuploid (n = 158) versus euploid and positive pregnancy embryos (n = 108) (AUC = 0.82).

LIMITATIONS, REASONS FOR CAUTION: The study protocol did not select which embryo to transfer and the cohort of 105 included blastocysts were all high quality. The study was also limited in number of participants and study sites. Increased power and performing the trial in more sites may have provided a stronger conclusion regarding the merits of the use of FLIM clinically.

WIDER IMPLICATIONS OF THE FINDINGS: FLIM failed to distinguish consistent patterns in mitochondrial metabolism between good-quality blastocysts leading to pregnancy compared to those that did not. Blastocyst ploidy status was, however, highly distinguishable. In addition, embryo regions and embryo day were consistently revealed by FLIM. While metabolic imaging detects mitochondrial metabolic features in human blastocysts, this pilot trial indicates it does not have the potential to serve as an effective embryo viability detection tool. This may be because mitochondrial metabolism plays an alternative role post-implantation.

STUDY FUNDING/COMPETING INTEREST(S): This study was sponsored by Optiva Fertility, Inc. Boston IVF contributed to the clinical site and services. Becker Hickl, GmbH, provided the FLIM system on loan. T.S. was the founder and held stock in Optiva Fertility, Inc., and D.S. and E.S. had options with Optiva Fertility, Inc., during this study.

TRIAL REGISTRATION NUMBER: The study was approved by WCG Connexus IRB (Study Number 1298156).

PMID:38195766 | DOI:10.1093/humrep/dead268