Search Results (5,855)

Background and Objectives: Persistent high-risk Human Papillomavirus (HPV) can cause cancers in the cervix, vulva, vagina, anus, penis, and oropharynx. A lack of knowledge about HPV can lead to vaccine hesitancy, which is detrimental to combating HPV-related diseases. This study aimed to assess the effectiveness of an HPV educational intervention to enhance university students’ awareness of HPV. Materials and Methods: We conducted a quasi-experimental one-group pre-test and post-test study on male and female college students from the College of Applied Medical Science and the College of Nursing in Riyadh, Saudi Arabia, at King Saud University. Data were collected from May 2023 to March 2024. The first section of the survey assessed sociodemographic factors, and the second section measured knowledge regarding HPV. Results: A total of 271 students completed the surveys, with 71 males (26.2%) and 200 females (73.8%) participating. Students aged 22 years or older had better HPV awareness. Gender significantly predicts HPV awareness, with female students being four times more likely to be aware of HPV compared to male students. After the educational intervention, significant improvements in HPV knowledge were observed in all items (p-values < 0.0001) and across all demographic groups. Misconceptions about HPV were corrected, and the overall knowledge score increased from 29.3% to 82.0%. Conclusions: Our results suggest that similar interventions could benefit other populations in the kingdom, potentially increasing vaccination rates. Full article

Multiple factors, from socioeconomic development to genetic background, can affect the regional impact of some diseases, and this has also been seen during the COVID-19 pandemic. The objective of this retrospective study was to characterize a population in the interior of Portugal regarding health status and COVID-19 epidemiology. Between October 2021 and January 2023, 1553 subjects residing in Beira Baixa, Portugal, were included. Using a self-report approach, demographic and clinical data were obtained. Blood group, blood pressure, peripheral oxygen saturation and anti-spike protein immunoglobulin concentration were also analyzed. Statistical analysis was performed using IBM SPSS Statistics. The average age of the participants was 48.95 (±14.43) years, with 64% being male and 36% being female. The most prevalent comorbidities were hypertension (19.2%), dyslipidemia (12.6%) and diabetes mellitus (6.6%). Half of the population was overweight, and more than half of the subjects had no history of tobacco consumption. Among the participants, 33% were infected with SARS-CoV-2: 70.1% had mild disease, 14.1% moderate disease and 1.4% severe disease. There was a very significant adherence to vaccination (97%). Previously infected or vaccinated people had higher anti-spike protein immunoglobulin values; this value depended on the vaccine administered (p < 0.001). Patients with autoimmune diseases and smokers had lower levels of anti-S IgG antibodies (p = 0.030 and p = 0.024, respectively). The severity of COVID-19 did not affect the concentration of anti-S IgG (p = 0.430). This study highlights the general health statuses and the impact of COVID-19 on a population in the Portuguese interior. Knowledge of the circulation and impact of the virus in this specific population can alert and assist in better interventions being conducted by health authorities. Full article

The study of dentition anomalies and pathologies in wildlife contributes, together with other indicators, to understanding the relevance of some factors on the health status of populations. This has not been properly evaluated in invasive mammals. To test the feasibility of eradication, the government of Tierra del Fuego performed the eradication of beavers (Castor canadensis) from 2016 to 2018: 1121 animals were removed and 970 examined. These beavers were examined to analyze the incidence of dentition anomalies and other dentition and cranial conditions. The beavers presented two dentition anomalies: hypodontia and hyperdontia (0.41% in both cases), and for the first time, a dentition anomaly in the upper quadrants was reported. Beavers also presented artifactual tooth loss (0.30%) and acquired tooth loss (0.61%) but with low incidence. The presence of fractured teeth (0.41%) and caries (0.31%) occurred in all age classes, also with low incidence. The third molar tooth was the most affected, showing a female bias. The 0.93% of skulls had a cranial abnormality represented as a buccal curvature. Malocclusion cases also were recorded (0.51%). The low prevalence of dentition anomalies, fractured teeth, caries, and cranial abnormalities would not compromise the lifespan of beavers. These results leave a precedent of dentition anomalies and dentition and cranial conditions in an invasive mammal. Full article

Monochamus saltuarius Gebler is a serious insect pest in Europe and East Asia regions, including Portugal, Spain, China, Japan, and Korea. It transfers the pine wood nematode Bursaphelenchus xylophilus to conifer trees, resulting in pine wilt disease (PWD). As temperature is a key factor influencing insect population dynamics, temperature-dependent models describing M. saltuarius oviposition could estimate population growth potential and evaluate outbreak risks. In this study, the longevity and fecundity of M. saltuarius females were measured under constant temperature conditions ranging from 20 to 32 °C, and temperature-dependent models were constructed. The longevity of M. saltuarius females ranged from 83.36 days to 22.92 days, with a total fecundity of 141 eggs and 52.77 eggs at 20 °C and 32 °C, respectively. To describe oviposition, we used a single-phase simulation describing oviposition as a single model and a two-phase simulation describing sexual maturation and oviposition as two separate models. These models effectively described M. saltuarius oviposition (r² > 0.96) under constant temperature conditions, with the two-phase simulation demonstrating greater accuracy overall. Such models could facilitate assessments of PWD risks. The modeling framework of this study shows potential for predicting threats from various forestry and agricultural pests. Full article

Multiple sclerosis (MS) is associated with a high prevalence of emotional disorders affecting the health-related quality of life of patients and their families. Pseudobulbar affect (PBA), also referred to as pathological laughing and crying, is an under-recognized and under-treated co-morbidity. We conducted a systematic literature review of 16 studies to determine the prevalence and clinical characteristics of PBA in patients with MS of all ages. Based on conservative figures available from 8/16 studies, the prevalence of PBA in the context of MS was found to range between 2% and 10% (median 10%), with higher percentages in the female population. Possible reasons for the observed variability in the prevalence data include heterogeneity of the diagnostic methodologies and common presence of confounding factors, such as co-morbid affective disorders. The clinical presentation was found to be comparable to that of PBA in the context of other neurological disorders, as it reflected the location of underlying lesions (especially in the brainstem) rather than the associated pathology. Clinicians should be prompted to consider PBA in the differential diagnosis of emotional disorders in the context of MS by using both clinical criteria and psychometric instruments. Further studies should be conducted to develop standardized diagnostic protocols and to optimize therapeutic approaches for the clinical management of this patient population. Full article

Over the past decades, China has been undergoing rapid economic growth, which may have significantly influenced the dietary patterns and health status of the Chinese population. Our study aimed to assess the associations of potential macronutrient trajectory patterns with chronic diseases and all-cause mortality using the latent class trajectory model (LCTM) and the longitudinal data of the China Health and Nutrition Survey obtained between 1991 and 2015. A 24-hour diet recall was used to assess the dietary intake. The Poisson regression model was employed to investigate the correlations between trajectory patterns and chronic diseases and all-cause mortality. A total of 8115 participants were included in the final analysis. We explored four and three trajectory patterns for male and female populations, respectively. We found that a decreasing very high-carbohydrate trajectory together with a U-shape protein trajectory was associated with a higher risk of diabetes in the male population (odds ratio (OR): 2.23; 95% confidence interval (CI): 1.31–3.77). A similar pattern for moderate protein intake was also associated with the risk of diabetes in the female population (OR: 1.82; 95% CI: 1.18–2.79). In addition, we show that a decreasing low-carbohydrate trajectory and an increasing high-fat trajectory were associated with a lower risk of all-cause mortality (OR: 0.76; 95% CI: 0.60–0.96) and a higher risk of obesity (OR: 1.24; 95% CI: 1.05–1.47) in males. Our results shed light on some salient nutritional problems in China, particularly the dual challenges of undernutrition and overnutrition. Full article

Adult-onset cases of idiopathic hypogonadotropic hypogonadism (IHH) are characterized by partial or normal puberty development until adolescence and by the impairment of the hypothalamic–pituitary–gonadal (HPG) axis in adulthood. WDR11 and DCC genes are known to be involved in axonal development, particularly of hypothalamic GnRH neurons, and ciliogenesis. We report a female case of adult-onset hypogonadism and cerebellar ataxia, in which we identified two gene mutations. A panel of 48 genes was set up to search for variants in the causative genes of CHH. The variants found were analyzed following the American College of Medical Genetics and Genomics (ACMG) criteria to define their pathogenicity. We identified a missense heterozygous variant in the WDR11 gene NM_018117.12:c.2306T>G (p.Met769Arg) and a mutation in a second gene DCC resulting in amino acid substitutions NM_005215.4:c.3533C>T (p.Ser1178Phe). These variants were classified as being of uncertain clinical significance. We assume that there is a link between the variants found and the impairment of the gonadotrophic and neurological phenotype of the patient. Therefore, we propose the genetic test to identify the best therapeutic approach to identify infertility in female patients with IHH; we believe it is necessary to test WDR11 and DCC genes in larger populations with the same condition to introduce it in future protocols of assessment. Full article

Background: Neonatal cerebral stroke includes a range of focal and multifocal ischemic and hemorrhagic brain lesions, occurring in about one of 3000 live births. More than 50% of children with neonatal stroke develop adverse outcomes, mainly unilateral cerebral palsy. Asymmetries in segmental movements at three months have been proven to be an early sign of CP in infants with unilateral brain damage. Recognition of additional early signs could enhance prognostic assessment and enable an early and targeted intervention. Aim: The aim of the study was to assess early signs of CP in infants with arterial cerebral stroke through the General Movements Assessment and the Motor Optimality Score—Revised (MOS-R). Method: Twenty-four infants born at term (12 females and 12 males) diagnosed with ACS, and 24 healthy infants (16 females and 8 males) were assessed. The GMs (fidgety movements) and MOS-R were assessed from videos recorded at 11–14 weeks of post-term age. Cognitive and motor outcomes were assessed at 24 months using the Griffiths III developmental quotient and Amiel-Tison neurological examination. The gross motor function classification system expanded and revised (GMFCS-E&R) was adopted to categorize CP. Results: Among infants with ACS, 21 (87.5%) developed unilateral CP. Most of them showed non-disabling CP (14 had GMFCS-E&R grade 1 [66.6%], 6 grade 2 [28.6%], and 1 grade 5 [4.8%]). Fidgety movements (FMs) were absent in 17 (70.8%), sporadic in 4 (16.7%) infants, and normal in 3 (12.5%). Segmental movement asymmetry was found in 22/24 (91.7%). According to the MOS-R, motor items (kicking, mouth movements), postural patterns (midline centered head, finger posture variability), and movement character (monotonous and stiff) were statistically different among infants with ACS and healthy infants. The MOS-R median global score was lower in the group with ACS compared to the control group (6 vs 26; p < 0.01). FMs, segmental movement asymmetry, and MOS-R global score were significantly correlated with abnormal outcome. MOS-R global scores less than or equal to 13 had 100% specificity and sensitivity in predicting GMFCS-E&R grade ≥ 2 CP in infants with ACS. Conclusions: The rate of CP was high among infants with ACS, but in most cases it showed low GMFCS-E&R grades. The study highlighted a significant correlation between MOS-R, together with absent FMs and unilateral CP in infants with ACS. Moreover, the MOS-R showed high sensitivity and specificity in the prediction of CP. Combined assessment of FMs and MOS-R could help to better identify infants at high risk of developing UCP in a population of infants with ACS. Early identification of precocious signs of unilateral CP is fundamental to providing an early individualized intervention. Full article

Healthcare workers (HCWs) are a high-risk group for hepatitis B virus (HBV) infection. Notably, about 5–10% of the general population does not respond to the HBV vaccination. In this study, we aimed to investigate DNA methylation (DNAm) in order to estimate the biological age of B cells from HCW of both sexes, either responder (R) or non-responder (NR), to HBV vaccination. We used genome-wide DNA methylation data to calculate a set of biomarkers in B cells collected from 41 Rs and 30 NRs between 22 and 62 years old. Unresponsiveness to HBV vaccination was associated with accelerated epigenetic aging (DNAmAge, AltumAge, DunedinPoAm) and was accompanied by epigenetic drift. Female non-responders had higher estimates of telomere length and lower CRP inflammation risk score when compared to responders. Overall, epigenetic differences between responders and non-responders were more evident in females than males. In this study we demonstrated that several methylation DNAm-based clocks and biomarkers are associated with an increased risk of non-response to HBV vaccination, particularly in females. Based on these results, we propose that accelerated epigenetic age could contribute to vaccine unresponsiveness. These insights may help improve the evaluation of the effectiveness of vaccination strategies, especially among HCWs and vulnerable patients. Full article

Suicidality poses a significant public health threat and stands as a leading cause of death and disability. Aside from committed suicides, a substantial portion of suicidal behaviors comprises suicide attempts and suicidal ideation. These events may be characterized by a non-fatal outcome, shedding light on the possibility of recurrence. The objectives of the present study were to assess hospitalization rate trends related to any suicidal event and to elucidate the risk factors associated with recurrent suicidal behaviors. In this population-based study, an observational descriptive analysis was conducted on all hospital discharge forms (HDRs, Italian SDO) registered for the residents of the Veneto Region from 2012 to 2021. Cases of attempted suicide (AS) and suicidal ideation (SI) were defined according to ICD coding. Age-standardized hospitalization rates were computed with the direct method. Join Point Regression was used to assess the significance of variations in trends. Factor risks for the reiteration of suicidal behaviors were assessed by multivariate logistic regression. Higher prevalence of SI occurred among individuals under 40 years of age and those affected by psychiatric disorders. Conversely, among individuals aged 60 and above, AS was more common. SI turned out to be associated with a higher likelihood of reiteration compared to AS. Individuals suffering from personality disorders and those with a history of AS as index case exhibited increased risk for the reiteration of AS. Females, younger individuals, and individuals experiencing SI as first episode were instead identified as more likely to repeat this form of suicidal behavior. Contemporary economic and environmental crises, a recent pandemic, and numerous conflicts represent significant additional menaces to mental well-being. Our analysis highlights a concerning positive trend in suicide attempts and ideations, underscoring the imperative for Public Health Systems to implement targeted preventive strategies and mental health promotion campaigns. In the absence of structured suicide registries, we demonstrated that HDRs can serve as an invaluable foundation for preventionists to address the phenomenon and strategically plan interventions. Full article

(1) Background: Functional habitual constipation (FC) in children is a common gastrointestinal problem. This study aimed to explore the local community’s view on this problem, emphasising the challenges that parents face in managing the condition and its impact on the child’s quality of life. (2) Methods: A prospective, cross-sectional, community-based study was conducted between March and July 2023. The survey received 933 responses. The target population was adults over 18 years of age living in the Eastern Province of Saudi Arabia. An electronically distributed questionnaire was designed in the Arabic language. (3) Results: The mean knowledge scores were significantly higher in females than males, with t (931) = −2.701 and p = 0.007. The Bonferroni post hoc test results indicated that participants between 20 and 29 years exhibited significantly higher levels of knowledge scores compared to those between 30 and 39 years. Furthermore, the results revealed that those with three or more children had significantly higher knowledge scores compared to those with only one child. (4) Conclusions: This study demonstrated that parents in the local community have a good perceived knowledge of FC, but it needs to be linked with practice. They tended to report high levels of perception and demonstrated better practices. These results emphasise the importance of exploring the local community’s view on constipation among children. Full article

Background/Objectives: Arthritis is a chronic, debilitating condition affecting millions of United States (US) adults. Regular physical exercise is particularly important for adults with arthritis. This study aimed to investigate the characteristics associated with regular physical exercise in US adults with arthritis. Methods: This cross-sectional database study used 2021 Medical Expenditure Panel Survey data and included US adults (age ≥ 18) alive with arthritis. A multivariable logistic regression model was developed to test the association of the following variables with regular physical exercise (defined as moderate-vigorous intensity exercise for ≥30 min ≥5 times weekly; yes, no): age, sex, Hispanic, race, census region, marriage status, schooling, employment, health insurance, household income, mental health, general health, smoking status, chronic conditions, pain, and functional limitations. Results: Overall, 5091 people (regular physical exercise n = 2331, no regular physical exercise n = 2760) were involved in this analysis. Most were female, non-Hispanic, white, married, had schooling beyond high school, were unemployed, had private health insurance, had mid-high household income, had good mental health, had good general health, were non-smokers, had two or more chronic conditions, had little/moderate pain, and did not have a functional limitation. In multivariable logistic regression analysis, male vs. female sex (odds ratio [OR] = 1.440, 95% confidence interval [CI] = 1.185–1.749), employed vs. unemployed (OR = 1.277, 95% CI = 1.005–1.624), good vs. poor general health (OR = 2.174, 95% CI = 1.673–2.824), little/moderate vs. quite a bit/extreme pain (OR = 1.418, 95% CI = 1.109–1.818), and no functional limitation (OR = 1.592, 95% CI = 1.282–1.980) were associated with higher odds of reporting regular physical exercise, while Midwest vs. West census region (OR = 0.698, 95% CI = 0.521–0.935) was associated with lower odds of reporting regular physical exercise. Conclusions: This study identified variables associated with regular physical exercise among US adults with arthritis. Further work is needed to develop interventions for characteristics that may help increase exercise and, subsequently, health outcomes in this population. Full article

Background: Cardiovascular diseases (CVDs) are associated with very high rates of re-hospitalization and mortality worldwide, so the complexity of these pathologies requires frequent access to hospital facilities. The guidelines also emphasize the importance of cardiac rehabilitation (CR) programs, which have demonstrated a favorable effect on outcomes, and cardiac telerehabilitation (CTR) could represent an innovative healthcare delivery model. The aim of our review is to study how technologies used in rehabilitation have changed over time and also to understand what types of rehabilitation programs have been used in telerehabilitation. Methods: We searched randomized controlled trials (RCTs) in three electronic databases, PubMed, Web of Science, and Scopus, from January 2015 to January 2024, using relevant keywords. Initially, 502 articles were found, and 79 duplicates were identified and eliminated with EndNote. Results: In total, 16 RCTs fulfilled the pre-defined criteria, which were analyzed in our systematic review. The results showed that after CTR, there was a significant improvement in main outcome measures, as well as in relation to technological advances. Conclusions: Moreover, compared to center-based rehabilitation, CTR can offer further advantages, with better cost-effectiveness, the breakdown of geographical barriers, and the improvement of access to treatment for the female population, which is traditionally more socially committed. Full article

Background/Objective: Autoimmune thyroid diseases (AITD) affect 2 to 5% of the general population. This study aimed to determine changes in activity of A-Tg and A-TPO antibodies before, during, and after pregnancy in women with previous AITD. Methods: This was a single-center study with a retrospective review of the medical records of 30 female patients aged 25–41 years who came to our endocrinology service in the city of Santo André, state of São Paulo, Brazil, to investigate thyroid diseases. The following data were reviewed: total triiodothyronine (totalT3), total thyroxine (totalT4), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and anti-TSH receptor antibodies (anti-TSH receptor or anti-thyrotropin receptor antibodies (TRAb), anti-thyroid peroxidase (A-TPO), and anti-thyroglobulin (A-Tg)). These data were reviewed for 30 patients before and during the three trimesters of pregnancy and during the three months after pregnancy. Results: During gestation, we observed a progressive decrease in the blood values of A-TPO and A-Tg, which reached their lowest values in the third trimester of pregnancy, but after birth, they returned to values statistically equivalent to those before pregnancy. Analyzing the three trimesters and the post-pregnancy period, A-TPO increased 192% between the first trimester and postpartum (p = 0.009); it increased 627% between the second trimester and postpartum (p < 0.001); and it increased >1000% between the third trimester and postpartum (p < 0.001). There was no significant difference in the A-TPO values between the pre- and post-gestational periods (p = 1.00), between the first and second trimesters (p = 0.080), or between the second and third trimesters (p = 0.247). Conclusions: According to the results presented here, we observed changes in the activities of A-Tg and A-TPO antibodies during and after pregnancy in women with previous AITD. In women who intend to become pregnant, are pregnant, or have given birth within three months, it is essential to monitor A-TPO, A-Tg, and thyroid function as well as serum thyroid hormones and TSH to identify thyroid dysfunction in a timely manner and adjust the treatment strategy to avoid the deleterious effects of hypothyroidism on both mother and baby during and after pregnancy. Full article

Alport syndrome (AS) is a hereditary glomerulopathy due to pathogenic variants in COL4A3, COL4A4, and COL4A5. Treatment with Renin–Angiotensin–Aldosterone System (RAAS) inhibitors can delay progression to end stage renal disease (ESRD). From 2018 until today, we performed Whole Exome Sequencing (WES) in 19 patients with AS phenotype with or without positive family history. Fourteen of these patients were children. Genetic testing was extended to family members at risk. All patients received a genetic diagnosis of AS: five X-linked AS (XLAS) males, five X-linked AS (XLAS) females, six autosomal dominant AS (ADAS), and one autosomal recessive AS (ARAS). After cascade screening four XLAS males and eight XLAS females, six ADAS and three ARAS heterozygotes were added to our initial results. Fifteen patients were eligible to start treatment with RAAS inhibitors after their diagnosis. All XLAS female patients, ARAS heterozygotes, and ADAS have been advised to be followed up, so that therapeutic intervention can begin in the presence of microalbuminuria. Genetic diagnosis of AS ensures early therapeutic intervention and appropriate follow up to delay progression to chronic kidney disease, especially in thet pediatric population. Full article