Targeted proteomics in a population-based study identifies serum PECAM-1 and TRIM21 as inflammation markers for periodontitis

Objectives Periodontitis (PD) can cause systematic inflammation and is associated with various metabolic processes in the body. However, robust serum markers for these relationships are still lacking. This study aims to identify novel circulating inflammation-related proteins associated with PD using targeted proteomics. Materials and methods We used population-based, cross-sectional data from 619 participants of the Polish Longitudinal University Study (Bialystok PLUS). Mean pocket probing depth (mPPD) and proportion of bleeding on probing (pBOP) served as exposure variables. Fifty-two inflammation-related proteins were measured using the Olink Target 96 Cardiovascular III and the Olink Target 96 Immune Response panels. Associations between periodontal measures and proteins were tested using covariate-adjusted linear regression models. Results At a false discovery rate of < 0.05, we identified associations of mPPD and pBOP with platelet-endothelial cell adhesion molecule-1 (PECAM-1) and tripartite motif–containing protein 21 (TRIM21). Conclusion This study revealed novel associations between PD and serum levels of PECAM-1 and TRIM21. Our results suggest that these proteins might be affected by molecular processes that take place in the inflamed periodontium. Clinical relevance Novel associations of PECAM-1 and TRIM21 with PD indicate promising serum markers for understanding the disease’s pathophysiological processes and call for further biomedical investigations

ATUAÇÃO DO ENFERMEIRO NA EDUCAÇÃO EM SAÚDE PELO PROGRAMA SAÚDE NA ESCOLA (PSE): REVISÃO INTEGRATIVA

Objective: To analyze national and international evidence on the role of nurses in health education and in the promotion of school health. Method: Descriptive study of the type Integrative Literature Review (RIL). Data were collected through PubMed, BVS and CINAHL databases. 22 articles were selected and the data were processed using the IRaMuTeQ software. The results were presented by three means: Descending Hierarchical Classification (CHD), Similitude Analysis and Word Cloud. Results: After processing, 3 classes were formed, as follows: The program allows professionals to lead and play their role by implementing education with children; The problem of Bullying in students' lives is related to their mental health; e The school is a very important resource to integrate parents, professionals and school-age children. the most used term in the studies was “school nurse” and is also the bridge for the connection with other terms. Conclusion: The role of the nurse is essential to promote health promotion and prevention through educational actions, increase the bond with the community, strengthen the primary health care (PHC) and the family health strategy (FHS), be the gateway to health services and encourage multidisciplinary care.Objetivo: Analizar la evidencia nacional e internacional sobre el papel del enfermero en la educación y promoción de la salud escolar. Método: Estudio descriptivo del tipo Revisión Integrativa de la Literatura (IRL). Los datos se recopilaron de las bases de datos PubMed, BVS y CINAHL. Se seleccionaron 22 artículos y los datos se procesaron mediante el software IRaMuTeQ. Los resultados fueron presentados por tres medios: Clasificación Jerárquica Descendente (CHD), Análisis de Similitud y Nube de Palabras. Resultados: Después del procesamiento, se formaron 3 clases, así: “El programa permite que los profesionales lideren y desempeñen su papel a través de la implementación de la educación con niños”; “El problema del bullying en la vida de los estudiantes está relacionado con su salud mental”; y “La escuela es un recurso muy importante para integrar a padres, profesionales y niños en edad escolar”. El término más utilizado en los estudios fue “enfermera escolar”, siendo puente con otros términos. Conclusión: El papel del enfermero es fundamental para la promoción y prevención de la salud a través de acciones educativas, aumentando el vínculo con la comunidad, fortaleciendo la Atención Primaria de Salud (APS) y la Estrategia de Salud de la Familia (ESF), facilitando el acceso a los servicios de salud y el estímulo de atención multidisciplinar.Analisar as evidências nacionais e internacionais sobre a atuação do enfermeiro na educação e promoção em saúde escolar. Método: Estudo descritivo do tipo Revisão Integrativa de Literatura (RIL). Os dados foram coletados nas bases de dados PubMed, BVS e CINAHL. Foram selecionados 22 artigos e os dados foram processados por meio do software IRaMuTeQ. Os resultados foram apresentados por três meios: Classificação Hierárquica Descendente (CHD), Análise de Similitude e Nuvem de Palavras. Resultados: Após o processamento obteve-se a formação de 3 classes, sendo: “O programa permite ao profissional liderar e desempenhar seu papel por meio da implementação da educação com as crianças”; “O problema do Bullying na vida do aluno está relacionado à sua saúde mental”; e “A escola é um recurso muito importante para integrar pai, profissionais e crianças em idade escolar”. O termo mais utilizado nos estudos foi “enfermeira escolar” sendo, ainda, a ponte com demais termos.  Conclusão: A atuação do enfermeiro é fundamental para a promoção e prevenção da saúde por meio de ações educativas, aumento do vínculo com a comunidade, fortalecimento da Atenção Primária à Saúde (APS) e da Estratégia Saúde da Família (ESF), facilitar o acesso aos serviços de saúde e estímulo da assistência multidisciplinar.Analisar as evidências nacionais e internacionais sobre a atuação do enfermeiro na educação e promoção em saúde escolar. Método: Estudo descritivo do tipo Revisão Integrativa de Literatura (RIL). Os dados foram coletados nas bases de dados PubMed, BVS e CINAHL. Foram selecionados 22 artigos e os dados foram processados por meio do software IRaMuTeQ. Os resultados foram apresentados por três meios: Classificação Hierárquica Descendente (CHD), Análise de Similitude e Nuvem de Palavras. Resultados: Após o processamento obteve-se a formação de 3 classes, sendo: “O programa permite ao profissional liderar e desempenhar seu papel por meio da implementação da educação com as crianças”; “O problema do Bullying na vida do aluno está relacionado à sua saúde mental”; e “A escola é um recurso muito importante para integrar pai, profissionais e crianças em idade escolar”. O termo mais utilizado nos estudos foi “enfermeira escolar” sendo, ainda, a ponte com demais termos.  Conclusão: A atuação do enfermeiro é fundamental para a promoção e prevenção da saúde por meio de ações educativas, aumento do vínculo com a comunidade, fortalecimento da Atenção Primária à Saúde (APS) e da Estratégia Saúde da Família (ESF), facilitar o acesso aos serviços de saúde e estímulo da assistência multidisciplinar

Leprosy among Patient Contacts: A Multilevel Study of Risk Factors

Leprosy is an infectious disease that can lead to physical disabilities, social stigma, and great hardship. Transmitted from person to person, it is still endemic in developing countries, like Brazil and India. Effective treatment has been available since 1960, but early diagnosis of the disease remains the most effective way to stop the transmission chain and avoid late diagnoses and subsequent disabilities. Knowledge of the risk factors for leprosy can facilitate early detection; therefore, our study aimed to investigate the factors presented by leprosy patients and their contacts, who are considered at highest risk of contracting the disease. We studied 6,158 contacts of 1,201 patients under surveillance from 1987 to 2007 in a Public Health Care Center in the City of Rio de Janeiro, Brazil. We evaluated the ways patient and contact demographics and epidemiological characteristics were associated with the detection of leprosy. Statistical analyses took into account both individual and group characteristics and their interrelationships. The main characteristics facilitating the contraction of leprosy among contacts were shown to be consanguinity and household association. Conversely, the bacillary load index of leprosy patients was the principle factor leading to disease among their contacts

microbeMASST: A Taxonomically-informed Mass Spectrometry Search Tool for Microbial Metabolomics Data

microbeMASST, a taxonomically informed mass spectrometry (MS) search tool, tackles limited microbial metabolite annotation in untargeted metabolomics experiments. Leveraging a curated database of >60,000 microbial monocultures, users can search known and unknown MS/MS spectra and link them to their respective microbial producers via MS/MS fragmentation patterns. Identification of microbe-derived metabolites and relative producers without a priori knowledge will vastly enhance the understanding of microorganisms’ role in ecology and human health

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

Multicountry research on comprehensive abortion policy implementation in Latin America: a mixed-methods study protocol

Introduction Access to comprehensive abortion care could prevent the death of between 13 865 and 38 940 women and the associated morbidity of 5 million women worldwide. There have been some important improvements in Latin America in terms of laws and policies on abortion. However, the predominant environment is still restrictive, and many women, adolescents and girls still face multiple barriers to exercise their reproductive rights. This research will systematically assess comprehensive abortion policies in five Latin American countries (Argentina, Colombia, Honduras, Mexico and Uruguay). The aim is to identify barriers, facilitators and strategies to the implementation of abortion policies, looking at four key dimensions—regulatory framework, abortion policy dynamics, abortion service delivery and health system and health outcomes indicators—to draw cross-cutting lessons learnt to improve current implementation and inform future safe abortion policy development.Methods and analysis A mixed-method design will be used in the five countries to address the four dimensions through the Availability, Accessibility, Acceptability and Quality of Care model. The data collection tools include desk reviews and semi-structured interviews with key actors. Analysis will be performed using thematic analysis and stakeholder analysis. A regional synthesis exercise will be conducted to draw lessons on barriers, facilitators and the strategies.Ethics and dissemination The project has been approved by the WHO Research Ethics Review Committee (ID: A66023) and by the local research ethics committees. Informed consent will be obtained from participants. Data will be treated with careful attention to protecting privacy and confidentiality. Findings from the study will be disseminated through a multipurpose strategy to target diverse audiences to foster the use of the study findings to inform the public debate agenda and policy implementation at national level. The strategy will include academic, advocacy and policy arenas and actors, including peer-reviewed publication and national and regional dissemination workshops