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The recent stall in the global reduction of malaria deaths has made the development of a highly effective vaccine essential. A major challenge to developing an efficacious vaccine is the extensive diversity of Plasmodium falciparum antigens. While genetic diversity plays a major role in immune evasion and is a barrier to the development of both natural and vaccine-induced protective immunity, it has been under-prioritized in the evaluation of malaria vaccine candidates. This study uses genomic approaches to evaluate genetic diversity in next generation malaria vaccine candidate PfRh5. We used targeted deep amplicon sequencing to identify non-synonymous Single Nucleotide Polymorphisms (SNPs) in PfRh5 (Reticulocyte-Binding Protein Homologue 5) in 189 P. falciparum positive samples from Southern Senegal and identified 74 novel SNPs. We evaluated the population prevalence of these SNPs as well as the frequency in individual samples and found that only a single SNP, C203Y, was present at every site. Many SNPs were unique to the individual sampled, with over 90% of SNPs being found in just one infected individual. In addition to population prevalence, we assessed individual level SNP frequencies which revealed that some SNPs were dominant (frequency of greater than 25% in a polygenomic sample) whereas most were rare, present at 2% or less of total reads mapped to the reference at the given position. Structural modeling uncovered 3 novel SNPs occurring under epitopes bound by inhibitory monoclonal antibodies, potentially impacting immune evasion, while other SNPs were predicted to impact PfRh5 structure or interactions with the receptor or binding partners. Our data demonstrate that PfRh5 exhibits greater genetic diversity than previously described, with the caveat that most of the uncovered SNPs are at a low overall frequency in the individual and prevalence in the population. The structural studies reveal that novel SNPs could have functional implications on PfRh5 receptor binding, complex formation, or immune evasion, supporting continued efforts to validate PfRh5 as an effective malaria vaccine target and development of a PfRh5 vaccine.

Background: One of the major challenges faced by healthcare facilities in Quebec, Canada, is the shortage of nurses specializing in Infection Prevention and Control (IPC), exacerbated by the broader nursing shortage. This survey aimed to identify effective strategies for retaining IPC nurses in Montreal, Canada, amidst the ongoing staff shortages and frequent rotations. Methods: A descriptive cross-sectional survey was conducted with a convenience sample of IPC nurses in Montreal, utilizing both open- and closed-ended questions. The survey was developed following a literature review. A pilot testing was followed by an open-ended survey in 2023 targeting IPC and clinical managers to gather further perspectives. Quantitative analysis was applied to the closed-ended responses, while thematic analysis was conducted on the open-ended responses. Bivariate analysis was employed to explore relationships between variables. Results: Quantitative and qualitative analyses identified five key strategies to address the IPC nurse shortage. Respondents, including IPC nurses and managers highlighted the importance of integrating non-nursing professionals into the IPC roles. A significant concern among IPC nurses was the lack of funding for specialized training and certification. Other retention challenges included inadequate salary recognition for educational qualifications, limited opportunities for career advancement, and insufficient organizational recognition of the importance of infection control. Moreover, the work environment was deemed essential for retaining IPC professionals. Conclusions: The findings from the current study provide valuable insights for policymakers seeking to improve IPC staff retention. Addressing Quebec's nursing shortages involves integrating non-nursing professionals into IPC roles and implementing retention strategies tailored to generational needs, such as horizontal promotions linked to progressive salary scales and educational requirements. Additionally, fostering a supportive work environment with work-life and study balance, flexible scheduling, and strong organizational recognition, while cultivating a robust infection control culture, is crucial for retaining IPC staff. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has disproportionately affected some New York City (NYC) neighborhoods that primarily consist of Black, Indigenous, and Latinx residents. In comparison to the rest of NYC, these neighborhoods experienced high hospitalization and COVID-related death rates, which has been attributed to a longstanding history of structural racism and disinvestment. While stay-at-home orders were implemented to reduce the spread of COVID-19, this may have also affected access and utilization of non-COVID related healthcare services. This study aims to assess the prevalence of and reasons for the disruption of non-COVID related healthcare services during the first 18 months of the pandemic. Methods: From September 30, 2021 to November 4, 2021, the NYC Health Department administered the COVID-19 Community Recovery Survey to a subset of residents who were part of the NYC Health Panel a probability-based survey panel. This cross-sectional survey, which included closed and open-ended questions, was either self-administered online or completed via CATI (Computer Assisted Telephone Interviewing) in English, Spanish, and Simplified Chinese. Descriptive statistics were used to summarize responses and unweighted, weighted, age-adjusted percentages, and 95% Confidence Intervals (CIs) were calculated. Results: With a response rate of 30.3% (N = 1358), more than half of participants (54%) reported disruption to either routine physical healthcare or mental health services. Concern about getting COVID-19 (61%), stay-at-home policies (40%), belief that care could safely be postponed (35%), and appointment challenges (34%) were among reasons for delaying routine healthcare. Concern about getting COVID-19 (38%) and reduced hours of service (36%) were primary reasons for delaying mental healthcare. Reported reasons for the sustained delay of care past 18 months involved COVID concerns, appointment, and insurance challenges. Conclusions: Due to the pandemic, some disruption to healthcare was expected. However, most study participants either avoided or experienced a delay in healthcare. The delay of non-COVID related healthcare throughout the pandemic may result in the further widening of the health inequity gap among NYC residents dealing with a higher chronic disease burden before the start of the COVID-19 pandemic in March 2020. Findings from this study can support equitable COVID-19 recovery, and guide efforts with health promotion. [ABSTRACT FROM AUTHOR]

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Akofena is the property of Universite Felix Houphouet Boigny and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIFS: Decrire les differentes dimensions de la participation parentale dans les interventions instaurees en milieu scolaire et identifier la relation entre chacune de ces dimensions et le developpement des comportements alimentaires des enfants suite a leur exposition a un projet d'education nutritionnel mis en place dans huit ecoles primaires de milieux defavorises de Montreal, le projet Petits cuistots--Parents en reseaux (PC-PR). METHODE: Cette recherche descriptive est conduite grace a une analyse secondaire de donnees d'un echantillon de 502 parents d'enfants frequentant les ecoles qui participent au projet PC-PR. La participation parentale est conceptualisee en quatre dimensions faisant reference a la notion du mesosysteme proposee par Bronfenbrenner (1979). Les comportements alimentaires tels que rapportes par les parents incluent le fait de: parler des ateliers, demander d'acheter certains aliments, lire les etiquettes sur l'emballage des produits et aider a realiser les repas. Des analyses descriptives, bivariees et multivariees sont effectuees. RESULTATS: Les donnees recueillies aupres des parents montrent une association positive entre la participation parentale a la maison et l'ensemble des comportements alimentaires examines chez les eleves. Toutefois, l'implication parentale a l'ecole n'est correlee a aucun des comportements. CONCLUSION: Cette recherche suggere l'importance de la participation parentale dans les interventions d'education nutritionnelle en milieu scolaire. Ces resultats contribuent a l'avancement des connaissances dans le domaine et servent de premisses a une reflexion visant a mieux orienter les interventions en promotion de la sante. MOTS CLES: ecole; participation; parent; comportement; nutrition GOALS: To describe the various dimensions of parental involvement in the interventions initiated in schools and to identify the relationship between each of these dimensions and the development of children's food choices following their exposure to a nutrition-education project implemented in eight primary schools in underprivileged neighbourhoods in Montreal--the Junior Cooks--Parents Network project (Petits cuistots--Parents en reseaux (PC-PR)). METHOD: This descriptive research was conducted thanks to a secondary analysis of data from a sample of 502 parents of children attending schools that participated in the PC-PR project. Parental participation is described in four aspects, making reference to the idea of a mesosystem, suggested by Bronfenbrenner (1979). Children's eating-related behaviour, as reported by the parents, included: talking about workshops, asking to buy certain foods, reading labels on product wrapping and helping to prepare the meal. Bivariate and multivariate descriptive analyses were performed. RESULTS: The data gathered from the parents show a positive association between in-home parental involvement and overall food behaviour in the students. However, there is no association between parental involvement at school and any of the behaviours. CONCLUSION: This research suggests the importance of parental participation in nutrition education interventions in schools. The results contribute to the advancement of knowledge in the field and serve as impetus for reflection on how to better direct health promotion interventions. KEY WORDS: School; participation; parent; behaviour; nutrition, L'ecole et la famille sont deux institutions ayant des pouvoirs d'influence mutuelle sur l'enfant. Le rapprochement de ces deux milieux visant l'adoption de saines habitudes de vie constitue un moyen [...]

Background: The environment of our hospital facilities is colonised by various microorganisms. These microorganisms in general and bacteria in particular are often responsible for nosocomial infections. The occurrence of these infections is linked firstly to the lack of asepsis, secondly to the nature of the colonising bacteria and thirdly to the immune status of the patients. The objective of this study was to evaluate the composition of the bacterial flora and to determine the antibiotic resistance profile of these bacteria. Methods: We proceeded to swab the surface of the work areas (table, bench, trolley, hospital bed, door wrist, gurney, incubator, respirator, etc.). The swabs were then soaked in a culture broth (Thioglycolate Broth or BT) for 18 to 24 hours before being plated on selective media for identification; Chapman agar, EMB agar (Eosin Methylen Blue), GSN agar (Blood Agar + nalidixic acid), Sabouraud agar. Results: The isolated bacteria consisted mainly of multidrugresistant bacteria (MDR). Thus, extended-spectrum beta-lactamase-secreting bacteria represented 5.5% (8 strains) of the isolated bacteria were distributed as follows: Enterobacter spp (25%, n=4) Klebsiella pneumoniae (12.5%, n=2) and Escherichia coli (12.5%, n=2). Among the other BMR, we found Acinetobacter spp (25%, n=4), Pseudomonas aeruginosa (6.25%, n=1) and methicillin-resistant Staphylococcus aureus (18.75%, n=3). Conclusion: Nosocomial infections are nowadays one of the main causes of prolonged hospital stay. The isolated bacteria of medical interest were mainly multidrug resistant bacteria. It is therefore imperative to respect the rules of hygiene during care and to evaluate the composition of the bacterial flora of the services in order to set up a strategic plan to fight against these infections. [ABSTRACT FROM AUTHOR]

Integrase inhibitors (INIs) are a potent option for HIV treatment. Limited data exist on INI resistance in West Africa, particularly in children living with HIV/AIDS. We determined the prevalence of integrase gene polymorphisms and the frequency of naturally occurring amino acid (aa) substitutions at positions associated with INI resistance. Dried blood spot (DBS) samples were obtained from one hundred and seven (107) HIV-1-infected children aged less than 15 years old in two West African countries, Benin and Mali. All children were naïve to INI treatment, 56 were naïve to anti-retroviral therapy (ART), and 51 had received ART. Genetic sequencing of HIV integrase was successful in 75 samples. The aa changes at integrase positions associated with INI resistance were examined according to the Stanford HIV Genotypic Resistance database. The median ages were 2.6 and 10 years for ART-naïve and -treated children, respectively. The most common subtypes observed were CRF02_AG (74.7%) followed by CRF06_cpx (20%). No major INI-resistance mutations at positions 66, 92, 121, 143, 147, 148, 155, and 263 were detected. The most prevalent INI accessory resistance mutations were: L74I/M (14/75, 18.6%) followed by E157Q (8/75, 10.6%), G163E/N/T/Q (5/75, 6.6%), Q95A/H/P (2/75, 2.6%), and T97A (4/75, 5.3%). Other substitutions observed were M50I/L/P, H51E/P/S/Q, I72V, T112V, V201I, and T206S. Polymorphisms at positions which may influence the genetic barrier and/or drive the selection of specific INI-resistance pathways were detected. However, no transmitted drug resistance (TDR) to INI was detected among samples of INI-naïve patients. These findings support the use of this treatment class for children with HIV-1, particularly in West Africa. [ABSTRACT FROM AUTHOR]

• A randomized trial compared prebiotics and probiotics in multiple sclerosis. • Prebiotics and probiotics have comparable adherence rates. • Prebiotics and probiotics are both well tolerated with minor adverse events. • There was a subjective preference for prebiotics over probiotics. • Bowel control improved after six weeks of probiotics. Dietary supplements can modulate the gut microbial ecosystem and affect the immune system. This has potential implications for autoimmune diseases, including multiple sclerosis (MS). Prior studies explored tolerability, symptomatic improvement, and immunologic effects of probiotics in people with MS (pwMS), but no study has examined prebiotics in this population or compared prebiotics with probiotics. This is a randomized, open-label trial of participants with relapsing-remitting MS on B-cell depletion therapy from two MS centers. 22 participants enrolled in the original cross-over study in which probiotic (Visbiome, containing Lactobacillus, Bifidobacterium and Streptococcus species) or prebiotic (Prebiotin, containing oligofructose enriched inulin) supplementation for 6 weeks was randomized, each followed by a washout period. Due to pandemic-related interruptions and expiration of the study supply of probiotics, another 15 participants enrolled in a single-arm study to receive prebiotic supplementation for 6 weeks followed by a washout period. We assessed supplement tolerability and patient-reported outcomes (PRO) relevant to MS (disability, fatigue, mood, and bowel symptoms) before and after each supplement administration period and each washout period. We bio-archived plasma, serum, peripheral blood mononuclear cells and stool samples at each timepoint for future multi-omic assessment. Prebiotics and probiotics had comparable adherence rates and both supplements were well tolerated in pwMS. Participants on either supplement reported minor adverse events, most of which were mild and self-limited. There was a subjective preference for prebiotics over probiotics. Comparing supplement-associated changes in PRO scores from baseline to 6 weeks post-supplementation, there were significant difference between prebiotics and probiotics for the change in patient-reported global symptom burden (MSRS-R Total) and bowel control (BWCS), but only probiotics statistically improved bowel control from baseline to post-supplementation. Supplementation with either prebiotics or probiotics is reasonably well-tolerated and safe. Probiotics improved bowel control, but did not improve other PROs in a 6-week time frame. These data regarding feasibility, tolerability, adherence, and adverse events of supplements will inform future clinical trial designs to definitively compare the efficacy and safety of prebiotics and probiotics. The biological data that will be generated from this study in the future will provide mechanistic insights into the effects of these dietary supplements on MS pathophysiology. [ABSTRACT FROM AUTHOR]

Thromboelastography (TEG) can predict bleeding in pediatric patients undergoing cardiac surgery. We hypothesized that results obtained from TEG® 5000 correlate with the new point-of-care TEG®6S system and that TEG® 6S rewarming maximum amplitude (MA) is associated with surrogate endpoints for perioperative bleeding in pediatric patients who underwent complex cardiac surgery. We describe a retrospective study of pediatric (≤18 years) patients who underwent complex cardiac surgery on cardiopulmonary bypass. Citrate whole-blood samples were used to compared TEG® 5000 vs.TEG®6S and TEG®6S-FLEV (with fibrinogen measurement) vs. Clauss-fibrinogen methods. TEG®6S parameters obtained during rewarming were compared to the surrogate endpoints for perioperative bleeding using linear regression analysis. Among 100 patients, 225 TEG® 5000 vs.TEG® 6S comparisons and 54 TEG®6S-FLEV were analyzed. Good correlation was observed for all parameters comparing TEG® 5000 to TEG® 6S and TEG®6S-FLEV to the Clauss-fibrinogen method (Pearson r≥.7). Similar to rewarming TEG® 5000 MA, rewarming TEG®6S MA was the only parameter independently associated with risk for perioperative bleeding (median [interquartile range {IQR}] in bleeding vs. nonbleeding patients: 35 [29, 48] vs. 37 [32, 55]; p=.02). A platelet transfusion calculator was developed based on TEG® 6S results by determining the relationship between platelet transfusion volume (mL/kg) and percent change in MA using linear regression analysis. TEG® 6S is a good alternative point-of-care method to analyze a patient’s coagulation profile and it is comparable to TEG® 5000 in pediatric patients undergoing cardiac surgery on cardiopulmonary bypass. Lower TEG® 6S MA during rewarming is associated with increased risk for perioperative bleeding. TEG analysis during rewarming may be useful in customizing platelet transfusion therapy by reducing the risk of bleeding while minimizing excessive blood product transfusions. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the prevalence of ADHD, and related comorbidities, mortality, and type of health service use among children and young adults, using different case definitions. Methods: We conducted a population‐based retrospective cohort study between 2000 and 2018, using the Quebec Integrated Chronic Disease Surveillance System (QICDSS) database. All residents aged less than 25 years eligible for health insurance coverage were included. We compared outcomes of three indicators (morbidity, services use and mortality) according two different algorithms of ADHD definitions, to the general population. Results: The cumulative prevalence of ADHD has risen steadily over the past decade, reaching 12.6% in 2017–2018. People with ADHD have a higher prevalence of psychiatric comorbidities, make greater use of medical, mental health services, and are hospitalized more often. The comparison of prevalence between the two algorithms and the general population for the three indicators showed that the cohort having one claim was very close to that with two or more, and statistically significant higher to that of people without ADHD. Conclusion: This finding support that a single claim algorithm for ADHD can be used for case definition. More research is needed on the impact of potentially effective treatments in improving consequences of ADHD. [ABSTRACT FROM AUTHOR]

Thromboelastography (TEG) can predict bleeding in pediatric patients undergoing cardiac surgery. We hypothesized that results obtained from TEGVR 5000 correlate with the new point-of-care TEGVR 6S system and that TEGVR 6S rewarming maximum amplitude (MA) is associated with surrogate endpoints for perioperative bleeding in pediatric patients who underwent complex cardiac surgery. We describe a retrospective study of pediatric (#18 years) patients who underwent complex cardiac surgery on cardiopulmonary bypass. Citrate whole-blood samples were used to compared TEGVR 5000 vs.TEGVR 6S and TEGVR 6S-FLEV (with fibrinogen measurement) vs. Clauss-fibrinogen methods. TEGVR 6S parameters obtained during rewarming were compared to the surrogate endpoints for perioperative bleeding using linear regression analysis. Among 100 patients, 225 TEGVR 5000 vs.TEGVR 6S comparisons and 54 TEGVR 6S-FLEV were analyzed. Good correlation was observed for all parameters comparing TEGVR 5000 to TEGVR 6S and TEGVR 6S-FLEV to the Claussfibrinogen method (Pearson r $ .7). Similar to rewarming TEGVR 5000 MA, rewarming TEGVR 6S MA was the only parameter independently associated with risk for perioperative bleeding (median [interquartile range {IQR}] in bleeding vs. nonbleeding patients: 35 [29, 48] vs. 37 [32, 55]; p 5 .02). A platelet transfusion calculator was developed based on TEGVR 6S results by determining the relationship between platelet transfusion volume (mL/kg) and percent change in MA using linear regression analysis. TEGVR 6S is a good alternative point-of-care method to analyze a patient's coagulation profile and it is comparable to TEGVR 5000 in pediatric patients undergoing cardiac surgery on cardiopulmonary bypass. Lower TEGVR 6S MA during rewarming is associated with increased risk for perioperative bleeding. TEG analysis during rewarming may be useful in customizing platelet transfusion therapy by reducing the risk of bleeding while minimizing excessive blood product transfusions. [ABSTRACT FROM AUTHOR]