Browse Articles

Long-term mortality and MACE outcomes of yoga-based cardiac rehabilitation in patients with CABG: a 15-year legacy study of a randomized controlled trial

Author Correction: Study of nitrate levels in fruits and vegetables to assess the potential health risks in Bangladesh

Publisher Correction: Production of abiotic or biogenic hydrocarbons on rock particles in the presence of H2O and carbon compounds

Finite element modeling of asymmetric expansion using ATOZTM expander

Asymmetric dentoskeletal expansion is one of the common complications associated with rapid palatal expansion (RPE), often leading to functional and aesthetic concerns. This study investigates the biomechanical performance of ATOZ™ expander using finite element method, with a focus on addressing asymmetrical expansion through expander design modifications. A 3D skull model incorporating teeth and sutures were reconstructed, and two scenarios were analyzed. Model I featured symmetrical suture maturation (stage B), and Model II with asymmetrical suture maturation, particularly more mature zygomatic sutures on the right side (Stage C). Five expander configurations were evaluated in each model. A 0.3 mm total displacement (0.15 mm per side) was applied parallel to the midpalatal suture. Results showed that in Model I, configurations 1, 2, and 3 resulted in relatively symmetrical expansion, while configurations 4 and 5 introduced asymmetry. In Model II, all configurations except configuration 4 demonstrated significant asymmetrical expansion toward the less mature left side. Configuration 4, which included one-sided dental support on the left, was found to redistribute forces and minimize asymmetry. The number of micro-implants had minimal impact on expansion outcomes, while dental support substantially influenced force distribution. These findings suggest that the ATOZ™ expander, especially when configured with one-sided dental support, offers a non-surgical solution to compensate for asymmetrical sutural resistance. This approach may improve clinical outcomes in patients exhibiting unilateral suture maturity and could help reduce the need for surgical intervention such as SARPE.

Phylogeny, phylogeography, and conservation of a rediscovered gecko from the Galápagos Islands

The rediscovery of species in iconic conservation sites like the Galápagos is eye-catching and can lead to quick and effective conservation actions. With 11 species occurring on most islands, Galápagos leaf-toed geckos (Phyllodactylus) are among the least known terrestrial vertebrates of the archipelago. Strikingly, reliable records of Phyllodactylus from Rábida Island prior to this study are limited to Holocene subfossils and a single photograph from 2012. Here we report the first vouchered specimens of Phyllodactylus from Rábida and present their phylogenetic and phylogeographic affinities with other gecko populations in the archipelago. Despite taxonomic uncertainty, we recognize Rábida gecko populations as a separate ESU within P. maresi, which also occurs in nearby islands (Santiago, Bartolomé, Mares), as well as in Marchena. Finally, we suggest that Rábida gecko populations benefited from the eradication of invasive rodents, which facilitated their rediscovery and the collection efforts reported here.

The dichotomous impacts of Semaphorin3E deficiency on exacerbating airway hyperresponsiveness, remodelling, and inflammation in type-2 low and type-2 high asthma models

Semaphorin3E has shown promise in alleviating the severity of asthma in preclinical studies; however, its role in the chronic features of type 2-low asthma remains unclear. Therefore, we aimed to investigate the role of Sema3E in a mouse model of severe asthma that exhibits a mix of granulocytic inflammation with neutrophils dominance and compared the results with those from the type-2 high eosinophilic asthma model. Sema3E knockout (KO) and wild-type (WT) mice were subjected to type-2 low and type-2 high regimens using house dust mite (HDM) combined with cyclic-di-GMP or HDM alone, respectively. Airway hyperresponsiveness parameters were measured using the FlexiVent ventilator. Bronchoalveolar lavage fluid cell phenotyping was performed by flowcytometry. Additionally, cytokines and antibodies were quantified using Mesoscale and ELISA. Mucus overproduction and goblet cell hyperplasia were visualized by Periodic-acid–Schiff staining. In comparison to WT mice, Sema3E KO mice exhibited an enhanced tissue resistance and tissue elastance in the type 2-low asthma model. Concurrently, Sema3E KO mice that were subjected to the type-2 low asthma model demonstrated an elevated presence of pulmonary neutrophils, dendritic cells, CD4 T cells, as well as increased levels of IL-17, TNF, IL-1β, CXCL-8, and MCP-1/CCL2 in comparison to their WT counterparts. However, in the type-2 high model, Sema3E KO mice exhibited a significant increase in goblet cell numbers and mucus overproduction, as well as enhancements in the number of eosinophils, IgE-producing B cells, and IL-4 levels compared to WT mice, highlighting the homeostatic role of Sema3E in the distinct immune niche of type-2 low and type-2 high asthma. Overall, our data showed that Sema3E is critical in modulating AHR, airway inflammation, and tissue remodelling in type 2 low and type 2 high phenotypes of asthma. The Sema3E regulatory network varies depending on the immunization regimen, affecting distinct parameters in type-2 low and type-2 high asthma models.

A method for feature division of Soccer Foul actions based on salience image semantics

The purpose of this study is to realize the automatic identification and classification of fouls in football matches and improve the overall identification accuracy. Therefore, a Deep Learning-Based Saliency Prediction Model (DLSPM) is proposed. DLSPM combines the improved DeepPlaBV 3+architecture for salient region detection, Graph Convolutional Networks (GCN) for feature extraction and Deep Neural Network (DNN) for classification. By automatically identifying the key action areas in the image, the model reduces the dependence on traditional image processing technology and manual feature extraction, and improves the accuracy and robustness of foul behavior identification. The experimental results show that DLSPM performs significantly better than the existing methods on multiple video motion recognition data sets, especially when dealing with complex scenes and dynamic changes. The research results not only provide a new perspective and method for the field of video motion recognition, but also lay a foundation for the application in intelligent monitoring and human-computer interaction.

Comparative association between NAFLD and MAFLD with cardiovascular events and mortality: Evidence from observational studies

Background Nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD) are increasingly recognized as multisystemic conditions with significant extrahepatic manifestations. Although both diseases have been linked to cardiovascular events and mortality, the strength of these associations remains controversial. This review aims to compare the risks of cardiovascular disease (CVD) events in individuals with NAFLD and MAFLD. Methods The PubMed, Embase, and Cochrane Library databases were searched to identify studies investigating the risk of CVD, CVD death, and all-cause death associated with NAFLD and MAFLD through April 28th, 2024. Data extraction and study quality assessment were performed using the Newcastle-Ottawa Scale. Statistical analysis utilized random-effects models. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Results Eleven cohort studies with 11,995,994 patients were included. Both NAFLD and MAFLD were associated with an increased risk of cardiovascular events (NAFLD group vs. non-NAFLD group: HR = 1.30, 95% confidence interval (CI): 1.13–1.49, I2 = 91%; MAFLD group vs. non-MAFLD group: HR = 1.54, 95% CI: 1.32–1.81, I2 = 92%) and all-cause death (NAFLD group vs. non-NAFLD group: HR = 1.18, 95% CI: 1.04–1.33, I2 = 55%; MAFLD group vs. non-MAFLD group: HR = 1.30, 95% CI: 1.20–1.40, I2 = 0%). The MAFLD-only group had a stronger association with cardiovascular death than the NAFLD-only group (MAFLD-only group vs neither MAFLD nor NAFLD group: HR = 1.46, 95% CI: 1.40–1.51, I2 = 0%; NAFLD-only group vs neither MAFLD nor NAFLD group: HR = 1.10, 95% CI: 0.95–1.28, I2 = 0%, P for interaction < 0.01). The GRADE assessment revealed low certainty for cardiovascular disease (CVD) (NAFLD only group vs. neither NAFLD nor MAFLD group), cardiovascular death (NAFLD only group vs. neither NAFLD nor MAFLD group), and all-cause death (MAFLD group vs non-MAFLD group), and very low certainty for other results. Conclusion MAFLD and NAFLD are both associated with cardiovascular events and all-cause mortality. However, the odds of cardiovascular death seems to be greater in patients with MAFLD than in those with NAFLD, suggesting that the use of MAFLD criteria may identify more at-risk individuals. PROSPERO registration CD42022361164.

A two-stage random-effects estimator for meta-analyses of the value per statistical life

We developed and examined the performance of a two-stage random-effects meta-analysis estimator for synthesizing published estimates of the value per statistical life (VSL). The meta-estimation approach accommodates unbalanced panels with one or multiple observations from each independent group of primary estimates, and distinguishes between sampling and non-sampling sources of error, both within and between groups. We used Monte Carlo simulation experiments to test the performance of the meta-estimator on constructed datasets. Simulation results indicate that, when applied to datasets of modest size, the approach performs best when the within-group non-sampling error variances are assumed to be homogeneous among groups. This allows for two levels of non-sampling errors while preserving degrees of freedom and therefore increasing statistical efficiency. Simulation results also show that the estimator compares favorably to several other commonly used meta-analysis estimators, including other two-stage estimators. As a demonstration, we applied the approach to a pre-existing meta-dataset including 113 VSL estimates assembled from 10 revealed preference and 9 stated preference studies conducted in the U.S. and published between 1999 and 2019.

Severity, mortality, long COVID-19, and quality of life: Insights from a cohort study of hospitalized COVID-19 patients during the delta variant predominance period in Thailand

Background The COVID-19 pandemic, declared in March 2020, has had significant global impacts, with Thailand reporting over 4.6 million cases and 32,000 fatalities by September 2022. Long COVID, or Post-COVID Conditions (PCC), affects 10–30% of COVID-19 patients globally, with symptoms lasting beyond three months. Common issues include fatigue, brain fog, respiratory problems, and psychological effects such as anxiety and depression. Symptoms can persist regardless of the initial infection severity, and ongoing research continues to refine understanding and management strategies. To address residual symptoms of COVID-19 during the Delta variant predominance period, a study was conducted from July to December 2021 at a tertiary care hospital in Chiang Mai, Thailand. The study aimed to describe the characteristics of COVID-19 patients, explore the Long COVID symptoms experienced by patients after discharge, and assess their quality of life. Methods The study characterized 604 are moderate to severe COVID-19 patients at Tertiary Care Hospital during the Delta wave in Thailand (July-December 2021), using secondary data from medical records. Confirmed cases were cohort monitored using a Long COVID questionnaire for symptoms, chronic conditions, and social impact a year after discharge. Quality of life was evaluated using the SF-12 questionnaire (SF-12: 12-Item Short Form Survey). Long COVID, in this study, is defined as the persistence or emergence of one or more physical, psychological, or cognitive symptoms that last for more than 12 weeks after the initial onset of COVID-19 and cannot be explained by alternative diagnoses. This includes, but is not limited to, symptoms such as fatigue, dyspnea, chest pain, cough, cognitive dysfunction (“brain fog”), insomnia, anxiety, or depression. Findings Most patients were Thai (85.9%) and female (57.3%), with obesity common among those aged 18–60 (48.3%). Severe cases and mortality were higher in patients over 60 (30.2%) and unvaccinated patients (60.4%). Severity was related with male gender, older age, lack of antiviral use, and being unvaccinated; overweight status, comorbidities, and abnormal chest x-rays were not significant. Deaths were influenced by gender, age, and antiviral use, but not hospital stay duration, overweight status, comorbidities, or vaccination status. At one-year follow-up, Long COVID symptoms were reported in a small proportion of patients (4.2% shortness of breath, 1.5% chronic cough), mostly in adults and older adults. Other symptoms were rare (<1%) and limited to the 18–60 age group. No severe neurological or systemic symptoms were reported. One-year post-hospitalization, 79.15% had no Long COVID symptoms. Quality of life scores were high (Physical Component Summary: PCS = 48.62, Mental Component Summary: MCS = 50.65). Interpretation This study found a very low prevalence of Long COVID symptoms, which may be due to the severity of the Delta variant leading to higher mortality among patients with severe illness. Those who survived and recovered mostly had moderate symptoms and were predominantly under 60 years of age, which may explain the lower occurrence of Long COVID in this group. The majority of COVID-19 patients in Chiang Mai experienced moderate symptoms and had a high survival rate. Despite varied long COVID symptoms, most reported good physical and mental health one year after recovery. These findings highlight the resilience of patients and the importance of monitoring long-term health outcomes.

Health care pathways described by care-seekers following a call to the emergency medical communication center—A Swedish perspective

Introduction A call to an emergency number is often the first course of action among care-seekers seeking emergency care. The emergency medical communication centre assesses the call and dispatches resources to meet the care-seekers’ care needs. Knowledge concerning specific healthcare pathways is sparse and does not include the care-seeker perspective. Therefore, the aim of this study was to explore care-seekers’ experiences of healthcare pathways following a call to the national emergency number. Methods The study was an explorative cross-sectional study using data from telephone interviews with callers to the Swedish national emergency number. Study informants (n = 141) provided descriptions of incidents (n = 156) that led up to the call, as well as their experiences following a healthcare pathway. Data analysis included mapping healthcare pathways, descriptive statistics, and gathering descriptions of care-seeker experiences. Results and conclusions This study shows the multiple healthcare pathways for care-seekers following a call to the national emergency number. The accessibility and availability of the healthcare system are found to be difficult to grasp among care-seekers. Decisions on which pathway to follow are primarily made by healthcare professionals rather than the care-seekers, which supports the notion that the system is not being designed from the care-seekers’ perspective. Expressions of increased vulnerability, being unsafe and feeling lost were common among the care-seekers, regardless of which pathway was followed. The findings of this study could be used as an incentive for healthcare providers to develop a healthcare system based on the found novel knowledge of the care-seekers’ perspective.

Assessment of positive psychological functioning among Chinese university students: Revision and psychometric properties of a psychological capital scale

Psychological capital serves as a psychological asset facilitating personal growth and enhanced performance. It aids individuals in navigating life’s myriad challenges and adversities, promoting psychological well-being and adaptability. Despite the widely recognized importance of psychological capital in enhancing competitiveness and work performance, existing assessment tools, such as the PCQ-24 developed by Luthans et al. (2007), have not been adequately validated in the Chinese university student population. To explore the factor structure of the Psychological Capital Questionnaire (PCQ-24) developed by Luthans et al., the researchers employed Principal Component Analysis (PCA) and Exploratory Factor Analysis (EFA), extracting factors with eigenvalues greater than 1. The results revealed a six-factor structure, which is inconsistent with the original four-factor structure of the PCQ-24 measurement tool. Therefore, Luthans’ psychological capital scale is not suitable for university students. Additionally, the indigenous scale developed by Chinese researchers Ke Jianglin et al (2009) is more suitable for organizational employees rather than university students. Hence, it is essential to revise and validate a psychological capital measurement tool appropriate for Chinese university students. To fill this gap, the researchers aimed to revise and validate a psychological capital scale suitable for Chinese university students based on the four structural dimensions proposed by Luthans et al. In this study, a large-scale survey of Chinese university students (N = 2780) was conducted, and SPSS 26.0 and AMOS 24.0 were used to statistically analyze the data and assess the psychometric properties of the Revised Mental Capital Scale. The results indicate that the revised psychological capital scale meets the psychometric requirements. The study concluded that the psychological capital scale revised and validated by the researcher can be used as an instrument to measure and assess the psychological capital of university students.

Western corn rootworm adult activity and immigrant resistance to Bt traits in first-year maize

The western corn rootworm (WCR) Diabrotica virgifera virgifera LeConte is an important insect pest of maize (Zea mays L.) in the midwestern United States of America (USA) and has evolved resistance to maize hybrids producing toxins from the bacterium Bacillus thuringiensis Berliner (Bt). This study was conducted in a landscape with a high proportion of continuous maize (maize planted ≥ two consecutive years) during 2021–2022 in northeast Nebraska, USA to increase our understanding of adult WCR activity in first-year maize and the introduction of Bt resistance by WCR immigrants. Pherocon AM unbaited sticky traps were placed at ear height in first-year maize fields and replaced weekly during adult WCR activity periods to determine density and gender of captured adults. Maize and WCR phenological interactions plus gender-specific behaviors appeared to be key determinants of WCR activity in first-year maize. Comparison of adult emergence and root injury in first- and second-year maize fields confirmed that crop rotation reduces a WCR population to near-zero. Field collections of adults were made from first-year and some adjacent continuous maize fields to estimate Bt susceptibility with Bt bioassays of F1 progeny. Similar resistance levels were observed in WCR collections from first-year and many adjacent continuous maize fields. Aggregate study results suggest adjacent maize fields were a major contributor of WCR immigrants. Significant variation in WCR immigration/ colonization and associated Bt resistance levels were observed in first-year maize, so scouting of first-year maize fields is recommended to match appropriate WCR management approaches to relative risk of injury in second-year maize.

Damage-softening constitutive model of palm fiber reinforced concrete based on weibull distribution and its correction method

Based on the Weibull random distribution of the micro-unit strength of fiber reinforced concrete, the parameters are introduced to describe the micro-unit strength of concrete reasonably, and it is used to establish a damage-softening constitutive model that can reflect the whole process of fiber reinforced concrete damage with the Drucker-Prager yield criterion. On this basis, according to the stress-strain curves of concrete with different palm fiber content and cement content, the functional relationship is discussed among the parameters with palm fiber content and cement content of concrete damage-softening model based on Weibull distribution, then a more realistic concrete damage- softening constitutive model is established with the modified model parameters. To consider the dynamic characteristics of micro-elements in palm fiber concrete during loading-unloading, a modified linear regression model parameter solving method is proposed. By comparing the experimental results with the calculated values, the rationality of the constitutive model and the parameter solution method is verified. The constitutive model proposed in this paper can well reflect the stress-strain relationship and damage evolution process of plam fiber reinforced concrete under different mix ratios, which can provide reference for the engineering application of brown fiber concrete.

Adaptive weighted dual MAML: Proposing a novel method for the automated diagnosis of partial sleep deprivation

Introduction Sleep disorders significantly disrupt normal sleep patterns and pose serious health risks. Traditional diagnostic methods, such as questionnaires and polysomnography, often require extensive time and are susceptible to errors. This highlights the need for automated detection systems to enhance diagnostic efficiency. This study proposes a novel method for the automated diagnosis of partial sleep deprivation utilizing electroencephalogram (EEG) signals. Materials and methods We utilized time-frequency images obtained from continuous wavelet transforms applied to two EEG channels for the automated diagnosis of sleep disorders. Although convolutional neural networks (CNNs) are commonly used for detecting these conditions, their performance is inadequate when applied to our heterogeneous and limited-scale EEG data. To overcome these limitations, we developed a Few-Shot Learning-based Model-Agnostic Meta-Learning (FSL-based MAML) approach aimed at improving classification accuracy and generalization abilities. Our method, Adaptive Weighted Dual MAML, combines two base models—a ResNet and a CNN-Transformer—within the MAML framework, which leverages multi-shot tasks to improve the EEG signal classification, Results Our findings demonstrated that the FSL-based MAML method, with a combined base model, achieves an average classification accuracy of 99% and an F1 score of 99%. Additionally, the proposed model achieved a more stable range of evaluation metrics, resulting in reduced performance fluctuations across tasks compared to the conventional MAML. This indicates stronger robustness and improved generalization to unseen tasks, Conclusions The results confirm the efficacy of our proposed approach as a robust solution for diagnosing partial sleep deprivation with enhanced accuracy and efficiency in an automated manner. This model provides a groundwork for addressing various sleep disorders through advanced EEG analysis techniques.

Spirituality, loneliness and mental health in Blackfeet American Indian adults

Prior work documents a relationship between spirituality and mental health in American Indians. Separately, a robust literature links loneliness to indices of mental health. The current study is grounded in Community Based Participatory Research methods and investigates the relationship between spirituality, loneliness and indices of mental health. In a sample of 276 Blackfeet American Indian adults, a linear regression controlling for age, gender, education and marital status showed that higher levels of spirituality predicted lower levels of loneliness (β = −.31, t(266)=−5.34, p < .001, r2 change = .10). and lower levels of symptoms of depression= (β = −.24, t(267)=−4.02, p < .001, r2 change = .06) and anxiety (β = −.33, t(267)=−5.94, p < .001, r2 change = .11). Further analyses showed that higher levels of spirituality were linked to fewer symptoms of depression in part through lower levels of loneliness indirect effect (standard error, SE)= −.42 (.11), 95% CI= [−.65,-.23]. Similarly, higher levels of spirituality were linked to fewer symptoms of anxiety in part through lower levels of loneliness (indirect effect (SE)=−.46 (.12), 95% CI= [=−.70, −.26]. The findings offer preliminary evidence to support the notion that spirituality may confer benefits for mental health in part by decreasing loneliness for Blackfeet American Indian adults. Future work should investigate the social and behavioral pathways through which spirituality is linked to loneliness and mental health in this community.

Progress towards the 95–95–95 targets to end HIV by 2030 in Lebanon, 2023

Background Lebanon faces an HIV epidemic concentrated in key populations. The national AIDS programme [NAP] hosted by WHO since 1989 achieved substantial progress towards the 95-95-95 UNAIDS targets. In 2023, we reviewed the programme to guide its planned transition back into the structure of the Ministry of Health [MOH]. Methods In 2023, we reviewed programme documents, epidemiological information and interviewed relevant stakeholders. We compiled national data along with WHO and UNAIDS estimates to describe the evolution of programme and epidemiological indicators, along with the result chain of input, process, output, outcome and impact. Results Domestic funding for the NAP increased from 73% in 2007 to 97% in 2018, before a drop in 2019 because of the financial crisis, when the NAP became dependent on international funding, including the Global Fund (commodities and services) and WHO (human resources). NAP core functions were governance, capacity building, monitoring and evaluation, anti-retro viral treatment [ART] dispensing and follow up for persons living with HIV [PLHIV] with some involvement in procurement, supply chain and laboratory testing. The NAP provided prevention, diagnosis and treatment services through Civil Society Organizations [CSOs]. In 2022, in Lebanon, 86% of PLHIV were diagnosed, among which 93% were on treatment and 95% virally suppressed. In 2022, NAP reported 232 new HIV infections, a 41% increase since 2010 and a 25% decrease in AIDS-related deaths during the same period. The estimated HIV incidence increased 4.4 times among MSM from 2008 to 2019, remained zero among commercial sex workers, and evolved from 0 to 0.11 per 1,000 to 0.9 per 1,000 in 2021 among PWIDs. Conclusions Lebanon is on track to achieve the UNAIDS 95-95-95 by 2025 targets. After transition into the MoPH, the NAP will need to [1] identify ways to sustain its sources of domestic funding, [2] build on its collaborations with CSOs to expand prevention activities in key populations, and [3] address the evolving needs of the population, including among transgenders, migrants, displaced people, and refugees, 4) maintain good quality core functions (capacity building, monitoring and evaluation, and medications).

SERS-based detection of DNA methylation for cancer diagnosis: Cation-mediated adsorption to silver nanoparticles

The high-throughput analysis of DNA methylation markers by label-free surface-enhanced Raman scattering (SERS) holds significant promise for advancing cancer detection. However, a deeper understanding of the factors governing DNA adsorption onto metal surfaces and the identification of reliable SERS bands indicative of DNA methylation levels are still needed. In this study, we evaluated the effects of several cations (Ca2+, Mg2+, Al3+, Be2+, Zn2+, Cu2+, Fe2+, and Na⁺) on the SERS signal of DNA and identified Ca2+ as providing the highest enhancement. Thus, the addition of 5x10-4 M Ca2+ yielded optimal SERS signals for genomic DNA extracted from calf thymus and from six human cell lines, including both benign and malignant types with varying methylation levels. Notably, the SERS activation effect due to Ca2+ could also be replicated by lowering the pH, suggesting that Ca2+ increases the signal enhancement by generating surface Ag⁺ which favors the adsorption of DNA. A strong positive correlation (R = 0.94, p = 0.005) was observed between the intensity of the SERS band at 790 cm-1 and the level of 5-methylcytosine, establishing this band as a robust marker for DNA methylation. This finding was further validated by monitoring methylation levels in a 180 bp DNA sequence from the promoter region of the SEPT9 gene, an FDA-approved biomarker for colorectal cancer. Additionally, the use of SYBR Green fluorescence assays revealed that hypermethylated genomic DNA exhibits greater affinity for silver surfaces compared to lower methylated DNA. Collectively, these findings provide important theoretical insights and practical directions for the development of future nanoparticle-based cancer detection assays utilizing methylation markers.

Dietary patterns of adults in Italy: Results from the third Italian National Food Consumption Survey, INRAN-SCAI

Diet is among the most significant modifiable risk factors for reducing the global burden of chronic diseases. This study aims to investigate the dietary patterns of adults in a large representative sample of the Italian population and to analyze these patterns according to sociodemographic characteristics. Adult participants of the third Italian National Food Consumption Survey were included. A total of 878 food items were classified into 24 pre-defined food groups using the FoodEx2 classification system. Dietary patterns were identified through principal component analysis, and Z-scores were calculated to assess adherence to these patterns. Associations between sociodemographic characteristics, energy intake, and dietary adherence scores were investigated using linear regression models. Based on data from 2,831 subjects (median age 47, IQR 35–60), five principal components (PCs) were retained, explaining 35.63% of the overall variance. PC1 was indicative of a high-fat diet, PC2 suggested a western eating behavior, PC3 represented a health-conscious lifestyle, PC4 can be characterized as an Italian traditional diet, and PC5 represented an unhealthy dietary pattern. According to Z-scores, 42.4% of our study cohort showed high adherence to at least one of the dietary patterns. Less healthy dietary patterns were more prevalent among males and individuals from northern Italian regions. Our results indicate a significant regional variation in terms of dietary pattern, mirroring the general trends of Italian eating habits of the last decades, characterized by a higher tendency towards a more westernized lifestyle. These findings underscore the importance of considering region-specific characteristics when designing future public health interventions and establishing, or updating, national dietary guidelines.

Amplicon sequencing of pasteurized retail dairy enables genomic surveillance of H5N1 avian influenza virus in United States cattle

Highly pathogenic avian influenza (HPAI) viruses with H5 hemagglutinin (HA) genes (clade 2.3.4.4b) are causing an ongoing panzootic in wild birds. Circulation of these viruses is associated with spillover infections in multiple species of mammals, including a large, unprecedented outbreak in American dairy cattle. Before widespread on-farm testing, there was an unmet need for genomic surveillance. Infected cattle can shed high amounts of HPAI H5N1 viruses in milk, allowing detection in pasteurized retail dairy samples. Over a 2-month sampling period in one Midwestern city, we obtained dairy products processed in 20 different states. Here we demonstrate that a tiled-amplicon sequencing approach produced over 90% genome coverage at greater than 20x depth from 5 of 13 viral RNA positive samples, with higher viral copies corresponding to better sequencing success. The sequences clustered phylogenetically within the rest of the cattle outbreak sequences reported. A combination of RT-qPCR testing and sequencing from retail dairy products can be a useful component of a One Health framework for responding to the avian influenza outbreak in cattle.