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Ultra-processed food intake and risk of type 2 diabetes:a pooled analysis of three prospective cohorts of Korean adults and an updated meta-analysis
No full textStudies suggest a positive association between ultra-processed food (UPF) intake and type 2 diabetes risk. However, studies were primarily conducted in Western populations with diets and disease profiles different from populations living elsewhere. In addition, the dose–response relationship needs to be further elucidated. We conducted an individual-level pooled analysis of three Korean prospective cohorts (n = 72,776). UPF intake (in the percentage of g/d as the main UPF unit) was assessed using validated food frequency questionnaires and categorized according to Nova classification. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). We subsequently conducted a meta-analysis of prospective studies, including recent studies from both Western and non-Western populations, to assess the dose–response relationship. In a pooled analysis of Korean cohorts (up to 18 years of follow-up), the highest (vs. lowest) quartile of UPF intake was associated with an increased type 2 diabetes risk (pooled HR [95% CI] = 1.11 [1.02, 1.21], p-trend = 0.03). The positive association persisted after additional adjustment for BMI, nutritional factors (fiber, sodium, and carbohydrate intakes), or diet quality score. Among individual UPF subgroups, processed meats, ready-to-eat/heat mixed dishes, and ice cream were positively associated with diabetes risk. In a meta-analysis of 17 prospective cohorts, every 10% (of g/d) increment in UPF intake was associated with a 10% (summary RR [95% CI] = 1.10 [1.08, 1.12]) higher risk in a dose–response fashion. Our meta-evidence supports that higher UPF intake may monotonically increase type 2 diabetes risk.</p
Neisseria gonorrhoeae Sequence Types During an Increase of Gonorrhea Among Young Women in 2022 and 2023 in the Netherlands
No full textBackground:Since September 2022, an ongoing increase in gonorrhea positivity rates and diagnoses among young women visiting sexual health centers was observed in the Netherlands. To gain more insight into possible drivers of this increase, this study aimed to investigate the molecular diversity, clustering, and transmission of Neisseria gonorrhoeae related to the gonorrhea increase in the Netherlands. Methods: Between January 2022 and March 2023, viable and stored N gonorrhoeae isolates from vaginal swab samples from 273 women <25 years of age were included from 4 sexual health centers in the Netherlands. All isolates were subjected to whole genome sequencing. The molecular diversity was investigated by analyzing (core genome) multilocus sequence types (STs) over time and by patient characteristics. Results:The prevalence of ST7359 and ST7822 increased from <5% in the beginning of 2022 to ∼23% in 2023 and ST9363 from 6% to 14%. ST7359 and ST9363 were associated with hosts with university-level education and Dutch ethnicity. ST7359 and ST7822 also included large clusters of genetically related isolates (<6-gene difference). No indication for reduced antimicrobial susceptibility to ceftriaxone was found in any ST. Conclusions:The N gonorrhoeae surge among young women is not caused by a single strain. The prevalence of STs shifted over time, and certain STs were associated with distinct populations and showed clustering of genetically related isolates. These findings suggest rapid clonal expansion of several circulating STs. This may be indicative of increased transmission within specific sexual networks.<p/
Sperm H3K9me3 levels are associated with embryo developmental dynamics and biochemical pregnancy in IVF patients with normozoospermia
No full textBackground: The posttranslational histone modification H3K9me3 is crucial for constitutive heterochromatin (cHC) and supports genome stability and gene regulation during development. This epigenetic mark persists in human sperm post histone-to-protamine transition and is transmitted to the embryo. Although H3K9me3 variability is linked to abnormal sperm parameters, its role in fertilization and embryo development remains unclear. Given its retention in sperm, aberrant H3K9me3 levels may underlie cases of unexplained male infertility. Objective: Investigate the variability of H3K9me3 levels in sperm from normozoospermic men and assess its association with early embryo development and IVF outcomes. Material and methods: H3K9me3 and histone H3 levels were quantified by Western blot in surplus sperm from 99 normozoospermic men undergoing IVF-treatment. Patients were stratified into quartiles based on the H3K9me3/H3 ratio. Pre-implantation embryo development was assessed by time-lapse imaging, focusing on nuclear precursor body (NPB) dynamics and morphokinetics. IVF outcomes were reported as cumulative biochemical and ongoing pregnancy rates per ovum pick-up and compared across H3K9me3/H3 quartiles.Results: H3K9me3/H3 ratios exhibited substantial inter-individual variability among normozoospermic patients. Embryos from the third H3K9me3/H3 ratio quartile (Q3) demonstrated the highest proportion of zygotes with NPB clustering and faster, more consistent development through the first two cleavage divisions compared to other quartiles. A significant non-linear association was found between H3K9me3/H3 ratio and cumulative biochemical pregnancy rates: couples in the lowest quartile (Q1) had significantly reduced odds of biochemical pregnancy compared to Q3 (adjusted OR [95% CI]: 0.30 [0.09–0.97], p = 0.045). No significant association was found for ongoing pregnancy rates. Discussion and conclusions: This study reveals that sperm H3K9me3 levels vary among normozoospermic men and correlate with early embryo development and biochemical pregnancy rates following IVF. However, no significant association was found with ongoing pregnancy, suggesting that additional mechanisms may determine long-term pregnancy viability. The non-linear relationship between H3K9me3/H3 ratio and embryo development suggests an optimal range for this epigenetic mark. These findings highlight the potential influence of paternal epigenetic variation, undetectable by standard semen analysis, on embryo quality and IVF outcomes. Further studies in larger cohorts are warranted to confirm these findings and clarify underlying mechanisms.</p
Do Children and Parents Agree on the Level of Asthma Control? A Systematic Review
No full textBackground: Asthma is a prevalent chronic condition in children, and is often not sufficiently controlled. Children and parents may have a different interpretation of the level of asthma control, which can lead to suboptimal treatment. This systematic review aims to synthesize literature regarding concordance between children and their parents in the perception of asthma control. Methods: A systematic literature search was conducted in EMBASE, MEDLINE, Web of Science, and Google Scholar up to February 5, 2025. Studies were included if they involved children aged 4-18 with asthma and their parents, assessed asthma control using questionnaires validated for children or derived from guidelines, and compared results of children and their parents. All healthcare settings were included. Four reviewers independently screened the studies and two extracted the data. Methodological quality was assessed using the Newcastle Ottawa Scale. Results: Nine publications were included, with a total of 1,693 children and 1,693 parents. Various questionnaires and guidelines were used to assess asthma control. The quality of the majority of the studies was rated satisfactory or good. The agreement between children and parents ranged from weak to very good. In many cases, there was a significant difference between the answers of the children and their parents: children often perceived their asthma to be less controlled compared to their parents. Discussion: The perception of asthma control is frequently discordant between children and parents, with children often reporting lower levels of asthma control. These findings highlight the importance and potential beneficial effects of shared decision-making between children, caregivers, and healthcare providers in improving treatment outcomes.</p
Utility of continuous EEG monitoring in postanoxic coma:a retrospective multicenter study
No full textBackground: Following postanoxic coma, continuous electroencephalography (cEEG) monitoring is widely applied for prognostication, guided by national guidelines recommending multimodal assessment. While the diagnostic accuracy of cEEG is well-established, its actual outcomes and impact on intensive care unit (ICU) length of stay (LOS) have largely remained unreported since guideline implementation. This study evaluates outcomes and the unique prognostic value of cEEG monitoring in patients with postanoxic coma after guideline implementation.Methods: This retrospective multicenter study analyzed 699 patients with postanoxic coma who underwent cEEG monitoring between January 2021 and January 2024 across three Dutch academic centers. Prognostic outcomes (favorable, poor, or uncertain) were classified based on established EEG patterns at 12- and 24-hour timepoints. For patients with a poor cEEG prognosis, clinical indicators (neurological examination, hemodynamic stability, additional prognostic modalities) were assessed to determine cEEG’s unique contribution. Results: Of 699 patients, 13.0% (n = 91) had a favorable, 16.2% (n = 113) a poor, and 70.8% (n = 495) an uncertain prognosis. Among those with a poor cEEG prognosis, 58% also had clinical indicators of a poor prognosis such as wide pupils with absent light reflexes or hemodynamic instability. Only 6.7% (n = 47) of all cEEGs provided unique additional prognostic value, with no other clinical indicators suggesting a poor prognosis. Conclusions: cEEG monitoring provided unique prognostic information in a small percentage of cases, with most yielding uncertain prognoses. This suggests current universal cEEG monitoring may be suboptimal given resource constraints and limited additional diagnostic yield.</p
Young Spanish Women Migrants as Au Pairs in the UK:Cleaning and Childcare During the COVID-19 Pandemic
No full textSince the 2008 financial crisis, the UK has emerged as a popular destination for young Spanish women navigating labour precariousness through (formerly intra-European Union) migration. Many adopt the au pair pathway as a strategic means to improve their English language skills and enhance future employability. However, while framed as a “cultural exchange”, the au pair scheme has faced sustained critique for masking a reality often characterised by precarious work, exploitation, and even abuse due to the great dependency of au pairs on host families and the various forms of worker control au pairs are exposed to. These dynamics were only exacerbated during the COVID-19 pandemic. Drawing on seven qualitative interviews with au pairs with a Spanish migration background and direct experience as an au pair by one of this article’s authors, this article applies the labour process theory (LPT) to interrogate the deterioration of living and working conditions for au pairs in the UK. The analysis demonstrates how the interplay of three distinct worker control mechanisms, intersecting with gendered vulnerabilities, intensified the subjugation of this specific group of domestic and care workers during the global health crisis.</p
Preadolescents and Their Online World:Activities, Opportunities, and Challenges
No full textTo thrive in today’s digital media society, preadolescents (8–12-year-olds) should adaptively navigate online opportunities and challenges. Supporting them in this requires a clear understanding of how they experience their online world. Therefore, this study examined preadolescents’ online activities and their perceptions of online opportunities and challenges using qualitative methods. In a participatory project, 129 preadolescents explored their online world with interactive activities. An inductive thematic analysis was conducted on the verbatim transcripts of the audio-recorded sessions and photographs of the work created during sessions. The results provided nuanced and comprehensive insights into preadolescents’ online activities, opportunities, and challenges, illustrating the complex and ever-evolving nature of their online world. This study underscores the need for additional research involving preadolescents to better understand what they need to thrive in today’s digital media society.</p
Organ monitoring and identification of ischemic liver injury during ex situ porcine liver machine perfusion:A randomized controlled study
No full textThe global shortage of donor livers has led to an increased reliance on extended-criteria donor livers, including those from donors after circulatory death. Utilizing marginal livers necessitates distinguishing between injured but recoverable livers and those that are irreversibly damaged. Bile duct injury, prevalent in these grafts, poses significant risks, as ischemic injuries can be challenging to assess and may lead to recipient bile duct strictures and ultimately graft failure. This study aimed to identify objective measurements that enhance existing viability criteria and facilitate the diagnosis of ischemic injuries. We employed ex situ machine perfusion (MP) to monitor porcine livers subjected to standardized biliary injury (BileINJ), standardized global liver injury (GlobalINJ), and no injury (CTRL, total n=23). Using microdialysis catheters and pCO 2 sensors, we analyzed liver tissue, hilar plate, and bile duct, in addition to standard viability assessments, collecting data on 77 variables. Principal component analysis indicated distinct clustering of the GlobalINJ and partially the BileINJ group away from the CTRL group during MP. Feature extraction models highlighted microdialysate lactate, lactate/pyruvate ratio, glycerol, tissue pCO 2 , and blood gas hematocrit as critical indicators for classifying liver state. Histopathological evaluations confirmed group-specific liver and bile injuries. We identified unique metabolic patterns that differentiate ischemically injured from non-injured porcine livers and were able to distinguish liver and biliary injury. Real-time monitoring of livers using microdialysis and tissue pCO 2 during MP is feasible and clinically available. Measurements taken in the hilar plate show the ability to identify bile duct damage while not introducing measurement devices to the vulnerable bile duct itself. Our findings enable more objective and timely selection of transplantable livers and warrant further investigation in clinical studies.</p
