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Although male–female differences in placental structure and function have been observed, little is understood about their molecular underpinnings. Here, we present a mega-analysis of 14 publicly available placenta DNA methylation (DNAm) microarray datasets to identify individual CpGs and regions associated with fetal sex. In the discovery dataset of placentas from full term pregnancies (N = 532 samples), 5212 CpGs met genome-wide significance ( p  < 1E−8) and were enriched in pathways such as keratinization (FDR p -value = 7.37E−14), chemokine activity (FDR p -value = 1.56E−2), and eosinophil migration (FDR p -value = 1.83E−2). Nine differentially methylated regions were identified (fwerArea < 0.1) including a region in the promoter of ZNF300 that showed consistent differential DNAm in samples from earlier timepoints in pregnancy and appeared to be driven predominately by effects in the trophoblast cell type. We describe the largest study of fetal sex differences in placenta DNAm performed to date, revealing genes and pathways characterizing sex-specific placenta function and health outcomes later in life.

The use of Electronic Nicotine Delivery Systems (ENDS), or vaping devices, has raised concerns about their potential impact on oral health, particularly periodontal disease. While traditional smoking is a well-established risk factor for periodontal disease, the biological and microbial effects of ENDS use are less well understood. Our study examined how vaping and vaping behaviors influence the subgingival plaque microbiome and the associated metabolic pathways that may contribute to oral disease. We enrolled 70 healthy adults aged 18–35, including 48 regular ENDS users and 22 non-vaping controls. ENDS users were categorized by puffing behavior into low, medium, and high flow groups using a validated topography device. All participants underwent periodontal screening and provided saliva and subgingival plaque samples. To evaluate exposure profiles, ENDS users also submitted their personal devices for emissions testing, and volatile organic compounds (VOCs) were collected and analyzed using gas chromatography-mass spectrometry and high-performance liquid chromatography. Compared to non-vapers, ENDS users demonstrated distinct shifts in their oral microbiome, with reductions in beneficial taxa and increased bacteria associated with inflammation and periodontal disease. These changes were more pronounced in high-puff volume users, who also exhibited lower microbial diversity. Functional profiling revealed vaping-associated enrichment of pathways related to lipid metabolism, inflammation, and xenobiotic degradation. Untargeted salivary metabolomics identified metabolic disruptions consistent with these functional shifts. Integrative network analyses incorporating VOC measurements demonstrated correlations between microbial composition, puff volume, and metabolic disruptions, particularly in lipid-regulated and inflammatory pathways. To our knowledge, this is one of the first studies to integrate vaping behavior, oral microbiome profiling, salivary metabolomics, and VOC emissions analysis in a human cohort. These findings suggest ENDS use, especially at higher intensities, may disrupt oral microbial and metabolic homeostasis through both biological and chemical pathways potentially enhancing periodontal disease risk. These patterns point to potential biological and chemical pathways of concern, warranting further investigation and informing public health priorities.

Home health aides and attendants (HHAs) provide in-home care to the growing population of older adults who want to age in place. Despite their vital role in patient care, HHAs are an underserved and vulnerable population of health care professionals who often experience poor health themselves. Activity tracking devices offer a promising way to improve HHAs' health-related awareness and promote health behavior change, particularly regarding physical activity and sleep quality, 2 areas in which the workforce struggles. This study aimed to understand how feasible it is for HHAs to use activity tracking devices and assess their perceptions of such devices for improving their health. Specifically, we conducted (1) a field study to assess the use, feasibility, and acceptability of these devices among HHAs and (2) a qualitative study to understand HHAs' perspectives on and reactions to activity trackers on and off the job. We partnered with the 1199 Service Employees International Union Training and Employment Fund to conduct a field study with home care agency-employed HHAs working in New York City, New York. Participants wore activity tracking devices for 4 weeks that collected data on physical activity and sleep. The HHAs were subsequently interviewed on their experiences with and attitudes toward the devices and asked to reflect on personalized visualizations of their data to prompt them to think aloud. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using grounded theory. A total of 17 HHAs participated; their mean age was 48.7 (SD 12.2) years, 15 (88%) were women, 11 (65%) identified as Black, 5 (29%) identified as Hispanic or Latinx, and they had worked as HHAs for a mean of 11.7 (SD 7.5) years. In total, 94% (n=16) of the HHAs wore their activity trackers for the full 28-day study period. Participants took a mean of 10,230 (SD 3586) daily steps during the study period and slept for a mean of 6.27 (SD 0.58) hours per night. Overall, 4 key themes emerged: (1) activity tracking devices enhanced participants' health awareness by providing empirical data for self-reflection; (2) this increased awareness led to positive behavior changes, including setting and achieving health-related goals; (3) HHAs believed that these devices could improve not only their own health but also that of their patients through positive behavior changes; and (4) despite this optimism, participants emphasized that their ability to modify sleep and activity patterns was constrained by social and occupational determinants, with sleep improvements being particularly challenging. Our findings suggest that appropriately designed personal tracking interventions could offer a promising approach to supporting positive health-related changes in this historically overlooked workforce, potentially improving their well-being and the quality of care they provide to their patients.

Among patients with coronavirus disease (COVID-19), IgM levels increased early after symptom onset for those with mild and severe disease, but IgG levels increased early only in those with severe disease. A similar pattern was observed in a separate serosurveillance cohort. Mild COVID-19 should be investigated separately from severe COVID-19.

Due to ligament laxity, bearing dislocation occurs in 1–6% of Oxford Domed Lateral (ODL) replacements with most dislocations occurring medially. Dislocations were studied using a previously built mechanical rig, however testing using the rig was inefficient. The aim of this study was to develop a better tool that was more reliable and efficient. An established robotics software package, the Open Motion Planning Library, was modified to accept the ODL components. Using a robotics path planning algorithm, the mobile bearing was allowed to find a way out from between the femoral and tibial components i.e. to dislocate. Testing assessed a range of clinically relevant positions of the femoral component relative to the tibial component. Dislocations were labelled as medial, lateral, anterior or posterior depending on the dislocation direction. The Distraction to Dislocation (DD) measured the minimum vertical distraction of the femoral component from the tibial component for a dislocation to occur. Results were validated against the mechanical rig. Statistical analysis of medial dislocation showed excellent agreement with an intraclass correlation value of 0.993 (95% CI 0.982–0.998). All DDs from the dislocation analysis tool were within 1 mm of the mechanical rig DDs with results sharing a remarkably similar trend. The robotics dislocation analysis tool output DDs which were marginally higher than the manual mechanical rig: 0.50 mm anteriorly, 0.25 mm posteriorly and 0.50 mm laterally. Medially, the computational DD differed on average by 0.09 mm (stand deviation: 0.2026 mm). Our study describes the development and validation of a novel robotics dislocation analysis tool, which allows mobile bearing dislocation risk quantification. The tool may also be used to improve surgical implantation parameters and to assess new implant designs that aim to reduce the medial dislocation risk to an acceptable level.

Cervical cancer is one of the leading causes of cancer death in women, even though it is a preventable disease. Most deaths occur in low- and middle-income countries. In addition to early detection and receipt of standard treatments, survivorship is an important component of high quality of care across the cancer continuum. To assess the survival status of advanced-stage cervical cancer patients after cancer treatment has started. A one-year prospective cohort study was employed to assess the survival status of women with advanced stages of cervical cancer. A total of 180 cervical cancer patients were recruited, and the study was conducted from January 10, 2022, to September 20, 2023. Data entry and analysis were done in the SPSS 29 version. Descriptive statistics were used to examine participant characteristics. The Kaplan-Meier procedure and log rank test were used to estimate the duration of survival. Bivariate and multivariate Cox regression analyses were computed for predictor variables with survival status. Patients receiving cancer treatment at FIGO stages IVA and IVB had survived by 56% and 24%, respectively, whereas patients receiving treatment at stages IIB and IIIA had survived by 100%. The estimated mean survival time at one-year follow-up was 5.706 months (95% CI: 3.785-7.627) for patients with FIGO stage IVB, but 11.537 months (95% CI: 11.199-11.887) for those with stages II and III (P < 0.001). Women over 60 years old had a 1.5-fold higher risk of death than those under 60 (HR: 1.482, P = 0.040). The one-year cumulative survival rate among advanced-stage cervical cancer patients was 77%. Major factors associated with survival were age, cancer stage, the presence of anemia, and waiting time for treatment.

Periodontal disease in pregnancy is considered a risk factor for adverse birth outcomes. Periodontal disease has a microbial etiology, however, the current state of knowledge about the subgingival microbiome in pregnancy is not well understood. To characterize the structure and diversity of the subgingival microbiome in early and late pregnancy and explore relationships between the subgingival microbiome and preterm birth among pregnant Black women. This longitudinal descriptive study used 16S rRNA sequencing to profile the subgingival microbiome of 59 Black women and describe microbial ecology using alpha and beta diversity metrics. We also compared microbiome features across early (8-14 weeks) and late (24-30 weeks) gestation overall and according to gestational age at birth outcomes (spontaneous preterm, spontaneous early term, full term). In this sample of Black pregnant women, the top twenty bacterial taxa represented in the subgingival microbiome included a spectrum representative of various stages of biofilm progression leading to periodontal disease, including known periopathogens and Other organisms associated with periodontal disease reflected in the subgingival microbiome included several spp., and spp. Measures of alpha or beta diversity did not distinguish the subgingival microbiome of women according to early/late gestation or full term/spontaneous preterm birth; however, alpha diversity differences in late pregnancy between women who spontaneously delivered early term and women who delivered full term were identified. Several taxa were also identified as being differentially abundant according to early/late gestation, and full term/spontaneous early term births. Although the composition of the subgingival microbiome is shifted toward complexes associated with periodontal disease, the diversity of the microbiome remains stable throughout pregnancy. Several taxa were identified as being associated with spontaneous early term birth. Two, in particular, are promising targets of further investigation. Depletion of the oral commensal in early pregnancy and elevated levels of in late pregnancy were both associated with spontaneous early term birth.

The development of health concepts beyond traditional markers of illness and death has made the evaluation of quality of life (QoL) crucial to patient care. Yet, there is little research evaluating the pre- and post-treatment QoL of cervical cancer survivors in Ethiopia. This study aimed to assess the pre- and post-treatment QoL of women diagnosed with advanced-stage cervical cancer. A cohort design was conducted at the Tikur Anbessa Specialized Hospital Oncology Center. A total of 166 cervical cancer patients were recruited consecutively. Data was collected through interviews with standardized questionnaires before and after treatment. The Wilcoxon rank test was used to assess the significant differences in pre-treatment and post-treatment quality of life. Additionally, the Mann-Whitney -test was also employed. Statistical significance was determined with p-values <0.05 and a 95% confidence interval. Women who were in stages IVA and IVB were 24.7% and 10.2%, respectively. Both the global health scale (66.67 [47.92-75] to 83.33 [66.67-83.33]) and the functional domain QoL (66.67 [40-80] to 70 [46.67-86.66]) showed statistically significant improvements from pre-treatment to post-treatment QoL. Women under the age of 45 were found to have higher global health QOL (P < 0.001) and functional domain QOL (P = 0.029). Women presented in stages II and III had comparatively higher global health QoL (P = 0.008) and functional domain QoL (P = 0.021). Global health QOL and the majority of functional quality of life significantly improved following six months of cancer treatment. But there was no discernible change in terms of sexual enjoyment, sexual function, or activity. Age, marital status, the duration since diagnosis, the stage of the cancer, and the presence of comorbidities were the factors that affected the improvement of post-treatment quality of life.

Background Fractures are a common and a major cause of disability and death, with up to 10% of fractures failing to heal normally. These fractures are called \"fracture non-unions\". Currently, debate on the impact of non-union in the medical and research communities exists. Unfortunately, this indirectly minimizes the impact of fracture non-unions, and hinders further research work which could reduce unnecessary patient suffering. In this study, we aim to explore the lived experiences of fracture non-union patients in one-on-one interviews to determine whether fracture non-union is a burden for patients, and if so, to outline the burden on patients and their close circles. Methods Eligible participants will include adult patients who currently have/previously (in the last 36 months) had a long bone fracture that has not healed normally. Data will be collected through in-depth face-to-face or telephone interviews, complemented by quantitative data captured using the standardized Euroqol EQ-5D-5L questionnaire. With consent, interviews will be audio-recorded and transcribed verbatim. Using NVIVO software, we will develop grouped codes and categories to describe and provide insight into the experience of fracture non-union patients. EQ-5D-5L, and EQ VAS data will be presented using a measure of central tendency and a measure of dispersion to provide insight into the overall health related quality of life for patients. Ethics and dissemination The study was approved by the Health Research Authority and Health and Care Research Wales Approval (approval date: 27 March 2024; IRAS project ID: 337652). Results from this study aim to improve the information and support provided to fracture non-union patients. Findings will be disseminated to the study participants, healthcare professionals, and local commissioners through peer-reviewed articles and at academic conferences.

Fractures are a common and a major cause of disability and death, with up to 10% of fractures failing to heal normally. These fractures are called \"fracture non-unions\". Currently, debate on the impact of non-union in the medical and research communities exists. Unfortunately, this indirectly minimizes the impact of fracture non-unions, and hinders further research work which could reduce unnecessary patient suffering. In this study, we aim to explore the lived experiences of fracture non-union patients in one-on-one interviews to determine whether fracture non-union is a burden for patients, and if so, to outline the burden on patients and their close circles. Eligible participants will include adult patients who currently have/previously (in the last 36 months) had a long bone fracture that has not healed normally. Data will be collected through in-depth face-to-face or telephone interviews, complemented by quantitative data captured using the standardized Euroqol EQ-5D-5L questionnaire. With consent, interviews will be audio-recorded and transcribed verbatim. Using NVIVO software, we will develop grouped codes and categories to describe and provide insight into the experience of fracture non-union patients. EQ-5D-5L, and EQ VAS data will be presented using a measure of central tendency and a measure of dispersion to provide insight into the overall health related quality of life for patients. The study was approved by the Health Research Authority and Health and Care Research Wales Approval (approval date: 27 March 2024; IRAS project ID: 337652). Results from this study aim to improve the information and support provided to fracture non-union patients. Findings will be disseminated to the study participants, healthcare professionals, and local commissioners through peer-reviewed articles and at academic conferences.