Urinary tract infections (UTIs) are linked to adverse pregnancy outcomes, yet epidemiological data on gestational UTIs in Kenya are limited. This study assessed diagnostic and management practices in Kisumu County to inform diagnostic and antimicrobial stewardship. A hospital-based retrospective study was conducted from February 2020 to February 2021 among 416 records of pregnant women at Chulaimbo and Nyahera Sub-County Hospitals. Socio-demographic, laboratory, and clinical history data were collected using structured forms and analysed in STATA 16.0. Statistical methods included chi-square, multivariate logistic regression, and Spearman’s rank correlation (p ≤ 0.05). Dipstick-based presumptive proportion of UTIs was 57.9% (241/416). Only 1.4% (6/416) had microbiological confirmation despite infections being recorded. The mean maternal age was 23.92 years, parity two, mean antenatal visits two, and mean haemoglobin 10.73 ± 1.8 g/dL. The first antenatal care attendance occurred at varying gestational ages in 56% (233/416). Antibiotics prescribed were 60% from WHO ‘Access’ group and 40% from ‘Watch’ group. Gestational UTI’s in Kisumu County were frequently managed without confirmatory diagnosis, increasing antimicrobial resistance risk. Strengthening management requires better laboratory capacity, sustained financial investment, improved antibiotic access, and adherence to WHO AWaRe guidelines to protect maternal and neonatal health.

Background: Individuals with intellectual disabilities face increased risks of obesity and health issues. Carers in residential settings play a crucial role in shaping their dietary habits. This study explores how carers influence eating behaviours to identify strategies for healthy eating. Method: Seventeen semi-structured interviews were conducted with carers from three community homes. Thematic analysis identified three key themes: (i) whose responsibility is it?; (ii) food autonomy and choice in the context of caring relationships; (iii) opportunities for working together to support dietary choices. Results: Carers strive to encourage healthy eating while respecting residents' autonomy, particularly in those with cognitive impairments or on psychotropic medications. They use strategies like rapport-building, personalised care, and nutrition education. However, these efforts are limited by gaps in knowledge, time constraints, and variation in application and impact. Conclusions: Findings highlight the practice gap and the need for better training and resources to support carers in promoting healthy food choices while respecting residents' autonomy.

Background: Antimicrobial resistance (AMR) is now considered one of the greatest global health threats. This is further compounded by a lack of new antibiotics in development. Antimicrobial stewardship programmes can improve and optimize the use of antibiotics, thereby increasing the cure rates of antibiotic treatment and decreasing the problem of AMR. In addition, diagnostic and antimicrobial stewardships in the pathology laboratories are useful tools to guide clinicians on patient treatment and to stop the inappropriate use of antibiotics in empirical treatment or narrow antibiotics. Medical Laboratory Scientists are at the forefront of performing antibiotics susceptibility testing in pathology laboratories, thereby helping clinicians to select the appropriate antibiotics for patients suffering from bacterial infections. Methods: This cross-sectional study surveyed personal antimicrobial usage, the knowledge and awareness on AMR, and antimicrobial stewardship, as well as barriers to antimicrobial susceptibility testing among medical laboratory scientists in Nigeria using pre-tested and validated questionnaires administered online. The raw data were summarized and exported in Microsoft Excel and further analyzed using IBM SPSS version 26. Results: Most of the respondents were males (72%) and 25–35 years old (60%). In addition, the BMLS degree was the highest education qualification most of the respondents (70%) achieved. Of the 59.2% of the respondents involved in antibiotics susceptibility testing, the disc diffusion method was the most commonly used (67.2%), followed by PCR/Genome-based detection (5.2%). Only a small percentage of respondents used the E-test (3.4%). The high cost of testing, inadequate laboratory infrastructure, and a lack of skilled personnel are the major barriers to performing antibiotics susceptibility testing. A higher proportion of a good AMR knowledge level was observed in male respondents (75%) than females (42.9%). The knowledge level was associated with the respondent’s gender (p = 0.048), while respondents with a master’s degree were more likely to possess a good knowledge level of AMR (OR: 1.69; 95% CI: 0.33, 8.61). Conclusion: The findings of this study indicate that Nigerian medical laboratory scientists had moderate awareness of AMR and antibiotic stewardship. It is necessary to increase investments in laboratory infrastructure and manpower training, as well as set up an antimicrobial stewardship programme to ensure widespread antibiotics susceptibility testing in hospitals, thereby decreasing empirical treatment and the misuse of antibiotics.

Malnutrition results in a high prevalence of stunting, underweight, and micronutrient deficiencies. This study investigated the effect of a multi-nutrient fortified dairy-based drink on micronutrient status, growth, and cognitive development in malnourished [height-for-age z-score (HAZ) and/or weight-for-age z-score (WAZ) &lt; -1 SD and &gt;-3 SD] Nigerian toddlers (<i>n</i> = 184, 1-3 years). The product was provided in different daily amounts (200, 400, or 600 ml) for 6 months. At baseline and endline, venous blood and urine samples were collected to determine micronutrient status. Bodyweight, height, waist, and head circumference were measured, and corresponding Z-scores were calculated. The Bayley-III Screening Test was used to classify the cognitive development of the children. In a modified per-protocol (PP) population, the highest prevalence's of micronutrient deficiencies were found for vitamin A (35.5%) and selenium (17.9%). At endline, there were no significant improvements in iodine, zinc, vitamin B12, and folate status in any of the three groups. Regarding vitamin D status (25OHD), consumption of 600 and 400 ml resulted in an improved status as compared to baseline, and in a difference between the 600- and 200-ml groups. Consumption of 600 ml also increased vitamin A and selenium status as compared to baseline, but no differences were found between groups. Within the groups, WAZ, weight-for-height z-score (WHZ), and BMI-for-age z-score (BAZ) improved, but without differences between the groups. For HAZ, only the 600 ml group showed improvement within the group, but it was not different between groups. For the absolute weight, height, and head circumference only trends for differences between groups were indicated. Cognition results did not differ between the groups. Within groups, all showed a decline in the per cent of competent children for receptive language. To study the effects of a nutritional intervention on linear growth and cognition, a longer study duration might be necessary. Regarding the improvement of micronutrient status, 600 ml of fortified dairy-based drink seems most effective.

Background: Moderate-to-late preterm infants (32–34 weeks GA) have increased risk of neonatal morbidities compared to term infants, however dedicated nutritional guidelines are lacking. Methods: Moderate-to-late preterm infants received a preterm formula (n = 17) or breastmilk (n = 24) from age 2–10 weeks in a non-randomized, open-label observational study. Anthropometric measurements were assessed bi-weekly. Blood concentrations of hemoglobin, ferritin, serum retinol, and 25-hydroxy-vitamin D (25OHD) were analyzed at age 2 and 10 weeks. Result: Average growth per day was 14.7 g/kg BW/day in formula-fed and 12.8 g/kg BW/day in breastmilk-fed infants but not different from each other. Length and head circumference in both groups were in line with the median reference values of the Fenton growth chart. At 10 weeks of age, hemoglobin tended to be higher in the formula-fed group (10.2 g/dL vs. 9.6 g/dL, p = 0.053). 25OHD increased in formula- and breastmilk-fed infants from 73.8 to 180.9 nmol/L and from 70.7 to 97.6 nmol/L, respectively. Serum retinol only increased in the formula-fed group (0.63 to 1.02 µmol/L, p < 0.001). Conclusion: Breastfeeding resulted in adequate growth in moderate-late preterm infants but was limiting in some micronutrients. The preterm formula provided adequate micronutrients, but weight gain velocity was higher than the Fenton reference value. Impact statement: Unfortified breastmilk resulted in adequate growth in weight, length and head circumference in Nigerian moderate to late preterm infants during an study period of 8 weeks, but status of vitamin D, vitamin A and iron needs to be monitored. The high-energy formula, developed for very preterm infants, resulted in higher growth in body weight in moderate to late preterm infants than the median of the Fenton preterm growth chart. This study supports the necessity of dedicated nutritional guidelines, and regular monitoring of growth and nutritional status of moderate to late preterm infants.

In this study, we examined how a critical posttranscriptional regulator, the RNA‐binding protein HuR (gene name Elavl1), contributes to the development and maintenance of limb skeletal tissue. Using the Prx1‐Cre knockout model, we examined the effect of germline knockout (Elavl1KO) and limb mesenchyme‐specific knockout (MSC‐Elavl1KO) of HuR on limb development. We found that Elavl1KO disrupted the development of the limb skeleton and was associated with a loss of signaling from the apical ectodermal ridge (AER). In contrast, MSC‐Elavl1KO did not appear to affect skeletal development. Mature MSC‐Elavl1KO mice appeared healthy, but their limb skeleton exhibited abnormal bone structure in both males and females at 2.5 months of age. Osteoblasts isolated from MSC‐Elavl1KO mice exhibited lower expression of osteoblastic marker genes, and their ability to generate a mineralized matrix was markedly impaired. RNA‐Seq analysis of these osteoblasts demonstrated that loss of HuR substantially influenced their transcriptome, affecting genes associated with a wide range of cellular processes. Finally, using siRNA knockdown in the human MG63 cell line, we identified that loss of HuR leads to increased mRNA turnover of the osteoblastic transcription factor Runx2. Overall, the study has demonstrated a critical role for HuR‐mediated posttranscriptional control in skeletal development and homeostasis, but finds that its expression in mesenchyme‐derived cells only becomes critical in mature skeletal tissue.

Introduction/purpose: Autism is a complex neurodevelopmental condition thought to affect 1 in 100 children globally. More commonly diagnosed in males, and during childhood, diagnoses are increasingly being made throughout adulthood. Purpose: To establish what age autistic people receive their diagnosis, and whether the age of diagnosis was influenced by their sex and by the presence of intellectual disability. Design: A quantitative, cross-sectional, retrospective study. Data was collected from the Primary Care records of 6 GP Practices covering Ellesmere Port, a large town in Northwest England with 71,210 people registered. Mean age of diagnosis was calculated for the group then for each subgroup, to allow comparison between males and females, and those with and without a documented intellectual disability. Findings: Data from 1130 autistic participants were analysed. Age of participants was between 3 - 81 years with an age of autism diagnosis of 1 - 72 years. 85.6% of participants were diagnosed with autism by the age of 25 years, most commonly at 3 years of age (11.9%). The average age of diagnosis was 2.48 years later for females diagnosed across the lifespan. Average age of diagnosis was 5.05 years later for those with a learning disability. Practical implications: This study highlights the importance of healthcare professionals, educators and care givers recognising autistic traits in people across the lifespan, including the potential for diagnostic overshadowing. There are implications for commissioning autistic services, to ensure adequate assessment pathway capacity for adolescents and adults as well as children.

Background: Young adults are reported as one of the major consumers of sugar-sweetened beverages (SSBs) globally and the consumption of SSBs is associated with long-term medical conditions. The Health Belief Model (HBM) has been applied to understand SSB consumption by children and adolescents through the use of its constructs. There is a gap in knowlege of HBM application to SSB consumption of young adults. Therefore, the present study was undertaken to fill this gap. Objective: The primary objective of the study was to determine if an association existed between SSB consumption status and the constructs of the HBM: perceived susceptibility, perceived severity, perceived barriers, perceived benefits, self-efficacy, and cues in young adult students. Design: Cross-sectional data were obtained using an online self-administered structured questionnaire. Descriptive statistics and Chi-squared (X2) test for association were used to analyse the data. Setting: Participants were recruited via email and WhatsApp. Participants: Seventy young adult students aged 18 to 30 years studying at the University of Chester, England. Results: The mean age of the participants was 25.5 years (SD: 3.0). 53% consumed SSBs on a given day. Postgraduates (58%), Blacks (52%), and Asian students (70%) had the greater percentages of SSB consumers. There was a very strong significant association between SSB consumption status and level of perceived severity of diseases from a high intake of SSBs, X2 (1, N = 70) = 6.94, P = 0.01, Cramer’s V = 0.32. Also, a very strong association existed between SSB consumption status and self-efficacy level to control SSB intake, X2 (1, N = 70) = 8.83, P = 0.00, Cramer’s V = 0.36. Conclusions: A high percentage of young adult students especially those from minority ethnic groups in the UK consumed SSBs which indicates that targeted initiatives at these groups are required to control their intake. Interventions to control SSB intake in young adult students should consider increasing their level of perceived severity of diseases from a high intake of SSBs and self-efficacy to control SSB intake. We recommend actions that can further increase their awareness of how serious diseases from a high intake of SSBs are. We also recommend measures intended to increase the confidence of young adult students in their ability to avoid SSBs when they are stressed, after writing exam, when they are eating, and when they engage in sedentary activities. In particular, modifying their environment to prevent the availability of SSBs at home and regulating the promotion and cost (via taxation) of SSBs in stores would help to increase their self- efficacy level. Further studies to determine why a greater percentage of postgraduate students are consuming SSBs despite their level of education is required. More comprehensive research on SSB consumption in young adults using the HBM is necessary.

Dogs (Canis familiaris) are widely used as scent detectors due to their sensitive olfactory capabilities, endurance, and ability to cover large areas quickly. They are in high demand due to a global rise in terrorist threats using specialized explosive contraptions. Detection dogs are often faced with high temperatures and physical exertion, which can increase panting rate as a function of evaporative cooling, inhibiting olfactory ability. This study examined the impact of exercise on the search performance of 11 explosive detection dogs (eight labradors and three springer spaniels). They completed two trial sets: one after exercise with a ball thrower and one without exercise. They were timed while searching for three types of explosives: trinitrotoluene, composition-4, and ammonium nitrate. Data were analyzed in R using mixed effects models, revealing that exercise significantly affected search duration and success for all types of explosives. Searches averaged 29.58 seconds without exercise, while post-exercise searches took 44.91 seconds. Dogs were 1.14 times more likely to locate explosives without prior exercise. Dogs took the longest to find trinitrotoluene and were fastest with ammonium nitrate and composition-4. These findings highlight the importance of allowing detection dogs adequate rest, as even brief exercise can impact their search performance.

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