Contribution of Bacterial Infection to Male Infertility in Nigerians

There is disagreement as to the influence of certain microbial infection on male infertility and such agents are ignored. The incidence of these microbial agents in seminal fluid isolates is on the increase. This study therefore evaluates the prevalence of male factor infertility and contribution of microbial infection to male infertility in Kano, northern Nigeria. Seminal fluid analysis in five hundred males who were investigated for infertility was evaluated using the 5th generation SQ AII C-P sperm quality analyzer and the Neubaeur counting chamber. The result indicates that 58.2% had sperm density less than twenty million per millilitre. The oligospermic subjects (sperm density 2-19 millions/ml) were 27.6%, severe oligospermic (sperm density less than 2 million) 13.2% and azoospermia, 17.4%. Asthenospermia (motility less than 50%) decrease from 44.8% in oligospermia to 24.0% in severe oligospermia. Teratospermia (abnormal morphology greater than 50%) also deteriorated from 46.3% to 35.4% in oligospermic and severe oligospermic males respectively. Seminal fluid infection increases with decreasing sperm density, motility and morphology. The prevalence of abnormal sperm indices and bacterial infection is high and Staphylococcus aureus infection should be treated and no longer ignored in the management of male factor infertility

High Prevalence of Antibiotic-Resistant Mycoplasma genitalium in Nongonococcal Urethritis: The Need for Routine Testing and the Inadequacy of Current Treatment Options.

Background. Empirical antibiotic therapy for nongonococcal urethritis (NGU) and cervicitis is aimed at Chlamydia trachomatis, but Mycoplasma genitalium, which also commonly causes undiagnosed NGU, necessitates treatment with macrolides or fluoroquinolones rather than doxycycline, the preferred chlamydia treatment. Prevalence of M. genitalium and associated genotypic markers of macrolide and fluoroquinolone resistance among men symptomatic of urethritis were investigated. Genetic diversity of M. genitalium populations was determined to infer whether findings were applicable beyond our setting. Methods. Mycoplasma genitalium and other NGU pathogens were detected using nucleic acid amplification methods, and DNA sequencing was used to detect genotypic resistance markers of macrolide and fluoroquinolone antibiotics in 23S ribosomal RNA, gyrA, gyrB, and parC genes. MG191 single-nucleotide polymorphism typing and MG309 variable number tandem analysis were combined to assign a dual locus sequence type (DLST) to each positive sample. Results. Among 217 men, M. genitalium prevalence was 16.7% (95% confidence interval [CI], 9.5%-24.0%) and C. trachomatis prevalence was 14.7% (95% CI, 7.8%-21.6%) in NGU cases. Nine of 22 (41%; 95% CI, 20%-62%) patients with M. genitalium were infected with DLSTs possessing genotypic macrolide resistance and 1 patient was infected with a DLST having genotypic fluoroquinolone resistance. Typing assigned M. genitalium DLSTs to 2 major clusters, broadly distributed among previously typed international strains. Genotypic macrolide resistance was spread within these 2 clusters. Conclusions. Mycoplasma genitalium is a frequent undiagnosed cause of NGU in this population with rates of macrolide resistance higher than those previously documented. Current guidelines for routine testing and empirical treatment of NGU should be modified to reduce treatment failure of NGU and the development of further resistance

Impact of mass drug administration of azithromycin for trachoma elimination on prevalence and azithromycin resistance of genital Mycoplasma genitalium infection

Background Mass drug administration (MDA) of 20 mg/kg (maximum 1 g in adults) azithromycin for ocular Chlamydia trachomatis (CT) infection is a key component of the WHO trachoma elimination strategy. However, this dose may be suboptimal in Mycoplasma genitalium infection and may encourage emergence of antimicrobial resistance (AMR) to azithromycin. Objectives To determine the effect of MDA for trachoma elimination on M. genitalium prevalence, strain type and azithromycin resistance. Methods A secondary analysis of CT-negative vulvovaginal swabs from three outpatient antenatal clinics (Honiara, Solomon Islands) from patients recruited either pre-MDA, or 10 months post-MDA in two cross-sectional surveys was carried out. Swabs were tested for M. genitalium infection using Fast Track Diagnostics Urethritis Plus nucleic acid amplification assay. M. genitalium-positive samples were subsequently tested for azithromycin resistance by sequencing domain V of the 23S rRNA DNA region of M. genitalium and underwent phylogenetic analysis by dual locus sequence typing. Results M. genitalium prevalence was 11.9% (28/236) in women pre-MDA and 10.9% (28/256) 10 months post-MDA (p=0.7467). Self-reported receipt of azithromycin as part of MDA was 49.2% in women recruited post-MDA and 17.9% (5/28) in those who tested M. genitalium positive. Of samples sequenced (21/28 pre-MDA, 22/28 post-MDA), all showed a macrolide susceptible genotype. Strain typing showed that sequence types diverged into two lineages, with a suggestion of strain replacement post-MDA. Conclusion A single round of azithromycin MDA in an island population with high baseline M. genitalium prevalence did not appear to impact on either prevalence or azithromycin resistance, in contrast to reported decreased genital CT prevalence in the same population. This may be due to limitations such as sample size, including CT-negative samples only, and low MDA coverage. Further investigation of the impact of multiple rounds of MDA on M. genitalium azithromycin AMR in antibiotic experienced and naïve populations is warranted

Multivalued SK-contractions with respect to b-generalized pseudodistances

A new class of multivalued non-self-mappings, called SK-contractions with respect to b-generalized pseudodistances, is introduced and used to investigate the existence of best proximity points by using an appropriate geometric property. Some new fixed point results in b-metric spaces are also obtained. Examples are given to support the usability of our main result

Absence of association between behavior problems in childhood and hypertension in midlife

Background It is known that behavior in childhood is associated with certain physical and mental health problems in midlife. However, there is limited evidence on the role of childhood behavior problems in the development of hypertension in adulthood. The present study aimed to examine whether behavior problems in childhood influenced the risk of hypertension in midlife in the United Kingdom 1958 birth cohort. Methods The 1958 British birth cohort comprised 17,638 individuals born in the first week of March 1958 in the United Kingdom. Behavior problems were assessed at 7, 11, and 16 years of age by parents and teachers. At age 45, blood pressure was measured and hypertension was recorded if blood pressure was ≥140/90 mm Hg or if the participants were informed by their health professionals that they had high blood pressure. Behavioral information was reported according to the Rutter Children's Behaviour Questionnaire (RCBQ) and the Bristol Social Adjustment Guide (BSAG). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine behavior problems in childhood in relation to hypertension at 45 years of age according to logistic regression analysis, with adjustment for sex, social class in childhood and adulthood, childhood cognition, birth weight, gestational age at birth, body mass index (BMI), smoking, alcohol consumption, and physical activity. Results Behavior problems reported by parents at 7, 11, and 16 years were not associated with hypertension in midlife (OR, 0.93; 95% CI, 0.81, 1.07; OR, 0.95; 95% CI, 0.81, 1.11; OR, 0.98; 95% CI, 0.85, 1.12, respectively). Similarly, teacher-reported behavior problems at 7, 11, and 16 years were not associated with hypertension in midlife (OR, 0.92; 95% CI, 0.72, 1.18; OR, 0.92; 95% CI, 0.84, 1.02; OR, 1.03; 95% CI, 0.92, 1.15, respectively). Further separate analyses showed similar results for males and females. Conclusion There is no association between behavior problems in childhood and hypertension in midlife

Defective monocyte oxidative burst predicts infection in alcoholic hepatitis and is associated with reduced expression of NADPH oxidase

Objective In order to explain the increased susceptibility to serious infection in alcoholic hepatitis, we evaluated monocyte phagocytosis, aberrations of associated signalling pathways and their reversibility, and whether phagocytic defects could predict subsequent infection. Design Monocytes were identified from blood samples of 42 patients with severe alcoholic hepatitis using monoclonal antibody to CD14. Phagocytosis and monocyte oxidative burst (MOB) were measured ex vivo using flow cytometry, luminometry and bacterial killing assays. Defects were related to the subsequent development of infection. Intracellular signalling pathways were investigated using western blotting and PCR. Interferon-γ (IFN-γ) was evaluated for its therapeutic potential in reversing phagocytic defects. Paired longitudinal samples were used to evaluate the effect of in vivo prednisolone therapy. Results MOB, production of superoxide and bacterial killing in response to Escherichia coli were markedly impaired in patients with alcoholic hepatitis. Pretreatment MOB predicted development of infection within two weeks with sensitivity and specificity that were superior to available clinical markers. Accordingly, defective MOB was associated with death at 28 and 90 days. Expression of the gp91phox subunit of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase was reduced in patients with alcoholic hepatitis demonstrating defective MOB. Monocytes were refractory to IFN-γ stimulation and showed high levels of a negative regulator of cytokine signalling, suppressor of cytokine signalling-1. MOB was unaffected by 7 days in vivo prednisolone therapy. Conclusions Monocyte oxidative burst and bacterial killing is impaired in alcoholic hepatitis while bacterial uptake by phagocytosis is preserved. Defective MOB is associated with reduced expression of NADPH oxidase in these patients and predicts the development of infection and death

Identification of Regulatory Requirements Relevant to Business Processes: A Comparative Study on Generative AI, Embedding-based Ranking, Crowd and Expert-driven Methods

Organizations face the challenge of ensuring compliance with an increasing amount of requirements from various regulatory documents. Which requirements are relevant depends on aspects such as the geographic location of the organization, its domain, size, and business processes. Considering these contextual factors, as a first step, relevant documents (e.g., laws, regulations, directives, policies) are identified, followed by a more detailed analysis of which parts of the identified documents are relevant for which step of a given business process. Nowadays the identification of regulatory requirements relevant to business processes is mostly done manually by domain and legal experts, posing a tremendous effort on them, especially for a large number of regulatory documents which might frequently change. Hence, this work examines how legal and domain experts can be assisted in the assessment of relevant requirements. For this, we compare an embedding-based NLP ranking method, a generative AI method using GPT-4, and a crowdsourced method with the purely manual method of creating relevancy labels by experts. The proposed methods are evaluated based on two case studies: an Australian insurance case created with domain experts and a global banking use case, adapted from SAP Signavio's workflow example of an international guideline. A gold standard is created for both BPMN2.0 processes and matched to real-world textual requirements from multiple regulatory documents. The evaluation and discussion provide insights into strengths and weaknesses of each method regarding applicability, automation, transparency, and reproducibility and provide guidelines on which method combinations will maximize benefits for given characteristics such as process usage, impact, and dynamics of an application scenario

Down-titration of biologics for the treatment of rheumatoid arthritis: A systematic literature review

Biologic therapies have improved the management of rheumatoid arthritis (RA) and the treat-to-target approach has resulted in many patients achieving remission. In the current treatment landscape, clinicians have begun considering dose reduction/tapering for their patients. Rheumatology guidelines in Asia, Europe, and the United States include down-titration of biologics but admit that the level of evidence is moderate. We conducted a systematic literature review to assess the published studies that evaluate down-titration of biologics in RA. The published literature was searched for studies that down-titrated the following biologics: abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, rituximab, and tocilizumab. Eligible studies included randomized controlled trials (RCTs), non-RCTs, observational, and pharmacoeconomic studies. The outcomes of interest were (1) efficacy and health-related quality of life, (2) disease flares, and (3) impact on cost. Eleven full-text publications were identified; only three were RCTs. Study results suggest that dosing down may be an option in many patients who have achieved remission or low disease activity. However, some patients are likely to experience a disease flare. Across the studies, the definition of disease flare and the down-titration criteria were inconsistent, making it difficult to conclude which patients may be appropriate and when to attempt down-titration. Studies have evaluated the practice of dosing down biologic therapy in patients with RA; however, a relatively small number of RCTs have been published. Although down-titration may be an option for some patients in LDA or remission, additional RCTs are needed to provide guidance on this practice

Serological Survey of Antibodies against Brucella Organisms in One Humped Camel (Camelus dromedarius) Herds in the Lake Chad Area of Borno State, North Eastern Nigeria

Sero-prevalence of brucellosis in the one-humped camel (Camelus dromedarius) was carried out in the Lake Chad area of Borno state. A total of two hundred and fifty four (254) sera samples collected from adult camels in herds located in the Lake Chad Area of Borno state, North easternNigeria, were tested using Rose Bengal Plate test (RBPT) and Microtitre Serum Agglutination Test (MSAT). Twenty four samples (9.4%) were positive by both RBPT and MSAT, out of which 10 (3.9%) and 14 (5.5%) were males andfemale respectively. There was no statistically significant association between sex and positive serological reaction (P>0.05

Poisoning Attacks against Recommender Systems: A Survey

Modern recommender systems (RS) have seen substantial success, yet they remain vulnerable to malicious activities, notably poisoning attacks. These attacks involve injecting malicious data into the training datasets of RS, thereby compromising their integrity and manipulating recommendation outcomes for gaining illicit profits. This survey paper provides a systematic and up-to-date review of the research landscape on Poisoning Attacks against Recommendation (PAR). A novel and comprehensive taxonomy is proposed, categorizing existing PAR methodologies into three distinct categories: Component-Specific, Goal-Driven, and Capability Probing. For each category, we discuss its mechanism in detail, along with associated methods. Furthermore, this paper highlights potential future research avenues in this domain. Additionally, to facilitate and benchmark the empirical comparison of PAR, we introduce an open-source library, ARLib, which encompasses a comprehensive collection of PAR models and common datasets. The library is released at https://github.com/CoderWZW/ARLib.Comment: 9 pages,3 figure