SRHR Aspiration Research Cluster Publications

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In-depth proteome coverage of in vitro-cultured Treponema pallidum and quantitative comparison analyses with in vivo-grown treponemes
(Journal of Proteome Research, 2024) Houston, Simon; Gomez, Alloysius; Geppert, Andrew; Goodyear, Mara C.; Cameron, Caroline E.
Previous mass spectrometry (MS)-based global proteomics studies have detected a combined total of 86% of all Treponema pallidum proteins under infection conditions (in vivo-grown T. pallidum). Recently, a method was developed for the long-term culture of T. pallidum under in vitro conditions (in vitro-cultured T. pallidum). Herein, we used our previously reported optimized MS-based proteomics approach to characterize the T. pallidum global protein expression profile under in vitro culture conditions. These analyses provided a proteome coverage of 94%, which extends the combined T. pallidum proteome coverage from the previously reported 86% to a new combined total of 95%. This study provides a more complete understanding of the protein repertoire of T. pallidum. Further, comparison of the in vitro-expressed proteome with the previously determined in vivo-expressed proteome identifies only a few proteomic changes between the two growth conditions, reinforcing the suitability of in vitro-cultured T. pallidum as an alternative to rabbit-based treponemal growth. The MS proteomics data have been deposited in the MassIVE repository with the data set identifier MSV000093603 (ProteomeXchange identifier PXD047625).
Canadian network for mood and anxiety treatments 2024 clinical practice guideline for the management of perinatal mood, anxiety and related disorders
(Canadian Journal of Psychiatry, 2025) Vigod, Simone N.; Frey, Benicio; Clark, Crystal T.; Grigoriadis, Sophie; Barker, Lucy C.; Brown, Hilary K.; Charlebois, Jaime; Dennis, Cindy Lee; Fairbrother, Nichole; Green, Sheryl; Letourneau, Nicole L.; Oberlander, Tim F.; Sharma, Verinder; Singla, Daisy R.; Stewart, Donna E; Tomasi, Patricia; Ellington, Brittany D.; Fleury, Cathleen; Tarasoff, Lesley A.; Tomfohr-Madsen, Lianne; Da Costa, Deborah; Beaulieu, Serge; Brietzke, Elisa; Kennedy, Sidney H.; Lam, Raymond W.; Milev, Roumen V.; Parikh, Sagar V.; Ravindran, Arun V.; Samaan, Zainab; Schaffer, Ayal; Taylor, Valerie H.; Tourjman, Smadar V.; Van Ameringen, Michael; Yatham, Lakshmi N.; Van Lieshout, Ryan J.
Background The Canadian Network for Mood and Anxiety Treatments (CANMAT) publishes clinical practice guidelines for mood and anxiety disorders. This CANMAT guideline aims to provide comprehensive clinical guidance for the pregnancy and postpartum (perinatal) management of mood, anxiety and related disorders. Methods CANMAT convened a core editorial group of interdisciplinary academic clinicians and persons with lived experience (PWLE), and 3 advisory panels of PWLE and perinatal health and perinatal mental health clinicians. We searched for systematic reviews of prevention and treatment interventions for perinatal depressive, bipolar, anxiety, obsessive–compulsive and post-traumatic stress disorders (January 2013–October 2023). We prioritized evidence from reviews of randomized controlled trials (RCTs), except for the perinatal safety of medications where reviews of large high-quality observational studies were prioritized due to the absence of RCT data. Targeted searches for individual studies were conducted when systematic reviews were limited or absent. Recommendations were organized by lines of treatment based on CANMAT-defined levels of evidence quality, supplemented by editorial group consensus to balance efficacy, safety, tolerability and feasibility considerations. Results The guideline covers 10 clinical sections in a question-and-answer format that maps onto the patient care journey: case identification; organization and delivery of care; non-pharmacological (lifestyle, psychosocial, psychological), pharmacological, neuromodulation and complementary and alternative medicine interventions; high-risk clinical situations; and mental health of the father or co-parent. Equity, diversity and inclusion considerations are provided. Conclusions This guideline's detailed evidence-based recommendations provide clinicians with key information to promote the delivery of effective and safe perinatal mental healthcare. It is hoped that the guideline will serve as a valuable tool for clinicians in Canada and around the world to help optimize clinical outcomes in the area of perinatal mental health.
Proteomic analysis of the Treponema pallidum subsp. pallidum ss14 strain: Coverage and comparison with the Nichols strain proteome
(Frontiers in Microbiology, 2024) Houston, Simon; Marshall, Steven; Gomez, Alloysius; Cameron, Caroline E.
Introduction: Strains of the syphilis spirochete, Treponema pallidum ssp. pallidum, group into one of two deep-branching clades: the Nichols clade or the globally dominant Street Strain 14 (SS14) clade. To date, in-depth proteome-wide analyses have focused on Nichols clade strains. Methods: The T. pallidum SS14 clade reference strain (SS14) proteome was characterized via protein detection and quantification analyses using mass spectrometry, and comparison was made to the Nichols clade reference strain (Nichols) proteome. Results: Approximately two thirds of all proteins from T. pallidum SS14 were detected and quantitated, allowing confirmation of expression of 259 proteins for the first time in this strain, including 11 known/putative outer membrane proteins (OMPs). SS14 and Nichols proteome comparative analyses demonstrated similar protein expression/quantification profiles between the two strains, and showed that inter-strain amino acid sequence differences are located primarily within predicted surface-exposed regions in 16 known/putative OMPs. Discussion: This study provides the first comparative analyses of the proteomes from the T. pallidum SS14 and Nichols strains. The findings inform syphilis vaccine design by confirming the expression of known/predicted OMP vaccine candidates in SS14 treponemes, and via the finding that most inter-strain variable residues found in OMPs are predicted to be located in surface-exposed, host-facing regions of these proteins.
Syphilis vaccine development: Aligning vaccine design with manufacturing requirements
(Human Vaccines & Immunotherapeutics, 2024) Waugh, Sean; Cameron, Caroline E.
Syphilis, caused by Treponema pallidum subsp. pallidum, is a global health concern with increasing rates worldwide. Current prevention strategies, including screen-and-treat approaches, are not sufficient to resolve rising infection rates, emphasizing the need for a vaccine. Developing a syphilis vaccine necessitates a range of cross-disciplinary considerations, including essential disease-specific protection, technical requirements, economic feasibility, manufacturing constraints, public acceptance, equitable vaccine access, alignment with global public vaccination programs, and identification of essential populations to be vaccinated to achieve herd immunity. Central to syphilis vaccine development is prioritization of global vaccine availability, including access in low- to middle-income settings. Various vaccine platforms, including subunit, virus-like particle (VLP), mRNA, and outer membrane vesicle (OMV) vaccines, present both advantages and challenges. The proactive consideration of both manufacturing feasibility and efficacy throughout the pre-clinical research and development stages is essential for producing an efficacious, inexpensive, and scalable syphilis vaccine to address the growing global health burden caused by this disease.
Identification of antibodies induced by immunization with the syphilis vaccine candidate Tp0751
(Vaccine, 2025) Urselli, Francesca; Gomez, Alloysius; Gray, Matthew D.; Cameron, Caroline E.; Taylor, Justin J.
The continued and increasing prevalence of syphilis worldwide highlights the need for an effective syphilis vaccine to complement public health measures. Previous work demonstrated that immunization of the rabbit animal model with vaccine candidates derived from the T. pallidum endothelial cell adhesin Tp0751 could reduce dissemination of T. pallidum to lymph nodes. In those studies, a proportion of animals exhibited complete inhibition of treponemal dissemination and others exhibited partial or no inhibition of treponemal dissemination, consistent with results expected from an outbred animal model. In the current study we further characterized the Tp0751-specific antibody response in immunized animals that showed inhibition of T. pallidum dissemination. To do this, we generated Tp0751 tetramers to identify Tp0751-specific B cells before and after immunization. Using this approach, we found a robust expansion of Tp0751-specific B cells in the blood and spleens of immunized animals compared to unimmunized control animals. Ten antibodies from Tp0751-immunized rabbits were cloned and binding to specific structural regions of the Tp0751 protein was assessed using epitope mapping assays and structural modeling. Importantly, nine out of the ten antibodies cloned from Tp0751 tetramer-binding B cells were able to significantly inhibit T. pallidum attachment to human endothelial cells in vitro, including antibodies exhibiting weaker binding to Tp0751. Combined, our results provide a proof-of-principle that Tp0751-based subunit vaccines can stimulate strong B cell responses resulting in the production of antibodies able to inhibit T. pallidum attachment to endothelial cells.
Treponema pallidum induces pro-inflammatory cytokine secretion in macrophages and macrophage-endothelial co-cultures
(Frontiers in Cellular and Infection Microbiology, 2025) Waugh, Sean; Ranasinghe, Akash; Reynolds, Lisa A.; Cameron, Caroline E.
Syphilis, caused by the extracellular bacterium Treponema pallidum ssp. pallidum, is a multi-stage and systemic infection that is lifelong in the absence of treatment. Two host cell types that frequently encounter T. pallidum during infection are endothelial cells and macrophages; treponemes disseminate through the vasculature and cross the blood–brain and placental barriers by traversing endothelial cell barriers, and macrophages are known to be critical for clearance of T. pallidum. Despite the importance of macrophages in treponemal clearance and endothelial cells in treponemal dissemination, a comprehensive understanding of the cytokines secreted by T. pallidum-exposed macrophages in the presence and absence of endothelial cells has not yet been achieved. To address this knowledge gap, we conducted time-course cytokine secretion profiling of macrophage-differentiated THP-1 cells alone and in co-culture with human brain microvascular endothelial cells. These experiments revealed reduced IL-8 secretion and increased secretion of RANTES, soluble ICAM-1, IL-1?, MCP-1, GM-CSF, TNF, and IL-6 in T. pallidum-exposed macrophage monocultures and macrophage-endothelial cell co-cultures compared to the same culture conditions in the absence of T. pallidum. These investigations enhance our understanding of macrophage-mediated, T. pallidum-focused innate immune responses occurring at endothelial sites. Further, this study provides insight into pro-inflammatory mechanisms elicited after exposure to this pathogen that may contribute to endothelial junction disruption, T. pallidum dissemination, and syphilis symptoms.
New pathways in syphilis vaccine development
(Sexually Transmitted Diseases, 2024) Liu, Andy; Giacani, Lorenzo; Hawley, Kelly L.; Cameron, Caroline E.; Seña, Arlene C.; Konda, Kelika A.; Radolf, Justin D.; Klausner, Jeffrey D.
The New Pathways in Syphilis Vaccine Development meeting was held before the start of the STI & HIV 2023 World Congress as a pre-meeting symposium to highlight recent advances in the development of an effective syphilis vaccine and discuss the challenges still faced by investigators. Internationally renowned public health officials, clinical investigators, and basic researchers from academia, government, and community-based organizations met on July 24, 2023, in Chicago, Illinois. Four speakers discussed key research findings in syphilis vaccine development, which included antigen selection, identification of epitopes associated with protective immunity, and delivery platforms, with great emphasis on development of chimeric antigens. Significant progress was also shown on the elucidation of Treponema pallidum genomes from virtually all continents to assess the diversity in vaccine candidates of the syphilis spirochete.
The relationship of childhood maltreatment, adult sexual victimization, depressed mood and symptoms of trauma with fear of childbirth
(Journal of Affective Disorders, 2025) Fairbrother, Nichole; Keeney, Cora; Mao, Yue; Beck, Quincy M.
Background: Fear of childbirth (FoB) is experienced to some degree by most pregnant people and can be intense enough to merit treatment. Despite significant research on the topic of FoB, studies investigating various forms of maltreatment and mental health symptoms in relation to FoB are very limited. In particular, studies including multiple forms of maltreatment along with mental health symptoms as predictors of FoB are extremely limited. We sought to fill this gap and clarify the relative contributions of these variables to the prediction of FoB. Methods: This was a secondary analysis of data from pregnant people in Canada. Participants (N = 881) provided demographic and reproductive history information, completed self-report measures of FoB, childhood maltreatment (multiple forms), adult sexual victimization, depressed mood and symptoms of posttraumatic stress disorder (PTSD). They were also administered a diagnostic interview to assess for specific phobia, FoB. Analyses included descriptive information, Wilcoxon rank sum tests, linear and logistic regression, and path analysis. Results: Most forms of maltreatment showed some association with increased FoB. However, when assessed together, only emotional maltreatment remained a significant predictor of FoB. Both depressed mood and symptoms of PTSD contributed more to FoB than maltreatment, and mediated the relationship of emotional maltreatment with FoB. The only direct effects of childhood emotional maltreatment on FoB were for fears of medical interventions and feelings of embarrassment during labour and delivery. Limitations: Study findings fill significant gaps in our understanding of the relationship between maltreatment, mental health symptoms and FoB. However, the study sample was limited to Canadian participants, most of whom were socio-economically advantaged, cis-gender women of European descent, thus limiting the generalizability of the findings. Further, as childhood maltreatment and sexual assault experiences in adulthood were reported retrospectively, study findings are also vulnerable to recall bias. Conclusions: Findings contribute to our understanding of the relationship between childhood maltreatment, adult sexual victimization, mental health and FoB. These findings can facilitate future research and improved care via a focus on depressed mood, symptoms of PTSD, emotional maltreatment and specific fears of medical interventions and social discomfort as significant contributors to one's experience of FoB.
Time-course transcriptomics reveals the impact of Treponema pallidum on microvascular endothelial cell function and phenotype
(Frontiers in Microbiology, 2025) Waugh, Sean; Goodyear, Mara C.; Gomez, Alloysius; Ranasinghe, Akash; Lithgow, Karen V.; Falsafi, Reza; Hancock, Robert E. W.; Lee, Amy H.; Cameron, Caroline E.
Syphilis, caused by Treponema pallidum subsp. pallidum, is an urgent global public health threat. Syphilis vaccine development has been impeded by limited understanding of the molecular mechanisms that enable T. pallidum to establish and maintain infection. The vascular endothelium is critical for T. pallidum attachment, dissemination, and host immune response initiation; however, the molecular details of T. pallidum-endothelial interactions are incompletely understood. To enhance understanding, we performed time-course transcriptomic profiling on T. pallidum-exposed brain microvascular endothelial cells. These analyses showed T. pallidum exposure altered pathways related to extracellular matrix, growth factors, integrins, and Rho GTPases. The induced transcriptional response was consistent with endothelial to mesenchymal transition, a process involved in fetal development and vascular dysfunction. In cells exposed to T. pallidum, the primary transcription factor associated with this process (Snail) was increased at both the transcript and protein levels, and microscopy analyses demonstrate F-actin cellular contraction. This study provides a comprehensive understanding of the molecular responses of endothelial cells to T. pallidum and identified the host pathways that might cause syphilis disease symptoms, information that could aid in syphilis vaccine design.
Anxiety and related disorders during the perinatal and postpartum periods
(Annual Review of Clinical Psychology, 2025) Fairbrother, Nichole; Challacombe, Fiona L.; Green, Sheryl M.; O'Mahen, Heather A.
Anxiety and anxiety-related disorders are, as a group, the most common mental health conditions and are more common among women compared with among men. It is now evident that these disorders affect one in five pregnant and postpartum people and are more common than depression. For some disorders (e.g., obsessive–compulsive disorder), there is also evidence of an elevated risk for their development and exacerbation during perinatal periods. In this article, we review the literature pertaining to anxiety and anxiety-related disorders during the perinatal period. We also provide information related to pregnancy-specific anxiety and fear of childbirth constructs that exist outside of diagnostic classification but are particularly important in the perinatal context. We review the scope, prevalence, and etiology of these disorders as well as comorbidity, screening, assessment, and treatment. We conclude with an overview of some of the key gaps in knowledge and recommendations for future research.
DMEM and EMEM are suitable surrogate media to mimic host environment and expand leptospiral pathogenesis studies using in vitro tools
(bioRxiv, 2025) Garcia, Leandro E.; Lin, Zitong; Culos, Sophie; Muenker, M Catherine; Johnson, Emily E.; Wang, Zheng; Lopez-Giraldez, Francesc; Giraud-Gatineau, Alexandre; Jackson, Angela; Picardeau, Mathieu; Goodlett, David R.; Townsend, Jeffrey P.; Pětrošová, Helena; Wunder, Elsio A., Jr.
Pathogenic Leptospira species can survive and thrive in a wide range of environments. Distinct environments expose the bacteria to different temperatures, osmolarities, and amounts and sources of nutrition. However, leptospires are mostly cultured, in a laboratory setting under in vitro conditions that do not reflect natural environments. This constraint on laboratory cultures limits the applicability of in vitro studies to the understanding of even simple pathogenic processes. Here we report, investigate, and identify a medium and conditions that mimic the host environment during leptospirosis infection, expanding the available in vitro tools to evaluate leptospiral pathogenesis. We quantified genome-wide gene expression of pathogenic Leptospira interrogans cultured in different in vitro media compositions (EMJH, DMEM, EMEM, and HAN). Using EMJH as standard, we compared gene expression in these compositions to genome-wide gene expression gathered in a host environment: whole blood (WB) of hamsters after infection with pathogenic leptospires. Leptospires cultured in DMEM and EMEM media shared 40% and 47% of all differentially expressed genes (DEGs) of leptospires present within WB (FDR<0.01), while leptospires cultured in HAN media only shared 20% of DEGs with those from WB. Furthermore, gene and pathway expression of leptospires cultured on DMEM and EMEM media exhibited a better correlation with leptospires grown in WB, including promoting expression of a similar leptospiral lipid A profile to the one identified directly in host tissues. Taken together, these results indicate that commercial cell-culture media EMEM or DMEM are better surrogates for in vivo pathogenic studies than EMJH or HAN media in Leptospira. These alternative culture conditions, using media that are a standard supply worldwide, provide a reproducible and cost-effective approach that can accelerate research investigation and reduce the number of animal infections necessary for basic research of leptospirosis.
Novel insights into the distribution and effects of perfluorooctanesulfonic acid (PFOS) in the nervous system of a frog tadpole model by mass spectrometry imaging
(Environmental Science & Technology, 2026) Poulsen, Rikke; Field, Emma M.; Jackson, Angela M.; Kuecks-Winger, Haley; Thambirajah, Anita A.; Goodlett, David R.; Helbing, Caren C.; Pětrošová, Helena
Determining how environmental contaminants localize within tissues is essential for understanding the consequences of sublethal exposures. Therefore, we optimized a mass spectrometry imaging (MSI) workflow to study the distribution and biological effects of contaminants in an environmentally relevant frog tadpole model. We applied the method to the entire tadpole head postexperimental exposure to the legacy contaminant, perfluorooctanesulfonic acid (PFOS; 0.1–100 ?g/L, 48 h). At 10 ?g/L, PFOS unexpectedly localized mainly to the olfactory epithelium. At 100 ?g/L, PFOS was distributed throughout all tissues except for the brain, where only the pineal gland showed significant accumulation. The pineal gland, a neuroendocrine organ regulating the circadian rhythm, is not protected by the blood–brain barrier. Together, these findings indicate that PFOS did not readily cross the blood–brain barrier. In both the olfactory epithelium and pineal gland, effects of PFOS were reflected in changes in the abundances of endogenous lipids. The results open questions for the most adverse outcomes of PFOS exposure, including effects on the olfactory-mediated behavior and circadian rhythm. The present study exemplifies how MSI advances our analytical toolbox. The ability to localize contaminants within biological compartments is critical for the characterization of their toxic effects and risks to wildlife and humans.
Reappraising the relationship between hyperinsulinemia and insulin resistance in PCOS
(Journal of Endocrinology, 2025) Houston, Emma J.; Templeman, Nicole M.
Polycystic ovary syndrome (PCOS), a reproductive endocrine disorder with quintessential features of metabolic dysfunction, affects millions of women worldwide. Hyperinsulinemia (i.e., elevated insulin without hypoglycemia) is a common metabolic feature of PCOS that worsens its reproductive symptoms by exacerbating pituitary hormone imbalances and increasing levels of bioactive androgens. Hyperinsulinemia in PCOS is often attributed to insulin resistance, based on the concept that impaired insulin-mediated glucose disposal would induce compensatory insulin hypersecretion. However, it is challenging to define the sequential relationship between insulin sensitivity and insulin secretion, as they are tightly interlinked, and evidence suggests that hyperinsulinemia can alternatively precede insulin resistance. Notably, other drivers of hyperinsulinemia (outside of insulin resistance) may be highly relevant in the context of PCOS. For instance, high androgen levels can augment both hyperinsulinemia and insulin resistance, generating a self-perpetuating cycle of reproductive and metabolic dysfunction. In this review, we evaluate the cause-and-effect relationships between insulin resistance and hyperinsulinemia in PCOS. We examine evidence for the prevailing theory of insulin resistance as the primary defect that causes secondary compensatory hyperinsulinemia, and an alternative framework of hyperinsulinemia as the earlier defect that perpetuates reproductive and metabolic features of PCOS. Considering the heterogeneous nature of PCOS, it is improbable that its metabolic characteristics always follow the same progression. Comprehensively examining all mechanistic regulators of hyperinsulinemia and insulin resistance in PCOS might thereby lead to improved prevention and management strategies, and address critical knowledge gaps in the progression of PCOS pathogenesis.
Proteomic changes in cancer cell lines as a result of bacterial infection
(Proteomics, 2025) Ren, Bo; Weke, Kenneth; Hardie, Darryl; Goncheva, Mariya I.; Hupp, Ted; Alfaro, Javier Antonio; Pětrošová, Helena; Goodlett, David R.
Bacterial infections have been implicated in shaping the tumor microenvironment (TME), but their effects on cancer cell proteomes remain unexplored. In this study, we analyzed proteomic changes in melanoma (A375) and ovarian cancer (OVCAR3) cell line models following infection with Staphylococcus aureus strain USA300 or Salmonella enterica strain SL1344 using mass spectrometry-based label-free quantitative proteomics. Bacterial infection leads to widespread changes in host protein expression in the cancer cells, with levels of proteins involved in mitochondrial metabolism, RNA processing, and cellular stress response all increasing in relative abundance. In contrast, proteins involved in DNA repair, cytoskeletal structure, vesicle trafficking, and cell cycle regulation were consistently downregulated. The magnitude of the observed changes varied by the cancer cell type. Understanding these interactions may provide new directions for the role of bacteria in tumor progression and therapeutic resistance.
The aesthetic labour of polycystic ovarian syndrome: The strife of heteronormative standards and the possibilities of queering sexualities
(Sexualities, 2025) Cacchioni, Thea
This article contributes to the burgeoning qualitative literature on experiences of Polycystic Ovarian Syndrome (PCOS) by considering PCOS in relation to post-structural theory on gender, sexuality, embodiment, and aesthetic labour. Although to some degree culturally contingent, interview accounts with 30 people diagnosed with PCOS suggest that infertility, hairiness, acne, and/or fatness are a difficult combination with heterosexuality and a source of stigma regardless of identity. This article outlines the aesthetic labour women engaged in to meet heterosexual standards, highlighting structure, and where possible, agency in this work. It also highlights the potential of queer relationships, communities, and perspectives to disrupt heteronormative pressures, considering the promise and limits of bodily acceptance
Glucose enrichment accelerates C. elegans reproductive aging via non-autonomous DAF-2/insulin-like receptor signaling in somatic tissues
(bioRxiv, 2025) Athar, Faria; Houston, Emma J.; Jewett, Emily; Templeman, Nicole M.
Detrimental effects of chronic high-sugar overconsumption can extend from molecular and cellular responses to systemic changes. Reproductive systems are particularly sensitive to diet and energetic state, yet the long-term reproductive consequences of overnutrition are poorly defined. Here, we used Caenorhabditis elegans to study the impacts of glucose excess on reproductive aging. Glucose supplementation shortens C. elegans lifespan, and we found that it also hastens age-related reproductive decline, evidenced by a greater deterioration in oocyte quality and lower fertility with age. We next evaluated insulin-like signaling contributions, as this glucose-responsive pathway is well known to regulate both somatic aging and reproductive aging. Intriguingly, while 20 mM glucose enrichment still shortens the lifespan of daf-2(e1370) mutants, we found that it had no detrimental impact on their reproductive aging phenotypes. Using auxin-induced tissue-selective degradation, we discovered that DAF-2/insulin-like receptor signaling in C. elegans intestine and body wall musculature is required for glucose enrichment to exert damaging impacts on the reproductive system. However, suppressing insulin-like signaling in either of these tissues is sufficient to protect C. elegans against glucose-induced reproductive aging. These findings suggest that insulin-like signalling in metabolically active somatic tissues may represent a key link between overnutrition and reproductive aging.
Insulin levels early in perimenopause inform vasomotor symptom incidence across the menopausal transition
(Journal of Clinical Endocrinology and Metabolism, 2026) Athar, Faria; Gregory, Sarah; Houston, Emma J.; Templeman, Nicole M.
Context Metabolic health affects the menopausal transition. Metabolic characteristics like body mass index (BMI) affect vasomotor syndrome incidence, but the role of elevated insulin, an early marker of metabolic dysfunction, remains understudied. Objective This work aimed to determine whether midlife insulin levels are associated with vasomotor symptom incidence or reproductive hormone trajectories. Methods Longitudinal analyses of community-based data from the Study of Women's Health Across the Nation (SWAN) were conducted. We analyzed the 704 SWAN participants (of 3302) without oophorectomy or hysterectomy who had metabolic data for age 47 and did not take insulin/medications for hyperglycemia. Mean fasting insulin at age 47 was 10.117?µIU/mL (SD = 6.711), with 27.0 BMI (SD = 6.6); the mean age of the final menstrual period for these participants was 51.0 years (SD = 2.3). Main outcome measures included vasomotor symptom timings and durations, and trajectories of estradiol (E2), follicle-stimulating hormone (FSH), and testosterone (T) across the menopausal transition. Results Higher insulin at age 47 predicted younger onsets of hot flashes and night sweats, longer durations of hot flashes and cold sweats, and greater T rise. BMI associations with vasomotor symptoms paralleled those of insulin, but BMI appeared more closely linked to slower E2 decline and blunted FSH rise. In Cox proportional hazards models, elevated age-47 insulin was associated with increased likelihood of hot flashes; this remained statistically significant with BMI and glucose as covariates. Conclusion Perimenopausal fasting insulin and BMI show complementary but distinct associations with menopausal changes. Elevated insulin predicts earlier and prolonged vasomotor symptoms, and is associated with higher T.
Reach of GetCheckedOnline among gay, bisexual, transgender and queer men and Two-Spirit people and correlates of use 5 years after program launch in British Columbia, Canada
(Sexually Transmitted Infections, 2024) Montiel, Andrés; Ablona, Aidan; Klassen, Ben; Card, Kiffer G.; Lachowsky, Nathan J.; Brennan, David J.; Grace, Daniel; Worthington, Catherine; Gilbert, Mark
Objectives: Understanding who uses internet-based sexually transmitted and blood-borne infection (STBBI) services can inform programme implementation, particularly among those most impacted by STBBIs, including gender and sexual minority (GSM) men. GetCheckedOnline, an internet-based STBBI testing service in British Columbia, Canada, launched in 2014. Our objectives were to assess reach, identify factors associated with use of GetCheckedOnline 5 years into implementation and describe reasons for using and not using GetCheckedOnline among GSM men. Methods: The Sex Now 2019 Survey was an online, cross-sectional survey of GSM men in Canada administered from November 2019 to February 2020. Participants were asked a subset of questions related to use of GetCheckedOnline. Multivariable binary logistic regression modelling was used to estimate associations between correlates and use of GetCheckedOnline. Results: Of 431 British Columbia (BC) participants aware of GetCheckedOnline, 27.6% had tested using the service. Lower odds of having used GetCheckedOnline were found among participants with non-white race/ethnicity (adjusted OR (aOR)=0.41 (95% CI 0.21 to 0.74)) and those living with HIV (aOR=0.23 (95% CI 0.05 to 0.76)). Those who usually tested at a walk-in clinic, relative to a sexual health clinic, had greater odds of using GetCheckedOnline (aOR=3.91 (95% CI 1.36 to 11.61)). The most commonly reported reason for using and not using GetCheckedOnline was convenience (78%) and only accessing the website to see how the service worked (48%), respectively. Conclusion: Over a quarter of GSM men in BC aware of GetCheckedOnline had used it. Findings demonstrate the importance of social/structural factors related to use of GetCheckedOnline. Service promotion strategies could highlight its convenience and privacy benefits to enhance uptake.
Shaping the future of Leptospira serotyping
(Journal of Medical Microbiology, 2025) Giraud-Gatineau, Alexandre; Dagbo, Kouessi; Pětrošová, Helena; Werts, Catherine; Veyrier, Fréderic J.; Picardeau, Mathieu
Leptospirosis is a re-emerging zoonosis caused by a diverse range of pathogenic Leptospira, which are divided into species, serogroups and serovars. Although advances in genomics have recently refined species classification, serotyping, which is based on the antigenic variability of lipopolysaccharides O-antigens, still relies heavily on traditional and labour-intensive methods. In addition, the molecular basis of serovar diversity is not fully understood, which poses challenges for rapid and accurate serovar and/or serogroup identification. However, identification of serovars remains crucial for epidemiological studies, surveillance, diagnostics, understanding host–pathogen interactions and vaccine development. In this review, we assess current techniques for Leptospira serovar and serogroup identification and explore emerging DNA-based methodologies for serovar and serogroup prediction.
Diagnostic classification of fear of childbirth: Why specific phobia may not be enough
(Behavioural and Cognitive Psychotherapy, 2025) Fairbrother, Nichole; Keeney, Cora
Background: Fear of childbirth (FoB) is a common experience during pregnancy which can cause clinically significant distress and impairment. To date, a number of investigations of FoB have assumed that clinically significant FoB is best understood as a type of specific phobia. However, preliminary evidence suggests that specific phobia may not be the only diagnostic category under which clinically significant symptoms of FoB are best described. Aim: The current study is the first to investigate which DSM-5 diagnostic categories best describe clinically significant symptoms of FoB. Method: Pregnant people reporting high levels of FoB (n = 18) were administered diagnostic interviews related to their experience of FoB. Results: Participants (n = 18) were predominantly nulliparous (73.3%), cisgender women (83.3%). Of these, 14 (77.8%) met criteria for one or more DSM-5 anxiety-related disorders. Preliminary findings suggest that primary FoB may align with specific phobia criteria, whereas secondary FoB (following a traumatic birth) may be better classified under post-traumatic stress disorder (PTSD). FoB also featured in other anxiety-related disorders but was not the primary focus (e.g. obsessive-compulsive disorder). Four participants did not meet criteria for any DSM-5 disorder. Conclusions: Findings provide preliminary evidence that clinically significant FoB fits within existing DSM-5 categories, in particular specific phobia and PTSD. Although FoB-related concerns appears in other anxiety-related disorder categories, it does not appear as the primary focus. Although informative, due to the small sample employed in this research, replication in larger and more diverse samples is needed.

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