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Article ; Online: Body composition and laboratory parameters in children with down syndrome: The DONUT study

Pecoraro, Luca / Ferron, Elena / Solfa, Martina / Mirandola, Massimo / Lauriola, Silvana / Piacentini, Giorgio / Pietrobelli, Angelo

Clinical Nutrition ESPEN. 2023 Oct., v. 57 p.253-257

2023

Abstract: Children affected by Down syndrome (DS) have a higher prevalence of obesity, dyslipidemia, and altered liver enzymes. This study investigates a small sample of pediatric patients with DS and possible associations among their anthropometric and laboratory ...

Abstract	Children affected by Down syndrome (DS) have a higher prevalence of obesity, dyslipidemia, and altered liver enzymes. This study investigates a small sample of pediatric patients with DS and possible associations among their anthropometric and laboratory data. Cross-sectional study involving 33 children (5–17 years old) affected by DS. Children underwent the measurement of anthropometric parameters through bioelectrical impedance analysis and a venous sampling to check their hepatic and lipid profiles. 54.6% of subjects were overweight or obese according to WHO (BMI z-score ≥1) and 42% of subjects were overweight or obese according to McCarthy et al. with a percentage of body fat (PBF) ≥ 85° centiles. 28% of subjects were dyslipidemic, showing an alteration of total, LDL, HDL cholesterol or triglycerides according to our laboratory reference values, and a low HDL value (under the normal range for gender and age) was the most frequent lipidic alteration (12.5%). An association was found between some values: lower HDL value was associated with higher PBF (p = 0.025); higher ALT value was associated with higher BMI z-score (p = 0.01) and higher PBF (p = 0.01); higher GGT value was associated with higher BMI z-score (p = 0.002) and higher PBF (p = 0.002). Children with DS are at high risk for obesity and its complications. Our results show dyslipidemia and altered liver enzymes in obese subjects. Pediatricians should monitor children with DS for obesity and consider liver function testing and lipid profiles on children with DS and obesity.
Keywords	Down syndrome ; bioelectrical impedance ; body fat ; clinical nutrition ; cross-sectional studies ; gender ; high density lipoprotein cholesterol ; hyperlipidemia ; liver ; liver function ; obesity ; risk ; Childhood obesity ; Dyslipidemia ; Non-alcoholic fatty liver disease ; DS ; PBF ; HDL ; ALT ; GGT ; BMI ; BIA ; NAFLD
Language	English
Dates of publication	2023-10
Size	p. 253-257.
Publishing place	Elsevier Ltd
Document type	Article ; Online
ISSN	2405-4577
DOI	10.1016/j.clnesp.2023.07.003
Database	NAL-Catalogue (AGRICOLA)

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Article: A Scalable Pseudonymization Tool for Rapid Deployment in Large Biomedical Research Networks: Development and Evaluation Study.

Abu Attieh, Hammam / Neves, Diogo Telmo / Guedes, Mariana / Mirandola, Massimo / Dellacasa, Chiara / Rossi, Elisa / Prasser, Fabian

JMIR medical informatics

2024 Volume 12, Page(s) e49646

Abstract: Background: The SARS-CoV-2 pandemic has demonstrated once again that rapid collaborative research is essential for the future of biomedicine. Large research networks are needed to collect, share, and reuse data and biosamples to generate collaborative ... ...

Abstract	Background: The SARS-CoV-2 pandemic has demonstrated once again that rapid collaborative research is essential for the future of biomedicine. Large research networks are needed to collect, share, and reuse data and biosamples to generate collaborative evidence. However, setting up such networks is often complex and time-consuming, as common tools and policies are needed to ensure interoperability and the required flows of data and samples, especially for handling personal data and the associated data protection issues. In biomedical research, pseudonymization detaches directly identifying details from biomedical data and biosamples and connects them using secure identifiers, the so-called pseudonyms. This protects privacy by design but allows the necessary linkage and reidentification. Objective: Although pseudonymization is used in almost every biomedical study, there are currently no pseudonymization tools that can be rapidly deployed across many institutions. Moreover, using centralized services is often not possible, for example, when data are reused and consent for this type of data processing is lacking. We present the ORCHESTRA Pseudonymization Tool (OPT), developed under the umbrella of the ORCHESTRA consortium, which faced exactly these challenges when it came to rapidly establishing a large-scale research network in the context of the rapid pandemic response in Europe. Methods: To overcome challenges caused by the heterogeneity of IT infrastructures across institutions, the OPT was developed based on programmable runtime environments available at practically every institution: office suites. The software is highly configurable and provides many features, from subject and biosample registration to record linkage and the printing of machine-readable codes for labeling biosample tubes. Special care has been taken to ensure that the algorithms implemented are efficient so that the OPT can be used to pseudonymize large data sets, which we demonstrate through a comprehensive evaluation. Results: The OPT is available for Microsoft Office and LibreOffice, so it can be deployed on Windows, Linux, and MacOS. It provides multiuser support and is configurable to meet the needs of different types of research projects. Within the ORCHESTRA research network, the OPT has been successfully deployed at 13 institutions in 11 countries in Europe and beyond. As of June 2023, the software manages data about more than 30,000 subjects and 15,000 biosamples. Over 10,000 labels have been printed. The results of our experimental evaluation show that the OPT offers practical response times for all major functionalities, pseudonymizing 100,000 subjects in 10 seconds using Microsoft Excel and in 54 seconds using LibreOffice. Conclusions: Innovative solutions are needed to make the process of establishing large research networks more efficient. The OPT, which leverages the runtime environment of common office suites, can be used to rapidly deploy pseudonymization and biosample management capabilities across research networks. The tool is highly configurable and available as open-source software.
Language	English
Publishing date	2024-04-23
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2798261-0
ISSN	2291-9694
ISSN	2291-9694
DOI	10.2196/49646
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Article ; Online: Body composition and laboratory parameters in children with down syndrome: The DONUT study.

Pecoraro, Luca / Ferron, Elena / Solfa, Martina / Mirandola, Massimo / Lauriola, Silvana / Piacentini, Giorgio / Pietrobelli, Angelo

Clinical nutrition ESPEN

2023 Volume 57, Page(s) 253–257

Abstract: Background & aims: Children affected by Down syndrome (DS) have a higher prevalence of obesity, dyslipidemia, and altered liver enzymes. This study investigates a small sample of pediatric patients with DS and possible associations among their ... ...

Abstract	Background & aims: Children affected by Down syndrome (DS) have a higher prevalence of obesity, dyslipidemia, and altered liver enzymes. This study investigates a small sample of pediatric patients with DS and possible associations among their anthropometric and laboratory data. Methods: Cross-sectional study involving 33 children (5-17 years old) affected by DS. Children underwent the measurement of anthropometric parameters through bioelectrical impedance analysis and a venous sampling to check their hepatic and lipid profiles. Results: 54.6% of subjects were overweight or obese according to WHO (BMI z-score ≥1) and 42% of subjects were overweight or obese according to McCarthy et al. with a percentage of body fat (PBF) ≥ 85° centiles. 28% of subjects were dyslipidemic, showing an alteration of total, LDL, HDL cholesterol or triglycerides according to our laboratory reference values, and a low HDL value (under the normal range for gender and age) was the most frequent lipidic alteration (12.5%). An association was found between some values: lower HDL value was associated with higher PBF (p = 0.025); higher ALT value was associated with higher BMI z-score (p = 0.01) and higher PBF (p = 0.01); higher GGT value was associated with higher BMI z-score (p = 0.002) and higher PBF (p = 0.002). Conclusions: Children with DS are at high risk for obesity and its complications. Our results show dyslipidemia and altered liver enzymes in obese subjects. Pediatricians should monitor children with DS for obesity and consider liver function testing and lipid profiles on children with DS and obesity.
MeSH term(s)	Humans ; Child ; Child, Preschool ; Adolescent ; Down Syndrome ; Overweight/complications ; Cross-Sectional Studies ; Body Composition ; Obesity/complications ; Cholesterol, HDL
Chemical Substances	Cholesterol, HDL
Language	English
Publishing date	2023-07-10
Publishing country	England
Document type	Journal Article
ISSN	2405-4577
ISSN (online)	2405-4577
DOI	10.1016/j.clnesp.2023.07.003
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Article ; Online: Mediterranean diet and physical activity in Down syndrome pediatric subjects: the DONUT STUDY

Pecoraro, Luca / Solfa, Martina / Ferron, Elena / Mirandola, Massimo / Lauriola, Silvana / Piacentini, Giorgio / Pietrobelli, Angelo

International Journal of Food Sciences and Nutrition. 2022 Oct. 3, v. 73, no. 7 p.973-980

2022

Abstract: Children with Down syndrome (DS) are characterised by peculiar dietary choices and approach to physical activity. The aim of this study is to quantify their adherence to the Mediterranean diet, their level of physical activity and lipid profile. Cross- ... ...

Abstract	Children with Down syndrome (DS) are characterised by peculiar dietary choices and approach to physical activity. The aim of this study is to quantify their adherence to the Mediterranean diet, their level of physical activity and lipid profile. Cross-sectional study, involving 61 children affected by DS. Parents of the patients were requested to complete two questionnaires, Mediterranean Diet Quality Index in children and adolescents (KIDMED) and Godin Leisure-Time Physical Activity Questionnaire (Godin). In addition, children underwent a venous sampling to check their lipid profile. High scores on KIDMED and Godin were found and were associated with a reduced likelihood of being overweight or obese (0.001< p < 0.077; 0.001< p < 0.248). The level of physical activity and the probability of finding pathological HDL values in plasma were inversely related (0.001< p < 0.263). The DONUT study proves that KIDMED and Godin questionnaires can identify children affected by DS that can lead to develop inadequate anthropometric variables and low levels of HDL cholesterol. Moreover, the results of this study show that, despite potential difficulties in the pursuit of a correct diet and an adequate approach to physical activity, children with DS could achieve results that are substantially like those of non-DS children.
Keywords	Down syndrome ; Mediterranean diet ; cross-sectional studies ; food quality ; high density lipoprotein cholesterol ; lipid composition ; overweight ; physical activity ; probability ; questionnaires ; childhood obesity ; KIDMED questionnaire ; Godin questionnaire
Language	English
Dates of publication	2022-1003
Size	p. 973-980.
Publishing place	Taylor & Francis
Document type	Article ; Online
ZDB-ID	1121877-0
ISSN	1465-3478 ; 0963-7486
ISSN (online)	1465-3478
ISSN	0963-7486
DOI	10.1080/09637486.2022.2104227
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Article ; Online: Mediterranean diet and physical activity in Down syndrome pediatric subjects: the DONUT STUDY.

Pecoraro, Luca / Solfa, Martina / Ferron, Elena / Mirandola, Massimo / Lauriola, Silvana / Piacentini, Giorgio / Pietrobelli, Angelo

International journal of food sciences and nutrition

2022 Volume 73, Issue 7, Page(s) 973–980

Abstract: Introduction: Children with Down syndrome (DS) are characterised by peculiar dietary choices and approach to physical activity. The aim of this study is to quantify their adherence to the Mediterranean diet, their level of physical activity and lipid ... ...

Abstract	Introduction: Children with Down syndrome (DS) are characterised by peculiar dietary choices and approach to physical activity. The aim of this study is to quantify their adherence to the Mediterranean diet, their level of physical activity and lipid profile. Methods: Cross-sectional study, involving 61 children affected by DS. Parents of the patients were requested to complete two questionnaires, Results: High scores on KIDMED and Godin were found and were associated with a reduced likelihood of being overweight or obese (0.001< Conclusions: The
MeSH term(s)	Adolescent ; Child ; Humans ; Diet, Mediterranean ; Cross-Sectional Studies ; Down Syndrome ; Cholesterol, HDL ; Exercise ; Surveys and Questionnaires ; Feeding Behavior
Chemical Substances	Cholesterol, HDL
Language	English
Publishing date	2022-07-31
Publishing country	England
Document type	Journal Article
ZDB-ID	1121877-0
ISSN	1465-3478 ; 0963-7486
ISSN (online)	1465-3478
ISSN	0963-7486
DOI	10.1080/09637486.2022.2104227
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Mycoplasma genitalium

Sandri, Angela / Carelli, Maria / Visentin, Alessandro / Savoldi, Alessia / De Grandi, Gelinda / Mirandola, Massimo / Lleo, Maria M / Signoretto, Caterina / Cordioli, Maddalena

Frontiers in cellular and infection microbiology

2023 Volume 13, Page(s) 1155451

Abstract: Background: Mycoplasma genitalium: Methods: From 2017 to 2021, genital (urine) and extragenital (pharyngeal and anorectal swabs) biological specimens were provided by men-who-have-sex-with-men (MSM) attending the STI clinic of the Infectious Disease ... ...

Abstract	Background: Mycoplasma genitalium Methods: From 2017 to 2021, genital (urine) and extragenital (pharyngeal and anorectal swabs) biological specimens were provided by men-who-have-sex-with-men (MSM) attending the STI clinic of the Infectious Disease Unit at the Verona University Hospital, Verona, Italy. A total of 1040 MSM were evaluated and 107 samples from 96 subjects resulted positive for MG. Among the MG-positive samples, all those available for further analysis (n=47) were considered for detection of mutations known to be associated with macrolide and quinolone resistance. 23S rRNA, Results: A total of 96/1040 (9.2%) subjects tested positive for MG in at least one anatomical site. MG was detected in 107 specimens: 33 urine samples, 72 rectal swabs and 2 pharyngeal swabs. Among them, 47 samples from 42 MSM were available for investigating the presence of mutations associated with macrolide and quinolone resistance: 30/47 (63.8%) showed mutations in 23S rRNA while 10/47 (21.3%) in Conclusion: Our observations confirm that mutations in 23S rRNA gene are associated with azithromycin treatment failure and that mutations in
MeSH term(s)	Male ; Humans ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Moxifloxacin/pharmacology ; Azithromycin/pharmacology ; Mycoplasma genitalium/genetics ; Homosexuality, Male ; Fluoroquinolones/pharmacology ; RNA, Ribosomal, 23S/genetics ; Macrolides/pharmacology ; Drug Resistance, Bacterial/genetics ; Sexual and Gender Minorities ; Mutation ; Sexually Transmitted Diseases ; Genitalia ; Prevalence
Chemical Substances	Anti-Bacterial Agents ; Moxifloxacin (U188XYD42P) ; Azithromycin (83905-01-5) ; Fluoroquinolones ; RNA, Ribosomal, 23S ; Macrolides
Language	English
Publishing date	2023-03-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2619676-1
ISSN	2235-2988 ; 2235-2988
ISSN (online)	2235-2988
ISSN	2235-2988
DOI	10.3389/fcimb.2023.1155451
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Article: Gut Microbiome Disruption Following SARS-CoV-2: A Review.

Righi, Elda / Dalla Vecchia, Ilaria / Auerbach, Nina / Morra, Matteo / Górska, Anna / Sciammarella, Concetta / Lambertenghi, Lorenza / Gentilotti, Elisa / Mirandola, Massimo / Tacconelli, Evelina / Sartor, Assunta

Microorganisms

2024 Volume 12, Issue 1

Abstract: COVID-19 has been associated with having a negative impact on patients' gut microbiome during both active disease and in the post-acute phase. In acute COVID-19, rapid alteration of the gut microbiome composition was observed, showing on one side a ... ...

Abstract	COVID-19 has been associated with having a negative impact on patients' gut microbiome during both active disease and in the post-acute phase. In acute COVID-19, rapid alteration of the gut microbiome composition was observed, showing on one side a reduction in beneficial symbionts (e.g.,
Language	English
Publishing date	2024-01-09
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms12010131
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Article ; Online: A multi-country comparative study of two treponemal tests for the serodiagnosis of syphilis amongst men who have sex with men (MSM): Chemo-luminescent assay vs Treponema pallidum particle agglutination assay.

Gios, Lorenzo / Mirandola, Massimo / Cordioli, Maddalena / Zorzi, Antonella / Sherriff, Nigel / Vera, Jaime / Wlazly, Dominika / Hassan-Ibrahim, Mohammed Osman / Padovese, Valeska / Anabel Darmanin / Peeling, Rosanna W / Unemo, Magnus / Blondeel, Karel / Toskin, Igor

BMC infectious diseases

2024 Volume 24, Issue Suppl 1, Page(s) 313

Abstract: Introduction: International guidelines recommend routine screening for syphilis (aetiological agent: Treponema pallidum subspecies pallidum) amongst key populations and vulnerable populations using tests detecting treponemal and non-treponemal ... ...

Abstract	Introduction: International guidelines recommend routine screening for syphilis (aetiological agent: Treponema pallidum subspecies pallidum) amongst key populations and vulnerable populations using tests detecting treponemal and non-treponemal antibodies. Whilst treponemal tests have high sensitivities and specificities, they differ regarding subjective or objective interpretation, throughput and workload. Chemiluminescence immunoassays (CLIAs) are cost- and time-effective automated methods for detecting treponemal antibodies. The Treponema pallidum particle agglutination assay (TPPA) has been considered the "gold standard" treponemal assay, however, this includes a highly manual procedure, low throughput and subjective interpretation. The present multi-country study evaluated the ADVIA Centaur® Syphilis CLIA (Siemens Healthcare) assay compared to the reference SERODIA-TP·PA® (Fujirebio Diagnostics) for the serodiagnosis of syphilis amongst men who have sex with men (MSM). Method: 1,485 MSM were enrolled in Brighton (UK), Malta, and Verona (Italy) as part of a larger WHO multi-country and multi-site ProSPeRo study. Ethical approval was obtained. Serum was tested with the ADVIA Centaur® Syphilis CLIA assay and SERODIA-TP·PA®, in accordance with the manufacturers' instructions, for a first round of validation. A second round of validation was carried out for discrepant results that were additionally tested with both Western Blot (Westernblot EUROIMMUN®) and an Immunoblot (INNO-LIA, Fujirebio Diagnostics). Sensitivity, specificity, positive and negative predictive value (PPV and NPV), likelihood ratios (positive/negative), and the Diagnostic Odds Ratio (DOR)/pre-post-test probability (Fagan's nomogram) were calculated. Results: Out of 1,485 eligible samples analysed in the first phase, the SERODIA-TP·PA® identified 360 positive and 1,125 negative cases. The ADVIA Centaur® Syphilis CLIA assay (Siemens) identified 366 positives, missclassifying one TPPA-positive sample. In the second phase, the ADVIA Centaur® Syphilis CLIA resulted in 1 false negative and 4 false positive results. Considering the syphilis study prevalence of 24% (95% CI: 22-26.7), The sensitivity of the ADVIA Centaur® Syphilis CLIA assay was 99.7% (95% CI: 98.5-100), and the specificity was 99.4% (95% CI: 98.7-99.7). The ROC area values were 0.996 (95% CI: 0.992-0.999), and both the PPV and NPV values were above 98% (PPV 98.1%, 95% CI: 96.1-99.2; NPV 99.9%, 95% CI: 99.5-100). Conclusions: The ADVIA Centaur® Syphilis CLIA assay showed similar performance compared to the SERODIA-TP·PA®. Considering the study is based on QUADAS principles and with a homogeneous population, results are also likely to be generalisable to MSM population but potentially not applicable to lower prevalence populations routinely screened for syphilis. The automated CLIA treponemal assay confirmed to be accurate and appropriate for routine initial syphilis screening, i.e. when the reverse testing algorithm is applied.
MeSH term(s)	Male ; Humans ; Syphilis ; Treponema pallidum ; Homosexuality, Male ; Antibodies, Bacterial ; Sexual and Gender Minorities ; Syphilis Serodiagnosis/methods ; Serologic Tests/methods ; Sensitivity and Specificity ; Luminescent Measurements/methods ; Agglutination
Chemical Substances	Antibodies, Bacterial
Language	English
Publishing date	2024-03-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-024-09100-x
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Article: Hepatitis B Virus Reactivation upon Immunosuppression: Is There a Role for Hepatitis B Core-Related Antigen in Patients with Immune-Escape Mutants? A Case Report.

Caviglia, Gian Paolo / Zorzi, Antonella / Rizzetto, Mario / Mirandola, Massimo / Olivero, Antonella / Carolo, Giada

Diagnostics (Basel, Switzerland)

2021 Volume 11, Issue 12

Abstract: The reactivation of hepatitis B virus (HBVr) in patients undergoing pharmacological immunosuppression is a potentially fatal clinical event that may occur in patients with overt or occult HBV infection. The risk of HBVr is mainly determined by the type ... ...

Abstract	The reactivation of hepatitis B virus (HBVr) in patients undergoing pharmacological immunosuppression is a potentially fatal clinical event that may occur in patients with overt or occult HBV infection. The risk of HBVr is mainly determined by the type of immunosuppressive therapy and the HBV serologic profile, with a higher risk in patients positive for the hepatitis B surface antigen (HBsAg), and a lower risk in HBsAg-negative/antibodies to core antigen-positive subjects. Notably, a considerable proportion of patients experiencing HBVr showed a high degree of variability of the HBV S gene, possibly leading to immune escape mutants. These mutations, usually in the "a-determinant" of the HBsAg, can cause diagnostic problems and consequently hamper the appropriate management strategy of patients at risk of HBVr. Here, we describe a case of HBVr in a patient with a diagnosis of chronic myeloid leukemia and a previous history of kidney transplant, providing evidence of the potential usefulness of hepatitis B core-related antigen measurement in patients with HBV immune-escape mutants at risk of viral reactivation.
Language	English
Publishing date	2021-11-24
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics11122185
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Article ; Online: Changes in the prevalence of self-reported sexually transmitted bacterial infections from 2010 and 2017 in two large European samples of men having sex with men-is it time to re-evaluate STI-screening as a control strategy?

Marcus, Ulrich / Mirandola, Massimo / Schink, Susanne B / Gios, Lorenzo / Schmidt, Axel J

PloS one

2021 Volume 16, Issue 3, Page(s) e0248582

Abstract: Background/objectives: Many European countries reported increased numbers of syphilis, gonorrhoea and chlamydia diagnoses among men who have sex with men (MSM) in recent years. Behaviour changes and increased testing are thought to drive these increases. ...

Abstract	Background/objectives: Many European countries reported increased numbers of syphilis, gonorrhoea and chlamydia diagnoses among men who have sex with men (MSM) in recent years. Behaviour changes and increased testing are thought to drive these increases. Methods: In 2010 and 2017, two large online surveys for MSM in Europe (EMIS-2010, EMIS-2017) collected self-reported data on STI diagnoses in the previous 12 months, diagnostic procedures, STI symptoms when testing, number of sexual partners, and sexual behaviours such as condom use during the last intercourse with a non-steady partner in 46 European countries. Multivariate regression models were used to analyse factors associated with diagnoses of syphilis, gonorrhoea/chlamydia, and respective diagnoses classified as symptomatic and asymptomatic. If applicable, they included country-level screening rates. Results: Questions on STI diagnoses and sexual behaviours were answered by 156,018 (2010) and 125,837 (2017) participants. Between 2010 and 2017, overall diagnoses with gonorrhoea/chlamydia and syphilis increased by 76% and 83% across countries. Increases were more pronounced for asymptomatic compared to symptomatic infections. The proportion of respondents screened and the frequency of screening grew considerably. Condomless anal intercourse with the last non-steady partner rose by 62%; self-reported partner numbers grew. Increased syphilis diagnoses were largely explained by behavioural changes (including more frequent screening). Gonorrhoea/chlamydia increases were mainly explained by more screening and a change in testing performance. A country variable representing the proportion of men screened for asymptomatic infection was positively associated with reporting symptomatic gonorrhoea/chlamydia, but not syphilis. Discussion/conclusion: The positive association of country-level screening rates with the proportion of symptomatic infections with gonorrhoea/chlamydia may indicate a paradoxical effect of screening on incidence of symptomatic infections. Treatment of asymptomatic men might render them more susceptible to new infections, while spontaneous clearance may result in reduced susceptibility. Before expanding screening programmes, evidence of the effects of screening and treatment is warranted.
MeSH term(s)	Adult ; Europe/epidemiology ; Homosexuality, Male ; Humans ; Male ; Mass Screening ; Prevalence ; Retrospective Studies ; Sexual Behavior ; Sexually Transmitted Diseases, Bacterial/diagnosis ; Sexually Transmitted Diseases, Bacterial/epidemiology ; Sexually Transmitted Diseases, Bacterial/transmission
Language	English
Publishing date	2021-03-15
Publishing country	United States
Document type	Clinical Trial ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0248582
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