bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnitude of Khat use and associated factors among women attending antenatal care in Gedeo zone health centers, southern Ethiopia: a facility based cross sectional study
Authors: Mekuriaw Birhanie , Belayneh Zelalem , Yitayih Yimenu
Published: January 2020

Background

Khat (Catha edulis) is a fresh green leave commonly chewed for recreational purpose and its euphoric effect as a result of dopamine activities stimulation effect of Khat. Women may use Khat during their pregnancy to tolerate their pregnancy related distress. Khat has biological, social or psychological complications; adverse pregnancy outcomes and negatively affects the health of the mother and the fetus. However, magnitude, pattern and associated factors of Khat use are not well addressed among pregnant women in Ethiopia. The aim of this study was to address this gap by assessing the magnitude and associated factors of Khat use among women attending antenatal care service at Gedeo zone rural health centers.

Methods

This was a facility based cross-sectional study conducted at rural health centers in Gedeo zone from June 1st to August 1st, 2017. The data were collected through structured interview using an interview guide developed from different literatures. A total of 718 pregnant women attending antenatal care service participated in the study using multi stage sampling technique. Bivariable and multivariable analysis were used to identify associated factors of Khat use among women during their current pregnancy period. In the multivariable analysis, variables withP-Values of less than 0.05 were considered as statistically significant correlates of Khat use. The strength of the association was also measured with adjusted odds ratio at a corresponding 95% confidence interval.

Results

The lifetime and current prevalence of khat use among pregnant women were 11.0% (95%CI: 8.8–13.2) and 9.9% (95% CI: 7.7–12), respectively. The odds of being khat user was higher among those who had khat user partner [AOR = 3.450, 95% C.I (1.907–6.244)], respondents with alcohol use behavior [AOR = 3.235, 95% C.I (1.573–6.659)] and mental distress [AOR = 3.575, 95% C.I (2.067–6.189)].

Conclusion

Significant proportions of pregnant women were experiencing khat chewing during pregnancy. Having khat user partner, alcohol use behavior and metal distress were significantly associated with khat use of pregnant women. This demonstrates a need to integrate the prevention, early identification and intervention of Khat use as a component of treatment modality for pregnant women during their antenatal visit.
Discrimination: a health hazard for people from refugee and asylum-seeking backgrounds resettled in Australia
Authors: Ziersch Anna , Due Clemence , Walsh Moira
Published: January 2020

Background

Research has shown that discrimination is harmful to health, but there is relatively little known about discrimination experienced by people from refugee and asylum-seeking backgrounds in resettlement countries and associated health effects. This qualitative-focused mixed methods paper reports on discrimination experienced by refugees and asylum seekers, responses to discrimination, and impacts on health.

Methods

As part of a broader study of housing, social inclusion and health, surveys were completed by 423 adult refugees and asylum seekers living in South Australia who had been in Australia for up to 7 years. The survey included questions on discrimination based on skin colour, ethnicity and religion, as well as questions on hope, trust, belonging, sense of control and health (including the SF-8). Semi-structured interviews were conducted with 65 survey participants, purposively sampled by visa status, continent and gender, further exploring experiences of discrimination. These and survey open-ended responses were analysed thematically.

Results

Twenty-two percent of survey participants reported experiences of discrimination since arriving in Australia (14% in the last year), and 90% of these felt that discrimination had harmed their health. Key settings of discrimination were public transport, within the neighbourhood, and in relation to employment. Those who reported discrimination had significantly worse mental health (p < .000) but not physical health. Discrimination was also associated with less sense of belonging (p = .001), lower levels of trust (p = .038), reduced sense of control (p = .012) and less hope (p = .006). Incidents described in interviews and the open-ended survey responses included incivility, physical assault, and denial of services, experienced across intersecting characteristics of race/ethnicity, religion, gender and visa status. Responses to discrimination spanned affective, cognitive and behavioural dimensions, ranging across types of experience, participant characteristics and context, with most individuals reporting multiple response types. While some of the responses were reported by participants as protective of health, participants’ reflections indicated significant negative impacts on mental health in particular.

Conclusion

Discrimination featured in the resettlement experiences of a significant number of refugees and asylum seekers, with participants reporting clear negative impacts on mental health. Addressing discrimination is a key resettlement and health issue requiring urgent action.
Screening and socioeconomic associations of dyslipidemia in young adults
Authors: Hudson Stephen E. , Feigenbaum Matthew S. , Patil Nirav , Ding Elan , Ewing Alex , Trilk Jennifer L.
Published: January 2020

Background

The Southern region of the United States is home to substantial populations with obesity, dyslipidemia, and hypertriglyceridemia, while also housing a large percentage of America’s minority, rural, and low socioeconomic status (SES) peoples. Adult-onset cardiovascular disease (CVD) research may be informed by investigating associations(s) between late adolescent demographic variables and lipid values. Our objective was to investigate lipid parameter associations with college-age socioeconomic status, which may improve age-specific screening algorithms for management or prevention of adult-onset CVD.

Methods

Using an Analysis of Variance test and a general linear model, associations between gender, race/ethnicity, SES, and athletic participation on lipid parameters (VLDL-C, LDL-C, TG, TC, and HDL-C) were analyzed in 4423 private liberal arts college students enrolled in freshman-level wellness courses at Furman University in Greenville, SC. Comparative data were collected from an age-matched sample (National Health and Nutrition Examination Survey: NHANES 2003–2016). Our main outcomes were statistically significant relationships between any lipid values (TC, HDL-C, LDL-C, TG) and any demographic variables (gender, SES, ethnicity, athlete status).

Results

Males demonstrated lower TC and LDL-C, and higher HDL-C values. HDL-C was highest in athletes. African-American students demonstrated healthier VLDL-C, TG, and HDL-C values. With similar distributions, the age-matched NHANES comparison group showed unhealthier values in nearly all categories.

Conclusions

College students may have better lipid health than the general population. African-Americans may have seemingly healthier lipid values than age-matched individuals independent of athletic or college enrollment which has already been demonstrated in other studies. Future research should include SES relationships in lipid screening paradigms along with other appropriate risk factors for cardiovascular disease. Based on our comparative data, pediatric health providers and researchers may consider education as a potential protective factor against poor lipid health when considering lipid screening protocols for students.
Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors
Authors: Collings Paul J. , Dogra Sufyan A. , Costa Silvia , Bingham Daniel D. , Barber Sally E.
Published: January 2020

Background

Evidence suggests that South Asian school-aged children and adults are less active compared to the white British population. It is unknown if this generalises to young children. We aimed to describe variability in levels of physical activity and sedentary time in a bi-ethnic sample of young children from a deprived location.

Methods

This observational study included 202 South Asian and 140 white British children aged 1.5 to 5y, who provided 3181 valid days of triaxial accelerometry (Actigraph GT3X+). Variability in sedentary time and physical activity levels were analysed by linear multilevel modelling. Logistic multilevel regression was used to identify factors associated with physical inactivity (failing to perform ≥180 min of total physical activity including ≥60 min moderate-to-vigorous physical activity (MVPA) per day).

Results

There were no significant ethnic differences in the overall levels of behaviours; South Asian and white British children spent half of daily time sedentary, just over 40% in light physical activity, and the remaining 7.5 to 8% of time in MVPA. Sedentary time was lower and physical activity levels were higher in older children, and levels of MVPA and vector magnitude counts per minute (CPM) were higher on weekends compared to weekdays. In South Asian children, sedentary time was lower on weekends. Sedentary time was lower and physical activity levels were higher in spring compared to winter in white British children, and in all seasons compared to winter in South Asian children. South Asian children born at high birth weight performed more MVPA, and in both ethnicities there was some evidence that children with older mothers were more sedentary and less active. Sedentary time was higher and light physical activity was lower in South Asian children in the highest compared to the lowest income families. South Asian girls performed less MVPA, registered fewer vector magnitude CPM, and were 3.5 times more likely to be physically inactive than South Asian boys.

Conclusions

Sedentary time and physical activity levels vary by socio-demographic, temporal and perinatal characteristics in young children from a deprived location. South Asian girls have the most to gain from efforts to increase physical activity levels.

Trial registration

The Pre-schoolers in the Playground (PiP) pilot randomized controlled trial is registered with the ISRCTN (ISRCTN54165860;http://www.isrctn.com).
Study protocol the Continuing Care Project: a randomised controlled trial of a continuing care telephone intervention following residential substance dependence treatment
Authors: Kelly Peter , Deane Frank , Baker Amanda , Byrne Gerard , Degan Tayla , Osborne Briony , Townsend Camilla , McKay James , Robinson Laura , Oldmeadow Christopher , Lawson Kenny , Searles Andrew , Lunn Joanne
Published: January 2020

Background

A priority area in the field of substance dependence treatment is reducing the rates of relapse. Previous research has demonstrated that telephone delivered continuing care interventions are both clinically and cost effective when delivered as a component of outpatient treatment. This protocol describes a NSW Health funded study that assesses the effectiveness of delivering a telephone delivered continuing care intervention for people leaving residential substance treatment in Australia.

Methods/design

All participants will be attending residential alcohol and other drug treatment provided by The Salvation Army or We Help Ourselves. The study will be conducted as a randomised controlled trial, where participants will be randomised to one of three treatment arms. The treatment arms will be: (i) 12-session continuing care telephone intervention; (ii) 4-session continuing care telephone intervention, or (iii) continuing care plan only. Baseline assessment batteries and development of the participants’ continuing care plan will be completed prior to participants being randomised to a treatment condition. Research staff blind to the treatment condition will complete follow-up assessments with participants at 3-months and 6-months after they have been discharged from their residential service.

Discussion

This study will provide comprehensive data on the effect of delivering the continuing care intervention for people exiting residential alcohol and other drug treatment. If shown to be effective, this intervention can be disseminated to improve the rates of relapse among people leaving residential alcohol and other drug treatment.

Trial registration

Australian New Zealand Clinical Trials Registry, ACTRN12618001231235. Registered on 23rd July 2018.https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375621&isReview=true
Societal risk factors for overweight and obesity in women in Zimbabwe: a cross-sectional study
Authors: Mangemba Nancy T. , San Sebastian Miguel
Published: January 2020

Background

Overweight and obesity are well-recognized risk factors for various non-communicable diseases. Evidence shows an increasing burden of overweight and obesity in low and middle-income countries, especially in women. Little is known about the risk factors in Zimbabwe. The aim of this study was to determine the socioeconomic risk factors for overweight and obesity in non-pregnant adult Zimbabwean women.

Methods

A cross-sectional study was conducted using the 2015 Zimbabwe Demographic Health Survey (n = 8904) data on the adult female population aged 15 to 49. Body mass index (BMI) was calculated by dividing the body weight by height squared. The socio-economic variables studied were age, marital status, residence, province, religion, education, household wealth index, household size, access to mass media and the use of contraception. Prevalence of overweight (BMI ≥ 25–29.9 kg/m2) and obesity (BMI ≥30 kg/m2) were determined. Simple and multivariable logistic regressions were then used to ascertain any relationships.

Results

The weighted prevalence of overweight and obesity in adult females was 34.2 and 12.3% respectively. The odds for being overweight and obese were significantly higher with increasing age (Adjusted Odds Ratio (AOR 2.76, 95% CI:2.45–3.11 for overweight and AOR 3.24, 95% CI:2.69–3.90 for obesity) with marriage (AOR 1.58, 95% CI:1.38–1.79 for overweight and AOR 1.54, 95% CI:1.27–1.87 for obesity), high wealth status (AOR 4.01, 95% CI:2.93–5.50 for overweight and AOR 6.97, 95% CI:4.08–11.9 for obesity), and the use of hormonal contraception (AOR 1.24, 95% CI:1.07-1.41 for overweight and AOR 1.35, 95% CI:1.10–1.64 for obesity). Additionally, having higher education increased the odds of being obese (AOR 1.44, 95% CI:1.07–1.96) while being Christian increased the odds for being overweight (AOR 1.13, 95% CI:1.00–1.28).

Conclusions

The prevalence of overweight and obesity among women in Zimbabwe was high. The key social factors associated were older age, being married, being wealthy and the use of hormonal contraception. Having a higher education and being Christian also increased the risk of being obese and overweight respectively. The design of multi-faceted overweight and obesity reduction programs for women that focus on increasing physical activity and strengthening of social support systems are necessary to combat this epidemic.
Factors associated with anaemia and iron deficiency among women of reproductive age in Northeast Thailand: a cross-sectional study
Authors: Jamnok Jutatip , Sanchaisuriya Kanokwan , Sanchaisuriya Pattara , Fucharoen Goonnapa , Fucharoen Supan , Ahmed Faruk
Published: January 2020

Background

Anaemia and iron deficiency (ID) affect women of reproductive age globally and considered to be a major public health problem in developing countries. This study determines the prevalence of anaemia and ID among women of reproductive age in urban northeast Thailand and examined the relative contribution of various risk factors to anaemia and ID in this population.

Methods

Three hundred ninety-nine non-pregnant women, aged 18–45 years, from three universities in northeast Thailand participated in this cross-sectional study. Selected socio-demographic, history of blood loss, usual consumption of red meat and tea/coffee, and anthropometric data were collected. Complete blood count including haemoglobin (Hb) concentration, serum ferritin (SF), C-reactive protein (CRP), and thalassemia were determined. Multiple logistic regressions were applied to identify the risk factors of anaemia and ID.

Results

Overall, 370 participants were included for data analyses after excluding women with severe/intermedia thalassemia diseases and/or those with positive serum CRP. The prevalence of anaemia, ID, and iron deficiency anaemia (IDA) were 28.4, 28.4, and 13.2%, respectively. Women with thalassemia had a higher prevalence of anaemia but a lower prevalence of ID than the women without thalassemia. By multiple regression analysis, ID [adjusted OR (AOR) = 4.9, 95% CI = 2.8–8.3], two α-gene defects (AOR = 8.0, 95% CI = 3.0–21.3) and homozygous Hb E (AOR = 8.5, 95% CI = 3.0–24.3) were identified as the potential risk factors of anaemia. Further, the odds of ID were significantly higher among women who donated blood within the past 3 months (AOR = 6.7, 95% CI = 2.8–16.3), and had moderate to a high amount of blood loss during menstruation (AOR = 2.2, 95% CI = 1.3–3.9).

Conclusion

This study found a relatively high but differential prevalence of anaemia and ID among women of reproductive age with or without thalassemia. Only homozygous Hb E and two α-gene defects of thalassemia types and ID were the main factors contributing to anaemia. Recent blood donation, and moderate to a high amount of blood loss during menstruation were potential risk factors of ID in this population.
Association between peripheral blood/bronchoalveolar lavage eosinophilia and significant oxygen requirements in patients with acute eosinophilic pneumonia
Authors: Choi Joon Young , Lim Jeong Uk , Jeong Ho Jung , Lee Ji Eun , Rhee Chin Kook
Published: January 2020

Background

We investigated the association between a combination of two markers, peripheral (PEC) and bronchoalveolar lavage (BAL) eosinophil percentage (BEP), and oxygen requirements in patients with acute eosinophilic pneumonia (AEP).

Methods

We retrospectively reviewed the medical records of patients with AEP treated at the Armed Forces Capital Hospital between May 2012 and May 2017. We used correlation analyses to assess the association between PEC/BEP and clinical outcomes in AEP patients. Receiver operating characteristic (ROC) curve analyses were used to calculate the cut-off value for BEP that categorised patients requiring a significant oxygen supply. The BAL/blood eosinophil (BBE) score was introduced to stratify patients with peripheral eosinophilia and elevated BEP. Clinical characteristics and outcomes were compared between the different groups. Multiple logistic regression was performed for significant oxygen requirements using two different models using age, C-reactive protein (CRP), smoking duration, and BBE score (model 1) and age, CRP, BEP, and PEC (model 2).

Results

Among the 338 patients, 99.7% were male, and their mean age was 20.4 ± 1.4 years. Only 0.6% of patients were never smokers and the mean number of smoking days was 26.2 ± 25.4. Correlation analyses revealed that both the PaO2/FiO2 ratio and duration of oxygen supply were associated with BEP. ROC curve analyses indicated a cut-off level of 41.5%. Patients with a high BBE score had favourable outcomes in terms of hypoxemia, hospital days, intensive care unit admission, oxygen supply days, and steroid treatment days. Multiple logistic regression revealed that BEP and BBE score tended to be associated with significant oxygen requirements.

Conclusions

In this study, we revealed that both peripheral and BAL eosinophilia is associated with favourable outcomes in AEP patients.
Profile and factors associated with glycaemic control of patients with type 2 diabetes in Greece: results from the diabetes registry
Authors: Souliotis Kyriakos , Koutsovasilis Anastasios , Vatheia Georgia , Golna Christina , Nikolaidi Sofia , Hatziagelaki Erifili , Kotsa Kalliopi , Koufakis Theocharis , Melidonis Andreas , Papazafiropoulou Athanasia , Tentolouris Nikolaos , Siami Evangelia , Sotiropoulos Alexios
Published: January 2020

Background

Strict glycaemic control early in the treatment process has been shown to reduce the occurrence of micro- and macro- vascular complications of diabetes in the long-term. Thus, treatment guidelines advise early intensification of treatment to achieve glycaemic control goals. However, evidence in Greece suggests that, despite guideline recommendations, glycaemic control among patients with T2DM remains challenging. This study presents the demographic and clinical characteristics of patients with T2DM in Greece using data from an electronic registry designed specifically for this treatment category and investigates the factors that are independently associated with glycaemic control.

Methods

This is a multi-center, observational, cross-sectional study to investigate epidemiological and clinical factors affecting glycaemic control among patients with T2DM in Greece. Data was collected via a web-based disease registry, the Diabetes Registry, which operated from January 1st to December 31st, 2017. Five large specialized diabetes centers operating in Greek hospitals participated in the study.

Results

Data for 1141 patients were retrieved (aged 63.02 ± 12.65 years, 56.9% male). Glycaemic control (Hb1Ac < 7%) was not achieved in 57.1% of patients. Factors independently associated with poor glycaemic control were: family history of diabetes [OR: 1.53, 95% CI: 1.06–2.23], BMI score between 25 to 30 [OR: 2.08, 95% CI: 1.05–4.13] or over 30 [OR: 2.12, 95% CI 1.12–4.07], elevated LDL levels [OR: 1.53, 95% 1.06–2.21] and low HDL levels [OR: 2.12, 95% CI: 1.44–3.12]. Lastly, use of injectable antidiabetic agents (in monotherapy or in combination) was less likely to be associated with poor glycaemic control versus treatment with combination of oral and injectable agents [OR: 0.50, 95% CI: 0.24–1.01]. This association was found to be marginally statistically significant.

Conclusion

Inadequate lipid control, family history of diabetes and presence of obesity (ΒΜΙ ≥ 30 kg/m2) were associated with poor glycaemic control among study sample, whereas use of injectable antidiabetic agents was less likely to be associated with poor glycaemic control. These findings indicate how complex optimal glycaemic control is, highlighting the need for tailored interventions in high-risk subpopulations with T2DM.
Membrane fixation for osseous graft stabilization in periodontally accelerated osteogenic orthodontics: a comparative study
Authors: Liu Xiaohan , Fan Baoting , Abdelrehem Ahmed , Ma Zhigui , Yang Chi
Published: January 2020

Background

Periodontally accelerated osteogenic orthodontics (PAOO) is a treatment for bone defects associated with a lack of bone graft stability, especially in coronal locations. This study aimed to compare a modified technique of membrane fixation that utilizes periosteal sutures (using a pouch design) with the traditional approach, which does not use membrane fixation.

Methods

Twenty-eight patients with a total of 168 teeth treated were divided into two groups: 1-A, in which patients were treated using the modified technique (with membrane fixation), and group 2-B, in which patients were treated using the traditional technique (without membrane fixation). The postoperative bone thickness was evaluated via radiographic examination.

Results

Postoperative improvements in bone augmentation were detected in both groups. At 12 months, the values of the CHBT (measured from the midpoint of the coronal third to the labial cortical surface, 0.84 ± 0.33 mm) and the values of VBL (measured from the alveolar crest to the cemento-enamel junction, − 2.35 ± 0.80 mm)were significantly greater in the modified technique group than those in the traditional technique group (CHBT:0.12 ± 0.21 mm and VBL:-1.39 ± 0.99 mm; P = 0.00 and P = 0.01).

Conclusions

This study shows that compared to the traditional technique, the modified PAOO technique with membrane fixation using periosteal sutures provides improved graft stabilization, superior coronal augmentation and satisfactory vertical volume.
Knowledge regarding antibiotic use among students of three medical schools in Medellin, Colombia: a cross-sectional study
Authors: Higuita-Gutiérrez Luis Felipe , Molina -Garcia Valentina , Acevedo Guiral Jenifer , Gómez Cadena Liceth , Roncancio Villamil Gustavo Eduardo , Jiménez Quiceno Judy Natalia
Published: January 2020

Background

The objective of the present study was to describe the knowledge regarding the antibiotic therapy of students of three medical schools in Medellín, Colombia.

Methods

The study population comprised medical students who were enrolled in three universities. The instrument contained questions regarding their current academic term, the university, the perceived quality of the education received on antibiotic therapy and bacterial resistance, and specific questions on upper respiratory tract infections, pneumonia, urinary tract infections, and skin and soft tissue infections. The information was analyzed by calculating frequencies and measures of dispersion and central tendency. Knowledge regarding the treatment for each type of infection was compared using the Mann–Whitney U test and the Kruskal–Wallis H test.

Results

We included 536 medical students, of which 43.5% students consider that the university has not sufficiently trained them to interpret antibiograms and 29.6% students consider that the quality of information received on the subject at their university ranges from regular to poor. The mean score for knowledge regarding antibiotic therapy for upper respiratory tract infections was 44.2 (9.9) on a scale from 0 to 100. The median score with regard to the treatment of pneumonia was 52.9 (14.7), that of urinary tract infection was 58.7 (14.8), and that of skin and soft tissue infections was 63.1 (19.4). The knowledge regarding antibiotic therapy for upper respiratory tract infections, pneumonia, and urinary tract infection does not improve with the academic term, the university, or perceived quality of the education received.

Conclusion

A large proportion of medical students perceive that the training received from the university is insufficient with regard to antibiotic use and bacterial resistance, which is consistent with the limited knowledge reflected in the selection of antibiotic treatment for respiratory, urinary tract, and skin and soft tissue infections. Overall, the situation was identical among all universities, and it did not significantly increase with the completion of an academic term.
Assessment of willingness to Tele-monitoring interventions in patients with type 2 diabetes and/or hypertension in the public primary healthcare setting
Authors: Sin David Yang Ern , Guo Xiaoxuan , Yong Dayna Wei Wei , Qiu Tian Yu , Moey Peter Kirm Seng , Falk Muller-Riemenschneider , Tan Ngiap Chuan
Published: January 2020

Background

Tele-monitoring (TM) is remote monitoring of individuals via info-communication technology, enabling them and their relatives or care-providers to recognize their health status conveniently. TM will be successful only if the individuals, often patients with medical conditions, are willing to accept and adopt it in their daily lives. This study aimed to determine the prevalence of willingness of patients with type 2 diabetes mellitus (T2DM) and/or hypertension towards the use of TM, and the factors influencing their uptake.

Methods

A cross-sectional survey was conducted at two public primary care clinics (polyclinics) in north-eastern Singapore, where TM had not been implemented. After the patients with T2DM and/or hypertension consented after fulfilling the eligibility criteria, they were first introduced to the concept of TM using pictogram and explanation by the investigators. Data on their demography, clinical parameters, technological literacy and acceptance of TM based on the Health Information Technology Acceptance Model (HITAM) were subsequently collected, computed, analyzed, followed by regression analyses to identify the factors associated with their willingness to use TM.

Results

Among 1125 eligible multi-ethnic Asian patients approached, 899 of them completed the assisted questionnaire survey, yielding a response rate of 79.9%. Their mean age was 58 ± 8 years, females 51.3% and Chinese 69.3%. Overall, 53.0% of the patients were willing to use TM. Personal beliefs on technology (OR = 3.54, 95%CI = 2.50–4.50,p < 0.001), prior technology utility (OR = 3.18, 95%CI = 1.57–6.42,p = 0.001), Patient’s requirements to be accompanied (OR = 1.48, 95% CI = 1.054–2.082,P = 0.03) Cost considerations (OR = 2.96, 95% CI = 2.257–3.388,P < 0.01) and technological literacy (OR = 2.77, 95%CI = 2.05–3.38,p < 0.001) were associated with willingness to use TM.

Conclusion

Slightly over half of the patients were willing to use TM. Factors such as age, ethnicity, technological literacy, beliefs and previous utility of technology of the patients have to be addressed before implementing TM in primary care.
Using health facility-based serological surveillance to predict receptive areas at risk of malaria outbreaks in elimination areas
Authors: Surendra Henry , Supargiyono  , Ahmad Riris A. , Kusumasari Rizqiani A. , Rahayujati Theodola B. , Damayanti Siska Y. , Tetteh Kevin K. A. , Chitnis Chetan , Stresman Gillian , Cook Jackie , Drakeley Chris
Published: January 2020

Background

In order to improve malaria burden estimates in low transmission settings, more sensitive tools and efficient sampling strategies are required. This study evaluated the use of serological measures from repeated health facility-based cross-sectional surveys to investigate Plasmodium falciparum and Plasmodium vivax transmission dynamics in an area nearing elimination in Indonesia.

Methods

Quarterly surveys were conducted in eight public health facilities in Kulon Progo District, Indonesia, from May 2017 to April 2018. Demographic data were collected from all clinic patients and their companions, with household coordinates collected using participatory mapping methods. In addition to standard microscopy tests, bead-based serological assays were performed on finger-prick bloodspot samples from 9453 people. Seroconversion rates (SCR, i.e. the proportion of people in the population who are expected to seroconvert per year) were estimated by fitting a simple reversible catalytic model to seroprevalence data. Mixed effects logistic regression was used to examine factors associated with malaria exposure, and spatial analysis was performed to identify areas with clustering of high antibody responses.

Results

Parasite prevalence by microscopy was extremely low (0.06% (95% confidence interval 0.03–0.14, n = 6) and 0 for P. vivax and P. falciparum, respectively). However, spatial analysis of P. vivax antibody responses identified high-risk areas that were subsequently the site of a P. vivax outbreak in August 2017 (62 cases detected through passive and reactive detection systems). These areas overlapped with P. falciparum high-risk areas and were detected in each survey. General low transmission was confirmed by the SCR estimated from a pool of the four surveys in people aged 15 years old and under (0.020 (95% confidence interval 0.017–0.024) and 0.005 (95% confidence interval 0.003–0.008) for P. vivax and P. falciparum, respectively). The SCR estimates in those over 15 years old were 0.066 (95% confidence interval 0.041–0.105) and 0.032 (95% confidence interval 0.015–0.069) for P. vivax and P. falciparum, respectively.

Conclusions

These findings demonstrate the potential use of health facility-based serological surveillance to better identify and target areas still receptive to malaria in an elimination setting. Further implementation research is needed to enable integration of these methods with existing surveillance systems.
Improving phytosterol biotransformation at low nitrogen levels by enhancing the methylcitrate cycle with transcriptional regulators PrpR and GlnR of Mycobacterium neoaurum
Authors: Zhang Yang , Zhou Xiuling , Wang Xuemei , Wang Lu , Xia Menglei , Luo Jianmei , Shen Yanbing , Wang Min
Published: January 2020

Background

Androstenedione (AD) is an important steroid medicine intermediate that is obtained via the degradation of phytosterols by mycobacteria. The production process of AD is mainly the degradation of the phytosterol aliphatic side chain, which is accompanied by the production of propionyl CoA. Excessive accumulation of intracellular propionyl-CoA produces a toxic effect in mycobacteria, which restricts the improvement of production efficiency. The 2-methylcitrate cycle pathway (MCC) plays a significant role in the detoxification of propionyl-CoA in bacterial. The effect of the MCC on phytosterol biotransformation in mycobacteria has not been elucidated in detail. Meanwhile, reducing fermentation cost has always been an important issue to be solved in the optimizing of the bioprocess.

Results

There is a complete MCC in Mycobacterium neoaurum (MNR), prpC, prpD and prpB in the prp operon encode methylcitrate synthase, methylcitrate dehydratase and methylisocitrate lyase involved in MCC, and PrpR is a specific transcriptional activator of prp operon. After the overexpression of prpDCB and prpR in MNR, the significantly improved transcription levels of prpC, prpD and prpB were observed. The highest conversion ratios of AD obtained by MNR-prpDBC and MNR-prpR increased from 72.3 ± 2.5% to 82.2 ± 2.2% and 90.6 ± 2.6%, respectively. Through enhanced the PrpR of MNR, the in intracellular propionyl-CoA levels decreased by 43 ± 3%, and the cell viability improved by 22 ± 1% compared to MNR at 96 h. The nitrogen transcription regulator GlnR repressed prp operon transcription in a nitrogen-limited medium. The glnR deletion enhanced the transcription level of prpDBC and the biotransformation ability of MNR. MNR-prpR/ΔglnR was constructed by the overexpression of prpR in the glnR-deleted strain showed adaptability to low nitrogen. The highest AD conversion ratio by MNR-prpR/ΔglnR was 92.8 ± 2.7% at low nitrogen level, which was 1.4 times higher than that of MNR.

Conclusion

Improvement in phytosterol biotransformation after the enhancement of propionyl-CoA metabolism through the combined modifications of the prp operon and glnR of mycobacteria was investigated for the first time. The overexpress of prpR in MNR can increase the transcription of essential genes (prpC, prpD and prpB) of MCC, reduce the intracellular propionyl-CoA level and improve bacterial viability. The knockout of glnR can enhance the adaptability of MNR to the nitrogen source. In the MNRΔglnR strain, overexpress of prpR can achieve efficient production of AD at low nitrogen levels, thus reducing the production cost. This strategy provides a reference for the economic and effective production of other valuable steroid metabolites from phytosterol in the pharmaceutical industry.
Ubiquitin-specific protease 7 is a drug-able target that promotes hepatocellular carcinoma and chemoresistance
Authors: Zhang Wei , Zhang Jingxin , Xu Chenzhou , Zhang Shiqing , Bian Saiyan , Jiang Feng , Ni Wenkai , Qu Lishuai , Lu Cuihua , Ni Runzhou , Fan Yihui , Xiao Mingbing , Liu Jinxia
Published: January 2020

Background

Ubiquitin-specific protease 7 (USP7) is a de-ubiquitin enzyme that plays an essential role in multiple cancers and becomes a target for treatment. However, the role of USP7 and its therapeutic value for HCC remains unclear.

Methods

USP7 expression was examined in HCC tissues by western blot and immunohistochemistry. The correlation of USP7 and HCC prognosis was analyzed by Kaplan–Meier survival method. Mass spectrometry was determined and cell proliferation and tumorigenicity assays were conducted in vitro and in vivo treated by P22077 and sgRNA-USP7.

Results

USP7 expression was significantly increased in HCC and associated with its progression. Interestingly, many HCC cells are sensitive to USP7 inhibition by using P22077. P22077 treatment not only induced cell death but also inhibited cell proliferation and migration in Huh7 and SK-Hep1 cells. In a xenograft model, P22077 efficiently inhibited tumor growth. In chemo-resistant HCC cells, P22077 decreased cell sensitivity to chemotherapy. In addition, mass spectrometry reveals 224 of significantly changed proteins upon P22077 treatment.

Conclusions

We demonstrate a critical role of USP7 in HCC devolvement and chemoresistance. Disruption of USP7 function results in dis-regulated several key biological processes and subsequently activates BAX. USP7 might be a novel and drug-able target in HCC.
Demonstration of anti-tumour bystander killing with prodrug-preloaded suicide gene-engineered tumour cells: a potential improvement for cancer therapeutics
Authors: Zweiri Jehad , Christmas Stephen E.
Published: January 2020

Background

Therapeutic approaches for cancer rely on careful consideration of finding the optimal way of delivering the pro-drug for cellular-based cancer treatment. Cell lines and cell cultures have been used in these studies to compare the in vitro and in vivo efficacy of autologous vs. allogeneic tumour cellular gene therapy. Here we have investigated and are reporting for the first time the effect of prodrug ganciclovir (GCV)-preloading (pre-treatment) in suicide gene therapy of cancer.

Methods

This study examines the effect of GCV-preloading (pre-treatment) on a range of tumour cell lines in conjunction with suicide gene therapy of cancer. To determine the efficacy of this modality, a series of in vitro and in vivo experiments were conducted using genetically modified and unmodified tumour cell lines.

Results

Following co-culture of herpes simplex virus thymidine kinase (HSV-TK) modified tumour cells and unmodified tumour cells both in vitro and in vivo, GCV-preloading (pre-treatment) of TK-modified human and mouse mesothelioma cells and ovarian tumour cells allowed them to mediate efficiently bystander killing of neighbouring unmodified tumour cells in vitro. In contrast, GCV-preloading of TK-modified human and mouse mesothelioma cells and ovarian tumour cells abolished their in vivo ability to induce bystander killing of unmodified tumour cells, although there was some tumour regression compared to control groups but this was not statistically significant. These results suggest that preloading TK modified tumour cells with GCV needs further study to define the most effective strategy for an in vivo application to retain their bystander killing potential after exposure to lethal doses of GCV in vitro.

Conclusions

This study highlights the promising possibility of improving the efficacy of pro-drug system to prevent any damage to the immune system and enhancing this type of suicide gene therapy of cancer, as well as the need for further studies to explore the discrepancies between in vitro and in vivo results.
Sustainable under nutrition reduction program and dietary diversity among children’s aged 6–23 months, Northwest Ethiopia: Comparative cross-sectional study
Authors: Worku Tigist , Gonete Kedir Abdela , Muhammad Esmael Ali , Atnafu Asmamaw
Published: January 2020

Introduction

Adequate dietary diversity is vital for the survival, growth and development of infants and children. Inadequate dietary diversity is the major cause of micronutrient deficiency in Sub-saharan Africa, including Ethiopia, where only less than one-fourth of the children aged 6–23 months obtain adequate diversified diet. Thus country implemented a strategy known as the Sustainable Undernutrtion Reduction (SUR) programs to alleviate the problem. However, empirical evidences are scarce on the impact of the program on children aged 6–23 months. Therefore, this study aimed to compare the level of dietary diversity among children aged 6–23 months in districts covered and not covered by SURE program in West Gojjam zone.

Methods

A community based comparative cross-sectional study was conducted in three districts of West Gojjam zone, Ethiopia, from February 29 to April 20, 2019. A total of 832 mother and child pairs were selected by the simple random sampling technique. A pretested and structured interviewer-administered questionnaire was used to collect data. A binary logistic regression model was fitted to identify factors associated with dietary diversity. Crude odds and adjusted odds ratios with 95% confidence intervals (CI) were calculated to assess the strength of associations and significance of the identified factors for dietary diversity score.

Result

The overall proportion of adequate dietary diversity among children aged 6–23 months was 29.9% (95% CI: 27.0–33.0), whereas in SURE covered and uncovered districts it was 33.4% (95%CI: 29.0–38.and 26.4%(95% CI: 22.0, 31.0), respectively. ANC (Antenatal care) (AOR = 1.7; 95% CI: 1.16, 2.55) and postnatal care services (AOR = 2.1; 95% CI: 1.38, 3.28), participating in food preparation programs (AOR = 1.9; 95% CI: 1.19, 2.96), GMP (AOR = 2.74,95%CI:1.80, 4.18), vitamin A supplementation (AOR = 2.10,95%CI:1.22, 3.61) and household visits by health extension workers (AOR = 2.0; 95% CI: 1.25, 3.21) were significantly associated with dietary diversity.

Conclusion

The proportion of adequate dietary diversity was higher among children in the program than those out of the program. ANC visits, PNC follow-ups, women’s participating in food preparation programs and household visits by health extension workers were significantly associated with dietary diversity. Therefore, and strengthening and scaling up the program to non covered districts and providing health and nutrition counseling on Infant and Young Child Feeding (IYCF) during ANC and PNC services are recommended for achieving the recommended dietary diversity.
The synthetic steroid tibolone exerts sex-specific regulation of astrocyte phagocytosis under basal conditions and after an inflammatory challenge
Authors: Crespo-Castrillo Andrea , Garcia-Segura Luis-Miguel , Arevalo Maria-Angeles
Published: January 2020

Background

Tibolone is a synthetic steroid used in clinical practice for the treatment of climacteric symptoms and osteoporosis. Active metabolites of tibolone, generated in target tissues, have an affinity for estrogen and androgen receptors. Astrocytes are direct targets for estrogenic compounds and previous studies have shown that tibolone protects brain cortical neurons in association with a reduction in reactive astrogliosis in a mouse model of traumatic brain injury. Since phagocytosis is a crucial component of the neuroprotective function exerted by astrocytes, in the present study, we have assessed whether tibolone regulates phagocytosis in primary astrocytes incubated with brain-derived cellular debris.

Methods

Male and female astrocyte cell cultures were obtained from newborn (P0-P2) female and male Wistar rats. Astrocytic phagocytosis was first characterized using carboxylate beads, Escherichia coli particles, or brain-derived cellular debris. Then, the effect of tibolone on the phagocytosis of Cy3-conjugated cellular debris was quantified by measuring the intensity of Cy3 dye-emitted fluorescence in a given GFAP immunoreactive area. Before the phagocytosis assays, astrocytes were incubated with tibolone in the presence or absence of estrogen or androgen receptor antagonists or an inhibitor of the enzyme that synthesizes estradiol. The effect of tibolone on phagocytosis was analyzed under basal conditions and after inflammatory stimulation with lipopolysaccharide.

Results

Tibolone stimulated phagocytosis of brain-derived cellular debris by male and female astrocytes, with the effect being more pronounced in females. The effect of tibolone in female astrocytes was blocked by a selective estrogen receptor β antagonist and by an androgen receptor antagonist. None of these antagonists affected tibolone-induced phagocytosis in male astrocytes. In addition, the inhibition of estradiol synthesis in the cultures enhanced the stimulatory effect of tibolone on phagocytosis in male astrocytes but blocked the effect of the steroid in female cells under basal conditions. However, after inflammatory stimulation, the inhibition of estradiol synthesis highly potentiated the stimulation of phagocytosis by tibolone, particularly in female astrocytes.

Conclusions

Tibolone exerts sex-specific regulation of phagocytosis in astrocytes of both sexes, both under basal conditions and after inflammatory stimulation.
Age-specific differences in the time-frequency representation of surface electromyographic data recorded during a submaximal cyclic back extension exercise: a promising biomarker to detect early signs of sarcopenia
Authors: Habenicht R. , Ebenbichler G. , Bonato P. , Kollmitzer J. , Ziegelbecker S. , Unterlerchner L. , Mair P. , Kienbacher T.
Published: January 2020

Purpose

Motivated by the goal of developing new methods to detect early signs of sarcopenia, we investigated if surface electromyographic (SEMG) data recorded during the performance of cyclic, submaximal back extensions are marked by age-specific differences in their time and frequency characteristics. Furthermore, day-to-day retest reliability of the EMG measures was examined.

Methods

A total of 86 healthy volunteers used a back dynamometer to perform a series of three maximal voluntary contractions (MVC) consisting of isometric back extensions, followed by an isometric back extension at 80% MVC, and finally 25 slow cyclic back extensions at 50% MVC. SEMG data was recorded bilaterally at L1, L2, and L5 from the iliocostalis lumborum, longissimus, and multifidus muscles, respectively. Tests were repeated two days and six weeks later. A linear mixed-effects model with fixed effects “age, sex, test number” and the random effect “person” was performed to investigate age-specific differences in both the initial value and the time-course (as defined by the slope of the regression line) of the root mean square (RMS-SEMG) values and instantaneous median frequency (IMDF-SEMG) values calculated separately for the shortening and lengthening phases of the exercise cycles. Generalizability Theory was used to examine reliability of the EMG measures.

Results

Back extensor strength was comparable in younger and older adults. The initial value of RMS-SEMG and IMDF-SEMG as well as the RMS-SEMG time-course did not significantly differ between the two age groups. Conversely, the IMDF-SEMG time-course showed more rapid changes in younger than in older individuals. Absolute and relative reliability of the SEMG time-frequency representations were comparable in older and younger individuals with good to excellent relative reliability but variable absolute reliability levels.

Conclusions

The IMDF-SEMG time-course derived from submaximal, cyclic back extension exercises performed at moderate effort showed significant differences in younger vs. older adults even though back extension strength was found to be comparable in the two age groups. We conclude that the SEMG method proposed in this study has great potential to be used as a biomarker to detect early signs of sarcopenic back muscle function.