Article Gate
Not a member yet
471 research outputs found
Sort by
Anaemia Prevalence More Than Doubles in an Academic Year in a Cohort of Tertiary Students: A Repeated-Measure Study in Cape Coast, Ghana
Full text linkBackground. The stress of academic life may predispose young adults to poor dietary habits, which could potentially precipitate nutritional deficiencies, such as iron deficiency. This study evaluated factors predictive of optimal iron stores as well as changes in haematological parameters over the course of an academic year in a cohort of tertiary students. Materials and Methods. The repeated-measure cohort study recruited 117 undergraduate students from September 2018 to May 2019. Venous blood samples were drawn for full blood count estimation, qualitative glucose-6-phosphate dehydrogenase (G6PD) status, haemoglobin variants, and blood group determination during the first 2 weeks of semester 1. However, anthropometric parameters as well as full blood counts were determined for each participant during the first week and last week of semesters 1 and 2. Additionally, semistructured questionnaires were used to capture sociodemographic data. Also, serum ferritin was estimated for each participant using enzyme-linked immunosorbent assay. Results. Overall, 23.1% and 15.5% of participants inherited G6PD defect (G6PDd) or haemoglobin variants, respectively. However, group O (68/117; 58.1%) was the predominant ABO blood group and an overwhelming 90.6% (106/117) inherited Rh D antigen. The prevalence of anaemia increased from 20% at the beginning of the first semester to 45.1% at the latter part of the second semester. G6PDd participants had significantly higher median serum ferritin than G6PD normal participants ( = 0.003). Also, a significantly higher proportion of females were iron depleted (25% vs. 2.3%) or iron deficient (14.3% vs. 9.3%) compared to males. Moreover, being male, G6PD deficient, or 21–25 years was associated with increased odds of participants having optimal serum ferritin levels. Conclusion. The progression of anaemia prevalence from mild to severe public health problem over the course of one academic year should urgently be addressed
A day in the life: Using contextual interviews to understand the health of home-based Mapuche weavers
Full text linkThe craft sector employs 305 million people worldwide, primarily women, rural and home-based workers. Home-based weavers, an understudied workforce, are subject to a range of hazards and adverse health effects related to their weaving work and domestic responsibilities (e.g., housework, farm work, childcare, eldercare). The Mapuche represent Chile’s largest Indigenous group with about 20 percent residing in the Araucanía region, where agriculture and tourism, including craftwork, are important sources of income. Using a purposive sampling approach, we conducted Spanish-language contextual interviews (N = 10) with Mapuche weavers across four communities, allowing us to observe participants in their home settings, watching them weave and discussing tasks, decision-making, and behaviors during the work process. Participants ranged in age from 29–55 years. A combination of semi-structured, audio-recorded interviews, videos, photographs and written observations yielded a time-wheel of a typical day for each weaver; the types of weaving and non-weaving work (including hours per day); workspace visuals; self-reported health problems, causes and treatments; exposure hazards; and potential ergonomic interventions. In addition to weaving, housework (n = 10), farm work (n = 7), wool production (n = 7), natural and chemical dyeing (n = 7) and child-rearing (n = 4) were identified as work activities. The most commonly cited weaving-related health problems were eyestrain (n = 7) and pain in the back (n = 6), shoulder (n = 5), arm (n = 4), hand (n = 4), neck (n = 3), wrist (n = 3) and fingers (n = 3). When asked to identify potential improvements to their weaving workspace, participants identified the need to having a dedicated workspace for weaving (n = 7), improving their existing workspace with better seating (n = 4), lighting (n = 3), insulation (n = 2) and increasing the size of their workspace (n = 2). This methodology, blending traditional occupational health tools with qualitative methods, was instrumental in understanding the range of hazards associated with home-based work and identifying potential ergonomic interventions for this global workforce
Using the Theoretical Framework of Acceptability for qualitative assessment of the "COMBAT" VAW intervention in Ghana
Full text linkViolence against women (VAW) is a global health problem, which leads to negative sexual, reproductive, mental and physical health outcomes, as well as death in extreme cases. Globally, over 35% of women are reported to have experienced some form of violence, while in Ghana, 37% of women have ever experienced physical violence. Considering that the sustainability of community-based VAW interventions is largely dependent on ownership, this study used the Theoretical Framework of Acceptability (TFA) to assess the COMBAT (Community Based Action Teams) intervention (for example, ethicality, self-efficacy, and intervention coherence) which was implemented to prevent violence against women in Ghana. This qualitative research study was conducted at baseline and end-line of the intervention, which used COMBAT as a vehicle to change social norms on gender and violence in the Central region, Ghana. Participants comprised of adult (women and men) who reside in the Agona District. We analyzed the transcripts from eight (8) Focus Group Discussions conducted within one of the two intervention recipient sites (4 female community FGDs and 4 male community FGDs). Data was analyzed thematically using the Nvivo software version 12. Through the application of the TFA, the findings show that community members perceive VAW as inappropriate at the individual and community levels (ethicality), have good knowledge of the COMBAT intervention and how it works (intervention coherence). Also, the study shows that participants have a positive attitude towards the intervention and its components (positive affective attitude), and could take up components of the intervention, by reporting and seeking for VAW support (positive self-efficacy). There was a perceived reduction in VAW practices in the various communities, as well as a reduction in the abuse of women, thereby improving their well-being (intervention effectiveness). The COMBAT strategy was accepted by the community members hence could be sustained as a culturally appropriate intervention for preventing VAW
Recognition for Stems of Tomato Plants at Night Based on a Hybrid Joint Neural Network
Full text linkRecognition of plant stems is vital to automating multiple processes in fruit and vegetable production. The colour similarity between stems and leaves of tomato plants presents a considerable challenge for recognising stems in colour images. With duality relation in edge pairs as a basis, we designed a recognition algorithm for stems of tomato plants based on a hybrid joint neural network, which was composed of the duality edge method and deep learning models. Pixel-level metrics were designed to evaluate the performance of the neural network. Tests showed that the proposed algorithm has performs well at detecting thin and long objects even if the objects have similar colour to backgrounds. Compared with other methods based on colour images, the hybrid joint neural network can recognise the main and lateral stems and has less false negatives and positives. The proposed method has low hardware cost and can be used in the automation of fruit and vegetable production, such as in automatic targeted fertilisation and spraying, deleafing, branch pruning, clustered fruit harvesting and harvesting with trunk shake, obstacle avoidance, and navigation
Use of the Fractal Dimension to Differentiate Epithelium and Connective Tissue in Oral Leukoplakias
Full text linkBackground: Oral leukoplakia (OL) is considered one of the most common potentially malignant oral disorders (OPMD), with a verified increased risk of developing oral cancer. The identification of the dysplasia grade (low–high) is the only consolidated factor used to evaluate this risk. The objective of this study was to verify the role of the fractal dimension (FD) in assessing this dysplasia. Methods: To begin, 29 OL and 10 normal oral mucosa (NOM) biopsies were retrieved for FD analysis of the epithelial (dime) and the connective (dimc) tissue. Results: In the OL group, the median value of dime is higher (1.67, IQR = 0.12) than for the NOM group (1.56, IQR = 0.08), with statistically significant differences (Wilcoxon test, p = 0.0031). There were no differences in relation to dimc. Significant differences were observed between the non-dysplasia vs. high-grade (p = 0.0156) and low-grade vs. high-grade (p = 0.0049) groups. No significant differences were identified in relation to dimc for the different degrees of dysplasia. For a cut-off point of 1.44 of dime, a specificity of 96.6% was obtained, a sensitivity of 100%, and an AUC = 0.819 (p = 0.003). Conclusions: FD at the level of the epithelium may be used as a diagnostic tool in OL
DU Is Induced by Low Levels of Urinary ATP in a Rat Model of Partial Bladder Outlet Obstruction: The Incidence of Both Events Decreases after Deobstruction
Full text linkObjectives. To investigate, in initial phases of bladder outlet obstruction (BOO), the urinary ATP levels, the incidence of detrusor underactivity (DU), and if they change after deobstruction. Methods. Adult female Wistar rats submitted to partial BOO (pBOO) and sham-obstruction were used. Cystometry was performed 3 or 15 days after pBOO and fluid was collected from the urethra for ATP determination. Bladders were harvested for morphological evaluation of the urothelium. DU was defined as the average of voiding contractions (VC) of sham-operated animals, with 3 SD at 15 days after the sham surgery. In another group of animals in which pBOO was relieved at 15 days and bladders were let to recover for 15 days, the incidence of DU and ATP levels were also accessed. The Kruskal–Wallis test was followed by Dunn’s multiple comparisons test, and Spearman’s correlation test was used. Results. DU was present in 13% and 67% of the bladders at 3 and 15 days after pBOO, respectively, and in 20% of the bladders at 15 days after deobstruction. ATP levels were significantly lower in DU/pBOO versus sham and non-DU/pBOO rats. A strong positive correlation between ATP levels and VC/min was obtained (r = 0.63). DU bladders had extensive areas in which umbrella cells appeared stretched, the width exceeding that presented by sham animals. Conclusions. Low urothelial ATP parallels with a high incidence of DU early after pBOO.
1. Introduction
Detrusor underactivity (DU) associated with prolonged partial bladder outlet obstruction (pBOO) is mostly attributed to the impairment of the detrusor muscle and the efferent pathway [1, 2]. However, effective detrusor contractions cannot be generated in the absence of sensory input arising from the bladder [3]. During bladder distension, the stretch of urothelial cells causes the release of signalling molecules among which ATP plays a key role after binding to P2X3 purinergic receptors expressed in the rich suburothelial sensory fibre network [4–6]. The disruption of this urothelial sensory fibre crosstalk decreases the frequency of expulsive bladder voiding contractions (VC) and increases the postvoid residual urine [5].
At the beginning of the obstructive process, bladders develop compensatory mechanisms to increase the strength of detrusor contraction, among which detrusor hypertrophy is the most evident [7, 8]. However, after variable periods, decompensation may supervene, resulting in weak contractions unable to initiate and maintain normal micturition [7, 8]. In the switch from compensated into decompensated stages, a decrease in blood perfusion is a constant finding in men, pigs, and rodents suffering from prolonged pBOO [4, 9]. Although ischemia may injure parasympathetic and sensory nerves, the urothelium, which has the highest metabolic rate in the whole bladder, is particularly vulnerable [2, 10].
A recent clinical study showed that 79% of men with DU and BOO submitted to prostatectomy recovered spontaneous voiding [11]. This observation seems to indicate that reversible events rather than an irreversible replacement of smooth muscle cells by collagen [7, 9] or bladder denervation [1] participate in the early development of DU. The rapid urothelial turnover makes the reactivation of the ATP-mediated urothelial sensory fibre crosstalk as one foreseeable event. With these in mind, this study tested the hypothesis that DU observed in initial phases of pBOO courses with low levels of urinary ATP and that correction of pBOO increases the proportion of animals with normal bladders and normal levels of urinary ATP
Management of Bladder Pain Syndrome (BPS): A Practical Guide
Full text linkBladder pain syndrome (BPS) is a prevalent and pervasive disease. The physical and psychological sequelae can be very burdensome for the patient, and the condition represents a real challenge for the clinician as well. With no simple pathognomonic test, finding harmony in navigating patient care can be demanding. Diagnosis and management rely upon a multidisciplinary and holistic approach. Treatment options include conservative measures and pharmacotherapies as well as bladder instillation therapies. Ultimately, surgery may be offered but only in cases of refractory disease. This article offers a pragmatic guide for clinicians managing this challenging disease.
1. Manuscript
Bladder pain syndrome (BPS) is a disease of ubiquity, and epidemiological studies estimate it to affect 1.8–51/10,000 individuals worldwide [1]. However, there is evidence to suggest that the prevalence is underreported and that less than 10% of disease sufferers receive a formal diagnosis [2]. Prior to recent changes in standardised terminology, BPS was formerly referred to as interstitial cystitis (IC) [3]. This shift in nomenclature reflects its multifactorial aetiology and the symptom-based approach, which now occupies the diagnostic workup. The burden of the BPS is substantial, regarding both physical and psychological sequelae. It has been highlighted by the World Health Organization (WHO) as a major public health issue [4, 5]. Difficulties in diagnosing the condition are mirrored by the challenges faced in treating it. Despite the availability of an abundance of novel treatments, most of these have a limited evidence basis to support their use [6]. Such is the diversity in clinical phenotypes associated with BPS, and there is a huge range in treatment strategies offered worldwide. While numerous international guidelines do exist, recommendations can be divergent [7, 8]. It can therefore be quite difficult for the clinician to find harmony in navigating patient care. Our aim was to provide an overview of a practical framework for the contemporary management of BPS
Etiological spectrum of persistent fever in the tropics and predictors of ubiquitous infections: a prospective four-country study with pooled analysis
Full text linkPersistent fever, defined as fever lasting for 7 days or more at first medical evaluation, has been hardly investigated as a separate clinical entity in the tropics. This study aimed at exploring the frequencies and diagnostic predictors of the ubiquitous priority (i.e., severe and treatable) infections causing persistent fever in the tropics.
Methods
In six different health settings across four countries in Africa and Asia (Sudan, Democratic Republic of Congo [DRC], Nepal, and Cambodia), consecutive patients aged 5 years or older with persistent fever were prospectively recruited from January 2013 to October 2014. Participants underwent a reference diagnostic workup targeting a pre-established list of 12 epidemiologically relevant priority infections (i.e., malaria, tuberculosis, HIV, enteric fever, leptospirosis, rickettsiosis, brucellosis, melioidosis, relapsing fever, visceral leishmaniasis, human African trypanosomiasis, amebic liver abscess). The likelihood ratios (LRs) of clinical and basic laboratory features were determined by pooling all cases of each identified ubiquitous infection (i.e., found in all countries). In addition, we assessed the diagnostic accuracy of five antibody-based rapid diagnostic tests (RDTs): Typhidot Rapid IgM, Test-itTM Typhoid IgM Lateral Flow Assay, and SD Bioline Salmonella typhi IgG/IgM for Salmonella Typhi infection, and Test-itTM Leptospira IgM Lateral Flow Assay and SD Bioline Leptospira IgG/IgM for leptospirosis
Human placental proteomics and exon variant studies link AAT/SERPINA1 with spontaneous preterm birth
Full text linkPreterm birth is defined as live birth before 37 completed weeks of pregnancy, and it is a major problem worldwide. The molecular mechanisms that lead to onset of spontaneous preterm birth are incompletely understood. Prediction and evaluation of the risk of preterm birth is challenging as there is a lack of accurate biomarkers. In this study, our aim was to identify placental proteins that associate with spontaneous preterm birth.
Methods
We analyzed the proteomes from placentas to identify proteins that associate with both gestational age and spontaneous labor. Next, rare and potentially damaging gene variants of the identified protein candidates were sought for from our whole exome sequencing data. Further experiments we performed on placental samples and placenta-associated cells to explore the location and function of the spontaneous preterm labor-associated proteins in placentas.
Results
Exome sequencing data revealed rare damaging variants in SERPINA1 in families with recurrent spontaneous preterm deliveries. Protein and mRNA levels of alpha-1 antitrypsin/SERPINA1 from the maternal side of the placenta were downregulated in spontaneous preterm births. Alpha-1 antitrypsin was expressed by villous trophoblasts in the placenta, and immunoelectron microscopy showed localization in decidual fibrinoid deposits in association with specific extracellular proteins. siRNA knockdown in trophoblast-derived HTR8/SVneo cells revealed that SERPINA1 had a marked effect on regulation of the actin cytoskeleton pathway, Slit–Robo signaling, and extracellular matrix organization.
Conclusions
Alpha-1 antitrypsin is a protease inhibitor. We propose that loss of the protease inhibition effects of alpha-1 antitrypsin renders structures critical to maintaining pregnancy susceptible to proteases and inflammatory activation. This may lead to spontaneous premature birth
Initiatives to address leprosy as a human rights issue through the mandate of UN Special Rapporteur: Achievements and challenges
Full text linkLeprosy, or Hansen’s disease, is one of the oldest infectious diseases in the world. It has long been associated with stigma and discrimination, but only in recent years has this aspect been formally recognized by the international community as a human rights issue. The UN Human Rights Council first adopted a resolution on leprosy in 2008, and this was later followed by a UN General Assembly resolution in 2010. Nonbinding principle and guidelines on elimination of discrimination against persons affected by leprosy and their family members accompanied the 2010 resolution, but these have yet to be fully implemented. In 2017, the Human Rights Council appointed a Special Rapporteur on leprosy to investigate the extent to which the principles and guidelines have been implemented, and her term was extended for a further 3 years in 2020. Considering the proper implementation of the principles and guidelines to be key to eliminating the discrimination that persons affected by leprosy and their families face in various parts of the world, this paper looks at the contribution the Special Rapporteur can make. Based on an assessment of her activities to date, it concludes that the Special Rapporteur has actively worked to build networks with persons affected by leprosy and related organizations and gain their trust, but has faced challenges in organizing official country visits. It goes on to analyze what sort of legacy the Special Rapporteur should aim to leave behind after completing her second term and how she can go about doing so in the time remaining. To this end, it makes 5 suggestions: (1) gather information systematically on the actual situation of discrimination; (2) compile a collection of success stories; (3) ensure that there is consistency between legally binding international covenants and treaties and the principles and guidelines; (4) present proposals for concrete actions that can be taken after the Special Rapporteur’s second term ends; and (5) initiate a feasibility study on creating an “index” and “indicators” to measure the current status of stigma and discrimination and the extent to which the principles and guidelines have been implemented