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3 hrs ago


BACKGROUND China initiated major health-care reforms in 2009 aiming to provide universal health care for all by 2020. However, little is known about trends in health-care use and health outcomes across different socioeconomic groups in the past decade. METHODS We used data from the China Kadoorie Biobank (CKB), a nationwide prospective cohort study of adults aged 30-79 years in 2004-08, in ten regions (five urban, five rural) in China. Individuals who were alive in 2009 were included in the present study. Data for all admissions were obtained by linkage to electronic hospital records from the health insurance system, and to region-specific disease and death registers. Generalised linear models were used to estimate trends in annual hospital admission rates, 28-day case fatality rates, and mean length of stay for stroke, ischaemic heart disease, and any cause in all relevant individuals. FINDINGS 512 715 participants were recruited to the CKB between June 25, 2004, and July 15, 2008, 505 995 of whom were stillwer socioeconomic groups for stroke and ischaemic heart disease. INTERPRETATION Between 2009 and 2016, lower socioeconomic groups in China had greater increases in hospital admission rates and greater reductions in case fatality rates for stroke and ischaemic heart disease. Additional strategies are needed to further reduce socioeconomic differences in health-care use and disease outcomes. FUNDING Wellcome Trust, Medical Research Council, British Heart Foundation, Cancer Research UK, Kadoorie Charitable Foundation, China Ministry of Science and Technology, and Chinese National Natural Science Foundation. BACKGROUND Stroke is a leading cause of death and disability worldwide. Despite considerable improvements in diagnosis and treatment, little is known about the short-term and long-term prognosis after a first stroke in low-income and middle-income countries, including China. We aimed to assess the short-term and long-term risk of recurrent stroke and mortality after a first stroke for each of the major pathological stroke types. METHODS This population-based cohort study included adults aged 35-74 years without disability who were recruited to the China Kadoorie Biobank (CKB). A baseline survey was conducted in ten geographical areas (five urban, five rural) in China, and participants had clinical measurements recorded. Participants were followed up by monitoring death registries and by electronic linkage to health registries and health insurance claims databases, with follow-up until Jan 1, 2017. Participants were excluded from analyses if they had a previous history of stroke, transient ischaemic attack, orecondary prevention of stroke in China are needed to reduce these risks. FUNDING Wellcome Trust, Medical Research Council, British Heart Foundation, Cancer Research UK, Kadoorie Charitable Foundation, Chinese Ministry of Science and Technology, National Natural Science Foundation of China. COPYRIGHT © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. BACKGROUND An estimated 5·1 million stillbirths and neonatal deaths occur annually. Household surveys, most notably the Demographic and Health Survey (DHS), run in more than 90 countries and are the main data source from the highest burden regions, but data-quality concerns remain. We aimed to compare two questionnaires a full birth history module with additional questions on pregnancy losses (FBH+; the current DHS standard) and a full pregnancy history module (FPH), which collects information on all livebirths, stillbirths, miscarriages, and neonatal deaths. METHODS Women residing in five Health and Demographic Surveillance System sites within the INDEPTH Network (Bandim in Guinea-Bissau, Dabat in Ethiopia, IgangaMayuge in Uganda, Matlab in Bangladesh, and Kintampo in Ghana) were randomly assigned (individually) to be interviewed using either FBH+ or FPH between July 28, 2017, and Aug 13, 2018. The primary outcomes were stillbirths and neonatal deaths in the 5 years before the survey interview (measured by somplete than does FBH+, but has the potential to increase reporting of stillbirths in high burden contexts. https://www.selleckchem.com/products/sar405.html The between-site heterogeneity we found might reflect variations in interviewer training and survey implementation, emphasising the importance of interviewer skills, training, and consistent implementation in data quality. FUNDING Children's Investment Fund Foundation. BACKGROUND We aimed to evaluate and improve the accuracy of the ultrasound scan in estimating gestational age in late pregnancy (ie, after 24 weeks' gestation) in low-income and middle-income countries (LMICs), where access to ultrasound in the first half of pregnancy is rare and where intrauterine growth restriction is prevalent. METHODS This prospective, population-based, cohort study was done in three LMICs (Bangladesh, Pakistan, and Tanzania) participating in the WHO Alliance for Maternal and Newborn Health Improvement study. Women carrying a live singleton fetus dated by crown-rump length (CRL) measurements between 8+0-14+6 weeks of gestation, who were willing to return for two additional ultrasound scans, and who planned on delivering in the study area were enrolled in the study. Participants underwent ultrasonography at 24+0-29+6 weeks and at 30+0-36+6 weeks' gestation. Birthweights were measured within 72 h of birth, and the proportions of infants who had a small-for-gestational-age birthweight (ie, ause of the WHO logo is not permitted. This notice should be preserved along with the Article's original URL.BACKGROUND To date, dementia prediction models have been exclusively developed and tested in high-income countries (HICs). However, most people with dementia live in low-income and middle-income countries (LMICs), where dementia risk prediction research is almost non-existent and the ability of current models to predict dementia is unknown. This study investigated whether dementia prediction models developed in HICs are applicable to LMICs. METHODS Data were from the 10/66 Study. Individuals aged 65 years or older and without dementia at baseline were selected from China, Cuba, the Dominican Republic, Mexico, Peru, Puerto Rico, and Venezuela. Dementia incidence was assessed over 3-5 years, with diagnosis according to the 10/66 Study diagnostic algorithm. Discrimination and calibration were tested for five models the Cardiovascular Risk Factors, Aging and Dementia risk score (CAIDE); the Study on Aging, Cognition and Dementia (AgeCoDe) model; the Australian National University Alzheimer's Disease Risk Index (ANU-ADRI); the Brief Dementia Screening Indicator (BDSI); and the Rotterdam Study Basic Dementia Risk Model (BDRM).

13 hrs ago


Child marriage is a human rights violation disproportionately impacting girls in low- and middle-income countries. In the Middle East region, conflict and displacement have prompted concerns that families are increasingly resorting to child marriage to cope with economic insecurity and fears from sexual violence. This study set out to examine child marriage among Syrian refugees residing in Egypt with the aim of understanding drivers of child marriage in this context of displacement as well as how child marriage affects refugee girls' wellbeing.

This analysis draws from 15 focus group discussions (FGD) conducted with married and unmarried girls, as well as parents of adolescent girls in three governorates in Egypt. FGDs included a participatory ranking exercise and photo-elicitation. Additionally, we conducted 29 in-depth interviews with girls and mothers, as well as 28 key informant interviews with health providers, community leaders, and humanitarian actors. The data was thematically analyzed using a cofforts to address child marriage among Syrian refugees must acknowledge the different ways in which displacement can influence child marriage attitudes and practices and should capitalize on positive changes that have the potential to catalyze social norm change. Moreover, targeted, focused and contextualized interventions should not only focus on preventing child marriage but also on mitigating its impacts.
Efforts to address child marriage among Syrian refugees must acknowledge the different ways in which displacement can influence child marriage attitudes and practices and should capitalize on positive changes that have the potential to catalyze social norm change. Moreover, targeted, focused and contextualized interventions should not only focus on preventing child marriage but also on mitigating its impacts.
High rates of unintended adolescent pregnancy are a significant health problem in Uganda. To improve access to family planning (FP) services, community-based Village Health Teams (VHTs) are widely employed in Uganda to deliver education and services. https://www.selleckchem.com/products/azd7545.html However, evaluations of FP programs suggest that mainly older, married women use VHT FP services.

To better understand youth reluctance to use VHTs, we collected quantitative FP and contraceptive-seeking behavior data from a survey of 250 youths aged 15-25 in randomly selected households in Nakaseke District, which we triangulated with data from 3 focus group discussions (FGDs) (n= 15).

Most respondents received FP services from the formal health sector, not VHTs. Only half had talked to a VHT, but 65% knew that VHTs provide free FP services, and most (82%) felt comfortable talking to VHTs about FP. The main reasons for discomfort were fear that VHTs would violate privacy (mentioned by 60% of those not comfortable), that VHTs would talk to parents (33%), shge and sex may be more important for younger adolescents than older youths for whom quality concerns predominate.
VHTs are a known source of FP services but not widely used by youth due to privacy and quality of care concerns. VHT messaging and training should increase focus on ensuring privacy, protecting confidentiality, providing respectful care, and addressing concerns about contraceptive side effects. Preferences for VHTs of similar age and sex may be more important for younger adolescents than older youths for whom quality concerns predominate.
The United States needs to increase access to effective obesity prevention and treatment programming for impoverished youth at risk for health disparities. Although recommended, schools have difficulty consistently implement evidence-based obesity programing. We report on the effectiveness of adding structured nutrition education and minimum physical activity (PA) requirements to standard middle school after-school programming.

Using a longitudinal pre-post study design, we evaluated program effectiveness at one year on target behaviors on students recruited during three consecutive school years (2016-2018). We used generalized linear (or logistic) mixed-effects modeling to determine 1) impact on healthy weight and target healthy behavior attainment, and 2) whether target behavior improvement and weight change were associated with after-school program attendance. The seven target behaviors relate to eating healthy, physical activity, and sleep.

Over the three years, a total of 76 students enrolled and ctivities and may bring us closer to solving obesity in at-risk youth in impoverished communities.

ClinicalTrials.gov identifier (NCT number) NCT03565744 . Registered 21 June 2018 - Retrospectively registered.
ClinicalTrials.gov identifier (NCT number) NCT03565744 . Registered 21 June 2018 - Retrospectively registered.
Although evidence suggests that functional endurance capacity is the most important component associated with future health, little is known of how it is associated with multiple other physical fitness components. Since various physical fitness aspects do not change the same as functional endurance capacity during childhood, it is necessary to establish possible associations between functional endurance capacity and other physical fitness components in children. Therefore, the main purpose of the study was to test the associations between functional endurance capacity with other physical fitness components in 7-14-year-old children, stratified by gender.

In this cross-sectional study, we recruited 1612 children [mean age ± standard deviation (SD) = 9.72 ± 2.37 years; 52.5% girls). Health-related physical fitness components included 1) body-mass index (kg/m
) calculated from height and weight (measure of body size), 2) sit-and-reach test (measure of flexibility), 3) standing broad jump (measure of explosiional endurance capacity is weakly to moderately associated with other physical fitness components, pointing out that such measure should be tested separately from other aspects of physical fitness in school-aged children.
Although significant, functional endurance capacity is weakly to moderately associated with other physical fitness components, pointing out that such measure should be tested separately from other aspects of physical fitness in school-aged children.

14 hrs ago


The aberrant tRNA metabolism resulted in the impairment of mitochondrial translation, respiratory deficiency, decreasing membrane potentials and ATP production, increasing production of reactive oxygen species and promoting autophagy. These demonstrated the pleiotropic effects of m.4295A>G mutation on tRNAIle and mitochondrial functions. Our findings highlighted the essential role of deficient posttranscriptional modifications in the structure and function of tRNA and their pathogenic consequence of deafness.RNA-guided nucleases (RGNs) based on CRISPR systems permit installing short and large edits within eukaryotic genomes. However, precise genome editing is often hindered due to nuclease off-target activities and the multiple-copy character of the vast majority of chromosomal sequences. Dual nicking RGNs and high-specificity RGNs both exhibit low off-target activities. Here, we report that high-specificity Cas9 nucleases are convertible into nicking Cas9D10A variants whose precision is superior to that of the commonly used Cas9D10A nickase. Dual nicking RGNs based on a selected group of these Cas9D10A variants can yield gene knockouts and gene knock-ins at frequencies similar to or higher than those achieved by their conventional counterparts. Moreover, high-specificity dual nicking RGNs are capable of distinguishing highly similar sequences by 'tiptoeing' over pre-existing single base-pair polymorphisms. Finally, high-specificity RNA-guided nicking complexes generally preserve genomic integrity, as demonstrated by unbiased genome-wide high-throughput sequencing assays. https://www.selleckchem.com/products/act001-dmamcl.html Thus, in addition to substantially enlarging the Cas9 nickase toolkit, we demonstrate the feasibility in expanding the range and precision of DNA knockout and knock-in procedures. The herein introduced tools and multi-tier high-specificity genome editing strategies might be particularly beneficial whenever predictability and/or safety of genetic manipulations are paramount.
Schistosomiasis in non-immune travellers can cause acute schistosomiasis, a multi-systemic hypersensitivity reaction. Little is known regarding acute schistosomiasis in children. We describe acute schistosomiasis in paediatric travellers and compare them with adult travellers.

A retrospective study of paediatric travellers (0-18years old) diagnosed with schistosomiasis at Sheba Medical Center. Patients' findings are compared with those of adult travellers from the same travel groups.

18 children and 24 adults from five different trips to Tanzania, Uganda, Nigeria and Laos were infected (90% of the exposed travellers). The median bathing time of the infected children was 30minutes (interquartile range 15-30minutes). The most common presentations were respiratory symptoms in 13 (72%), eosinophilia in 13 (72%) and fever in 11 (61%). Acute illness included a median of 2.5 symptoms. Three children required hospitalization and three were asymptomatic. Fatigue was significantly less common in children comparedith a relevant travel history.
The impact that the coronavirus disease 2019 (COVID-19)-related early lockdown has had on dietary habits of the population and on food insecurity is unknown.

The aim of this study was to document the change in diet quality and in food insecurity observed during the COVID-19-related early lockdown. We hypothesized that the lockdown was associated with a deterioration in overall diet quality and an increase in food insecurity.

Data are from a COVID-19 subsample of NutriQuébec, a web-based cohort destined to study temporal changes in dietary habits among adults in Quebec, Canada. Participants completed questionnaires before (between June 2019 and February 2020) and during (April to May 2020) early lockdown, including a validated web-based 24-h recall (n=853) and a questionnaire on food security (n=922). Primary study outcomes were temporal changes in diet quality measured by the Healthy Eating Index (HEI)-2015 and in the prevalence of food insecurity.

There was a small increase in the HEI-2015 during they improved and prevalence of food insecurity was reduced in this sample of adults from Quebec during the COVID-19-related early lockdown. These results may be generalizable only to relatively healthy populations.
The present study aimed to determine the correlation between serum carcinoembryonic antigen (CEA) level and the severity of interstitial lung disease (ILD) in clinically amyopathic DM (CADM) patients.

We performed a retrospective study including 41 Chinese CADM patients without malignancy. Serum CEA levels, clinical and laboratory findings were collected. Association tests between CEA levels and disease activity parameters were performed.

Among the 41 patients, 16 (39.0%) developed rapidly progressive (RP)-ILD; of them, 14 (87.5%) had elevated serum CEA levels. Multivariate logistic regression analysis indicated that an elevated serum CEA level was an independent risk factor for RP-ILD. The incidence of elevated CEA level was significantly higher in patients with RP-ILD than in those without RP-ILD (87.5 vs 16.0%, P < 0.001). Furthermore, CEA levels were higher in patients with CADM with RP-ILD [26.87 (6.71) μg/l] than in those without RP-ILD [3.23 (0.64) μg/l] (P < 0.001). CEA levels in CADM patients were associated with the ferritin, alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase levels, and CT scores of the lungs. Also, elevated CEA levels are related to the organizing pneumonia pattern and lower lung zone consolidation in high-resolution CT. Moreover, the cumulative survival rate was significantly lower (68.4 vs 31.6%, P < 0.001) in the group with a CEA level >8.75 μg/l than that in the group with a CEA level <8.75 μg/l.

An elevated serum CEA level is common in patients with CADM, and a higher serum CEA level is a powerful indicator of RP-ILD and poor prognosis in those patients.
An elevated serum CEA level is common in patients with CADM, and a higher serum CEA level is a powerful indicator of RP-ILD and poor prognosis in those patients.Catalytically inactive Cas9 (dCas9) has become an increasingly popular tool for targeted gene activation/inactivation, live-cell imaging, and base editing. While dCas9 was reported to induce base substitutions and indels, it has not been associated with structural variations. Here, we show that dCas9 impedes replication fork progression to destabilize tandem repeats in budding yeast. When targeted to the CUP1 array comprising ∼16 repeat units, dCas9 induced its contraction in most cells, especially in the presence of nicotinamide. Replication intermediate analysis demonstrated replication fork stalling in the vicinity of dCas9-bound sites. Genetic analysis indicated that while destabilization is counteracted by the replisome progression complex components Ctf4 and Mrc1 and the accessory helicase Rrm3, it involves single-strand annealing by the recombination proteins Rad52 and Rad59. Although dCas9-mediated replication fork stalling is a potential risk in conventional applications, it may serve as a novel tool for both mechanistic studies and manipulation of genomic instability.

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3 hrs ago


BACKGROUND China initiated major health-care reforms in 2009 aiming to provide universal health care for all by 2020. However, little is known about trends in health-care use and health outcomes across different socioeconomic groups in the past decade. METHODS We used data from the China Kadoorie Biobank (CKB), a nationwide prospective cohort study of adults aged 30-79 years in 2004-08, in ten regions (five urban, five rural) in China. Individuals who were alive in 2009 were included in the present study. Data for all admissions were obtained by linkage to electronic hospital records from the health insurance system, and to region-specific disease and death registers. Generalised linear models were used to estimate trends in annual hospital admission rates, 28-day case fatality rates, and mean length of stay for stroke, ischaemic heart disease, and any cause in all relevant individuals. FINDINGS 512 715 participants were recruited to the CKB between June 25, 2004, and July 15, 2008, 505 995 of whom were stillwer socioeconomic groups for stroke and ischaemic heart disease. INTERPRETATION Between 2009 and 2016, lower socioeconomic groups in China had greater increases in hospital admission rates and greater reductions in case fatality rates for stroke and ischaemic heart disease. Additional strategies are needed to further reduce socioeconomic differences in health-care use and disease outcomes. FUNDING Wellcome Trust, Medical Research Council, British Heart Foundation, Cancer Research UK, Kadoorie Charitable Foundation, China Ministry of Science and Technology, and Chinese National Natural Science Foundation. BACKGROUND Stroke is a leading cause of death and disability worldwide. Despite considerable improvements in diagnosis and treatment, little is known about the short-term and long-term prognosis after a first stroke in low-income and middle-income countries, including China. We aimed to assess the short-term and long-term risk of recurrent stroke and mortality after a first stroke for each of the major pathological stroke types. METHODS This population-based cohort study included adults aged 35-74 years without disability who were recruited to the China Kadoorie Biobank (CKB). A baseline survey was conducted in ten geographical areas (five urban, five rural) in China, and participants had clinical measurements recorded. Participants were followed up by monitoring death registries and by electronic linkage to health registries and health insurance claims databases, with follow-up until Jan 1, 2017. Participants were excluded from analyses if they had a previous history of stroke, transient ischaemic attack, orecondary prevention of stroke in China are needed to reduce these risks. FUNDING Wellcome Trust, Medical Research Council, British Heart Foundation, Cancer Research UK, Kadoorie Charitable Foundation, Chinese Ministry of Science and Technology, National Natural Science Foundation of China. COPYRIGHT © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. BACKGROUND An estimated 5·1 million stillbirths and neonatal deaths occur annually. Household surveys, most notably the Demographic and Health Survey (DHS), run in more than 90 countries and are the main data source from the highest burden regions, but data-quality concerns remain. We aimed to compare two questionnaires a full birth history module with additional questions on pregnancy losses (FBH+; the current DHS standard) and a full pregnancy history module (FPH), which collects information on all livebirths, stillbirths, miscarriages, and neonatal deaths. METHODS Women residing in five Health and Demographic Surveillance System sites within the INDEPTH Network (Bandim in Guinea-Bissau, Dabat in Ethiopia, IgangaMayuge in Uganda, Matlab in Bangladesh, and Kintampo in Ghana) were randomly assigned (individually) to be interviewed using either FBH+ or FPH between July 28, 2017, and Aug 13, 2018. The primary outcomes were stillbirths and neonatal deaths in the 5 years before the survey interview (measured by somplete than does FBH+, but has the potential to increase reporting of stillbirths in high burden contexts. https://www.selleckchem.com/products/sar405.html The between-site heterogeneity we found might reflect variations in interviewer training and survey implementation, emphasising the importance of interviewer skills, training, and consistent implementation in data quality. FUNDING Children's Investment Fund Foundation. BACKGROUND We aimed to evaluate and improve the accuracy of the ultrasound scan in estimating gestational age in late pregnancy (ie, after 24 weeks' gestation) in low-income and middle-income countries (LMICs), where access to ultrasound in the first half of pregnancy is rare and where intrauterine growth restriction is prevalent. METHODS This prospective, population-based, cohort study was done in three LMICs (Bangladesh, Pakistan, and Tanzania) participating in the WHO Alliance for Maternal and Newborn Health Improvement study. Women carrying a live singleton fetus dated by crown-rump length (CRL) measurements between 8+0-14+6 weeks of gestation, who were willing to return for two additional ultrasound scans, and who planned on delivering in the study area were enrolled in the study. Participants underwent ultrasonography at 24+0-29+6 weeks and at 30+0-36+6 weeks' gestation. Birthweights were measured within 72 h of birth, and the proportions of infants who had a small-for-gestational-age birthweight (ie, ause of the WHO logo is not permitted. This notice should be preserved along with the Article's original URL.BACKGROUND To date, dementia prediction models have been exclusively developed and tested in high-income countries (HICs). However, most people with dementia live in low-income and middle-income countries (LMICs), where dementia risk prediction research is almost non-existent and the ability of current models to predict dementia is unknown. This study investigated whether dementia prediction models developed in HICs are applicable to LMICs. METHODS Data were from the 10/66 Study. Individuals aged 65 years or older and without dementia at baseline were selected from China, Cuba, the Dominican Republic, Mexico, Peru, Puerto Rico, and Venezuela. Dementia incidence was assessed over 3-5 years, with diagnosis according to the 10/66 Study diagnostic algorithm. Discrimination and calibration were tested for five models the Cardiovascular Risk Factors, Aging and Dementia risk score (CAIDE); the Study on Aging, Cognition and Dementia (AgeCoDe) model; the Australian National University Alzheimer's Disease Risk Index (ANU-ADRI); the Brief Dementia Screening Indicator (BDSI); and the Rotterdam Study Basic Dementia Risk Model (BDRM).

13 hrs ago


Child marriage is a human rights violation disproportionately impacting girls in low- and middle-income countries. In the Middle East region, conflict and displacement have prompted concerns that families are increasingly resorting to child marriage to cope with economic insecurity and fears from sexual violence. This study set out to examine child marriage among Syrian refugees residing in Egypt with the aim of understanding drivers of child marriage in this context of displacement as well as how child marriage affects refugee girls' wellbeing.

This analysis draws from 15 focus group discussions (FGD) conducted with married and unmarried girls, as well as parents of adolescent girls in three governorates in Egypt. FGDs included a participatory ranking exercise and photo-elicitation. Additionally, we conducted 29 in-depth interviews with girls and mothers, as well as 28 key informant interviews with health providers, community leaders, and humanitarian actors. The data was thematically analyzed using a cofforts to address child marriage among Syrian refugees must acknowledge the different ways in which displacement can influence child marriage attitudes and practices and should capitalize on positive changes that have the potential to catalyze social norm change. Moreover, targeted, focused and contextualized interventions should not only focus on preventing child marriage but also on mitigating its impacts.
Efforts to address child marriage among Syrian refugees must acknowledge the different ways in which displacement can influence child marriage attitudes and practices and should capitalize on positive changes that have the potential to catalyze social norm change. Moreover, targeted, focused and contextualized interventions should not only focus on preventing child marriage but also on mitigating its impacts.
High rates of unintended adolescent pregnancy are a significant health problem in Uganda. To improve access to family planning (FP) services, community-based Village Health Teams (VHTs) are widely employed in Uganda to deliver education and services. https://www.selleckchem.com/products/azd7545.html However, evaluations of FP programs suggest that mainly older, married women use VHT FP services.

To better understand youth reluctance to use VHTs, we collected quantitative FP and contraceptive-seeking behavior data from a survey of 250 youths aged 15-25 in randomly selected households in Nakaseke District, which we triangulated with data from 3 focus group discussions (FGDs) (n= 15).

Most respondents received FP services from the formal health sector, not VHTs. Only half had talked to a VHT, but 65% knew that VHTs provide free FP services, and most (82%) felt comfortable talking to VHTs about FP. The main reasons for discomfort were fear that VHTs would violate privacy (mentioned by 60% of those not comfortable), that VHTs would talk to parents (33%), shge and sex may be more important for younger adolescents than older youths for whom quality concerns predominate.
VHTs are a known source of FP services but not widely used by youth due to privacy and quality of care concerns. VHT messaging and training should increase focus on ensuring privacy, protecting confidentiality, providing respectful care, and addressing concerns about contraceptive side effects. Preferences for VHTs of similar age and sex may be more important for younger adolescents than older youths for whom quality concerns predominate.
The United States needs to increase access to effective obesity prevention and treatment programming for impoverished youth at risk for health disparities. Although recommended, schools have difficulty consistently implement evidence-based obesity programing. We report on the effectiveness of adding structured nutrition education and minimum physical activity (PA) requirements to standard middle school after-school programming.

Using a longitudinal pre-post study design, we evaluated program effectiveness at one year on target behaviors on students recruited during three consecutive school years (2016-2018). We used generalized linear (or logistic) mixed-effects modeling to determine 1) impact on healthy weight and target healthy behavior attainment, and 2) whether target behavior improvement and weight change were associated with after-school program attendance. The seven target behaviors relate to eating healthy, physical activity, and sleep.

Over the three years, a total of 76 students enrolled and ctivities and may bring us closer to solving obesity in at-risk youth in impoverished communities.

ClinicalTrials.gov identifier (NCT number) NCT03565744 . Registered 21 June 2018 - Retrospectively registered.
ClinicalTrials.gov identifier (NCT number) NCT03565744 . Registered 21 June 2018 - Retrospectively registered.
Although evidence suggests that functional endurance capacity is the most important component associated with future health, little is known of how it is associated with multiple other physical fitness components. Since various physical fitness aspects do not change the same as functional endurance capacity during childhood, it is necessary to establish possible associations between functional endurance capacity and other physical fitness components in children. Therefore, the main purpose of the study was to test the associations between functional endurance capacity with other physical fitness components in 7-14-year-old children, stratified by gender.

In this cross-sectional study, we recruited 1612 children [mean age ± standard deviation (SD) = 9.72 ± 2.37 years; 52.5% girls). Health-related physical fitness components included 1) body-mass index (kg/m
) calculated from height and weight (measure of body size), 2) sit-and-reach test (measure of flexibility), 3) standing broad jump (measure of explosiional endurance capacity is weakly to moderately associated with other physical fitness components, pointing out that such measure should be tested separately from other aspects of physical fitness in school-aged children.
Although significant, functional endurance capacity is weakly to moderately associated with other physical fitness components, pointing out that such measure should be tested separately from other aspects of physical fitness in school-aged children.

14 hrs ago


The aberrant tRNA metabolism resulted in the impairment of mitochondrial translation, respiratory deficiency, decreasing membrane potentials and ATP production, increasing production of reactive oxygen species and promoting autophagy. These demonstrated the pleiotropic effects of m.4295A>G mutation on tRNAIle and mitochondrial functions. Our findings highlighted the essential role of deficient posttranscriptional modifications in the structure and function of tRNA and their pathogenic consequence of deafness.RNA-guided nucleases (RGNs) based on CRISPR systems permit installing short and large edits within eukaryotic genomes. However, precise genome editing is often hindered due to nuclease off-target activities and the multiple-copy character of the vast majority of chromosomal sequences. Dual nicking RGNs and high-specificity RGNs both exhibit low off-target activities. Here, we report that high-specificity Cas9 nucleases are convertible into nicking Cas9D10A variants whose precision is superior to that of the commonly used Cas9D10A nickase. Dual nicking RGNs based on a selected group of these Cas9D10A variants can yield gene knockouts and gene knock-ins at frequencies similar to or higher than those achieved by their conventional counterparts. Moreover, high-specificity dual nicking RGNs are capable of distinguishing highly similar sequences by 'tiptoeing' over pre-existing single base-pair polymorphisms. Finally, high-specificity RNA-guided nicking complexes generally preserve genomic integrity, as demonstrated by unbiased genome-wide high-throughput sequencing assays. https://www.selleckchem.com/products/act001-dmamcl.html Thus, in addition to substantially enlarging the Cas9 nickase toolkit, we demonstrate the feasibility in expanding the range and precision of DNA knockout and knock-in procedures. The herein introduced tools and multi-tier high-specificity genome editing strategies might be particularly beneficial whenever predictability and/or safety of genetic manipulations are paramount.
Schistosomiasis in non-immune travellers can cause acute schistosomiasis, a multi-systemic hypersensitivity reaction. Little is known regarding acute schistosomiasis in children. We describe acute schistosomiasis in paediatric travellers and compare them with adult travellers.

A retrospective study of paediatric travellers (0-18years old) diagnosed with schistosomiasis at Sheba Medical Center. Patients' findings are compared with those of adult travellers from the same travel groups.

18 children and 24 adults from five different trips to Tanzania, Uganda, Nigeria and Laos were infected (90% of the exposed travellers). The median bathing time of the infected children was 30minutes (interquartile range 15-30minutes). The most common presentations were respiratory symptoms in 13 (72%), eosinophilia in 13 (72%) and fever in 11 (61%). Acute illness included a median of 2.5 symptoms. Three children required hospitalization and three were asymptomatic. Fatigue was significantly less common in children comparedith a relevant travel history.
The impact that the coronavirus disease 2019 (COVID-19)-related early lockdown has had on dietary habits of the population and on food insecurity is unknown.

The aim of this study was to document the change in diet quality and in food insecurity observed during the COVID-19-related early lockdown. We hypothesized that the lockdown was associated with a deterioration in overall diet quality and an increase in food insecurity.

Data are from a COVID-19 subsample of NutriQuébec, a web-based cohort destined to study temporal changes in dietary habits among adults in Quebec, Canada. Participants completed questionnaires before (between June 2019 and February 2020) and during (April to May 2020) early lockdown, including a validated web-based 24-h recall (n=853) and a questionnaire on food security (n=922). Primary study outcomes were temporal changes in diet quality measured by the Healthy Eating Index (HEI)-2015 and in the prevalence of food insecurity.

There was a small increase in the HEI-2015 during they improved and prevalence of food insecurity was reduced in this sample of adults from Quebec during the COVID-19-related early lockdown. These results may be generalizable only to relatively healthy populations.
The present study aimed to determine the correlation between serum carcinoembryonic antigen (CEA) level and the severity of interstitial lung disease (ILD) in clinically amyopathic DM (CADM) patients.

We performed a retrospective study including 41 Chinese CADM patients without malignancy. Serum CEA levels, clinical and laboratory findings were collected. Association tests between CEA levels and disease activity parameters were performed.

Among the 41 patients, 16 (39.0%) developed rapidly progressive (RP)-ILD; of them, 14 (87.5%) had elevated serum CEA levels. Multivariate logistic regression analysis indicated that an elevated serum CEA level was an independent risk factor for RP-ILD. The incidence of elevated CEA level was significantly higher in patients with RP-ILD than in those without RP-ILD (87.5 vs 16.0%, P < 0.001). Furthermore, CEA levels were higher in patients with CADM with RP-ILD [26.87 (6.71) μg/l] than in those without RP-ILD [3.23 (0.64) μg/l] (P < 0.001). CEA levels in CADM patients were associated with the ferritin, alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase levels, and CT scores of the lungs. Also, elevated CEA levels are related to the organizing pneumonia pattern and lower lung zone consolidation in high-resolution CT. Moreover, the cumulative survival rate was significantly lower (68.4 vs 31.6%, P < 0.001) in the group with a CEA level >8.75 μg/l than that in the group with a CEA level <8.75 μg/l.

An elevated serum CEA level is common in patients with CADM, and a higher serum CEA level is a powerful indicator of RP-ILD and poor prognosis in those patients.
An elevated serum CEA level is common in patients with CADM, and a higher serum CEA level is a powerful indicator of RP-ILD and poor prognosis in those patients.Catalytically inactive Cas9 (dCas9) has become an increasingly popular tool for targeted gene activation/inactivation, live-cell imaging, and base editing. While dCas9 was reported to induce base substitutions and indels, it has not been associated with structural variations. Here, we show that dCas9 impedes replication fork progression to destabilize tandem repeats in budding yeast. When targeted to the CUP1 array comprising ∼16 repeat units, dCas9 induced its contraction in most cells, especially in the presence of nicotinamide. Replication intermediate analysis demonstrated replication fork stalling in the vicinity of dCas9-bound sites. Genetic analysis indicated that while destabilization is counteracted by the replisome progression complex components Ctf4 and Mrc1 and the accessory helicase Rrm3, it involves single-strand annealing by the recombination proteins Rad52 and Rad59. Although dCas9-mediated replication fork stalling is a potential risk in conventional applications, it may serve as a novel tool for both mechanistic studies and manipulation of genomic instability.

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immigration had a significant effect on having a regular provider but not on number of consultations. Differences in health care utilization for recent and for established immigrants observed in this study may be partially explained by Canada's evolving immigration policy and the economic and social integration of immigrants over time.
Various conditions with cellular decay are associated with elevated cell-free DNA (cfDNA). This study aimed to investigate if perioperatively measured cfDNA levels were associated with the surgical approach, complications, or recurrence.

Plasma was obtained from patients who underwent surgery for colon cancer at admission and at the time of discharge. Quantitative measurement of cfDNA was performed by amplifying two amplicons of 102 base pairs (bp) and 132bp of Beta-2-Microglobulin (B2M) and Peptidyl-Prolyl cis-trans Isomerase A (PPIA), respectively.

cfDNA was measured in 48 patients who underwent surgery for colonic cancer. Sixteen patients had recurrence during the follow-up period, fifteen developed a postoperative complication, and seventeen patients developed neither, acting as the control group. Postoperative cfDNA levels were significantly elevated from baseline samples, across all groups, with a median preoperatively B2M level of 48.3 alleles per mL and postoperatively of 220 alleles per mL and a median preoperatively level PPIA of 26.9 alleles per mL and postoperatively of 111.6 alleles per mL (p < 0.001 for B2M and p < 0.001 for PPIA). Postoperative levels of PPIA, but not B2M, were significantly higher in patients experiencing complications than in the control group (p = 0.036). However, a tendency towards an association between the surgical approach and the changes in cfDNA levels was found for PPIA (p = 0.058), and B2M (p = 0.087).

Plasma cfDNA was increased after surgery in all patients with colon cancer. Postoperative PPIA levels were significantly higher in patients experiencing surgical complications but not in B2M levels.
Plasma cfDNA was increased after surgery in all patients with colon cancer. Postoperative PPIA levels were significantly higher in patients experiencing surgical complications but not in B2M levels.
Loneliness is associated with severe consequences for both the physical and mental health of older people. Research has shown that mobility limitations are an important risk factor for the emergence and maintenance of feelings of loneliness. The aim of this study was to explore the experiences of loneliness among community-dwelling older people with reduced mobility and its underlying dynamics.

This study employed a qualitative, descriptive design, inspired by a grounded theory approach. Participants were purposively recruited in collaboration with home health care providers. The main inclusion criteria were as follows aged 75years or older, being mobile impaired, experiencing feelings of loneliness, and living at home and being cognitively able to be interviewed. Data analysis of 15 semi-structured, in-depth interviews was conducted based on the Qualitative Analysis Guide of Leuven (QUAGOL).

Loneliness was expressed through all the stories, but it appeared as an elusive, intangible phenomenon. Both inds.
Antiretroviral therapy (ART) is known to reduce tuberculosis (TB) incidence among people living with HIV (PLWH). However, studies describing the impact of long-term ART and CD4 count recovery on TB incidence remain scarce due to limited follow up in previous studies. We evaluated TB incidence in a long-term cohort of PLWH on ART in Thailand.

We conducted an analysis of PLWH aged ≥ 18years who started ART between 1996 and December 2020. Participants were followed up every 6months for routine HIV care. TB risk factors, body mass index (BMI), physical examination and full differential blood counts were evaluated at each clinic visit, and CD4 cell counts and HIV RNA every 12months. Participants diagnosed with TB > 3months after starting ART were classified as incident cases. Time to event models with death as a competing risk, were used to derive the TB cumulative incidence function (CIF) after ART initiation, and assess time-updated factors associated with incident TB using a six month lag.

A total of 2D4 cell counts, who are underweight, or currently having substance abuse should be carefully monitored.
Despite a marked reduction in TB incidence following ART, ongoing TB risk remains high among PLWH, despite long-term suppressive ART. Those with low CD4 cell counts, who are underweight, or currently having substance abuse should be carefully monitored.
Globally, approximately 6,700 newborn deaths and 5,400 stillbirths occur daily. The true figure is likely higher, with under reporting of adverse pregnancy outcomes (APOs) noted. Decision-making in health is influenced by various factors, including one's social networks. We sought to understand APOs disclosure within social networks in Uganda, Ghana, Guinea-Bissau and Bangladesh and how this could improve formal reporting of APOs in surveys. METHODS A qualitative, exploratory multi-country study was conducted within four health and demographic surveillance system sites. 16 focus group discussions were held with 147 women aged 15-49years, who had participated in a recent household survey. Thematic analysis, with both deductive and inductive elements, using three pre-defined themes of Sender, Message and Receiver was done using NVivo software.

Disclosure of APOs was a community concern, with news often shared with people around the bereaved for different reasons, including making sense of what happened and ourage more bereaved women to inform them and seek care.Microtubule associated proteins (MAPs), defined as proteins that bind microtubules but are not molecular motors or severing enzymes, play a key role in regulating microtubule stability in neurons. Existing studies of the evolutionary relationships between these proteins are limited to genomic data from a small number of species. We therefore used a large collection of publicly available reference-quality eukaryotic proteomes to carry out a phylogenetic analysis of microtubule associated proteins in both vertebrates and invertebrates. Complete or near-complete reference quality proteomes were obtained from Uniprot. Microtubule associated proteins were identified using InterProtScan, aligned using MUSCLE and then phylogenetic trees constructed using the WAG algorithm. We identified 889 proteins with tubulin binding domains, of which 663 were in eukaryotes, including 168 vertebrates and 64 invertebrates. The vertebrate proteins separated into three families, resembling human MAP 2, MAP4 and MAPT, respectively, while invertebrate MAPs clustered separately. We found significant variation in number of microtubule associated proteins and number of microtubule binding domains between taxa, with fish and mollusks having an unexpectedly high number of MAPs and binding domains, respectively. Our findings represent a novel analysis of the evolution of microtubule associated proteins based on publicly available proteomics data sets. We were able to confirm the phylogeny of MAPs identified based on more limited genomic analyses, and in addition, derived several novel insights on the structure and function of MAPs.
Due to rapid urbanization, Covid-19 pandemic and increasing food prices, a higher rate of food insecurity has been observed in recent years in India. Thus, we aim to study the prevalence of food insecurity among older Indian adults and the association of food insecurity as a modifiable risk factor with late-life cognitive impairment.

Data for this study were obtained from the recent release of the Longitudinal Ageing Study in India (2017-18). The total sample size for the study was 31,464 older adults aged 60 years and above. Cognitive functioning was measured through five broad domains (memory, orientation, arithmetic function, executive function, and object naming) adapted from the cognitive module of the US Health and Retirement Study (HRS). Descriptive statistics along with cross-tabulation were presented in the study. Additionally, multivariable logistic regression analysis was used to fulfil the objectives of the study.

It was found that 7.7% of older adults in rural areas reduced their size of mens focusing on food security may have unintended positive impacts on late-life mental wellbeing as the older age is associated with higher cognitive deficits.
The findings of the study highlight that the food security status in older adults may bring about greater challenges due to their limited economic resources. Interventions focusing on food security may have unintended positive impacts on late-life mental wellbeing as the older age is associated with higher cognitive deficits.
The Yinzhou Center for Disease Prevention and Control (CDC) in China implemented an integrated health big data platform (IHBDP) that pooled health data from healthcare providers to combat the spread of infectious diseases, such as dengue fever and pulmonary tuberculosis (TB), and to identify gaps in vaccination uptake among migrant children.

IHBDP is composed of medical data from clinics, electronic health records, residents' annual medical checkup and immunization records, as well as administrative data, such as student registries. We programmed IHBDP to automatically scan for and detect dengue and TB carriers, as well as identify migrant children with incomplete immunization according to a comprehensive set of screening criteria developed by public health and medical experts. We compared the effectiveness of the big data screening with existing traditional screening methods.

IHBDP successfully identified six cases of dengue out of a pool of 3972 suspected cases, whereas the traditional method only identified four cases (which were also detected by IHBDP). https://www.selleckchem.com/products/dihydroethidium.html For TB, IHBDP identified 288 suspected cases from a total of 43,521 university students, in which three cases were eventually confirmed to be TB carriers through subsequent follow up CT or T-SPOT.TB tests. As for immunization screenings, IHBDP identified 240 migrant children with incomplete immunization, but the traditional door-to-door screening method only identified 20 ones.

Our study has demonstrated the effectiveness of using IHBDP to detect both acute and chronic infectious disease patients and identify children with incomplete immunization as compared to traditional screening methods.
Our study has demonstrated the effectiveness of using IHBDP to detect both acute and chronic infectious disease patients and identify children with incomplete immunization as compared to traditional screening methods.
Most of older adults' falls are related to inefficient balance recovery after an unexpected loss of balance, i.e., postural perturbation. Effective balance recovery responses are crucial to prevent falls. Due to the considerable consequences of lateral falls and the high incidence of falls when walking, this study aimed to examine the effect of a concurrent cognitive task on older adults' balance recovery stepping abilities from unannounced lateral perturbations while walking. We also aimed to explore whether cognitive performance accuracy is affected by perturbed walking and between task trade-offs.

In a laboratory-based study, 20 older adults (> 70 years old) performed the following test conditions (1) cognitive task while sitting; (2) perturbed walking; and (3) perturbed walking with a concurrent cognitive task. The cognitive task was serial numbers subtraction by seven. Single-step and multiple-step thresholds, highest perturbation achieved, 3D kinematic analysis of the first recovery step, and cognitive task performance accuracy were compared between single-task and dual-task conditions.

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28, 95% CI -0.43, -0.12 difference in WAZ), and birth during the preharvest season (November to March) (-0.22, 95% CI -0.33, -0.11 difference in WAZ). The most common neonatal serious AEs were respiratory tract infections and neonatal sepsis (2.2 and 1.4 events per 100 child-months, respectively). The study cohort represents a high-risk population for whom interventions to improve child growth and development are urgently needed. Further analyses are needed to understand the persistent impacts of seasonal malnutrition and the interactions between seasonality, socioeconomic status, and the study interventions.Adult T-cell leukemia/lymphoma (ATLL) is a peripheral T-cell neoplasm caused by the human T-cell leukemia virus type 1 (HTLV-1). It is characterized by a short survival time and lack of response to chemotherapy. We report a case of a 56-year-old woman, from the Brazilian northeast state of Bahia, who presented with a 2-month history of infiltrated papular and nodular skin lesions, especially on her forehead and also on her lower and upper limbs. Laboratory tests revealed positive serology for HTLV-1. Histopathological findings and the immunohistochemical profile confirmed the diagnosis of adult T-cell lymphoma/leukemia. A month after the diagnosis, the patient presented acute fatigue and pronounced paleness of the skin, dying of septic shock after her first chemotherapy cycle. The aim of this case report was to emphasize the importance of maintaining high clinical suspicion for ATLL, considering the epidemiological profile of the disease, especially for patients whose only early symptoms are cutaneous lesions.Diagnosis of tuberculosis with GeneXpert and same-day initiation of tuberculosis treatment (SITT) has important public health and clinical benefits. GeneXpert allows for rapid diagnosis, hence presenting an opportunity for SITT. We determined the association between GeneXpert diagnosis and SITT, and the effect of SITT on treatment success rate among adult persons with bacteriologically confirmed pulmonary tuberculosis (BC-PTB) in rural eastern Uganda. https://www.selleckchem.com/products/lb-100.html We conducted a retrospective cohort study using routinely collected data at 10 health facilities, used modified Poisson regression analysis to determine the association between GeneXpert and SITT, and expressed the results as risk ratio (RR). We used propensity score-matched analysis to match SITT participants to delayed initiation of treatment (DIT) participants and then performed logistic regression analysis to determine the independent effect of SITT on treatment success rate, expressed as odds ratio (OR). Of 1,045 participants, 764 (73.1%) had SITT. The use of GeneXpert for diagnosis of tuberculosis was associated with higher likelihood of SITT (adjusted RR [aRR], 1.28; 95% CI 1.19-1.37) and for persons with new BC-PTB diagnosis (aRR, 1.16; 95% CI 1.02-1.32). We successfully matched 530 participants (265 in SITT and 265 in DIT) through 11 nearest neighbor caliper matching. Before propensity score-matched analysis, SITT was not significantly associated with treatment success rate (adjusted OR, 0.97; 95% CI 0.70-1.33). After propensity score-matched analysis, SITT remained nonsignificantly associated with treatment success rate (OR, 0.96; 95% CI 0.67-1.40). GeneXpert thus increases the likelihood of SITT, but SITT has no significant effect on treatment success rate.Infodemics, often including rumors, stigma, and conspiracy theories, have been common during the COVID-19 pandemic. Monitoring social media data has been identified as the best method for tracking rumors in real time and as a possible way to dispel misinformation and reduce stigma. However, the detection, assessment, and response to rumors, stigma, and conspiracy theories in real time are a challenge. Therefore, we followed and examined COVID-19-related rumors, stigma, and conspiracy theories circulating on online platforms, including fact-checking agency websites, Facebook, Twitter, and online newspapers, and their impacts on public health. Information was extracted between December 31, 2019 and April 5, 2020, and descriptively analyzed. We performed a content analysis of the news articles to compare and contrast data collected from other sources. We identified 2,311 reports of rumors, stigma, and conspiracy theories in 25 languages from 87 countries. Claims were related to illness, transmission and mortality (24%), control measures (21%), treatment and cure (19%), cause of disease including the origin (15%), violence (1%), and miscellaneous (20%). Of the 2,276 reports for which text ratings were available, 1,856 claims were false (82%). Misinformation fueled by rumors, stigma, and conspiracy theories can have potentially serious implications on the individual and community if prioritized over evidence-based guidelines. Health agencies must track misinformation associated with the COVID-19 in real time, and engage local communities and government stakeholders to debunk misinformation.Japanese encephalitis (JE) virus is a mosquito-borne flavivirus endemic throughout Asia. Incidence in non-endemic countries is rare, with an estimate of less than one case per one million travelers. Most human JE infections are asymptomatic or cause a mild, nonspecific febrile illness. Neurological involvement, if present, is usually severe and associated with high mortality or ongoing neurological sequelae in survivors. Ocular manifestations are rare with JE, but uveitis has been described to be associated with other flavivirus infections, including West Nile virus. We report the first probable case of JE chorioretinitis acquired by a 45-year-old Australian traveler to Bali. This case highlights the importance of a detailed ocular examination when there is clinical suspicion of JE.The prevalence of malaria in India is decreasing, but it remains a major concern for public health administration. The role of submicroscopic malaria and asymptomatic malaria parasitemia and their persistence is being explored. A cross-sectional survey was conducted in the Kandhamal district of Odisha (India) during May-June 2017. Blood samples were collected from 1897 individuals for screening of asymptomatic parasitemia. Samples were screened using rapid diagnostic tests (RDTs) and examined microscopically for Plasmodium species. Approximately 30% of randomly selected samples (n = 586) were analyzed using real-time PCR (qPCR), and the genetic diversity of Plasmodium falciparum was analyzed. The prevalence of Plasmodium species among asymptomatic individuals detected using qPCR was 18%, which was significantly higher than that detected by microscopy examination (5.5%) or RDT (7.3%). Of these, 37% had submicroscopic malaria. The species-specific prevalence among asymptomatic malaria-positive cases for P. falciparum, Plasmodium vivax, and mixed infection (P.