Health

Published by Scientific Research Publishing
Online ISSN: 1949-5005
Publications
Comparison of survival rates for drug resistant and parental cell lines 
ABCC1 is up-regulated on the cell surface of vincristine resistant cells 
ABCC1 is a functional drug efflux transporter Left-centered white peak: VCR-resistant Jurkat cells maintained in calcein AM fluorescent dye without verapamil. Right-centered white peak: VCR-sensitive Jurkat cell maintained in calcein AM fluorescent dye without verapamil. Purple peak: VCR-resistant Jurkat cells maintained in calceim AM fluorescent dye with verapamil. These peaks demonstrate that verapamil can block the ABCC1-mediated efflux of the calcein AM fluorescent dye, demonstrating that ABCC1 retains functional transporter physiology in Jurkat cells. 
siRNA restores sensitivity to vincristine resistant cells over-expressing ABCC1 
ABCC1 expression levels are elevated in patients for whom induction fails in Children's Oncology Group T-ALL Studies 9404 and AALL0434 
Article
In acute lymphoblastic leukemia (ALL), multidrug resistance is often mediated by ATPase Binding Cassette (ABC) proteins, which principally involve ABCB1 (multidrug resistance 1, MDR1) and ABCC1 (multidrug resistance protein 1, MRP1). However, direct comparisons between the differential effects of ABCB1 and ABCC1 have been difficult, since identical cell lines with differential expression of these transporters have not been developed. In this study, we developed and compared the biological profiles of Jurkat cell lines that selectively over-expressed ABCB1 and ABCC1. Vincristine (VCR) plays an important role in the treatment of T-lineage ALL (T-ALL), and is often the first drug given to newly-diagnosed patients. Because of its importance in treatment, we provided escalating, sub-lethal doses of VCR to Jurkat cells, and extended our observations to expression profiling of newly diagnosed patients with T-ALL. We found that VCR-resistant cells over-expressed ABCC1 nearly 30-fold. The calcein AM assay confirmed that VCR-resistant cells actively extruded VCR, and that ABCC1-mediated drug resistance conferred a different spectrum of multidrug resistance than other T-ALL induction agents. siRNA experiments that blocked ABCC1 export confirmed that VCR resistance could be reversed in vitro. Analyses of T-lymphoblasts obtained from 92 newly diagnosed T-ALL patients treated on Children's Oncology Group Phase III studies 8704/9404 showed that induction failure could be explained in all but one case by the over-expression of ABCB1 or ABCC1. Taken together, these results suggest that over-expression of ABC transporters plays a contributing role in mediating treatment failure in T-ALL, and underscore the need to employ alternate treatment approaches in patients for whom induction failed or for those with relapsed disease.
 
Article
Second hand smoke exposure (SHSe) relates to many chronic and acute illnesses. Low income African American (AA) maternal smokers and their children have disproportionately higher tobacco-use and child SHSe-related morbidity and mortality than other populations. While public health officials promote residential smoking restrictions to reduce SHSe and promote smoking cessation, little is known about the impact of restrictions in changing smoking behavior and SHSe in this population. Thus, the purpose of this study was to examine associations between residential smoking restrictions, maternal smoking, and young children's SHSe in the context of other factors known to influence low income AA mothers' smoking behavior. For this study, we used cross-sectional, baseline data from 307 AA maternal smokers' pre-treatment interviews completed as part of a subsequent behavioral counseling trial to reduce their young (< 4 years old) children's SHSe. Residential smoking restriction was dichotomized as 0 = no restrictions and 1 = some restrictions. Child urine cotinine provided a biomarker of SHSe. Mothers reported cigarettes/day smoked, cigarettes/day exposed to child, and intention to quit. Multivariate regressions modeled effects of restriction as the primary predictor of smoking and exposure outcomes. Maternal smoking patterns such as cigarettes per day (β = 0.52, p < 0.001) and years smoked (β = -0.11; p = 0.03) along with presence of additional smokers in the home (β = 0.10; p = 0.04), but not residential restriction (β = -0.09, p = 0.10), predicted reported SHSe. Restriction did not relate to baby cotinine or maternal intention to quit. Thus, residential smoking restrictions may contribute to efforts to reduce children's SHSe and promote maternal smoking change; but alone, may not constitute a sufficient intervention to protect children. Multi-level intervention approaches that include SHSe-reduction residential smoking policies plus support and cessation assistance for smokers may be a necessary approach to smoke-free home adoption and adherence.
 
Summary of platelet profiles in study groups of mice. 
Article
Angiotensin II (Ang II) is a critical component of the renin-angiotensin system that contributes to hypertension. Although platelets in blood from hypertensive subjects have an abnormal biological profile, it is unclear if circulating Ang II influences platelet aggregation or thrombus formation. One of the abnormalities presented to the platelets during hypertension is an elevated plasma concentration of serotonin (5-HT) caused by reduced 5-HT uptake secondary to loss of the 5-HT transporter (SERT) on the platelet plasma membrane. In the current study, we evaluated in vivo platelet function after 7 days of subcutaneous Ang II infusion to establish hypertension in mice and additionally assessed the biology of isolated platelets exposed to Ang II in vitro. The administration of Ang II elevated systolic blood pressure, but markers of platelet activation including P-selectin and (PE)Jon/A staining were not changed. However, the aggregation response to collagen was reduced in isolated platelets from Ang II-infused mice, which also showed reduced 5-HT uptake by SERT. In vitro exposure of isolated platelets to Ang II also resulted in a loss of surface SERT associated with a reduced aggregation response to collagen. These abnormalities were reversed by increasing concentrations of the Ang II receptor antagonist, valsartan. Interestingly, SERT KO mice failed to fully develop hypertension in response to Ang II infusion and isolated platelets from these animals were insensitive to the anti-aggregatory influence of Ang II. Thus, Ang II blunts the aggregation responses of platelets and the mechanism underlying this action may involve a loss of SERT on the platelet plasma membrane. The latter event depletes intracellular 5-HT in platelets, an event that is associated with reduced aggregation. The widespread use of antihypertensive drugs that target the renin-angiotensin system suggest the potential clinical utility of our findings and emphasize the importance of understanding the impact of Ang II on platelet function.
 
Plots of observed minus predicted probability of positive nodes versus number of positive nodes for six models. 
Zero inflated negative binomial model for number of involved nodes.
Comparison of model fit characteristics.
Article
Clinicians need to predict the number of involved nodes in breast cancer patients in order to ascertain severity, prognosis, and design subsequent treatment. The distribution of involved nodes often displays over-dispersion-a larger variability than expected. Until now, the negative binomial model has been used to describe this distribution assuming that over-dispersion is only due to unobserved heterogeneity. The distribution of involved nodes contains a large proportion of excess zeros (negative nodes), which can lead to over-dispersion. In this situation, alternative models may better account for over-dispersion due to excess zeros. This study examines data from 1152 patients who underwent axillary dissections in a tertiary hospital in India during January 1993-January 2005. We fit and compare various count models to test model abilities to predict the number of involved nodes. We also argue for using zero inflated models in such populations where all the excess zeros come from those who have at some risk of the outcome of interest. The negative binomial regression model fits the data better than the Poisson, zero hurdle/inflated Poisson regression models. However, zero hurdle/inflated negative binomial regression models predicted the number of involved nodes much more accurately than the negative binomial model. This suggests that the number of involved nodes displays excess variability not only due to unobserved heterogeneity but also due to excess negative nodes in the data set. In this analysis, only skin changes and primary site were associated with negative nodes whereas parity, skin changes, primary site and size of tumor were associated with a greater number of involved nodes. In case of near equal performances, the zero inflated negative binomial model should be preferred over the hurdle model in describing the nodal frequency because it provides an estimate of negative nodes that are at "high-risk" of nodal involvement.
 
Article
It is known that activated N-methyl-D-aspartate receptors (NMDARs) are a major route of excessive calcium ion (Ca(2+)) entry in central neurons, which may activate degradative processes and thereby cause cell death. Therefore, NMDARs are now recognized to play a key role in the development of many diseases associated with injuries to the central nervous system (CNS). However, it remains a mystery how NMDAR activity is recruited in the cellular processes leading to excitotoxicity and how NMDAR activity can be controlled at a physiological level. The sodium ion (Na(+)) is the major cation in extracellular space. With its entry into the cell, Na(+) can act as a critical intracellular second messenger that regulates many cellular functions. Recent data have shown that intracellular Na(+) can be an important signaling factor underlying the up-regulation of NMDARs. While Ca(2+) influx during the activation of NMDARs down-regulates NMDAR activity, Na(+) influx provides an essential positive feedback mechanism to overcome Ca(2+)-induced inhibition and thereby potentiate both NMDAR activity and inward Ca(2+) flow. Extensive investigations have been conducted to clarify mechanisms underlying Ca(2+)-mediated signaling. This review focuses on the roles of Na(+) in the regulation of Ca(2+)-mediated NMDAR signaling and toxicity.
 
PM 2.5 and PM 10 monthly mean concentrations reported in 2004 by PR-EQB for the rural coastal region of Fajardo, Puerto Rico. 
Endotoxin concentration in PM 2.5 and PM 10 extracts.
Schematic model explaining the movement of African dust through the Atlantic Ocean (ADEAO) reaching the Puerto Rican coast (ADEPRC) and the possible relationship between its constituents (e.g., PM 2.5-10 , ENX, TMET, other PM constituents). Briefly, as African dust crosses the Atlantic 
Article
African dust storm events (ADE) travel across the Atlantic Ocean (ADEAO) and reach the Puerto Rican coast (ADEPRC), potentially impacting air quality and human health. To what extent seasonal variations in atmospheric particulate matter (PM) size fractions, composition and sources trigger respiratory-adverse effects to Puerto Ricans is still unclear. In the present study, we investigated the pro-inflammatory and cytotoxic effects of PM samples harvested during ADEAO (PM10), ADEPRC (PM2.5 and PM10) and Non-ADE (Preand Post-ADEAO and Non-ADEPRC), using BEAS-2B cells. Endotoxins (ENX) in PM2.5 and PM10 extracts and traces of metals (TMET) in PM2.5 extracts were also examined. IL-6 and IL-8 secretion and cytotoxicity were used as endpoints. ADEAO and ADEPRC extracts were found to be more cytotoxic than Non-ADE and ADEAO were more toxic than ADEPRC extracts. PM10 extracts from ADEAO and Post-ADEAO caused significant secretion of IL-8. IL-6 and IL-8 secretion was higher following treatment with PM10 and PM2.5 ADEPRC than with Non-ADEPRC extracts. ENX levels were found to be higher in PM10 ADEAO than in the rest of the samples tested. TMET levels were higher in PM2.5 ADEPRC than in Non-ADEPRC extracts. Deferoxamine significantly reduced cytotoxicity and IL-6 and IL-8 secretion whereas Polymyxin B did not. TMET in PM2.5 fractions is a major determinant in ADEPRC-induced toxicity and work in conjunction with ENX to cause toxicity to lung cells in vitro. ENX and TMET may be responsible, in part, for triggering PM-respiratory adverse responses in susceptible and predisposed individuals.
 
Mean difference scores between baseline and post-intervention by group.
Article
BACKGROUND: Very little is known about the impact of psychosocial stress on underlying biological mechanisms in African American lupus patients, although African American women display the highest rates of lupus. Due to the exposure of African Americans to a unique trajectory of stressors throughout the life course, it may be critical to understand the relationship between psychosocial stress and underlying biological mechanisms that influence disease activity and pathology in this high risk group. METHODS: To begin to fill this research void, an evidence based self-management program was piloted among a cohort of African American lupus patients participating in an SLE database project at the Medical University of South Carolina (MUSC). To assess disease activity, during each clinic visit, a history is obtained, and physical examination, phlebotomy, and urine collection are performed. SLE Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (SDI) scores are assessed at each visit. Disease data corresponding with data collection timeframes for each participant were extracted from the MUSC SLE Database to assess the effectiveness of the program. RESULTS: Several differences were observed between the intervention and control groups on symptoms pertaining to lupus activity, and many of these differences had large effect sizes. DISCUSSION: Our findings can be rapidly translated into improved delivery of health care and targeted trials/interventions with relevance to health disparities, and if widely implemented, morbidities and mortality related to lupus could be drastically reduced in African-Americans.
 
Description of survey methodology.
Map showing water sampling areas in the study ward.
Article
The World Bank estimates that 21% of all communicable diseases in India are related to unsafe water with diarrhoea alone causing more than 0.1 million deaths annually. The WHO drinking water surveillance parameters of quality, quantity, accessibility, affordability and continuity were assessed in one vulnerable ward of Ahmedabad-a fast growing city in Western India. Interviews with key informants of the ward office, health centre and water supply department, secondary analysis and mapping of field test reports and a questionnaire-based survey of different household types were conducted. We found that Ahmedabad Municipal Corporation (AMC) supplies water to the ward intermittently for two hours during the day. Housing society clusters supplement their AMC water supply with untested bore-well water. The water quality surveillance system is designed for a twenty-four-hour piped distribution of treated surface water. However, in order to maintain surveillance over an intermittent supply that includes ground water, the sampling process should include periodic surveys of water actually consumed by the citizens. The laboratory capacity of the Central Water Testing Laboratory should expand to include more refined tests for microbial and chemical contamination.
 
Determination of the effect of (a) passage number and (b) adrenaline on the beating characteristic in P19CL6 cells cultured under adherent conditions. (a) P19CL6 cells (passage 12) were cultured with 0-20 M adrenaline and pulse rate was recorded on day 15 of incubation. Linear regression analysis showed a correlation of pulse rate with adrenaline concentration (y = 1.1x + 21.8, R 2 = 0.541, P < 0.001) and one-way ANOVA confirmed a significant effect of adrenaline on pulse rate in P19CL6 cells (P < 0.001). Cells were cultured in three biological repeats and beating was recorded in at least six localized areas in the well. a, b, and c represent groups with a significant difference in average pulse rate. (b) P19CL6 cells from different passage numbers (12-16) were cultured in the presence of DMSO and pulse rate (beats/min) was recorded on day 15 of incubation. Linear regression analysis shows a significant effect of passage number on pulse rate (y =-2.58x + 63.3, R 2 = 0.486, P < 0.001) and two-way ANOVA confirmed significance difference between the different passage numbers of P19CL6 cells (P < 0.01).
Sequences of oligonucleotide primers used for PCR.
Correlation matrix of mRNA expression levels in P19CL6 and H9C2 (2-1) cells, and skeletal muscle, adult heart and embryonic heart tissue samples, as analyzed by microarray analysis.
Khodadadi et al 2009
Analysis of transcriptomic expression data (microarrays) by PLS analysis. Gene expression data from microarray analysis was reduced by linear regression, using the LLAMA algorithm [19-21]. The data was further analysed by PCA and subsequently PLS to demonstrate discrimination between the samples (R 2 X for principal components 1 and 2 is 0.52 and 0.33, respectively) and generate a list of variable importance that could be used in the DAVID analysis.
Article
The P19CL6 cell-line, a clone of the P19 mouse embryonal carcinoma cell-line, has been extensively used as a model for cardiomyocytes as these cells can be differentiated into a cardiomyocyte phenotype upon incubation with di-methyl sulfoxide. Uniquely, these cells can be observed to "beat" when monitored by microscopy. We started investigating the response of P19CL6 cells to fatty acids, but highly variable results lead us to investigate the phenotype of the P19CL6 cells in more depth. In this study we demonstrated that the P19CL6 cells are responsive to adrenaline, but loose the "beating" phenotype after 16 passages in culture. Analysis of specific mRNA transcripts indicated that the P19CL6 cells express both cardiac- and skeletal muscle-specific genes, while global analysis of microarray data showed clear differences between the P19CL6 cells and cardiac tissue of embryonic or adult origin. In conclusion, our observations suggest caution in the use of the P19CL6 cells as a model of cardiomyocytes unless rigorous validation for the intended analysis has been undertaken.
 
Article
This paper introduces a simple, quantitative assessment tool to follow up the recovery of gait. Today, micro-electro-mechanical systems (MEMS) technology provides with small, simple, low-power consuming and easy to don and doff sensors. In our approach we have selected an accelerome-ter and introduced a new quantity that characterizes the gait pattern in the frequency domain, we term it Gait Spectral Index (GSI). GSI allows assessing gait quality and closely relates to the speed and cadence of gait (dynamics). We have tested the GSI approach to quantify the quality of the gait of healthy young and elderly, and post-stroke hemiplegic individuals. We investigated the repeatability and coherence of GSI in healthy individuals (young and elderly) and contrasted this to the post-stroke hemiplegic individuals. We found that high correlation of the GSI with conventional gait parameters. This suggests that GSI, which needs only data from one acceler-ometer, could be an objective quantitative measure of the quality of the walking thereby a simple yet reliable measure of the recovery of function during neuronrehabilitation.
 
Sample summary statistics: 1994-1996 panel.
Tracking health shocks, 1994-1996 panel.
Results explaining consequences of household bankruptcy filings, 1994-1996.
Economic impact.
Article
Using household-level data from the Panel Study of Income Dynamics, we estimate the extent to which medical expenses are responsible for driving households to bankruptcy. Our results suggest that an increase of 10 percent in medical debts would cause a 27 percent increase in the filing propensity of households with primarily medical debt, and an approximately 36 percent increase in filing propensity of households where medical debts co-exist with primarily credit card debts. Studying the post- bankruptcy scenario, we find that filers are 19 percent less likely to own a home even several years after the filing, compared to non-filers. However, the consequences are less adverse for medical filers i.e. those who filed due to high medical bills compared to other filers.
 
Physique of subjects
Present lifestyle and nutrition habits and the OSI of premenopausal females
Present lifestyle and nutrition habits and the OSI of postmenopausal females
Past lifestyle and nutrition habits and the OSI of premenopausal females
Article
This study is examined the effect of past and present lifestyle habits and nutrition on the osteosono assessment index (OSI) in pre- and post-menopausal females. The subjects were 200 premenopausal females (38.8±10.3years) and 156 postmenopausal females (59.2±5.9 years). BMD (Body mineral density) was estimated by right-calcaneal OSI using an ultrasonic transmission method with an AOS-100 device (ALOKA). The number of postmenopausal females in the close examination and guidance required groups (80 cases: 51.3%) (OSI < 2.428) was significantly higher than that of premenopausal females (44 cases: 22.0%) (X2=33.105: P<0.000). In premenopausal females, the proportion of subjects that had not taken vitamin D in the past (in junior high school and high school) was significantly higher in the close examination-guidance required group (OSI < 2.428) than in the normal group (OSI ≥ 2.428). However, in postmenopausal females, there was no significant difference in past and present lifestyle habits and nutrition between the close examination-guidance required group and the normal group. In premenopausal females, it was determined that the intake of vitamin D during puberty increased the absorption of calcium significantly. © 2010 SciRes.
 
Non-isokinetic strengths in untraiened persons and competitive swimmers. 
Isometric and isokinetic strengths by dominant and non dominant legs in untrained persons and competitive swimmers. 
The abmodality between both legs about isometric and isokinetic parameters. 
Isometric strengths by dominant (■) and non dominant (□) leg during knee extension and flexion in untrained persons and competitive swimmers.  
Isokinetic strengths by dominant (■) and non dominant (□) leg during knee extension and flexion in untrained persons and competitive swimmers. *: the peak torque was significantly larger in dominant leg. †: the torque was significantly larger in competitive swimmers . U: untrained persons, S: competitive.  
Article
Competitive swimmers may gain a specific train- ing effect as the result of long term exercise in the water. This study aimed to compare isomet-ric, non-isokinetic and isokinetic muscle streng- ths in competitive swimmers and untrained per- sons. Twelve young male adults without exercise experience for over three years and twelve swim- mers with over 10 years of competitive swimming experience performed various strength tests. Non-isokinetic tests were evaluated using one repetition of maximum half squat, vertical jump, and drop jump. Isometric and isokinetic (60 and 180 deg/s) muscle strengths were measured by both legs in knee extension and flexion. There were no significant differences between non- isokinetic and isometric muscle strengths of both groups. On the other hand, all isokinetic parameters in both angular velocities were sig-nificantly larger in competitive swimmers. There was significant laterality of isokinetic strength in untrained persons, but not in competitive swimmers. In addition, right and left differences of isokinetic strength tended to be smaller in competitive swimmers. In conclusion, competi-tive swimmers tended to be superior only in isokinetic strength, which is a similar muscle contraction in the water, and have less right and left differences.
 
Population demographic and general health characteristics. 
Article
Background: The first 1000 days of life, including pregnancy and the first 2 years of age have been considered essential for an adequate development and growth. Several studies have stated that malnutrition during pregnancy and not having a normal birth weight have negative impact on childhood and adulthood, and contribute to burden of disease. Adequate information on this matter provides the possibility for making recommendations on health and nutrition policies. Objective: The aim is to describe the nutritional status during the first 1000 days in four countries of Latin America: Colombia, Argentina, Chile and Brazil. Methods: The analysis consists of two complementary approaches: 1) An extensive search on published and gray literature and a critical analysis of secondary data bases was conducted in Colombia, Argentina, Chile and Brazil following a standardized methodology in 2013. Maternal and child nutritional status, breast feeding, nutri-tional deficiencies, and dietary habits during the first 1000 days were the variables of interest; 2) Information gaps were identified, interviews to local experts from academia, government and hospitals were conducted to fill each of the countries information gap. Data was organized in an online data base called NutriPl@net. Results: Despite the inherent country differences, the nutritional challenges during the first 1000 days are similar. Obesity prevalence is increasing in pregnant women. Under weight remains a problem in all 4 countries, with the highest prevalence in Argentina. Over weight prevalence is highest in Chile and obesity prevalence in Brazil. Micronutrient deficiencies in pregnant women have been described, especially high for folic acid, iron, zinc, vitamins A, B6, B12, C, E and riboflavin. Moreover, in the region, anemia is the most common micronutrient deficiency during pregnancy. Gestational diabetes, hypertension, obesity and pre-eclampsia are major causes of maternal, perinatal and infant morbidity and mortality. Conclusions: In order to understand regional and country-specific needs, it is fundamental to collect standardized information related to the nutrition status during the first 1000 days. The low prevalence of exclusive breastfeeding and micronutrient deficiencies such as iron, zinc and vitamin A as risk factors for morbidity and mortality in children 0 - 2 years old is common and priority issues in the region. Persistence of anemia despite the use of fortified foods and supplementation remains a problem, and no complete data regarding sugar, sodium and fatty acids consumption and changes in the diet and habits before, during and after pregnancy are available. The gaps that are found to justify the need for further studies including population based surveys with standardized methodology that can warrant comparability.
 
Article
Introduction: There is evidence that malnutrition during the first 1000 days of life contributes to the development of chronic diseases in adulthood and therefore may produce a lasting impact on the health of the population. Colombia, like other middle-income countries suffers the double burden of malnutrition in pregnant women and children under 5 years. Also, chronic diseases have positioned within the leading causes of morbidity and mortality. Objective: The aim is to estimate the burden of disease of noncommunicable chronic diseases-NCD’s (hypertension, obesity, diabetes mellitus II) in adults attributable to nutritional risk factors (no-breastfeeding and low birthweight) in the period of 1000 days in Colombia. Methods: The population attributable fraction and the number of NCD’s (hypertension, diabetes mellitus II and obesity) cases due to the risk factors (low birthweight and no-breastfeeding) were estimated. Prevalences of NCD’s and risk factors of interest were taken from national health surveys. Effect measures (odds ratios/relative risks) of the associations 1—low birthweight and hypertension, diabetes mellitus II and 2—no-breastfeeding and obesity were obtained after a systematic literature search. Results: It was estimated that not receiving breastfeeding in the 1000 days could contribute up to 29.9% of all cases of obesity, equivalent to about 4,009,779 cases across the country. Low birth weight could contribute up to 2.1% of cases of hypertension in men and to 4.0% of cases in women, equivalent to 103.769 cases across the country. In addition, low birth weight could contribute to 6.3% of diabetes mellitus II cases, which is equivalent to 23.857 cases in the country. Conclusion: In Colombia, risk factors during the first 1000 days like not receiving breastfeeding and having low birth weight could contribute up to 4,113,549 cases of obesity, hypertension and diabetes mellitus II, with important implications for the health of the population and the Colombian health system.
 
Cardiovascular characteristics of patients with apical ballooning. 
Demographics and clinical characteristics of patients with apical ballooning. 
Article
Apical ballooning syndrome (Takotsubo cardiomyopathy) is an increasingly recognized form of acute systolic dysfunction which is usually reversible. It typically occurs in post-menopausal women following a major psychological stressor. We conducted a single center, retrospective analysis of all hospitalized patients from 2001-2012 and found 104 patients who met the diagnostic criteria for apical ballooning. In this current largest series of its kind, 83% of the patients were women. Among both men and women, an antecedent stressor was not always identified. The exact pathophysiologic mechanism resulting in apical ballooning remains poorly understood. These findings challenge the paradigm that catecholamine cardiotoxicity in the setting of relative estrogen deficiency results in the cardiomyopathy.
 
Effects of resistance training on body composition. ** p < 0.01 as compared with 6-month.
Effects of resistance training on physical strength. * p < 0.05 as compared with 6-month; ** p < 0.01 as compared with 6-month.
Effects of resistance training on saliva HSD2. * p < 0.05 as compared with 6-month; ** p < 0.01 as compared with 6-month.
Article
The Japanese Orthopedic Association proposed a concept called locomotive syndrome (LS) to identify middle-aged and older adults at high risk of requiring health care services because of problems with locomotion-associated lower muscle mass. To prevent LS, it is important to increase muscle mass and muscle strength in middle-age by continuous resistance training. A total of 38 men and women were assessed at baseline and 6 months. Body composition, physical strength and salivary cortisol and cortisone were analyzed. The exercise intervention program was performed by individual muscle endurance level. Body weight, muscle weight and basal metabolism were increased after exercise intervention. The 30-second sit-up test and 3-minute walking were increased, and the 10-time sit-to-stand was decreased significantly. This may be related to increase of leg and abdominal muscular strength. The exercise intervention program increased salivary 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) activities significantly. These results suggested that 11β-HDS2 became the index for the increase of muscular strength to prevent LS.
 
Article
Spatial autocorrelation methodologies, including Global Moran’s I and Local Indicators of Spatial Association statistic (LISA), were used to describe and map spatial clusters of 13 leading malignant neoplasms in Taiwan. A logistic regression fit model was also used to identify similar characteristics over time. Two time periods (1995-1998 and 2005-2008) were compared in an attempt to formulate common spatio-temporal risks. Spatial cluster patterns were identified using local spatial autocorrelation analysis. We found a significant spatio-temporal variation between the leading malignant neoplasms and well-documented spatial risk factors. For instance, in Taiwan, cancer of the oral cavity in males was found to be clustered in locations in central Taiwan, with distinct differences between the two time periods. Stomach cancer morbidity clustered in aboriginal townships, where the prevalence of Helicobacter pylori is high and even quite marked differences between the two time periods were found. A method which combines LISA statistics and logistic regression is an effective tool for the detection of space-time patterns with discontinuous data. Spatio-temporal mapping comparison helps to clarify issues such as the spatial aspects of both two time periods for leading malignant neoplasms. This helps planners to assess spatio-temporal risk factors, and to ascertain what would be the most advantageous types of health care policies for the planning and implementation of health care services. These issues can greatly affect the performance and effectiveness of health care services and also provide a clear outline for helping us to better understand the results in depth.
 
Comparison of overall outcomes found by 3 studies with similar methodologies. 
Article
Objectives: To evaluate the long-term outcome of adolescents with anorexia nervosa and attempt to define prognostic factors for outcome. Methods: Transversal, descriptive epidemiological study with a strict methodology: minimum interval of 4 years since first admission, evaluation using clearly defined diagnostic criteria (EAT-40 self-evaluation, HSCL, global patient-driven self-evaluation and hetero evaluation: clinical interview and LECE). The 198 subjects are former adolescent anorexics treated at the Hopital d’Enfants (Children’s Hospital) in Nancy (France). Results: Clinical evaluation of the 144 subjects traced showed positive outcome for 68.1%, intermediate outcome for 23.2% and poor outcome for 8.7%. 5 factors for a good prognosis were found (middle socioeconomic class of parents, no prior treatment, hospitalization > 1 month, follow-up
 
Disaster Areas following the Great East Japan Earthquake, with Miyagi Prefecture shown in Black from which the Participants Were Recruited. Sources: Fukushima Prefecture Earthquake Damage Information http://wwwcms.pref.fukushima.jp/pcp_portal/PortalServlet?DISPLAY_ID=DIRECT&NEXT_DISPLA Y_ID=U000004&CONTENTS_ID=24914; Iwate Prefecture Disaster Prevention Portal Site http://www.pref.iwate.jp/~bousai/; Miyagi Prefecture Official Website http://www.pref.miyagi.jp/site/ej-earthquake/.
Mother's anxiety in a disaster area. 
Article
The Great East Japan Earthquake, a magnitude 9.0 quake that occurred on March 11, 2011, left more than 20,000 killed or missing and resulted in more than 400,000 people being displaced. The Fukushima Nuclear Power Plant accident released large amounts of radioactive material into the air. Among the victims of this combined disaster were many pregnant and parturient women, and this study aimed to determine post-disaster anxiety among this specific population and measures for the future. Participants were 259 women (mean age 33.02 ± 4.79 years) who gave birth around the time of the earthquake in Miyagi Prefecture, one of the disaster areas. Sixteen months after the earthquake, we administered survey questionnaires on anxiety. We transcribed questionnaire responses, coded raw data by context, and categorized these codes by commonality. After extracting subcategories of anxiety-related factors, we categorized them into more abstract concepts. Among the participants, 126 (48.6%) reported having no available professionals with whom they could consult about childrearing. Participants reported anxiety in the following 12 categories: “radiation,” “child’s physical and mental growth/development,” “recurrence of earthquake and tsunami,” “financial issues,” “childrearing environment,” “living environment,” “maternal employment,” “stigma,” “familial issues,” “maternal health,” “childrearing,” and “the future”. A beneficial way to reduce maternal anxiety in the 12 areas identified would be to develop support systems that provide continuous support for children’s mental health care needs, psychological guidance, community support for maternal empowerment, outreach for individual support, and professional consultation for mothers who have high anxiety about radioactivity.
 
Article
Introduction: More than 350 million people are chronic carriers of HBV and many of them develop progressive diseases, including cirrhosis and hepatocellular carcinoma. Many of those infected develop persistent disease and a proportion goes on to develop liver failure and cancer. Researchers showed that double mutations of the x gene at position 1762 and 1764, have been found in chronic hepatitis B. These mutations were proposed to be associated with fulminant hepatitis B increasing risk of hepatocellular carcinoma. This project aimed to investigate mutation in the x gene region of HBV infected patients in Golestan province, Iran. Method: 100 patients were entered in this study. Hepatitis B viral DNA was extracted from plasma and PCR was performed using specific primers. Direct sequencing and alignment of x gene were applied using reference sequence from Gene Bank database (Okamoto, 1988; Accession number AB033559). Results: Among the chronic HBV patients 51% were male. The results showed that 49% of patients had A1762T, G1764A mutations changing AGG to stop codon TGA. 27% and 24% of cases were showed mutation only in A1762T and G1764A positions respectively. Conclusion: This study was shown presence of X gene mutation in HBV infected people in Golestan province, Iran. The rate of mutation in two positions 1762 and 1764 of HBV genotype D X gene was higher than the average rate of the world (34%).
 
Questionnaire used for selection of subjects with xerostomia (oral dryness feeling).
The xerostomia inventory (XI). 
Clinical characteristics of menopausal women with/ without oral dryness (OD) feeling. 
Article
The aim of this study was to compare serum 17β-estradiol of menopausal women with/without Oral Dryness (OD) feeling, and evaluate the re-lationship between serum 17β-estradiol and severity of OD feeling. A case-control study was carried out on 70 selected menopausal women aged 40 -77 years with or without OD feeling (35 as case, 35 as control) conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Xerostomia inventory (XI) score was used as an index of OD feeling severity. The serum 17β-estradiol concentration was meas-ured by an enzyme immunoassay kit (ELISA). Statistical analysis of Student's t-test and Spearman correlation coefficient was used. The mean serum concentration of 17β-estradiol was significantly lower in case than control. There was a significant negative correlation between XI score and concentration of 17β-estradiol in menopausal women (r = –0.311, P = 0.004). It seems that there is a negatively slight correla-tion between OD feeling severity and serum 17β-estradiol in menopausal women.
 
Summary of reviewed case studies.
Article
Adrenoleukodystrophy (ALD) is an X-linked inherited metabolic disease associated with the accumulation of very long chain fatty acids (VLCFA) in the nervous system, adrenal cortex, and testes. At least seven phenotypes can be distinguished, which are Addison only, childhood, adolescent and adult cerebral ALD, adrenomyeloneuropathy (AMN), and symptomatic or asymptomatic carriers. Children most often develop rapidly a progressive cerebral disease, whereas adults rarely develop a cerebral disease. The majority of adult-onset ALD patients are AMN. The prognosis of ALD remains unpredictable in individual patients. Family history can be very informative. The plasma VLCFA assay permits precise diagnosis. Specific changes on brain Magnetic Resonance Imaging (MRI) can have diagnostic utility. However, there is considerable overlap among adult-onset leukodystrophies. Adult onset form of cerebral X-linked ALD (AOCALD) is a rare disease. The disease progresses rapidly with widespread demyelination of the cerebral hemispheres. AOCALD is an important differential diagnosis for adults with psychiatric symptoms and progressive cognitive changes. In this article, we review on case reports of AOCALD.
 
States with reported laboratory-confirmed COVID-19 cases, recoveries, deaths and days since last reported case 9 May, 2020 [44].
Article
Coronavirus disease 2019 (COVID-19) pandemic has emerged as a global health crisis, with 3,855,788 infected persons and 256,862 deaths worldwide as of May 9, 2020. In Nigeria, the first case of the pandemic was reported by the Nigerian Centre for Disease Control on February 27, 2020. Between the dates when the index case was reported and May 9, 2020, the nation has recorded a total of 4151 confirmed COVID-19 cases from 25,951 samples screened and 745 (18%) cases discharged with 128 deaths indicating a case fatality rate of 3.1%. Thirty-four (34) States and the Federal Capital Territory have rec-orded coronavirus disease. The most affected States in Nigeria is Lagos (epi-centre of COVID-19) with 1764 cases, followed by 576 cases in Kano states and only one COVID-19 case in Anambra State 42 days since the last report of index case. Demographically, a total of 2828 male subjects have been infected representing 68% and 1323 female subjects representing 32%. The age group 31 - 40 years is mostly affected accounting for 24%. The number of people with travel history is 210 (5%), 947 (23%) contacts, 2618 (63%) with-out epidemiological link and 376 (9%) with an incomplete information. Nigeria is currently witnessing community transmission of COVID-19. Some ob-served issues aiding community transmission of COVID-19 in Nigeria are: the distrust of some Nigeria citizens towards government on COVID-19 management, poverty, religious beliefs, ignorance on face mask sharing, low level of informed populace, misconceptions, stigmatization of infected individuals, poor health facilities, inadequate testing Centre, shortage of health workers, poor treatment among others. Effective people’s health preventive behaviour and community-based health policy and strategies to mitigate these challenges are therein suggested.
 
A conceptual framework for studying perceptions and barriers to contraceptive use. Modified from: Fishbein and Ajzen (1980); Twa-Twa (1997); Gage (1998); Magnani et al. (2001); Prince and Hawkins (2007).
Characteristics of the study population according to background variables: Nairobi, Kenya, 2010 (N = 1119).
Differentials in contraceptive use by Perception variables, Nairobi, Kenya, 2010.
Differentials in contraceptive use by Barrier variables, Nairobi, Kenya, 2010.
Results of the final model indicating odds ratios of the perceptions and barriers on contraceptive use, Nairobi, Kenya, 2010.
Article
Even after the launch of family planning program in Kenya, in 1967, contraceptive use among adolescents has remained below 10 percent while child bearing has increased from 2 percent at age 15 to 36 percent at age 19. To understand the roles of perceptions and barriers on contraceptive use, a mixed method study design was applied to a conceptual framework that operationalized these concepts using data from different sources of social interactions in Nairobi, Kenya. Quantitative data were collected from 1119 adolescents aged 15 - 19 years. Qualitative data were collected from adolescents, adolescents’ parents and their school teachers. The later were analyzed and interpreted together with the results from cross-tabulations and logistic regression in order to understand the roles of perceptions and barriers. Contraceptive use was found to be 8.6 percent among the adolescents. Overall, unfavourable perceptions among adolescents, parents and teachers seemed to have contributed to low contraceptive use. Unfavourable perceptions played greater role compared to barriers such as sexual partner communication, opinion on adolescents to use a contraceptives and ability to seek contraceptives. Qualitative data show that teachers and parents lack adequate information and skills to discuss sexuality issues. Linking data among adolescents, parents and teachers help to understand the roles of perceptions and barriers to contraceptive use in Kenya. The findings suggest capacity building of teachers and parents on accurate sexuality information for adolescents while services should be youth-friendly.
 
Relationship of the deaths from COVID-19 per 1 million population to the Gross Domestic Product per capita.
Non-parametric (Spearman's rho) correlation coefficients among variables stu- died.
Article
Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) have been an arguable risk factor for COVID-19 diseases because they could upregulate Angiotensin Converting Enzyme-2 (ACE2) expression, facilitating SARS-CoV2 entry to the lungs. Several retrospective clinical studies, however, found no such effect. Here, we explore how the use of ACEIs and ARBs links to COVID-19 across all countries of the world. Methods: Data on the availability of ACEIs and ARBs for 200 countries and on the number of cases and number of deaths per country by 28 December 2020 were extracted from WHO and Worldometer website, respectively. Data on life expectancy at age 65 years as a measure of ageing were from WHO and on Gross Domestic Product Per Capita (GDP PPP) and the percentage of urbanization were from the World Bank. Excel and SPSS v 26 software were used for statistical analyses. Results: In linear regression and logistic conditional regression analysis, GDP correlates with COVID-19 prevalence (rho = 0.66, p > 0.001) and deaths from COVID-19 (rho = 0.55, p < 0.001) while urbanization and life expectancy do not when GDP influence is controlled for. After statistically removing the effects of GDP on the prevalence and mortality from COVID-19, we found that countries without ACEI and ARB availability had lower COVID-19 cases and deaths (p < 0.02). Conclusions: Our study based on the global data contradicts findings of most published clinical studies at regional levels. We found that GDP positively correlates with prevalence of and mortality related to COVID-19. ACEI and ARB use increases COVID-19 infectivity and mortality. Keywords COVID-19, RAAS Inhibitors, Ecological Analysis, ACEIs, ARBs
 
Plasmodium berghei parasitaemia (%) in mice treated with Chloroquine phos- phate stabilized with the Medicinal synthetic Aluminum-magnesium silicate and with B-vitamins.
Packed cell volume (%) of Plasmodium berghei-infected mice treated with Chloroquine phosphate stabilized with the Medicinal synthetic Aluminum-magnesium silicate and with B-vitamins.
Red blood cell counts (×10,000) of Plasmodium berghei-infected mice treated with Chloroquine phosphate stabilized with the Medicinal synthetic Aluminum-magnesium sili- cate and with B-vitamins.
Body temperature ((˚C)) of plasmodium berghei-infected mice treated with Chloroquine phosphate stabilized with the Medicinal synthetic Aluminum-magnesium silicate and with B-vitamins.
Article
Abstract To reduce Chloroquine’s (CQ) side effects, so that increasing its duration for anti-Covid- 19 trials could be safe, the drug was potentiated by stabilizing it with Medicinal synthetic Aluminum-magnesium silicate (MSAMS). CQ-treatment for five Plasmodium berghie -infected mice-groups were: 7 mg/kg (normal dose); 7 mg/kg (CQ-MSAMS); 7 mg/kg (CQ-MSAMS + B-vitamins), 5.25 mg/kg (CQ-MSAMS + B-vitamins) and the control. Means of parasitaemia, 42.00 ± 15.74 of the normal-dose group, 37.22 ± 11.88 of the 7 mg/kg (CQ-MSAMS) group and 33.57 ± 12.62 of the 7 mg/kg (CQ-MSAMS + B-vitamins) group showed no significant (P ≥ 0.05) reduction from 52.50 ± 11.99 of the control, but the 5.25 mg/kg (CQ-MSAMS + B-vitamins) dose, cleared (P ≤ 0.01) the parasiteamia (00.00 ± 00.00), showing that MSAMS-potentiated Chloroquine, has best efficacy at 75% of the recommended dose. Fever and anemia were absent at that 5.25 mg/kg, suggesting that lower doses of CQ have reduced side effects. Keywords Antiviral Treatment with Chloroquine, Lower Doses, Reduction of Side Effects, MSAMS
 
Article
The paper evaluates the ways in which Hamilton, Ontario’s three daily newspapers covered the influenza epidemic, 1918-1920. In Hamilton, the central aspect of influenza coverage was Dr. Roberts’ decision to close all public meeting places twice during 1918. No other story but those connected to a public meeting ban could sustain interest. Thus, the story for the press was to be the ban: whether to ban, what to ban, to lift or not, to reimpose. The story monopolized influenza coverage to such an extent that traditional threads, such as morbidity and mortality and personal interest stories, received little attention. The ban, because it restricted personal freedoms and involved local politics and commerce, received extensive coverage. In the absence of a ban, the influenza story could fade out of the press even during some of the most virulent periods of the epidemic. The paper finds that influenza was not transformative in Hamilton and in fact, demonstrated the viability of traditional charitable responses to disease. The actions carried out by Hamilton’s Board of Health cannot be considered “modern” as its methods were more akin to the nineteenth century than those of the later bacteriological age.
 
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Muhammad Waleed Darawad
  • University of Jordan
Mahmoud Maharmeh
  • University of Jordan
Arvin Bhana
  • University of KwaZulu-Natal/ South African Medical Research Council
Kaymarlin Govender
  • University of KwaZulu-Natal
Inge Petersen
  • University of KwaZulu-Natal