ResearchPad - adults https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Recreational drug use among Nigerian university students: Prevalence, correlates and frequency of use]]> https://www.researchpad.co/article/elastic_article_15734 Given the paucity of data on recreational drug use and the recent media attention on the abuse of drugs such as codeine cough syrups and tramadol, in Nigeria, our study examined the prevalence and frequency of recreational drug use among young adults from two Nigerian universities. We drew from the Socio-ecological Model to examine the influence of factors at the individual and family level on recreational drug use among adolescents and young adults.MethodsThis cross-sectional study was conducted between February and March 2018 among a final sample of 784 male and female university students selected using stratified random sampling. Binary logistic regression was used to identify significant predictors of ever use and current use of drugs.ResultsOur analyses showed that 24.5% of students had ever used drugs for recreational purposes, and 17.5% are current users. The median drug use frequency over the past month was six days among current users (n = 137). In the multivariable analyses, living in the same household as one's mother (AOR 0.28 95% CI 0.16–0.49), adequate family support (AOR 0.48 95% CI 0.26–0.89) and frequent attendance of religious fellowships (AOR 0.13 95% CI 0.07–0.25) were significantly associated with a lower likelihood of recreational drug use. However, male sex (AOR 1.52 95% CI 1.05–2.21) was associated with higher odds of recreational drug use.ConclusionThe family should be considered as an important unit to sensitize young people on the harmful effects of drug use. It is also vital that religious leaders speak against drug use in their various fellowships. There is a need to address recreational drug use on Nigerian campuses by educating students about its adverse impacts. ]]> <![CDATA[Trust as a mediator in the relationship between childhood sexual abuse and IL-6 level in adulthood]]> https://www.researchpad.co/article/elastic_article_14728 Childhood sexual abuse (CSA) has been shown to predict the coupling of depression and inflammation in adulthood. Trust within intimate relationships, a core element in marital relations, has been shown to predict positive physical and mental health outcomes, but the mediating role of trust in partners in the association between CSA and inflammation in adulthood requires further study. The present study aimed to examine the impact of CSA on inflammatory biomarkers (IL-6 and IL-1β) in adults with depression and the mediating role of trust. A cross-sectional survey data set of adults presenting with mood and sleep disturbance was used in the analysis. CSA demonstrated a significant negative correlation with IL-6 level (r = -0.28, p<0. 01) in adults with clinically significant depression, while trust showed a significant positive correlation with IL-6 level (r = 0.36, p < .01). Sobel test and bootstrapping revealed a significant mediating role for trust between CSA and IL-6 level. CSA and trust in partners were revealed to have significant associations with IL-6 level in adulthood. Counterintuitively, the directions of association were not those expected. Trust played a mediating role between CSA and adulthood levels of IL-6. Plausible explanations for these counterintuitive findings are discussed.

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<![CDATA[National and regional prevalence of posttraumatic stress disorder in sub-Saharan Africa: A systematic review and meta-analysis]]> https://www.researchpad.co/article/elastic_article_14691 Repeated and prolonged exposure to violence, armed conflict, and mass-casualty events, combined with a lack of access to mental health treatment, may result in a substantial effect on the population burden of posttraumatic stress disorder (PTSD) in sub-Saharan Africa (SSA).While many studies of PTSD have been conducted in SSA, most of these studies derived their estimates from nonrepresentative samples or specific populations.Population-representative epidemiologic data are critical to understand the burden of PTSD in SSA and develop national and regional policies to address that burden.What did the researchers do and find?We conducted a systematic review and meta-analysis of the prevalence of PTSD from representative national and regional studies in SSA.Pooled prevalence estimates were calculated across all studies, and then within subgroups including by sex, assessment time frame (i.e., 1 week, 1 month, 1 year), use of a screening or diagnostic measure, and whether populations were affected or not affected by mass-casualty war or armed conflict.We identified 25 unique studies (N = 58,887) across 10 of the 48 SSA countries.The pooled prevalence of probable PTSD across all studies was 22% (95% CI 13%–32%).The pooled prevalence of probable PTSD in participants from war-exposed regions was 30% (95% CI 20%–40%), while the estimate from war-unexposed regions was 8% (95% CI 3%–15%; p = 0.01).What do these findings mean?These data suggest that PTSD symptoms and probable PTSD are common in SSA.However, information was only found on 10 of the 48 SSA countries, and only 6 studies provided national-level data.Only one study used a measure of PTSD symptoms whose reliability and validity had been assessed previously in the population of interest.Our results suggest both that PTSD is a major public health problem in SSA and that large gaps in our knowledge of this problem remain. ]]> <![CDATA[Mortality estimates by age and sex among persons living with HIV after ART initiation in Zambia using electronic medical records supplemented with tracing a sample of lost patients: A cohort study]]> https://www.researchpad.co/article/elastic_article_13858 Despite many studies demonstrating differences in HIV-related outcomes between men and women on antiretroviral therapy (ART) in sub-Saharan Africa, few studies use a probability sample that would enable them to offer regionally representative estimates.Many studies taken from routine service delivery settings are unable to account for outcomes among individuals lost to follow-up, which may threaten the validity of estimates comparing mortality in men and women.Furthermore, whether differences in survival between men and women vary across other important sociodemographic characteristics (such as age) remains underexplored.What did the researchers do and find?We used a multistage sampling approach to enumerate an analysis population of HIV-positive patients visiting public health facilities in 4 provinces in Zambia (Lusaka, Southern, Eastern, and Western).We estimated the association between sex and mortality overall and by age, adjusting for other sociodemographic and clinical characteristics.Of 49,129 adults newly initiating ART, the mortality rate was almost twice as high in men compared to women.Analysis of age-by-sex interactions revealed particularly elevated mortality among young males (as compared to females of the same age). While mortality rates appeared to fall with age among men, mortality rates rose with age among women, and by 50 years of age, women had a 2–3 times higher rate of death compared to women under 30.What do these findings mean?Among adults living with HIV in Zambia, men on average experience greater mortality compared to women, but this difference varies markedly by age, even after adjustment for other sociodemographic and clinical characteristics (e.g., baseline level of immunosuppression).Additional means of engaging and supporting younger men in HIV care is urgently needed and may include improved access to self-testing, use of financial incentives, and male-friendly services that feature flexible hours, an integrated multi-disease care model, and reduced visit frequency.Rising mortality associated with age in women greater than would be expected in the general population suggests that health services targeting women of reproductive age may be in part responsible for good clinical outcomes in younger women, but also highlights the need for specific programs to engage older women in care. ]]> <![CDATA[The association between national income and adult obesity prevalence: Empirical insights into temporal patterns and moderators of the association using 40 years of data across 147 countries]]> https://www.researchpad.co/article/elastic_article_13857 At a country level, population obesity prevalence is often associated with economic affluence, reflecting a potential adverse outcome concomitant with economic growth. We estimated the pattern and strength of the empirically observed relationship between national income and adult obesity prevalence, and the moderating role of countries’ macro-environments on this relationship.MethodsWe assembled data on national obesity prevalence, income and a range of variables that characterize macro-environments related to 147 countries from multiple international organizations and databases. We used a Bayesian hierarchical model to estimate the relationship (elasticities) between national income (using Gross Domestic Product Per Capita, GDPPC) and adult obesity prevalence, and the moderating effects of five different dimensions (globalization orientation, demographic characteristics, economic environment, labor market characteristics, and strength of health policies) of countries’ macro-environments on the income elasticities. Using the latest (2019–2024) available national income growth projections from the International Monetary Fund, we forecast future global trends in obesity prevalence.FindingsOver the 40-years 1975–2014, adult obesity prevalence increased at a declining rate with GDPPC across the 147 countries. The mean income elasticity estimates were 1.23 (95% credible interval 1.04–1.42) for males and 1.01 (0.82–1.18) for females. The elasticities were positively associated with the extent of political globalization and negatively associated with urbanization and share of agriculture in the national GDP. Income based projections indicate that obesity prevalence would continue to grow at an average annual rate of 2.47% across the studied countries during 2019–2024.ConclusionsPopulation obesity prevalence exhibits a positive relationship with national income and there is no evidence that the relationship, while weakening, actually turns negative at higher income levels (“obesity Kuznets curve”). Based on current trends, global obesity prevalence will continue to increase during 2019–2024, with the rate of growth higher in low- and middle-income countries. As most people currently live in low- and middle-income countries with rising incomes, our findings underscore the urgent societal imperatives for effective policy initiatives, especially those that target the concomitant “nutrition transition” process with economic affluence, to break or at least further weaken the positive relationship of population obesity prevalence with national income. ]]> <![CDATA[Gender norms and mass deworming program access in Comé, Benin: A qualitative assessment of gender-associated opportunities and challenges to achieving high mass drug administration coverage]]> https://www.researchpad.co/article/N0cbc3c85-9c5e-43fe-983c-4afc7d1b8db3

The World Health Organization’s Neglected Tropical Disease Roadmap has accelerated progress towards eliminating select neglected tropical diseases (NTDs). This momentum has catalyzed research to determine the feasibility of interrupting transmission of soil-transmitted helminths (STH) using community-wide mass drug administration (MDA). This study aims to identify potential gender-specific facilitators and barriers to accessing and participating in community-wide STH MDA, with the goal of ensuring programs are equitable and maximize the probability of interrupting STH transmission. This research was conducted prior to the launch of community-wide MDA for STH in Comé, Benin. A total of 10 focus group discussions (FGDs) were conducted separately among 40 men, 38 women, and 15 community drug distributors (CDDs). Salient themes included: both men and women believe that community-wide MDA would reduce the financial burden associated with self-treatment, particularly for low income adults. Community members believe MDA should be packaged alongside water, sanitation, and other health services. Women feel past community-wide programs have been disorganized and are concerned these distributions will be similar. Women also expressed interest in increased engagement in the implementation of future community-based public health programs. Men often did not perceive themselves to be at great risk for STH infection and did not express a high demand for treatment. Finally, the barriers discussed by CDDs generally did not align with gender-specific concerns, but rather represented concerns shared by both genders. A door-to-door distribution strategy for STH MDA is preferred by women in this study, as this platform empowers women to participate as health decision makers for their family. In addition, involving women in planning and implementation of community-wide programs may help to increase treatment coverage and compliance.

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<![CDATA[Fingerprint evidence for the division of labour and learning pottery-making at Early Bronze Age Tell eṣ-Ṣâfi/Gath, Israel]]> https://www.researchpad.co/article/N5152a5b5-1b3f-41e8-b706-9ccd50f6a496

The organization of craft production has long been a marker for broader social, economic and political changes that accompanied urbanism. The identity of producers who comprised production groups, communities, or workshops is out of reach using conventional archaeological data. There has been some success using epidermal prints on artefacts to identify the age and sex of producers. However, forensic research indicates that a combination of ridge breadth and ridge density would best identify the age and sex of individuals. To this end, we combine mean ridge breadth (MRB) and mean ridge density (MRD) to distinguish the age and sex of 112 fingerprints on Early Bronze Age (EB) III pottery from the early urban neighbourhood at Tell eṣ-Ṣâfi/Gath, Israel, dating to a 100 year time span. Our analysis accounts for the shrinkage of calcareous fabrics used to make six type of vessels, applies a modified version of the Kamp et al. regression equation to the MRB for each individual print, and infers sex by correlating MRD data to appropriate modern reference populations. When the results are combined, our analyses indicate that most fingerprints were made by adult and young males and the remainder by adult and young females. Children’s prints are in evidence but only occur on handles. Multiple prints of different age and sex on the same vessels suggest they were impressed during the training of young potters. Production appears dominated by adult and young males working alone, together, and in cooperation with adult and/or young females. Vessels with prints exclusively by females of any age are rare. This male dominant cooperative labour pattern contrasts recent studies showing that adult women primarily made Neolithic figurines in Anatolia, and more females than males were making pottery prior to the rise of city-states in northern Mesopotamia.

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<![CDATA[Perceptions of the adult US population regarding the novel coronavirus outbreak]]> https://www.researchpad.co/article/N553f4024-2f4a-46cb-88f1-f6e3510ba4a4

The Coronavirus Disease 2019 (COVID-19) outbreak is spreading globally. Although COVID-19 has now been declared a pandemic and risk for infection in the United States (US) is currently high, at the time of survey administration the risk of infection in the US was low. It is important to understand the public perception of risk and trust in sources of information to better inform public health messaging. In this study, we surveyed the adult US population to understand their risk perceptions about the COVID-19 outbreak. We used an online platform to survey 718 adults in the US in early February 2020 using a questionnaire that we developed. Our sample was fairly similar to the general adult US population in terms of age, gender, race, ethnicity and education. We found that 69% of the respondents wanted the scientific/public health leadership (either the CDC Director or NIH Director) to lead the US response to COVID-19 outbreak as compared to 14% who wanted the political leadership (either the president or Congress) to lead the response. Risk perception was low (median score of 5 out of 10) with the respondents trusting health professionals and health officials for information on COVID-19. The majority of respondents were in favor of strict infection prevention policies to control the outbreak. Given our results, the public health/scientific leadership should be at the forefront of the COVID-19 response to promote trust.

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<![CDATA[Regional variations in geographic access to inpatient hospices and Place of death: A Population-based study in England, UK]]> https://www.researchpad.co/article/N0789e4f1-219e-494f-9677-036e019c10b6

Background

There is much variation in hospice use with respect to geographic factors such as area-based deprivation, location of patient’s residence and proximity to services location. However, little is known about how the association between geographic access to inpatient hospice and hospice deaths varies by patients’ region of settlement.

Study aim

To examine regional differences in the association between geographic access to inpatient hospice and hospice deaths.

Methods

A regional population-based observational study in England, UK. Records of patients aged ≥ 25 years (n = 123088) who died from non-accidental causes in 2014, were extracted from the Office for National Statistics (ONS) death registry. Our cohort comprised of patients who died at home and in inpatient hospice. Decedents were allocated to each of the nine government office regions of England (London, East Midlands, West Midlands, East, Yorkshire and The Humber, South West, South East, North West and North East) through record linkage with their postcode of usual residence. We defined geographic access as a measure of drive times from patients’ residential location to the nearest inpatient hospice. A modified Poisson regression estimated the association between geographic access to hospice, comparing hospice deaths (1) versus home deaths (0). We developed nine regional specific models and adjusted for regional differences in patient’s clinical & socio-demographic characteristics. The strength of the association was estimated with adjusted Proportional Ratios (aPRs).

Findings

The percentage of deaths varied across regions (home: 86.7% in the North East to 73.0% in the South East; hospice: 13.3% in the North East to 27.0% in the South East). We found wide differences in geographic access to inpatient hospices across regions. Median drive times to hospice varied from 4.6 minutes in London to 25.9 minutes in the North East. We found a dose-response association in the East: (aPRs: 0.22–0.78); East Midlands: (aPRs: 0.33–0.63); North East (aPRs: 0.19–0.87); North West (aPRs: 0.69–0.88); South West (aPRs: 0.56–0.89) and West Midlands (aPRs: 0.28–0.92) indicating that decedents who lived further away from hospices locations (≥ 10 minutes) were less likely to die in a hospice.

Conclusion

The clear dose-response associations in six regions underscore the importance of regional specific initiatives to improve and optimise access to hospices. Commissioners and policymakers need to do more to ensure that home death is not due to limited geographic access to inpatient hospice care.

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<![CDATA[Economic and public health impact of decentralized HIV viral load testing: A modelling study in Kenya]]> https://www.researchpad.co/article/5c803c61d5eed0c484ad883e

Kenya has the world’s 4th largest HIV burden. Various strategies to control the epidemic have been implemented, including the implementation of viral load (VL) testing to monitor HIV patients on ARVs. Like many resource limited settings, Kenya’s healthcare system faces serious challenges in effectively providing quality health services to its population. Increased investments to strengthen the country’s capacity to diagnose, monitor and treat diseases, particularly HIV and TB, continue to be made but are still inadequate in the face of global health goals like the UNAIDS 90:90:90 which require scaling up of VL tests amid existing constraints. In Kenya, there is an increase in the demand for VL tests amidst these existing constraints. The GeneXpert system is a diagnostic point-of-care technology that can quantify, amongst others, HIV VL. Currently, GeneXpert technology is widely distributed in Kenya for testing of tuberculosis. This study aimed to determine the economic and public health impact of incorporating VL test modules on the existing GeneXpert infrastructure. Markov models were constructed for different populations (non-pregnant adults, pregnant women and children). The scenarios analysed were 100% centralized VL testing compared to 50% GeneXpert plus 50% centralized VL testing, with time horizons of 5 years for the adult and child populations, and 31 months for the pregnant population. Incremental effectiveness was measured in terms of the number of HIV transmissions or opportunistic infections avoided when implementing the GeneXpert scenario compared to a 100% centralized scenario. The model indicated that, for all three populations combined, the GeneXpert scenario resulted in 117 less HIV transmissions and 393 less opportunistic infections. The cost decreased by $21,978,755 for the non-pregnant and pregnant adults and $22,808,533 for non-pregnant adults, pregnant adults and children. The model showed that GeneXpert would cost less and be more effective in terms of total cost per HIV transmission avoided and the total cost per opportunistic infection avoided, except for the pregnant population, when considered separately.

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<![CDATA[Neutralizing Antibody against Enterovirus D68 in Children and Adults before 2014 Outbreak, Kansas City, Missouri, USA1]]> https://www.researchpad.co/article/5c94e826d5eed0c4846555f3

We evaluated enterovirus D68 seroprevalence in Kansas City, Missouri, USA, from samples obtained during 2012–2013. Neutralizing antibodies against Fermon and the dominant 2014 Missouri isolate were universally detected. Titers increased with age. Widespread circulation of enterovirus D68 occurred before the 2014 outbreak. Research is needed to determine a surrogate of protection.

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<![CDATA[Serum creatinine and estimated glomerular filtration rates in HIV positive and negative adults in Ethiopia]]> https://www.researchpad.co/article/5c6c75bfd5eed0c4843d00e4

Background

Glomerular filtration rate estimating equations using serum creatinine are not validated in most African settings. We compared serum creatinine and estimated glomerular filtration rate (eGFR) in HIV positive and negative adults and assessed the performance of eGFR equations ((Cockcroft and Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)) compared to 24-hour creatinine clearance in HIV positive adults.

Methods

Data were collected on demographic, anthropometric, body composition, clinical parameters and serum creatinine in HIV positive and negative adults. 24-hour urine was collected from some of the HIV positive adults who volunteered. Bias was calculated as mean difference between 24-hr creatinine clearance and eGFR (eGFR– 24 hour creatinine clearance) and the accuracy of each eGFR equation was calculated as the percentage of estimates within 30% of creatinine clearance.

Results

A total of 340 HIV positive and 100 HIV negative adults were included in this study. Creatinine clearance was determined for 46 of HIV positive adults. Serum creatinine increased with increasing age, weight, height, body surface area, fat free mass and grip strength in both HIV positive and negative adults (P<0.05). No difference was observed in eGFR between HIV positive and HIV negative adults. For all eGFR equations, the correlation between eGFR and 24-hr creatinine clearance was 0.45–0.53 and the accuracy within 30% of 24-hr creatinine clearance was 24–46%. Removing ethnic coefficient reduced the bias and improved accuracy of the CKD-EPI and the MDRD estimates.

Conclusion

Ethiopian HIV positive adults in the present study had good kidney function at the initiation of antiretroviral treatment. However, all eGFR equations overestimated 24-hr creatinine clearance in the study population. Creatinine based eGFR equations that accounts for low muscle mass and body surface area are needed.

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<![CDATA[Dynamic stability and stepping strategies of young healthy adults walking on an oscillating treadmill]]> https://www.researchpad.co/article/5c6dc9dad5eed0c48452a314

Understanding how people modify their stepping to maintain gait stability may provide information on fall risk and help to understand strategies used to reduce loss of balance. The purpose of this study was to identify the stepping strategies healthy young individuals select to maintain balance while walking on a destabilizing surface in various directions. A treadmill mounted on top of a 6 degree-of-freedom motion base was used to generate support surface oscillations in different degrees of freedom and amplitudes. Fifteen healthy young adults (21.3 ± 1.4 years) walked at self-selected speeds while continuous sinusoidal oscillations were imposed to the support surface in a one degree of freedom: rotation or translation in the mediolateral (ML) direction and rotation or translation in the anteroposterior (AP) direction, with each condition repeated at three different amplitudes. We compared step width, length, and frequency and the mean and variability of margin of stability (MoS) during each experimental walking condition with a control condition, in which the support surface was stationary. Subjects chose a common strategy of increasing step width (p < 0.001) and decreasing step length (p = 0.008) while increasing mediolateral MoS (p < 0.001), particularly during oscillations that challenged frontal plane control, with rotations of the walking surface producing the greatest changes to stepping.

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<![CDATA[Effects of mother-offspring and father-offspring dynamics on emerging adults’ adjustment: The mediating role of emotion regulation]]> https://www.researchpad.co/article/5c6dca1bd5eed0c48452a7ac

The present study tested a theoretical model of emotion regulation between parent-offspring dynamics and emerging adults’ adjustment. The mediating role of emotion regulation strategies, including cognitive reappraisal and expressive suppression, were investigated for the effects of mother-offspring and father-offspring dynamics on emerging adults’ adjustment. A sample of 352 Chinese emerging adults in Hong Kong (230 female, 121 male) participated in this study. Participants were asked to complete a set of self-reported questionnaires. Findings based on structural equation modeling indicated that greater mother-offspring intimacy and father-offspring intimacy predicted emerging adults’ better cognitive reappraisal and psychological, social, and general health. Greater mother-offspring conflict also predicted more expressive suppression and poorer psychological and social functioning. Distinctive mediation pathways as a function of parents’ gender were identified. These findings enrich the literature for parent-offspring dynamics and emotion regulation as explanatory processes of emerging adults’ adjustment.

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<![CDATA[The impact of bilingualism on executive functions and working memory in young adults]]> https://www.researchpad.co/article/5c6dc9a6d5eed0c484529f7c

A bilingual advantage in a form of a better performance of bilinguals in tasks tapping into executive function abilities has been reported repeatedly in the literature. However, recent research defends that this advantage does not stem from bilingualism, but from uncontrolled factors or imperfectly matched samples. In this study we explored the potential impact of bilingualism on executive functioning abilities by testing large groups of young adult bilinguals and monolinguals in the tasks that were most extensively used when the advantages were reported. Importantly, the recently identified factors that could be disrupting the between groups comparisons were controlled for, and both groups were matched. We found no differences between groups in their performance. Additional bootstrapping analyses indicated that, when the bilingual advantage appeared, it very often co-occurred with unmatched socio-demographic factors. The evidence presented here indicates that the bilingual advantage might indeed be caused by spurious uncontrolled factors rather than bilingualism per se. Secondly, bilingualism has been argued to potentially affect working memory also. Therefore, we tested the same participants in both a forward and a backward version of a visual and an auditory working memory task. We found no differences between groups in either of the forward versions of the tasks, but bilinguals systematically outperformed monolinguals in the backward conditions. The results are analysed and interpreted taking into consideration different perspectives in the domain-specificity of the executive functions and working memory.

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<![CDATA[Genes encoding SATB2-interacting proteins in adult cerebral cortex contribute to human cognitive ability]]> https://www.researchpad.co/article/5c648d17d5eed0c484c81f75

During CNS development, the nuclear protein SATB2 is expressed in superficial cortical layers and determines projection neuron identity. In the adult CNS, SATB2 is expressed in pyramidal neurons of all cortical layers and is a regulator of synaptic plasticity and long-term memory. Common variation in SATB2 locus confers risk of schizophrenia, whereas rare, de novo structural and single nucleotide variants cause severe intellectual disability and absent or limited speech. To characterize differences in SATB2 molecular function in developing vs adult neocortex, we isolated SATB2 protein interactomes at the two ontogenetic stages and identified multiple novel SATB2 interactors. SATB2 interactomes are highly enriched for proteins that stabilize de novo chromatin loops. The comparison between the neonatal and adult SATB2 protein complexes indicates a developmental shift in SATB2 molecular function, from transcriptional repression towards organization of chromosomal superstructure. Accordingly, gene sets regulated by SATB2 in the neocortex of neonatal and adult mice show limited overlap. Genes encoding SATB2 protein interactors were grouped for gene set analysis of human GWAS data. Common variants associated with human cognitive ability are enriched within the genes encoding adult but not neonatal SATB2 interactors. Our data support a shift in the function of SATB2 in cortex over lifetime and indicate that regulation of spatial chromatin architecture by the SATB2 interactome contributes to cognitive function in the general population.

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<![CDATA[Development of a preliminary in vitro drug screening assay based on a newly established culturing system for pre-adult fifth-stage Onchocerca volvulus worms]]> https://www.researchpad.co/article/5c4a305ed5eed0c4844bfe74

Background

The human filarial parasite Onchocerca volvulus is the causative agent of onchocerciasis (river blindness). It causes blindness in 270,000 individuals with an additional 6.5 million suffering from severe skin pathologies. Current international control programs focus on the reduction of microfilaridermia by annually administering ivermectin for more than 20 years with the ultimate goal of blocking of transmission. The adult worms of O. volvulus can live within nodules for over 15 years and actively release microfilariae for the majority of their lifespan. Therefore, protracted treatment courses of ivermectin are required to block transmission and eventually eliminate the disease. To shorten the time to elimination of this disease, drugs that successfully target macrofilariae (adult parasites) are needed. Unfortunately, there is no small animal model for the infection that could be used for discovery and screening of drugs against adult O. volvulus parasites. Here, we present an in vitro culturing system that supports the growth and development of O. volvulus young adult worms from the third-stage (L3) infective stage.

Methodology/Principal findings

In this study we optimized the culturing system by testing several monolayer cell lines to support worm growth and development. We have shown that the optimized culturing system allows for the growth of the L3 worms to L5 and that the L5 mature into young adult worms. Moreover, these young O. volvulus worms were used in preliminary assays to test putative macrofilaricidal drugs and FDA-approved repurposed drugs.

Conclusion

The culture system we have established for O. volvulus young adult worms offers a promising new platform to advance drug discovery against the human filarial parasite, O. volvulus and thus supports the continuous pursuit for effective macrofilaricidal drugs. However, this in vitro culturing system will have to be further validated for reproducibility before it can be rolled out as a drug screen for decision making in macrofilaricide drug development programs.

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<![CDATA[Magnitude of road traffic accident related injuries and fatalities in Ethiopia]]> https://www.researchpad.co/article/5c59fea3d5eed0c4841351e4

Background

In many developing countries there is paucity of evidence regarding the epidemiology of road traffic accidents (RTAs). The study determines the rates of injuries and fatalities associated with RTAs in Ethiopia based on the data of a recent national survey.

Methods

The study is based on the secondary data of the Ethiopian Demographic and Health Survey conducted in 2016. The survey collected information about occurrence injuries and accidents including RTAs in the past 12 months among 75,271 members of 16,650 households. Households were selected from nine regions and two city administrations of Ethiopia using stratified cluster sampling procedure.

Results

Of the 75,271 household members enumerated, 123 encountered RTAs in the reference period and rate of RTA-related injury was 163 (95% confidence interval (CI): 136–195) per 100,000 population. Of the 123 causalities, 28 were fatal, making the fatality rate 37 (95% CI: 25–54) per 100,000 population. The RTA-related injuries and fatalities per 100,000 motor vehicles were estimated as 21,681 (95% CI: 18,090–25,938) and 4,922 (95% CI: 3325–7183), respectively. Next to accidental falls, RTAs were the second most common form of accidents and injuries accounting for 22.8% of all such incidents. RTAs contributed to 43.8% of all fatalities secondary to accidents and injuries. Among RTA causalities, 21.9% were drivers, 35.0% were passenger vehicle occupants and 36.0% were vulnerable road users including: motorcyclists (21.0%), pedestrians (12.1%) and cyclists (2.9%). Approximately half (47.1%) of the causalities were between 15–29 years of age and 15.3% were either minors younger than 15 years or seniors older than 64 years of age. Nearly two-thirds (65.0%) of the victims were males.

Conclusion

RTA-related causalities are extremely high in Ethiopia. Male young adults and vulnerable road users are at increased risk of RTAs. There is a urgent need for bringing road safety to the country's public health agenda.

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<![CDATA[HIV prevalence and determinants of loss-to-follow-up in adolescents and young adults with tuberculosis in Cape Town]]> https://www.researchpad.co/article/5c63392bd5eed0c484ae6139

TB remains a leading cause of mortality and morbidity in sub-Saharan Africa, due to the HIV epidemic. As TB treatment is lengthy, the completion of the full course of treatment may be especially challenging for young people. We therefore aimed to identify the extent of and reasons underlying loss to follow-up from TB treatment among young people in Cape Town. Accordingly, we reviewed the outcomes of young people treated for TB in Cape Town during 2009–2013, across three age groups: younger adolescents (10–14 years); older adolescents; (15–19 years) and young adults (20–24 years). We employed logistic regression analysis to identify risk factors for loss from TB care. 23,737 patients aged 10–24 were treated for drug sensitive TB over the study period. Of these, the HIV co-infection prevalence was 18.5% for younger adolescents, 12.9% for older adolescents and 33.1% for young adults. From age 16, HIV prevalence increased disproportionately among young women: by age 22, over 50% of women were TB/HIV co-infected compared to 14% of men. TB treatment success (cure plus completion) was 84.4%, while 1.7% of patients died, 9.5% were lost-to follow-up and 0.4% failed treatment. Being an older adolescent (aOR 1.75 [95% CI: 1.38–2.21]) or young adult (aOR: 1.96 [95% CI: 1.57–2.45]) increased the risk of loss-to-follow up, relative to being a younger adolescent. Further risk factors for loss from TB care were male gender (aOR: 1.33 [95% CI:1.20–1.46]), being a TB/HIV co-infected young person (aOR 1.74 [95% CI: 1.57–1.93]) and having had prior treatment for TB (aOR 3.17 [95% CI 2.87–3.51]). We identified risk factors for loss to follow-up and highlighted the need to focus on HIV prevention and retention in TB care among young people. TB care tailored to the needs of young people could improve patient retention, similar to improved outcomes reported by youth friendly HIV clinics.

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<![CDATA[Association of attitudes towards genetically modified food among young adults and their referent persons]]> https://www.researchpad.co/article/5c61e900d5eed0c48496f613

Most research on consumer attitudes does not consider that attitudes are likely influenced by people with whom we have some relationship even though socioeconomic, psychological and political theories recognize the importance of referent individuals’ opinions in attitude formation. Knowledge on the role of referent individuals’ opinions in attitude formation could improve the understanding of consumer acceptance of foods frequently associated with health or other concerns. This article examines the association of attitudes towards genetically modified (GM) crops and foods between young adults and their referent individuals using data collected in 2016 via surveys from the Czech Republic, Russia and Ukraine. Loglinear models of cell counts in contingency tables reveal a positive association of GM food attitudes between young adults and their referent individuals. This association was stronger in Russia and the Czech Republic than it was in Ukraine and stronger between female young adults and their referent individuals than between males and their referent individuals. Concordance in GM food attitudes with mothers is significantly stronger than concordance with best friends but not significantly different from concordance with fathers.

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