Passive smoking in the etiology of non-syndromic orofacial clefts:a systematic review and meta-analysis

Background Studies have found a consistent positive association between maternal smoking and nonsyndromic orofacial clefts (NSOFC). However, no comprehensive assessment of the association between NSOFC and passive smoking has been undertaken. This systematic review and meta-analysis explores the relationship between maternal passive smoking and NSOFC, and compares the associations between passive and active smoking. Methods and Findings Search strategy, inclusion / exclusion criteria, and data extraction from studies reporting maternal passive smoking and NSOFC was implemented without language restrictions. Risks of bias in the identified studies were assessed and this information was used in sensitivity analyses to explain heterogeneity. Meta-analysis and meta-regression of the extracted data were performed. Egger's test was used to test for small study effects. Fourteen eligible articles were identified. Maternal passive smoking exposure was associated with a twofold increase in risk of NSOFC (odds ratio: 2.11, 95% confidence interval: 1.54-2.89); this was apparent for both cleft lip with and without palate (OR: 2.05, 95% CI: 1.27-3.3) and cleft palate (OR: 2.11, 95% CI: 1.23-3.62). There was substantial heterogeneity between studies. In the studies that provided data enabling crude and adjusted odd ratios to be compared, adjustment for potential confounders attenuated the magnitude of association to about a 1.5-fold increase in risk. Conclusion Overall, maternal passive smoking exposure results in a 1.5 fold increase in risk of NSOFC, similar to the magnitude of risk reported for active smoking, but there is marked heterogeneity between studies. This heterogeneity is not explained by differences in the distribution of cleft types, adjustment for covariates, broad geographic region, or study bias/quality. This thorough meta-analysis provides further evidence to minimize exposure to environmental tobacco smoke in policy making fora and in health promotion initiatives.</p

Linking agroecosystems producing farmed seafood with food security and health status to better address the nutritional challenges in Bangladesh

Financial support: The authors wish to acknowledge funding from Immana to write this review. The research of B.d.R. and A.A.S. is supported by the Scottish Government’s Rural and Environment Science and Analytical Services Division (RESAS). N.R. is funded by the University of Copenhagen, A.-A.M. is funded by Noakhali Science and Technology University Bangladesh, T.A. is funded by icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), and F.M. and D.C.L. are funded by the University of Stirling. Funding agencies had no role in the design, analysis or writing of this article. Conflict of interest: None to report. Authorship: All authors contributed to the writing of the manuscript. Ethics of human subject participation: Not applicable.Peer reviewedPublisher PD

Prophylactic properties of biofloc- or Nile tilapia-conditioned water against Vibrio parahaemolyticus infection of whiteleg shrimp (Penaeus vannamei)

Isolates of Vibrio parahaemolyticus (VpAHPND) that carry a plasmid encoding two Pir-like toxins cause acute hepatopancreatic necrosis disease (AHPND), a disease that has caused devastating economic losses to the shrimp industry, particularly in Asia. However, lower prevalence of AHPND infection has been associated with farms that operate with biofloc or lower salinity culture water. Therefore, the aim of this present study was to investigate the effects of biofloc and Nile tilapia (Oreochromis niloticus)-conditioned water prepared at different culture water salinities on survival of whiteleg shrimp (Penaeus vannamei) bath-challenged experimentally with VpAHPND. First, groups of shrimp were bath-challenged with VpAHPND in clear 15 ppt seawater (CW) or in the presence of a pre-cultured biofloc at 25%, 50% and 100% (v/v). Survival during 96 h post-challenge was significantly greater in groups cultured in 50% and 100% biofloc (p

Linkages of agroecosystems producing farmed seafood on food security, nutritional status and adolescent health in Bangladesh

Funding Information: We wish to acknowledge funding from Innovative Methods and Metrics for Agriculture and Nutrition Actions (IMMANA) to write this review. The research of BdR and AAS is supported by the Scottish Government's Rural and Environment Science and Analytical Services Division (RESAS). NR is funded by the University of Copenhagen, AG and TA are funded by the International Centre for Diarrhoeal Disease Research Bangladesh, AAM is funded by Noakhali Science and Technology University Bangladesh and FM and DL are funded by the University of Stirling.Peer reviewedPublisher PD

Ultrastructural analysis of collagen fibril diameter distribution in cleft lip

Objective: A preliminary study to determine collagen fibril diameter (CF-ED) distribution on medial and lateral sides of cleft lip (CL). Material and Methods: Tissue samples from medial and lateral sides of CL were fixed in 2.5% glutaraldehyde and 1% osmium tetroxide and embedded in Araldite CY212 resin for transmission electron microscopy. The analysis of CF-ED was performed using the ImageJ program. To characterize the packaging of collagen fibrils (CFs) in the two tissues, we estimated the collagen number density (CF-ND) and fibril-area-fraction (FAF). Differences in measurements across the two sides were calculated using Wilcoxon signed-rank test. Results: The CF-ED was statistically significantly (p < 0.001) smaller on the medial side (45.69 ± 7.89 nm) than on the lateral side (54.18 ± 7.62 nm). The medial side had a higher CF-ND and a higher percentage of FAF than the lateral side. Conclusion: Our finding of a smaller CF-ED and higher CF-ND and FAF for the medial side suggests possible differences in size and distribution of CFs between medial and lateral sides of CL. This finding provides knowledge toward underlying tissue biomechanics that may help reconstruction of perioral tissue scaffolds, ultimately resulting in better treatment of patients with oral clefts

Implementing a 48 h EWTD-compliant rota for junior doctors in the UK does not compromise patients’ safety : assessor-blind pilot comparison

Background: There are currently no field data about the effect of implementing European Working Time Directive (EWTD)-compliant rotas in a medical setting. Surveys of doctors’ subjective opinions on shift work have not provided reliable objective data with which to evaluate its efficacy. Aim: We therefore studied the effects on patient's safety and doctors’ work-sleep patterns of implementing an EWTD-compliant 48 h work week in a single-blind intervention study carried out over a 12-week period at the University Hospitals Coventry & Warwickshire NHS Trust. We hypothesized that medical error rates would be reduced following the new rota. Methods: Nineteen junior doctors, nine studied while working an intervention schedule of <48 h per week and 10 studied while working traditional weeks of <56 h scheduled hours in medical wards. Work hours and sleep duration were recorded daily. Rate of medical errors (per 1000 patient-days), identified using an established active surveillance methodology, were compared for the Intervention and Traditional wards. Two senior physicians blinded to rota independently rated all suspected errors. Results: Average scheduled work hours were significantly lower on the intervention schedule [43.2 (SD 7.7) (range 26.0–60.0) vs. 52.4 (11.2) (30.0–77.0) h/week; P < 0.001], and there was a non-significant trend for increased total sleep time per day [7.26 (0.36) vs. 6.75 (0.40) h; P = 0.095]. During a total of 4782 patient-days involving 481 admissions, 32.7% fewer total medical errors occurred during the intervention than during the traditional rota (27.6 vs. 41.0 per 1000 patient-days, P = 0.006), including 82.6% fewer intercepted potential adverse events (1.2 vs. 6.9 per 1000 patient-days, P = 0.002) and 31.4% fewer non-intercepted potential adverse events (16.6 vs. 24.2 per 1000 patient-days, P = 0.067). Doctors reported worse educational opportunities on the intervention rota. Conclusions: Whilst concerns remain regarding reduced educational opportunities, our study supports the hypothesis that a 48 h work week coupled with targeted efforts to improve sleep hygiene improves patient safety

Adolescent girls in aquaculture ecozones at risk of nutrient deficiency in Bangladesh development and validation of an integrated metric

Acknowledgements We wish to acknowledge funding from the Innovative Methods and Metrics for Agriculture and Nutrition Actions (IMMANA) to undertake this research. We acknowledge the Nutritional Analytical Service, University of Stirling, United Kingdom for laboratory analyses. The work of BdR and AAS is funded by the Scottish Government Rural & Environment Science & Analytical Services. Funding This work is funded through the Innovative Methods and Metrics for Agriculture and Nutrition Actions (IMMANA) programme. IMMANA Phase 1 is funded with UK Aid from the UK government, led by the London School of Hygiene and Tropical Medicine (LSHTM).Peer reviewedPublisher PD

Stable sulforaphane protects against gait anomalies and modifies bone microarchitecture in the spontaneous STR/Ort model of osteoarthritis

Osteoarthritis (OA), affecting joints and bone, causes physical gait disability with huge socio-economic burden; treatment remains palliative. Roles for antioxidants in protecting against such chronic disorders have been examined previously. Sulforaphane is a naturally occurring antioxidant. Herein, we explore whether SFX-01®, a stable synthetic form of sulforaphane, modifies gait, bone architecture and slows/reverses articular cartilage destruction in a spontaneous OA model in STR/Ort mice. Sixteen mice (n = 8/group) were orally treated for 3 months with either 100 mg/kg SFX-01® or vehicle. Gait was recorded, tibiae were microCT scanned and analysed. OA lesion severity was graded histologically. The effect of SFX-01® on bone turnover markers in vivo was complemented by in vitro bone formation and resorption assays. Analysis revealed development of OA-related gait asymmetry in vehicle-treated STR/Ort mice, which did not emerge in SFX-01®-treated mice. We found significant improvements in trabecular and cortical bone. Despite these marked improvements, we found that histologically-graded OA severity in articular cartilage was unmodified in treated mice. These changes are also reflected in anabolic and anti-catabolic actions of SFX-01® treatment as reflected by alteration in serum markers as well as changes in primary osteoblast and osteoclast-like cells in vitro. We report that SFX-01® improves bone microarchitecture in vivo, produces corresponding changes in bone cell behaviour in vitro and leads to greater symmetry in gait, without marked effects on cartilage lesion severity in STR/Ort osteoarthritic mice. Our findings support both osteotrophic roles and novel beneficial gait effects for SFX-01® in this model of spontaneous OA