Thioindigo-Based Photoswitchable Hydrogen Bond Arrays

In the context of hydrogen bonded materials, most efforts have been focusing on designing and synthesizing acceptor and donor arrays that in their original forms are capable of hydrogen bonding. However, less attention has been paid to the molecules that potentially act as viable acceptors or donors upon exposure to external stimuli. This thesis describes the design, synthesis and photophysical properties of photochromic thioindigo derivatives as potential acceptors. Illumination of light can induce photoisomerization of thioindigo derivatives where they can change their orientation to generate linear hydrogen bond arrays (AAA). This linear arrangement accounts for the formation of hydrogen bonded complexes with different donor arrays (AAA-DD(D)). The stability of the complexes was determined by using 1H NMR titration procedure where the most stable complex showed a Ka of 2.3 x 10-5 M-1

Is there any correlation between duration of vomiting before pyloromyotomy and eradication of symptoms after pyloromyotomy in hypertrophic pyloric stenosis?

Introduction: Hypertrophic pyloric stenosis (HPS) is among common GI disorders in young infants, with an incidence of 1-2:1000 live births in the world. In this study, we wanted to investigate the correlation between duration of symptoms before surgery and eradication of symptoms after pyloromyotomy in HPS.Materials and methods: One hundred and twenty five (102 boys and 23 girls) patients with suspected infantile HPS were treated surgically by Ramstedt pyloromyotomy between 2004 and 2014 at pediatric surgery ward of Tabriz Children’s Hospital, Iran. The demographic features, clinical findings, diagnostic work-up and postoperative specifications of the patients were studied retrospectively.Results: We studied 125 patients with HPS. Male to female ratio was 4:1. The patients were 16 to 90 days of old and the mean age was 39±1.42 days. The range of pyloric canal length was 7.60 to 29.00 mm and the mean length was 19.54±3.42 mm. Pyloric muscle diameter was 2.70 to 9.00 mm and the mean diameter was 4.86±1.14 mm. Seventy two percent of patients had episodes of vomiting after operation. Mean time of persistence of vomiting after pyloromyotomy was 15.73±0.15 hours. Mean discharge time was 55.22±0.08 hours. Radiologic findings did not show any significant correlation with persistence of vomiting or discharge time. Conclusion: The present study revealed that duration of vomiting before surgery and continuing symptoms could not predict postoperative symptom eradication after pyloromyotomy in HPS

Breast cancer-preventive behaviors: exploring Iranian women’s experiences

BACKGROUND: Breast cancer-preventive behaviors are critical for community and women’s health. Although many studies have addressed women’s knowledge and attitudes toward breast cancer, little information is available about their experiences of breast cancer preventive behaviors. This study aimed to explore the experiences of Iranian women regarding preventive behaviors. METHODS: This was a qualitative study. A sample of Iranian women aged 30 years and over was selected purposefully. Data collected through focus group and semi-structured audiotaped interviews and were analyzed by conventional content analysis. RESULTS: The following five main themes emerged from the analysis: attitude toward breast cancer and preventive behaviors, stress management, healthy lifestyle, perceived social support and individual/environmental barriers. The findings showed that women were highly motivated to preventive behaviors of breast cancer but faced considerable challenges. CONCLUSIONS: The findings indicated that increased awareness, positive attitudes, stronger motivational factors, and fewer barriers toward preventive behaviors are most important parameters that might encourage women to practice breast cancer-preventive behaviors

Investigating Preventive Effect of Vitamin D and N-acetylcysteine Against Kidney Injury in Rats Versus the Promotive Effect of Paraquat

Background: Paraquat (PQ) is one of the most important herbicides used in agriculture. Objectives: This study was conducted to compare the preventive effect of vitamin D (Vit D) and N-acetylcysteine (NAC) against kidney injury in rats versus the promotive effect of PQ. Methods: In this study, rats were divided into six groups. The control group (group 1) received normal saline, Vit D group (group 2) received intraperitoneal (IP) injections of+Vit D (2 μg/kg), NAC group (group 3) received NAC (6.25 mg/kg, IP), PQ group (group 4) received PQ (5 mg/kg/d, IP), PQ+Vit D group (group 5) received PQ+Vit D (5 mg/kg/d+2 μg/kg/d, IP) and PQ+NAC group (group 6) received PQ+NAC (5 mg/kg/d+6.25 mg/kg/d, IP). The animals were treated for 7 consecutive days as a sub-chronic exposure. After the collection of urea and serum creatinine, biomarkers of oxidative stress and kidney histopathology were investigated. Results: PQ increased lipid peroxidation (LPO), urea, and serum creatinine, but it significantly decreased total antioxidant capacity (TAC) and thiol groups. In the groups treated with Vit D and NAC, it was observed that LPO, urea, and creatinine significantly decrease compared with the PQ group, and TAC, thiol groups, and Vit D levels increased in kidney tissue. Conclusion: The obtained findings revealed that both Vit D and NAC used as preventive compound were able to reduce oxidative stress and tissue damage caused by PQ toxicity in the kidney

Effective Factors of the Healthy Nutritional Behavior Based on the Application of Social Cognitive Theory among 13-15-Year-Old Students

Background: There is a rapid spurt in non-communicable diseases because of some significant changes in nutrition patterns around the globe. Controlling the main risk factors, namely lack of physical activity and smoking, might decrease more than 50% of the deaths and disabilities caused by these factors. This study aimed to investigate the effective factors of healthy food behavior based on the application cognitive social theory to 13 to 15-year- old students. Materials and Methods: This cross-sectional study was performed on 330 students aged 13–15 years, in Zarrin- Dasht County, Fars Province, south of Iran who were randomly selected from public schools assigned to the study in 2016. The data gathering tools were demographic questionnaire, a researcher-made questionnaire of social cognitive theory (outcome expectations, outcome values, self-efficacy, social support, and self-regulation), and another questionnaire on nutritional behavior. Questionnaires were completed by students. For analyzing data, the SPSS-22 software, multiple regression, and correlation tests were used.   Results: 330 students aged 13–15 years with seventh, eighth and ninth educational grade participated in this study. Among different constructs of social cognitive theory, outcome expectations (P=0.001), social support (P=0.005), and self-regulation (P=0.001), have made significant contribution to the explanation of the variance of appropriate nutritional behavior among the students. In total, these variables account for approximately 63% of the variance of nutritional behaviors. Conclusion According to the results of this study outcome expectations, social support, and self-regulation might be effective in designing educational interventions to achieve healthy food behavior in students

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

© 2020 Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding: Bill & Melinda Gates Foundation

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations