“It is a thing that depends on God”

Background: Pregnancy among adolescent girls in Niger contributes to 34% of all deaths among females ages 15–19, but there is a dearth of research as to the specific contextual causes. In Zinder region, an area that is especially impoverished and where girls are at heightened risk, there is very little information on the main obstacles to improving adolescents’ health and well-being. This qualitative study examines the underlying social, individual and structural factors influencing married girls’ early first birth and participation in alternative opportunities (such as education or economic pursuits) in Niger. Methodology: In July of 2017, researchers conducted in-depth interviews with a non-probability sample of community members in three communes of Zinder Region, Niger. Participants (n = 107) included adolescent girls, husbands of adolescent girls, influential adults, community leaders, health providers, and positive deviants. All interviews were transcribed, coded and analyzed using Dedoose software. Results: Participants recognize the health benefits of delaying first birth, but stigma around infertility and contraceptive use, desire for children, and belief that childbirth is “God’s will” interfere with a girl’s ability to delay. Girls’ social isolation, lack of mobility or autonomy, and inability to envision alternatives to early motherhood compound the issue. Participants favor adolescents’ pursuit of increased economic opportunities or education, but would not support delaying birth to do so. Conclusions: Findings indicate the need for a holistic approach to delaying early birth and stimulating girls’ participation in economic and educational pursuits. Potential interventions include mitigating barriers to reproductive health care; training adolescent girls on viable economic activities; and providing educational opportunities for girls. Effective programs should also include or target immediate members of the girls’ families (husbands, parents, in-laws), influential local leaders and members of the community at large

Women's and health workers’ Voices in open, inclusive communities and effective spaces (VOICES)

Given the growing popularity of the social accountability approach to governance, we developed and tested measures of governance outcomes to evaluate maternal and reproductive health social accountability interventions. We articulate a theory of change for how CARE's Community Score Card©, a social accountability approach, 1) empowers women, 2) empowers health workers and 3) creates expanded, inclusive and effective spaces for the two to interact. Our measures worked well in surveys of women and health workers. For women, eight of 13 scales had alphas ≥.70. For health workers, five of 11 scales were ≥.70; four were .60–.69. To our knowledge, this is the first attempt to develop comprehensive measures of governance outcomes to evaluate a social accountability approach for maternal and reproductive health

Understanding individual, family and community perspectives on delaying early birth among adolescent girls

Background: Pregnancy among adolescent girls in Bangladesh is high, with 66% of women under the age of 18 reporting a first birth; this issue is particularly acute in the northern region of Bangladesh, an area that is especially impoverished and where girls are at heightened risk. Using formative research, CARE USA examined the underlying social, individual and structural factors influencing married girls’ early first birth and participation in alternative opportunities (such as education or economic pursuits) in Bangladesh. Methods: In July of 2017, researchers conducted in-depth interviews of community members in two sub-districts of northern Bangladesh (Kurigram Sadar and Rajarhat). Participants (n = 127) included adolescent girls (both married and unmarredi), husbands of adolescent girls, influential adults in the girls’ lives, community leaders, and health providers. All interviews were transcribed, coded and organized using Dedoose software. Results: Participants recognize the health benefits of delaying first birth, but stigma around infertility and contraceptive use, pressure from mothers-in-law and health provider bias interfere with a girl’s ability to delay childbearing. Girls’ social isolation, lack of mobility or autonomy, and inability to envision alternatives to early motherhood compound the issue; provider bias may also prevent access to methods. While participants agree that pursuit of education and economic opportunities are important, better futures for girls do not necessarily supersede their marital obligations of childrearing and domestic chores. Conclusions: Findings indicate the need for a multi-level approach to delaying early birth and stimulating girls’ participation in economic and educational pursuits. Interventions must mitigate barriers to reproductive health care; train adolescent girls on viable economic activities; and provide educational opportunities for girls. Effective programs should also address contextual issues by including immediate members of the girls’ families, particularly the husband and mother-in-law

Immunophenotype of Gastric Tumors Unveils a Pleiotropic Role of Regulatory T Cells in Tumor Development.

Gastric cancer (GC) patients display increased regulatory T cell (Tregs) numbers in peripheral blood and among tumor-infiltrating lymphocytes. Nevertheless, the role of Tregs in GC progression remains controversial. Here, we sought to explore the impact of Tregs in GCs with distinct histology, and whether Tregs can directly influence tumor cell behavior and GC development. We performed a comprehensive immunophenotyping of 82 human GC cases, through an integrated analysis of multispectral immunofluorescence detection of T cells markers and patient clinicopathological data. Moreover, we developed 3D in vitro co-cultures with Tregs and tumor cells that were followed by high-throughput and light-sheet imaging, and their biological features studied with conventional/imaging flow cytometry and Western blotting. We showed that Tregs located at the tumor nest were frequent in intestinal-type GCs but did not associate with increased levels of effector T cells. Our in vitro results suggested that Tregs preferentially infiltrated intestinal-type GC spheroids, induced the expression of IL2Rα and activation of MAPK signaling pathway in tumor cells, and promoted spheroid growth. Accumulation of Tregs in intestinal-type GCs was increased at early stages of the stomach wall invasion and in the absence of vascular and perineural invasion. In this study, we proposed a non-immunosuppressive mechanism through which Tregs might directly modulate GC cells and thereby promote tumor growth. Our findings hold insightful implications for therapeutic strategies targeting intestinal-type GCs and other tumors with similar immune context

Chronic Antidiabetic Sulfonylureas In Vivo: Reversible Effects on Mouse Pancreatic β-Cells

In a mouse study aiming to understand why long-term treatment for type 2 diabetes with sulfonylureas eventually fails, Colin Nichols and Maria Remedi suggest that slow restoration of insulin secretion may be possible after a drug-resting period

Clinical and laboratory features associated with macrophage activation syndrome in Still's disease: data from the international AIDA Network Still's Disease Registry

: To characterize clinical and laboratory signs of patients with still's disease experiencing macrophage activation syndrome (MAS) and identify factors associated with MAS development. patients with still's disease classified according to internationally accepted criteria were enrolled in the autoInflammatory disease alliance (AIDA) still's disease registry. clinical and laboratory features observed during the inflammatory attack complicated by MAS were included in univariate and multivariate logistic regression analysis to identify factors associated to MAS development. A total of 414 patients with Still's disease were included; 39 (9.4%) of them developed MAS during clinical history. At univariate analyses, the following variables were significantly associated with MAS: classification of arthritis based on the number of joints involved (p = 0.003), liver involvement (p = 0.04), hepatomegaly (p = 0.02), hepatic failure (p = 0.01), axillary lymphadenopathy (p = 0.04), pneumonia (p = 0.03), acute respiratory distress syndrome (p < 0.001), platelet abnormalities (p < 0.001), high serum ferritin levels (p = 0.009), abnormal liver function tests (p = 0.009), hypoalbuminemia (p = 0.002), increased LDH (p = 0.001), and LDH serum levels (p < 0.001). at multivariate analysis, hepatomegaly (OR 8.7, 95% CI 1.9-52.6, p = 0.007) and monoarthritis (OR 15.8, 95% CI 2.9-97.1, p = 0.001), were directly associated with MAS, while the decade of life at Still's disease onset (OR 0.6, 95% CI 0.4-0.9, p = 0.045), a normal platelet count (OR 0.1, 95% CI 0.01-0.8, p = 0.034) or thrombocytosis (OR 0.01, 95% CI 0.0-0.2, p = 0.008) resulted to be protective. clinical and laboratory factors associated with MAS development have been identified in a large cohort of patients based on real-life data

Introductory note [to special issue on vinegars and acetic acid bacteria]

The exploitation of acetic acid bacteria has a long history infermentation processes and it is now an emerging field inbiotechnological applications, such as biosynthesis of higheconomical relevance molecules, and in food industry, wheremore reliable and controlled microbiological processes forvinegar and other fermented beverages production are required.The metabolic potential of acetic acid bacteria is joined to theirability to partially oxidize carbohydrates releasing the corresponding products (aldehydes, ketones and organic acids) into the medium. Due this feature acetic acid bacteria are knownsince a long time as the main agent of vinegar production butalso as contaminant in other fermented beverages like wine

Influenza della composizione del mezzo sull’attività biologica dell’ABT.

La composizione del mosto cotto esercita una forte pressione selettiva sui microrganismi presenti determinando la prevalenza di lieviti o batteri acetici in funzione della combinazioni di variabili quali, il pH, la concentrazione in solidi solubili, la presenza di etanolo o di acido acetico. In sei differenti composizioni del mezzo ottenuti variando la percentuale di mosto cotto e mosto fresco d’uva, sono stati osservati andamenti fermentativi significativamente diversi, ma riconducibili a due tipologie: una a prevalente attività fermentativa ad opera di lieviti fruttosofili e l’altra a prevalente attività ossidativa ad opera di batteri acetici. Ciò che sembra maggiormente determinare lo sviluppo di lieviti o di batteri è la concentrazione zuccherina iniziale. Concentrazioni del mezzo superiori ai 30 °Brix, in presenza di acido acetico (1% circa) e valori di pH bassi, imprimono una forte pressione selettiva che consente lo sviluppo di poche specie di lievito, prevalentemente fruttosofile, ma non dei batteri acetici. Al contrario concentrazioni di solidi solubili inferiori a 30 °Brix non inibiscono lo sviluppo dei batteri acetici. Inoltre, alcuni prodotti del metabolismo microbico possono essere impiegati come indicatori indiretti della prevalenza di un determinato gruppo nel processo fermentativo