Factors influencing anti-retroviral therapy uptake among HIV positive and exposed children aged below 14 years in Meru North District, Kenya

Background: Anti-retroviral Therapy (ART) is a major intervention for children infected and exposed to HIV infection and it influences their morbidity and mortality.Objective: To investigate factors influencing ARV uptake in HIV positive and exposed children aged below 14 years in Meru North District.Design: A descriptive cross-sectional study.Setting: The Nyambene District Hospital, Miathene Sub - District Hospital and Maua Methodist Hospital paediatrics comprehensive care clinics (PCCC) in Meru North District.Subjects: Parents or guardians with children less than 14 years of age exposed or infected with HIV who visited the selected health facilities.Results: About 222 caregivers were interviewed with mean age of 38.4 + 10.3 years ranging from 21 to 70 years. About 120 (54.0%) were aged between 30 to 39 years, Most of the caregivers 106 (47.7%) had acquired education up to primary level. Marital status of the caregivers revealed that 104 (46.8%) were married while 16 (6.3%) were cohabiting. Relationship between children ARV uptake and marital status of caregiver was significant (OR= 2.1, 95% C.I= 1.0 – 4.6, P=0.050). Significant association between source of medical advice and children ARV uptake (P<0.05) was evident.Conclusion: Achieving widespread public health benefits of ARV roll-out requires community - level interventions in marriages and information distribution to ensure local acceptability of antiretroviral drugs. Better management and improvement of health status of HIV exposed and infected children will be enhanced by improved ARV uptake.Recommendation: The study recommends integration and decentralization of ARV services through social supports, encouraging disclosure of HIV statuses for positive living and enhanced ARV uptake and enhanced awareness creation on ARVs and HIV information to caregivers at all levels

The APOB insertion/deletion polymorphism (rs17240441) influences postprandial lipaemia in healthy adults

BACKGROUND: Apolipoprotein (apo)B is the structural apoprotein of intestinally- and liver- derived lipoproteins and plays an important role in the transport of triacylglycerol (TAG) and cholesterol. Previous studies have examined the association between the APOB insertion/deletion (ins/del) polymorphism (rs17240441) and postprandial lipaemia in response to a single meal; however the findings have been inconsistent with studies often underpowered to detect genotype-lipaemia associations, focused mainly on men, or with limited postprandial characterisation of participants. In the present study, using a novel sequential test meal protocol which more closely mimics habitual eating patterns, we investigated the impact of APOB ins/del polymorphism on postprandial TAG, non-esterified fatty acids, glucose and insulin levels in healthy adults. FINDINGS: Healthy participants (n = 147) consumed a standard test breakfast (0 min; 49 g fat) and lunch (330 min; 29 g fat), with blood samples collected before (fasting) and on 11 subsequent occasions until 480 min after the test breakfast. The ins/ins homozygotes had higher fasting total cholesterol, LDL-cholesterol, TAG, insulin and HOMA-IR and lower HDL-cholesterol than del/del homozygotes (P < 0.017). A higher area under the time response curve (AUC) was evident for the postprandial TAG (P < 0.001) and insulin (P = 0.032) responses in the ins/ins homozygotes relative to the del/del homozygotes, where the genotype explained 35% and 7% of the variation in the TAG and insulin AUCs, respectively. CONCLUSIONS: In summary, our findings indicate that the APOB ins/del polymorphism is likely to be an important genetic determinant of the large inter-individual variability in the postprandial TAG and insulin responses to dietary fat intake

Ethnic variation in outcome of people hospitalised during the first COVID-19 epidemic wave in Wales (UK):an analysis of national surveillance data using Onomap, a name-based ethnicity classification tool

Objective To identify ethnic differences in proportion positive for SARS-CoV-2, and proportion hospitalised, proportion admitted to intensive care and proportion died in hospital with COVID-19 during the first epidemic wave in Wales.Design Descriptive analysis of 76 503 SARS-CoV-2 tests carried out in Wales to 31 May 2020. Cohort study of 4046 individuals hospitalised with confirmed COVID-19 between 1 March and 31 May. In both analyses, ethnicity was assigned using a name-based classifier.Setting Wales (UK).Primary and secondary outcomes Admission to an intensive care unit following hospitalisation with a positive SARS-CoV-2 PCR test. Death within 28 days of a positive SARS-CoV-2 PCR test.Results Using a name-based ethnicity classifier, we found a higher proportion of black, Asian and ethnic minority people tested for SARS-CoV-2 by PCR tested positive, compared with those classified as white. Hospitalised black, Asian and minority ethnic cases were younger (median age 53 compared with 76 years; p&lt;0.01) and more likely to be admitted to intensive care. Bangladeshi (adjusted OR (aOR): 9.80, 95% CI 1.21 to 79.40) and ‘white – other than British or Irish’ (aOR: 1.99, 95% CI 1.15 to 3.44) ethnic groups were most likely to be admitted to intensive care unit. In Wales, older age (aOR for over 70 years: 10.29, 95% CI 6.78 to 15.64) and male gender (aOR: 1.38, 95% CI 1.19 to 1.59), but not ethnicity, were associated with death in hospitalised patients.Conclusions This study adds to the growing evidence that ethnic minorities are disproportionately affected by COVID-19. During the first COVID-19 epidemic wave in Wales, although ethnic minority populations were less likely to be tested and less likely to be hospitalised, those that did attend hospital were younger and more likely to be admitted to intensive care. Primary, secondary and tertiary COVID-19 prevention should target ethnic minority communities in Wales

Salmonella in Indian ready-to-cook poultry: antibiotic resistance and molecular characterization

The availability and popularity of processed, ready-to-cook (RTC) poultry products are increasing in India. Though fresh poultry is known to be contaminated with Salmonella, the prevalence of this foodborne pathogen in RTC poultry products is not reported. Eighty-seven chilled and frozen RTC poultry samples of 4 different brands obtained from supermarkets and departmental stores in Mumbai were analyzed for the presence of Salmonella. The prevalence of Salmonella was higher (51%) in chilled RTC samples as compared to the frozen RTC samples (5%). The frozen RTC samples of one brand were free from Salmonella. S. Typhimurium (75.2%) was the most prevalent serovar, followed by S. Enteritidis (23%) and S. Weltevreden (1.7%). A high percentage (81.4%) of the isolates were found to be resistant to 5 or more antibiotics and class 1 integron, which has been shown to confer multi-drug resistance, was detected in 69.9% of the isolates. Multiple antibiotic resistance index of isolates was high (0.6) indicating the indiscriminate use of antibiotics during poultry farming. High genetic diversity was observed among the Salmonella serovars based on Pulsed Field Gel Electrophoresis profiles. Results showed the presence of multi-drug resistant Salmonella serovars in processed, chilled RTC poultry products marketed in Mumbai, India

A nutrigenetic approach for investigating the relationship between vitamin B12 status and metabolic traits in Indonesian women

Purpose: Adverse effects of maternal vitamin B12 deficiency have been linked to major clinical outcomes, including increased body mass index and gestational diabetes, however, less is known about vitamin B12 nutrition in non-pregnant women. Hence, the aim of the present study was to explore the relationships between metabolic traits and vitamin B12 status in a cohort of healthy Indonesian women and to investigate whether these relationships were modified by dietary intake using a genetic approach. Methods: A total of 117 Minangkabau women (aged 25-60 years), from the city of Padang, West Sumatra underwent anthropometric, biochemical, dietary intake analysis and genetic tests. Genetic risk scores (GRS) based on nine vitamin B12 associated single nucleotide polymorphisms (SNPs) (B12-GRS) and nine metabolic SNPs (metabolic-GRS) were constructed. Results: The B12-GRS and metabolic-GRS had no effect on vitamin B12 (P>0.160) and metabolic traits (P>0.085). However, an interaction was observed between the B12-GRS and dietary fibre intake (g) on glycated haemoglobin (HbA1C) levels (P interaction=0.042), where among those who consumed a low fibre diet (4.90 ± 1.00 g/day), individuals carrying ≥9 risk alleles for vitamin B12 deficiency had significantly higher HbA1C levels (P=0.025) compared to those carrying ≤8 risk alleles. Conclusion: Our study showed a significant impact of the B12-GRS on HbA1C concentrations through the influence of a dietary factor, however, our study failed to provide evidence for an impact of metabolic-GRS on lowering B12 concentrations. Further replication studies utilizing larger sample sizes are needed to confirm our findings

Interaction between TCF7L2 polymorphism and dietary fat intake on high density lipoprotein cholesterol

Recent evidence suggests that lifestyle factors influence the association between the Melanocortin 4 receptor (MC4R) and Transcription Factor 7-Like 2 (TCF7L2) gene variants and cardio-metabolic traits in several populations; however, the available research is limited among the Asian Indian population. Hence, the present study examined whether the association between the MC4R single nucleotide polymorphism (SNP) (rs17782313) and two SNPs of the TCF7L2 gene (rs12255372 and rs7903146) and cardio-metabolic traits is modified by dietary factors and physical activity. This cross sectional study included a random sample of normal glucose tolerant (NGT) (n = 821) and participants with type 2 diabetes (T2D) (n = 861) recruited from the urban part of the Chennai Urban Rural Epidemiology Study (CURES). A validated food frequency questionnaire (FFQ) was used for dietary assessment and self-reported physical activity measures were collected. The threshold for significance was set at P = 0.00023 based on Bonferroni correction for multiple testing [(0.05/210 (3 SNPs x 14 outcomes x 5 lifestyle factors)]. After Bonferroni correction, there was a significant interaction between the TCF7L2 rs12255372 SNP and fat intake (g/day) (Pinteraction = 0.0001) on high-density lipoprotein cholesterol (HDL-C), where the 'T' allele carriers in the lowest tertile of total fat intake had higher HDL-C (P = 0.008) and those in the highest tertile (P = 0.017) had lower HDL-C compared to the GG homozygotes. In a secondary analysis of SNPs with the subtypes of fat, there was also a significant interaction between the SNP rs12255372 and polyunsaturated fatty acids (PUFA, g/day) (Pinteraction<0.0001) on HDL-C, where the minor allele carriers had higher HDL-C in the lowest PUFA tertile (P = 0.024) and those in the highest PUFA tertile had lower HDL-C (P = 0.028) than GG homozygotes. In addition, a significant interaction was also seen between TCF7L2 SNP rs12255372 and fibre intake (g/day) on HDL-C (Pinteraction<0.0001). None of the other interactions between the SNPs and lifestyle factors were statistically significant after correction for multiple testing. Our findings indicate that the association between TCF7L2 SNP rs12255372 and HDL-C may be modified by dietary fat intake in this Asian Indian population

Event detection using roles and relationships of entities

A method, system, and computer program product for event detection using roles and relationships of entities are provided in the illustrative embodiments. A training event and a set of entities participating in the training event are identified in a training data. For a first entity in the set of entities, a first role occupied by the entity in the event is determined. A behavior attribute is assigned to the first role. A relationship of the first role with a second role corresponding to a second entity in the set of entities is determined. An event rule is constructed to detect an event corresponding to the training event in new data and comprising a plurality of roles, behavior attributes, and the relationship. The plurality of roles includes the first role and the second role, and the plurality of behavior attributes includes the behavior attribute assigned to the first role.Board of Regents, University of Texas Syste

Interaction between the genetic risk score and dietary protein intake on cardiometabolic traits in South East Asian

Background: Cardiometabolic diseases are complex traits which are influenced by several single nucleotide polymorphisms (SNPs). Thus, analysing the combined effects of multiple gene variants might provide a better understanding of disease risk than using a single gene variant approach. Furthermore, studies have found that the effect of SNPs on cardiometabolic traits can be influenced by lifestyle factors, highlighting the importance of analysing gene-lifestyle interactions. Aims: In the present study, we investigated the association of 15 gene variants with cardiometabolic traits and examined whether these associations were modified by lifestyle factors such as dietary intake and physical activity. Methods: The study included 110 Minangkabau women [aged 25-60 years and body mass index (BMI) 25.13±4.2 kg/m2] from Padang, Indonesia. All participants underwent a physical examination followed by anthropometric, biochemical and dietary assessments and genetic tests. A genetic risk score (GRS) was developed based on 15 cardio-metabolic disease-related SNPs. The effect of GRS on cardiometabolic traits was analysed using general linear models. GRS-lifestyle interactions on continuous outcomes were tested by including the interaction term (e.g., lifestyle factor*GRS) in the regression model. Models were adjusted for age, BMI and location (rural or urban), wherever appropriate. Results: There was a significant association between GRS and BMI, where individuals carrying 6 or more risk alleles had higher BMI compared to those carrying 5 or less risk alleles (P=0.018). Furthermore, there were significant interactions of GRS with protein intake on waist circumference (WC) and triglyceride concentrations (Pinteraction= 0.002 and 0.003, respectively). Amongst women who had a lower protein intake (13.51±1.18% of the total daily energy intake), carriers of six or more risk alleles had significantly lower WC and triglyceride concentrations compared with carriers of five or less risk alleles (P=0.0118 and 0.002, respectively). Conclusions: Our study confirmed the association of GRS with higher BMI and further showed a significant effect of the GRS on WC and triglyceride levels through the influence of a low-protein diet. These findings suggest that following a lower protein diet, particularly in genetically predisposed individuals, might be an effective approach for addressing cardiometabolic diseases among South East Asian women