Blood pressure patterns in rural, semi-urban and urban children in the Ashanti region of Ghana, West Africa

BACKGROUND: High blood pressure, once rare, is rapidly becoming a major public health burden in sub-Saharan/Africa. It is unclear whether this is reflected in children. The main purpose of this study was to assess blood pressure patterns among rural, semi-urban, and urban children and to determine the association of blood pressure with locality and body mass index (BMI) in this sub-Saharan Africa setting. METHODS: We conducted a cross-sectional survey among school children aged 8–16 years in the Ashanti region of Ghana (West-Africa). There were 1277 children in the study (616 boys and 661 females). Of these 214 were from rural, 296 from semi-urban and 767 from urban settings. RESULTS: Blood pressure increased with increasing age in rural, semi-urban and urban areas, and in both boys and girls. The rural boys had a lower systolic and diastolic blood pressure than semi-urban boys (104.7/62.3 vs. 109.2/66.5; p < 0.001) and lower systolic blood pressure than urban boys (104.7 vs. 107.6; p < 0.01). Girls had a higher blood pressure than boys (109.1/66.7 vs. 107.5/63.8; p < 0.01). With the exception of a lower diastolic blood pressure amongst rural girls, no differences were found between rural girls (107.4/64.4) and semi-urban girls (108.0/66.1) and urban girls (109.8/67.5). In multiple linear regression analysis, locality and BMI were independently associated with blood pressure in both boys and girls. CONCLUSION: These findings underscore the urgent need for public health measures to prevent increasing blood pressure and its sequelae from becoming another public health burden. More work on blood pressure in children in sub-Saharan African and other developing countries is needed to prevent high blood pressure from becoming a major burden in many of these countries

Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications

Superparamagnetic iron oxide nanoparticles can providemultiple benefits for biomedical applications in aqueous environments such asmagnetic separation or magnetic resonance imaging. To increase the colloidal stability and allow subsequent reactions, the introduction of hydrophilic functional groups onto the particles’ surface is essential. During this process, the original coating is exchanged by preferably covalently bonded ligands such as trialkoxysilanes. The duration of the silane exchange reaction, which commonly takes more than 24 h, is an important drawback for this approach. In this paper, we present a novel method, which introduces ultrasonication as an energy source to dramatically accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove the generic character, different functional groups were introduced on the surface including polyethylene glycol chains, carboxylic acid, amine, and thiol groups. Their colloidal stability in various aqueous buffer solutions as well as human plasma and serum was investigated to allow implementation in biomedical and sensing applications.status: publishe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The heart rate response to alcohol intoxication and its relationship with alcohol consumption, delinquency, and intoxicated aggressive and disinhibited behaviors /

Alcohol abuse/dependence frequently co-occurs with antisocial personality disorder (ASPD) and conduct disorder (CD). Furthermore, crime studies have generally found that alcohol is involved in over 50% of violent crimes, and experimental studies support the notion that acute alcohol consumption indirectly increases the likelihood of aggressive and disinhibited behaviors in the laboratory. However, the mechanisms underlying alcohol's association with such behaviors remain unclear. The goals of this thesis were therefore to further elucidate potential mechanisms underlying (a) alcohol-induced aggressive, disinhibited behaviors and (b) the high comorbidity between delinquent, aggressive behaviors (characterizing CD/ASPD) and alcohol misuse/abuse/dependence. Thus, four studies were conducted, focusing on individual differences in the physiological response to alcohol intoxication. Specifically examined was the elevated heart rate (HR) response to alcohol, which is thought to reflect an increased sensitivity to alcohol-induced reward.Results of Study I indicated that high HR Responders to alcohol self-reported increased multiple year delinquency (physical aggression, theft, and destruction of property), as well as more alcohol consumption and an increased positive subjective feeling following intoxication, as compared to low HR Responders. Furthermore, a high HR response was related to increased extraversion, disinhibition, boredom susceptibility, and total sensation seeking. Study II revealed that Aggressive Sons of Male Alcoholics (Agg-SOMAs) had the highest intoxicated HR response, and reported the most alcohol consumption, as compared to Non-Agg-SOMAs, or Agg - or Non-Agg - Non-SOMAs. Studies III and IV revealed that intoxicated high HR responders exhibited the most physical aggression (assessed by the Taylor Aggression Paradigm), as well as the most behavioral disinhibition (assessed by the Go/No-Go task) as compared to sober high HR Responders, or sober/intoxicated low HR responders.In summary, individuals with a high HR response to alcohol appear to have an increased propensity for multiple addictive, disinhibited and aggressive behaviors. This determines a phenotype of both potential heuristic and clinical importance. These findings are discussed within the context of a hypothetical model of (a) the high comorbidity between alcohol use/misuse and aggression/ASPD, and (b) the increased likelihood of alcohol-induced aggressive, disinhibited behaviors

Expérience de recherche participative dans le bassin du Madon (Lorraine, France)

La recherche participative (ou recherche citoyenne) permet d’établir un partenariat entre le milieu académique (laboratoire universitaire et ses chercheurs) et le milieu associatif ou scolaire pour réaliser des études à visée scientifique. Elles permettent à la fois de mieux faire apprécier la démarche scientifique au grand public (qu’il s’agisse d’enfants ou d’adultes) et d’obtenir des données, sur le long terme ou sur un grand secteur géographique, utiles au chercheur. C’est dans ce cadre que deux actions se sont déroulées entre 2012 et 2014 sur le bassin du Madon, l’un des affluents de la Moselle, dans le sud de la Lorraine. Une première action a été réalisée dans le cadre d’une manifestation socioculturelle (les Chemins de l’Eau) organisée par la Fédération Départementale des Foyers Ruraux en juin 2013 : afin de sensibiliser les visiteurs aux ressources en eau dans leur environnement immédiat, une hydrothèque a été créée. La seconde action s’est adressée à des classes de primaire (CE2-CM1-CM2 et CM2) de trois localités rurales le long du Madon (Lerrain, Mattaincourt et Haroué). Tous les échantillons ont ensuite fait l’objet d’analyses au laboratoire : pH, conductivité, carbone organique dissous, azote total dissous, azote ammoniacal, ions majeurs, propriétés optiques (spectroscopie UV-visible, fluorescence). Ces expériences ont permis d’avoir un suivi temporel de trois stations le long du Madon et de participer à une cartographie des ressources en eau des Vosges en fonction des caractéristiques du bassin versant et de l’usage des sols. Dans les deux cas, le public visé a montré un vif intérêt.Participatory research establishes a partnership between the academic community (university laboratory and its researchers) and the associative or school environment, in order to conduct scientific studies. This approach favours a better understanding of the scientific approach by the public (whether children or adults) and provides data on the long-term or over a large geographical area that are useful for researchers. It is in this context that two actions took place between 2012 and 2014 in the Madon River watershed. The Madon River is a tributary of the Moselle, in the south of Lorraine (northeastern France). The first action was carried out as part of a socio-cultural event (les Chemins de l’Eau) organized by the Fédération Départementale des Foyers Ruraux in June 2013 to educate visitors about the water resources in their immediate environment. A water library was created. The second action was focused on primary school classes (CE2-CM1-CM2 and CM2) from three rural communities along the Madon (Lerrain, Mattaincourt and Haroué). All samples were subjected to laboratory analysis: pH, conductivity, dissolved organic carbon, total dissolved nitrogen, ammonia nitrogen, major ions, optical properties (UV-visible spectroscopy, fluorescence). These experiments provided a temporal monitoring of three stations along the Madon River and allowed the public to participate in the mapping of water resources in the Vosges area based on watershed characteristics and land use. In both cases the participants proved to be very interested by the approach

Rare capture: The detection of synchronous diffuse large B-cell lymphoma and lung adenocarcinoma diagnosed by effusion cytology

The diagnosis of two primary synchronous malignancies in a single pleural effusion cytology specimen is exceedingly rare. We describe, to the best of our knowledge, the first reported case of lung adenocarcinoma and suspected relapse of Diffuse Large B-Cell Lymphoma (DLBCL) diagnosed from a solitary effusion sample

Standardized 4-step technique of bladder neck dissection during robot-assisted radical prostatectomy

Bladder neck (BN) dissection is considered one of the most challenging steps during robot-assisted radical prostatectomy. Better understanding of the BN anatomy, coupled with a standardized approach may facilitate dissection while minimizing complications. We describe in this article the 4 anatomic spaces during standardized BN dissection, as well other technical maneuvers of managing difficult scenarios including treatment of a large median lobe or patients with previous transurethral resection of the prostate. The first step involves the proper identification of the BN followed by slow horizontal dissection of the first layer (the dorsal venous complex and perivesicle fat). The second step proceeds with reconfirming the location of the BN followed by midline dissection of the second anatomical layer (the anterior bladder muscle and mucosa) using the tip of the monopolar scissor until the catheter is identified. The deflated catheter is then grasped by the assistant to apply upward traction on the prostate from 2 directions along with downward traction on the posterior bladder wall by the tip of the suction instrument. This triangulation allows easier, and safer visual, layer by layer, dissection of the third BN layer (the posterior bladder mucosa and muscle wall). The forth step is next performed by blunt puncture of the fourth layer (the retrotrigonal fascia) aiming to enter into the previously dissected seminal vesical space. Finally, both vas deferens and seminal vesicles are pulled through the open BN and handed to the assistant for upper traction to initiate Denovillier’s dissection and prostate pedicle/neurovascular bundle control

Vertical transmission of HIV in Belgium: A 1986-2002 retrospective analysis

Prophylactic interventions have lead to the reduction of the mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV-1) to less than 2% in industrialized countries. The aim of this study was to evaluate the changes over time in vertical transmission according to the standard care of prophylaxis in the practice of a single large reference center and to identify the risk factors for failure. The rate of MTCT decreased progressively from 10% in 1986-1993 to 4.7% in 1999-2002, reflecting the progressive implementation of newly available means of prevention. During the last period evaluated (1999-2002), where highly active antiretroviral therapy (HAART) prophylaxis was the standard of care, 17% of women had a viral load between 400 and 20,000 copies/ml around delivery and 5% had a viral load above 20,000 copies/ml. High viral load and low CD4 lymphocyte count were strongly associated with vertical transmission. The rate of MTCT in women who received HAART for more than one month during pregnancy was 1.7%, compared to 13.3% in women treated with HAART for less than one month. The risk of vertical transmission in the absence of therapy was four times higher than before the era of antiretroviral therapy (ART; p=0.05). In conclusion, since the prevention of MTCT of HIV with HAART is the standard of care, a short duration or absence of ART during pregnancy linked to late or absent prenatal care is associated with a high risk of transmission. The early detection of HIV-1 infection in pregnant women, and close follow up and support during pregnancy are crucial to the success of the prevention of transmission. © 2008 Springer-Verlag.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

7.7 dB/km losses in inhibited coupling hollow-core photonic crystal fibers

International audienc