Low prevalence of detectable serum cardiac troponin I among healthy Tanzanian adults: observational study

Background: Cardiac troponin test is used in detecting various heart disorders. The objective of this study was to establish normal reference levels for serum cardiac Troponin I which could be utilized for selection of vaccines and determine any electrocardiogram (EKG) changes among healthy volunteers.Methods: A total of 263 healthy blood donors from Dar es Salaam, Tanzania were included in this sub-study. A thorough medical history and physical examination to rule out any major chronic disease like heart failure, chronic kidney diseases, diabetes mellitus and HIV was undertaken.  Ten mL of blood sample for the purpose of establishing normal reference values for Troponin I assessment and parallel EKG was performed to all participants. Results: Of the 263 subjects, males were156 (59.3%) and females were 107 (40.7%). Median (range) age was 34 years old. The manufacture’s reference level for serum Cardiac Troponin I was 0.00-0.39 µg/L. Serum Cardiac Troponin I was detected in two blood donors (0.76%). However, their Troponin I levels were within the manufacturer’s normal range (0.01-0.36 µg/L).  Clinically both subjects were healthy and their EKG tracing were unremarkable.Conclusions: Our study has shown that among healthy subjects, detectable serum cardiac Troponin I is a rare finding. The manufacturer’s range is applicable in our setting and can be used in the ongoing vaccine trial. The significance of minimally elevated serum cardiac Troponin I may represent a subclinical cardiac injury and have important clinical implications, a hypothesis that should be tested in future longitudinal outcome studies

Cu-Mn and Cu-Ce supported over agro-based carbons: characteristics and NOx adsorption study

As there is an urgent need for cheaper and sustainable resources for selective catalytic reduction catalyst, this study determined the potential, in terms of the catalyst characteristics and NOx adsorption, of coconut shell (CSAC) and palm kernel shell activated carbons (PSAC) to be used as precursors for the catalyst in a low-temperature flue gas denitrification system. The carbons were impregnated with bimetallic catalysts –copper-manganese (Cu-Mn) and copper-cerium (Cu-Ce) – before calcined at low temperature. The produced coconut shell catalysts (CuMn/CS and CuCe/CS) and palm kernel shell catalysts (CuMn/PS and CuCe/PS) were then characterized using a nitrogen adsorption-desorption test, Fourier-Transform infra-red, x-ray fluorescence, x-ray diffraction and hydrogen temperature-programmed reduction. The removal of NOx was also studied for all catalysts in a fixed-bed reactor. It was found that CuMn/CS gave the highest NOx removal. CuMn/CS had high pore volume, good Cu-Mn crystallinity, highmetal loading and dispersion, high copper reduction activity at the operating temperature, and rich in ketone and amine surface functional groups. It is then concluded that the coconut shell has the potential to be developed as a good SCR catalyst via impregnation with Cu-Mn

Estimation of key potentially toxic elements in arid agricultural soils using Vis-NIR spectroscopy with variable selection and PLSR algorithms

Potentially toxic elements (PTEs) pose a significant threat to soil and the environment. Therefore, the fast quantification of PTEs is crucial for better management of contaminated sites. Versatile technique such as Visible near-infrared spectroscopy (Vis–NIRS) (350–2,500 nm) has attracted tremendous attention for assessing PTEs and has achieved promising results combined with successful multivariate analysis. This research investigated the potential of Vis–NIRS combined with partial least squares regression (PLSR) and variable selection methods to assess key PTEs (Cd, Co, Cu, Cr, Pb, and Zn) in agricultural soils under arid conditions. The soil samples (80) were collected from a polluted area around Al-Moheet drainage, Minya Governorate–upper Egypt. The samples were scanned using an ASD FieldSpec-4 spectroradiometer. Simulated annealing (SA) and uninformative variable elimination (UVE) were used to select the effective wavelengths in predicting PTEs. PLSR was used to develop the spectral models using the full range (FR-PLS) and feature-selected spectra techniques SA (SA-PLS) and UVE (UVE-PLS). The results indicated that UVE-PLS models performed better than FR-PLS and SA-PLS models in predicting the key PTEs. The obtained coefficient of determination (R2) and the ratio of performance to deviation (RPD) were 0.74 and 2.48 (Cr), 0.72 and 2.03 (Pb), 0.62 and 1.86 (Cd), 0.59 and 1.78 (Cu), 0.52 and 1.68 (Co), and 0.46 and 1.41 (Zn), respectively. The results suggested that the UVE-PLS spectral model is promising for predicting Cr, Pb, and Cd, and can be improved for predicting Cu, Co, and Zn elements in agricultural soils

Factor V G1691A (Leiden) is a major etiological factor in Egyptian Budd-Chiari syndrome patients

Objective: Budd-Chiari syndrome is a multifactorial disease in which several prothrombotic disorders may predispose patients to the development of thrombosis at this uncommon location (hepatic veins). The aim of this study was to determine the prevalence and characteristics of inherited thrombophilia in Egyptian Budd-Chiari syndrome patients.Materials and Methods: The study included 47 Budd-Chiari syndrome patients (20 children and 27 adults). Genotyping of Factor V G1691A (Leiden), prothrombin G20210A (PT), and methylenetetrahydrofolate reductase C677T were performed using real-time PCR and fluorescence melting curve detection analysis.Results: Factor V Leiden was observed in 29 patients (61.7%). It is the only factor that caused Budd-Chiari syndrome in 18 of the patients and in 5 of the patients with inferior vena cava involvement. Myeloproliferative disease was noted in 12 (25.5%) patients, antiphospholipid syndrome in 5 (10.6%), and Behcet’s disease in 3 (6.4%). Interestingly, 3 of the children with Budd-Chiari syndrome had lipid storage disease.Conclusion: Factor V Leiden was a major etiological factor in Egyptian Budd-Chiari syndrome patients, which may have been related to the high frequency of this mutation in the study region. Factor V Leiden was also a strong thrombophilic factor and the leading cause of inferior vena cava thrombosis in these patients. Lipid storage disease should be included as a risk factor for Budd-Chiari syndrome

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Is Overweight in Stunted Preschool Children in Cameroon Related to Reductions in Fat Oxidation, Resting Energy Expenditure and Physical Activity?

Recent studies suggest that early modifications in metabolic pathways and behaviour, leading to energy conservation and reduced linear growth, could represent adaptations to nutritional constraints during foetal life and infancy. Impaired fat oxidation, low resting energy expenditure and reduced physical activity, resulting from these adaptations, could facilitate fat storage and development of overweight in growth-retarded children that consume more energy-dense food. This study aims at assessing whether: (1) dual-burden preschool children (simultaneously stunted and overweight) of Yaounde (Cameroon) have low birth-weight (indicator of foetal undernutrition) and reductions in fat oxidation, resting energy expenditure (REE) and physical activity, (2) fat oxidation, REE and physical activity are associated with foetal growth.162 children (24-72 months) were considered: 22 stunted-overweight (SO), 40 stunted (S), 41 overweight (O), and 59 non stunted-non overweight (NSNO). Nutritional status and body composition were assessed using anthropometry and multifrequency bioimpedance analysis. Fasting respiratory quotient (RQ) and REE were measured by indirect calorimetry. Physical activity was determined using accelerometers, food questionnaires were used for diet assessment and birth-weight was noted. Mean RQs and REE (weight adjusted) did not differ between stunted children (SO and S) and non-stunted children (O and NSNO). SO and S children spent more time in sedentary activities than O children (p = 0.01 and p = 0.02, respectively) and less time in moderate-to-vigorous activities than NSNO children (p = 0.05 and p = 0.04, respectively). SO children's diet was less diverse (p = 0.01) with less animal products (p = 0.006). Multiple linear regressions model revealed that birth-weight is predictive of RQ (β = 0.237, p<0.01, R(2) = 0.08).This study showed that growth retardation in stunted-overweight children could be associated with postnatal nutritional deficiencies. Overweight in stunted children could be associated with reduced physical activity in the context of nutrition transition. High birth-weight was a predictor of reduced lipid oxidation, a risk factor of fat deposition

Injection Drug Use Is a Risk Factor for HCV Infection in Urban Egypt

OBJECTIVE: To identify current risk factors for hepatitis C virus (HCV) transmission in Greater Cairo. DESIGN AND SETTING: A 1:1 matched case-control study was conducted comparing incident acute symptomatic hepatitis C patients in two "fever" hospitals of Greater Cairo with two control groups: household members of the cases and acute hepatitis A patients diagnosed at the same hospitals. Controls were matched on the same age and sex to cases and were all anti-HCV antibody negative. Iatrogenic, community and household exposures to HCV in the one to six months before symptoms onset for cases, and date of interview for controls, were exhaustively assessed. RESULTS: From 2002 to 2007, 94 definite acute symptomatic HCV cases and 188 controls were enrolled in the study. In multivariate analysis, intravenous injections (OR = 5.0; 95% CI = 1.2-20.2), medical stitches (OR = 4.2; 95% CI = 1.6-11.3), injection drug use (IDU) (OR = 7.9; 95% CI = 1.4-43.5), recent marriage (OR = 3.3; 95% CI = 1.1-9.9) and illiteracy (OR = 3.9; 95% CI = 1.8-8.5) were independently associated with an increased HCV risk. CONCLUSION: In urban Cairo, invasive health care procedures remain a source of HCV transmission and IDU is an emerging risk factor. Strict application of standard precautions during health care is a priority. Implementation of comprehensive infection prevention programs for IDU should be considered

Elevated rates of horizontal gene transfer in the industrialized human microbiome

Industrialization has impacted the human gut ecosystem, resulting in altered microbiome composition and diversity. Whether bacterial genomes may also adapt to the industrialization of their host populations remains largely unexplored. Here, we investigate the extent to which the rates and targets of horizontal gene transfer (HGT) vary across thousands of bacterial strains from 15 human populations spanning a range of industrialization. We show that HGTs have accumulated in the microbiome over recent host generations and that HGT occurs at high frequency within individuals. Comparison across human populations reveals that industrialized lifestyles are associated with higher HGT rates and that the functions of HGTs are related to the level of host industrialization. Our results suggest that gut bacteria continuously acquire new functionality based on host lifestyle and that high rates of HGT may be a recent development in human history linked to industrialization.Peer reviewe