Health of conflict-affected children in South Sudan. Children's roles, skills and competencies in identifying health threats, proposing solutions and implementing action

ABSTRACT Background: This research was conducted in 2010, in Akobo County, Jonglei State, South Sudan, a region with a long history of inter-ethnic conflict. Consideration of children in situations of armed conflict tends to focus on their protection and frequently portrays children as passive victims. Previous research and evaluations of child participatory programming, however, provide powerful testimonies as to the capacities and desire of children to be more involved. The aim of this research was to explore children’s health needs from a child perspective and to determine existing and potential opportunities and challenges for children to participate in health decision making. Methodology: This research uses qualitative and quantitative methods for different but well defined purposes within the same overall research project. Qualitative methods including interviews, focus group discussions, non-participant observations and workshops were used to explore knowledge and perspectives related to children’s health needs, children’s risk exposure and available means of protection as well as children’s roles, skills and capabilities to engage in decision making. Subsequently, a cross sectional mental health survey was conducted to investigate exposure to traumatic events, Post-traumatic Stress Disorder (PTSD), anxiety and depression using the Harvard Trauma Questionnaire (HTQ) and the Hopkins Symptom Checklist (HSCL-25). Positive outcomes were identified using the Post-traumatic Growth Inventory (PTGI). Multivariate linear regression analysis was used to define associations between variables. Results: One hundred and forty-four children aged 7-18, 88 adult community members and 20 staff of service providers participated in the qualitative study. Psychological distress was identified as the main perceived health threat and as a potential challenge to children’s participation. The qualitative findings further illustrate children’s suffering, but also the resilience and adaptability of children affected by armed conflict and their capacity and motivation to contribute and take action to improve their everyday life. Adult community members showed a high level of trust and belief in children’s strength, ability and willingness to address issues, take risks and make decisions. At the same time, adults voiced great concerns about losing authority and control over their children if children were given more rights. Interviews with service providers showed that half of them had consulted with children at some point during program implementation. A higher degree of children’s participation, where children have the initial idea and decide how the project is to be carried out, with adults available but not taking charge, was found to be an issue of concern to child mandated agencies alone. Three hundred and fifty-three children aged 12-18 participated in the cross-sectional mental health survey. The survey findings showed a high prevalence of experienced traumas and adverse mental health outcomes: 64.5% of the children met symptom criteria for PTSD, 72.2% of the children met symptom criteria for anxiety and 65.4% of the children met symptom criteria for depression. Linear regression analysis showed statistically significant relationships between orphan hood (

2019 European Thyroid Association Guidelines on the Management of Thyroid Dysfunction following Immune Reconstitution Therapy.

Thyroid dysfunction (TD) frequently occurs as an autoimmune complication of immune reconstitution therapy (IRT), especially in individuals with multiple sclerosis treated with alemtuzumab, a pan-lymphocyte depleting drug with subsequent recovery of immune cell numbers. Less frequently, TD is triggered by highly active antiretroviral therapy (HAART) in patients infected with human immunodeficiency virus (HIV), or patients undergoing bone-marrow/hematopoietic-stem-cell transplantation (BMT/HSCT). In both alemtuzumab-induced TD and HIV/HAART patients, the commonest disorder is Graves' disease (GD), followed by hypothyroidism and thyroiditis; Graves' orbitopathy is observed in some GD patients. On the contrary, GD is rare post-BMT/HSCT, where hypothyroidism predominates probably as a consequence of the associated radiation damage. In alemtuzumab-induced TD, the autoantibodies against the thyrotropin receptor (TRAb) play a major role, and 2 main aspects distinguish this condition from the spontaneous form: (1) up to 20% of GD cases exhibit a fluctuating course, with alternating phases of hyper- and hypothyroidism, due to the coexistence of TRAb with stimulating and blocking function; (2) TRAb are also positive in about 70% of hypothyroid patients, with blocking TRAb responsible for nearly half of the cases. The present guidelines will provide up-to-date recommendations and suggestions dedicated to all phases of IRT-induced TD: (1) screening before IRT (recommendations 1-3); (2) monitoring during/after IRT (recommendations 4-7); (3) management of TD post-IRT (recommendations 8-17). The clinical management of IRT-induced TD, and in particular GD, can be challenging. In these guidelines, we propose a summary algorithm which has particular utility for nonspecialist physicians and which is tailored toward management of alemtuzumab-induced TD. However, we recommend prompt referral to specialist endocrinology services following diagnosis of any IRT-induced TD diagnosis, and in particular for pregnant women and those considering pregnancy

Activités Antiproliférative et Antiradicalaire d’extraits Aqueux de Quatre Plantes Médicinales Congolaises

Le but de ce travail est d’évaluer les propriétés antiproliférative et antiradicalaire des extraits aqueux de quatre plantes médicinales congolaises dont Morinda lucida, Klainedoxa gabonensis, Tephrosia vogelii et Nauclea latifolia. L’activité antiproliférative de l’extrait aqueux de chacune des quatre espèces a été évaluée in vitro sur une lignée cellulaire cancéreuse (U87-MG) et une lignée cellulaire normale (Hek-293) en utilisant le test MTT. L’activité antiradicalaire a été évaluée en mesurant la capacité de piégeage du radical DPPH. Des analyses phytochimiques des extraits ont été réalisées par chromatographie sur couche mince et par HPLC-PDA. Les extraits aqueux de Klainedoxa gabonenis et de Tephrosia vogelii ont montré une activité antiproliférative contre les cellules cancéreuses U87-MG avec des valeurs de CI50 inférieures à 90 μg/ml. L’extrait aqueux de Klainedoxa gabonenis a montré également une activité antiradicalaire remarquable (CI50 = 4 ± 0,73 μg/ml) .En plus, le traitement des cellules cancéreuses U87-MG à la fois par l’extrait aqueux de Klainedoxa gabonensis (100 μg/ml) et par un inhibiteur de la protéine MEK (1μM) provoque une suppression totale de la prolifération des cellules U87-MG (glioblastome). L’analyse en HPLC–PDA de l’extrait aqueux Klainedoxa gabonenis a montré la présence des composés de type acide gallique (41, 9 %) et quercétine (2,17 %). Notre étude a permis d’identifier deux plantes médicinales aux propriétés antiprolifératives parmi les quatre plantes médicinales congolaises évaluées dont une possédant à la fois les propriétés antiproliférative et antiradicalaire. The purpose of this work is to evaluate antiprolifertive and DPPH radical scavenging activities of aqueous extracts from Morinda lucida Smith, Klainedoxa gabonensis Pierre ex Engl, Tephrosia vogelii Hook f and Nauclea latifolia Sm. The antiproliferative activity of the aqueous extract of each of the four species was evaluated in vitro on a cancer cell line (U87-MG) and a normal cell line (Hek-293) using the MTT assay. The antiradicalar activity was evaluated by measuring the scavenger capacity of the DPPH radical. Phytochemical analyzes of the extract were performed by thin layer chromatography and HPLC-PDA. The aqueous extracts of Klainedoxa gabonenis and Tephrosia vogelii showed antiproliferative activity against U87-MG cancer cells with IC50 values below 90 μg / ml. The aqueous extract of Klainedoxa gabonenis also showed remarkable antiradical activity (IC50 = 4± 0,73 μg/ml). In addition, the treatment of U87-MG cancer cells by both the aqueous extract of Klainedoxa gabonensis (100 μg / ml) and by an MEK protein inhibitor (1 μM) causes a total suppression of U87-cell proliferation. MG (glioblastoma). HPLC-PDA analysis of the aqueous extract Klainedoxa gabonenis showed the presence of gallic acid compounds (41.9%) and Quercetin (2.17%).: Our study identified two medicinal plants with antiproliferative properties among the four Congolese herbal medicines evaluated, one with both anti-proliferative and antiradical properties

Gene Birth, Death, Modification, Poaching, Crippling, Dimorphism and Culling: The Challenge for Genomics

This brief survey covers the main events in the evolution of eukaryotic genes in broad brush style. It concentrates on regulatory DNA, an area that has been relatively neglected, and where we believe that the present case-by-case analysis is likely to be supplemented by more general, genomics-based methods. It is biased towards immunology, in part because the immune system relies heavily on polymorphism of regulatory DNA to provide flexibility and in part because of our own field of interest. It gives a central place to recent work that has shown how analysis of electronic genomes can be used to trace gene duplication and its consequences. It mentions cellular systems that offer models for the study of evolution of regulatory DNA on a small scale. It alludes to the unanswered question of how genomes adjust their overall size

2019 European thyroid association guidelines on the management of thyroid dysfunction following immune reconstitution therapy

Thyroid dysfunction (TD) frequently occurs as an autoimmune complication of immune reconstitution therapy (IRT), especially in individuals with multiple sclerosis treated with alemtuzumab, a pan-lymphocyte depleting drug with subsequent recovery of immune cell numbers. Less frequently, TD is triggered by highly active antiretroviral therapy (HAART) in patients infected with human immunodeficiency virus (HIV), or patients undergoing bone-marrow/hematopoietic-stem-cell transplantation (BMT/HSCT). In both alemtuzumab-induced TD and HIV/HAART patients, the commonest disorder is Graves’ disease (GD), followed by hypothyroidism and thyroiditis; Graves’ orbitopathy is observed in some GD patients. On the contrary, GD is rare post-BMT/HSCT, where hypothyroidism predominates probably as a consequence of the associated radiation damage. In alemtuzumab-induced TD, the autoantibodies against the thyrotropin receptor (TRAb) play a major role, and 2 main aspects distinguish this condition from the spontaneous form: (1) up to 20% of GD cases exhibit a fluctuating course, with alternating phases of hyper- and hypothyroidism, due to the coexistence of TRAb with stimulating and blocking function; (2) TRAb are also positive in about 70% of hypothyroid patients, with blocking TRAb responsible for nearly half of the cases. The present guidelines will provide up-to-date recommendations and suggestions dedicated to all phases of IRT-induced TD: (1) screening before IRT (recommendations 1–3); (2) monitoring during/after IRT (recommendations 4–7); (3) management of TD post-IRT (recommendations 8–17). The clinical management of IRT-induced TD, and in particular GD, can be challenging. In these guidelines, we propose a summary algorithm which has particular utility for nonspecialist physicians and which is tailored toward management of alemtuzumab-induced TD. However, we recommend prompt referral to specialist endocrinology services following diagnosis of any IRT-induced TD diagnosis, and in particular for pregnant women and those considering pregnancy

The G-protein–gated K+ channel, IKACh, is required for regulation of pacemaker activity and recovery of resting heart rate after sympathetic stimulation

Parasympathetic regulation of sinoatrial node (SAN) pacemaker activity modulates multiple ion channels to temper heart rate. The functional role of the G-protein–activated K+ current (IKACh) in the control of SAN pacemaking and heart rate is not completely understood. We have investigated the functional consequences of loss of IKACh in cholinergic regulation of pacemaker activity of SAN cells and in heart rate control under physiological situations mimicking the fight or flight response. We used knockout mice with loss of function of the Girk4 (Kir3.4) gene (Girk4−/− mice), which codes for an integral subunit of the cardiac IKACh channel. SAN pacemaker cells from Girk4−/− mice completely lacked IKACh. Loss of IKACh strongly reduced cholinergic regulation of pacemaker activity of SAN cells and isolated intact hearts. Telemetric recordings of electrocardiograms of freely moving mice showed that heart rate measured over a 24-h recording period was moderately increased (10%) in Girk4−/− animals. Although the relative extent of heart rate regulation of Girk4−/− mice was similar to that of wild-type animals, recovery of resting heart rate after stress, physical exercise, or pharmacological β-adrenergic stimulation of SAN pacemaking was significantly delayed in Girk4−/− animals. We conclude that IKACh plays a critical role in the kinetics of heart rate recovery to resting levels after sympathetic stimulation or after direct β-adrenergic stimulation of pacemaker activity. Our study thus uncovers a novel role for IKACh in SAN physiology and heart rate regulation

Contribution to van der Waerden's conjecture

AbstractIn this paper, we give two different elementary proofs for the inequality which states that the permanent of doubly stochastic matrices is greater than or equal to (n!/nn). This inequality was proved earlier by the author, and independently by Egorychev and Falikman

In situ targeted activation of an anticancer agent using ultrasound-triggered release of composite droplets

International audienc

The effect of cartilage and bone density of mushroom-shaped, photooxidized, osteochondral transplants: an experimental study on graft performance in sheep using transplants originating from different species

BACKGROUND: Differences in overall performance of osteochondral photooxidized grafts were studied in accordance of their species origin and a new, more rigorous cleansing procedure using alcohol during preparation. METHODS: Photooxidized mushroom-shaped grafts of bovine, ovine, human and equine origin were implanted in the femoral condyles of 32 sheep (condyles: n = 64). No viable chondrocytes were present at the time of implantation. Grafts were evaluated at 6 months using plastic embedded sections of non-decalcified bone and cartilage specimens. Graft incorporation, the formation of cyst-like lesions at the base of the cartilage junction as well as cartilage morphology was studied qualitatively, semi-quantitatively using a score system and quantitatively by performing histomorphometrical measurements of percentage of bone and fibrous tissue of the original defects. For statistical analysis a factorial analysis of variance (ANOVA- test) was applied. RESULTS: Differences of graft performance were found according to species origin and cleansing process during graft preparation. According to the score system cartilage surface integrity was best for equine grafts, as well as dislocation or mechanical stability. The equine grafts showed the highest percentage for bone and lowest for fibrous tissue, resp. cystic lesions. The new, more rigorous cleansing process decreased cartilage persistence and overall graft performance. CONCLUSION: Performance of grafts from equine origin was better compared to bovine, ovine and human grafts. The exact reason for this difference was not proven in the current study, but could be related to differences in density of cartilage and subchondral bone between species