Trends in, projections of, and inequalities in reproductive, maternal, newborn and child health service coverage in Vietnam 2000-2030: A Bayesian analysis at national and sub-national levels

Background: To assess the reproductive, maternal, newborn and child health (RMNCH) service coverage in Vietnam with trends in 2000-2014, projections and probability of achieving targets in 2030 at national and sub-national levels; and to analyze the socioeconomic, regional and urban-rural inequalities in RMNCH service indicators. Methods: We used national population-based datasets of 44,624 households in Vietnam from 2000 to 2014. We applied Bayesian regression models to estimate the trends in and projections of RMNCH indicators and the probabilities of achieving the 2030 targets. Using the relative index, slope index, and concentration index of inequality, we examined the patterns and trends in RMNCH coverage inequality. Findings: We projected that 9 out of 17 health service indicators (53%) would likely achieve the 2030 targets at the national level, including at least one and four ANC visits, BCG immunization, access to improved water and adequate sanitation, institutional delivery, skilled birth attendance, care-seeking for pneumonia, and ARI treatment. We observed very low coverages and zero chance of achieving the 2030 targets at national and sub-national levels in early initiation and exclusive breastfeeding, family planning needs satisfied, and oral rehydration therapy. The most deprived households living in rural areas and the Northwest, Northeast, North Central, Central Highlands, and Mekong River Delta regions would not reach the 80% immunization coverage of DPT3, Polio3, Measles and full immunization. We found socioeconomic, regional, and urban-rural inequalities in all RMNCH indicators in 2014 and no change in inequalities over 15 years in the lowest-coverage indicators. Interpretation: Vietnam has made substantial progress toward UHC. By improving the government\u27s health system reform efforts, re-allocating resources focusing on people in the most impoverished rural regions, and restructuring and enhancing current health programs, Vietnam can achieve the UHC targets and other health-related SDGs

Flocculation of Reactive Blue 19 (RB19) using Alum and the Effects of Catalysts Addition

There are a variety of primary coagulants which can be used in a water treatment plant. One of the earliest, and still the most extensively used, is aluminum sulfate, also known as alum. Aluminum Sulfate (Alum) is one of the most commonly used flocculent in waste water treatment processes. Effectiveness of Alum in flocculation process is determined by many factors such as the effluents pH, flocculent dose as well as the use of catalyst to improve efficiency rate of flocculation. Hence special attention to these factors especially the use of catalyst has been brought about by this study. Experiments were carried out using Reactive Blue 19 Dye as the contaminant of waste water and two catalysts namely Calcium Hydroxide (CaOH2) and Poly Aluminum Chloride (PACl) were evaluated. The results obtained proved that indeed after addition of catalysts, removal efficiency rates of Alum can be increased up to 25% using Calcium Hydroxide and up to 35% using Poly Aluminum Chloride compared to Alum alone. The optimum conditions for this study were at pH 5.5 ~7.5, 300 mg/L of Alum 30seconds of rapid mixing time with 300 rpm , 30rpm of mixing rate for 5 minutes and 30 minutes of settling time. Moreover, Alum showed the highest performance under these conditions and using 50 mg/L PACl as catalyst with 98.52% of COD reduction and 90.60% of color reduction. In conclusion, Alum with the support of PACl as catalyst is an effective coagulant, which can reduce the level of COD and Dye Color in Reactive Blue 19 contaminated wastewater

Molecular dissection of box jellyfish venom cytotoxicity highlights an effective venom antidote

The box jellyfish Chironex fleckeri is extremely venomous, and envenoming causes tissue necrosis, extreme pain and death within minutes after severe exposure. Despite rapid and potent venom action, basic mechanistic insight is lacking. Here we perform molecular dissection of a jellyfish venom-induced cell death pathway by screening for host components required for venom exposure-induced cell death using genome-scale lenti-CRISPR mutagenesis. We identify the peripheral membrane protein ATP2B1, a calcium transporting ATPase, as one host factor required for venom cytotoxicity. Targeting ATP2B1 prevents venom action and confers long lasting protection. Informatics analysis of host genes required for venom cytotoxicity reveal pathways not previously implicated in cell death. We also discover a venom antidote that functions up to 15 minutes after exposure and suppresses tissue necrosis and pain in mice. These results highlight the power of whole genome CRISPR screening to investigate venom mechanisms of action and to rapidly identify new medicines

Cysteine aminoethylation enables the site-specific glycosylation analysis of recombinant human erythropoietin using trypsin

Recombinant human erythropoietin (rhEPO) is an important biopharmaceutical for which glycosylation is a critical quality attribute. Therefore, robust analytical methods are needed for the in-depth characterization of rhEPO glycosylation. Currently, the protease GluC is widely established for the site-specific glycosylation analysis of rhEPO. However, this enzyme shows disadvantages, such as its specificity and the characteristics of the resulting (glyco)peptides. The use of trypsin, the gold standard protease in proteomics, as the sole protease for rhEPO is compromised, as no natural tryptic cleavage site is located between the glycosylation sites Asn24 and Asn38. Here, cysteine aminoethylation using 2-bromoethylamine was applied as an alternative alkylation strategy to introduce artificial tryptic cleavage sites at Cys29 and Cys33 in rhEPO. The (glyco)peptides resulting from a subsequent digestion using trypsin were analyzed by reverse-phase liquid chromatography-mass spectrometry. The new trypsin-based workflow was easily implemented by adapting the alkylation step in a conventional workflow and was directly compared to an established approach using GluC. The new method shows an improved specificity, a significantly reduced chromatogram complexity, allows for shorter analysis times, and simplifies data evaluation. Furthermore, the method allows for the monitoring of additional attributes, such as oxidation and deamidation at specific sites in parallel to the site-specific glycosylation analysis of rhEPO.Proteomic

Biological dosimetry after radiosynoviorthesis with rhenium-186 sulphide and erbium-169 citrate

Zur Abschätzung der radiobiologischen Sicherheit des Verfahrens wird in dieser Arbeit die Radiosynoviorthese (RSO) mit Re-186 und Er-169 hinsichtlich biologischer Strahleneffekte untersucht. Bei 23 Patienten wurde eine RSO mit Rhenium-186-Sulfid- (10 Patienten) oder Erbium-169-Zitratkolloid (13 Patienten) durchgeführt. Das behandelte Gelenk wurde anschließend ruhig gestellt. Bei allen Patienten erfolgte vor und 17–19 Tage (Re-186) bzw. 45–50 Tage (Er-169) nach der RSO eine venöse Blutentnahme. Zur Analyse der Strahlenexposition wurde die Häufigkeit von dizentrischen Chromosomen in Lymphozyten der ersten Zellteilung in vitro bestimmt. Pro Patient wurden mindestens 1000 Zellen vor und nach der RSO untersucht, was nach längerer Einwirkung niederenergetischer Strahlung ausreichend ist, um im bestrahlten Kollektiv die im Rahmen der RSO erwarteten Strahlendosen nachzuweisen. Ergänzend wurde bei den mit Re-186 behandelten Patienten der Aktivitätsabtransport aus dem Gelenk mittels Ganzkörperszintigraphie bestimmt. In der Untersuchung von insgesamt 47017 Zellen fanden sich vor RSO mit Re-186 bzw. Er-169 40 bzw. 88, danach 59 bzw. 105 dizentrische Chromosomen in Lymphozyten des peripheren Blutes. Eine signifikante Zunahme der dizentrischen Chromosomen nach der RSO zeigte sich nicht. Der Aktivitätsabtransport nach RSO mit Re-186 lag durchschnittlich unter 5 % (unter 3 MBq) und ist damit als gering einzustufen. Die Ergebnisse der Untersuchung von Chromosomenaberrationen und des Aktivitätsabtransports nach Radiosynoviorthese mit Rhenium-186 und Erbium-169 sprechen für eine geringe Strahlenexposition der Patienten und damit für die Sicherheit des Verfahrens.The aim of the present studies was to investigate the biological radiation effect of radiosynoviorthesis (RSO) with Re-186 and Er-169 in order to evaluate the safety of this procedure. RSO with rhenium-186 sulfide colloid (10 patients) or erbium-169 citrate colloid (13 patients) was carried out in a total of 23 patients. Afterwards, the treated joint was immobilised for three days using splints. From all patients, blood was drawn immediately before and 17 to 19 days (Re-186) or 45 to 50 days (Er-169) after RSO. To evaluate the radiation dose, the yield of dicentric chromosomes in lymphocytes was determined exclusively in metaphases of the first cell cycle in vitro. At least 1000 cells per patient have been analysed before and after RSO which is sufficient to find potential radiation effects after long-term exposure to low energy radiation such as to expect after RSO. In addition, for Re-186 the activity leakage from the treated joint was measured by whole-body scintigraphy. In a total of 47017 cells analysed from 46 blood samples, 40 and 88 before and 59 and 105 dicentrics after RSO with Re-186 and Er-169 were found. This showed no statistically significant increase in the number of dicentric chromosomes. The measured average activity leakage of less than 5 % (less than 3 MBq) was considered to be low. The results of chromosome analysis and activity measurement after RSO prove that this procedure is associated with a low effective dose in treated patients and thus can be considered a safe treatment

Tear fluid biomarkers in ocular and systemic disease: potential use for predictive, preventive and personalised medicine

In the field of predictive, preventive and personalised medicine, researchers are keen to identify novel and reliable ways to predict and diagnose disease, as well as to monitor patient response to therapeutic agents. In the last decade alone, the sensitivity of profiling technologies has undergone huge improvements in detection sensitivity, thus allowing quantification of minute samples, for example body fluids that were previously difficult to assay. As a consequence, there has been a huge increase in tear fluid investigation, predominantly in the field of ocular surface disease. As tears are a more accessible and less complex body fluid (than serum or plasma) and sampling is much less invasive, research is starting to focus on how disease processes affect the proteomic, lipidomic and metabolomic composition of the tear film. By determining compositional changes to tear profiles, crucial pathways in disease progression may be identified, allowing for more predictive and personalised therapy of the individual. This article will provide an overview of the various putative tear fluid biomarkers that have been identified to date, ranging from ocular surface disease and retinopathies to cancer and multiple sclerosis. Putative tear fluid biomarkers of ocular disorders, as well as the more recent field of systemic disease biomarkers, will be shown

Community evaluation of glycoproteomics informatics solutions reveals high-performance search strategies for serum glycopeptide analysis

Glycoproteomics is a powerful yet analytically challenging research tool. Software packages aiding the interpretation of complex glycopeptide tandem mass spectra have appeared, but their relative performance remains untested. Conducted through the HUPO Human Glycoproteomics Initiative, this community study, comprising both developers and users of glycoproteomics software, evaluates solutions for system-wide glycopeptide analysis. The same mass spectrometrybased glycoproteomics datasets from human serum were shared with participants and the relative team performance for N- and O-glycopeptide data analysis was comprehensively established by orthogonal performance tests. Although the results were variable, several high-performance glycoproteomics informatics strategies were identified. Deep analysis of the data revealed key performance-associated search parameters and led to recommendations for improved 'high-coverage' and 'high-accuracy' glycoproteomics search solutions. This study concludes that diverse software packages for comprehensive glycopeptide data analysis exist, points to several high-performance search strategies and specifies key variables that will guide future software developments and assist informatics decision-making in glycoproteomics

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks