Low knowledge of newborn danger signs among pregnant women in Papua New Guinea and implications for health seeking behaviour in early infancy – findings from a longitudinal study

Background: Globally, 2.5 million babies die in the first 28 days of life each year with most of these deaths occurring in low- and middle-income countries. Early recognition of newborn danger signs is important in prompting timely care seeking behaviour. Little is known about women’s knowledge of newborn danger signs in Papua New Guinea. This study aims to assess this knowledge gap among a cohort of women in East New Britain Province. Methods: This study assessed knowledge of newborn danger signs (as defined by the World Health Organization) at three time points from a prospective cohort study of women in East New Britain Province, factors associated with knowledge of danger signs after childbirth were assessed using logistic regression. This study includes quantitative and qualitative interview data from 699 pregnant women enrolled at their first antenatal clinic visit, followed up after childbirth (n = 638) and again at one-month post-partum (n = 599). Results: Knowledge of newborn danger signs was very low. Among the 638 women, only 9.4% knew three newborn danger signs after childbirth and only one knew all four essential danger signs defined by Johns Hopkins University ‘Birth Preparedness and Complication Readiness’ Index. Higher knowledge scores were associated with higher gravidity, income level, partner involvement in antenatal care, and education. Conclusion: Low levels of knowledge of newborn danger signs among pregnant women are a potential obstacle to timely care-seeking in rural Papua New Guinea. Antenatal and postnatal education, and policies that support enhanced education and decision-making powers for women and their families, are urgently needed

Septic Shock: A Genomewide Association Study and Polygenic Risk Score Analysis.

Previous genetic association studies have failed to identify loci robustly associated with sepsis, and there have been no published genetic association studies or polygenic risk score analyses of patients with septic shock, despite evidence suggesting genetic factors may be involved. We systematically collected genotype and clinical outcome data in the context of a randomized controlled trial from patients with septic shock to enrich the presence of disease-associated genetic variants. We performed genomewide association studies of susceptibility and mortality in septic shock using 493 patients with septic shock and 2442 population controls, and polygenic risk score analysis to assess genetic overlap between septic shock risk/mortality with clinically relevant traits. One variant, rs9489328, located in AL589740.1 noncoding RNA, was significantly associated with septic shock (p = 1.05 × 10-10); however, it is likely a false-positive. We were unable to replicate variants previously reported to be associated (p < 1.00 × 10-6 in previous scans) with susceptibility to and mortality from sepsis. Polygenic risk scores for hematocrit and granulocyte count were negatively associated with 28-day mortality (p = 3.04 × 10-3; p = 2.29 × 10-3), and scores for C-reactive protein levels were positively associated with susceptibility to septic shock (p = 1.44 × 10-3). Results suggest that common variants of large effect do not influence septic shock susceptibility, mortality and resolution; however, genetic predispositions to clinically relevant traits are significantly associated with increased susceptibility and mortality in septic individuals

Are hygiene and public health interventions likely to improve outcomes for Australian Aboriginal children living in remote communities? A systematic review of the literature

Background Australian Aboriginal children living in remote communities still experience a high burden of common infectious diseases which are generally attributed to poor hygiene and unsanitary living conditions. The objective of this systematic literature review was to examine the epidemiological evidence for a relationship between various hygiene and public health intervention strategies, separately or in combination, and the occurrence of common preventable childhood infectious diseases. The purpose was to determine what intervention/s might most effectively reduce the incidence of skin, diarrhoeal and infectious diseases experienced by children living in remote Indigenous communities. Methods Studies were identified through systematically searching electronic databases and hand searching. Study types were restricted to those included in Cochrane Collaboration Effective Practice and Organisation of Care Review Group (EPOC) guidelines and reviewers assessed the quality of studies and extracted data using the same guidelines. The types of participants eligible were Indigenous populations and populations of developing countries. The types of intervention eligible for inclusion were restricted to those likely to prevent conditions caused by poor personal hygiene and poor living environments. Results The evidence showed that there is clear and strong evidence of effect of education and handwashing with soap in preventing diarrhoeal disease among children (consistent effect in four studies). In the largest well-designed study, children living in households that received plain soap and encouragement to wash their hands had a 53% lower incidence of diarrhoea (95% CI, 0.35, 0.59). There is some evidence of an effect of education and other hygiene behaviour change interventions (six studies), as well as the provision of water supply, sanitation and hygiene education (two studies) on reducing rates of diarrhoeal disease. The size of these effects is small and the quality of the studies generally poor. Conclusion Research which measures the effectiveness of hygiene interventions is complex and difficult to implement. Multifaceted interventions (which target handwashing with soap and include water, sanitation and hygiene promotion) are likely to provide the greatest opportunity to improve child health outcomes in remote Indigenous communities

The role of in hospite zooxanthellae photophysiology and reef chemistry on elevated pCO2 effects in two branching Caribbean corals: Acropora cervicornis and Porites divaricata

Previous studies suggest uniform reductions in coral calcification under ocean acidification (OA); however, greater tolerance has been observed under natural diel metabolic signals present on reefs. In addition, few studies have examined the role of in hospite zooxanthellae energetics on coral OA tolerance. In this study, we examined zooxanthellae photosynthesis and coral calcification responses using seawater with natural metabolic dissolved inorganic carbon (DIC) dynamics from a fringing back reef on Little Cayman Island, Caribbean. The experimental design included Acropora cervicornis and Porites divaricata microcolonies grown in continuously flowing seawater with (∼1000 matm) and without (∼500 matm) CO2 enrichment to year 2100 predicted levels. Calcification rates were measured weekly, while linear extension and zooxanthellae photosynthesis were determined at the termination of the 28 d experiment. Results showed A. cervicornis microcolonies maintained both photosynthesis and calcification under elevatedCO2 partial pressure (pCO2) relative to controls.However, photosynthesis and calcification rates of P. divaricata microcolonies were reduced by ∼80 and 20%, respectively, under relatively high [DIC]:[H+] ratios and aragonite saturation states (Ωarag). Porites divaricata calcification response to elevated pCO2 was linked to photophysiological dysfunction of the algal symbiont, an indicator that this species was metabolically depressed under elevated pCO2. In contrast to calcification, linear extension rates were unaffected by pCO2 in both species. Future studies should investigate how elevated pCO2 may compromise zooxanthellae-coral interactions with an emphasis on DIC uptake pathways

Fryns syndrome associated with recessive mutations in PIGN in two separate families

Fryns syndrome is an autosomal recessive condition characterized by congenital diaphragmatic hernia (CDH), dysmorphic facial features, distal digital hypoplasia, and other associated malformations, and is the most common syndromic form of CDH. No gene has been associated with this condition. Whole-exome sequence data from two siblings and three unrelated individuals with Fryns syndrome were filtered for rare, good quality, coding mutations fitting a recessive inheritance model. Compound heterozygous mutations in <i>PIGN</i> were identified in the siblings, with appropriate parental segregation: a novel STOP mutation (c.1966C>T: p.Glu656X) and a rare (minor allele frequency <0.001) donor splice site mutation (c.1674+1G>C) causing skipping of exon 18 and utilization of a cryptic acceptor site in exon 19. A further novel homozygous STOP mutation in <i>PIGN</i> (c.694A>T: p.Lys232X) was detected in one unrelated case. All three variants affected highly conserved bases. The two remaining cases were negative for <i>PIGN</i> mutations. Mutations in <i>PIGN</i> have been reported in cases with multiple congenital anomalies, including one case with syndromic CDH. Fryns syndrome can be caused by recessive mutations in <i>PIGN</i>. Whether <i>PIGN</i> affects other syndromic and non-syndromic forms of CDH warrants investigation

Impact of donor-acceptor functionalization on the properties of linearly π-conjugated oligomers: establishing quantitative relationships for the substituent and substituent cooperative effect based on quantum chemical calculations

To understand better the impact of donor-acceptor substitution on the properties of linearly π-conjugated compounds, we performed a computational study on a series of variably substituted trans-polyacetylenes, polyynes, and polythiophenes. The focus of this work is on how rapidly the impact of a given substituent or a given combination of substituents vanishes along the π-conjugated chain. The response of the structural (bond-length alternation, rotational barrier) and molecular properties ((hyper)polarizability, chemical shift) to substitution is analyzed using different protocols, including a superposition model for the evaluation of the cooperative effect of substituents in homo- and heterosubstituted oligomers. With the exception of the (hyper)polarizability, the impact of donor-acceptor substitution is found to vanish following an exponential. The rate of decay of the substituent impact is found to be characteristic for each backbone, whereas the choice of substituent determines the absolute value of the respective property. The combination of substituents is shown to determine whether the substituent cooperative effect on a property is of an enhancing or damping nature. The rate of decay of the cooperative effect on most properties, including the (hyper)polarizability, is also found to follow an exponential law