Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015 : a novel analysis from the Global Burden of Disease Study 2015

Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r= 0.88), an index of 11 universal health coverage interventions (r= 0.83), and human resources for health per 1000 (r= 0.77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28.6 to 94.6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40.7 (95% uncertainty interval, 39.0-42.8) in 1990 to 53.7 (52.2-55.4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21.2 in 1990 to 20.1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73.8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-systemcharacteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe

In vitro screening, homology modeling and molecular docking studies of some pyrazole and imidazole derivatives

International audienceA series of synthesized compounds based on pyrazole and imidazole skeletons prepared by palladium catalysts via a one-pot reaction was screened to determine their inhibitory potency against the pathogen fungus Fusarium oxysporum f.sp. albedinis (F.o.a) and four bacteria strains namely Micrococcus luteus, Bacillus subtilis, Staphylococcus aureus and Escherichia coli. The obtained result showed that these compounds exhibit an efficiency antifungal action. Whereas, they showed a very weak antibacterial activity. The structure-activity relationship (SAR) Analysis and lipophilicity study demonstrates the presence of a strong relation between the structure of the ligands and the antifungal activity. On the other hand, a homology modeling and molecular docking study was carried out on the most active compounds against F.o.a fungus, in order to understand and determine the molecular interactions taking place between the ligand and the corresponding receptor of the studied target

A NEW C,C-LINKED FUNCTIONALIZED BIPYRAZOLE: SYNTHESIS, CRYSTAL STRUCTURE, SPECTROSCOPIES AND DFT STUDIES. EVALUATION OF THE ANTIBACTERIAL ACTIVITY AND CATALYTIC PROPERTIES

International audienceThe synthesis of new C,C-linked functionalized bipyrazole is reported. Its molecular structure has been confirmed by spectroscopic and spectrometric methods and its single crystal structure determined by X-ray analysis. The ligand 2 has been subjected to DFT and TD-DFT theoretical calculations and results are consistent with the experimental chemical analyses. The compound possesses no antibacterial activity up to 256 g/mL. However, its complexes with copper(II) salts are found to be good catalysts for the oxidation of 3,5-di-tert-butylcatechol (DTBC) into 3,5-di-tert-butylquinone (DTBQ) with a rate varying from 9.58 μmol• L-1• min-1 for the 2-[Cu(MeCO2)2] complex to 5.27 μmol• L-1• min-1 for the 2-[Cu(BF4)2] complex

Characterization and Antimicrobial Activity of Nigella sativa Extracts Encapsulated in Hydroxyapatite Sodium Silicate Glass Composite

N. sativa is an interesting source of bioactive compounds commonly used for various therapeutic purposes. Associate its seeds extracts with biomaterials to improve their antimicrobial properties are highly demanded. This study aims to investigate the encapsulation of NS extracts in hydroxyapatite nanoparticle sodium silicate glass (nHap/SSG) scaffold. NS essential oil (HS) was extracted by hydrodistillation, while hexane (FH) and acetone extracts (FA) were obtained using Soxhlet extraction. (FH) was the most abundant (34%) followed by (FA) (2.02%) and (HS) (1.2%). GC-MS chromatography showed that the (HS) contained beta cymene, alpha thujene, β-pinene and thymoquinone, while (FH) had mostly fatty acids and (FA) decane, 2.9-dimethyl, benzene 1,3,3-trimethylnonyl and beta cymene. Loaded nHap/SGG scaffolds with various amount of (FH), (HS) and (FA) at 1.5, 3, and 6 wt%; were elaborated then characterized by ATR-FTIR, X-ray and SEM techniques and their antimicrobial activity was studied. Samples loaded with 1.5 wt% HE was highly active against C. albicans (19 mm), and at 3 wt% on M. luteus (20 mm) and S. aureus (20 mm). Additionally, loaded scaffolds with 1.5 wt% AE had an important activity against M. luteus (18.9 mm) and S. aureus (19 mm), while the EO had low activities on all bacterial strains. The outcome of this finding indicated that loaded scaffolds demonstrated an important antimicrobial effect that make them promising materials for a wide range of medical applications

By-Products of Olive Oil in the Service of the Deficiency of Food Antioxidants: The Case of Butter

Further downstream in the olive oil extraction process, the Mediterranean Basin faces a serious environmental threat caused by olive waste. Despite their polluting profile, olive waste is considered to be a very rich source of natural antioxidants, such as polyphenols. In this study, the latter was valued as a source of natural antioxidants and compared with a synthetic antioxidant ascorbic acid. Concentrations of 2, 4, 6, and 8 mg of the olive mill waste water as well as pomace and ascorbic acid are added to butter (commercial butter) and placed under storage conditions in the oven (accelerated test: 60°C) for 3 months. The alteration of the butter used was followed by determination of the peroxide value and acidity and microbiological analysis. The results obtained show that butters containing olive by-products have undergone less marked oxidative deterioration than those of the control (without additives). The best oxidative stability of butter was achieved by adding 80 mg/kg of butter, a result comparable with that obtained by adding ascorbic acid

IN VITRO BIODEGRADATION OF OLEUROPEIN BY LACTOBACILLUS PLANTARUM FSO175 IN STRESS CONDITIONS (pH, NaCl AND GLUCOSE)

International audienceThe objective of this work is to study the oleuropein (OLP) biodegradation by a strain of Lactobacillus plantarum FSO175 under conditions (pH 4.5, NaCl 5% and glucose 1%), during 7 days of incubation at 30 °C, in modified MRS broth containing OLP as carbon source. The results obtained, by HPLC analyses, showed that the biodegradation of OLP by L. plantarum FSO175, is accompanied with increase of hydroxytyrosol (HT) content and acidity values. The yields of OLP degradation and HT accumulation are depending on carbon sources, stress conditions and time of incubation. So that, the drastic reduction in OLP biodegradation, obtained at pH 6.7 (trial B), decreased significantly (p <0.05) in presence of NaCl 5% (trial D) and with glucose 1% (trial C). Indeed, the OLP biodegradation rate was maximal at pH 4.5 (trial E) and was higher even with NaCl 5% (trial F). In contrast, in presence of combined stress conditions (glucose 1%, pH 4.5 and NaCl 5%: trial G), the biodegradation of OLP decreased significantly (p <0.05). The effectiveness of the strain L. plantarum FSO175 in OLP biodegradation leading to variable yields of HT production, revealed its promising perspectives as starter culture, under controlled stress conditions of pH 4.5 and NaCl 5%, allowing the production of green table olives rich of HT, the main antioxidant highly desired in foods