Development of Inflammatory Bowel Disease in HIV Patients:A Danish Cohort Study (1983-2018) With American Validation (1999-2018)

BACKGROUND AND AIMS: Human immunodeficiency virus (HIV) infection is associated with several immune-mediated disorders. However, the risk of inflammatory bowel disease (IBD) in people living with HIV (PLWH) remains unclear. We aimed to assess the risk of IBD among PLWH using a nationwide, population-based Danish cohort and to validate findings in a large American insurance-based database. METHODS: Using Danish registries (1983–2018), we identified 8995 PLWH and age- and sex-matched them to 449,750 HIV-negative individuals. Cox regression analysis was undertaken to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for IBD diagnosis. Results were stratified by sex, age, and year of HIV diagnosis. Using an American insurance-based cohort, Explorys (1999–2018), we assessed the prevalence odds ratio (OR) and 95% CI of IBD diagnosis in PLWH compared with HIV-negative individuals. RESULTS: IBD diagnosis among PLWH in Denmark was increased (HR: 2.25, 95% CI: 1.78–2.83) compared with matched HIV-negative individuals. This was seen for both Crohn’s disease (HR: 2.25, 95% CI: 1.47–3.44) and ulcerative colitis (HR: 2.24, 95% CI: 1.70–2.96) and in male (HR: 2.75, 95% CI: 2.15–3.52) but not female (HR: 0.93, 95% CI: 0.48–1.79) PLWH. Explorys analysis also showed an increased odds of IBD diagnoses among PLWH (OR: 1.41; 95% CI: 1.35–1.49). CONCLUSION: This study finds an increased risk of IBD diagnosis among PLWH in both a Danish and US cohort, highlighting a need to consider IBD in PLWH with new-onset gastrointestinal symptoms. Further research into the role of antiretroviral therapy in this relationship is required

Improvements in Multicarrier Modulation Systems using a Wavelet OFDM Scheme

yesThis paper investigates the performance of wavelet OFDM signals over a wireless communications link. The scheme is shown to be generally similar to Fourier based OFDM, but with some additional features, and improved characteristics. The sensitivity of both schemes to the nonlinear amplification in the transmitter is compared by monitoring the time domain output data and the adjacent channel power ratio (ACPR) performance

Anti-cancer effects and mechanism of actions of aspirin analogues in the treatment of glioma cancer

INTRODUCTION: In the past 25 years only modest advancements in glioma treatment have been made, with patient prognosis and median survival time following diagnosis only increasing from 3 to 7 months. A substantial body of clinical and preclinical evidence has suggested a role for aspirin in the treatment of cancer with multiple mechanisms of action proposed including COX 2 inhibition, down regulation of EGFR expression, and NF-κB signaling affecting Bcl-2 expression. However, with serious side effects such as stroke and gastrointestinal bleeding, aspirin analogues with improved potency and side effect profiles are being developed. METHOD: Effects on cell viability following 24 hr incubation of four aspirin derivatives (PN508, 517, 526 and 529) were compared to cisplatin, aspirin and di-aspirin in four glioma cell lines (U87 MG, SVG P12, GOS – 3, and 1321N1), using the PrestoBlue assay, establishing IC50 and examining the time course of drug effects. RESULTS: All compounds were found to decrease cell viability in a concentration and time dependant manner. Significantly, the analogue PN517 (IC50 2mM) showed approximately a twofold increase in potency when compared to aspirin (3.7mM) and cisplatin (4.3mM) in U87 cells, with similar increased potency in SVG P12 cells. Other analogues demonstrated similar potency to aspirin and cisplatin. CONCLUSION: These results support the further development and characterization of novel NSAID derivatives for the treatment of glioma

Neglected Tropical Diseases in Sub-Saharan Africa: Review of Their Prevalence, Distribution, and Disease Burden

The neglected tropical diseases (NTDs) are the most common conditions affecting the poorest 500 million people living in sub-Saharan Africa (SSA), and together produce a burden of disease that may be equivalent to up to one-half of SSA's malaria disease burden and more than double that caused by tuberculosis. Approximately 85% of the NTD disease burden results from helminth infections. Hookworm infection occurs in almost half of SSA's poorest people, including 40–50 million school-aged children and 7 million pregnant women in whom it is a leading cause of anemia. Schistosomiasis is the second most prevalent NTD after hookworm (192 million cases), accounting for 93% of the world's number of cases and possibly associated with increased horizontal transmission of HIV/AIDS. Lymphatic filariasis (46–51 million cases) and onchocerciasis (37 million cases) are also widespread in SSA, each disease representing a significant cause of disability and reduction in the region's agricultural productivity. There is a dearth of information on Africa's non-helminth NTDs. The protozoan infections, human African trypanosomiasis and visceral leishmaniasis, affect almost 100,000 people, primarily in areas of conflict in SSA where they cause high mortality, and where trachoma is the most prevalent bacterial NTD (30 million cases). However, there are little or no data on some very important protozoan infections, e.g., amebiasis and toxoplasmosis; bacterial infections, e.g., typhoid fever and non-typhoidal salmonellosis, the tick-borne bacterial zoonoses, and non-tuberculosis mycobaterial infections; and arboviral infections. Thus, the overall burden of Africa's NTDs may be severely underestimated. A full assessment is an important step for disease control priorities, particularly in Nigeria and the Democratic Republic of Congo, where the greatest number of NTDs may occur

Global impacts of Covid-19 on lifestyles and health and preparation preferences: an international survey of 30 countries

Background: The health area being greatest impacted by coronavirus disease 2019 (COVID-19) and residents' perspective to better prepare for future pandemic remain unknown. We aimed to assess and make cross-country and cross-region comparisons of the global impacts of COVID-19 and preparation preferences of pandemic. Methods: We recruited adults in 30 countries covering all World Health Organization (WHO) regions from July 2020 to August 2021. 5 Likert-point scales were used to measure their perceived change in 32 aspects due to COVID-19 (-2 = substantially reduced to 2 = substantially increased) and perceived importance of 13 preparations (1 = not important to 5 = extremely important). Samples were stratified by age and gender in the corresponding countries. Multidimensional preference analysis displays disparities between 30 countries, WHO regions, economic development levels, and COVID-19 severity levels. Results: 16 512 adults participated, with 10 351 females. Among 32 aspects of impact, the most affected were having a meal at home (mean (m) = 0.84, standard error (SE) = 0.01), cooking at home (m = 0.78, SE = 0.01), social activities (m = -0.68, SE = 0.01), duration of screen time (m = 0.67, SE = 0.01), and duration of sitting (m = 0.59, SE = 0.01). Alcohol (m = -0.36, SE = 0.01) and tobacco (m = -0.38, SE = 0.01) consumption declined moderately. Among 13 preparations, respondents rated medicine delivery (m = 3.50, SE = 0.01), getting prescribed medicine in a hospital visit / follow-up in a community pharmacy (m = 3.37, SE = 0.01), and online shopping (m = 3.33, SE = 0.02) as the most important. The multidimensional preference analysis showed the European Region, Region of the Americas, Western Pacific Region and countries with a high-income level or medium to high COVID-19 severity were more adversely impacted on sitting and screen time duration and social activities, whereas other regions and countries experienced more cooking and eating at home. Countries with a high-income level or medium to high COVID-19 severity reported higher perceived mental burden and emotional distress. Except for low- and lower-middle-income countries, medicine delivery was always prioritised. Conclusions: Global increasing sitting and screen time and limiting social activities deserve as much attention as mental health. Besides, the pandemic has ushered in a notable enhancement in lifestyle of home cooking and eating, while simultaneously reducing the consumption of tobacco and alcohol. A health care system and technological infrastructure that facilitate medicine delivery, medicine prescription, and online shopping are priorities for coping with future pandemics

Water profitability analysis to improve food security and climate resilience: a case study in the Egyptian Nile Delta

The food self-sufficiency policy has always featured as an unquestionable policy objective for Egypt. This is understandable when one considers both the high population growth and the social and political vulnerability associated with a dependence on food imports and world market food prices such as wheat. Intensive agriculture has led to a growing subsidy burden for the Egyptian government. In addition, the agricultural fields in Egypt are commonly distributed with relatively small sizes parcels that usually reduce the reliability of the agricultural sector, particularly in the delta region, to meet the national food policy. On top of that, climate change, through changing weather patterns and increased temperatures, is affecting agricultural yields and thus farmers’ livelihoods. A water profitability analysis was conducted for three governorates in the Nile Delta in Egypt to establish a baseline and assess the net return per unit of water of the main crops in each of these governorates; this can act as a reference of the water profitability of different crops before they are affected by climate change and other internal and external factors. The analysis was based on extensive in-person surveys in each governorate in addition to workshop discussions with farmers. The study has highlighted the impact of a lack of extension services, which limits farmers’ ability to increase their land and water productivity. Farmers with more access to subsidized production inputs managed to achieve higher levels of water profitability even on smaller lands. Finally, we drew from our findings key policy actions to improve water profitability and land productivity for farmers in the Nile Delta to achieve higher levels of food security. This will help build resilient food production systems that are reliable in the face of climate change and other drivers. In addition, an integrated nexus strategy and plan for the inter- and intra-country is recommended to address the challenges related to food and climate security

Multiple regression and Artificial Neural Network for long-term rainfall forecasting using large scale climate modes

In this study, the application of Artificial Neural Networks (ANN) and Multiple Regression analysis (MR) to forecast long-term seasonal spring rainfall in Victoria, Australia was investigated using lagged El Nino Southern Oscillation (ENSO) and Indian Ocean Dipole (IOD) as potential predictors. The use of dual (combined lagged ENSO-IOD) input sets for calibrating and validating ANN and MR Models is proposed to investigate the simultaneous effect of past values of these two major climate modes on long-term spring rainfall prediction. The MR models that did not violate the limits of statistical significance and multicollinearity were selected for future spring rainfall forecast. The ANN was developed in the form of multilayer perceptron using Levenberg-Marquardt algorithm. Both MR and ANN modelling were assessed statistically using mean square error (MSE), mean absolute error (MAE), Pearson correlation (r) and Willmott index of agreement (d).The developed MR and ANN models were tested on out-of-sample test sets; the MR models showed very poor generalization ability for east Victoria with correlation coefficients of -0.99~ -0.90 compared to ANN with correlation coefficients of 0.42~0.93; ANN models also showed better generalization ability for central and west Victoria with correlation coefficients of 0.68~0.85 and 0.58~0.97 respectively. The ability of multiple regression models to forecast out-of-sample sets is compatible with ANN for Daylesford in central Victoria and Kaniva in west Victoria (r=0.92 and 0.67 respectively). The errors of the testing sets for ANN models are generally lower compared to multiple regression models. The statistical analysis suggest the potential of ANN over MR models for rainfall forecasting using large scale climate modes

Low levels of HIV test coverage in clinical settings in the UK: a systematic review of adherence to 2008 guidelines

Objectives: To quantify the extent to which guideline recommendations for routine testing for HIV are adhered to outside of genitourinary medicine (GUM), sexual health (SH) and antenatal clinics. Methods: A systematic review of published data on testing levels following publication of 2008 guidelines was undertaken. Medline, Embase and conference abstracts were searched according to a predefined protocol. We included studies reporting the number of HIV tests administered in those eligible for guideline recommended testing. We excluded reports of testing in settings with established testing surveillance (GUM/SH and antenatal clinics). A random effects meta-analysis was carried out to summarise level of HIV testing across the studies identified. Results: Thirty studies were identified, most of which were retrospective studies or audits of testing practice. Results were heterogeneous. The overall pooled estimate of HIV test coverage was 27.2% (95% CI 22.4% to 32%). Test coverage was marginally higher in patients tested in settings where routine testing is recommended (29.5%) than in those with clinical indicator diseases (22.4%). Provider test offer was found to be lower (40.4%) than patient acceptance of testing (71.5%). Conclusions: Adherence to 2008 national guidelines for HIV testing in the UK is poor outside of GUM/SH and antenatal clinics. Low levels of provider test offer appear to be a major contributor to this. Failure to adhere to testing guidelines is likely to be contributing to late diagnosis with implications for poorer clinical outcomes and continued onwards transmission of HIV. Improved surveillance of HIV testing outside of specialist settings may be useful in increasing adherence testing guidelines