Building cooperation through health initiatives: an Arab and Israeli case study

<p>Abstract</p> <p>Background</p> <p>Ongoing conflict in the Middle East poses a major threat to health and security. A project screening Arab and Israeli newborns for hearing loss provided an opportunity to evaluate ways for building cooperation. The aims of this study were to: a) examine what attracted Israeli, Jordanian and Palestinian participants to the project, b) describe challenges they faced, and c) draw lessons learned for guiding cross-border health initiatives.</p> <p>Methods</p> <p>A case study method was used involving 12 key informants stratified by country (3 Israeli, 3 Jordanian, 3 Palestinian, 3 Canadian). In-depth interviews were tape-recorded, transcribed and analyzed using an inductive qualitative approach to derive key themes.</p> <p>Results</p> <p>Major reasons for getting involved included: concern over an important health problem, curiosity about neighbors and opportunities for professional advancement. Participants were attracted to prospects for opening the dialogue, building relationships and facilitating cooperation in the region. The political situation was a major challenge that delayed implementation of the project and placed participants under social pressure. Among lessons learned, fostering personal relationships was viewed as critical for success of this initiative.</p> <p>Conclusion</p> <p>Arab and Israeli health professionals were prepared to get involved for two types of reasons: a) Project Level: opportunity to address a significant health issue (e.g. congenital hearing loss) while enhancing their professional careers, and b) Meta Level: concern about taking positive steps for building cooperation in the region. We invite discussion about roles that health professionals can play in building "cooperation networks" for underpinning health security, conflict resolution and global health promotion.</p

Two long-period transiting exoplanets on eccentric orbits: NGTS-20 b (TOI-5152 b) and TOI-5153 b

Long-period transiting planets provide the opportunity to better understand the formation and evolution of planetary systems. Their atmospheric properties remain largely unaltered by tidal or radiative effects of the host star, and their orbital arrangement reflects a different, and less extreme, migrational history compared to close-in objects. The sample of long-period exoplanets with well determined masses and radii is still limited, but a growing number of long-period objects reveal themselves in the TESS data. Our goal is to vet and confirm single transit planet candidates detected in the TESS space-based photometric data through spectroscopic and photometric follow up observations with ground-based instruments. We use the Next Generation Transit Survey (NGTS) to photometrically monitor the candidates in order to observe additional transits. We report the discovery of two massive, warm Jupiter-size planets, one orbiting the F8-type star TOI-5153 and the other orbiting the G1-type star NGTS-20 (=TOI-5152). From our spectroscopic analysis, both stars are metal-rich with a metallicity of 0.12 and 0.15, respectively. Follow-up radial velocity observations were carried out with CORALIE, CHIRON, FEROS, and HARPS. TOI-5153 hosts a 20.33 day period planet with a planetary mass of 3.26 (+-0.18) Mj, a radius of 1.06 (+-0.04) Rj , and an orbital eccentricity of 0.091 (+-0.026). NGTS-20 b is a 2.98 (+-0.16) Mj planet with a radius of 1.07 (+-0.04) Rj on an eccentric (0.432 +- 0.023) orbit with an orbital period of 54.19 days. Both planets are metal-enriched and their heavy element content is in line with the previously reported mass-metallicity relation for gas giants. Both warm Jupiters orbit moderately bright host stars making these objects valuable targets for follow-up studies of the planetary atmosphere and measurement of the spin-orbit angle of the system.Comment: 17 pages, 13 figures, accepted to A&

Age-Related Changes of Myelin Basic Protein in Mouse and Human Auditory Nerve

Age-related hearing loss (presbyacusis) is the most common type of hearing impairment. One of the most consistent pathological changes seen in presbyacusis is the loss of spiral ganglion neurons (SGNs). Defining the cellular and molecular basis of SGN degeneration in the human inner ear is critical to gaining a better understanding of the pathophysiology of presbyacusis. However, information on age-related cellular and molecular alterations in the human spiral ganglion remains scant, owing to the very limited availably of human specimens suitable for high resolution morphological and molecular analysis. This study aimed at defining age-related alterations in the auditory nerve in human temporal bones and determining if immunostaining for myelin basic protein (MBP) can be used as an alternative approach to electron microscopy for evaluating myelin degeneration. For comparative purposes, we evaluated ultrastructural alternations and changes in MBP immunostaining in aging CBA/CaJ mice. We then examined 13 temporal bones from 10 human donors, including 4 adults aged 38–46 years (middle-aged group) and 6 adults aged 63–91 years (older group). Similar to the mouse, intense immunostaining of MBP was present throughout the auditory nerve of the middle-aged human donors. Significant declines in MBP immunoreactivity and losses of MBP+ auditory nerve fibers were observed in the spiral ganglia of both the older human and aged mouse ears. This study demonstrates that immunostaining for MBP in combination with confocal microscopy provides a sensitive, reliable, and efficient method for assessing alterations of myelin sheaths in the auditory nerve. The results also suggest that myelin degeneration may play a critical role in the SGN loss and the subsequent decline of the auditory nerve function in presbyacusis

An electron microscopic autoradiographic study of proline incorporation by mouse lingual epithelium

Mouse lingual epithelium incorporates significant amounts of L-proline-2, 3-H 3 one hour after intraperitoneal injection of the tritiated amino acid. All viable cell strata incorporated approximately equal amounts of proline as assessed by autoradiographic techniques. Grain counts at 30 minutes, 1 hour, 4 hours and 24 hours, the four time periods studied, indicated a progressive incorporation of proline up to 4 hours following injection. Preferential incorporation of proline into any one cell structure or group of structures was not observed. Keratohyalin granules (KHG's) demonstrated incorporated proline; however, usually only one silver grain appeared over each granule, and, based on grain counts, the amount of proline incorporated by KHG's appeared slightly less than the general labeling observed in KHG-containing cells. This finding supports recent biochemical studies which have indicated a considerably lower proline content of keratohyalin than had previously been reported. Significant proline incorporation into the epithelial basal lamina was not observed during the 24 hours of this study. Thus, while recent recombination experiments have conclusively demonstrated that epithelial basal cells synthesize considerable quantities of basal lamina in a 24 hour period; it would appear that epithelial basal cells contribute little to a formed, intact basal lamina. This finding lends credence to the concept of a long basal lamina turnover time.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47661/1/441_2004_Article_BF00307250.pd

High HIV Prevalence and Associated Risk Factors Among Female Sexual Partners of Male Injection Drug Users (MWID) in Ho Chi Minh City, Vietnam

Injection drug use is a major factor in acquiring and transmitting HIV in Vietnam. This analysis aims to present estimates of HIV infection and factors associated with HIV infection among female sex partners (FSP) of MWID in Ho Chi Minh City (HCMC), Vietnam. Cross-sectional surveys were conducted in 2011 and 2013 among males who inject drugs (MWID) who then referred their FSP for a behavioral and biologic survey. In total, 445 MWID and FSPs were enrolled. HIV prevalence among MWID was 50 and 35 % among FSPs. Among FSPs, 60.3 % reported ever using illegal drugs and among those, 72.7 % reported ever injecting illicit drugs. Among FSP, injection drug for >1 year [adjusted Odds Ratio (aOR), 95 % CI 2.94, 1.19–7.26), p value = <0.001] and having a male partner infected with HIV [(aOR 3.35: 1.97–5.69), p value = <0.001] were associated with HIV infection. The prevalence of HIV infection is high among FSP of MWID in HCMC and is highly associated with the injection drug use behavior of the FSP. Harm-reduction intervention programs that focus on the MWID-FSP couple or directly on the FSPs are required

High hepatitis C virus (HCV) prevalence among men who have sex with men (MSM) in Vietnam and associated risk factors: 2010 Vietnam Integrated Behavioural and Biologic Cross-Sectional Survey

Background Hepatitis C virus (HCV) is an increasing health issue among key populations such as men who have sex with men (MSM). We sought to assess the burden of and risk factors for HCV among MSM in Vietnam. Methods We analysed behavioural and demographic data and stored specimens from MSM surveyed in four provinces through Vietnam's 2009-2010 Integrated Biologic and Behavioural Survey, which used probability-based, respondent-driven sampling. Commercial hepatitis B surface antigen (HBsAg) and HCV/antibody (HCV Ag/Ab) testing were performed on archived sera with follow-up PCR for HCV RNA and genotype determination. Results Among the 1588 MSM surveyed, the median (range) frequency, by province, of HCV Ag/Ab detection was 28.4% (13.7%-38.8%); 84.5% (83.1%-100%) among HIV-infected and 21.9% (8.9%-28.2%) among HIV-uninfected. HCV prevalence was higher in northern Hanoi and Hai Phong provinces than in southern Ho Chi Minh City and Chan Tho provinces. Among a convenience sample of 67 HCV Ag/Ab+ MSM, 67.2% were HCV RNA+; of 41 genotyped, 73.2% were genotype 1. HBsAg prevalence varied from 8.5% to 27.4%. In the multivariable logistic regression analysis, being HIV-infected (adjusted OR (aOR) 19.0; 7.0-51.9), ever having used injected drugs (aOR 4.4; 1.6-12.4) and age >25years were significant risk factors for testing HCV Ag/Ab+. Conclusions HCV infection in Vietnam appears to be high among MSM, particularly among HIV-infected MSM, with a north-south gradient. Given overlapping risk behaviours and associations between HCV and HIV, integrating HIV and HCV programme services to prevent both HIV and HCV transmission among MSM is indicated

Correlates of HIV infection among female sex workers in Vietnam: Injection drug use remains a key risk factor

Objective: Women who sell sex and use drugs have dual risks for HIV infection. Despite increasing reports of drug use among female sex workers (FSW) in Vietnam, FSW HIV interventions remain focused mainly on sexual risk reduction. We assessed the impact of drug use and inconsistent condom use on HIV infection among FSW in Vietnam, which few studies have quantified. Methods: We surveyed 5298 women aged ≥18 years who had sold sex in the past month from ten geographically dispersed provinces. We performed multivariate logistic regression on data from provinces with high (≥10%) or low (<10%) HIV prevalence among FSW. Results: Compared to FSW who never used illicit drugs, the odds of HIV infection among FSW who had ever injected drugs and those who reported non-injection drug use were 3.44 (CI 2.32-5.09) and 1.76 (CI 1.14-2.71), respectively, in high-prevalence provinces. FSW who always used condoms with clients had lower odds of HIV infection than those who did not (AOR = 0.71; CI 0.52-0.98). In low-prevalence provinces lifetime injection drug use (AOR 22.05, CI 12.00-40.49), but not non-injecting drug use or inconsistent condom use, was significantly associated with HIV infection. Conclusions: Because injection drug use and inconsistent condom use were key risk factors for HIV infection in high-prevalence provinces, drug injection risk reduction should be as much a focus of HIV prevention as sexual risk reduction. Where HIV prevalence remains low in FSW, a more general emphasis on harm reduction for all drug users will benefit FSW

Prevalence and correlates of HIV infection among men who inject drugs in a remote area of Vietnam

Abstract Background Lack of information on the HIV epidemic among men who inject drugs (MWID) in northwestern Vietnam, a remote area, may hamper national efforts to control the disease. We examined HIV prevalence, needle–syringe sharing behaviors, and associated factors among MWID in three areas of northwestern Vietnam. Methods We used descriptive analysis to report the characteristics, frequency of risk behaviors, and of access to healthcare services among the MWID. Univariable logistic regression was used to assess the associations between the HIV infection, needle–syringe sharing behaviors, and their independent variables. We further explored these associations in multivariable analyses where we included independent variables based on a priori knowledge and their associations with the dependent variables determined in univariable analyses (p <  0.25). Results The HIV prevalence was 37.9, 16.9, and 18.5% for Tuan Giao, Bat Xat, and Lao Cai City, respectively, and 25.4% overall. MWID of Thai minority ethnicity were more likely to be HIV-positive (adjusted odds ratio (AOR) 3.55; 95% confidence interval (CI) 1.84–6.87). The rate of needle–syringe sharing in the previous 6 months was approximately 9% among the MWID in Tuan Giao and Lao Cai City, and 27.8% in Bat Xat. Two thirds of the participants never underwent HIV testing before this study. Ever having been tested for HIV before this study was not associated with any needle–syringe sharing behaviors. Among the HIV-positive MWID, those who received free clean needles and syringes were less likely to give used needles and syringes to peers (AOR 0.21; 95% CI 0.06–0.79). Going to a “hotspot” in the previous week was associated with increased odds of needle–syringe sharing in multiple subgroups. Conclusion Our findings on HIV prevalence and testing participation among a subset of MWID in the northwestern Vietnam were corroborated with trend analysis results from the most recent HIV/STI Integrated Biological and Behavioral Surveillance report (data last collected in 2013.) We provided important insights into these MWID’s risky injection behaviors. We suggest heightened emphasis on HIV testing and needle and syringe provision for this population. Also, policymakers and program implementers should target hotspots as a main venue to tackle HIV epidemics