Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

Correlation between Combined Urinary Metal Exposure and Grip Strength under Three Statistical Models:A Cross-sectional Study in Rural Guangxi

Objective This study aimed to investigate the potential relationship between urinary metals copper(Cu),arsenic(As),strontium(Sr),barium(Ba),iron(Fe),lead(Pb)and manganese(Mn)and grip strength.Methods We used linear regression models,quantile g-computation and Bayesian kernel machine regression(BKMR)to assess the relationship between metals and grip strength.Results In the multimetal linear regression,Cu(β=−2.119),As(β=−1.318),Sr(β=−2.480),Ba(β=0.781),Fe(β=1.130)and Mn(β=−0.404)were significantly correlated with grip strength(P<0.05).The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was−1.007(95%confidence interval:−1.362,−0.652;P<0.001)when each quartile of the mixture of the seven metals was increased.Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength,with Cu,As and Sr being negatively associated with grip strength levels.In the total population,potential interactions were observed between As and Mn and between Cu and Mn(P_(interactions) of 0.003 and 0.018,respectively).Conclusion In summary,this study suggests that combined exposure to metal mixtures is negatively associated with grip strength.Cu,Sr and As were negatively correlated with grip strength levels,and there were potential interactions between As and Mn and between Cu and Mn.

Spatial cluster mapping and environmental modeling in pediatric inflammatory bowel disease

BACKGROUND Geographical(geospatial)clusters have been observed in inflammatory bowel disease(IBD)incidence and linked to environmental determinants of disease,but pediatric spatial patterns in North America are unknown.We hypothesized that we would identify geospatial clusters in the pediatric IBD(PIBD)population of British Columbia(BC),Canada and associate incidence with ethnicity and environmental exposures.AIM To identify PIBD clusters and model how spatial patterns are associated with population ethnicity and environmental exposures.METHODS One thousand one hundred eighty-three patients were included from a BC Children’s Hospital clinical registry who met the criteria of diagnosis with IBD≤age 16.9 from 2001–2016 with a valid postal code on file.A spatial cluster detection routine was used to identify areas with similar incidence.An ecological analysis employed Poisson rate models of IBD,Crohn’s disease(CD),and ulcerative colitis(UC)cases as functions of areal population ethnicity,rurality,average family size and income,average population exposure to green space,air pollution,and vitamin-D weighted ultraviolet light from the Canadian Environmental Health Research Consortium,and pesticide applications.RESULTS Hot spots(high incidence)were identified in Metro Vancouver(IBD,CD,UC),southern Okanagan regions(IBD,CD),and Vancouver Island(CD).Cold spots(low incidence)were identified in Southeastern BC(IBD,CD,UC),Northern BC(IBD,CD),and on BC’s coast(UC).No high incidence hot spots were detected in the densest urban areas.Modeling results were represented as incidence rate ratios(IRR)with 95%CI.Novel risk factors for PIBD included fine particulate matter(PM2.5)pollution(IRR=1.294,CI=1.113-1.507,P<0.001)and agricultural application of petroleum oil to orchards and grapes(IRR=1.135,CI=1.007-1.270,P=0.033).South Asian population(IRR=1.020,CI=1.011-1.028,P<0.001)was a risk factor and Indigenous population(IRR=0.956,CI=0.941-0.971,P<0.001),family size(IRR=0.467,CI=0.268-0.816,P=0.007),and summer ultraviolet(IBD=0.9993,CI=0.9990–0.9996,P<0.001)were protective factors as previously established.Novel risk factors for CD,as for PIBD,included:PM2.5 air pollution(IRR=1.230,CI=1.056-1.435,P=0.008)and agricultural petroleum oil(IRR=1.159,CI=1.002-1.326,P=0.038).Indigenous population(IRR=0.923,CI=0.895–0.951,P<0.001),as previously established,was a protective factor.For UC,rural population(UC IRR=0.990,CI=0.983-0.996,P=0.004)was a protective factor and South Asian population(IRR=1.054,CI=1.030–1.079,P<0.001)a risk factor as previously established.CONCLUSION PIBD spatial clusters were identified and associated with known and novel environmental determinants.The identification of agricultural pesticides and PM2.5 air pollution needs further study to validate these observations.

Acceptance of COVID-19 vaccine and its related determinants in Nigeria:An online survey

BACKGROUND Vaccine hesitancy is a major challenge in the fight against the coronavirus disease 2019(COVID-19)pandemic.Identifying the sociodemographic factors associated with vaccine acceptance among Nigerians is crucial for improving vaccine uptake.AIM To assess the acceptance rate of COVID-19 vaccine and its related determinants among Nigerians.METHODS An online cross-sectional survey(observational study)was conducted between February 2021 and May 2021,using a questionnaire hosted on SurveyMonkey.The invitation to take part in the poll was sent out to participants through social networking platforms.A logistic regression was used to determine which sociodemographic factors were associated with vaccine acceptance constructs.RESULTS A total of 1800 persons responded to the survey,a larger proportion of whom were males(53.9%)and within the age group of 21-30 years(29.4%)and earned an average income of less than$500 per month(43.3%).Only 0.56%of participants had a high perceived risk of COVID-19 infection,while only 1.11%had a perceived risk of dying from COVID-19.The perception rate of the COVID-19 vaccine among participants was 51.1%,while the acceptance rate was 63.9%.There was no significant association between the COVID-19 vaccine acceptance rate and related determinants assessed,particularly age(χ²=3.049,P=0.550),sex(χ²=0.102,P=0.749),average income(χ²=3.802,P=0.875),and religion(χ²=2.819,P=0.420).Participants with chronic conditions demonstrated a higher acceptance rate compared to the general population.CONCLUSION Despite the positive perception observed and substantial vaccine acceptance rate among the study participants,more public health interventions are still needed to enhance vaccine acceptability in Nigeria.

Traditional medicine in Tanzania:a review of historical perspective,current practices and challenges

The use of traditional medicine(TM)is essential for preventing and treating diseases and thus improving human health.Worldwide,TM has been used since time immemorial.In Tanzania,the use of TM was most common during precolonial era before it was discriminated during the Germany colonial rule.However,it regained the attention during the private sector emergence era(1985-2004).Currently,there are ongoing efforts to integrate TM and modern medicine to improve healthcare systems in developing countries for sustainable healthcare management.This review aims to provide an overview of the historical and current status,challenges,and future direction for TM in Tanzania.The analysis revealed that the development of TM was somehow underdeveloped during the colonial rule but regained its popularity after independence.Currently,there are many opportunities such as the presence of legal and institutional frameworks,a varied medicinal biodiversity,with some of them being endemic to Tanzania,political will etc.Despite the available opportunities,there are numerous challenges to the development and use of TM.These include inadequate financial and human resources for research,poor conservation of medicinal biodiversity;modernization;intellectual property rights of TM knowledge;lack of safety,efficacy,and quality data of medicinal products.The development and utility of TM as a resource is crucial to protect practise.Thus,the study recommends more capacity building in terms of finances,technology development,human resources training,advocacy and integration of TM into healthcare system.

Examining the relationship between sport and health among USA women:An analysis of the Behavioral Risk Factor Surveillance System

Background：Research has been conducted linking sports participation and health in childhood and adolescence;however,little is known about the contribution of sport to women＇s health.The purpose of this study was to examine the relationship between sport and women＇s health in the USA by analyzing data from the Behavioral Risk Factor Surveillance System（BRFSS）.Methods：This study was a secondary data analysis of the 2013 national BRFSS survey.Unlike the BRFSS core component from previous years,in2013,participants were questioned extensively about their physical activity behaviors.Seventy-six different activities were identifie by the participants.Two researchers categorized the 76 activities as sport,conditioning exercise,recreation,or household tasks based on previously identifie categories.Logistic regression was utilized to calculate odds ratios and adjusted odds ratios for chronic diseases based on physical activity category.Results：Women who participated in sport had better health outcomes with significant y lower odds for all chronic diseases except asthma and better general health than women who participated in conditioning exercise,household tasks,or recreation,and many of the significan differences remained after controlling for demographic characteristics.Conclusion：Sport participation was associated with more positive health outcomes among women in the USA compared with the other categories.As a means to improve health of women,the USA could focus on efforts to increase sport participation among women.

In vivo mouse models to study bile acid synthesis and signaling

The synthesis of bile acids(BAs)is carried out by complex pathways characterized by sequential chemical reactions in the liver through various cytochromes P450(CYP)and other enzymes.Maintaining the integrity of these pathways is crucial for normal physiological function in mammals,encompassing hepatic and neurological processes.Studying on the deficiencies in BA synthesis genes offers valuable insights into the significance of BAs in modulating farnesoid X receptor(FXR)signaling and metabolic homeostasis.By creating mouse knockout(KO)models,researchers can manipulate deficiencies in genes involved in BA synthesis,which can be used to study human diseases with BA dysregulation.These KO mouse models allow for a more profound understanding of the functions and regulations of genes responsible for BA synthesis.Furthermore,KO mouse models shed light on the distinct characteristics of individual BA and their roles in nuclear receptor signaling.Notably,alterations of BA synthesis genes in mouse models have distinct differences when compared to human diseases caused by the same BA synthesis gene deficiencies.This review summarizes several mouse KO models used to study BA synthesis and related human diseases,including mice deficient in Cyp7a1,Cyp27a1,Cyp7a1/Cyp27a1,Cyp8b1,Cyp7b1,Cyp2c70,Cyp2a12,and Cyp2c70/Cyp2a12,as well as germ-free mice.

Entomophagy and Public Health: A Review of Microbiological Hazards

The world population’s constant increase and the continuous need to ensure food safety and security are among the major challenges to be faced in the next 30 years. In addition, human diet is evolving with a decreased inclusion of proteins from animal sources. In this context, consumption of insects by humans (entomophagy) could be an alternative solution to the intake of protein derived from conventional livestock, due to the lower environmental impact of insect rearing compared to traditional farming. Furthermore, various insect species have promising nutritional profiles regarding both macro and micronutrients. Nowadays, it is recognized that about 2 billion people consume insects at a worldwide scale, with more than 2000 different species to have been reported. Since the beginning of the 2000s, mass rearing of insects for human consumption has been developing all over the world. Nevertheless edible insects are foodstuffs of animal origin and are usually consumed in their entirety, including the digestive tract, meaning that they may contain biological agents with hazardous potential (e.g. bacteria, parasites, viruses, prions, yeasts, molds, mycotoxins, histamine, and antibiotic resistance genes) and they must undergo a thorough analysis. Therefore, establishing the synthesis of the current knowledge on entomophagy and the related biological hazards is the main purpose of this review.

Understanding the Lifestyle Correlates with Chronic Constipation and Self-Rated Health

The objective of this study is to evaluate the healthy and unhealthy behaviors as risk factors for chronic constipation and self-rated health status. Eight hundred tenth students enrolled from a university in Miaoli city, Taiwan. Chronic constipation was assessed using Chinese questionnaire. Information of unhealthy and healthy lifestyles was interviewed by constructed questionnaire. Thirty-six percentage of university students were assessed as chronic constipation. Using multivariate logistic regression adjusted for age, sex, race and BMI, we found chronic constipation significantly correlated with frequency of consumption from snack, fast food, fried food, daily consumption of water, physical activity and junk food used as regular food. Moreover, these unhealthy behaviors significantly correlated with self-rated health status. Students with chronic constipation had poor self-rated health status. It is urgent to create healthy behaviors to reduce the risk for chronic constipation or upgrade self-rated health status in university students.

Evaluation of Occupational Risk Factors for Healthcare Workers through Analysis of the Florida Workers’ Compensation Claims Database

The purpose of this study is to evaluate occupational risk factors for nurses and CNAs by analyzing the Florida workers’ compensation claims database. Risk factors for the cause of injury, nature of injury, body part injured, and demographic and lifestyle factors were evaluated for a sample of CNAs, nurses, and restaurant servers. The results identified falls, lifting, being struck, and pushing and pulling as major causes for injury among nurses and CNAs as compared to servers. Regarding the nature of injury, sprains and strains constituted the majority of claims for nurses and CNAS with the lower back being the body part most commonly injured in a claim. The results of this study indicate that nurses and CNAs are at far greater risk for physical injury than injury or illness from chemical or biological exposures. It is recommended that emphasis must be placed on interventions for musculoskeletal injuries such as falls and lifting, taking into account environmental factors such as age and lifestyle factors that further exacerbate risk for injury.

Determining Environmental Impacts for Sensitive Species: Using Iconic Species as Bioindicators for Management and Policy

Environmental assessment of impacts, management, and policy are important aspects of protection of human health and the environment. Assessing the impacts of human activities requires selection of bioindicator species that can be used to assess, manage, and develop public policies that ensure ecosystem integrity, and therefore sustainability of social, cultural, and economic systems. With the use of Chinook Salmon (Oncorhynchus tshawytscha), Pacific Cod (Gadusmacrocephalus), Mallard (Anas platyrhynchos), and Red Knot (Calidris canutus rufa), we explore assessment and measurement endpoints, and their relationship to management and development of public policy. This combination of fish and birds provides a diversity of life histories, ecosystem roles, human values, and resource use to explore their use as bioindicators and endpoints. It also allows examination of 1) conservation and protection of species and biodiversity, 2) protection of ecosystems, 3) provision of goods and services, and 4) societal well-being.

Occupational Health Surveillance: Pulmonary Function Test in Proppant Exposures

Workers involved in hydraulic fracking processes are exposed to various types of chemicals and dusts in their workplaces, such as proppants, which hold open the fissures created in the fracking process. Recently, ceramic proppants have been developed that may be less hazardous to workers than traditional proppants. Pulmonary function testing of workers producing ceramic proppant was used to assess the potential inhalation hazards of ceramic proppant. 100 male workers from a producer of ceramic proppant were evaluated with pulmonary function test data collected and evaluated using The American Thoracic Society (ATS) acceptability criteria. A comparison group was selected from the Third National Health and Nutrition Examination Survey (NHANES III) spirometry laboratory subset. No pulmonary function deficits were found in the worker group in comparison to the NHANES III population. Mean FEV1 and FVC values in workers were 3.8 and 4.8 liters respectively, and were greater as compared to the NHANES III population of similar demographics. An FEV1/FVC ratio of less than 0.8, when compared to the NHANES III group, produced an odds ratio of 0.44 in worker group, indicating less risk of preclinical pulmonary dysfunction. Overall, exposure to ceramic proppant was not found to produce an adverse impact on pulmonary function in workers engaged in the manufacture of ceramic proppant.

基于基准剂量方法的动物替代策略及其应用

剂量-反应评估作为风险评估中的关键定量步骤,其作用是确定安全剂量水平。与传统最大无害剂量方法相比,基准剂量(BMD)法促进了3R原则(减少、替代和优化)在毒理试验中的使用。本文综述了BMD法特性,包括对研究设计的依赖性较小、在起始点中更好地量化不确定性及整合额外信息能力等;总结了BMD法基于剂量-反应评估和数据整合在减少动物使用方面的作用。

Prevalence of Induced Abortion among Female Students in Selected Tertiary Learning Institutions in Gaborone City, Botswana

Induced abortion signifies that pregnancy has been tempered with. Abortion is the removal of an embryo or fetus weighing less than 500 grams from its mother. It can either be spontaneous (unprompted) or induced. Abortion remains one of the leading causes of maternal deaths in developing countries with induced abortion being the key cause. In 2014 from January to August, 9 abortion related deaths occurred in Botswana. There are several reasons female students in tertiary institutions resort to seeking induced abortion which include the socio-demographics like age and socio-economic factors like financial instability. Parental fears, unintended pregnancy and pressure from the partner also force females to terminate pregnancy. Induced abortion has claimed many women’s lives especially in developing countries with very restrictive abortion laws like Botswana as women do not access safe abortion care services. The study intends to establish the determinants of induced abortion among female students in selected tertiary learning institutions in Gaborone City, Botswana. It concentrated primarily on determining the prevalence of induced abortion. This was a descriptive cross-sectional study using both quantitative and qualitative data collection techniques. Systematic random sampling technique was used to come up with 278 participants. Prior to commencement of data collection, all ethical and logistical prerequisites were satisfied. Informed consent was solicited from all the study participants and the purpose of the study was fully explained. A self-administered questionnaire was used to collect data. Microsoft Excel spread sheet was used to code, clean, and enter the data, which was then exported for analysis to the statistical package for social sciences version 24. Frequency distribution tables, percentages graphs, and pie charts were used to illustrate the descriptive information. The study revealed that prevalence of induced abortion among female students in Gaborone City is 7.9%. They even suggested that induced abortion be liberalized. Age was the only socio-demographic factor associated with induced abortion with p = 0.047 using Chi Square test χ2 = 7.609, df = 3. The study findings concluded that female students resort to induced abortion as a result of pressure from both parents and male partners especially when the pregnancy is unintended. The study recommends that the abortion law in Botswana be made liberal to ease access to safe abortion care services. It also recommends that contraceptive commodities should consistently be available in public health facilities.

Moving beyond Wastewater:Perspectives on Environmental Surveillance of Infectious Diseases for Public Health Action in Low-Resource Settings

Although testing wastewater for public health surveillance has recently received significant attention in the United States,researchers and public health professionals have long realized the tremendous promise of environmental surveillance(ES),defined as tracking pathogens of interest in fecally contaminated surface waters,soil,or fomites,in low-resource settings for public health action.1,2 The power of ES in lowresource settings is most clearly illustrated with the over 30 years of well-established and standardized polio surveillance.As part of the Global Polio Eradication Initiative,the World Health Organization(WHO)has accredited 146 laboratories within the Global Polio Lab Network(GPLN).These facilities across 92 countries process over 8,000 wastewater or fecally contaminated surface water samples per year,in addition to over 220,000 stool samples annually.3 The data generated from the GPLN are closely linked to clear public health action related to targeted vaccination campaigns.The investment and adoption of ES for polio eradication efforts serves as a use-case for other targets of interest.To explore the current state of the field,the National Science Foundation-funded Research Coordination Network(RCN)on Wastewater Based Epidemiology for SARS-CoV-2 and Emerging Public Health Threats held a workshop in December 2023 to discuss the opportunities and challenges for ES in low-resource settings(Figure 1).Discussions during the workshop highlighted knowledge gaps,best-practices,target selection,academic/government/private partnerships and overall public health action and sustainability of these programs.

Gonadotrophin-releasing hormone-Ⅰ and -Ⅱ stimulate steroidogenesis in prepubertal murine Leydig cells in vitro

Aim： To study the effect and mechanism of gonadotrophin-releasing hormone （GnRH） on murine Leydig cell steroidogenesis. Methods： Purified murine Leydig cells were treated with GnRH-Ⅰ and -Ⅱ agonists, and testosterone production and steroidogenic enzyme expressions were determined. Results： GnRH-Ⅰ and -Ⅱ agonists significantly stimulated murine Leydig cell steroidogenesis 60%-80% in a dose- and time-dependent manner （P 〈 0.05）. The mRNA expressions of steroidogenic acute regulatory （STAR） protein, P450scc, 3β-hydroxysteroid dehydrogenase （HSD）, but not 17β-hydroxylase or 17β-HSD, were significantly stimulated by both GnRH agonists with a 1.5- to 3-fold increase （P 〈 0.05）. However, only 3β-HSD protein expression was induced by both GnRH agonists, with a 1.6- to 2-fold increase （P 〈 0.05）. Conclusion： GnRH directly stimulated murine Leydig cell steroidogenesis by activating 3β-HSD enzyme expression.

Endoscopic retrograde cholangiopancreatography in cirrhosis-a systematic review and meta-analysis focused on adverse events

AIM To investigate indications and outcomes of endoscopic retrograde cholangiopancreatography(ERCP) in cirrhotics, especially adverse events. Patients with cirrhosis undergoing ERCP are believed to have increased risk. However, there is a paucity of literature describing the indications and outcomes of ERCP procedures in patients with cirrhosis, especially focusing on adverse events.METHODS We performed a systematic appraisal of major literature databases, including PubMed and EMBASE, with a manual search of literature from their inception until April 2017.RESULTS A total of 6,505 patients from 15 studies were analyzed(male ratio 59%, mean age 59 years), 11% with alcoholic and 89% with non-alcoholic cirrhosis, with 56.2% Child-Pugh class A, and 43.8% class B or C. Indications for ERCP included choledocholithiasis 60.9%, biliary strictures 26.2%, gallstone pancreatitis 21.1% and cholangitis 15.5%. Types of interventions included endoscopic sphincterotomy 52.7%, biliary stenting 16.7% and biliary dilation 4.6%. Individual adverse events included hemorrhage in 4.58%(95%CI: 2.77-6.75%, I^2 = 85.9%), post-ERCP pancreatitis(PEP) in 3.68%(95%CI: 1.83-6.00%, I^2 = 89.5%), cholangitis in 1.93%(95%CI: 0.63-3.71%, I^2 = 87.1%) and perforation in 0.00%(95%CI: 0.00-0.23%, I^2 = 37.8%). Six studies were used for comparison of ERCPrelated complications in cirrhosis vs non-cirrhosis, which showed higher overall rates of complications in cirrhosis patients with pooled OR of 1.63(95%CI: 1.27-2.09, I2 = 65%): higher rates of hemorrhage with OR of 2.05(95%CI: 1.62-2.58, I^2 = 2.1%) and PEP with OR of 1.33(95%CI: 1.04-1.70, I2=65%), but similar cholangitis rates with OR of 1.23(95%CI: 0.67-2.26, I^2 = 44.3%).CONCLUSION There is an overall higher rate of adverse events related to ERCP in patients with cirrhosis, especially hemorrhage and PEP. A thorough risk/benefit assessment should be performed prior to undertaking ERCP in patients with cirrhosis.

Space radiation and cardiovascular disease risk

Future long-distance space missions will be associated with significant exposures to ionizing radiation,and the health risks of these radiation exposures during manned missions need to be assessed. Recent Earth-based epidemiological studies in survivors of atomic bombs and after occupational and medical low dose radiation exposures have indicated that the cardiovascular system may be more sensitive to ionizing radiation than was previously thought. This has raised the concern of a cardiovascular disease risk from exposure to space radiation during long-distance space travel. Groundbased studies with animal and cell culture models play an important role in estimating health risks from space radiation exposure. Charged particle space radiation has dense ionization characteristics and may induce unique biological responses,appropriate simulation of the space radiation environment and careful consideration of the choice of the experimental model are critical. Recent studies have addressed cardiovascular effects of space radiation using such models and provided first results that aid in estimating cardiovascular disease risk,and several other studies are ongoing. Moreover,astronauts could potentially be administered pharmacological countermeasures against adverse effects of space radiation,and research is focused on the development of such compounds. Because the cardiovascular response to space radiation has not yet been clearly defined,the identification of potential pharmacological countermeasures against cardiovascular effects is still in its infancy.

Involvement of fatty acid-CoA ligase 4 in hepatocellular carcinoma growth: Roles of cyclic AMP and p38 mitogen-activated protein kinase

AIM: Fatty acid-CoA ligase 4 (FACL4) is an arachidonatepreferring enzyme which has been shown to be up-regulated in human colon cancer tissues and implicated in the colon tumorigenesis. The purpose of this study was to investigatethe role of FACL4 in the human hepatocellular carcinoma (HCC) tumorigenesis and the specific signal pathways involved in this process.METHODS: We investigated the expression and regulation of FACL4 in HCC, adjacent non-tumorous liver tissues, and cell lines.RESULTS: In HCC patients, we demonstrated that FACL4 gene expression was markedly elevated in the cancerous tissues than in the adjacent non-cancerous liver tissues.In addition, several human hepatoma cell lines, including Hep3B and HepG2, expressed high levels of FACL4. Stable overex-pression of FACL4 knockdown plasmids (small interfering RNA, siRNA) to Hep3B cells significantly decreased FACL4 expression and subsequently limited the cell proliferation. Treatment of Hep3B cells with 8bromo-cAMP and SB203508 (p38 MAPK inhibitor) significantly suppressed the FACL4 expression. CONCLUSION: FACL4 is involved in the HCC tumorigenesis and both cAMP and p38 MAPK pathways are associated with the regulation of FACL4 in HCC.