Study of Antenatal Care Completion Determinant Factors in Kedougou Health District (Senegal)

Introduction: Maternal mortality is a public health problem of more concern to developing countries. As part of improving the maternofoetal prognosis during pregnancy and childbirth, it is essential to carry out regular follow-ups of pregnant women (FE) through antenatal consultations (ANC). In fact, the World Health Organization (WHO) recommends at least four ANC at regular intervals during pregnancy. In Senegal the completion rate varies greatly depending on the region. In the District of Kédougou it was 41% in 2017 (DHIS2). The national target was not achieved despite the interventions. Thus we studied the determinants of CPN completion in the health district of Kedougou in 2017. Method: The study is of a descriptive and analytical cross-sectional type and concerned a sample of 884 women who gave birth between October 2017 and September 2018. They were chosen by a sample whose distribution in the district was made according to the quota method while respecting the demographic weight of each area of responsibility of the District. Results: The results of our study showed that the average age of women was 24 years with an average number of pregnancies equal to 3. The ANC completion rate at 37% was lower than the administrative data rate which was 41%. The determinants with a statistically most significant link with the completion of ANC are respectively satisfaction with the care and quality of service, the level of information of women regarding PNC, marital status, affordability and distance from the location of the ANC. Conclusion: Increasing women’s incomes, increasing communication about ANC, and bringing health services closer together are needed to improve the completion rate of antenatal care visits.

Association of Host Interferon-γ Gene Polymorphism with Toxoplasma gondii Infection in Pregnant Women of Bangladesh

Human toxoplasmosis is caused by the intracellular protozoan parasite Toxoplasma gondii. Although T. gondii infection is generally asymptomatic for most of the immunocompetent adults, severe complications may occur particularly in pregnant women and immunocompromised individual. Host cell immunity plays a critical role in parasite differentiation and persistence in the host. Therefore, genetic polymorphism in the host immune genes, for instance interferon-γ gene could be linked with possibility of T. gondii infection. The objective of the study was to verify the link between the single nucleotide polymorphisms (SNPs) in the IFN-γ gene of pregnant women and T. gondii infection through correlating with anthropometric and sociodemographic parameters. In this study, ninety-two (N = 92) pregnant women (16 - 40 years) and healthy controls (N = 95) with similar age ranges were included. Among them, 25% (n = 23) pregnant women were seropositive for T. gondii IgG antibodies by Rapid Test Assay. Allelic and genotypic frequencies of IFN-γ +874T/A (rs2430561) SNPs were evaluated by using ARMS-PCR. The distribution of the A and T alleles in the specific position of the IFN-γ gene in the T. gondii-infected pregnant women and the control groups did not differ significantly, according to the data. However, we found a higher frequency (13.04%) of A/A genotype in T. gondii infected pregnant women as compared to non-infected individuals (8.70%), demonstrating that T. gondii infection susceptibility may be increased by homozygosity for the A allele. Further studies are to be needed to find out the link between host gene polymorphism and T. gondii infection in Bangladesh.

Synergistic governance:China's roadmap to improved health through climate and clean air actions

The COP28's inaugural Health Day highlighted the growing recognition of the connection between climate and health,while China's State Council released its third air quality action plan aiming at ongoing health improvement.The Synergetic Roadmap project[1],which aims to track China's progress towards carbon neutrality and clean air,provides valuable insights to answer a set of intriguing questions concerning environmental health determinants,their source sectors,and the methods for harmonizing disparate actions to maximize health gain.

Health-oriented strategies are needed to optimize China’s 2025 clean air action plan

Recently,China’s State Council issued the Continuous Improvement of Air Quality Action Plan(hereafter,the third action plan),which follows the Air Pollution Prevention and Control Action Plan(2013–2017)(hereafter,the first action plan)and the Three-Year Action Plan for Winning the Blue Sky Defense Battle(2018–2020)(hereafter the second action plan).The first two action plans yielded nationwide health benefits[1–3],from improving lung function[4]to saving medical expenditures[5].Based on our previous estimates[6],due to reductions in the fine particulate matter(PM2.5)level,implementation of the first and second action plans was expected to increase life expectancy by 2.11 and 3.68 months.

CABYR binds to AKAP3 and Ropporin in the human sperm fibrous sheath

Calcium-binding tyrosine phosphorylation-regulated protein （CABYR） is a highly polymorphic calcium-binding tyrosine- and serine-/threonine-phosphorylated fibrous sheath （FS） protein involved in capacitation. A putative domain （amino acids 12-48） homologous to the regulatory subunit of type II cAMP-dependent protein kinase A （RII） dimerisation and A kinase-anchoring protein （AKAP）-binding domains of protein kinase A at the N-terminus suggests that CABYR may self-assemble and bind to AKAPs. Moreover, there is evidence that CABYR has limited interaction with AKAPs. However, further evidence and new relationships between CABYR and other FS proteins, including AKAPs, will be helpful in understanding the basic physiology of FS. In this study, a new strategy for co-immunoprecipitation of insoluble proteins, as well as the standard co-immunoprecipitation method in combination with mass spectrometry and western blot, was employed to explore the relationship between CABYR, AKAP3 and Ropperin. The results showed that AKAP3 was co.immunoprecipitated with CABYR by the anti-CABYR-A polyclonal antibody, and, conversely, CABYR was also co.immunoprecipitated with AKAP3 by the anti-AKAP3 polyclonal antibody. Another RIl-like domain containing protein, Ropporin, was also co-immunoprecipitated with CABYR, indicating that Ropporin is one of CABYR＇s binding partners. The interactions between CABYR, AKAP3 and Ropporin were confirmed by yeast two-hybrid assays. Further analysis showed that CABYR not only binds to AKAP3 by its RII domain but binds to Ropporin through other regions besides the RIl-like domain. This is the first demonstration that CABYR variants form a complex not only with the scaffolding protein AKAP3 but also with another Rll-like domain-containing protein in the human sperm FS.

Is there an optimal time to initiate adjuvant chemotherapy to predict benefit of survival in non-small cell lung cancer?

Objective: Adjuvant chemotherapy (AC) after curative resection is known to improve the survival of patients with non-small cell lung cancer (NSCLC); however, few studies have reported the correlation between the time to initiation of AC (TTAC) and survival in NSCLC patients. Methods: The clinical data of 925 NSCLC patients who received curative resection and post-operative AC at the Cancer Hospital of Chinese Academy of Medical Sciences between 2003 and 2013 were retrospectively analyzed. TTAC was measured from the date of surgery to the initiation of AC. Disease-free survival (DFS) was defined as the duration from surgery to the time of tumor recurrence or last follow-up evaluation. The optimal cut-off value of TTAC was determined by maximally selected log-rank statistics. The DFS curve was estimated using the Kaplan-Meier method, and the Cox proportional hazards regression model was used to identify risk factors independently associated with DFS. Propensity score matching (PSM) was performed for survival analysis using the match data. Results: The optimal discriminating cut-off value of TTAC was set at d 35 after curative resection based on which the patients were assigned into two groups: group A (<= 35 d) and group B (> 35 d). There was no significant difference in the DFS between the two groups (P=0.246), indicating that the TTAC is not an independent prognostic factor for DFS. A further comparison continued to show no significant difference in the DFS among 258 PSM pairs (P=0.283). Conclusions: There was no significant correlation between the TTAC and DFS in NSCLC patients. Studies with larger samples are needed to further verify this conclusion.

Online Effective Identification of Glycopeptide Using Liquid Chromatography Combined with Fourier Transform Ion Cyclotron Resonance Mass Spectrometry (FTICR-MS)

The detailed glycan structural analysis of glycoprotein is amenable to glycopeptide enrichment. Here, we develop a simple, effective and economical approach to enrich glycopeptides from proteolytically digested peptide mixtures by chromatographic column packed with graphite carbon and activated charcoal (G/A-column). Glycopeptide from ovalbumin was efficiently enriched by homemade G/A-column using liquid chromatography and the structure of glycopeptide was obtained by tandem mass spectrometry using Fourier transform ion cyclotron resonance mass spectrometry. The results in this study demonstrate that G/A-column can be used to enrich N-glycolpeptides and be benefit for online identification of glycopeptide using LC-MS.

The Influence of Social Desirability on Self-Reported Sexual Behavior in HIV Survey in Rural Ethiopia

Objective: It is in order to examine associations between social desirability (SD) and self-reports of abstinence among youths in rural Ethiopia. Methods: Youths of ages 15-24 (114 participants) were administered questionnaire to assess HIV knowledge and primary abstinence and a modified Marlowe-Crowne Social Desirability Scale to assess SD bias. The relationships between SD groups (dichotomized into high and low) and abstinence by various characteristics were assessed by using Fisher’s exact p-values. Results: The odds of individuals reporting abstinence were 13.2 times greater in the high SD group compared to the low SD group (p-value 0.002) when adjusted for education, gender, age group, and HIV knowledge. The differences in abstinence between the high and low SD score groups were also examined for selected variables. Conclusions: Individuals who exhibited more SD bias were more likely to report primary abstinence. SD bias should be considered when conducting self-reported surveys to measure the effectiveness of HIV prevention programs.

Serum β-hCG level on day 7 of frozen-thawed embryo transfer: association with the clinical pregnancy outcomes in artificial cycles

Objective:The relationship between serum beta human chorionic gonadotropin(β-hCG)levels of patients(7 days after the transplantation of frozen-thawed embryos)and the pregnancy outcomes was investigated.Methods:This study was designed as a retrospective clinical trial of 366 women who underwent frozen-thawed embryo transfers(FETs)in artificial cycles.Patients were divided into three groups:clinical pregnancy group,biochemical pregnancy group,and non-pregnant group according to their pregnancy outcomes.Serumβ-hCG levels were tested on day 4,7,9,11 and 14 after FET.Results:In the clinical pregnancy group,the serumβ-hCG levels after 7-day post-transplantation were significantly elevated(16.20 IU/L vs.3.07 vs.0.1 IU/L;P<0.05)compared with the other two groups.Furthermore,it was found that Area Under Curve(AUC=0.96)was significant with cut-off value higher than 4.26 IU/L(sensitivity=92.3%,specificity=90.2%)to predict the clinical pregnancy outcomes in the receiver operating characteristic(ROC)analysis ofβ-hCG concentrations on day 7 of post-transplantation.Conclusion:Our results suggested that the elevated serumβ-hCG levels on day 7 of post-transplantation could predict the positive clinical pregnancy outcomes in artificial FET cycles.

Development of a Method to Determine the Environmental Burden of Diseases and an Application to Identify Factors Driving Changes in the Number of PM_(2.5)-Related Deaths in China between 2000 and 2010

The attributable burden is codetermined by the exposure level and nontarget characteristics.However,the conventional method of health impact assessment based on preestablished exposure−response functions includes only a few well-known characteristics and thus is insufficient to capture the comprehensive variation.We aimed to develop a method to fuse health impact assessment with epidemiological analysis and to identify factors driving baseline risk.The method was applied to identify the factors underlying the change in the number of fine particulate matter(PM_(2.5))related deaths in China between 2000 and 2010.During the study period,the number of PM_(2.5)-related deaths across China's Mainland increased by 0.62(95%CI:0.57,0.69)million,with 0.65(95%CI:0.47,0.91)million,0.55(95%CI:0.39,0.79)million,and 0.11(95%CI:0.06,0.18)million deaths being associated with increased PM_(2.5)exposure,population aging,and growth in population size,respectively.However,economic growth,urbanization,improvement of welfare services,and improvement of hospital services resulted in 0.25(95%CI:0.15,0.40)million,0.16(95%CI:0.10,0.27)million,0.16(95%CI:0.09,0.26)million,and 0.09(95%CI:0.05,0.15)million fewer deaths,respectively.Results indicated that increased exposure was the major driver of the change in the number of PM_(2.5)-related deaths,and economic growth was the main driver of increased resilience to air pollution.

The 2022 report of synergetic roadmap on carbon neutrality and clean air for China:Accelerating transition in key sectors

China is now confronting the intertwined challenges of air pollution and climate change.Given the high synergies between air pollution abatement and climate change mitigation,the Chinese government is actively promoting synergetic control of these two issues.The Synergetic Roadmap project was launched in 2021 to track and analyze the progress of synergetic control in China by developing and monitoring key indicators.The Synergetic Roadmap 2022 report is the first annual update,featuring 20 indicators across five aspects:synergetic governance system and practices,progress in structural transition,air pollution and associated weather-climate interactions,sources,sinks,and mitigation pathway of atmospheric composition,and health impacts and benefits of coordinated control.Compared to the comprehensive review presented in the 2021 report,the Synergetic Roadmap 2022 report places particular emphasis on progress in 2021 with highlights on actions in key sectors and the relevant milestones.These milestones include the proportion of non-fossil power generation capacity surpassing coal-fired capacity for the first time,a decline in the production of crude steel and cement after years of growth,and the surging penetration of electric vehicles.Additionally,in 2022,China issued the first national policy that synergizes abatements of pollution and carbon emissions,marking a new era for China's pollution-carbon co-control.These changes highlight China's efforts to reshape its energy,economic,and transportation structures to meet the demand for synergetic control and sustainable development.Consequently,the country has witnessed a slowdown in carbon emission growth,improved air quality,and increased health benefits in recent years.

The main and added effects of heat on mortality in 33 Chinese cities from 2007 to 2013

Increases in ambient temperatures and the frequency of extreme heat events constitute important burdens on global public health.However,evidence on their effects on public health is limited and inconclusive in China.In this study,data on daily deaths recorded in 33 Chinese cities from 2007 to 2013 was used to evaluate the effect of heat on mortality in China.In addition to the definition of a heatwave established by the China Meteorological Administration,we combined four city-specific relative thresholds(90th,92.5th,95th,and 97.5th percentiles)of the daily mean temperature during the study period and three durations of≽2,≽3,and≽4 days,from which 13 heatwave definitions were developed.Then,we estimated the main and added effects of heat at the city level using a quasi-Poisson generalized additive model combined with a distributed lag nonlinear model.Next,the estimates for the effects were pooled at the national level using a multivariable meta-analysis.Subgroup analysis was performed according to sex,age,educational attainment,and spatially stratified heterogeneity.The results showed that the mortality risk increased from 22.3%to 37.1%due to the effects of the different heatwave definitions.The added effects were much lower,with the highest increase of 3.9%(95%CI:1.7%–6.1%)in mortality risk.Females,the elderly,populations with low educational levels,and populations living inland in China were found to be the most vulnerable to the detrimental effects of heat.These findings have important implications for the improvement of early warning systems for heatwaves.

Evolution in disparity of PM_(2.5)pollution in China

The spatial disparity of air pollutants is one of the key influential factors for environmental inequality.We quantitatively evaluated the evolution of PM_(2.5)spatial disparity in China during 2013–2020,and investigated the associations between PM_(2.5)spatial disparity and economic indicators.Differences in PM_(2.5)between more-and less-polluted cities declined over time,suggesting decreased absolute disparity.However,the more polluted cities in 2013 remained so in 2017 and 2020,and vice versa,indicating persistent relative disparity.PM_(2.5)pollution levels increased with higher GDP per capita in less-developed areas of China,but such negative effects weakened over time,while economic development tended to promote cleaner air in developed areas of China.Therefore,policies to improve air quality and promote economic development simultaneously are needed in China to reduce the disparity of air pollution and promote all people to enjoy environmental equality.

Synergetic roadmap of carbon neutrality and clean air for China

It is well recognized that carbon dioxide and air pollutants share similar emission sources so that synergetic policies on climate change mitigation and air pollution control can lead to remarkable co-benefits on greenhouse gas reduction,air quality improvement,and improved health.In the context of carbon peak,carbon neutrality,and clean air policies,this perspective tracks and analyzes the process of the synergetic governance of air pollution and climate change in China by developing and monitoring 18 indicators.The 18 indicators cover the following five aspects:air pollution and associated weather-climate conditions,progress in structural transition,sources,inks,and mitigation pathway of atmospheric composition,health impacts and benefits of coordinated control,and synergetic governance system and practices.By tracking the progress in each indicator,this perspective presents the major accomplishment of coordinated control,identifies the emerging challenges toward the synergetic governance,and provides policy recommendations for designing a synergetic roadmap of Carbon Neutrality and Clean Air for China.

是应该考虑剖宫产对儿童长期健康风险的时候了

剖宫产可以改善母婴健康，甚至挽救生命，但是在过去的20年中，许多国家的剖宫产率显著上升，引起人们对不必要的高剖宫产率的担忧。在英国，母亲要求剖宫产分娩相对很少，占分娩的1％～2％，

Evaluation of DNA damage profile in obese women and its association to risk of metabolic syndrome,polycystic ovary syndrome and recurrent preeclampsia

Metabolic syndrome(MS)is a cluster of metabolic abnormalities.Obesity and MS are always accompanied by elevated oxidative stress which might affect cellular biomolecules such as DNA.The aim of the present study is to investigate DNA damage profile in obese premenopausal women and its relation to the risk of MS,polycystic ovary syndrome(PCOS)and history of recurrent pre-eclampsia.The study included 90 obese women included cases with MS(nZ30),PCOS(n Z30)and previous history of recurrent preeclampsia(nZ30)and,age-matched healthy non-obese control women(n Z 50).The assessment of leukocyte DNA damage was done by comet assay for all cases and controls.Anthropometry and biochemical parameters have been measured.Results showed that mean percent of DNA damage was significantly higher in MS,PCOS as well as in women with the recurrent preeclampsia as compared to healthy controls.The high level of mean DNA damage frequency in obese women was significantly associated with the increased number of metabolic syndrome components.Cases with 2,3 and 3e5 components showed significantly higher levels of DNA damage than controls.Moreover,cases with 3e5 MS components showed significant higher DNA compared to those with the two components.Regarding PCOS,significant positive association between the mean frequency of DNA damage and waist circumference was observed.The study suggests that metabolic abnormalities,PCOS and recurrent pre-eclampsia might be contributed in development of DNA damage in obese women.DNA damage can serve as an early marker for obesity complications in premenopausal women.

Is serum sex hormone-binding globulin a dominant risk factor for metabolic syndrome？

This multi-center, cross-sectional study investigated the association between serum testosterone （T） levels, serum sex hormone-binding globulin （SHBG） levels, and the risk of metabolic syndrome （MS） in 3332 adult Chinese men. The prevalence of MS was 34.7%, and men with MS had lower serum levels of total T （TT） and SHBG than those without MS （P 〈 0.001）. There was no significant difference in serum free T （FT） levels between subjects with and without MS （P = 0.627）. In logistic regression analysis, the association between MS and serum SHBG levels persisted after adjusting for age, body mass index （BMI）, smoking and drinking status, and serum TT （odds ratio [OR] 0.962, 95% confidence interval [95% CI] 0.954-0.969, P 〈 0.01）. However, the association between serum TT level and the risk of MS was weak after adjusting for age, BMI, SHBG level, and smoking and drinking status （OR 0,981, 95% CI 0.960-1.007）. Our study reveals that both serum TT and SHBG levels, but not serum FT, are inversely associated with the prevalence of MS and that serum SHBG is an independent and dominant risk factor for MS.This multi-center, cross-sectional study investigated the association between serum testosterone （T） levels, serum sex hormone-binding globulin （SHBG） levels, and the risk of metabolic syndrome （MS） in 3332 adult Chinese men. The prevalence of MS was 34.7%, and men with MS had lower serum levels of total T （TT） and SHBG than those without MS （P 〈 0.001）. There was no significant difference in serum free T （FT） levels between subjects with and without MS （P = 0.627）. In logistic regression analysis, the association between MS and serum SHBG levels persisted after adjusting for age, body mass index （BMI）, smoking and drinking status, and serum TT （odds ratio [OR] 0.962, 95% confidence interval [95% CI] 0.954-0.969, P〈 0.01）. However, the association between serum TT level and the risk of MS was weak after adjusting for age, BMI, SHBG level, and smoking and drinking status （OR 0,981, 95% CI 0.960-1.007）. Our study reveals that both serum TT and SHBG levels, but not serum FT, are inversely associated with the prevalence of MS and that serum SHBG is an independent and dominant risk factor for MS.

Susceptibility of patients with chronic obstructive pulmonary disease to heart rate difference associated with the short-term exposure to metals in ambient fine particles:A panel study in Beijing,China

Susceptibility of patients with chronic obstructive pulmonary disease(COPD)to cardiovascular autonomic dysfunction asso-ciated with exposure to metals in ambient fine particles(PM2.5,particulate matter with aerodynamic diameter≤2.5µm)remains poorly evidenced.Based on the COPDB(COPD in Beijing)panel study,we aimed to compare the associations of heart rate(HR,an indicator of cardiovascular autonomic function)and exposure to metals in PM2.5 between 53 patients with COPD and 82 healthy controls by using linear mixed-effects models.In all participants,the HR levels were significantly associated with interquartile range increases in the average concentrations of Cr,Zn,and Pb,but the strength of the associations differed by exposure time(from 1.4%for an average 9 days(d)Cr exposure to 3.5%for an average 9 d Zn exposure).HR was positively associated with the average concentrations of PM2.5 and certain metals only in patients with COPD.Associations between HR and exposure to PM2.5,K,Cr,Mn,Ni,Cu,Zn,As,and Se in patients with COPD significantly differed from those in health controls.Furthermore,association between HR and Cr exposure was robust in COPD patients.In conclusion,our findings indicate that COPD could exacerbate difference in HR following exposure to metals in PM2.5.

Increasing life expectancy in China by achieving its 2025 air quality target

China is striving to build a“Beautiful China”characterized by clean air.The country has committed to further reducing its national mean fine particle(PM_(2.5))concentration by 10%from 2020 to 2025,following the substantial improvements in its air quality during the past decade.Meanwhile,the“Healthy China”mission has pledged to increase the national mean life expectancy by one year during the same period.Yet,to what extent will the“Beautiful China”mission contribute to the“Healthy China”vision by reducing the levels of the detrimental PM_(2.5) is still unclear.Here,by coupling the life table approach and an epidemiological concentration-response model,this study quantifies the potential benefits of achieving China's 2025 air quality target on the national life expectancy.The analysis reveals that the Chinese citizen could expect to extend the average life expectancy by 42.5 days by 2025 due to improved air quality.In addition,if the Chinese government outperforms the planned air quality target,as it usually does,the gains would increase to 65.4 days,~18% of the“Healthy China”life expectancy increment task.Further reductions in PM_(2.5) concentration would lead to accelerated gains in life expectancy both nationally and at the city level,providing strong incentives for the authorities to keep improving air quality.This study reveals the notable benefits on individual life that could be expected from air quality improvement in China and suggests that longer life expectancy is achievable by implementing a health-prioritized air quality management mechanism.

Association of PM_(2.5)Reduction with Improved Kidney Function:A Nationwide Quasiexperiment among Chinese Adults

Background.Increasing evidence from human studies has revealed the adverse impact of ambient fine particles(PM_(2.5))on health outcomes related to metabolic disorders and distant organs.Whether exposure to ambient PM_(2.5)leads to kidney impairment remains unclear.The rapid air quality improvement driven by the clean air actions in China since 2013 provides an opportunity for a quasiexperiment to investigate the beneficial effect of PM_(2.5)reduction on kidney function.Methods.Based on two repeated nationwide surveys of the same population of 5115 adults in 2011 and 2015,we conducted a difference-indifference study.Variations in long-term exposure to ambient PM_(2.5)were associated with changes in kidney function biomarkers,including estimated glomerular filtration rate by serum creatinine(GFRscr)or cystatin C(GFRcys),blood urea nitrogen(BUN),and uric acid(UA).Results.For a 10μg/m^(3)reduction in PM_(2.5),a significant improvement was observed for multiple kidney functional biomarkers,including GFRscr,BUN and UA,with a change of 0.42(95%confidence interval[CI]:0.06,0.78)mL/min/1.73m^(2),-0.38(-0.64,-0.12)mg/dL,and-0.06(-0.12,-0.00)mg/dL,respectively.A lower socioeconomic status,indicated by rural residence or low educational level,enhanced the adverse effect of PM_(2.5)on kidney function.Conclusions.These results support a significant nephrotoxicity of PM_(2.5)based on multiple serum biomarkers and indicate a beneficial effect of improved air quality on kidney function.