A Scoping Review of the Biological, Socioeconomic and Environmental Determinants of Overweight and Obesity Among Middle Eastern and Northern African Nationalities.

Objectives: Globally, and particularly in the Middle East and North Africa (MENA) region, overweight and obesity have become serious public health concerns. This scoping review aimed to identify and summarise the available data on the determinants of overweight and obesity among MENA nationalities. Methods: An extensive search of electronic databases, including Google Scholar, PubMed and ProQuest, for articles published from 2007 until 2022 was conducted. A total of 10 articles, of the 333 that were found in the original search, met the inclusion criteria. Data extraction and quality assessment were applied to each of the selected studies. Results: There is an intricate interplay of anthropometric, behavioural, sociodemographic and environmental factors that caused overweight and obesity in this population. Conclusions: A thorough synthesis of the factors influencing overweight and obesity in MENA nationalities was provided by this scoping review.

Use of zinc deposited in deciduous teeth as a retrospective measurement of dietary zinc exposure during early development.

Purpose: We proposed that zinc (Zn) deposition in deciduous teeth would be a timed record of exposure to this essential micronutrient over very early life. We tested this hypothesis by gathering information on the maternal and child's diet during pregnancy and early infancy and measuring mineral deposition in the dentine at points during deciduous tooth development. Methods: We developed a short food frequency questionnaire (S-FFQ) to record consumption of food containing Zn during pregnancy and over the first year of life of the child in an Indonesian population. Zn, Sr and Ca were measured by laser ablation ICP-MS in a series of points across the developmental timeline in deciduous teeth extracted from 18 children undergoing the process as part of dental treatment whose mothers completed the SFFQ. Mothers and children were classified into either high Zn or low Zn groups according to calculated daily Zn intake. Results: The Zn/Sr ratio in dentine deposited over late pregnancy and 0-3 months post-partum was higher (p < 0.001, 2-way ANOVA; p < 0.05 by Holm-Sidak post hoc test) in the teeth of children of mothers classified as high Zn consumers (n = 10) than in children of mothers classified as low Zn consumers (n = 8). Conclusion: The S-FFQ was validated internally as adequately accurate to measure zinc intake retrospectively during pregnancy and post-partum (∼7 years prior) by virtue of the correlation with measurements of zinc in deciduous teeth. The ratio of Zn/Sr in deciduous teeth appears to be a biomarker of exposure to zinc nutrition during early development and offers promise for use as a record of prior exposure along a timeline for research studies and, potentially, to identify individuals at heightened risk of detrimental impacts of poor early life zinc nutrition on health in later life and to implement preventative interventions.

Soil self-cleaning capacity: Removal of organic compounds during sub-surface irrigation with sewage effluent.

Globally, the reuse of treated sewage effluent for irrigation purposes is increasingly encouraged as a practical solution against the mismatch between the demand for and availability of freshwater resources. The reuse of sewage effluent for sub-surface irrigation (SSI) in agriculture serves the dual purpose of supplying water to crops and diminishing emissions of contaminants of emerging concern (CoECs) into surface water. To investigate such reuse, in a real scale cropland with SSI using sewage effluent, from September 2017 to March 2019 including the extremely dry year 2018, residues were followed of 133 CoECs as related to their physicochemical properties and quantified by liquid chromatography coupled to high-resolution mass spectrometry. Of the 133 target CoECs, 89 were retrieved in the field, most non-detect CoECs have low persistency. During the growing season with sub-surface irrigation, CoECs spread to the shallow groundwater and rhizosphere. Significantly lower concentrations are found between infiltration pipes as compared to directly next to the pipes in shallow groundwater for all persistency-mobility classes. CoECs belonging to the class pm (low persistency and low mobility) or class PM (high persistency and high mobility) class show no change amongst their removal in the rhizosphere and groundwater in a dry versus normal year. CoECs belonging to the class pM (low persistency and high mobility) show high seasonal dynamics in the rhizosphere and shallow groundwater, indicating that these CoECs break down. CoECs of the class Pm (high persistency and low mobility) only significantly build up in the rhizosphere next to infiltration pipes. Climatic conditions with dry summers and precipitation surplus and drainage in winter strongly affect the fate of CoECs. During the dry summer of 2018 infiltrated effluent is hardly diluted, resulting in significantly higher concentrations for the CoECs belonging to the classes pM and Pm. After the extremely dry year of 2018, cumulative concentrations are still significantly higher, while after a normal year during winter precipitation surplus removes CoECs. For all persistency-mobility classes in the shallow groundwater between the pipes, we find significant removal efficiencies. For the rhizosphere between the pipes, we find the same except for Pm. Next to the pipes however we find no significant removal for all classes in both the rhizosphere and shallow groundwater and even significant accumulation for Pm. For this group of persistent moderately hydrophobic CoECs risk characterization ratio's were calculated for the period of time with the highest normalized concentration. None of the single-chemical RCRs are above one and the ΣRCR is also far below one, implying sufficiently safe ambient exposures. Overall the deeper groundwater (7.0-11.8 m below soil surface) has the lowest response to the sub-surface irrigation for all persistency-mobility. When adopting a SSI STP effluent reuse system care must be taken to monitor the CoECs that are (moderately) hydrophobic as these can build up in the SSI system. For the deeper groundwater and for the discharge to the surface water, we find significant removal for the pM and the PM class but not for other classes. In conclusion, relatively high removal efficiencies are shown benefiting the surface waters that would otherwise receive the STP effluent directly.

Stigma towards health care providers taking care of COVID-19 patients: A multi-country study.

Background: Health care providers (HCPs) have always been a common target of stigmatization during widespread infections and COVID-19 is not an exception. Aim: This study aims to investigate the prevalence of stigmatization during the COVID-19 pandemic among HCPs in seven different countries using the Stigma COVID-19 Healthcare Providers tool (S19-HCPs). Design: Cross-sectional. Methods: The S19-HCPs is a self-administered online survey (16-item) developed and validated by the research team. The participants were invited to complete an online survey. Data collection started from June-July 2020 using a convenience sample of HCPs from Iraq, Jordan, Egypt, Saudi Arabia, Indonesia, Philippines, and Kuwait. Results: A total number of 1726 participants were included in the final analysis. The majority of the study participants were Jordanians (22%), followed by Kuwaitis (19%), Filipinos (18%) and the lowest participants were Indonesians (6%). Other nationalities were Iraqis, Saudis, and Egyptians with 15%, 11% and 9% respectively. Among the respondents, 57% have worked either in a COVID-19 designated facility or in a quarantine center and 78% claimed that they had received training for COVID-19. Statistical significance between COVID-19 stigma and demographic variables were found in all aspect of the S19-HCPs. Conclusion: The findings of this study demonstrated high levels of stigmatization against HCPs in all the included seven countries. On the other hand, they are still perceived positively by their communities and in their utmost, highly motivated to care for COVID-19 patients. Educational and awareness programs could have a crucial role in the solution of stigmatization problems over the world.

Structural and psychological empowerment and its influencing factors among nursing students in Oman.

BACKGROUND: This study explored the empowerment of nursing students to contribute to nursing education and recommend ways of increasing the engagement of nursing students in their training. The development of empowerment among nursing students leads to the maximum achievement of learning competencies and enables them to eventually become competent nurses. PURPOSE: This study examined the relationship between student nurses' characteristics, structural empowerment, and psychological empowerment. METHODS: A total of 185 nursing students were recruited through systematic sampling at Sultan Qaboos University, with a 92% response rate. Nursing students' level of psychological empowerment, in terms of meaning, competence, self-determination, and impact, and their level of structural empowerment, in terms of access to opportunity, support, information, and resources were investigated using a self-designed questionnaire. RESULTS: The results showed that "access to support" was rated as the highest dimension by the students, followed by "access to information," "informal power," "access to opportunity," "access to resources," and "formal power." The global empowerment mean score was 3.64 (SD = 1.01), and the total structural empowerment score was 20.58 (SD = 3.62). The multivariate multiple regression analysis revealed that students' year level and involvement in school organizations had multivariate effects on the four dimensions of psychological empowerment. Students who were involved in school organizations had higher scores for the dimensions of "meaning," "competence," and "impact" than students who were not involved in any school organization. CONCLUSION: Power can be either developed or acquired, and its definition is expressed based on the achievement objective. Age is not a barrier, as it had little or no impact on nursing student experiences and no correlation with structural empowerment.

Long-term clinical, virological and immunological outcomes following planned treatment interruption in HIV-infected children.

OBJECTIVES: Planned treatment interruption (PTI) of antiretroviral therapy (ART) in adults is associated with adverse outcomes. The PENTA 11 trial randomized HIV-infected children to continuous ART (CT) vs. CD4-driven PTIs. We report 5 years' follow-up after the end of main trial. METHODS: Post-trial, all children resumed ART. Clinical, immunological, virological and treatment data were collected annually. A sub-study investigated more detailed immunophenotype. CT and PTI arms were compared using intention-to-treat. Laboratory parameters were compared using linear regression, adjusting for baseline values; mixed models were used to include all data over time. RESULTS: In all, 101 children (51 CT, 50 PTI) contributed a median of 7.6 years, including 5.1 years of post-trial follow-up. Post-trial, there were no deaths, one pulmonary tuberculosis and no other CDC stage B/C events. At 5 years post-trial, 90% of children in the CT vs. 82% in the PTI arm had HIV RNA < 50 copies/mL (P = 0.26). A persistent increase in CD8 cells was observed in the PTI arm. The sub-study (54 children) suggested that both naïve and memory populations contributed to higher CD8 cells following PTI. Mean CD4/CD8 ratios at 5 years post-trial were 1.22 and 1.08 in CT and PTI arms, respectively [difference (CT - PTI) = -0.15; 95% CI: -0.34-0.05), P = 0.14]. The sub-study also suggested that during the trial and at early timepoints after the end of the trial, reduction in CD4 in the PTI arm was mainly from loss of CD4 memory cells. CONCLUSIONS: Children tolerated PTI with few long-term clinical, virological or immunological consequences.

Maternal health, pregnancy and birth outcomes for women involved in care proceedings in Wales: a linked data study.

BACKGROUND: Under the Children Act 1989, local authorities in Wales, UK, can issue care proceedings if they are concerned about the welfare of a child, which can lead to removal of a child from parents. For mothers at risk of child removal, timely intervention during pregnancy may avert the need for this and improve maternal/fetal health; however, little is known about this specific population during the antenatal period. The study examined maternity characteristics of mothers whose infants were subject to care proceedings, with the aim of informing preventative interventions targeted at high risk mothers. METHODS: Anonymised administrative data from Cafcass Cymru, who provide child-focused advice and support for family court proceedings in Wales, were linked to population-based maternity and health records held within the Secure Anonymised Information Linkage Databank. Linked data were available for 1111 birth mothers of infants involved in care proceedings between 2015 and 2018. Findings were benchmarked with reference to an age-deprivation-matched comparison group (n = 23,414), not subject to care proceedings but accessing maternity services during this period. Demographic characteristics, maternal health, reproductive history, interaction with midwifery services, and pregnancy and birth outcomes were examined. Descriptive and statistical tests of independence were used. RESULTS: Half of the women in the cohort (49.4%) resided in the most deprived areas. They were more likely to be younger at entry to motherhood (63.5% < 21 years-of-age compared to 42.7% in the comparison group), to have mental health (28.6% compared to 8.2%) and substance use issues (10.4% compared to 0.6%) and to smoke (62.7% compared to 24.8%) during pregnancy. The majority first engaged with maternity services within their first trimester of pregnancy (63.5% compared to 84.4%). Babies were more likely to be born preterm (14.2% compared to 6.7%) and, for full-term babies, to have low birthweights (8.0% compared to 2.8%). CONCLUSION: This novel linkage study highlights multiple vulnerabilities experienced by pregnant mothers who have experienced care proceedings concerning an infant. Policy and practice colleagues require a clearer picture of women's needs if child protection and health services are to offer effective services which prevent the need for family court proceedings and infant removal.

The utilization of social networking sites, their perceived benefits and their potential for improving the study habits of nursing students in five countries.

BACKGROUND: The abundance of easy and accessible information and the rapid development of social networking sites (SNSs) have proven that the world is small and within reach. The great implication of this interconnectivity is attributable to the change in the learning and sharing environment, which for the most part is something that classrooms are lacking. Considering the potential implications of SNSs in nursing education reveals the benefits of SNSs in allowing students to communicate and interact with a wider audience and beyond the classroom. The aim of this study is to identify the extent of SNS utilization, the perceived benefits of SNSs and the potential of SNSs for improving the study habits of nursing students in five countries (Israel, Iraq, Oman, the Philippines and Turkey). METHODS: This study is a quantitative cross-sectional study that determined the relationship between the utilization of SNSs, the perceived benefits of SNSs, and the potential of SNSs for improving the study habits of nursing students in the five participating countries (Israel, Iraq, Oman, the Philippines, and Turkey). This paper is based on carefully analysing the survey responses of a sample of 1137 students from an online hosting site. The online instrument focuses on the extent of the utilization and benefits of SNSs according to their accessibility, usability, efficiency and reliability. RESULTS: Based on the Pearson correlation coefficient (r) our findings, reveal a significant positive correlation between the extent of a possible improvement in study habits and the extent of SNS utilization in terms of the four domains, namely, accessibility (r = 0.246), usability (r = 0.377), reliability (r = 0.287) and efficiency (r = 0.387). CONCLUSION: It can be concluded that there is a significant positive correlation between students' study habits and the extent of SNS utilization, meaning that the more students devote themselves to their study habits, the higher the level of SNS utilization. The use of SNSs by nursing students has positive and negative implications, and there is greater potential for further improving approaches to nursing education through the adaptation of curricula based on the proper utilization of SNSs.

Data Resource: population level family justice administrative data with opportunities for data linkage.

INTRODUCTION: Although there has been considerable progress in the use of administrative data for applied health research, the family justice field lags behind. Better use of administrative data are essential to enhance understanding of how the family justice system is working, as well as the characteristics of, and outcomes for, children and families. The Family Justice Data Partnership (FJDP) supports this aim through analyses of core family justice and linked datasets in the SAIL Databank (Secure Anonymised Information Linkage). Cafcass Cymru provide expert advice for children involved in family court proceedings in Wales, ensuring decisions are made in the best interests of the child. We provide an overview of Cafcass Cymru data. We also describe and illustrate linkage to administrative datasets within SAIL. METHODS: Cafcass Cymru data was transferred to SAIL using a standardised approach to provide de-identified data with Anonymised Linking Fields (ALF) for successfully matched records. Three cohorts were created: all individuals involved in family court applications; all individuals with an ALF allowing subsequent health data linkage; and all individuals with a Residential Anonymised Linking Field (RALF) enabling area-level deprivation analysis. RESULTS: Cafcass Cymru application data are available for child protection matters (public law, range 2011-2019, n=12,745), and child arrangement disputes (private law, range 2005-2019, n=52,023). An 80% data linkage match rate was achieved. 40% had hospital admissions within two years pre or post application; 54% had emergency department attendances and 61% had outpatient appointments. Individuals were more likely to reside in deprived areas regardless of law type. CONCLUSION: Cafcass Cymru data can be accessed through the SAIL Databank. The FJDP will continue to enhance research opportunities for all to better understand the family justice system, and outcomes for those involved, such as health and wellbeing for children and family members.

Lessons for test and treat in an antiretroviral programme after decentralisation in Uganda: a retrospective analysis of outcomes in public healthcare facilities within the Lablite project.

BACKGROUND: We describe the decentralisation of antiretroviral therapy (ART) alongside Option B+ roll-out in public healthcare facilities in the Lablite project in Uganda. Lessons learned will inform programmes now implementing universal test and treat (UTT). METHODS: Routine data were retrospectively extracted from ART registers between October 2012 and March 2015 for all adults and children initiating ART at two primary care facilities (spokes) and their corresponding district hospitals (hubs) in northern and central Uganda. We describe ART initiation over time and retention and use of Cox models to explore risk factors for attrition due to mortality and loss to follow-up. Results from tracing of patients lost to follow-up were used to correct retention estimates. RESULTS: Of 2100 ART initiations, 1125 were in the north, including 944 (84%) at the hub and 181 (16%) at the spokes; children comprised 95 (10%) initiations at the hubs and 14 (8%) at the spokes. Corresponding numbers were 642 (66%) at the hub and 333 (34%) at the spokes in the central region (77 [12%] and 22 [7%], respectively, in children). Children <3 y of age comprised the minority of initiations in children at all sites. Twenty-three percent of adult ART initiations at the north hub were Option B+ compared with 45% at the spokes (25% and 65%, respectively, in the central region). Proportions retained in care in the north hub at 6 and 12 mo were 92% (95% CI 90 to 93) and 89% (895% CI 7 to 91), respectively. Corresponding corrected estimates in the north spokes were 87% (95% CI 78 to 93) and 82% (95% CI 72 to 89), respectively. In the central hub, corrected estimates were 84% (95% CI 80 to 87) and 78% (95% CI 74 to 82), and were 89% (95% CI 77.9 to 95.1) and 83% (95% CI 64.1 to 92.9) at the spokes, respectively. Among adults newly initiating ART, being older was independently associated with a lower risk of attrition (adjusted hazard ratio [aHR] 0.93 per 5 y [95% CI 0.88 to 0.97]). Other independent risk factors included initiating with a tenofovir-based regimen vs zidovudine (aHR 0.60 [95% CI 0.46 to 0.77]), year of ART initiation (2013 aHR 1.55 [95% CI 1.21 to 1.97], ≥2014 aHR 1.41 [95% CI 1.06 to 1.87]) vs 2012, hub vs spoke (aHR 0.35 [95% CI 0.29 to 0.43]) and central vs north (aHR 2.28 [95% CI 1.86 to 2.81]). Independently, patient type was associated with retention. CONCLUSIONS: After ART decentralisation, people living with human immunodeficiency virus (HIV) were willing to initiate ART in rural primary care facilities. Retention on ART was variable across facilities and attrition was higher among some groups, including younger adults and women initiating ART during pregnancy/breastfeeding. Interventions to support these groups are required to optimise benefits of expanded access to HIV services under UTT.

Nonequilibrium Steady States in Fluid Transport through Mesopores: Dynamic Mean Field Theory and Nonequilibrium Molecular Dynamics.

We present a dynamic mean field theory (DMFT) and nonequilibrium dual control volume grand canonical molecular dynamics (GCMD) simulation study of steady-state fluid transport in slit-shaped mesopores under an applied chemical potential gradient. The main focus is on states where the bulk conditions on one side of the pore would lead to a capillary condensed state in the pore at equilibrium while those on the other side would lead to a vapor state in the pore. This choice of conditions is motivated by certain separation applications in which condensable vapors permeate through mesoporous membranes. Under these circumstances, we have found partially filled states with a liquid-like state at the high chemical potential end of the pore and a vapor-like state at the low chemical potential end. This phenomenon is accompanied by hysteresis. The existence of partially filled states has been hypothesized in previous work but the present paper reveals them as an emergent feature of the systems. We find that predictions of DMFT are in good qualitative agreement with the overall GCMD results. However, the GCMD results demonstrate that the transport is faster through the partially filled pore than through the unfilled pore, a feature not captured by DMFT.

Quality of Life and the Predictive Roles of Religiosity and Spiritual Coping Among Nursing Students: A Multi-country Study.

There has been high interest in religious and spirituality practices among college students due to positive benefits to university life. However, no studies have been conducted examining nursing students' religiosity and use of spiritual coping and its impact on their QOL. This cross-sectional, descriptive study measured the QOL and examined the predictive roles of religiosity and spiritual coping among nursing students from four countries. Nursing students reported high overall QOL and health. Significant differences were revealed on the religiosity and spiritual coping of students in terms of demographic characteristics. Findings show frequent attendance to organized and non-organized religious activities lead to better physical and environmental domains, and using non-organized religious activities frequently lead to improved psychological health. More frequent use of non-religious coping strategies was associated with better physical, psychological, and environmental health, and improved social relationships.

Exploring barriers and solutions in advancing cross-centre population data science.

INTRODUCTION: It is widely acknowledged that population health and administrative data, especially when linked at the individual level, hold great value for research. Cross-centre working between data centres providing access to such data has the potential to further increase this value by effectively expanding the data available for research. However, there is limited published information on how to address the challenges and achieve success. The aim of this paper is to explore perceived barriers and solutions to inform developments in cross-centre working across data centres. METHODS: We carried out a narrative literature review on data sharing and cross centre working. We used a mixed methods approach to assess the opinions of members of the public on cross-centre data sharing, and the views and experiences of among data centre staff connected with the UK Farr Institute for Health Informatics Research. RESULTS: The literature review uncovered a myriad of practical and cultural issues. Our engagement with a public group suggested that cross-centre working involving anonymised data being moved between established centres is considered acceptable. The main themes emerging from discussions with data centre staff were dedicated resourcing, practical issues, information governance and culture. CONCLUSION: In seeking to advance cross-centre working between data centres, we conclude that there is a need for dedicated resourcing, indicators to recognise data reuse, collaboration to solve common issues, and balancing necessary barrier removal with incentivisation. This will require on-going commitment, engagement and an academic culture change.

A Profile of the SAIL Databank on the UK Secure Research Platform.

BACKGROUND: The Secure Anonymised Information Linkage (SAIL) Databank is a national data safe haven of de identified datasets principally about the population of Wales, made available in anonymised form to researchers across the world. It was established to enable the vast arrays of data collected about individuals in the course of health and other public service delivery to be made available to answer important questions that could not otherwise be addressed without prohibitive effort. The SAIL Databank is the bedrock of other funded centres relying on the data for research. APPROACH: SAIL is a data repository surrounded by a suite of physical, technical and procedural control measures embodying a proportionate privacy-by-design governance model, informed by public engagement, to safeguard the data and facilitate data utility. SAIL operates on the UK Secure Research Platform (SeRP), which is a customisable technology and analysis platform. Researchers access anonymised data via this secure research environment, from which results can be released following scrutiny for disclosure risk. SAIL data are being used in multiple research areas to evaluate the impact of health and social exposures and policy interventions. DISCUSSION: Lessons learned and their applications include: managing evolving legislative and regulatory requirements; employing multiple, tiered security mechanisms; working hard to increase analytical capacity efficiency; and developing a multi-faceted programme of public engagement. Further work includes: incorporating new data types; enabling alternative means of data access; and developing further efficiencies across our operations. CONCLUSION: SAIL represents an ongoing programme of work to develop and maintain an extensive, whole population data resource for research. Its privacy-by-design model and UK SeRP technology have received international acclaim, and we continually endeavour to demonstrate trustworthiness to support data provider assurance and public acceptability in data use. We strive for further improvement and continue a mutual learning process with our contemporaries in this rapidly developing field.

GooD4Mum: A general practice-based quality improvement collaborative for diabetes prevention in women with previous gestational diabetes.

AIMS: Gestational diabetes (GDM) and Type 2 diabetes pose tremendous health and economic burdens as worldwide incidence increases. Primary care-based systematic diabetes screening and prevention programs could be effective in women with previous GDM. GooD4Mum aimed to determine whether a Quality Improvement Collaborative (QIC) would improve postpartum diabetes screening and prevention planning in women with previous GDM in general practice. METHODS: Fifteen general practices within Victoria (Australia) participated in a 12-month QIC, consisting of baseline and four quarterly audits, guideline-led workshops and Plan-Do-Study-Act feedback cycles after each audit. The primary outcome measures were the proportion of women on local GDM registers completing a diabetes screening test and a diabetes prevention planning consultation within the previous 15 months. RESULTS: Diabetes screening increased with rates more than doubled from 26% to 61% and postpartum screening increased from 43%-60%. Diabetes prevention planning consultations did not show the same level of increase (0%-10%). The recording of body mass index improved overall (51%-69%) but the number of women with normal body mass index did not. CONCLUSIONS: GooD4Mum supported increased diabetes screening and the monitoring of high risk women with previous GDM in general practice.

In-office balloon sinus dilation versus medical therapy for recurrent acute rhinosinusitis: a randomized, placebo-controlled study.

BACKGROUND: A limited number of studies have demonstrated symptomatic improvement for recurrent acute rhinosinusitis (RARS) patients after endoscopic sinus surgery. In this randomized, controlled study we evaluated 24-week outcomes for balloon sinus dilation (BSD) performed in-office (IO) with medical management (MM) as compared with MM only for RARS patients. METHODS: Adults diagnosed with RARS were randomized to groups with BSD plus MM (n = 29) or MM alone (n = 30). Patients who received MM alone also received a sham BSD-IO procedure to blind them to group assignment. Patients were followed to 48 weeks posttreatment. The primary outcome was the difference between arms in change in Chronic Sinusitis Survey (CSS) score from baseline to 24 weeks. Secondary endpoints included comparisons of Rhinosinusitis Disability Index (RSDI) score, medication usage, medical care visits, and sinus infections. RESULTS: Change in patient-reported quality of life (QOL), as measured by the CSS total score from baseline to 24 weeks, was significantly greater in the BSD plus MM group compared with the MM-only group (37.3 ± 24.4 [n = 26] vs 21.8 ± 29.0 [n = 27]; p = 0.0424). CONCLUSION: BSD plus MM proved superior to MM alone in enhancing QOL for RARS patients. BSD plus MM should be considered as a viable treatment option for properly diagnosed RARS patients.

C24 Sphingolipids Govern the Transbilayer Asymmetry of Cholesterol and Lateral Organization of Model and Live-Cell Plasma Membranes.

Mammalian sphingolipids, primarily with C24 or C16 acyl chains, reside in the outer leaflet of the plasma membrane. Curiously, little is known how C24 sphingolipids impact cholesterol and membrane microdomains. Here, we present evidence that C24 sphingomyelin, when placed in the outer leaflet, suppresses microdomains in giant unilamellar vesicles and also suppresses submicron domains in the plasma membrane of HeLa cells. Free energy calculations suggested that cholesterol has a preference for the inner leaflet if C24 sphingomyelin is in the outer leaflet. We indeed observe that cholesterol enriches in the inner leaflet (80%) if C24 sphingomyelin is in the outer leaflet. Similarly, cholesterol primarily resides in the cytoplasmic leaflet (80%) in the plasma membrane of human erythrocytes where C24 sphingolipids are naturally abundant in the outer leaflet. We conclude that C24 sphingomyelin uniquely interacts with cholesterol and regulates the lateral organization in asymmetric membranes, potentially by generating cholesterol asymmetry.

A comparison of dynamic mean field theory and grand canonical molecular dynamics for the dynamics of pore filling and capillary condensation of fluids in mesopores.

We use results from grand canonical molecular dynamics (GCMD) to test the predictions from dynamic mean field theory (DMFT) for the pore filling and capillary condensation mechanisms of a fluid confined in slit shaped mesopores. The theory predicts that capillary condensation occurs by a nucleation process in which a liquid bridge forms between the two walls, and the pore is filled via the growth of this bridge. For longer pores, multiple bridging is seen. These mechanisms are confirmed by the molecular dynamics simulations. The primary difference between the theory and simulations lies in the role of fluctuations. DMFT predicts a single nucleation time and location, while in GCMD (and in nature) a distribution of nucleation times and locations is seen.

Validating the portal population of the United Kingdom Multiple Sclerosis Register.

The UK Multiple Sclerosis Register (UKMSR) is a large cohort study designed to capture 'real world' information about living with multiple sclerosis (MS) in the UK from diverse sources. The primary source of data is directly from people with Multiple Sclerosis (pwMS) captured by longitudinal questionnaires via an internet portal. This population's diagnosis of MS is self-reported and therefore unverified. The second data source is clinical data which is captured from MS Specialist Treatment centres across the UK. This includes a clinically confirmed diagnosis of MS (by Macdonald criteria) for consented patients. A proportion of the internet population have also been consented at their hospital making comparisons possible. This dataset is called the 'linked dataset'. The purpose of this paper is to examine the characteristics of the three datasets: the self-reported portal data, clinical data and linked data, in order to assess the validity of the self-reported portal data. The internet (n = 11,021) and clinical (n = 3,003) populations were studied for key shared characteristics. We found them to be closely matched for mean age at diagnosis (clinical = 37.39, portal = 39.28) and gender ratio (female %, portal = 73.1, clinical = 75.2). The Two Sample Kolmogorov-Smirnov test was for the continuous variables to examine is they were drawn from the same distribution. The null hypothesis was rejected only for age at diagnosis (D = 0.078, p < 0.01). The populations therefore, were drawn from different distributions, as there are more patients with relapsing disease in the clinical cohort. In all other analyses performed, the populations were shown to be drawn from the same distribution. Our analysis has shown that the UKMSR portal population is highly analogous to the entirely clinical (validated) population. This supports the validity of the self-reported diagnosis and therefore that the portal population can be utilised as a viable and valid cohort of people with Multiple Sclerosis for study.

Quality of life of nursing students from nine countries: A cross-sectional study.

BACKGROUND: Nursing student life is stressful as a result of the work they exert to learn concepts ranging from basic to complicated issues and health concerns for maintaining overall human health. Hence, assessing the quality of life (QOL) of nursing students is important to determine if they have excellent well-being levels as they go through the learning process. OBJECTIVES: This study measured and compared QOL of respondents by country of residence, and identified the QOL predictors of students. DESIGN: Descriptive, cross-sectional design. SETTINGS: A multi-country study conducted in Chile, Egypt, Greece, Hong Kong, India, Kenya, Oman, Saudi Arabia, and the United States of America. PARTICIPANTS: A convenience sample of 2012 Bachelor of Science in Nursing (BSN) students. METHODS: A self-administered questionnaire containing demographic characteristic items and the World Health Organization QOL-BREF (WHOQOL-BREF) was used to gather data from respondents. RESULTS: The highest overall QOL was recorded in the physical health domain, whereas the lowest was in the social health domain. The perceived highest and lowest QOL dimension varied between countries. Age, country of residence, and monthly family income showed statistically significant multivariate effect on the aspects of QOL. CONCLUSIONS: Considering their stressful lives, the present study underscores the importance of ensuring the highest level of well-being among nursing students. The maintenance of high levels of well-being among nursing students should also be prioritized to maximize their learning and ensure their satisfaction in their student life.