Data collection using open access technology in multicentre operational research involving patient interviews.

Conducting multicentre operational research is challenging due to issues related to the logistics of travel, training, supervision, monitoring and troubleshooting support. This is even more burdensome in resource-constrained settings and if the research includes patient interviews. In this article, we describe an innovative model that uses open access tools such as Dropbox, TeamViewer and CamScanner for efficient, quality-assured data collection in an ongoing multicentre operational research study involving record review and patient interviews. The tools used for data collection have been shared for adaptation and use by other researchers.

Conduire des recherches opérationnelles multicentriques est un défi, particulièrement dans les contextes de ressources limitées, en tenant compte des questions de logistique de déplacement, de formation, de supervision, de suivi et de soutien à la résolution des problèmes; encore plus si cette recherche implique des entretiens avec des patients. Dans cet article, nous décrivons un modèle innovant qui utilise des outils à accès ouvert comme Dropbox, TeamViewer et CamScanner pour un recueil de données efficace et de qualité assurée dans le cadre d'une recherche opérationnelle continue multicentrique impliquant des revues de dossiers et des entretiens avec des patients. Les outils utilisés pour le recueil de données ont été partagés pour l'adaptation et l'utilisation par d'autres chercheurs.

La realización de investigaciones operativas multicéntricas puede ser problemática, sobre todo en los entornos con restricción de los recursos, habida cuenta de las dificultades en la organización de los desplazamientos, la capacitación, la supervisión, el seguimiento y el apoyo a la resolución de problemas; más aun, cuando la investigación precisa entrevistas a los pacientes. En el presente artículo se describe un modelo innovador que utiliza herramientas de libre acceso como las plataformas Dropbox, TeamViewer y CamScanner, con el fin de lograr una obtención de datos eficiente y de calidad garantizada, en una investigación operativa multicéntrica en curso que comporta el examen de las historias clínicas y entrevistas a los pacientes. Se comunican las herramientas utilizadas en la recogida de datos, con la finalidad de que otros investigadores puedan adaptarlas y las apliquen.

Childhood overweight and obesity trends in Canada. / Tendances en matière d'embonpoint et d'obésité chez les enfants au Canada.

INTRODUCTION: Excess weight is a key risk factor for chronic disease, and the systematic collection, analysis and reporting of key trends are important to surveillance of overweight and obesity. METHODS: We used univariate analyses to calculate current prevalence estimates of excess weight among Canadian children and youth. RESULTS: Almost 1 in 7 children and youth is obese. Rates vary based on sociodemographic factors such as age, sex, socioeconomic status and place of residence. Overall, the rates of excess weight have been relatively stable over the past decade. CONCLUSION: Ongoing monitoring of childhood obesity will provide useful information to assist with sustained actions to promote healthy weights.

INTRODUCTION: L'excès de poids est un facteur de risque important de maladies chroniques. La collecte, l'analyse et la diffusion systématiques des tendances clés dans ce domaine sont importantes pour la surveillance de l'embonpoint et de l'obésité. MÉTHODOLOGIE: Nous avons utilisé des analyses univariées pour calculer des estimations de la prévalence actuelle de l'excès de poids chez les enfants et les jeunes canadiens. RÉSULTATS: Près d'un enfant ou jeune sur sept est obèse. Les taux varient en fonction de facteurs sociodémographiques comme l'âge, le sexe, le statut socioéconomique et le lieu de résidence. Dans l'ensemble, les taux d'excès de poids sont demeurés relativement stables depuis dix ans. CONCLUSION: Faire le suivi de l'obésité juvénile fournit des renseignements utiles à la prise de mesures à long terme pour la promotion d'un poids santé.

Monitoring positive mental health and its determinants in Canada: the development of the Positive Mental Health Surveillance Indicator Framework.

INTRODUCTION: The Mental Health Strategy for Canada identified a need to enhance the collection of data on mental health in Canada. While surveillance systems on mental illness have been established, a data gap for monitoring positive mental health and its determinants was identified. The goal of this project was to develop a Positive Mental Health Surveillance Indicator Framework, to provide a picture of the state of positive mental health and its determinants in Canada. Data from this surveillance framework will be used to inform programs and policies to improve the mental health of Canadians. METHODS: A literature review and environmental scan were conducted to provide the theoretical base for the framework, and to identify potential positive mental health outcomes and risk and protective factors. The Public Health Agency of Canada's definition of positive mental health was adopted as the conceptual basis for the outcomes of this framework. After identifying a comprehensive list of risk and protective factors, mental health experts, other governmental partners and non-governmental stakeholders were consulted to prioritize these indicators. Subsequently, these groups were consulted to identify the most promising measurement approaches for each indicator. RESULTS: A conceptual framework for surveillance of positive mental health and its determinants has been developed to contain 5 outcome indicators and 25 determinant indicators organized within 4 domains at the individual, family, community and societal level. This indicator framework addresses a data gap identified in Canada's strategy for mental health and will be used to inform programs and policies to improve the mental health status of Canadians throughout the life course.

TITRE: Surveillance de la santé mentale positive et de ses facteurs déterminants au Canada : élaboration d'un cadre d'indicateurs de surveillance de la santé mentale positive. INTRODUCTION: D'après la Stratégie en matière de santé mentale pour le Canada, la collecte de données sur la santé mentale au Canada a besoin d'être améliorée. La mise en place de systèmes de surveillance sur la maladie mentale n'a pas suffi à combler toutes les lacunes statistiques relevant de la santé mentale positive et de ses facteurs déterminants au Canada. L'objectif de ce projet était d'élaborer un Cadre d'indicateurs de surveillance de la santé mentale positive, dans le but de dresser un portrait de la santé mentale positive au Canada, ainsi que de ses facteurs déterminants. Les données recueillies grâce à ce cadre de surveillance serviront de référence pour l'établissement des programmes et des politiques d'amélioration de la santé mentale des Canadiens. MÉTHODOLOGIE: Un examen de la littérature et une analyse contextuelle ont été réalisés afin de fournir une base théorique au cadre et de sélectionner divers critères d'évaluation de la santé mentale positive et de ses facteurs de risque et de protection. La définition de la santé mentale positive adoptée par l'Agence de la santé publique du Canada a servi de référence conceptuelle lors de l'élaboration du cadre. À partir de la liste exhaustive des risques et des facteurs de protection qui a été réalisée, des experts en santé mentale, des partenaires gouvernementaux et des intervenants indépendants ont été invités à classer les indicateurs choisis par ordre de priorité. Ces groupes ont ensuite été invités à sélectionner les méthodes de mesure les plus prometteuses pour chacun des indicateurs. RÉSULTATS: Le cadre conceptuel de surveillance de la santé mentale positive et de ses facteurs déterminants qui a été ainsi élaboré contient 5 indicateurs de résultats et 25 indicateurs de déterminants, répartis en 4 niveaux contextuels : « individu ¼, « famille ¼, « communauté ¼ et « société ¼. Ce cadre d'indicateurs vise à combler les lacunes en matière de données relevées par la Stratégie en matière de santé mentale pour le Canada, et il servira de référence pour l'établissement des programmes et des politiques d'amélioration de la santé mentale des Canadiens tout au long de leur vie.

EFFECTS OF VARIOUS SEMEN EXTENDERS ON SEMEN PARAMETERS FOR THE PURPOSE OF HUMAN MALE FERTILITY PRESERVATION.

BACKGROUND: Cryopreservation enables semen to be preserved at subzero temperatures, usually at -196 degrees C. There is a need in preparing good extender for the semen to be cryopreserved until use, especially in the field of assisted reproduction. OBJECTIVE: To elucidate the apt extender for preserving both infertile and fertile samples for a minimum period and to check the post thaw results for various extenders used. MATERIALS AND METHODS: A total of 103 samples were collected for this research, and after semen analysis the semen samples were categorized into oligospermia (n = 20), oligoasthenospermia (n = 22), asthenospermia (n = 24), normospermia (n = 28), and control (n = 9). RESULTS: The extender supplemented with various antioxidants yields better results when compared to all the other extenders in case of fertile and infertile samples. CONCLUSION: Supplementing semen extender with antioxidants and various ingredients is the concern in designing an apt semen extender recipe. This research prescribes antioxidant extender (E4) to preserve the infertile and fertile semen samples for the purpose of research and also for doing assisted reproduction.

Evidence Brief--Trends and projections of obesity among Canadians.

The prevalence of obesity, defined as body mass index (BMI) of 30 kg/m2 or higher for adults and as 2 standard deviations above the World Health Organization growth standard mean for children, has increased in many parts of the world. Obese adults are at an increased risk of certain chronic conditions, including hypertension, type 2 diabetes, cardiovascular diseases and some cancers, and of premature death. Obese children have increased cardiometabolic risk, including dyslipidemia, insulin resistance and elevated blood pressure. Excess childhood body weight that continues into adulthood can affect quality of life, educational attainment and earnings over the lifecourse. The Public Health Agency of Canada has projected an annual direct health care cost (including physician, hospitalization and medication costs) of those categorized as obese in Canada in constant 2001 Canadian dollars. Calculated as $7.0 billion in 2011, this annual direct health care cost is projected to rise to $8.8 billion by 2021, based on simulated average direct health care costs, which are higher among the obese ($2,283) than the overweight ($1,726), the underweight ($1,298) and those at normal weight ($1,284). Canadian estimates from 2006 and 2008 that used different methodologies place the annual economic burden (direct and indirect costs) of obesity between $4.6 billion and $7.1 billion. The purpose of this evidence brief is to show current Canadian obesity prevalence rates and estimates for the future using objectively measured height and weight to calculate BMI. The use of objectively measured height and weight to derive BMI is strongly recommended, especially for children and adolescents, as self- or proxy-reported height and weight tend to underestimate actual weight and consequently BMI and obesity prevalence.

TITRE: Synthèse portant sur les données probantes - Tendances et projections relatives à l'obésité chez les Canadiens. INTRODUCTION: La prévalence de l'obésité ­ soit un indice de masse corporelle (IMC) supérieur ou égal à 30 kg/m2 chez les adultes ou deux écarts-types au-dessus de la médiane de la norme de croissance de l'Organisation mondiale de la santé chez les enfants ­ a augmenté dans de nombreuses régions du monde. Les adultes obèses sont plus susceptibles d'être atteints de certaines affections chroniques, notamment d'hypertension, de diabète de type 2, de cardiopathies et de certains cancers, ainsi que de mourir prématurément. Les enfants obèses présentent aussi un risque cardiométabolique accru (dyslipidémie, résistance à l'insuline et hypertension artérielle). Un excès pondéral pendant l'enfance qui se poursuit à l'âge adulte peut nuire à la qualité de vie, au rendement scolaire et au revenu tout au long de la vie. L'Agence de la santé publique du Canada a estimé les coûts annuels directs, en dollars canadiens constants de 2001, des soins de santé (coûts liés aux médecins, aux hospitalisations et aux médicaments) pour les personnes classées comme obèses au Canada. Évalués à 7,0 milliards de dollars en 2011, ils devraient atteindre 8,8 milliards de dollars d'ici 2021, d'après un calcul à partir des moyennes actuelles qui font qu'ils sont plus élevés chez les obèses (2 283 $) que chez les personnes en surpoids (1 726 $), les personnes en insuffisance pondérale (1 298 $) et les personnes de poids normal (1 284 $). Des estimations canadiennes antérieures, de 2006 et 2008 et obtenues par des méthodologies différentes, ont évalué le fardeau économique annuel (coûts directs et indirects) de l'obésité dans une fourchette allant de 4,6 à 7,1 milliards de dollars. Cette synthèse fondée sur des données probantes vise à présenter les taux de prévalence de l'obésité au Canada à la fois actuels et projetés, à partir d'un calcul de l'IMC reposant sur des mesures objectives de la taille et du poids. L'utilisation de mesures objectives de la taille et du poids pour calculer l'IMC est fortement recommandée, particulièrement chez les enfants et les adolescents, car lorsque la taille et le poids sont autodéclarés ou obtenus par procuration, le poids réel est généralement sous-estimé, ce qui fait que l'IMC et la prévalence de l'obésité le sont également.

Prevalence and patterns of chronic disease multimorbidity and associated determinants in Canada.

INTRODUCTION: Multimorbidity is increasingly recognized as a key issue in the prevention and management of chronic diseases. We examined the prevalence and correlates of chronic disease multimorbidity in the general adult Canadian population in relation to age and other key determinants. METHODS: We extracted data from the Canadian Community Health Survey 2011/12 on 105 416 Canadian adults. We analysed the data according to the number of multimorbidities (defined as 2+ or 3+ diseases from a list of 9) and examined the determinants of multimorbidity using regression analyses. RESULTS: Our findings show that 12.9% of Canadians report 2+ chronic diseases and 3.9% report 3+ chronic diseases. Those reporting 3 or more chronic diseases were more likely to be female, older, living in the lowest income quintile and to have not completed high school. In the overall population, social deprivation is associated with a 3.7 odds of multimorbidity, but when examined across age groups, the odds of multimorbidity were notably higher in middle age, 7.5 for those aged 35 to 49 years and 5.4 for those aged 50 to 64 years. DISCUSSION: As the proportion of Canadians living with multiple chronic diseases increases, we need to assess chronic disease from a holistic perspective that captures multimorbidity and upstream factors, to facilitate broader and more context-appropriate associations with healthy living, quality of life, health care costs and mortality. Special consideration should be given to the role that social deprivation plays in the development of multimorbidity. Canadians living in the lowest socioeconomic group are not only more likely to develop multimorbidity, but the onset of multimorbidity is also likely to be significantly earlier.

TITRE: Prévalence et profils de la multimorbidité au Canada et déterminants associés. INTRODUCTION: La prise en compte de la multimorbidité est de plus en plus reconnue comme un élément fondamental de la prévention et de la prise en charge des affections chroniques. Cette étude porte sur la prévalence et les corrélats de la multimorbidité chez les adultes canadiens en fonction de l'âge et de certains autres déterminants clés. MÉTHODOLOGIE: Nous avons extrait des données portant sur 105 416 adultes canadiens ayant répondu à l'Enquête sur la santé dans les collectivités canadiennes de 2011-2012. Nous les avons analysées en fonction du nombre d'affections concomitantes présentes (deux ou plus ou trois ou plus, sur une liste de neuf) et nous avons cherché à caractériser les déterminants de la multimorbidité à l'aide de régressions. RÉSULTATS: D'après notre analyse, 12,9 % des Canadiens souffraient de deux affections chroniques ou plus et 3,9 % de trois ou plus. Les répondants ayant déclaré souffrir de trois affections chroniques ou plus étaient plus susceptibles d'être des femmes, d'être plus âgés, de faire partie d'un ménage dont le revenu fait partie du quintile le plus faible et dont le niveau de scolarité le plus élevé de l'un des membres était inférieur aux études secondaires. La multimorbidité en lien avec le dénuement social était associée à une cote de 3,7 dans la population en général, mais de 7,5 chez les 35 à 49 ans et de 5,9 chez les 50 à 64 ans, soit la population d'âge moyen. ANALYSE: La proportion de Canadiens atteints de multiples affections chroniques étant en augmentation, nous devons adopter, pour étudier les affections chroniques et leurs facteurs en amont, une approche globale qui tienne compte de la multimorbidité, afin d'agir de manière globale et adaptée au contexte pour favoriser une vie saine et une meilleure qualité de vie et pour réduire les coûts des soins de santé et la mortalité. On devrait particulièrement tenir compte du rôle joué par le dénuement social dans l'apparition de la multimorbidité, car non seulement les Canadiens du groupe socioéconomique le plus démuni sont plus susceptibles de souffrir de multimorbidité, mais celle-ci surgira aussi probablement beaucoup plus précocement.

Type-specific human papillomavirus infections and Pap test findings in Inuit and non-Inuit women in Nunavut, Canada.

OBJECTIVE: To determine the prevalence and distribution of type-specific human papillomavirus (HPV) infections and their association with cytological outcomes in women living in the Canadian territory of Nunavut. METHODS: Surveillance of type-specific HPV infection was conducted. Cervical specimens of all Inuit, First Nations and non-Aboriginal women in Nunavut who presented for a Pap test in any clinical setting between January 2008 and March 2009 were tested for HPV infection. The association between high-grade cervical lesions and HPV type was also examined. RESULTS: HPV results were available for 4,043 individual women (13 to 77 years). Of those with known ethnicity (N=4,033), 89.2% were Inuit, 0.4% were First Nations and 10.4% were non-Aboriginal. First Nations women were included in all analyses except those making comparisons by ethnicity, due to the small number of individuals in this group. Overall, 29.9% of women were found to be infected with HPV (any type) and 19.9% with any high-risk HPV (type 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 or 59). Most often, women were infected with HPV 16 (6.4%) followed by HPV 31 (3.1%). There were no statistically significant differences between Inuit and non-Aboriginal (reference group) women 20 years of age and older regarding the prevalence of any HPV (odds ratios (OR): 1.19, 95% confidence intervals (CI): 0.92-1.54), high-risk HPV (OR: 1.06, 95% CI: 0.78-1.44) or HPV 16 and 18 (OR: 0.81, 95% CI: 0.51-1.27). HPV 31 was the only type that was significantly more frequent among Inuit than non-Aboriginal women (OR: 3.95, 95% CI: 1.24-12.54). There was no difference in the overall occurrence of cervical abnormalities between non-Aboriginal and Inuit women (p-value = 0.17). HPV 16 was strongly associated with cervical dysplasia, being present in 50.9% of specimens with a high-grade lesion. CONCLUSION: HPV is a significant public health issue in the territory of Nunavut. The findings presented in this article are similar to those in other studies among Inuit women, with prevalence of HPV being higher than in studies conducted among non-Inuit women in other regions of Canada. These results provide a baseline of HPV prevalence that precedes the introduction of the Nunavut HPV Immunization Program in 2010 and will allow for future evaluation. The high prevalence of HPV infection among women living in Nunavut can be reduced through immunization and associated high-grade cervical abnormalities mitigated by regular cervical screening.

Monitoring chronic diseases in Canada: the Chronic Disease Indicator Framework.

INTRODUCTION: The Public Health Agency of Canada developed the Chronic Disease Indicator Framework (the Framework) with the goal of systematizing and enhancing chronic disease surveillance in Canada by providing the basis for consistent and reliable information on chronic diseases and their determinants. METHODS: Available national and international health indicators, frameworks and national health databases were reviewed to identify potential indicators. To make sure that a comprehensive and balanced set of indicators relevant to chronic disease prevention was included, a conceptual model with "core domains" for grouping eligible indicators was developed. Specific selection criteria were applied to identify key measures. Extensive consultations with a broad range of government partners, non-governmental organizations and public health practitioners were conducted to reach consensus and refine and validate the Framework. RESULTS: The Framework contains 41 indicators organized in a model comprised of 6 core domains: social and environmental determinants, early life / childhood risk and protective factors, behavioural risk and protective factors, risk conditions, disease prevention practices, and health outcomes/status. Also planned is an annual release of updated data on the proposed set of indicators, including national estimates, breakdowns by demographic and socioeconomic variables, and time trends. CONCLUSIONS: Understanding the evidence related to chronic diseases and theirdeterminants is key to interpreting trends and crucial to the development of public health interventions. The Framework and its related products have the potential of becoming an indispensable tool for evidence-informed decision making in Canada.

TITRE: Surveillance des maladies chroniques au Canada : Cadre conceptuel d'indicateurs des maladies chroniques. INTRODUCTION: L'Agence de la santé publique du Canada a conçu le Cadre conceptuel d'indicateurs des maladies chroniques (le Cadre) dans le but de systématiser et d'améliorer la surveillance des maladies chroniques au Canada en instaurant les fondements d'une information uniforme et fiable sur les maladies chroniques et leurs déterminants. MÉTHODOLOGIE: Des indicateurs de santé nationaux et internationaux, des cadres conceptuels ainsi que des bases de données sur la santé nationale ont été examinés pour identifier les indicateurs potentiels. Pour s'assurer d'obtenir un ensemble complet et équilibré d'indicateurs pertinents en matière de prévention des maladies chroniques, nous avons élaboré un modèle conceptuel comprenant des « champs de référence ¼ pour le regroupement des indicateurs. Plusieurs critères de sélection ont été appliqués pour le choix des mesures clés. Des consultations approfondies avec un large éventail de partenaires du gouvernement, d'organismes non gouvernementaux et de professionnels de la santé publique ont été réalisées pour en arriver à un consensus et pour perfectionner et valider le Cadre. RÉSULTATS: Le Cadre comprend 41 indicateurs structurés autour de 6 champs de référence : les déterminants sociaux et environnementaux, les facteurs de risque et de protection en bas âge, les facteurs de risque et de protection comportementaux, les conditions à risque, les pratiques de prévention des maladies, l'état de santé global et les impacts sur la santé. Nous avons aussi prévu une mise à jour annuelle des données touchant l'ensemble des indicateurs proposés, que ce soit les estimations nationales, les ventilations par variables démographiques et socioéconomiques ou les tendances temporelles. CONCLUSION: Comprendre les données probantes liées aux maladies chroniques et leurs déterminants est nécessaire pour interpréter les tendances et crucial pour élaborer des interventions efficaces en matière de santé publique. Le Cadre et ses produits connexes sont susceptibles de devenir un outil indispensable d'aide à la décision axée sur des données probantes au Canada.

Interaction of plant pigment brazilin with synthetic and natural DNA: spectroscopic and in silico perspective.

The interactions between the molecules and DNA shape up an avenue for DNA targeted therapeutics. For the first time, brazilin, a major component of Caesalpinia sappan L., has been investigated for its interaction with natural and synthetic DNA. Detailed analyses of the binding property of brazilin dye with DNA by UV-vis, FTIR and Circular Dichroism were carried out. In addition, in silico studies have been conducted via tools of energy minimization and ligand optimization using Yasara and Argus Lab softwares along with the molecular docking server integrating Auto Dock, Mavin and Mopac. Results show that brazilin dye has commendable proficiency in being moulded as a binder with DNA. The specificity of the dye to stain nuclei in tissue sections positively indicates its interaction with nucleic acid. As the intracellular target for the majority of anticancer and antibiotic drugs is DNA, the study on the interaction between molecules like brazilin and DNA has great significance and implications in several biological applications.

Prediction of Zn concentration in human seminal plasma of Normospermia samples by Artificial Neural Networks (ANN).

PURPOSE: There has been an increasing interest in the evaluation of metal ion concentration, present in different body fluids. It is known that metal ions, especially zinc play vital role in the fertility of human semen. OBJECTIVE: The main objective of the study is to evaluate the Zn concentration in Normospermia samples by Atomic absorption spectroscopy (AAS) and to predict the same by artificial neural network (ANN). MATERIALS AND METHODS: Normospermia semen samples were collected from the patients who came to attend semen analysis at Bangalore assisted conception centre, Bangalore, India. Semen analysis was done according to World Health Organization (WHO) guidance. Atomic absorption spectroscopy was used to estimate the total Zn in these samples, while the Back propagation neural network algorithm (BPNN) was used to predict the Zn levels in these samples. RESULTS: Zinc concentration obtained by AAS and BPNN indicated that there was a good correlation between the estimated and predicted values and was also found to be statistically significant. CONCLUSION: The BPNN algorithm developed in this study could be used for the prediction of Zn concentration in human Normospermia samples. FUTURE PERSPECTIVE: The algorithm could be further developed to predict the concentration of all the trace elements present in human seminal plasma of different infertile categories.

Distribution of human papillomavirus types, cervical cancer screening history, and risk factors for infection in Manitoba.

OBJECTIVES: We conducted a study to investigate the prevalence of human papillomavirus (HPV) infections in an opportunistic sample of women in Manitoba, Canada. We inquired about risk factors associated with HPV infections and linked the HPV typing results with the cervical cancer screening history of the participants. METHODS: The study population included 592 women attending Papanicolaou (Pap) test clinics. After signing a consent form, participants were given a self-administered questionnaire on risk factors and received a conventional Pap test. Residual cells from the Pap tests were collected and sent for HPV typing. RESULTS: The mean age of the population was 43 years. A total of 115 participants (19.4%) had an HPV infection, 89 of whom had a normal Pap test. Of those who were HPV-positive, 61 (10.3%) had high-risk (Group 1) HPV. HPV-16 was the most prevalent type (15/115: 13.0% of infections). The most consistent risk factors for HPV infection were young age, Aboriginal ethnicity, higher lifetime number of sexual partners and higher number of sexual partners in the previous year. CONCLUSION: The prevalence of HPV types in Manitoba is consistent with the distributions reported in other jurisdictions. These data provide baseline information on type-specific HPV prevalence in an unvaccinated population and can be useful in evaluating the effectiveness of the HPV immunization program. An added benefit is in the validation of a proof of concept which links a population-based Pap registry to laboratory test results and a risk behaviour survey to assess early and late outcomes of HPV infection. This methodology could be applied to other jurisdictions across Canada where such capacities exist.

Characterizing viral subtypes to assess patterns of HIV transmission.

We characterized HIV-1 subtypes among 204 persons newly diagnosed with HIV in Ontario from 2003 to 2005 using samples from the Canadian HIV Strain and Drug Resistance Surveillance Program. We examined HIV-1 subtype by demographic characteristics and exposure category, and determined independent predictors of infection with a non-B HIV subtype using multivariate logistic regression. The distribution of HIV subtypes was: B 77.0%, C 10.3%, AG 4.9%, A 2.5%, AE 2.5% and others 3.0%. Overall, 23.0% were non-B, greater in women than in men (62.8% versus 12.4%, P < 0.0001) and persons under 35 years (31.1% versus 18.5% in those ≥35, P = 0.04). Non-B subtype was predominant (78.9%) among persons from HIV-endemic regions and considerable (28.6%) among other persons infected heterosexually. In multivariate modelling adjusted for gender, non-B subtype was significantly associated with birth in an HIV-endemic region (adjusted odds ratio [aOR] 59.2, P < 0.0001) and heterosexual exposure (aOR 6.3, P = 0.02). Additionally, compared with men who had sex with men, non-B subtype was greater among heterosexual women (aOR 17.8, P < 0.001) and women who injected drugs (injection drug use, aOR 13.4, P = 0.01). We found a non-negligible proportion of non-B subtypes among women infected heterosexually not from HIV-endemic countries, providing interesting insights into HIV transmission patterns.

Androgen receptor expression in human thyroid cancer tissues: a potential mechanism underlying the gender bias in the incidence of thyroid cancers.

Gender bias in the incidence of thyroid cancer is well known, however, the underlying mechanism is largely unknown. The current study determines variations in the molecular characteristics of thyroid cancers between men and women. Normal and cancerous thyroid tissues were collected from a total of 125 men and women who underwent surgical thyroidectomy. Testosterone levels in serum and thyroid cancer tissues were elevated in women while it decreased in men compared to respective control groups; whereas, ligand binding activity increased in men and decreased in women. Androgen receptor (AR) mRNA expression increased in a majority of men while it decreased in a majority of women except those with follicular thyroid carcinoma (FTC). In thyroid cancers of women, Pearson's correlation analysis showed a positive correlation of AR mRNA with AR protein, CBP and Sp1, whereas AR mRNA showed a negative correlation with p53. In case of men, AR mRNA showed a positive correlation with AR and cyclin D1 proteins in papillary thyroid carcinoma (PTC); and CBP and Sp1 in follicular thyroid adenoma (FTA), whereas AR mRNA showed a positive correlation with p53. Our study identified for the first time that AR is posttranscriptionally regulated by miR-124a in thyroid cancer tissues. Further, our in vitro studies with a PTC cell line (NPA-87-1) showed miR-124a as the potent inhibitor of AR that impairs cell proliferation even in the presence of testosterone. Thus, the current study suggests that: (i) the varying pattern of testosterone level and AR status in thyroid tissues of men and women may predispose to the gender specific incidence of thyroid tumors and (ii) miR-124a plays a significant role in determining the AR gene expression pattern and thus, androgen mediated thyroid tumor growth.

Influence of gender and anthropometric measures on severity of obstructive sleep apnea.

PURPOSE: Gender differences influence upper airway anatomy and physiology. The purpose of our study was to evaluate the influence of gender as well as anthropometric measures on severity of obstructive sleep apnea (OSA). METHODS: A retrospective review of patients referred to our sleep laboratory for evaluation of OSA was done. Patients with a diagnosis of OSA (Respiratory Disturbance Index (RDI) > 5) were included in the study. Anthropometric measurements were available for all the patients included in the study. Measurements of subjects' height, weight, neck size, and waist and hip sizes were used in the study; waist-hip ratio and neck-to-height ratio were calculated. RESULTS: Three hundred eighty-six females and 661 males were included. Women were older than men and had a higher body mass index (BMI) and waist-to-hip ratio; men had a thicker neck circumference and a higher neck-to-height ratio. The severity of OSA was significantly higher in males (RDI 41.2 ± 27.9 in men vs. 30.0 ± 26.7 in women, p < 0.0001) despite a lower BMI and age in the men. Severity of OSA, as measured by RDI, varied significantly with changes in anthropometric measures such as neck circumference, and waist and hip sizes in both genders. Waist-to-hip ratio was associated with severity of OSA in men but not in women (p = 0.19 and 0.0001 in women and men, respectively). However, no single anthropometric value was found to be strongly predictive of OSA severity. CONCLUSION: Despite having a higher mean BMI and age, women have lower RDI compared with men. Waist-to-hip ratio is more predictive of severity of OSA in men than in women. However, the correlation of anthropometric measures with severity of OSA was weak in our subjects.

Genetic admixture studies on four in situ evolved, two migrant and twenty-one ethnic populations of Tamil Nadu, south India.

We analysed the genetic structure of ≈ 1000 samples representing 27 ethnic groups settled in Tamil Nadu, south India, derived from two linguistic families (Dravidians and Indo-Europeans) representing four religious groups (Hinduism, Islam, Christianity and Jainism) using 11 mtDNA markers. Out of 27 ethnic groups, four are in situ populations (Anglo-Indian, Labbai Muslim, Nadar Christian and south Indian Jain) and two are migrants (Gypsy and north Indian Jain) from north India to Tamil Nadu, and 21 are native ethnic groups. Six of the markers we used were monomorphic (HaeIII663, HpaI3592, AluI5176, AluI7025, AluI13262, 9-bp deletion) and five markers were polymorphic (DdeI10394, AluI10397, HinfI12308, HincII13259 and HaeIII16517). Haplogroup frequencies, genetic affinities and admixture analysis are based on the genotype data of polymorphic markers observed in these populations. Haplogroup frequencies indicate that various ethnic groups entered Tamil Nadu during different time periods. Genetic affinities and admixture estimates revealed that the ethnic groups possessing advanced knowledge of farming cluster in a branch (C), and could be the late arrived settlers as agriculture, was introduced to this region at about 5 to 3 thousand years ago. In situ ethnic groups appear to have arisen at various times as a result of the prevailing dominant socio-cultural forces. Hierarchical Hindu caste system created many ethnic groups in the history of its existence; some of them became isolated for considerable period of time. Over all, among Tamil ethnic groups, in spite of caste systems' rigidity, built in flexibility in the system in the form of hypergamy and hypogamy had allowed maternal gene flow between them.

Trends in testing behaviours for hepatitis C virus infection and associated determinants: results from population-based laboratory surveillance in Alberta, Canada (1998-2001).

Little is currently known about hepatitis C virus (HCV) test seeking behaviours at the population level. Given the centralized nature of testing for HCV infection in the province of Alberta, Canada, we had an opportunity to examine HCV testing behaviour at the population level on all newly diagnosed HCV-positive cases using laboratory data to validate the time and number of prior tests for each case. Record linkage identified 3323, 2937, 2660 and 2703 newly diagnosed cases of HCV infections in Alberta during 1998, 1999, 2000 and 2001, respectively, corresponding to age-adjusted rates of 149.8, 129, 114.3 and 113.7 per 100,000 population during these years, respectively. Results from secondary analyses of laboratory data suggest that the majority of HCV cases (95.3%) who were newly diagnosed between 1998 and 2001 were first-time testers for HCV infection. Among repeat testers, analysis of a negative test result within 1 year prior to a first of a positive test report suggests that 211 (38.4%) may be seroconvertors. These findings suggest that 339 or 61.7% of repeat testers may not have discovered their serostatus within 1 year of infection. Among this group, HCV testing was sought infrequently, with a median interval of 2.3 years between the last negative and first positive test. This finding is of concern given the risks for HCV transmission, particularly if risk-taking behaviours are not reduced because of unknown serostatus. These findings also reinforce the need to make the most of each test-seeking event with proper counselling and other appropriate support services.

Exploring the environmental preference of weak interactions in (alpha/beta)8 barrel proteins.

The environmental preference for the occurrence of noncanonical hydrogen bonding and cation-pi interactions, in a data set containing 71 nonredundant (alpha/beta)(8) barrel proteins, with respect to amino acid type, secondary structure, solvent accessibility, and stabilizing residues has been performed. Our analysis reveals some important findings, which include (a) higher contribution of weak interactions mediated by main-chain atoms irrespective of the amino acids involved; (b) domination of the aromatic amino acids among interactions involving side-chain atoms; (c) involvement of strands as the principal secondary structural unit, accommodating cross strand ion pair interaction and clustering of aromatic amino acid residues; (d) significant contribution to weak interactions occur in the solvent exposed areas of the protein; (e) majority of the interactions involve long-range contacts; (f) the preference of Arg is higher than Lys to form cation-pi interaction; and (g) probability of theoretically predicted stabilizing amino acid residues involved in weak interaction is higher for polar amino acids such as Trp, Glu, and Gln. On the whole, the present study reveals that the weak interactions contribute to the global stability of (alpha/beta)(8) TIM-barrel proteins in an environment-specific manner, which can possibly be exploited for protein engineering applications.

Cigarette smoking induces heat shock protein 70 kDa expression and apoptosis in rat brain: Modulation by bacoside A.

Cigarette smoking is associated with the development of several diseases and antioxidants play a major role in the prevention of smoking-related diseases. Apoptosis is suggested as a possible contributing factor in the pathogenesis of smoking-induced toxicity. Therefore the present study was designed to investigate the influence of chronic cigarette smoke exposure on apoptosis and the modulatory effect of bacoside A (triterpenoid saponin isolated from the plant Bacopa monniera) on smoking-induced apoptosis in rat brain. Adult male albino rats of Wistar strain were exposed to cigarette smoke and simultaneously administered with bacoside A (10 mg/kg b.w./day, orally) for a period of 12 weeks. Expression of brain hsp70 was analyzed by Western blotting. Apoptosis was identified by DNA fragmentation, terminal deoxynucleotidyl transferase-mediated deoxy uridine triphosphate nick end labeling (TUNEL) staining and transmission electron microscopy. The results showed that exposure to cigarette smoke induced hsp70 expression and apoptosis as characterized by DNA laddering, increased TUNEL-positive cells and ultrastructural apoptotic features in the brain. Administration of bacoside A prevented expression of hsp70 and neuronal apoptosis during cigarette smoking. We speculate that apoptosis may be responsible for the smoking-induced brain damage and bacoside A can protect the brain from the toxic effects of cigarette smoking.

Conformation and stability of elastase from Atlantic cod, Gadus morhua.

Metal binding and conformational stability characteristics of psychrophilic elastase (ACE) from Atlantic cod (Gadus morhua) has been investigated. Chelation to Ca(2+) was found to be important for maintaining the biologically active conformation and for the thermal stability of the enzyme. However, presence of metal ions such as Zn(2+), Fe(3+) and Cu(2+) was found to inhibit its hydrolytic activity and so did the chelating agent EDTA. Both pH and guanidinium chloride induced denaturation of the enzyme was followed by monitoring the changes in the tryptophan fluorescence. ACE exhibited a simple two-state unfolding pattern in both acidic and basic conditions with the midpoint of transition at pH values 4.08 and 10.29, respectively. Guanidinium chloride and heat induced denaturation of the enzyme was investigated at two pH values, 5.50 and 8.00, wherein the enzyme possesses similar tertiary structure but differ in its hydrolytic activity. Guanidinium chloride induced denaturation indicated that the enzyme unfolds with a C(m) of 1.53 M at pH 8.0 and a DeltaG(H2O) of 6.91 kJ mol(-1) (28.65 J mol(-1) residue(-1)) which is the lowest reported for psychrophilic enzymes investigated till-date. However, at pH 5.50, DeltaG(H2O) value is slightly lowered by 0.65 kJ mol(-1) consistent with the observed increase in the apparent quenching constant obtained with acrylamide. On the other hand, increase in T(m) by 38.45 degrees C was observed for the enzyme at acid pH (5.50) in comparison to the heat induced unfolding at pH 8.0. The increase in the apparent T(m) has been attributed to the possible weak intermolecular association of the enzyme molecules at moderately high temperatures that is favoured by the increase in the accessible surface area / dynamics under acidic conditions. The stability characteristics of ACE have been compared with the available data for mesophilic porcine pancreatic elastase and possible mechanism for the low temperature adaptation of ACE has been proposed.

Enhanced catalytic and conformational stability of Atlantic cod trypsin upon neoglycosylation.

The applicability of psychrophilic enzymes is limited because of their lower thermodynamic stability in spite of their higher catalytic rate. In this study, we have shown that the thermodynamic stability of the psychrophilic Atlantic cod trypsin could be enhanced appreciably by covalent chemical modification with oxidized sucrose polymer without affecting its hydrolytic activity. The acquired stability of cod trypsin was found to be on par with the mesophilic porcine trypsin.