RESUMO
As a plant-specific transcription factor, lateral organ boundaries domain (LBD) protein was reported to regulate plant growth and stress response, but the functional research of subfamily II genes is limited. SlMYC2, a master regulator of Jasmonic acid response, has been found to exhibit high expression levels in fruit and has been implicated in the regulation of fruit ripening and resistance to Botrytis. However, its role in fruit expansion remains unknown. In this study, we present evidence that a subfamily II member of LBD, namely SlLBD40, collaborates with SlMYC2 in the regulation of fruit expansion. Overexpression of SlLBD40 significantly promoted fruit growth by promoting mesocarp cell expansion, while knockout of SlLBD40 showed the opposite result. Similarly, SlMYC2 knockout resulted in a significant decrease in cell expansion within the fruit. Genetic analysis indicated that SlLBD40-mediated cell expansion depends on the expression of SlMYC2. SlLBD40 bound to the promoter of SlEXPA5, an expansin gene, but did not activate its expression directly. While, the co-expression of SlMYC2 and SlLBD40 significantly stimulated the activation of SlEXPA5, leading to an increase in fruit size. SlLBD40 interacted with SlMYC2 and enhanced the stability and abundance of SlMYC2. Furthermore, SlMYC2 directly targeted and activated the expression of SlLBD40, which is essential for SlLBD40-mediated fruit expansion. In summary, our research elucidates the role of the interaction between SlLBD40 and SlMYC2 in promoting cell expansion in tomato fruits, thus providing novel insights into the molecular genetics underlying fruit growth.
Assuntos
Frutas , Regulação da Expressão Gênica de Plantas , Proteínas de Plantas , Solanum lycopersicum , Fatores de Transcrição , Solanum lycopersicum/genética , Solanum lycopersicum/crescimento & desenvolvimento , Solanum lycopersicum/metabolismo , Frutas/genética , Frutas/crescimento & desenvolvimento , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Fatores de Transcrição/metabolismo , Fatores de Transcrição/genética , Plantas Geneticamente Modificadas , Regiões Promotoras Genéticas/genéticaRESUMO
Cobalt-based catalysts are ideal for CO2 reduction reaction (CO2RR) due to the strong binding and efficient activation of CO2 molecules on cobalt. However, cobalt-based catalysts also show low free energy of hydrogen evolution reaction (HER), making HER competitive with CO2RR. Therefore, how to improve the product selectivity of CO2RR while maintaining the catalytic efficiency is a great challenge. Here, this work demonstrates the critical roles of the rare earth (RE) compounds (Er2O3 and ErF3) in regulating the activity and selectivity of CO2RR on cobalt. It is found that the RE compounds not only promote charge transfer but also mediate the reaction paths of CO2RR and HER. Density functional theory calculations verify that the RE compounds lower the energy barrier of *CO â CO conversion. On the other hand, the RE compounds increase the free energy of HER, which leads to the suppression of HER. As a result, the RE compounds (Er2O3 and ErF3) improve the CO selectivity of cobalt from 48.8 to 69.6%, as well as significantly increase the turnover number by a factor of over 10.
RESUMO
Functional cis-regulatory elements (CREs) act as precise transcriptional switches for fine-tuning gene transcription. Identification of CREs is critical for understanding regulatory mechanisms of gene expression associated with various biological processes in eukaryotes. It is well known that CREs reside in open chromatin that exhibits hypersensitivity to enzyme cleavage and physical shearing. Currently, high-throughput methodologies, such as DNase-seq, ATAC-seq, and FAIRE-seq, have been widely applied in mapping open chromatin in various eukaryotic genomes. More recently, differential MNase (micrococcal nuclease) treatment has been successfully employed to map open chromatin in addition to profiling nucleosome landscape in both mammalian and plant species. We have developed a MNase hypersensitivity sequencing (MH-seq) technique in plants. The MH-seq procedure includes plant nuclei fixation and purification, differential treatments of purified nuclei with MNase, specific recovery of MNase-trimmed small DNA fragments within 20~100 bp in length, and MH-seq library construction followed by Illumina sequencing and data analysis. MH-seq has been successfully applied for global identification of open chromatin in both Arabidopsis thaliana and maize. It has been proven to be an attractive alternative for profiling open chromatin. Thus, MH-seq is expected to be valuable in probing chromatin accessibility on a genome-wide scale for other plants with sequenced genomes. Moreover, MHS data allow to implement footprinting assays to unveil binding sites of transcription factors.
Assuntos
Arabidopsis , Cromatina , Animais , Cromatina/genética , Nucleossomos , Nuclease do Micrococo/metabolismo , Sequenciamento de Nucleotídeos em Larga Escala/métodos , DNA/genética , Arabidopsis/genética , Arabidopsis/metabolismo , Plantas/genética , Fatores de Transcrição/metabolismo , Mamíferos/genéticaRESUMO
PURPOSE: Little is known about how biomechanics governs the biological nature for humeral motion dynamically. Elbow motion ought to be investigated based on a musculoskeletal model and evidence the physiologic principle of upper limbs. METHOD: A humeral model was reconstructed by MIMICS after CT images input in *.dicom format, it was processed by Geomagic Studio for Surfaces, then gridded mesh and assigned materials by Hypermesh. On the other hand, a musculoskeletal model was built by AnyBody, physical motions were then simulated to export boundary condition and myodynamia during flexion and extension. Finally, all the humeral model and boundary were imported to Abaqus for finite element analysis. RESULT: During the simulative motion of flexion, the primary muscles are brachii biceps, brachialis anticus and teretipronator, their myodynamia increased and then decreased gradually, and reached its peak value at 30°; During extension, the main muscles are triceps brachii and brachialis anticus, their myodynamia increased and then decreased gradually too, and reached peak at 50°; In these two cases, their strain and displacement distributed at the middle of humerus. CONCLUSION: AnyBody is a novel modelling system to simulate physical motion, for example flexion and extension. Biceps brachii and brachialis anticus are functional for flexion, and triceps brachii plays a key role in extension critically. This simulation confirms the physiologic rule for sport event, humeral fixation and postoperative healing with clinical significance that minimizing joint forces from injury onset may promote pain-free ways.
Assuntos
Articulação do Cotovelo , Braço , Fenômenos Biomecânicos , Humanos , Músculo Esquelético , Amplitude de Movimento ArticularRESUMO
Although lagging behind studies in humans and other mammals, studies of R-loops in plants have recently entered an exciting stage in which the roles of R-loops in gene expression, genome stability, epigenomic signatures, and plant development and stress responses are being elucidated. Here, we review the strengths and weaknesses of existing methodologies, which were largely developed for R-loop studies in mammals, and then discuss the potential challenges of applying these methodologies to R-loop studies in plants. We then focus on recent advances in the functional characterization of R-loops in Arabidopsis thaliana and rice. Recent studies in plants indicate that there are coordinated relationships between R-loops and gene expression, and between R-loops and epigenomic signatures that depend, in part, on the types of R-loops involved. Finally, we discuss the emerging roles of R-loops in plants and directions for future research.
Assuntos
Arabidopsis , Oryza , Estruturas R-Loop , Arabidopsis/genética , Oryza/genéticaRESUMO
R-loops and covalent modifications of N 6 -methyladenine on DNA (D-6 mA) or RNA (R-m6A) have been documented to function in various cellular processes in eukaryotes. However, the relationships between R-loops and both covalent modifications are still elusive in plants. Here, we integrated existing ssDRIP-seq with D-6 mA and R-m6A data from Arabidopsis thaliana. We found that the presence of either of both modifications facilitates R-loop formation and transcription of overlapping genes. Interestingly, our study suggests that the presence of R-m6A is key to affect R-loop intensity and positively regulate gene transcription. Moreover, the presence of D-6 mA plays an additive role to facilitate the effect of R-m6A on R-loop intensity, however, D-6 mA may negatively regulate gene transcription when coexisted with R-m6A. Our analyses indicate that D-6 mA, R-m6A, or histone marks may act individually and cooperatively with R-loops in regulating gene transcription. Our study is the first to link R-loops with D-6 mA and R-m6A in plants, thereby providing new insights into interactions between R-loops with D-6 mA, R-m6A, and histone marks for regulating gene transcription. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12298-021-01010-5.
RESUMO
BACKGROUND AND OBJECTIVES: To compare mechanical properties of femoral tumor treatments so that better operative strategy for limb tumors surgery is optimized. METHODS: Fourteen femoral CT images were randomly selected to rebuild 3D models by MIMICS. They were then executed by reverse engineering softwares for simulative modes. Mode #1: Intralesional curettage with cement filled plus fixator; Mode #2: Distal femur resection with tumorous prosthesis replaced. Finally, the mechanical aspects such as stress and displacement were compared by finite element analysis. RESULTS: Analyzed by AnSys, the observation indexes were measured as follows: for displacement of femurs, d=1.4762 (< a=3.9042 < c=3.9845 < b=4.1159) in mm is the most staple of all models; for displacement of implants (fixators or prostheses), it's similar to the behavior of femurs and with no significant difference; for stresses of femurs, no significant difference was found among all models; the stresses of implants (fixations and prostheses) were observed as d=39.6334 (< a=58.6206 < c=61.8150 < b=62.6626) in MPa correspondently, which is the least; for stresses of the general system, the average of peak values for integrated devices of all models are: d=40.8072 (< a=58.6206 < c=61.7831< b=62.6626) in MPa, which is also the least. As a final result, both maximum values for displacement and stress of mode 2 are lower than those of mode 1. CONCLUSIONS: Our finite element analysis of limb salvage simulation in biomechanics proved that, to treat distal femoral bone tumors, prosthetic replacement is more efficient than intralesional curettage.
Assuntos
Neoplasias Ósseas , Salvamento de Membro , Fenômenos Biomecânicos , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Curetagem , Análise de Elementos Finitos , Humanos , Estresse MecânicoRESUMO
BACKGROUND: The World Health Organization End TB Strategy meant that compared with 2015 baseline, the reduction in pulmonary tuberculosis (PTB) incidence should be 20 and 50% in 2020 and 2025, respectively. The case number of PTB in China accounted for 9% of the global total in 2018, which ranked the second high in the world. From 2007 to 2019, 854 672 active PTB cases were registered and treated in Henan Province, China. This study was to assess whether the WHO milestones could be achieved in Henan Province. METHODS: The active PTB numbers in Henan Province from 2007 to 2019, registered in Chinese Tuberculosis Information Management System were analyzed to predict the active PTB registration rates in 2020 and 2025, which is conductive to early response measures to ensure the achievement of the WHO milestones. The time series model was created by monthly active PTB registration rates from 2007 to 2016, and the optimal model was verified by data from 2017 to 2019. The Ljung-Box Q statistic was used to evaluate the model. The statistically significant level is α = 0.05. Monthly active PTB registration rates and 95% confidence interval (CI) from 2020 to 2025 were predicted. RESULTS: High active PTB registration rates in March, April, May and June showed the seasonal variations. The exponential smoothing winter's multiplication model was selected as the best-fitting model. The predicted values were approximately consistent with the observed ones from 2017 to 2019. The annual active PTB registration rates were predicted as 49.1 (95% CI: 36.2-62.0) per 100 000 population and 34.4 (95% CI: 18.6-50.2) per 100 000 population in 2020 and 2025, respectively. Compared with the active PTB registration rate in 2015, the reduction will reach 23.7% (95% CI, 3.2-44.1%) and 46.8% (95% CI, 21.4-72.1%) in 2020 and 2025, respectively. CONCLUSIONS: The high active PTB registration rates in spring and early summer indicate that high risk of tuberculosis infection in late autumn and winter in Henan Province. Without regard to the CI, the first milestone of WHO End TB Strategy in 2020 will be achieved. However, the second milestone in 2025 will not be easily achieved unless there are early response measures in Henan Province, China.
Assuntos
Sistema de Registros , Tuberculose Pulmonar/epidemiologia , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Estações do Ano , Análise Espaço-Temporal , Organização Mundial da SaúdeRESUMO
BACKGROUND AND OBJECTIVES: There are many fixation methods for Pauwels- III fracture, the most common implants are Locking Plate (LP), Dynamic Hip Screw (DHS), Multiple Lag Screw (MLS), and mixed fixture (DHS+MLS) implants, the common procedure is HemiArthroplasty (HA). However, how these fixtures biomechanically function is not clear. The aims of this study are to compare the mechanical behaviors of these five implants by finite element modeling and determinate the most suitable procedure for individuals with Pauwels- III fractures. METHODS: We gathered 20 sets of femur images from CT scans in the *.dicom format first, and then processed them by using reverse engineering software programs, such as Mimics, Geomagic Studio, UG-8, Pro-Engineer and HyperMesh. Finally, we assembled and analyzed the five types of fixture models, the LP, DHS, MLS, DHS+LS and HA models, by AnSys. RESULTS: These numerical models of Pauwels III fractures, including fixators and a simulative HA, were validated by a previous study and a cadaver test. Our analytical findings include the following: the displacements of all fixtures were between 0.3801 and 1.0834 mm, and the differences were not statistically significantly different; the resulting average peaks in stress were e(Ha) = 43.859 ≤ d(LP) = 60.435 ≤ b(MLS) = 68.678 < c(LS+DHS) = 98.478 < a(DHS) = 248.595 in Mpa, indicating that the stress of DHS and DHS+LS are greater than those of LP, HA and MLS, while the last 3 models were not significantly different. CONCLUSIONS: To optimize the treatment for Pauwels III factures clinically, HA and LP should be proposed.
Assuntos
Fraturas do Colo Femoral , Fenômenos Biomecânicos , Parafusos Ósseos , Fêmur , Análise de Elementos Finitos , Fixação Interna de Fraturas , HumanosRESUMO
The superplastic deformation of a hot-extruded GH4151 billet was investigated by means of tensile tests with the strain rates of 10-4 s-1, 5 × 10-4 s-1 and 10-3 s-1 and at temperatures at 1060 °C, 1080 °C and 1100 °C. The superplastic deformation of the GH4151 alloy was reported here for the first time. The results reveal that the uniform fine-grained GH4151 alloy exhibited an excellent superplasticity and high strain rate sensitivity (exceeded 0.5) under all experimental conditions. It was found that the increase of strain rate resulted in an increased average activation energy for superplastic deformation. A maximum elongation of 760.4% was determined at a temperature of 1080 °C and strain rate of 10-3 s-1. The average activation energy under different conditions suggested that the superplastic deformation with 1 × 10-4 s-1 in this experiment is mainly deemed as the grain boundary sliding controlled by grain boundary diffusion. However, with a higher stain rate of 5 × 10-4 s-1 and 1 × 10-3 s-1, the superplastic deformation is considered to be grain boundary sliding controlled by lattice diffusion. Based on the systematically microstructural examination using optical microscope (OM), SEM, electron backscatter diffraction (EBSD) and TEM techniques, the failure and dynamic recrystallization (DRX) nucleation mechanisms were proposed. The dominant nucleation mechanism of dynamic recrystallization (DRX) is the bulging of original grain boundaries, which is the typical feature of discontinuous dynamic recrystallization (DDRX), and continuous dynamic recrystallization (CDRX) is merely an assistant mechanism of DRX. The main contributions of DRX on superplasticity elongation were derived from its grain refinement process.
RESUMO
BACKGROUND There is a growing recognition of sex-related disparities in atrial fibrillation (AF). However, limited data is available in Chinese AF patients. MATERIAL AND METHODS We compared symptoms, quality of life (QoL), and treatment of AF according to sex from the China AF Registry study. RESULTS We studied 14 723 patients with non-valvular AF, of whom 5645 patients (38.3%) were female. Women were older than men (67.5±10.6 vs. 62.2±12.2). Compared to men, women had more comorbidities and a higher proportion of CHA2DS2-VASC score ≥2. Women with AF experienced more severe or disabling symptoms than men (33.7% vs. 22.9% in age <75 group; 40.3% vs. 28.7% in age ≥75 group; both P<0.0001). After multivariate analysis, women with AF still had lower QoL (OR 0.69; 95%CI, 0.63-0.76; P<0.0001). Women tended to have lower rates of ablation and rhythm-control drug use in those aged <75 years. Oral anticoagulant use was low and had no sex difference in AF patients with a CHA2DS2-VASC score ≥2. CONCLUSIONS In Chinese AF patients, women were older and more symptomatic, and had worse QoL. Despite all these differences, women tended to receive less rhythm-control treatment in those aged <75 years. Oral anticoagulant was substantially underused in high stroke risk patients, regardless of sex.
Assuntos
Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/psicologia , Fatores Sexuais , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Sistema de Registros , Medição de Risco , Fatores de Risco , Caracteres Sexuais , Acidente Vascular Cerebral/tratamento farmacológico , Resultado do TratamentoRESUMO
BACKGROUND Results of the landmark Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) trial comparing rhythm control and rate control strategies has led to dramatic changes in the pharmacological management of non-valvular atrial fibrillation (NVAF) patients. We sought to investigate the effect of antiarrhythmic drugs (AADs) on the clinical outcomes of NVAF patients using "real-world" data from China. MATERIAL AND METHODS We evaluated the association between AAD usage and clinical outcomes using clinical data of 8161 NVAF patients who were AAD-naive before enrollment in the China Atrial Fibrillation Registry, recruited between August 2011 and February 2017. The primary outcome was all-cause mortality. RESULTS Compared with 6167 patients who never used any AADs, 1994 patients in the AAD group had lower incidence (per 100 person-years) of all-cause mortality (1.44 versus 3.91), cardiovascular death (0.45 versus 2.31), ischemic stroke (1.36 versus 2.03), and cardiovascular hospitalization (9.83 versus 10.22) over a mean follow-up duration of 316.7±90.4 days. After adjusting for potential confounders, AAD usage was associated with a lower risk of all-cause mortality [hazard ratio (HR): 0.50, 95% confidence interval (CI): 0.31-0.81] and decreased risk of cardiovascular death (HR: 0.30, 95% CI: 0.13-0.68). Subgroup analysis revealed AAD was associated with higher risk of cardiovascular hospitalization among female patients. CONCLUSIONS AAD usage was associated with lower risk of 1-year all-cause mortality and cardiovascular death in "real-world" patients with NVAF.
Assuntos
Antiarrítmicos/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/mortalidade , Idoso , Antiarrítmicos/farmacologia , China , Feminino , Hospitalização , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Sistema de Registros , Fatores de Risco , Acidente Vascular Cerebral/complicações , Resultado do TratamentoRESUMO
BACKGROUND: Pulmonary tuberculosis (PTB,both smear positive and smear negative) is an airborne infectious disease of major public health concern in China and other parts of the world where PTB endemicity is reported. This study aims at identifying PTB spatio-temporal clusters and associated risk factors in Zhaotong prefecture-level city, located in southwest China, where the PTB notification rate was higher than the average rate in the entire country. METHODS: Space-time scan statistics were carried out using PTB registered data in the nationwide TB online registration system from 2011 to 2015, to identify spatial clusters. PTB patients diagnosed between October 2015 and February 2016 were selected and a structured questionnaire was administered to collect a set of variables that includes socio-economic status, behavioural characteristics, local environmental and biological characteristics. Based on the discovery of detailed town-level spatio-temporal PTB clusters, we divided selected subjects into two groups including the cases that resides within and outside identified clusters. Then, logistic regression analysis was applied comparing the results of variables between the two groups. RESULTS: A total of 1508 subjects consented and participated in the survey. Clusters for PTB cases were identified in 38 towns distributed over south-western Zhaotong. Logistic regression analysis showed that history of chronic bronchitis (OR = 3.683, 95% CI: 2.180-6.223), living in an urban area (OR = 5.876, 95% CI: 2.381-14.502) and using coal as the main fuel (OR = 9.356, 95% CI: 5.620-15.576) were independently associated with clustering. While, not smoking (OR = 0.340, 95% CI: 0.137-0.843) is the protection factor of spatial clustering. CONCLUSIONS: We found PTB specially clustered in south-western Zhaotong. The strong associated factors influencing the PTB spatial cluster including: the history of chronic bronchitis, living in the urban area, smoking and the use of coal as the main fuel for cooking and heating. Therefore, efforts should be made to curtail these associated factors.
Assuntos
Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Antituberculosos/uso terapêutico , Bronquite Crônica/fisiopatologia , China/epidemiologia , Cidades , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fumar/fisiopatologia , Classe Social , Conglomerados Espaço-Temporais , Análise Espaço-Temporal , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/transmissãoRESUMO
Poor initiation and implementation and premature discontinuation of anti-tuberculous therapy, all forms of nonadherence, are major reasons for treatment failure, the development of drug-resistant tuberculosis, and transmission to other non-infected individuals. Directly Observed Therapy (DOT) has been the worldwide standard, but implementation of DOT is burdensome for providers and patients, especially in resource-limited settings, where most of the burden of active TB is located. Among the alternatives to DOT is electronic monitoring (EM) of drug dosing histories. Here we report a usability study of a newly-designed, modular electronic monitor product, called the MERM (Medication Event and Reminder Monitor), that is compatible with TB medication formats and supply chains in resource-limited settings. This study, done in a rural setting in China, showed that the use of the MERM for EM of TB medications was associated with a high degree of user performance, acceptability, and satisfaction among both TB patients and medical staff. Based on these data, EM is becoming the standard of care for drug-susceptible TB patients in China and scaled implementations in several other countries with high TB burden have begun. In addition, the MERM is being used in MDR-TB patients and in clinical trials involving patients with TB/HIV and latent TB.
Assuntos
Antituberculosos/administração & dosagem , Adesão à Medicação , Sistemas de Alerta/estatística & dados numéricos , Tuberculose/tratamento farmacológico , Sistemas de Alerta/instrumentação , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológicoRESUMO
BACKGROUND: The number of pulmonary tuberculosis (PTB) cases in China ranks third in the world. A continuous increase in cases has recently been recorded in Zhaotong prefecture-level city, which is located in the northeastern part of Yunnan province. This study explored the space-time dynamics of PTB cases in Zhaotong to provide useful information that will help guide policymakers to formulate effective regional prevention and control strategies. METHODS: The data on PTB cases were extracted from the nationwide tuberculosis online registration system. Time series and spatial cluster analyses were applied to detect PTB temporal trends and spatial patterns at the town level between 2011 and 2015 in Zhaotong. Three indicators of PTB treatment registration history were used: initial treatment registration rate, re-treatment registration rate, and total PTB registration rate. RESULTS: Seasonal trends were detected with an apparent symptom onset peak during the winter season and a registration peak during the spring season. A most likely cluster and six secondary clusters were identified for the total PTB registration rate, one most likely cluster and five secondary clusters for the initial treatment registration rate, and one most likely cluster for the re-treatment registration rate. The most likely cluster of the three indicators had a similar spatial distribution and size in Zhenxiong County, which is characterised by a poor socio-economic level and the largest population in Yunnan. CONCLUSION: This study identified temporal and spatial distribution of PTB in a high PTB burden area using existing health data. The results of the study provide useful information on the prevailing epidemiological situation of PTB in Zhaotong and could be used to develop strategies for more effective PTB control at the town level. The cluster that overlapped the three PTB indicators falls within the geographic areas where PTB control efforts should be prioritised.
Assuntos
Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Análise por Conglomerados , Feminino , Mapeamento Geográfico , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Prevalência , Estações do Ano , Fatores Socioeconômicos , Análise Espaço-Temporal , Tuberculose Pulmonar/terapia , Adulto JovemRESUMO
BACKGROUND: The Ebola virus disease spread rapidly in West Africa in 2014, leading to the loss of thousands of lives. Community engagement was one of the key strategies to interrupt Ebola transmission, and practical community level measures needed to be explored in the field and tailored to the specific context of communities. METHODS: First, community-level education on Ebola virus disease (EVD) prevention was launched for the community's social mobilizers in six districts in Sierra Leone beginning in November 2014. Then, from January to May of 2015, in three pilot communities, local trained community members were organized to engage in implementation of EVD prevention and transmission interruption measures, by involving them in alert case report, contact tracing, and social mobilization. The epidemiological indicators of transmission interruption in three study communities were evaluated. RESULTS: A total of 6 016 community social mobilizers from 185 wards were trained by holding 279 workshops in the six districts, and EVD message reached an estimated 631 680 residents. In three pilot communities, 72 EVD alert cases were reported, with 70.8 % of them detected by trained local community members, and 14 EVD cases were finally identified. Contact tracing detected 64.3 % of EVD cases. The median duration of community infectivity for the cases was 1 day. The secondary attack rate was 4.2 %, and no third generation of infection was triggered. No health worker was infected, and no unsafe burial and noncompliance to EVD control measures were recorded. The community-based measures were modeled to reduce 77 EVD cases, and the EVD-free goal was achieved four months earlier in study communities than whole country of Sierra Leone. CONCLUSIONS: The community-based strategy of social mobilization and community engagement was effective in case detection and reducing the extent of Ebola transmission in a country with weak health system. The successfully practical experience to reduce the risk of Ebola transmission in the community with poor resources would potentially be helpful for the global community to fight against the EVD and the other diseases in the future.
Assuntos
Surtos de Doenças/prevenção & controle , Ebolavirus/fisiologia , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/prevenção & controle , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Doença pelo Vírus Ebola/transmissão , Doença pelo Vírus Ebola/virologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Serra Leoa/epidemiologia , Adulto JovemRESUMO
BACKGROUND: The recent outbreak of the Ebola virus disease (EVD) in Sierra Leone has been characterized by the World Health Organization as one of the most challenging EVD outbreaks to date. The first confirmed case in Sierra Leone was a young woman who was admitted to a government hospital in Kenema following a miscarriage on 24 May 2014. On 5 January 2015, intensified training for an EVD response project was initiated at the medical university of Sierra Leone in Jui. To understand the knowledge, attitudes, practices, and perceived risk of EVD among the public, especially after this training, a rapid assessment was conducted from 10 to 16 March 2015. METHODS: Interviews were conducted with 466 participants based on questionnaires that were distributed from 10 to 16 March 2015 by cluster sampling in three adjacent communities, namely Jui, Grafton, and Kossoh Town, in the Western Area Rural District of Sierra Leone. RESULTS: It was found that knowledge about EVD was comprehensive and high. Positive attitude towards prevention was found to be satisfactory. Nearly all participants knew the reporting phone number 117 and had reported some change in behavior since learning about Ebola. More than half (62 %) of the participants had a history of travelling to urban areas, which increases the risk of infection. The multivariable logistic regression analysis showed that community and occupation were variables associated with perceived risk of EVD. CONCLUSIONS: Our study showed that community level social mobilization and community engagement were an effective strategy in the special context.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Doença pelo Vírus Ebola/prevenção & controle , Doença pelo Vírus Ebola/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Serra Leoa , Adulto JovemRESUMO
Both pulmonary tuberculosis (PTB) and intestinal helminth infection (IHI) affect millions of individuals every year in China. However, the national-scale estimation of prevalence predictors and prevalence maps for these diseases, as well as co-endemic relative risk (RR) maps of both diseases' prevalence are not well developed. There are co-endemic, high prevalence areas of both diseases, whose delimitation is essential for devising effective control strategies. Bayesian geostatistical logistic regression models including socio-economic, climatic, geographical and environmental predictors were fitted separately for active PTB and IHI based on data from the national surveys for PTB and major human parasitic diseases that were completed in 2010 and 2004, respectively. Prevalence maps and co-endemic RR maps were constructed for both diseases by means of Bayesian Kriging model and Bayesian shared component model capable of appraising the fraction of variance of spatial RRs shared by both diseases, and those specific for each one, under an assumption that there are unobserved covariates common to both diseases. Our results indicate that gross domestic product (GDP) per capita had a negative association, while rural regions, the arid and polar zones and elevation had positive association with active PTB prevalence; for the IHI prevalence, GDP per capita and distance to water bodies had a negative association, the equatorial and warm zones and the normalized difference vegetation index had a positive association. Moderate to high prevalence of active PTB and low prevalence of IHI were predicted in western regions, low to moderate prevalence of active PTB and low prevalence of IHI were predicted in north-central regions and the southeast coastal regions, and moderate to high prevalence of active PTB and high prevalence of IHI were predicted in the south-western regions. Thus, co-endemic areas of active PTB and IHI were located in the south-western regions of China, which might be determined by socio-economic factors, such as GDP per capita.
Assuntos
Coinfecção , Helmintíase/complicações , Enteropatias Parasitárias/complicações , Tuberculose Pulmonar/complicações , Teorema de Bayes , China/epidemiologia , Doenças Endêmicas , Helmintíase/epidemiologia , Humanos , Enteropatias Parasitárias/epidemiologia , Modelos Logísticos , Cadeias de Markov , Modelos Biológicos , Método de Monte Carlo , Tuberculose Pulmonar/epidemiologiaRESUMO
BACKGROUND: Clinical trials of Ebola vaccine are ongoing. Before it becomes commercially available, understanding the Ebola vaccine-related knowledge and attitude of the general population is imperative to developing an effective vaccine coverage strategy. METHODS: We conducted a survey including 400 participants from general communities of the West Area Rural District, Sierra Leone. Knowledge and attitudes about Ebola vaccine were investigated, and the determinants of having knowledge and a positive attitude toward accepting vaccination were identified. RESULTS: Over half (55.8%) of the participants were aware of Ebola vaccine. About 60% of the participants were willing to be study subjects if the Ebola vaccine clinical trial were conducted in their communities. Most of the participants (72.5%) were willing to take Ebola vaccination if it was free of charge. Given that the vaccination was not free, the proportion willing to pay a fee to take the vaccination declined dramatically to 26.6%. Using a forward step-wise logistic model, monthly salary was identified as the single determinant (OR for every 100,000 Leones increase: 1.17, 95%CI: 1.04-1.31) for awareness of Ebola vaccine, which was identified as the determinant (OR: 1.88, 95%CI: 1.17-3.02) for free vaccination uptake willingness. The combination of monthly salary, monthly average income of family members and their interaction was found to be associated with charged vaccination uptake willingness. DISCUSSION: Measures are still needed to promote the Ebola vaccine awareness and knowledge updating. Free or low-priced vaccine could increase the vaccination acceptability of the general community population significantly.
Assuntos
Vacinas contra Ebola/administração & dosagem , Conhecimentos, Atitudes e Prática em Saúde , Doença pelo Vírus Ebola/prevenção & controle , Vacinação/psicologia , Adolescente , Adulto , Vacinas contra Ebola/economia , Honorários e Preços , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Serra Leoa , Inquéritos e Questionários , Vacinação/economia , Adulto JovemRESUMO
BACKGROUND: Humoral and cellular immune responses play protective roles against Mycobacterium tuberculosis (MTB) infection. However, hookworm infection decreases the immune response to hookworm and bystander antigens. Currently, immune responses to co-infection of MTB and hookworm are still unknown, although co-infection has been one of the public health problems in co-endemic areas of pulmonary tuberculosis (PTB) and hookworm disease. Therefore, it is essential to evaluate B and T cell immune responses to the co-infection. METHODS: Seventeen PTB cases co-infected with hookworm, 26 PTB cases, 15 patients with hookworm infection, and 24 healthy controls without PTB or hookworm infection were enrolled in the study. Expressions of CD3, CD4, CD8, CD10, CD19, CD20, CD21, CD25, CD27, CD38, FoxP3, and PD-1 were assessed on B and T cell subsets using multicolor flow cytometry. RESULTS: For the B cell (CD19(+)) subsets, naïve B cells (CD10(-)CD27(-)CD21(+)CD20(+)), plasma cells (CD10(-)CD27(+)CD21(-)CD20(-)), and tissue-like memory B cells (CD10(-)CD27(-)CD21(-)CD20(+)) had higher proportions, whilst resting memory B cells (CD10(-)CD27(+)CD21(+)CD20(+)) had lower proportions in the group co-infected with MTB and hookworm as compared to other groups. Frequencies of activated memory B cells (CD10(-)CD27(+)CD21(-)CD20(+)) did not differ among the four groups. For the T cell (CD3(+)) subsets, frequencies of regulatory T cells (CD4(+)CD25(+)Foxp3(+)) and exhausted CD4(+) and CD8(+) T cells (CD4(+)PD-1(+) and CD8(+)PD-1(+)) were higher, and frequencies of activated CD4(+) and CD8(+) T cells (CD4(+)CD38(+) and CD8(+)CD38(+)) were lower in the co-infected group as compared to the other groups. CONCLUSION: The change patterns of the cell profile of circulating lymphocytes were indentified in human co-infection of MTB and hookworm, which might indicate that the humoral and cellular immune responses are more suppressed.