Epidemiological assessment of hepatitis E virus infection among 1565 pregnant women in Siem Reap, Cambodia using an in-house double antigen sandwich ELISA.

AIM: This study investigated hepatitis E virus (HEV) prevalence among pregnant women in Siem Reap, Cambodia, by developing a cost-effective, user-friendly in-house enzyme-linked immunosorbent assay (ELISA) for detecting total anti-HEV immunoglobulins (Ig). METHODS: The in-house ELISA was designed for large-scale screening in resource-limited settings. Its performance was benchmarked against two commercial tests: the Anti-HEV IgG EIA (Institute of Immunology, Co. Ltd) and the Anti-HEV IgG RecomLine LIA (Mikrogen). The in-house ELISA demonstrated a sensitivity of 76% and 71.4%, and a specificity of 94.1% and 98.6%, against the two commercial tests, respectively, with overall agreement rates of 92.4% and 94.3%. RESULTS: Among 1565 tested pregnant women, 11.6% were anti-HEV positive. Prevalence increased with age, particularly in women aged 35-40 years and over 40 years. No significant associations were found with education, number of children, family size, or history of blood transfusion and surgery, except for the occupation of the family head as a public officer. Of the total anti-HEV positive women, 22.7% had anti-HEV IgM, indicating recent or ongoing infection. CONCLUSION: The study concluded that the in-house ELISA is a viable option for HEV screening in regions with limited resources due to its high accuracy and cost-effectiveness. It is particularly suitable for large-scale studies and public health interventions in areas where HEV is endemic and poses a significant risk to pregnant women.

Natural course of post-COVID symptoms in adults and children.

More than 200 million COVID-19 survivors have lasting symptoms after recovering, but the duration and related risk factors remain uncertain. This study focused on all 6551 patients diagnosed with COVID-19 at a medical institution in Hiroshima from March 2020 to July 2022. In November 2022, a questionnaire survey was conducted regarding post-COVID symptoms and their duration. The prevalence and duration of post-COVID symptoms were illustrated using the Kaplan-Meier method. Risk factors for symptoms lasting over 3 months and interfering with daily life were assessed via multivariate logistic regression. A total of 2421 survivors responded: 1391 adults, 1030 children, median age 34 years (IQR 9-55), 51·2% male, 36·7% hospitalized, median time from infection to the survey was 295 days (IQR 201-538). Upon their initial recovery, the prevalence of post-COVID symptoms was 78·4% in adults and 34·6% in children. Three months later, the rates were 47·6% and 10·8%. After over one year, they were 31·0% and 6·8%. Regarding symptoms interfere with daily life, 304 people (12.6%) experienced symptoms lasting for over three months, with independent risk factors including age, being female, diabetes mellitus, infection during the Delta period, and current smoking. There was no significant association between vaccination history and post-COVID symptoms.

Do Electronic Health Literacy and Online Health Information-Seeking Behavior Mediate the Effects of Socio-Demographic Factors on COVID-19- and Non-communicable Disease-Related Behaviors Among Myanmar Migrants in Southern Thailand?

Introduction Myanmar migrants in Thailand are vulnerable to COVID-19 and non-communicable disease (NCD) risk behaviors, influenced by socio-demographic factors. In the digital age, migrants can seek extensive health information online, and their ability to understand and use electronic health information, which is known as electronic health literacy (e-Health literacy), becomes critical in making decisions about their health behaviors. This study aims to investigate the potential mediating roles of online health information-seeking and e-Health literacy in the associations between socio-demographic factors and COVID-19- and NCD-related behaviors. Methods Our study was conducted in 2022, involving 1,050 Myanmar migrants in two southern Thai cities. Data on socio-demographic factors, e-Health literacy, online health information seeking, COVID-19-related behaviors (adherence to COVID-19 protective behavior (CPB), vaccination), and NCD risk behaviors (smoking, betel chewing, alcohol consumption, substance abuse) were collected. Structural equation modeling (SEM) was employed to analyze the hypothesized relationships. Results Nearly all migrants received the COVID-19 vaccination in two doses and above, with reasonable good adherence to CPB. Migrants exhibited risky NCD-related behaviors, including current smoking (26.8%), alcohol consumption (17.5%), and betel chewing (25.8%). Approximately three-quarters (73.4%) had a limited e-Health literacy level, and the vast majority did not search for online health information. Their COVID-19- and NCD-related behaviors were directly influenced by socio-demographic factors without the significant mediation roles of e-Health literacy and online health information seeking. Conclusions Myanmar migrant workers in Southern Thailand had reasonably good practices in COVID-19-related behaviors despite engaging in risky NCD-related behaviors. These outcome behaviors were directly influenced by their socio-demographic factors, without the significant mediation roles of e-Health literacy and online health information seeking. The findings suggest that diverse interventions beyond e-Health strategies for future pandemic mitigation and enhancement of their health behaviors are needed.

Robust perovskite formation via vacuum thermal annealing for indoor perovskite solar cells.

Perovskite materials are fascinating candidates for the next-generation solar devices. With long charge carrier lifetime, metal-halide perovskites are known to be good candidates for low-light harvesting. To match the irradiance spectra of indoor light, we configured a triple-cation perovskite material with appropriate content of bromide and chloride (FA0.45MA0.49Cs0.06Pb(I0.62Br0.32Cl0.06)3) to achieve an optimum band gap (Eg) of [Formula: see text]1.80 eV. With low photon flux at indoor condition, minimal recombination is highly desirable. To achieve such goal, we, for the first time, combined dual usage of antisolvent deposition and vacuum thermal annealing, namely VTA, to fabricate a high-quality perovskite film. VTA leads to compact, dense, and hard morphology while suppressing trap states at surfaces and grain boundaries, which are key culprits for exciton losses. With low-cost carbon electrode architecture, VTA devices exhibited average power conversion efficiency (PCE) of 27.7 ± 2.7% with peak PCE of 32.0% (Shockley-Queisser limit of 50-60%) and average open-circuit voltage (Voc) of 0.93 ± 0.02 V with peak Voc of 0.96 V, significantly more than those of control and the vacuum treatment prior to heat.

Seroepidemiological study of factors affecting anti-spike IgG antibody titers after a two-dose mRNA COVID-19 vaccination in 3744 healthy Japanese volunteers.

Several factors related to anti-spike(S) IgG antibody titers after mRNA COVID-19 vaccination have been elucidated, but the magnitude of the effects of each factor has not been fully understood. This cross-sectional study assessed anti-S and anti-nucleocapsid (N) antibody titers on 3744 healthy volunteers (median age, 36 years; IQR, 24-49 years; females, 59.0%) who received two doses of mRNA-1273 or BNT162b2 vaccine and completed a survey questionnaire. Multiple regression was conducted to identify factors associated with antibody titers. All but one participant tested positive for anti-S antibodies (99.97%). The following factors were independently and significantly associated with high antibody titer: < 3 months from vaccination (ratio of means 4.41); mRNA-1273 vaccine (1.90, vs BNT162b2); anti-N antibody positivity (1.62); age (10's: 1.50, 20's: 1.37, 30's: 1.26, 40's: 1.16, 50's: 1.15, vs ≧60's); female (1.07); immunosuppressive therapy (0.54); current smoking (0.85); and current drinking (0.96). The largest impact on anti-S IgG antibody titers was found in elapsed time after vaccination, followed by vaccine brand, immunosuppressants, previous SARS-CoV-2 infection (anti-N antibody positive), and age. Although the influence of adverse reactions after the vaccine, gender, smoking, and drinking was relatively small, they were independently related factors.

Prevalence of Helicobacter pylori infection in the general population evaluated by a resident-register-based epidemiological study.

BACKGROUND: The current status of Helicobacter pylori infection in Japan has not been investigated. We evaluated the status of H. pylori infection in a Japanese general population using large-scale resident-register-based sampling. METHODS: All 6069 adults in a rural town and 6000 adults in two urban cities (3000 each), selected by register-based random sampling, were enrolled in our health check-up program. Antibody titers against Helicobacter pylori (cut-off value was 3 U/mL by Eiken E-plate) were evaluated, and subjects with a positive result were encouraged to undergo further examinations. RESULTS: A total of 1586 subjects participated in serum sampling. The overall prevalence of H. pylori infection was 40.0% (634/1586), and it increased with age both in rural and urban areas. Although the overall positive rate was higher in the rural area (49.4%) than in the urban areas (35.6 and 32.3%), there was no difference in H. pylori status of younger subjects between the two areas. Among 634 patients with a positive titer, 374 (59.0%) underwent further examinations including endoscopic examination, and 180/634 (28.4%) patients received eradication therapy. Gastric neoplasms (three adenocarcinomas and one adenoma) were found in our screening program. CONCLUSION: We clarified population-based random sampling data of H. pylori infection in a Japanese general population. In younger subjects, a decrease in the prevalence of H. pylori infection was confirmed both in rural and urban areas. This provides basic information for establishing a strategy to reduce gastric cancer deaths.

Distribution of FIB-4 index in the general population: analysis of 75,666 residents who underwent health checkups.

BACKGROUND: Fatty liver is frequently found in a general population, and it is critical to detect advanced fibrosis. FIB-4 index is considered a useful marker for evaluating liver fibrosis but the distribution of FIB-4 index in the general population remains unknown. METHODS: This cross-sectional study included residents who underwent ultrasonography at health checkups in Hiroshima or Iwate prefectures. The distribution of FIB-4 index in the total study population (N = 75,666) as well as in non-alcoholic fatty liver disease (NAFLD) populations (N = 17,968) and non-drinkers without fatty liver populations (N = 47,222) was evaluated. The distribution of aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT) levels was also evaluated. RESULTS: The mean FIB-4 index in the total study population was 1.20 ± 0.63. FIB-4 index ≥ 2.67, which indicates a high risk of liver fibrosis, was found in 16.4% of those aged ≥ 70 years. In the NAFLD population, 58.1% of those in their 60 s and 88.1% of those ≥ 70 years met the criteria for referral to hepatologists by using the recommended FIB-4 index cutoff value (≥ 1.3). The mean FIB-4 index in the NAFLD population (1.12 ± 0.58) was significantly lower than in the non-drinkers without fatty liver (1.23 ± 0.63, p < 0.0001). The non-drinkers without fatty liver tended to have higher AST relative to ALT levels (60.0% with AST/ALT > 1.0), whereas the results in the NAFLD population were opposite (14.8% with AST/ALT > 1.0). AST > ALT resulted in a higher FIB-4 index in non-drinkers without fatty liver due to the nature of FIB-4 index formula. CONCLUSIONS: The cutoff value of FIB-4 index (≥ 1.3) for triaging the elderly people with fatty liver for referral to hepatologists should be reconsidered to avoid over-referral. Due to the impact of age and characteristics of AST/ALT ratios, there is no prospect of using FIB-4 index for primary screening for liver fibrosis in a general population of unknown presence or absence of liver disease, even though it can be easily calculated using routine clinical indices. It is desired to develop a non-invasive method for picking up cases with advanced fibrosis latent in the general population.

Morbidity related to the lip-split mandibulotomy approach: a systematic and narrative review.

The lip-split mandibulotomy (LSMA) is an access procedure that has been used in head and neck (H&N) surgery as an aid to surgical resection of inaccessible tumours of the postertior oral cavity and oropharynx. Anecdotal evidence suggests that it has significant morbidity. Voices of concern within the H&N surgical community suggest that it has been abandoned in favour of technological advances such as robotic surgery. We report here the first (to our knowledge) registered systematic review of its kind, documenting the safety and efficiency of LSMA in H&N surgery. We performed a PRISMA-guided systematic review (PROSPERO-registered) and identified reports using a search algorithm in MEDLINE/EMBASE. LSMA-related surgical complications were recorded using the Clavien-Dindo classification. Secondary outcomes included swallowing dysfunction, facial cosmesis, and patient satisfaction recorded in health-related quality of life questionnaires (HRQoL). From 125 studies identified, 54 met the inclusion criteria (3872 patients). The LSMA mortality rate was 0%; we did not identify a single case of perioperative death. The median rate of osteoradionecrosis was 5.4%, whereas fistula formation was 5.7%. Malunion was noted in 4.9%. Other complications (surgical site infection, plate exposure) were around 5%. There was significant between-study variation with regards to swallowing assessment tools, but overall there was no significant difference in outcomes. This was also the case for the HRQoL questionairres. LSMA is a safe procedure with an acceptable rate of complications, and should definitely remain in the armamentarium of H&N surgery.

Mass Screening of SARS-CoV-2 Variants using Sanger Sequencing Strategy in Hiroshima, Japan.

This study aimed to develop the feasible and effective universal screening strategy of the notable SARS-CoV-2 variants by Sanger Sequencing Strategy and then practically applied it for mass screening in Hiroshima, Japan. A total of 734 samples from COVID-19 confirmed cases in Hiroshima were screened for the notable SARS-CoV-2 variants (B.1.1.7, B.1.351, P.1, B.1.617.2, B.1.617.1, C.37, B.1.1.529, etc.). The targeted spike region is amplified by nested RT-PCR using in-house designed primer set hCoV-Spike-A and standard amplification protocol. Additionally, randomly selected 96 samples were also amplified using primer sets hCoV-Spike-B and hCoV-Spike-C. The negative amplified samples were repeated for second attempt of amplification by volume-up protocol. Thereafter, the amplified products were assigned for Sanger sequencing using corresponding primers. The positive amplification rate of primer set hCoV-Spike-A, hCoV-Spike-B and hCoV-Spike-C were 87.3%, 83.3% and 93.8% respectively for standard protocol and increased to 99.6%, 95.8% and 96.9% after second attempt by volume-up protocol. The readiness of genome sequences was 96.9%, 100% and 100% respectively. Among 48 mutant isolates, 26 were B.1.1.7 (Alpha), 7 were E484K single mutation and the rest were other types of mutation. Moreover, 5 cluster cases with single mutation at N501S were firstly reported in Hiroshima. This study indicates the reliability and effectiveness of Sanger sequencing to screen large number of samples for the notable SARS-CoV-2 variants. Compared to the Next Generation Sequencing (NGS), our method introduces the feasible, universally applicable, and practically useful tool for identification of the emerging variants with less expensive and time consuming especially in those countries where the NGS is not practically available. Our method allows not only to identify the pre-existing variants but also to examine other rare type of mutation or newly emerged variants and is crucial for prevention and control of pandemic.

The Risk of Iatrogenic Hypercalcemia in Patients Undergoing Calcium Sulphate Beads Implantation in Prosthetic Joint Surgery: A Systematic Review.

Calcium sulphate beads are increasingly being used in the management of prosthetic joint infections (PJI). Traditionally their use was limited to a void or dead space-filling combined with other additives such as Hydroxyapatite. Over the last decade, they have been developed to act more frequently as an antibiotics delivery system. Stimulan, a bio-absorbable form of Calcium sulfate, theoretically has an increased risk of hypercalcemia. Over the last few years, there have been published case reports which report it as an isolated cause of iatrogenic hypercalcemia. The sparsity of literature on this topic makes it difficult for surgeons to decide on the use of Calcium sulphate beads in patients with hypercalcemia predisposition in conditions like autoimmune disorders, sarcoidosis, malignancy, granulomatous diseases, heterotopic ossification, and hyperparathyroidism. The study was performed to assess the risk of hypercalcemia in patients after Calcium sulphate beads implantation in PJI. Two reviewers searched relevant literature in 3 online databases using cochrane methodology for systematic reviews. Studies reporting complications with the use of calcium sulphate beads in prosthetic joints were included. Studies reporting on less than five patients and studies reporting use in any other surgeries were excluded. The search of databases resulted in a total of 96 articles. After screening, a total of four articles were deemed suitable to be included in the analysis. A total of 1049 patients underwent calcium sulfate beads implantation, out of which 44 (4.2%) reported hypercalcemia with 41 (3.91%) transient in nature and 3 (0.28%) required management, including one with ICU admission. The result of this systematic review shows that calcium sulphate beads are safe and effective against PJI. There is a significant risk of transient hypercalcemia in susceptible patients and a low risk of symptomatic hypercalcemia.

Giant posterior mediastinal schwannoma requiring a thoracoabdominal approach for excision: Case report and literature review.

BACKGROUND: A schwannoma is a tumor of the peripheral nerve sheath. They are the most common benign tumor; presenting at any age, and at any site of the body and also one of the most common posterior mediastinal tumors. Posterior mediastinal schwannoma is usually identified incidentally in chest radiographs and with follow-up imaging such as CT scan. Large posterior mediastinal schwannoma usually presents with local symptoms. To confirm diagnosis and obtain local control, surgical excision is the usual approach. CASE DESCRIPTION: Here, we present a case of a 56-year-old female who presented with chronic low back pain. The lesion was picked up on an ultrasound scan to look at her kidneys. She was not experiencing any neurological symptoms. Excision of the tumor was made through a right thoracoabdominal approach. A WHO Grade 1 tumor was diagnosed on histology. There were no signs of recurrence in the follow-up scans. CONCLUSION: Giant posterior mediastinal schwanommas are very rare with only one other reported case requiring a thoracoabdominal approach for excision. Though giant schwanommas raise concern for malignancy due to their large size, they generally turn out to be benign.

How can we turn the PI3K/AKT/mTOR pathway down? Insights into inhibition and treatment of cancer.

Introduction: The phosphatidylinositol 3-kinase/protein kinase-B/mammalian target of rapamycin (PI3K/AKT/mTOR) pathway is a fundamental regulator of cell proliferation and survival. Dysregulation in this pathway leads to the development of cancer. Accumulating evidence indicates that dysregulation in this pathway is involved in cancer initiation, progression, and recurrence. However, the pathway consists of various signal transducing factors related with cellular events, such as transformation, tumorigenesis, cancer progression, and drug resistance. Therefore, it is very important to determine the targets in this pathway for cancer therapy. Although many drugs inhibiting this signaling pathway are in clinical trials or have been approved for treating solid tumors and hematologic malignancies, further understanding of the signaling mechanism is required to achieve better therapeutic efficacy.Areas covered: In this review, we have describe the PI3K/AKT/mTOR pathway in detail, along with its critical role in cancer stem cells, for identifying potential therapeutic targets. We also summarize the recent developments in different types of signaling inhibitors.Expert opinion: Downregulation of the PI3K/AKT/mTOR pathway is very important for treating all types of cancers. Thus, further studies are required to establish novel prognostic factors to support the current progress in cancer treatment with emphasis on this pathway.

A case of irreversible bradycardia after rituximab therapy for diffuse large B-cell lymphoma.

This is a case of a middle-aged woman with underlying cardiac conduction system with episodes of AV Wenckebach, who subsequently developed significant AV conduction system abnormalities after receiving one standard dose of Rituximab infusion for diffuse large B-cell lymphoma. Rituximab, being a monoclonal antibody against CD-20 antigen, is effective in treatment of B-cell lymphoma but may also cause bradyarrythmias likely due to the calcium ion channel property of CD-20 antigen.

Signaling Inhibitors Accelerate the Conversion of mouse iPS Cells into Cancer Stem Cells in the Tumor Microenvironment.

Cancer stem cells (CSCs) are a class of cancer cells characterized by self-renewal, differentiation and tumorigenic potential. We previously established a model of CSCs by culturing mouse induced pluripotent stem cells (miPSCs) for four weeks in the presence of a conditioned medium (CM) of cancer cell lines, which functioned as the tumor microenvironment. Based on this methodology of developing CSCs from miPSCs, we assessed the risk of 110 non-mutagenic chemical compounds, most of which are known as inhibitors of cytoplasmic signaling pathways, as potential carcinogens. We treated miPSCs with each compound for one week in the presence of a CM of Lewis lung carcinoma (LLC) cells. However, one-week period was too short for the CM to convert miPSCs into CSCs. Consequently, PDO325901 (MEK inhibitor), CHIR99021 (GSK-3ß inhibitor) and Dasatinib (Abl, Src and c-Kit inhibitor) were found to confer miPSCs with the CSC phenotype in one week. The tumor cells that survived exhibited stemness markers, spheroid formation and tumorigenesis in Balb/c nude mice. Hence, we concluded that the three signal inhibitors accelerated the conversion of miPSCs into CSCs. Similarly to our previous study, we found that the PI3K-Akt signaling pathway was upregulated in the CSCs. Herein, we focused on the expression of relative genes after the treatment with these three inhibitors. Our results demonstrated an increased expression of pik3ca, pik3cb, pik3r5 and pik3r1 genes indicating class IA PI3K as the responsible signaling pathway. Hence, AKT phosphorylation was found to be up-regulated in the obtained CSCs. Inhibition of Erk1/2, tyrosine kinase, and/or GSK-3ß was implied to be involved in the enhancement of the PI3K-AKT signaling pathway in the undifferentiated cells, resulting in the sustained stemness, and subsequent conversion of miPSCs into CSCs in the tumor microenvironment.

Substitution of the CD81 Binding Site and ß-Sandwich Area in E2 of HCV in Cambodia.

The high genetic variability of hepatitis C virus (HCV) is the main obstacle to developing a vaccine. E2 has attracted attention for vaccine development because targeting this protein could potentially overcome issues related to the genetic diversity of HCV. In this study, we analyzed HCV genes in the general population of Cambodia and investigated the E2 locus as a candidate for vaccine development. HCV sero-epidemiological surveys were conducted between the period 2010 and 2014, with an HCV RNA-positive rate of 1.3% (11/868). Follow-up blood samples were collected from four anti-HCV- and HCV RNA- positive patients (genotype 1b: 2 cases, 6e: 1 case, 6r: 1 case) after 4.12 years. Analysis of HCV full-length nucleotide sequences in paired specimens revealed that the mutation rates of HCV genotypes 1b and 6e/6r were 1.61-2.03 × 10-3 and 2.52-2.74 × 10-3 substitutions/site/year, respectively. Non-synonymous substitutions were detected in HVR1, the front layer of the CD81 binding site, and the ß-sandwich, but not in the N-terminal region or adjacent to the CD81 binding site. Therefore, we conclude that the CD81 binding site is a promising locus for HCV vaccine development.

Increasing trends in admissions due to non-communicable diseases over 2012 to 2017: findings from three large cities in Myanmar.

BACKGROUND: Globally, cardiovascular diseases, chronic respiratory diseases, cancers, and diabetes are the four major non-communicable diseases (NCDs) contributing to more than 80% of mortality and morbidity due to NCDs. In Myanmar, the proportional mortality rate due to NCDs increased from 46.9% in 2000 to 68% in 2017. However, the trends and patterns of four major NCDs or their hospital admissions are not known. In this regard, we aimed to assess the trends and profile of admissions with four major NCDs using final diagnosis coded in International Classification of Diseases-2010 version (ICD-10) from medical record data of the large tertiary hospitals in different regions of Myanmar. RESULTS: Of the 774,970 total admissions in the study hospitals, the median and interquartile range (IQR) age was 39 (25-55) years and 51.6% were males. Over a 6-year period, there was not only 2.2-fold increase in the number of admissions due to any of four major NCDs but also their proportion increased significantly from 18.8% in 2012 to 25.4% in 2017 (chi-square for trend, p value < 0.001). The number of admissions due to cancers, cardiovascular diseases, and chronic respiratory diseases also showed linear increasing trends at the rate of 1741 (95% CI 766 to 2715), 1797 (95% CI 345 to 3249), and 597 (95% CI 530 to 612) per year, respectively. Though the admissions with diabetes increased over the years, the rate of increase of 284 (95% CI - 60 to 628) per year was not statistically significant. Among cancer admissions, colorectal (13.1%), breast (13.0%), and lung (11.0%) cancers were the commonest. Stroke (30.6%) and ischemic heart disease (21.9%) admissions were the highest among the cardiovascular diseases. Chronic obstructive pulmonary disease (35.5%) and type 2 diabetes (53.9%) were commonest among chronic respiratory diseases and diabetes, respectively. CONCLUSION: There was a disproportionate increase in NCD admissions which requires tertiary health facilities to increase their infrastructure and trained workforce to cater to such admissions. The primary health care facilities have to be strengthened for prevention, early detection, and efficient management of NCDs to prevent life-threatening complications requiring hospitalization.

Bioactive Phytochemical Constituents of Wild Edible Mushrooms from Southeast Asia.

Mushrooms have a long history of uses for their medicinal and nutritional properties. They have been consumed by people for thousands of years. Edible mushrooms are collected in the wild or cultivated worldwide. Recently, mushroom extracts and their secondary metabolites have acquired considerable attention due to their biological effects, which include antioxidant, antimicrobial, anti-cancer, anti-inflammatory, anti-obesity, and immunomodulatory activities. Thus, in addition to phytochemists, nutritionists and consumers are now deeply interested in the phytochemical constituents of mushrooms, which provide beneficial effects to humans in terms of health promotion and reduction of disease-related risks. In recent years, scientific reports on the nutritional, phytochemical and pharmacological properties of mushroom have been overwhelming. However, the bioactive compounds and biological properties of wild edible mushrooms growing in Southeast Asian countries have been rarely described. In this review, the bioactive compounds isolated from 25 selected wild edible mushrooms growing in Southeast Asia have been reviewed, together with their biological activities. Phytoconstituents with antioxidant and antimicrobial activities have been highlighted. Several evidences indicate that mushrooms are good sources for natural antioxidants and antimicrobial agents.

Experiences from the pilot implementation of the Package of Essential Non-communicable Disease Interventions (PEN) in Myanmar, 2017-18: A mixed methods study.

BACKGROUND AND OBJECTIVES: Myanmar adopted the World Health Organization (WHO) Package for Essential Non-Communicable Disease Interventions (PEN) in 20 pilot townships in 2017. This study was conducted to assess the implementation of PEN, its effectiveness and understand the facilitators and barriers in its implementation. METHODS: Mixed methods design involving a quantitative component (retrospective study analysing both aggregate and individual patient data from PEN project records; cross-sectional facility survey using a structured checklist) and a descriptive qualitative component. RESULTS: A total of 152,446 individuals were screened between May 2017-December 2018 comprising of current smokers (17.5%), tobacco chewers (26.3%), Body Mass Index ≥25 kg/m2 (30.6%), raised blood pressure i.e. ≥ 140/90 mmHg (35.2%) and raised blood sugar i.e. Random Blood Sugar >200 mg/dl, Fasting Blood Sugar >126 mg/dl (17.1%). Nearly 14.8% of those screened had Cardiovascular Disease (CVD) risk score ≥20%, 34.6% had CVD risk not recorded. Of 663 patients registered with diabetes and/or hypertension in 05 townships, 27 (4.1%) patients made three follow-up visits after the baseline visit, of whom, CVD risk assessment, systolic blood pressure and blood sugar measurement was done in all visits in 89.0%, 100.0% and 78.0% of cases respectively. Health facility assessment showed 64% of the sanctioned posts were filled; 90% of those appointed been trained in PEN; key essential medicines for PEN were available in half of the facilities surveyed. Confidence of the health care staff in managing common NCD and perceived benefits of the project were some of the strengths. CONCLUSION: High loss to follow up, poor recording of CVD risk score, lack of essential medicines and equipments were the key challenges identified that need to be addressed before further expansion of PEN project to other townships.

Association study of long non-coding RNA HOTAIR rs920778 polymorphism with the risk of cancer in an elderly Japanese population.

The HOTAIR gene encodes a long noncoding RNA (lncRNA), which functions in development and tumorigenesis. A single nucleotide polymorphism (SNP) rs920778 in the HOTAIR gene, has been recurrently studied for susceptibility to many cancers including oesophageal cancer, gastric cancer, lung cancer, and hepatocellular carcinoma. Most of these studies were conducted in Chinese populations, and a few in Turkish, Iranian, and Portuguese populations. They mostly give rise to controversial results. It still remains largely unknown whether the cancer risk is conferred in a Japanese population. Here, we established an association study on the representative SNP rs920778, to examine its contribution to the presence of cancer in consecutive autopsy cases in the JG-SNP database. A total of 1373 subjects (mean age 80) including 827 cancer positive and 546 cancer negative subjects were analyzed. As a result, the occurrence of overall cancer was not associated with the rs920778 polymorphism (p > 0.05). For each cancer type, we did not find association except for lung cancer (p = 0.04) which was more likely a by-chance association after multiple testing. Our findings imply that rs920778 polymorphism does not affect total cancer presence and the effect on specific cancer types is also weak in the Japanese population.