Accumulation characteristics of metals in human breast milk and association with dietary intake in northeastern China.

The trace elements present in breast milk play a vital role in the growth and development of infants. Nevertheless, numerous studies have reported the presence of toxic metal contamination in breast milk from various countries and regions, which poses potential risks to breastfed infants. This article aimed to investigate the characteristics of trace elements in breast milk and explore the relationship between breast milk and diet in Dalian, a coastal city in northeastern China. Breast milk samples and representative local food samples were collected from Dalian for research. The results revealed that 57 % of breast milk samples significantly exceeded the WHO safety limit (0.6 µg/L) for arsenic, with a measured mean value of 0.96 µg/L. Moreover, the levels of chromium (mean value: 2.63 µg/L) in 34 % of breast milk samples exceed the WHO recommended safety level (chromium: 1.5 µg/L). Aquatic foods accounted for 60 % to 90 % of the total intake of arsenic, cadmium, vanadium, mercury, and lead. The Spearman correlation analysis demonstrated strong positive correlations among breast milk metal elements, including copper-zinc (r = 0.68) and nickel­chromium (r = 0.89). Furthermore, the food-to-milk accumulation factors (FMAF) of strontium, nickel, arsenic, vanadium, cadmium, and mercury were relatively low (median values <0.005). While the FMAF values for chromium and lead were higher, with median values of 0.038 and 0.07, respectively. The results indicated potential risks of the toxic metal arsenic in breast milk from Dalian, China for breastfed infants. Therefore, continuous monitoring of breast milk for toxic metals and foodborne contamination is necessary.

Recent developments and challenges in uranium extraction from seawater through amidoxime-functionalized adsorbents.

As per statistical estimations, we have only around 100 years of uranium life in terrestrial ores. In contrast, seawater has viable uranium resources that can secure the future of energy. However, to achieve this, environmental challenges need to be overcome, such as low uranium concentration (3.3 ppb), fouling of adsorbents, uranium speciation, oceanic temperature, and competition between elements for the active site of adsorbent (such as vanadium which has a significant influence on uranium adsorption). Furthermore, the deployability of adsorbent under seawater conditions is a gigantic challenge; hence, leaching-resistant stable adsorbents with good reusability and high elution rates are extremely needed. Powdered (nanostructured) adsorbents available today have limitations in fulfilling these requirements. An increase in the grafting density of functional ligands keeping in view economic sustainability is also a major obstacle but a necessity for high uranium uptake. To cope with these challenges, researchers reported hundreds of adsorbents of different kinds, but amidoxime-based polymeric adsorbents have shown some remarkable advantages and are considered the benchmark in uranium extraction history; they have a high affinity for uranium because of electron donors in their structure, and their amphoteric nature is responsible for effective uranium chelation under a wide range of pH. In this review, we have mainly focused on recent developments in uranium extraction from seawater through amidoxime-based adsorbents, their comparative analysis, and problematic factors that are needed to be considered for future research.

Variability of PM10 level with gaseous pollutants and meteorological parameters during episodic haze event in Malaysia: Domestic or solely transboundary factor?

Haze has become a seasonal phenomenon affecting Southeast Asia, including Malaysia, and has occurred almost every year within the last few decades. Air pollutants, specifically particulate matter, have drawn a lot of attention due to their adverse impact on human health. In this study, the spatial and temporal variability of the PM10 concentration at Kelang, Melaka, Pasir Gudang, and Petaling Jaya during historic haze events were analysed. An hourly dataset consisting of PM10, gaseous pollutants and weather parameters were obtained from Department of Environment Malaysia. The mean PM10 concentrations exceeded the stipulated Recommended Malaysia Ambient Air Quality Guideline for the yearly average of 150 µg/m3 except for Pasir Gudang in 1997 and 2005, and Petaling Jaya in 2013. The PM10 concentrations exhibit greater variability in the southwest monsoon and inter-monsoon periods at the studied year. The air masses are found to be originating from the region of Sumatra during the haze episodes. Strong to moderate correlation of PM10 concentrations was found between CO during the years that recorded episodic haze, meanwhile, the relationship of PM10 level with SO2 was found to be significant in 2013 with significant negatively correlated relative humidity. Weak correlation of PM10-NOx was measured in all study areas probably due to less contribution of domestic anthropogenic sources towards haze events in Malaysia.

Role of doppler ultrasound in detecting vascular complications in recipients of living donor liver transplant (LDLT).

OBJECTIVE: To determine the role of Doppler ultrasound in the detection of vascular complications in recipients of living donor liver transplant, keeping contrast-enhanced computerised tomography of abdomen as the gold standard. METHODS: The retrospective study was conducted from February 16 to April 1, 2022, at the Pakistan Kidney and Liver Institute and Research Centre, Lahore, Pakistan, and comprised data of living donor liver transplant recipients who had undergone contrast-enhanced computerised tomography of abdomen within 24 hours of Doppler ultrasound between January 2021 and January 2022. For the diagnosis of hepatic vascular complications, the diagnostic values of Doppler ultrasound parameters were derived by correlating Doppler ultrasound findings with contrast-enhanced computerised tomography results. Data was analysed using SPSS 20. RESULTS: Of the 35 patients, 24(68.6%) were men and 11(31.4%) were women. The overall mean age was 45.86±13.8 years. For hepatic artery thrombosis, the use of Doppler ultrasound criteria yielded a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 96.6%, 83.3%, 100%, and 97.1% respectively. For hepatic artery stenosis, overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Doppler ultrasound was 100%, 96.8%, 75%, 100% and 97.1% respectively. Doppler ultrasound parameters resulted in a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 100% each in detecting portal vein and hepatic venous outflow tract thrombosis. Overall, Doppler ultrasound sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy was found to be 100%, 88.8%, 89.4%, 100% and 94.2% respectively. CONCLUSIONS: Doppler ultrasound was adequate to document vascular complications after living donor liver transplant in majority of the cases with high accuracy and sensitivity.

Nasogastric vs Orogastric Feeding in Stable Preterm (≤32 Weeks) Neonates: A Randomized Open-Label Controlled Trial.

BACKGROUND: Optimal route of tube feeding in preterm babies is not known. OBJECTIVES: To compare the frequency of bradycardia and desatu-ration episodes/hours in hemodynamically stable preterm neo-nates (≤32 wk gestational age) fed by nasogastric vs orogastric route. DESIGN: Randomized controlled trial. PARTICIPANTS: Hemodynamically stable preterm neonates (≤32 wk gestational age) requiring tube feeding. INTERVENTION: Nasogastric vs orogastric tube feeding. PRIMARY OUTCOME: Number of episodes of bradycardia and desaturations/hour. METHODS: Eligible preterm neonates fulfilling the inclusion criteria were enrolled. Each episode of insertion of a nasogastric tube or orogastric tube was labelled as a feeding tube insertion episode (FTIE). FTIE lasted from the time of insertion of tube till the time tube needed to be changed. Reinsertion of the tube in same baby was taken as a fresh FTIE. 160 FTIEs were evaluated during the study period, 80 FTIEs each in babies with gestational age <30 weeks and ≥30 weeks. Number of episodes of bradycardia and desaturation per hour were computed using records in the monitor till the time tube was in situ. RESULTS: The mean episodes of bradycardia and desaturations/hour [mean difference (95% CI) 0.144 (0.067-0.220); P<0.001] were higher in FTIE by nasogastric as compared to the oro-gastric route. CONCLUSION: Orogastric route may be preferable to the nasogastric route in hemodynamically stable preterm neonates.

Accumulation and distribution characteristics of rare earth elements (REEs) in the naturally grown marigold (Tagetes erecta L.) from the soil.

Rare earth elements (REEs) are considered environmental pollutants that have received extensive attention recently. The accumulation of REEs in plants is important because REEs can eventually enter the human body via the food chain. Marigolds are widely utilized as medicinal and commercial plants in medicine, feed, and therapeutics. Due to the extremely high demand for marigold in global, it is urgent to investigate the accumulation and distribution of REEs in marigold plants to reduce human and animal health risks. Marigold leaves tended to bioaccumulate the highest amounts of REEs from soil compared with other tissues. The distribution patterns of REEs in marigold were similar to those in the rhizosphere soil, which was enriched in light rare earth elements. Cerium accumulated most in marigold and soil, accounting for nearly 50% of ΣREEs, followed by lanthanum, neodymium, and yttrium. Roots were the most susceptible tissue affected by soil REE concentration, and a significant positive correlation was observed for REEs in the roots of marigold and soils (R = 0.87), while no significant correlation was observed for REEs in soils and other tissues. REEs were poorly transferred from soil to marigold, with bioaccumulation factor values for all tissues of marigold less than one. Additionally, REEs exhibited a positive correlation with Al and Fe in the roots, stems, leaves, and flowers of marigold. The present research revealed the biological interactions between marigold and soil and the distribution of REEs in various parts of marigold. It provides a reference for large-scale commercial cultivation and potential environmental risk in the future.

Measuring sustainable consumer food purchasing and behavior.

Consumer food purchasing and willingness to adopt a sustainable healthy diet (SHD) is a key factor affecting the sustainability of the entire food system. Studies have developed scales to measure consumer preferences for particular consumption patterns, while others have sought to empirically define the multiple dimensions of a sustainable food system (environmental, social, economic, etc.). This paper builds on these literatures by tracking consumers' SHD behaviors using a large-scale, longitudinal survey of adults in the United States and mapping them onto multiple systems-level indicators. We wanted to know whether consumers interact with the sustainability of their food along the same principles developed by experts. Our study defines 18 food purchasing behaviors that support the sustainability goals of leading scientific institutions, uses factor analysis to identify the unobserved drivers behind these behaviors, and creates SHD scores to investigate their correlations with other consumer characteristics and behaviors. Factor analysis results show consumer food purchasing is motivated by three underlying sustainability dimensions-Economic Security, Socio-Environment, and Nutrition-which are fewer constructs than often defined by academic researchers. SHD scores reveal higher adoption of behaviors that fall under Economic Security relative to the other two dimensions. All three sustainability constructs are impacted by socio-economic and demographic characteristics.

2D-2D heterostructure g-C3N4-based materials for photocatalytic H2 evolution: Progress and perspectives.

Photocatalytic hydrogen generation from direct water splitting is recognized as a progressive and renewable energy producer. The secret to understanding this phenomenon is discovering an efficient photocatalyst that preferably uses sunlight energy. Two-dimensional (2D) graphitic carbon nitride (g-C3N4)-based materials are promising for photocatalytic water splitting due to special characteristics such as appropriate band gap, visible light active, ultra-high specific surface area, and abundantly exposed active sites. However, the inadequate photocatalytic activity of pure 2D layered g-C3N4-based materials is a massive challenge due to the quick recombination between photogenerated holes and electrons. Creating 2D heterogeneous photocatalysts is a cost-effective strategy for clean and renewable hydrogen production on a larger scale. The 2D g-C3N4-based heterostructure with the combined merits of each 2D component, which facilitate the rapid charge separation through the heterojunction effect on photocatalyst, has been evidenced to be very effective in enhancing the photocatalytic performance. To further improve the photocatalytic efficiency, the development of novel 2D g-C3N4-based heterostructure photocatalysts is critical. This mini-review covers the fundamental concepts, recent advancements, and applications in photocatalytic hydrogen production. Furthermore, the challenges and perspectives on 2D g-C3N4-based heterostructure photocatalysts demonstrate the future direction toward sustainability.

The Malaysian HEalth and WellBeing AssessmenT (MyHEBAT) Study Protocol: An Initiation of a National Registry for Extended Cardiovascular Risk Evaluation in the Community.

Cardiovascular disease (CVD) has been a burden to many developing countries for decades, including Malaysia. Although various steps have been taken to prevent and manage CVD, it remains the leading cause of morbidity and mortality. The rising prevalence of CVD risk factors such as hypertension, hypercholesterolaemia, diabetes, overweight and obesity is the main driving force behind the CVD epidemic. Therefore, a nationwide health study coined as the Malaysian Health and Wellbeing Assessment (MyHEBAT) was designed. It aimed to investigate the prevalence of CVD and the associated risk factors in the community across Malaysia. The MyHEBAT study recruited participants (18-75 years old) through community health screening programmes from 11 states in Malaysia. The MyHEBAT study was further divided into two sub-studies, namely, the Cardiovascular Risk Epidemiological Study (MyHEBAT-CRES) and the MyHEBAT Familial Hypercholesterolaemia Study (MyHEBAT-FH). These studies assessed the prevalence of CVD risk factors and the prevalence of FH in the community, respectively. The data garnered from the MyHEBAT study will provide information for healthcare providers to devise better prevention and clinical practice guidelines for managing CVD in Malaysia.

Electrospun tannin-rich nanofibrous solid-state membrane for wastewater environmental monitoring and remediation.

Heavy metal, organic dyes, and bacterial contamination in water endanger human/animals' health, and therefore, the detection, adsorption, and capturing of contaminants are essential for environmental safety. Ligand-rich membranes are promising for sensors, adsorption, and bacterial decontamination. Herein, tannin (TA)-reinforced 3-aminopropyltriethoxysilane (APTES) crosslinked polycaprolactone (PCL) based nanofibrous membrane (PCL-TA-APTES) was fabricated via electrospinning. PCL-TA-APTES nanofibers possess superior thermal, mechanical, structural, chemical, and aqueous stability properties than the un-crosslinked membrane. It changed its color from yellowish to black in response to Fe2+/3+ ions due to supramolecular iron-tannin network (FeTA) interaction. Such selective sensing has been noticed after adsorption-desorption cycles. Fe3+ concentration, solution pH, contact time, and ligand concentration influence FeTA coordination. Under optimized conditions followed by image processing, the introduced membrane showed a colorimetric linear relationship against Fe3+ ions (16.58 µM-650 µM) with a limit of detection of 5.47 µM. The PCL-FeTA-APTES membrane could restrain phenolic group oxidation and result in a partial water-insoluble network. The adsorption filtration results showed that the PCL-FeTA-APTES membrane can be reused and had a higher methylene blue adsorption (32.04 mg/g) than the PCL-TA-APTES membrane (14.96 mg/g). The high capture efficiency of nanocomposite against Fe3+-based S. aureus suspension than Fe3+-free suspension demonstrated that Fe3+-bounded bacterium adhered to the nanocomposite through Fe3+/TA-dependent biointerface interactions. Overall, high surface area, rich phenolic ligand, porous microstructure, and super-wetting properties expedite FeTA coordination in the nanocomposite, crucial for Fe2+/3+ ions sensing, methylene blue adsorption-filtration, and capturing of Fe3+-bounded bacterium. These multifunctional properties could promise nanocomposite membrane practicability in wastewater and environmental protection.

Economic Impact Payments and Household Food Insufficiency during COVID-19: The Case of Late Recipients.

During the COVID-19 pandemic, the U.S. government distributed Economic Impact Payments (EIPs) to ease the economic hardships of American households. Using the Household Pulse Survey, we study the association of first-round EIPs with household-level food insufficiency in a sample of late recipients of EIPs. Studying the late recipients is important for two reasons, first, about 12 million eligible individuals did not automatically receive EIPs, and second, the late receipt of EIPs and the low-income status of late recipients allow us to tease out the relationship between EIPs and food insufficiency. We find that EIPs were associated with a 9.2 percentage points decrease in the likelihood of food insufficiency. However, households kept relying on free food acquisition to fight food hardship. Our results suggest that government efforts to provide more timely stimulus payments could be very impactful and significantly impact household food insufficiency.

A Membrane-Supported Bifunctional Poly(amidoxime-ethyleneimine) Network for Enhanced Uranium Extraction from Seawater and Wastewater.

Uranium extraction from natural seawater and wastewater are quintessential requirements to supply uninterrupted carbon-free nuclear energy and to prevent potential radiochemical and toxicological effects, respectively. Owing to the complexity and low-concentration uranium of these water samples, the design and synthesis of sorbent materials for uranium extraction with meaningful efficiencies remains a grand challenge. Herein, we reported a novel three-dimensional bifunctional network of hyperbranched poly(amidoxime-ethyleneimine) (PAO-h-PEI) using PEI as the skeleton material via cyanoethylation, crosslinking and then amidoximation. As a result of the synergistic supramolecular strategy, the PAO-h-PEI membrane achieved a remarkable adsorption capacity of 985.7 mg/g for aqueous uranium solution, which was 2.5 folds that of the monofunctional h-PEI membrane (387.6 mg/g). The PAO-h-PEI membrane also exhibited good selectivity towards uranium in the presence of various metal ions, high-content salt, and natural organic matter as well as common anions. According to the XPS and FTIR results, the utilization of amines as the second ligand enhanced uranyl binding by providing additional coordination sites or by interacting with oxime to force N-OH dissociation. The good reusability (adsorption rate of 93% after six adsorption-desorption cycles) and satisfactory adsorption performance in extracting low-concentration uranium in real seawater demonstrate its practicability.

Thiolated Polyethyleneimine-Based Polymer Sponge for Selective Removal of Hg2+ from Aqueous Solution.

Polymer sponges with molecular recognition provide a facile approach to water purification and industrial separation with easy operation. Herein, a thiolated polyethyleneimine (PEI)-based polymer sponge was prepared through cryo-polymerization of PEI, followed by grafting of PEI and then post-modification of the amine functionalities present within the hyperbranched structure with methyl mercaptoacetate, which afford high density of thiol functional groups on the surface of the sponge. The developed sponge was characterized by scanning electron microscopy and element analysis, and the adsorption kinetic and isotherm studies were conducted in detail. The sponge presents a remarkable maximum adsorption capacity of 2899.7 mg/g, which can be attributed to its high density of thiol functionalities. The sponge also shows excellent selectivity toward Hg2+ against other metal ions and natural organic matter, indicating its great potential in removing mercury from real water bodies. In addition, the sponge can be chemically regenerated and exhibits good reusability, which decreases the economic and environmental impacts. Hence, the high removal efficiency, high selectivity toward mercury, and good reusability of the sponge material highlight it as a promising sorbent for mercury removal in water pollution treatment.

Underwater suspended bifunctionalized polyethyleneimine-based sponge for selective removal of anionic pollutants from aqueous solution.

Highly selective and efficient removal of ionic pollutants, including ionic organic compounds and heavy metal ions from water, is still a huge challenge due to the complex nature of polluted water. To meet this challenge, we presented the synthesis of bifunctionalized polyethyleneimine-based sponges through cryo-polymerization via BDDE as the crosslinker followed by bifunctional modification with glycidyl trimethylammonium chloride (GTAC) and phenyl glycidyl ether (PGE), which simultaneously afford quaternary ammonium cation (strongly basic and hydrophilic) and phenyl (hydrophobic) functionalities, respectively. As a result, a hybrid hydrophilic-hydrophobic sponge is generated that could stably be suspended underwater due to the co-operative effect of the water-absorbing hydrophilic domain and the hydrophobic domain generating buoyancy. The quaternized and phenyl-functionalized PEI-based sponge (SQP-PEI) demonstrated highly selective and efficient removal of anionic pollutants from water, including diclofenac sodium (DIC), methyl orange (MO) and chromium (Cr(VI)) with co-existing interferences. The Langmuir isotherms revealed the maximum adsorption capacities of 342.7 mg/g, 491.9 mg/g, and 242.7 mg/g for DIC, MO, and Cr(VI), respectively. The studies of adsorption mechanism suggested that the bifunctional SQP-PEI sponge indeed afford both strong anion-exchange interaction and π-π interaction toward organic pollutants DIC and MO, and the strong anion-exchange interaction can be the dominated adsorption mechanism for anionic DIC, MO and Cr(VI) species. The suspended SQP-PEI also demonstrated excellent reusability, which shows the potential of SQP-PEI for real applications.

Governing heatwaves in Europe: comparing health policy and practices to better understand roles, responsibilities and collaboration.

BACKGROUND: The expectation that climate change will further exacerbate extreme weather events such as heatwaves is of primary concern to policymakers and scientists. Effective governance is fundamental to preparedness for and response to such threats. This paper explores the governance structures of European heat health action plans and provides insights into key stakeholders, roles, responsibilities and collaboration. METHODS: This was a two-phase qualitative study, in which we complemented a desk review of 15 European national heat health action plans (NHHAPs) with, after obtaining informed consent, 68 interviews in nine countries with key informants involved in the development, implementation and/or evaluation of these NHHAPs. A thematic analysis was used to analyze the NHHAPs inductively. This analysis focused on three themes: identifying key stakeholders, defining and assigning roles and collaboration among stakeholders. The iteratively created codebook was then applied to the analysis of the key informant interviews. All analyses were done using NVivo 10 qualitative analysis software. RESULTS: The majority of the NHHAPs have governance as one of their main objectives, to support the coordination of actions and collaboration among involved stakeholders. There are, however, significant differences between plan and practice. On the basis of the available data, we have little insight into the process of stakeholder identification, but we do find that most countries involve the same types of stakeholders. Roles are mainly defined and assigned in relation to the alert levels of the warning system, causing other role aspects and other roles to be vague and ambiguous. Collaboration is key to many NHHAP elements and is mainly experienced positively, though improvements and new collaborations are considered. CONCLUSIONS: Our findings show a need for a more deliberate and structured approach to governance in the context of NHHAPs. A cross-sectoral approach to the identification of key stakeholders can facilitate a broader preparedness and response to heatwaves. Roles and responsibilities of stakeholders should be defined and assigned more clearly to avoid confusion and to improve effective implementation. To this extent, we identify and describe seven key roles and potential stakeholders to which these roles are usually assigned. Finally, also collaboration among stakeholders can benefit from a cross-sectoral approach, but also formal structures can be beneficial.

The improvement on the skin surface by a new type of dermocosmetic loaded plant extract: A split face skin topographic study.

Various extrinsic and intrinsic origins slant skins and pledge evident vicissitudes of the skin surface. We explored the effects of dermocosmetic loaded medical Cannabis seed extract and evaluate the improvement on the skin surface in Asian and male volunteers in a split face topographic study. Dermocosmetic and base (without extract) fabricated were directed to apply by volunteers (Asian male) on their right and left cheek, respectively, in the split face skin topographic study up to three months. Efficacy of dermocosmetic versus base was assessed by non- invasive diagnostic technique focusing on skin texture parameters (energy, contrast and variance) and surface evaluation of the living skin (SELS), SEr (skin roughness), SEsc (skin scaliness), SEsm (skin smoothness), SEw (skin wrinkles). Unlike base, dermocosmetic showed significant effects on skin texture parameters (energy, variance and contrast) and SELS (SEr, SEsc, SEsm and SEw) parameters in Asian male volunteers when ANOVA applied. The level of significance was 5%. Dermocosmetic ultimately improved on skin surface and advocacies for anti-aging effects on skin appearance.

Strategies for prevention of gastrointestinal cancers in developing countries: a systematic review.

BACKGROUND: Gastrointestinal cancers account for one third of total cancer incidence and mortality in developing countries. To date, there is no systematic synthesis of evidence regarding strategies to prevent gastrointestinal cancers in developing countries. We aimed to provide a systematic overview of studies evaluating strategies for prevention or early detection of the three most common gastrointestinal cancers (gastric, liver and colorectal cancer) in developing countries. METHODS: We searched MEDLINE, Web of Science and WHO Global Index Medicus databases for relevant articles published until October 2016 using combinations of the search terms "gastrointestinal", "digestive system", "gastric", "liver", "colorectal", "cancer", "prevention", "early detection" and "developing country" (including names). RESULTS: Overall, 73 articles met the inclusion criteria, providing information on short- and long-term outcomes (up to 30 years) from various intervention studies (∼45% randomized). Trials on hepatitis B vaccination consistently showed vaccine efficacy over time and indicated long-term preventive effects on liver cancer incidence that start to become measurable at the population level. Studies on anti-H. pylori treatment suggested a reduction in gastric cancer incidence reaching statistical significance after long-term follow-up, while evidence regarding a preventive effect in persons with precancerous lesions is still inconclusive. The studies regarding colorectal cancer focused on early detection, ∼90% of which were restricted to intermediate endpoints. CONCLUSION: In conclusion, there were a number of studies on gastric and liver cancer prevention in developing countries showing promising results after long-term follow-up. Important next steps include pooled meta-analyses as far as possible given the heterogeneity between studies as well as implementation research.

Determination of antimicrobial susceptibility patterns in Staphylococcus aureus strains recovered from patients at two main health facilities in Kabul, Afghanistan.

BACKGROUND: Staphylococcus aureus (S. aureus) is a major pathogen implicated in skin and soft tissue infections, abscess in deep organs, toxin mediated diseases, respiratory tract infections, urinary tract infections, post-surgical wound infections, meningitis and many other diseases. Irresponsible and over use of antibiotics has led to an increased presence of multidrug resistant organisms and especially methicillin resistant Staphylococcus aureus (MRSA) as a major public health concern in Afghanistan. As a result, there are many infections with many of them undiagnosed or improperly diagnosed. We aimed to establish a baseline of knowledge regarding the prevalence of MRSA in Kabul, Afghanistan, as well as S. aureus antimicrobial susceptibility to current available antimicrobials, while also determining those most effective to treat S. aureus infections. METHODS: Samples were collected from patients at two main Health facilities in Kabul between September 2016 and February 2017. Antibiotic susceptibility profiles were determined by the disc diffusion method and studied using standard CLSI protocols. RESULTS: Out of 105 strains of S. aureus isolated from pus, urine, tracheal secretions, and blood, almost half (46; 43.8%) were methicillin-sensitive Staphylococcus aureus (MSSA) while 59 (56.2%) were Methicillin-resistant Staphylococcus aureus (MRSA). All strains were susceptible to vancomycin. In total, 100 (95.2%) strains were susceptible to rifampicin, 96 (91.4%) susceptible to clindamycin, 94 (89.5%) susceptible to imipenem, 83 (79.0%) susceptible to gentamicin, 81(77.1%) susceptible to doxycycline, 77 (77.1%) susceptible to amoxicillin + clavulanic acid, 78 (74.3%) susceptible to cefazolin, 71 (67.6%) susceptible to tobramycin, 68 (64.8%) susceptible to chloramphenicol, 60 (57.1%) were susceptible to trimethoprim-sulfamethoxazole, 47 (44.8%) susceptible to ciprofloxacin, 38 (36.2%) susceptible to azithromycin and erythromycin, 37 (35.2%) susceptible to ceftriaxone and 11 (10.5%) were susceptible to cefixim. Almost all (104; 99.05%) were resistant to penicillin G and only 1 (0.95%) was intermediate to penicillin G. Interestingly, 74.6% of MRSA strains were azithromycin resistant with 8.5% of them clindamycin resistant. Ninety-six (91.4%) of the isolates were multi-drug resistant. CONCLUSIONS: There was a high rate of Methicillin resistance (56.2%) among S. aureus strains in the samples collected and most (91.4%) were multidrug resistant. The most effective antibiotics to treat Staph infections were vancomycin, rifampicin, imipenem, clindamycin, amoxicillin-clavulanic acid, cefazolin, gentamicin and doxycycline. The least effective were azithromycin, ceftriaxone, cefixim and penicillin. We recommend that, where possible, in every case of S. aureus infection in Kabul, Afghanistan, Antibiotic susceptibility testing (AST) should be performed and responsible use of antibiotics should be considered.

Validity of self-reported family history of cancer: A systematic literature review on selected cancers.

Evidence regarding validity of self-reported family history of cancer (FHC) has been reviewed only for breast, colorectal, prostate, ovarian, endometrial and uterine cancer. We aimed to systematically review studies assessing validity of self-reported family history for the remaining cancer sites. We searched the Medline database for relevant studies published by January 2016. We extracted information on the study design and the positive predictive value (PPV) of self-reported FHC, defined as the proportion of reported cancer diagnoses among relatives that was confirmed by a reference standard (as a measure of over-reporting). We also extracted information on sensitivity of self-reported FHC (as a measure of underreporting). Overall, 21 studies were included that provided information on the PPV of self-reported FHC for relevant cancers and four studies also provided information on sensitivity. The PPV was highest (mostly >70%) for pancreatic, lung, thyroid and urinary system cancers and for leukemia and lymphoma, while it was lowest for stomach and liver cancer. Sensitivity was highest (>70%) for pancreatic cancer, lung cancer, brain cancer, melanoma, leukemia and lymphoma. For several cancers, sample sizes were low and the number of studies limited, particularly regarding sensitivity of self-reported FHC. In conclusion, for some cancers (e.g., pancreatic cancer, lung cancer, leukemia, lymphoma) self-reported FHC can be considered sufficiently valid to be useful, for example, in preventive counseling. For several cancers, it is not sufficiently studied or the pattern is inconsistent. This needs to be taken into account when using self-reported information about FHC in clinical practice or epidemiological research.

Iron supplementation decreases plasma zinc but has no effect on plasma fatty acids in non-anemic women.

Limited information is available on the role of iron in fatty acid metabolism in humans. We hypothesized that iron supplementation will increase desaturase activity, and so, the aim of this study was to determine the effect of iron supplementation on fatty acid desaturase activity in young women. Participants were randomly assigned to a control group (CG) or supplementation group (SG) who were provided with 37.4 mg of elemental iron daily for 12 weeks. Forty women completed the trial, n = 19 in CG and n = 21 in SG. The mean ages were 25.2 and 24.6 years, and body mass indices were 21.8 and 21.2 (kg/m(2)) in CG and SG, respectively. Serum ferritin concentrations increased significantly (P < .01) in subjects assigned to SG but were unchanged in CG. Serum iron concentrations were not significantly changed. Plasma zinc concentrations at the end of the intervention were similar to baseline values for individuals in CG but were decreased significantly (P = .004) in SG. Plasma fatty acids, phospholipid fatty acids, and desaturase activities, expressed as precursor-to-product ratios, were not significantly affected by the intervention, although in SG the concentration of serum ferritin was correlated positively (P < .05) with Δ6-desaturase activity. Supplementing non-anemic women with low dose iron improves iron status but has no significant effect on desaturase activity. The lack of a clear effect on an indirect indicator of desaturase activity may be related to the antagonism between iron and zinc, as illustrated by the decrease in plasma zinc concentrations in women who were supplemented with iron.