High serum copper level is associated with an increased risk of preeclampsia in Asians: A meta-analysis

Epidemiological studies evaluating the associations between serum copper and ratios of Cu/Zn and the preeclampsia (PE) risk in Asian population have produced inconsistent results. Therefore, we conducted a meta-analysis to summarize the relationships. We hypothesize that higher serum copper and ratios of Cu/Zn may increase the PE risk. A systematic literature search was performed in PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure (CNKI), VIP (Database of Chinese Scientific and Technical Periodicals) and Wangfang databases for relevant studies up to November 2016. Pooled standardized mean difference (SMD) was calculated with random effects model. The results showed that PE patients had a higher serum copper level [SMD (95% CI): 1.05 (0.34, 1.77), Z = 2.88, P for Z = 0.004; I² = 96.9%, P for I²< 0.0001] compared with healthy pregnancy controls. In subgroup analyses, a higher serum copper level in PE patients was observed in case–control studies [SMD (95% CI): 1.39 (0.44, 2.34)]. No significant difference was found between PE patients and healthy pregnancy controls for ratios of Cu/Zn [(SMD (95% CI): 0.26 (−0.77, 1.29), Z = 0.49, P for Z = 0.625; I² = 95.8%, P for I²< 0.0001)]. In conclusion, our meta-analysis indicates that a higher serum copper level is associated with an increased risk of PE. Further studies are needed to confirm these results in future research.     

Efficacy of 23-valent pneumococcal polysaccharide vaccine in preventing community-acquired pneumonia among immunocompetent adults: A systematic review and meta-analysis of randomized trials

BackgroundData on the efficacy of the 23-valent pneumococcal polysaccharide vaccine (PPV-23) in preventing adult community-acquired pneumonia (CAP) among the target population of individuals aged over 65 years and high-risk individuals aged 19–64 years are conflicting. As the Advisory Committee on Immunization Practices (ACIP) has recently demonstrated PPV-23 is likely beneficial to immunocompromised adults by the Grading, Assessment, Development, and Evaluation (GRADE) framework, we conducted meta-analysis to examine its efficacy in an immunocompetent population.MethodsWe searched the PUBMED, EMBASE, and Cochrane Library databases for randomized trials. Overall relative risks (RRs) with 95% confidential intervals (CIs) were calculated, and the Cochrane Q test (p, I²) was performed. Outcomes were assessed by the GRADE framework.ResultsSeven randomized trials involving 156,010 participants were included in this meta-analysis. High-quality evidence revealed that PPV-23 was weakly associated with the prevention of all-cause pneumonia ([RR] 0.87, [95%CI] 0.76–0.98, p = 0.11, I² = 43%), especially among the target population ([RR] 0.72, [95%CI] 0.69–0.94, p = 0.58 I² = 0%), the elderly group aged over 40 years ([RR] 0.80, [95%CI] 0.69–0.94) and the Japanese population ([RR] 0.72, [95%CI] 0.59–0.88, p = 0.24, I² = 30%). The target population included adults aged over 65 years and patients at high risk of pneumonia due to chronic lung disease, chronic obstructive pulmonary disease or living in a nursing home. Protective trends of PPV-23 in the outcomes of pneumococcal pneumonia ([RR] 0.54, [95%CI] 0.18–1.65, p = 0.01, I² = 77%) and mortality due to pneumonia ([RR] 0.67, [95%CI] 0.43–1.04, p = 0.67, I² = 0%) were observed, although the results were statistically insignificant, possibly due to the small number of trials included. PPV-23 did not prevent all-cause mortality ([RR] 1.04, [95%CI] 0.87–1.24, p = 0.95, I² = 0%).ConclusionsPPV-23 provided weak protection against all-cause pneumonia in an immunocompetent population, especially among the target population. The additional benefit of PPV-23 in preventing CAP further supports its application in the target population.     

Association between obesity and helicobacter pylori infection

ObjectivesThe relationship between obesity and helicobacter pylori infection has been extensively reported; however, evidence from existing literature showing conflicting data. This current meta-analysis sought to assess the association between obesity and the risk of helicobacter pylori infection by summarizing all available data.MethodsPubMed, Embase, Web of Science, Cochrane databases were screened to identify relevant literature that assessed the association between obesity and helicobacter pylori infection in participants before the end of May, 2022. Data extraction and quality assessment were performed. The odds ratio (OR) and 95% confidence interval (95% CI) were used to estimate the association between obesity and helicobacter pylori infection by using a random-effects model. In addition, sensitivity analysis and publication bias were conducted.ResultsA total of twenty-one studies with 307,462 participants were included in this meta-analysis. Pooled estimates showed that obesity is associated with an increased risk of helicobacter pylori infection compared to non-obese counterparts (21 studies; OR:1.34; 95% CI: 1.17–1.52; I² = 91%). We also conducted subgroup analysis according to sex and study design, respectively. We found that males were more likely to have helicobacter pylori infection than females (OR: 1.59; 95% CI: 1.28–1.97; I² = 94.7% for male percent > 50%; OR:1.14; 95% CI: 0.94–1.38; I² = 75.2% for male percent < 50%). Furthermore, pooled studies of case-control study (OR: 1.20; 95% CI:1.05, 1.37; I² = 82.4%) showed that the people with obesity had a significantly higher prevalence of helicobacter pylori infection.ConclusionThis comprehensive quantitative analysis provides an affirmation that obesity is associated with an increased risk of helicobacter pylori infection. From this point of view, the prevention of obesity is important in the treatment of helicobacter pylori infection.     

Skipping breakfast is associated with overweight and obesity: A systematic review and meta-analysis

ObjectiveIn recent years, many original studies have shown that skipping breakfast has been associated with overweight and obesity; however, the results of different studies are inconsistent. Therefore, we conducted a systematic review and meta-analysis of observational studies to synthesize the associations between skipping breakfast and the risk of overweight/ obesity.MethodsWe did a systematic search using Pubmed, and Ovid searched up to August 2019. Observational studies (cohort studies and cross-sectional studies) reporting adjusted Odds Ratio or Risk Ratio estimates for the association between breakfast skipping and overweight/obesity (including abdominal obesity). Summary odds ratio (or Risk Ratio) and 95% confidence intervals calculated with a random-effects model.Results45 observational studies (36 cross-sectional studies and 9 cohort studies) were included in this meta-analysis. In cross-sectional studies, The ORs of low frequency breakfast intake per week versus high frequency were 1.48 (95% CI 1.40–1.57; I² = 54.0%; P = 0.002) for overweight/obesity, 1.31 (95% CI 1.17–1.47; I² = 43.0%; P = 0.15) for abdominal obesity. In cohort studies, The RR of low-frequency breakfast intake per week versus high frequency was 1.44 (95% CI 1.25–1.66; I² = 61%; P = 0.009) for overweight/obesity.ConclusionsThis meta-analysis confirmed that skipping breakfast is associated with overweight/obesity, and skipping breakfast increases the risk of overweight/obesity. The results of cohort studies and cross-sectional studies are consistent. There is no significant difference in these results among different ages, gender, regions, and economic conditions.     

Physical activity and cardiovascular risk factors in children: meta-analysis of randomized clinical trials

ObjectiveTo assess the effects of physical activity interventions in preventing cardiovascular risk factors in childhood through a systematic review and meta-analysis of randomized clinical trials (RCTs).MethodsA search of online databases (PubMed, EMBASE and Cochrane CENTRAL) was conducted from inception until June 2013. RCTs enrolling children 6–12 years old conducted physical activity interventions longer than 6 months, assessing their effect on body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), total cholesterol (TC) and triglycerides (TG) were included. Data analysis was performed using a random-effects model.ResultsOf 23.091 articles retrieved, 11 RCTs (10.748 subjects) were included. Physical activity interventions were not associated with reductions of BMI [− 0.03 kg/m² (95%CI − 0.16, 0.13) I² 0%]. However, there was an association between the interventions and reduction of SBP [− 1.25 mmHg (95%CI − 2.47, − 0.02) I² 0%], DBP [− 1.34 mmHg (95%CI − 2.57, − 0.11) I² 43%] and TG [− 0.09 mmol/L (95%CI − 0.14, − 0.04) I² 0%], and increase of TC [0.14 mmol/L (95%CI 0.01, 0.27) I² 0%].ConclusionAs physical activity intervention programs lasting longer than 6 months are associated with reductions in blood pressure levels and triglycerides, they should be considered to be included in prevention programs for cardiovascular diseases in schoolchildren.     

Androgen Deprivation Therapy for Prostate Cancer Prevention: What Impact Do Related Adverse Events Have on Quality of Life?

ObjectivesTo elicit utilities for health-related quality-of-life (HRQL) impact of adverse events (AEs) associated with androgen-deprivation therapy (ADT) for prostate cancer prevention.Study DesignCross-sectional, online survey of men aged ≥55 years, experiencing symptoms similar to one or more AEs related to ADT (erectile dysfunction [ED], loss of libido, gynecomastia, ejaculatory problems) outside the context of treatment for prostate cancer (n = 190, plus n = 10 had prostate cancer, included to allow greater representation of men with gynecomastia) and an age/sex equivalent control group (n = 100). Utilities were collected using the EQ-5D and a condition-specific measure of sexual HRQL from which a preference-based single index could be scored (SQoL-3D). Regression analysis was used to estimate the impact of the AE on utility values using a variety of model types.ResultsMany participants reported more than one symptom, including ED (most common at n = 139), reduced libido (n = 99), ejaculatory disorder (n = 98), and gynecomastia (n = 20). EQ-5D and SQoL-3D utilities were weakly correlated (r = 0.296). From the ordinary least squares regression, EQ-5D and SQoL-3D disutilities were estimated for ED (?0.042; ?0.074), reduced libido (?0.053; ?0.048), ejaculatory disorder (?0.047; ?0.028), and gynecomastia (?0.043; ? 0.038), respectively. The use of tobit regression did not improve model predictions.ConclusionsUtility values elicited in this study provide useful indicators of the impact of AEs related to ADT in older men for use in cost-effectiveness evaluation of prophylaxis for prostate cancer, and of benefits of treatments for sexual dysfunction or gynecomastia in older men.     

A randomized clinical trial of home-based exercise combined with a slight caloric restriction on obesity prevention among women

ObjectiveThe study investigated the effectiveness of home-based exercise combined with a slight caloric restriction on weight change during 12 months in non-obese women.MethodsA randomized clinical trial with a factorial design was conducted from 2003 to 2005. Two hundred three middle-aged women (Rio de Janeiro/Brazil), 25–45 years, were randomly assigned to one of two groups: control (CG) and home-based exercise (HB). The HB group received a booklet on aerobic exercise that could be practiced at home (3 times/week–40 min/session), in low-moderate intensity, during 12 months. Both groups received dietary counseling aimed at a slight energy restriction of 100–300 calories per day.ResultsThe HB experienced a greater weight loss in the first 6 months (?1.4 vs. ?0.8 kg; p = 0.04), but after 12 months there was no differences between groups (?1.1 vs. ?1.0; p = 0.20). Of the serum biochemical markers, HDL cholesterol showed major change, with an increase at month 12 of 18.3 mg/dl in the HB compared to 9.5 in the CG (p < 0.01).ConclusionHome-based exercise promoted greater weight reduction during the first 6 months after which no further benefits are observed. Continuous favorable changes in HDL cholesterol after 1 year suggest that home-based exercise promote health benefits.     

Effects of aerobic,resistance, and combined exercise training on insulin resistance markers in overweight or obese children and adolescents: A systematic review and meta-analysis

ObjectiveTo assess the associations of aerobic, resistance, and combined exercise with changes in insulin resistance, fasting glucose, and fasting insulin in children and adolescents who are overweight or obese.Data SearchesMEDLINE via Pubmed, Cochrane-CENTRAL, SPORTDiscus, and LILACS.Study SelectionRandomized clinical trials of at least six weeks of duration that evaluated the ability of exercise training to lower at least one of the following outcomes: insulin resistance-HOMA, fasting glucose, and fasting insulin in children and/or adolescents classified as obese or overweight.Data Extraction and analysisTwo independent reviewers extracted data and assessed the quality of the included studies. Differences (exercise training group minus control group) in the outcomes evaluated were analyzed using a random effects model.ResultsOf 1853 articles retrieved, 17 studies were included. The meta-analysis showed that physical training in general was not associated with a reduction in fasting glucose levels compared to the control, but it was associated with reductions in fasting insulin levels (− 3.37 μU/ml; CI 95%, − 5.16 μU/ml to − 1.57 μU/ml; I², 54%, p = 0.003) and HOMA (− 0.61; CI 95%, − 1.19 to − 0.02; I², 49%, p = 0.040). In addition, each modality (aerobic, resistance, and combined) was compared to the control group. Aerobic exercise was associated with declines in fasting insulin levels (− 4.52 μU/ml; CI 95%, − 7.40 to − 1.65; I², 65%, p = 0.002) and in HOMA (− 1.33; 95% confidence interval, − 2.47 to − 0.18; I², 73%, p = 0.005).ConclusionsExercise training, especially aerobic training, is associated with the reduction of fasting insulin levels and HOMA in children and adolescents with obesity and overweight, and may prevent metabolic syndrome and type 2 diabetes.     

The effects of Tai Chi on fall prevention,fear of falling and balance in older people: A meta-analysis

ObjectiveTai Chi (TC) is an exercise training that is becoming increasingly popular as an intervention for single fall prevention. This meta-analysis was performed to evaluate the efficacy of TC on fall rate, fear of falling and balance in older people.MethodsRandomized controlled trials published between 1988 and January 2009 were included. In the Netherlands (2009) we used random effects models for the analyses, with data reported as incidence rate ratios (IRR) for falls and standardized mean differences (SMD) for fear of falling and balance.ResultsNine trials (representing 2203 participants) were included in the analyses. Compared with exercise controls, TC participants showed significant improvements in fall rates (2 trials included, IRR: 0.51, 95% CI 0.38–0.68) and static balance (2 trials included, SMD: 0.47, 95% CI 0.23–0.72). Compared with non-exercise controls, no improvement was found for TC participants in fall rates (5 trials, IRR: 0.79, 95% CI 0.60–1.03) or static balance (2 trials, SMD: 0.30, 95% CI ? 0.50–1.10), but a significant improvement was found for fear of falling (SMD: 0.37, 95% CI = 0.03–0.70).ConclusionsCurrently there is insufficient evidence to conclude whether TC is effective in fall prevention, decreasing fear of falling and improving balance in people over age 50 years.     

Hypolipidemic effect of the polysaccharide from Pholiota nameko

ObjectiveThis study was conducted to investigate the hypolipidemic effect of the polysaccharide isolated from Pholiota nameko (PNPS-1).MethodsHyperlipidemic Wistar rats were treated with PNPS-1 (20, 40, and 60 mg/kg orally).ResultsTreatment of hyperlipidemic Wistar rats with PNPS-1 led not only to significant decreases in very low-density lipoprotein/low-density lipoprotein cholesterol (?48.98% and ?21.54%, 40 and 60 mg/kg), triacylglycerol (?19.70%, ?17.17%, ?32.32%), phospholipids (?9.90%, ?19.80%, ?27.08%), and consequently the atherogenic index (23.61%, 70.42%, 82.85%) and a increase in high-density lipoprotein cholesterol (69.01% and 73.35%, 40 and 60 mg/kg) in serum, but also to significant decreases in total lipids (?10.24% and ?33.16%, 40 and 60 mg/kg), total cholesterol (?24.22%, ?34.26%, ?55.02%), triacylglycerol (?22.53% and ?38.50%, 40 and 60 mg/kg), and phospholipids (?27.41%, 60 mg/kg) in the liver. Further, PNPS-1 significantly suppressed lipid peroxidation by decreasing malondialdehyde and increasing antioxidant enzymes in serum (malondialdehyde, 9.94%, ?22.22%, ?32.75%; superoxide dismutase, 37.26%, 101%, 114%; catalase, 32.2%, 30.02%, 36.74%; glutathione peroxidase, 31.30%, 35.56%, 52.34%) of the 20-, 40-, and 60-mg/kg PNPS-1 groups and in the liver (malondialdehyde, ?32.26%, ?47.85%; catalase, 97%, 117%; glutathione peroxidase, 70.70%, 78.03%) in the 40- and 60-mg/kg PNPS-1 groups (superoxide dismutase, 24.35%, 67.49%, 234%). PNPS-1 was also effective in lowering body weight and some visceral weights (liver, heart, and kidney) in treated rats, except for the lung. PNPS-1 also ameliorated the pathologic changes in coronary arteries of hyperlipidemic rats.ConclusionThese results suggested that PNPS-1 significantly suppresses the development of hyperlipidemia and might be used as a potential therapeutic agent for hyperlipidemia.     

Moderate consumption of fatty fish reduces diastolic blood pressure in overweight and obese European young adults during energy restriction

ObjectiveDietary intervention studies suggest that a daily fish meal can improve blood pressure (BP); however, such a dietary regimen might be difficult to sustain. The objective of the present study was to investigate whether salmon consumption three times per week improves BP during energy restriction in young adults.MethodsIn this 8-wk intervention, 324 subjects (20–40 y of age, body mass index 27.5–32.5 kg/m², from Iceland, Spain, and Ireland) were randomized to one of four energy-restricted diets (?30% relative to estimated requirements): salmon (150 g three times per week, resulting in a daily consumption of 2.1 g of ω-3 long-chain polyunsaturated fatty acids [ω-3 LC-PUFAs]), cod (150 g three times per week, 0.3 g of ω-3 LC-PUFAs per day), fish oil capsules (1.3 g of ω-3 LC-PUFAs per day), or control (sunflower oil capsules, no seafood). Body weight, diastolic BP (DBP), systolic BP (SBP), and docosahexaenoic acid (DHA) in erythrocyte membrane were measured at baseline and endpoint.ResultsParticipants showed weight loss (?5.2 ± 3.2 kg, P < 0.001) and decreases in SBP (?4.4 ± 8.6 mmHg, P < 0.001) and DBP (?4.1 ± 7.4 mmHg, P < 0.001) after the intervention. The salmon (B = ?2.71, P = 0.032) and fish oil (B = ?2.48, P = 0.044) groups had significantly lower endpoint DPB than the cod group, but not significantly different from control. Lower baseline DHA (percentage) in erythrocytes was associated with greater DBP reductions (B = 0.576, P = 0.017).ConclusionSalmon consumption three times per week can decrease DBP similar to fish oil and significantly more than lean fish during an 8-wk energy restriction in young overweight individuals. A lower DHA content in erythrocyte membrane at baseline, which might indentify infrequent fish eaters, is associated with a greater DBP reduction in the course of an 8-wk dietary intervention providing fatty seafood.     

The effect of participation in school-based nutrition education interventions on body mass index: A meta-analysis of randomized controlled community trials

ObjectiveThe aim of this study was to evaluate the effectiveness of school-based nutrition education interventions in reducing or preventing overweight and obesity among children and adolescents.MethodsWe conducted a systematic search of 14 databases until May 2010 and cross-reference check in 8 systematic reviews (SRs) for studies published that described randomized controlled trials conducted in schools to reduce or prevent overweight in children and adolescents. An additional search was carried out using PubMed for papers published through May 2012, and no further papers were identified. Body mass index (BMI) was the primary outcome. The title and abstract review and the quality assessment were performed independently by two researchers. The software EPPI-Reviewer3 was used to store, manage and analyze all data. This SR is registered at ClinicalTrials.gov (NCT00985972).ResultsFrom the 4888 references initially retrieved, only 8 met the eligibility criteria for a random-effects meta-analysis. The total population consisted of 8722 children and adolescents. Across the studies, there was an average treatment effect of ? 0.33 kg/m² (? 0.55, ? 0.11 95% CI) on BMI, with 84% of this effect explained by the highest quality studies.ConclusionThis systematic review provides evidence that school-based nutrition education interventions are effective in reducing the BMI of children and adolescents.     

The impact of level of education on adherence to breast and cervical cancer screening: Evidence from a systematic review and meta-analysis

Objective. To assess the inequalities in adherence to breast and cervical cancer screening according to educational level. Methods. A systematic review was carried out between 2000 and 2013 by querying an electronic database using specific keywords. Studies published in English reporting an estimation of the association between level of education and adherence to breast and/or cervical cancer screening were included in the study. Two different meta-analyses were carried out for adherence to breast and cervical cancer screening, respectively: women with the highest level of education and women with the lowest level of education were compared. The level of heterogeneity was investigated and subgroup analyses were carried out. Results. Of 1231 identified articles, 10 cross-sectional studies were included in the analysis. The meta-analyses showed that women with the highest level of education were more likely to have both screenings with an overall OR = 1.61 (95% CI 1.36–1.91; I² = 71%) for mammography and OR = 1.96 (95% CI 1.79–2.16; I² = 0%) for Pap test, respectively. Stratified meta-analysis for breast cancer screening included only studies that reported guidelines with target age of population ≥ 50 years and showed a reduction in the level of heterogeneity and an increase of 36% in the adherence (95% CI 1.19–1.55; I² = 0%). Conclusions. This study confirms and reinforces evidence of inequalities in breast and cervical cancer screening adherence according to educational level.     

Nutrition intervention and adequate hygiene practices to improve iron status of vulnerable preschool Burkinabe children

ObjectiveTo determine the impact of an intervention that combined an increase in dietary and bioavailable iron intakes and an improvement in hygiene behaviors on the iron status of preschool children from Burkina Faso.MethodsThirty-three orphans and vulnerable children from 11 families who were 1–6 y old, were non-anemic, or had mild to moderate anemia were enrolled in an 18-wk trial. Using the probability approach for planning diets in an assisted-living facility, bioavailable iron intake was increased from 0.4 to 0.9 mg/d by increasing the amounts of meat and citrus fruits and by adding iron-rich condiments to the diet, for an estimated cost of U.S. $0.59/mo. Hygiene behaviors were modified by implementing hand-washing before meals and by the use of individual plates for meals. Iron status indicators were measured twice and means at enrollment and after intervention were compared.ResultsAfter intervention, hemoglobin concentration increased from 98.7 to 103.8 g/L (P = 0.006). There was a decrease in total iron binding capacity (107 to 91 μmol/L, P = 0.05) and a marginal increase in transferrin saturation (13% to 17%, P = 0.06). Significant improvement was not observed for serum ferritin concentration or prevalence of depleted iron stores, likely due to the confounding effect of infection. Anemia and iron-deficiency anemia were decreased from 64% to 30% and from 61% to 30%, respectively.ConclusionDietary modification associated with adequate hygiene behaviors could be a relevant strategy to control iron deficiency and anemia in areas where infection is a major health problem.     

La anemia aumenta el riesgo de mortalidad debido a fragilidad y discapacidad en mayores: Estudio FRADEA

ObjectiveTo analyze if anemia increases 10-year mortality risk associated to frailty and disability in older adults.DesignSubstudy of the FRADEA population-based concurrent cohort study (Frailty and dependence in Albacete), with a 10-year follow-up (2007-2017) in people older than 69 years.SettingAlbacete city, Spain.ParticipantsOf the 993 participants included in the first wave, 790 were selected with valid data on function (frailty and disability), anemia and vital status at 10 years.Main measurementsAnemia was defined according to the criteria of the World Health Organization (hemoglobin < 13 g/dL in men and < 12 g/dL in women). A functional classification variable was created, including frailty and disability, identifying four progressive functional levels: robust, prefrail, frail and disabled in basic activities of daily life, using frailty phenotype and Barthel index respectively. A new eight categories variable was constructed combining the four functional groups with the presence or absence of anemia. The association with mortality was determined by Kaplan-Meier and Cox proportional hazards analysis adjusted for age, sex, comorbidity, polypharmacy, institutionalization and creatinine.ResultsMean age was 79 years and 59.6% were women. 393 participants (49.7%) died during the follow-up period. The median survival was 98.4 months (interquartile range 61). The risk of mortality increased from the levels with better functionality to those with worse functionality, and for each subgroup it was higher in the participants with anemia. Prefrail without anemia HR [hazard ratio] 1.59 (95% CI 1.07-2.36) and with anemia HR 2.37 (95% CI 1.38-4.05). Frail without anemia HR 3.18 (95% CI 1.68-6.02) and with anemia HR 4.42 (95% CI 1.99-9.84). Disabled without anemia HR 3.81 (95% CI 2.45-5.84) and with anemia HR 5.48 (95% CI 3.43-8.76).ConclusionAnemia increases the risk of mortality associated with frailty and disability in older adults.     

The European I-MOVE Multicentre 2013–2014 Case-Control Study. Homogeneous moderate influenza vaccine effectiveness against A(H1N1)pdm09 and heterogenous results by country against A(H3N2)

BackgroundIn the first five I-MOVE (Influenza Monitoring Vaccine Effectiveness in Europe) influenza seasons vaccine effectiveness (VE) results were relatively homogenous among participating study sites. In 2013–2014, we undertook a multicentre case-control study based on sentinel practitioner surveillance networks in six European Union (EU) countries to measure 2013–2014 influenza VE against medically-attended influenza-like illness (ILI) laboratory-confirmed as influenza. Influenza A(H3N2) and A(H1N1)pdm09 viruses co-circulated during the season.MethodsPractitioners systematically selected ILI patients to swab within eight days of symptom onset.We compared cases (ILI positive to influenza A(H3N2) or A(H1N1)pdm09) to influenza negative patients. We calculated VE for the two influenza A subtypes and adjusted for potential confounders. We calculated heterogeneity between sites using the I² index and Cochrane's Q test. If the I² was <50%, we estimated pooled VE as (1 minus the OR) × 100 using a one-stage model with study site as a fixed effect. If the I² was >49% we used a two-stage random effects model.ResultsWe included in the A(H1N1)pdm09 analysis 531 cases and 1712 controls and in the A(H3N2) analysis 623 cases and 1920 controls. For A(H1N1)pdm09, the Q test (p = 0.695) and the I² index (0%) suggested no heterogeneity of adjusted VE between study sites. Using a one-stage model, the overall pooled adjusted VE against influenza A(H1N1)pdm2009 was 47.5% (95% CI: 16.4–67.0).For A(H3N2), the I² was 51.5% (p = 0.067). Using a two-stage model for the pooled analysis, the adjusted VE against A(H3N2) was 29.7 (95% CI: −34.4–63.2).ConclusionsThe results suggest a moderate 2013–2014 influenza VE against A(H1N1)pdm09 and a low VE against A(H3N2). The A(H3N2) estimates were heterogeneous among study sites. Larger sample sizes by study site are needed to prevent statistical heterogeneity, decrease variability and allow for two-stage pooled VE for all subgroup analyses.     

Cathodic adsorptive stripping voltammetric determination of rutin in soybean cultivars

A highly sensitive and selective cathodic adsorptive stripping voltammetric method for determination of rutin is presented. The method relies on the accumulation of a Cu(II)–rutin complex at a hanging mercury drop electrode (HMDE), followed by its reduction during a differential pulse voltammetric scan. The electrochemical behavior of the Cu(II)–rutin complex at HMDE was investigated by cyclic voltammetry. Results show that the electrode process is adsorption-controlled and gradually becomes less reversible at high scan rates where peak separation grows. Under the optimized conditions (phosphate buffer pH 6, ?1.000 V accumulation potential, 180 s accumulation time, 70 mV pulse amplitude, 50 mV s^?1 scan rate and 1.6 × 10^?6 M Cu(II) concentration), the reduction peak current (I_pc) of the Cu(II)–rutin complex is linear (I_pc (nA) = 10.070 + 1.9 × 10⁸ [Rutina]) to rutin concentration in the range from 2.0 × 10^?7 to 1.4 × 10^?6 M, with a correlation coefficient of 0.999. The detection and quantification limits obtained were 7.0 × 10^?9 M and 2.2 × 10^?8 M, respectively. The method was successfully applied to the determination of rutin in soybean cultivars, with recoveries of 94–105%.     

Lack of association between Toll-like receptor 4 gene Asp299Gly and Thr399Ile polymorphisms and tuberculosis susceptibility: A meta-analysis

ObjectiveToll-like receptor 4 (TLR4) plays a vital role in immunity to tubercle bacillus and its gene polymorphisms are supposed to affect tuberculosis susceptibility in some rather than all studies. Then, we integrated published data and performed a comprehensive meta-analysis to get more reliable estimations for the strength of associations between TLR4 gene polymorphisms and the risk of tuberculosis.MethodsWe systematically searched the electronic PubMed database for research articles about TLR4 gene polymorphisms and tuberculosis up to February 2012. Revman 5.0 software was adopted to conduct the meta-analysis. Crude odds ratio (ORs) and 95% confidence intervals (95% CIs) were calculated by either fixed-effects model or random-effects model.ResultsFinally, six case-control studies were identified, involving 1587 controls and 2110 patients. Overall, no significant associations were found between TLR4 gene Asp299Gly polymorphism and tuberculosis in the codominant models (GG vs AA: OR = 1.56, 95% CI = 0.76–3.21, P = 0.23; GA vs AA: OR = 1.01, 95% CI = 0.84–1.23, P = 0.89), the dominant model (GG + GA vs AA: OR = 1.04, 95% CI = 0.80–1.35, P = 0.75), the recessive model (GG vs GA + AA: OR = 1.55, 95% CI = 0.75–3.19, P = 0.24) and the allele model (G vs A: OR = 1.06, 95% CI = 0.81–1.40, P = 0.66). Similarly, no significant associations between TLR4 gene Thr399Ile and tuberculosis were observed (all P > 0.05).ConclusionsThe present meta-analysis suggests that TLR4 gene Asp299Gly and Thr399Ile polymorphisms are not associated with the susceptibility of tuberculosis.     

Specific and cross-reactive immune response to oral Salmonella Typhi Ty21a and parenteral Vi capsular polysaccharide typhoid vaccines administered concomitantly

BackgroundSince protective efficacy of the current typhoid vaccines—oral whole-cell Salmonella Typhi Ty21a and parenteral Vi-capsular polysaccharide preparation—is not optimal, and no vaccines are available against paratyphoid or non-typhoidal Salmonella (NTS) serotypes, new approaches deserve to be explored. The immunological mechanisms elicited by the two typhoid vaccines are mainly targeted against different structures. We studied whether these vaccines would enhance S. Typhi-specific immune response and cross-reactivity against other Salmonellae, if administered concomitantly.Materials and methodsVolunteers were immunized simultaneously with Ty21a and Vi vaccines (Ty21a + Vi group) or with either of the two singly (Ty21a and Vi groups). All volunteers were investigated for circulating specific and cross-reactive plasmablasts, identified by ELISPOT as IgA, IgG or IgM antibody-secreting cells (ASC) reactive with S. Typhi, S. Paratyphi A/B/C, or selected NTS serotypes (S. Enteritidis, S. Typhimurium).ResultsIn the Ty21a + Vi group, no specific or cross-reactive plasmablasts were detected before vaccination. After vaccination, the number of S. Typhi-specific plasmablasts (878 ASC/10⁶ PBMC, 95%CI 554–1201) proved higher than in the Ty21a (339 ASC/10⁶ PBMC; p < 0.001) and Vi (149 ASC/10⁶ PBMC; p < 0.001) groups. Likewise, cross-reactive responses in the Ty21a + Vi group were higher than in the Ty21a and Vi groups (Ty21a + Vi vs Ty21a: ASC against S. Paratyphi A/B, S. Enteritidis and S. Typhimurium p < 0.05, against S. Paratyphi C p < 0.01; Ty21a + Vi vs Vi: against S. Paratyphi C not significant, others p < 0.0001). A gut-directed homing profile was seen among O antigen-specific and a systemic one among Vi antigen-specific plasmablasts.ConclusionsConcomitant administration of Ty21a and Vi vaccines is well tolerated and induces an additive immune response to the two vaccines. Thus it enhances the magnitude of both typhoid-specific plasmablast responses and those cross-reacting with paratyphoid and most important NTS serotypes. The data encourage concomitant use of Ty21 and Vi vaccines for those at risk.