The prevalence of disability among Roma and non-Roma children in four West Balkan countries

BackgroundVery little is known about the prevalence of disability among Roma children.ObjectiveTo estimate the prevalence of disability and significant cognitive delay among Roma and non-Roma children aged from 2 to 17 years in four West Balkan countries.MethodsSecondary analysis of data collected in Round 6 of UNICEF's Multiple Indicators Cluster Surveys. Nationally representative samples of 6290 Roma and 13,005 non-Roma children in Kosovo, Montenegro, the Republic of North Macedonia, and Serbia.ResultsRoma children were twice as likely to have a disability, a less severe disability, multiple disabilities, and severe cognitive delay than their peers and were more likely to have functional limitations in all but one of the domains investigated.ConclusionsDisability is significantly more prevalent among Roma children aged 2–17 years than among their non-Roma peers in four Western Balkan countries. Future research should focus on the extent to which differences in disability may be attributable to differential rates of exposure to a range of social determinants.     

Marginal and internal fit of three-unit zirconia fixed dental prostheses: Effects of prosthesis design,cement space,and zirconia type

PurposeThe purpose of this study was to compare the marginal and internal fit of three-unit fixed dental prostheses (FDPs) fabricated using CAD/CAM with two designs, two cement space (CS), and two zirconia types.MethodsA master model with two zirconia abutments and a missing tooth was scanned with an intraoral scanner. FDPs were fabricated with two designs (Full contour: FC, Framework: FW), two zirconia types (multi-layer: L, single-layer: W), and two CS values (30 and 45 μm for L and 30 μm for W). There were six experimental groups. The fit of the FDPs was evaluated using the replica method. The space between an abutment and the FDPs in the marginal (MO), chamfer (CH), axial (AX), and occlusal (OC) areas was measured under an optical microscope and the data was statistically analyzed using three-way ANOVA and Bonferroni test (p < 0.05).ResultsFW-l-45 μm showed a significantly smaller space than those for the FC in MO (p = 0.011), CH (p = 0.001) and AXE (p = 0.003). FW-l-30 μm showed a significantly smaller space than that for the 45 µm in AXE (p = 0.000) and OC (p = 0.016). FW-W-30 µm showed a significantly smaller space than that for the L in MO (p = 0.000), CH (p = 0.000), AXE (p = 0.000), and OC (p = 0.002).ConclusionsThe design and CS of the FDPs affected the fit. FDPs with single-layer zirconia showed better fit than that obtained with multi-layer zirconia.     

Proteomic analysis of Brucella melitensis and Brucella ovis for identification of virulence factor using bioinformatics approachs

The genus Brucella includes several genetically monomorphic species but with different phenotypic and virulence characteristics. In this study, proteins of two Brucella species, B. melitensis type strain 16 M and B. ovis REO198 were compared by proteomics approach, in order to explain the phenotypic and pathophysiological differences among Brucella species and correlate them with virulence factors.Protein extracts from the two Brucella species were separated by SDS-PAGE and 5 areas, which resulted qualitatively and quantitatively different, were analyzed by nLC-MS/MS.A total of 880 proteins (274 proteins of B. melitensis and 606 proteins of B. ovis) were identified; their functional and structural features were analyzed by bioinformatics tools. Four unique peptides belonging to 3 proteins for B. ovis and 10 peptides derived from 7 proteins for B. melitensis were chosen for the high amount of predicted B-cell epitopes exposed to the solvent. Among these proteins, outer-membrane immunogenic protein (N8LTS7) and 25 kDa outer-membrane immunogenic protein (Q45321), respectively of B. ovis and B. melitensis, could be interesting candidates for improving diagnostics tests and vaccines.Moreover, 8 and 13 outer and periplasmic non homologue proteins of B. ovis and B. melitensis were identified to screen the phenotypic differences between the two Brucella strains. These proteins will be used to unravel pathogenesis and ameliorate current diagnostic assays.     

Correlation of Cord Blood pH,Base Excess,and Lactate Concentration Measured With a Portable Device for Identifying Fetal Acidosis

ObjectiveTo determine the effectiveness of portable lactate analyzers in identifying fetal acidosis by correlating arterial and venous lactate values from umbilical cord blood with lactate, pH, and base excess measurements from central laboratory analyzers.MethodsWe performed a prospective study using arterial and venous cord blood from 52 women with a singleton fetus delivered at term. We evaluated the correlation between the cord blood lactate concentration measured using two of the same portable devices (Lactate Plus, Nova Biomedical) with the result from a central laboratory analyzer. Analyses of the correlation between arterial lactate concentration measured on the portable device with arterial pH and base excess were then performed.ResultsWe observed a median arterial pH of 7.24 (range 7.05 to 7.35) and a median arterial lactate concentration of 3.7 mmol/L (range 1.7 to 8.8 mmol/L). An excellent correlation was observed between lactate concentrations measured by the two portable devices (arterial R² = 0.98 and venous R² = 0.98), and between the portable device and the central laboratory analyzer (arterial R² = 0.94 and venous R² = 0.95). In our population, the optimal cut-offs to predict a pH < 7.20 or a base excess > − 8.0 mmol/L were a lactate concentration of 4.9 mmol/L and 5.3 mmol/L, respectively, according to receiver operator characteristic analysis. With a lactate concentration > 4.9 mmol/L, the portable device had a sensitivity of 82% and a specificity of 90% to identify samples with an arterial pH < 7.20.ConclusionCord blood lactate concentration measured with a portable device is a good predictor of cord blood base excess and pH. Future studies should be designed to correlate scalp blood lactate measurements with clinical outcomes.     

Evaluation of the impact of HIV-1 infection and density of common nasopharyngeal bacterial colonizers in South African children immunized with 7-valent pneumococcal conjugate vaccine

BackgroundDue to limitations in standard culture methods, the impact of pneumococcal conjugate vaccine (PCV) immunization on nasopharyngeal bacterial carriage density is unclear, including among HIV-infected children.MethodsThe prevalence and density of serotype/serogroup-specific pneumococcal and other nasopharyngeal colonizing bacteria were investigated in archived swabs of HIV-infected and HIV-uninfected, PCV-7 immunized (at 6, 10 and 14 weeks of age) South African children collected at 9 and 16 months of age. During the course of the study, PCV-immunization of children in Soweto was limited to study-participants, as the vaccine had not been introduced into the public immunization program.ResultsAt 9 months of age, the prevalence of overall pneumococcal colonization was lower in HIV-infected (58.6%) than HIV-uninfected children (69.9%, p = 0.02), mainly due to lower prevalence of non-vaccine-serotype colonization (27.8% vs. 40%, respectively; p = 0.047). The mean-log₁₀ density of pneumococcal colonization was, however, higher in HIV-infected (4.81 CFU/ml) than HIV-uninfected pneumococcal colonized children (4.44 CFU/ml; p = 0.014); mainly due to higher mean-log₁₀ density of PCV7-serotype colonization (4.21 vs. 3.72 CFU/ml; p = 0.014). No difference in the prevalence or density of overall pneumococci was found at 16 months of age. The prevalence of non-vaccine serotype colonization remained 1.7 fold higher in HIV-uninfected (60.4%) than HIV-infected children (50.9%, p = 0.049). Other differences included a lower prevalence of H. influenzae colonization in HIV-infected (42.3% and 56%) than HIV-uninfected children (64.2% and 73.4%) at both 9 and 16 months of age respectively; however, the density of colonization was similar.ConclusionIncreased carriage density of residual PCV7-serotypes might cause HIV-infected children to have a higher risk of pneumococcal disease. The higher carriage density observed in HIV-infected children could be attributed to a combination of factors, including HIV treatment and impaired host immunity. Additional studies are needed.