The Association of Childhood Pneumonia with Household Air Pollution in Nepal: Evidence from Nepal Demographic Health Surveys

Introduction

Childhood pneumonia is a major cause of mortality worldwide while household air pollution (HAP) is a major contributor to childhood pneumonia in low and middle-income countries. This paper presents the prevalence trend of childhood pneumonia in Nepal and assesses its association with household air pollution.

Methods

The study analysed data from the 2006, 2011 and 2016 Nepal Demographic Health Surveys (NDHS). It calculated the prevalence of childhood pneumonia and the factors that cause household air pollution. The association of childhood pneumonia and HAP was assessed using univariate and multi-variate analysis. The population attributable fraction (PAF) of indoor pollution for causing pneumonia was calculated using 2016 NDHS data to assess the burden of pneumonia attributable to HAP factors.

Results

The prevalence of childhood pneumonia decreased in Nepal between 2006 and 2016 and was higher among households using polluting cooking fuels. There was a higher risk of childhood pneumonia among children who lived in households with no separate kitchens in 2011 [Adjusted risk ratio (ARR) 1.40, 95% CI 1.01–1.97] and in 2016 (ARR 1.93, 95% CI 1.14–3.28). In 2016, the risk of children contracting pneumonia in households using polluting fuels was double (ARR 1.98, 95% CI 1.01–3.92) that of children from households using clean fuels. Based on the 2016 data, the PAF for pneumonia was calculated as 30.9% for not having a separate kitchen room and 39.8% for using polluting cooking fuel.

Discussion for Practice

Although the occurrence of childhood pneumonia in Nepal has decreased, the level of its association with HAP remained high.

     

Poland's syndrome and Wilms tumor: An unusual association

Poland's syndrome, a rare congenital disorder with pectoralis muscular girdle defect, have been reported in association with lymphoreticular malignancies in the past. Childhood solid tumors in association with this congenital anomaly have not been reported so far. We describe this rare association of Poland's syndrome and Wilms tumor. Due to the possibility of increased risk of leukemogenesis in patients with Poland's syndrome, chemo-radiation therapy of Wilms tumor in our patient may increase the risk of secondary leukemia. Therapeutic modification of primary cancer in these patients may be necessary with careful long-term follow-up for early detection and treatment of secondary cancer. Med. Pediatr. Oncol. 30:67–68, 1998. © 1998 Wiley-Liss, Inc.     

Cancer phytotherapeutics: role for flavonoids at the cellular level

Dietary foods and fruits possess an array of flavonoids with unique chemical structure and diverse bioactivities relevant to cancer. Numerous epidemiological studies have validated the inverse relation between the consumption of flavonoids and the risk of cancer. Flavonoids possess cancer blocking and suppressing effects. Flavonoids modulate various CYPs involved in carcinogen activation and scavenging reactive species formed from carcinogens by CYP-mediated reactions. They induce biosynthesis of several CYPs. They are involved in the regulation of enzymes of phase-II responsible for xenobiotic biotransformation and colon microflora. Since cytochromes P450, P-gp and phase-II enzymes are involved in the metabolism of drugs and in the processes of chemical carcinogenesis, interactions of flavonoids with these systems hold great promise for their therapeutic potential. The role of flavonoids also includes the inhibition of activation of pro-carcinogens, inhibition of proliferation of cancer cells, selective death of cancer cells by apoptosis, inhibition of metastasis and angiogenesis, activation of immune response against cancer cells, modulation of the inflammatory cascade and the modulation of drug resistance. This has greatly extended the goal of cancer therapy from eradicating the affected cells to control of the cancer phenotype. Phytotherapy is being used in combination with other therapies as phytonutrients have been shown to work by nutrient synergy.     

The cystic fibrosis ΔF508 gene mutation and cancer

Following the observation that relatives of cystic fibrosis (CF) patients have an increased mortality due to leukaemia, a study was initiated to determine whether leukaemia patients had an increased prevalence of the ΔF508 CF mutation. No increase in carriers were found among leukaemias; however the carrier frequency of the ΔF508 mutation appeared to be reduced in patients with malignant melanoma analysed as a control group compared to the normal population. This paper extends our previous study and investigates several other common human tumours, including those of the colon, breast, and lymphoma tissue. Fewer than expected carriers remained among the melanoma group from South Wales. There were fewer than expected carriers among patients with colon cancer compared to the normal population. The prevalence of the ΔF508 mutation was normal in lymphomas and leukaemias. Hum Mutat 10:45–48, 1997. © 1997 Wiley-Liss, Inc.     

Powder Metallurgical Processing and Characterization of Molybdenum Addition to Tungsten Heavy Alloys by Spark Plasma Sintering

The effect of adding molybdenum to the heavy tungsten alloy of W-Ni-Fe on its material characteristics was examined in the current study. The elemental powders of tungsten, iron, nickel, and molybdenum, with a composition analogous to W-3Fe-7Ni-xMo (x = 0, 22.5, 45, 67.5 wt.%), were fabricated using the spark plasma sintering (SPS) technique at a sintering temperature of 1400 °C and under pressure of 50 MPa. The sintered samples were subjected to microstructural characterization and tested for mechanical strength. The smallest grain size of 9.99 microns was observed for the 45W-45Mo alloy. This alloy also gave the highest tensile and yield strengths of 1140 MPa and 763 MPa, respectively. The hardness increased with the increased addition of molybdenum. The high level of hardness was observed for 67.5Mo with a 10.8% increase in the base alloy’s hardness. The investigation resulted in the alloy of 45W-7Ni-3Fe-45Mo, observed to provide optimum mechanical properties among all the analyzed samples.     

Asymmetric Frequency-Specific Feedforward and Feedback Information Flow between Hippocampus and Prefrontal Cortex during Verbal Memory Encoding and Recall

Hippocampus and prefrontal cortex (PFC) circuits are thought to play a prominent role in human episodic memory, but the precise nature, and electrophysiological basis, of directed information flow between these regions and their role in verbal memory formation has remained elusive. Here we investigate nonlinear causal interactions between hippocampus and lateral PFC using intracranial EEG recordings (26 participants, 16 females) during verbal memory encoding and recall tasks. Direction-specific information theoretic analysis revealed higher causal information flow from the hippocampus to PFC than in the reverse direction. Crucially, this pattern was observed during both memory encoding and recall, and the strength of causal interactions was significantly greater during memory task performance than resting baseline. Further analyses revealed frequency specificity of interactions with greater causal information flow from hippocampus to the PFC in the delta-theta frequency band (0.5-8 Hz); in contrast, PFC to hippocampus causal information flow were stronger in the beta band (12-30 Hz). Across all hippocampus-PFC electrode pairs, propagation delay between the source and target signals was estimated to be 17.7 ms, which is physiologically meaningful and corresponds to directional signal interactions on a timescale consistent with monosynaptic influence. Our findings identify distinct asymmetric feedforward and feedback signaling mechanisms between the hippocampus and PFC and their dissociable roles in memory recall, demonstrate that these regions preferentially use different frequency channels, and provide novel insights into the electrophysiological basis of directed information flow during episodic memory formation in the human brain.SIGNIFICANCE STATEMENT Hippocampal-PFC circuits play a critical role in episodic memory in rodents, nonhuman primates, and humans. Investigations using noninvasive fMRI techniques have provided insights into coactivation of the hippocampus and PFC during memory formation; however, the electrophysiological basis of dynamic causal hippocampal-PFC interactions in the human brain is poorly understood. Here, we use data from a large cohort of intracranial EEG recordings to investigate the neurophysiological underpinnings of asymmetric feedforward and feedback hippocampal-PFC interactions and their nonlinear causal dynamics during both episodic memory encoding and recall. Our findings provide novel insights into the electrophysiological basis of directed bottom-up and top-down information flow during episodic memory formation in the human brain.     

Lack of difference in iron status assessed by soluble transferrin receptor between children with cerebral malaria and those with non-cerebral malaria.

We conducted this study to determine whether children with cerebral malaria are less likely to have tissue iron deficiency than those with non-cerebral malaria. Iron status was assessed by soluble transferrin receptor (sTfR), serum ferritin, and haemoglobin in 44 Za?rian children: 15 with cerebral malaria, 14 with non-cerebral malaria, and 15 without malaria (age range 0.5-16 years). Although there was no significant difference in the mean concentrations of sTfR, serum ferritin, or haemoglobin between either group of patients, a higher percentage of children with cerebral malaria (27 per cent) than those with non-cerebral malaria (14 per cent) or controls (7%) had sTfR levels above 7.3 mg/l (suggestive of tissue iron deficiency). A higher percentage of children with cerebral malaria (40 per cent) than with non-cerebral malaria (29 per cent) or controls (20 per cent) also had either serum ferritin < 100 micrograms/l and inflammation or sTfR > 7.3 mg/l or both. The data suggest that children with cerebral malaria are as likely to have tissue iron deficiency as those with non-cerebral malaria.     

Nonrandom chromosomal aberrations and clonal chromosomal evolution in acute leukemia associated with Down's syndrome

Nine Down's syndrome (DS) children, four with acute leukemia, one with acute leukemia as well as rhabdomyosarcoma, and four with other hematologic disorders, were analyzed for constitutional and acquired chromosomal aberrations. Acquired clonal chromosomal aberrations were identified only in the acute leukemia cases, and four of the five acute leukemia demonstrated numerical and/or structural aberrations involving chromosomes #8, #19, and #21. Of the 11 aneuploid stem cell lines identified in the five acute leukemia cases, trisomy 21, trisomy 8, trisomy 19, and tetrasomy or pentasomy 21 was found in 11, seven, four, and two lines, respectively. The frequent appearance of multiple stem cell lines with common and/or overlapping chromosomal aberrations in acute leukemia cases demonstrates the existence of genomic instability and heterogeneity of the neoplastic cell population, which results from clonal chromosomal evolution. Furthermore, trisomy 19 was identified only with the concurrent presence of trisomy 8, suggesting that the nondisjunction of chromosome #19 probably occurred after that of #8. Trisomy 21 was observed in every aneuploid stem cell line and, in one case, trisomy 21 was maintained in the bone marrow leukemic cells but not in the orbital rhabdomyosarcoma cells, indicating that this constitutional chromosomal aberration is probably crucial for and predisposed to the development of acute leukemia in DS patients. The association of acquired clonal chromosomal aberrations, especially those involving chromosomes #8, #19, and #21, with DS acute leukemia strongly suggests the clinical implication of cytogenetic analysis in the diagnosis of acute leukemia development in DS patients.