Carotid Atherosclerosis Is Associated With Poorer Hearing in Older Adults

ObjectivesCardiovascular disease may be linked to hearing loss through narrowing of the nutrient arteries of the cochlea, but large-scale population-based evidence for this association remains scarce. We investigated the association of carotid atherosclerosis as a marker of generalized cardiovascular disease with hearing loss in a population-based cohort.DesignCross-sectional.SettingA population-based cohort study.Participants3724 participants [mean age: 65.5 years, standard deviation (SD): 7.5, 55.4% female].MethodsUltrasound and pure-tone audiograms to assess carotid atherosclerosis and hearing loss.ResultsWe investigated associations of carotid plaque burden and carotid intima-media thickness (IMT) (overall and side-specific carotid atherosclerosis) with hearing loss (in the best hearing ear and side-specific hearing loss) using multivariable linear and ordinal regression models. We found that higher maximum IMT was related to poorer hearing in the best hearing ear [difference in decibel hearing level per 1-mm increase in IMT: 2.09 dB, 95% confidence interval (CI): 0.08, 4.10]. Additionally, third and fourth quartile plaque burden as compared to first quartile was related to poorer hearing in the best hearing ear (difference: 1.06 dB, 95% CI: 0.04, 2.08; and difference: 1.55 dB, 95% CI: 0.49, 2.60, respectively). Larger IMT (difference: 2.97 dB, 95% CI: 0.79, 5.14), third quartile plaque burden compared to first quartile (difference: 1.24 dB, 95% CI: 0.14, 2.35), and fourth plaque quartile compared to first quartile (difference: 2.12 dB, 95% CI: 0.98, 3.26) in the right carotid were associated with poorer hearing in the right ear.Conclusions and ImplicationsCarotid atherosclerosis is associated with poorer hearing in older adults, almost exclusively with poorer hearing in the right ear. Based on our results, it seems that current therapies for the prevention of cardiovascular disease may also prove beneficial for hearing loss in older adults by promoting and maintaining inner ear health.     

Circulating Tregs correlate with viral load reduction in chronic HBV-treated patients with tenofovir disoproxil fumarate

Limited response to current hepatitis B virus (HBV) drugs is possibly due to inadequate host cytotoxic cellular responses. Circulating Tregs have been shown to be associated with chronicity of HBV infection, but their profile during antiviral therapy has not been studied. We analyzed the frequency and effect of Tregs on cellular immune responses against HBV in 35 chronic hepatitis B eAg−ve and eAg+ve patients treated with tenofovir 300 mg/day. Frequency of Tregs and their modulatory role in cytokine-secreting cells were determined after stimulation with HBsAg or HBcAg in the absence or presence of Tregs and after blockage of PD-1/PDL-1 in peripheral blood mononuclear cells (PBMCs). Prior to therapy, eAg−ve patients had lower HBV DNA levels, reduced CD8 T cells, increased Tregs, and T cells expressing PD1. After 12 weeks of therapy, >2 log HBV viral reduction was observed in both groups, along with an increase frequencies of CD8 T cells in eAg−ve patients and increased expression of chemokine receptors/Toll-like receptors in both groups. PD-1 expression on CD8 cells in PBMCs was decreased in both groups during therapy but not on Tregs. In eAg–ve group, sustained increase of Tregs was observed till week 12, which declined at week 24. In both groups, after 24 weeks, depletion of CD4⁺CD25⁺ Tregs from PBMCs enhanced HBV-specific T cell responses, and blockage of PD-1/PDL1 pathway did enhance pro-inflammatory cytokine production in eAg+ve patients but not in eAg−ve. We conclude that Tregs induced by HBV replication in vivo are expanded in eAg−ve patients more. Reduction in HBV DNA by tenofovir partially restored adaptive immune responses and also reduced the Tregs. Blockage of PD-1/PDL1, enhanced cytokine production in eAg+ve patients but not in eAg−ve, suggests that distinctly different immunologic mechanisms are involved in eAg+ve and eAg−ve patients.     

Protective effects of histamine H3-receptor ligands in schizophrenic behaviors in experimental models

Schizophrenia (SCZ) afflicts around 1% of the world's population with characteristic symptoms such as hallucinations, delusions, and cognitive disorders. Several experimental studies in the past have indicted brain histaminergic neuronal system involvement in the pathogenesis of psychotic disorders including SCZ. Present study investigates anti-schizophrenic activity using two histamine H(3)-receptor (H(3)R)-antagonists/inverse agonists, ciproxifan (3.0 mg/kg, i.p.) and clobenpropit (15 mg/kg, i.p.), on some of the established animal model of schizophrenia, for example, amphetamine (AMPH) and dizocilpine (MK-801)-induced hyperactivity, apomorphine (APO)-induced climbing behavior, scopolamine and MK-801-induced learning and memory deficits and haloperidol-induced catalepsy including determination of acetylcholinesterase (AChE) activity. Results of the present study demonstrate that ciproxifan and clobenpropitwere able to control AMPH and MK-801-induced hyperlocomotor activities demonstrated as reduced horizontal activity and reduced number of movements made by rats. Further, there was overall reduction in APO-induced climbing behavior. Learning and memory deficits, as evaluated on elevated plus maze, followed by estimation of brain AChE activity demonstrated positive results with these protypical imidazole H(3)R-antagonists/inverse agonists.     

Salmonella enterica Serovar Typhi-Specific Immunoglobulin A Antibody Responses in Plasma and Antibody in Lymphocyte Supernatant Specimens in Bangladeshi Patients with Suspected Typhoid Fever

Many currently available diagnostic tests for typhoid fever lack sensitivity and/or specificity, especially in areas of the world where the disease is endemic. In order to identify a diagnostic test that better correlates with typhoid fever, we evaluated immune responses to Salmonella enterica serovar Typhi (serovar Typhi) in individuals with suspected typhoid fever in Dhaka, Bangladesh. We enrolled 112 individuals with suspected typhoid fever, cultured day 0 blood for serovar Typhi organisms, and performed Widal assays on days 0, 5, and 20. We harvested peripheral blood lymphocytes and analyzed antibody levels in supernatants collected on days 0, 5, and 20 (using an antibody-in-lymphocyte-supernatant [ALS] assay), as well as in plasma on these days. We measured ALS reactivity to a serovar Typhi membrane preparation (MP), a formalin-inactivated whole-cell preparation, and serovar Typhi lipopolysaccharide. We measured responses in healthy Bangladeshi, as well as in Bangladeshi febrile patients with confirmed dengue fever or leptospirosis. We categorized suspected typhoid fever individuals into different groups (groups I to V) based on blood culture results, Widal titer, and clinical features. Responses to MP antigen in the immunoglobulin A isotype were detectable at the time of presentation in the plasma of 81% of patients. The ALS assay, however, tested positive in all patients with documented or highly suspicious typhoid, suggesting that such a response could be the basis of improved diagnostic point-of-care-assay for serovar Typhi infection. It can be important for use in epidemiological studies, as well as in difficult cases involving fevers of unknown origin.Salmonella enterica serovar Typhi (serovar Typhi) is the cause of typhoid fever, an illness that affects over 20,000,000 individuals worldwide each year, killing over 200,000 (5, 8, 16). The largest burden of typhoid fever is borne by impoverished individuals in resource-poor areas of the world. Serovar Typhi is a human-restricted invasive enteric pathogen which, after ingestion, crosses the intestinal mucosa, is taken up by gut-associated lymphoreticular tissues, and enters the systemic circulation. Both mucosal and systemic host immune responses are stimulated after infection. Serovar Typhi is an intracellular pathogen, and antibody and cell-mediated immune responses occur after infection or immunization with live oral attenuated typhoid vaccines (10, 25, 34).Diagnostic tests for typhoid fever often lack sensitivity and/or specificity, especially in areas of the world that are endemic for typhoid fever, where clinically distinguishing typhoid fever from other febrile illnesses is difficult (5, 17, 39). Microbiologic culturing of blood is approximately 30 to 70% sensitive, with the highest sensitivity being associated with an absence of prior use of antibiotics and the culturing of larger volumes of blood, features that complicate this mode of diagnosis in young children (5, 6, 8, 36). Microbiologic culturing of bone marrow aspirates is more sensitive than blood but often clinically impractical (1, 11, 12). Serum Widal assay titers are often nonspecific in endemic settings and are of limited value unless titers are markedly elevated or are analyzed for changes from acute to convalescent phases of illness (18, 33, 38). Molecular diagnostic assays including PCR are promising, but issues of practicality, contamination, and quality control have limited their use in many resource-poor areas of the world (14).Since serovar Typhi interacts with both the mucosal and the systemic immune systems, we were interested to determine whether analyses of mucosal immune responses would give improved insight into this human-restricted infection. Activated mucosal lymphocytes migrate from intestinal tissue and circulate within peripheral blood before rehoming to mucosal tissues (20, 31). This migration peaks 1 to 2 weeks after intestinal infection and may be measured by using peripheral blood mononuclear cells (PBMC) in an antibody-secreting cell (ASC) assay (19, 26) or in supernatants recovered from harvested PBMC (the “antibody in lymphocyte supernatant” [ALS] assay) (7, 31). Although ALS and ASC responses have previously been measured after immunization with oral live attenuated typhoid vaccines, detailed analyses of ALS or ASC responses in individuals with wild-type typhoid fever are lacking (21, 24). In order to gain further insight into mucosal immune responses during wild-type serovar Typhi infection, we undertook a study to characterize the serum and ALS responses to serovar Typhi among individuals with suspected typhoid fever in Bangladesh.     

Effects of the antifouling agent tributyltin on the sinking behavior,photosynthetic rate and biochemical composition of the marine planktonic diatom Thalassiosira pseudonana

This study investigated the changes in the sinking rates and physiochemical characteristics of the planktonic marine diatom, Thalassiosira pseudonana, caused by 72?h exposure to antifouling agent tributyltin (TBT) at 1.0?µg?L^?1 (72-h 10% effective concentration for growth rate, EC10), and 1.7?µg?L^?1 (EC50). After 72?h of exposure, the sinking rates of T. pseudonana cells were changed from 0.13–0.08?m day^?1 in the control, 0.08–0.05?m day^?1 in the EC10 treatment, and 0.04–0.006?m day^?1 in the EC50 treatment. The results revealed that the sinking rate of T. pseudonana decreased significantly compared with the control at 48?h in the EC10 treatment group and at 24, 48, and 72?h in the EC50 treatment group. The photosynthetic performance index on an absorption basis and the maximum quantum yields of photosystem II also decreased significantly (P?<?0.05) in the TBT treatments compared with the control. There was a significant (P?<?0.05) positive correlation between sinking rates and cellular protein contents (ng cell^?1). Changes in the biochemical and physiochemical composition of the cells suggest that interference with photosynthetic processes by TBT may have reduced their specific gravity and thereby caused a decrease in the sinking rates of T. pseudonana. The results of this investigation suggest the importance of considering the effects of pollutants on the sinking behaviors of diatoms when evaluating the adverse effects of pollutants on marine primary production.

     

Earning Their Keep: The Productivity of Older Women and Men in Rural Bangladesh

In Bangladesh, being active and able to participate in productive activities is often essential to ensure ongoing health and survival. This study aims to describe and explore the patterns of participation in productive activities by older people in Matlab, a rural area of Bangladesh. Data from a cross sectional survey of people over 60 years of age was utilised. Six hundred and twenty five men and women participated in home based interviews providing information about their participation in productive activities including work, domestic activities and community groups. Overall, 94.4% of subjects reported participation in at least one productive activity. Men were the main participants in paid work and community groups, with 62% reporting engagement in paid work and 44% contributing to community groups. Both men (95.4%) and women (91.9%) reported performing at least one domestic activity. Performance of higher numbers of domestic tasks was associated with being younger, female, not requiring any assistance with self care, not married, not living with any children and earning between 100–999 Bangladesh Taka in the past month. Participation in community groups was low with only 26% of the sample reporting any involvement. This study indicates a high level of productivity in the older population in Matlab which benefits the individual, the family and the wider community. The safety and suitability of typical productive activities needs further investigation, in order to inform strategies protecting the older population from the effects of over work and harmful activities.     

Haversian cortical bone model with many radial microcracks: an elastic analytic solution

In this study, the fracture micromechanics of Haversian cortical bone has been considered. To this effect, a two-dimensional micromechanical fibre-ceramic matrix composite tissue materials model has been presented. The interstitial tissue was modeled as a matrix and the osteon was modeled as a fibre, followed by the application of linear elastic fracture mechanics theory. The solution for edge dislocations, in terms of Green's functions, was adopted to formulate a system of singular integral equations for the radial microcracks in the matrix in vicinity of the osteon. The problem was solved for various configurations and the corresponding stress intensity factors were computed. The results of this study indicated that the interaction between microcracks and an osteon was limited to vicinity of the osteon. Furthermore, the effect of microstructure morphology and heterogeneity on the fracture behavior has been established. The interactions between microcracks were also analyzed for various configurations. These selected configurations exhibited the effects of stress amplification and stress shielding.     

Weight management practices and their relationship to knowledge, perception and health status of Saudi females attending diet clinics in Riyadh city

The objective of the study was to identify weight management (WM) practices among women attending diet clinics in Riyadh city, assess their impact on knowledge, perceptions, nutritional and health status and define some predictors for weight reduction among these women. The pretest-posttest research design was used. All female clients attending 8 diet clinics for the first visit within 8 months period and fulfilling the study inclusion criteria (212 out of 263) were included. The results show that out of 170 females who had previously tried to lose weight, only 32.4% reported success in reducing weight, meanwhile 61.7% reported weight regain. The mean total score of dietary practices, physical activity score, self efficacy and satisfaction of self-body image were improved significantly at posttest. Analysis of 24 h. dietary recall revealed that total energy and nutrients intake were significantly reduced at posttest. Dieting related problems increased significantly at posttest. Nutritional knowledge was at moderately fair level at both pretest and posttest; however it showed a significant improvement in the posttest. Perceived severity, perceived barriers and negative modeling effect were significantly decreased at the posttest. Over expectation for weight reduction was clearly evident as posttest body mass index (BMI) revealed a wide discrepancy between the expected and final weights. However, as compared to initial and final BMI, there was an increase in women who attained normal weight and a decrease in the percentage of obese and morbid obese women. All anthropometric indices, blood pressure, biochemical investigation showed significant improvement at posttest. Among the five WM modalities studied, moderate hypo-calorie plan diet modality was the longest (chi = 5.6 month) with the least weight loss (7.8%) and the minimum side effects. Both groups under very low calorie diet and protein diet had the highest weight reduction (13.2% &12.3%), at the same time both diets exhibited the highest number of side effects. The study recommends use of the primary approach for achieving weight loss through therapeutic life style change with banning those modalities accompanied with serious health complications.     

Feasibility of a first responder programme in rural Bangladesh

Objectives

To develop and implement a first responder training programme, assess the feasibility of training lay persons with low literacy in rural Bangladesh and determine the acceptability of the programme in the community.

Methods

A first responder training programme including cardiopulmonary resuscitation (CPR) was developed covering 20 villages in a rural sub-district in north-central Bangladesh. 2398 participants received training and 2120 graduated over a 14-month period. Responders were a mix of adolescents, community volunteers and community elders. The programme was evaluated through post-training assessment of knowledge and skills of participants and performance evaluation of trainers. A focus group discussion was used to assess the response of community leaders to usefulness and community acceptance of the programme.

Results

Materials developed for training include a low-literacy training manual, posters and a training video. Almost 90 per cent (88.4) of participants qualified in post training assessment. Adolescents and community volunteers had higher pass rates than community elders. In all, CPR skills showed a significant decline over 9 months of assessment, while first aid knowledge appeared stable over the same period. Community leaders considered the programme useful for the community and expressed their support for the programme.

Conclusion

Developing a first responder training programme that includes CPR in a rural Bangladesh community is feasible if participants have secondary school attainment. Adolescents and young adults are suitable candidates. Evaluation is ongoing to see whether the programme graduates were able to reduce morbidity and mortality through effective first response efforts.