Meta‐analysis: Association between hepatitis B virus preS mutation and hepatocellular carcinoma risk

Previous observational studies suggested that hepatitis B virus (HBV) preS mutation plays an important role in the existence of HBV‐related hepatocellular carcinoma (HCC). However, the results are still debatable. With an increasing number of studies about this topic, this study employed a meta‐analysis to identify the association between HBV preS mutation and HCC risk. We searched for eligible studies from PubMed, ProQuest, CINAHL, ScienceDirect and Springer databases to assess the association between HBV mutation and HCC risk. This meta‐analysis was conducted using RevMan 5.3 to provide pooled estimate for odds ratio (ORs) with 95% confidence intervals (95% CIs). Twenty‐one clinical studies were included in this meta‐analysis study which consisted of 1738 participants with HBV‐related HCC and 3740 HBsAg‐positive patients without HCC. All studies used samples of Asian population. PreS deletion was the most common mutation found in all studies. We found that ORs of HBV overall preS deletion was associated with HCC (OR = 3.28; 95% CI = 2.32‐4.65; P < .00001; random‐effects model). Each preS1 and preS2 deletion was associated with increased risk of HCC, with OR 2.42 (95% CI = 1.25‐4.68, P = .008) and 3.36 (95% CI = 2.04‐5.55, P < .00001), respectively. PreS2 start codon mutation was also significantly associated with HCC risk (OR = 2.47; 95% CI: 1.15‐5.27; P = .02; random‐effect model). The result of this meta‐analysis suggested that HBV preS deletion (all, preS1 and preS2) and preS2 start codon mutation might contribute to the increased risk of HBV‐related HCC.     

Health literacy of people living with HIV in a rural area in Indonesia: A cross-sectional study

Indonesia, the fourth most populated country in the world, has experienced a fivefold increase in Human Immunodeficiency Virus (HIV)-infected individuals since 2001. Little is known about health literacy in people living with HIV (PLHIV) in Indonesia. This study aimed to determine the level of health literacy among PLHIV in Indonesia and assess associations between sociodemographic variables, beliefs about medicines, stigma and health literacy. We conducted a cross-sectional study using questionnaires in PLHIV in Papua, Indonesia. The short version of the Test of Functional Health Literacy in Adults (S-TOFHLA), Beliefs about Medicines Questionnaire (BMQ) and HIV stigma scale as well as questions on demographic information were completed by the participants from two hospitals in Papua, Indonesia. In a multivariate logistic regression analysis, we assessed the association between sociodemographic variables, stigma, beliefs about medicine and low health literacy. Overall, 331 participants were included, 62.0% female, 67.0% Papuans. A total of 38.5% of participants had low health literacy. PLHIV with multi-dose regimen were less likely to have low health literacy than those taking a fixed-dose combination (OR = 0.51; 95%CI = 0.32–0.82). PLHIV who had social support in medicine-taking were more likely to have low health literacy (OR = 1.78; 95%CI = 1.07–2.97). More awareness about medication overuse (OR = 1.17; 95%CI = 1.06–1.29) and medication harm (OR = 1.10; 95%CI = 1.01–1.20) were also associated with having low health literacy. Overall, interventions targeting health literacy may be a promising strategy to improve self-management.     

冷冻保护剂对牛精子功能和渗透压的影响

本文验证了一个假设：在精子中添加和去除冷冻保护剂可能导致精子的调节容量减少,渗透物质损失,精子功能降低。不进行冷冻和解冻的情况下,常用的冷冻保护剂可以降低培养基中牛精子的总活力和前进运动力,降低精子通过宫颈粘液的能力,破坏精子头膜,并导致精子尾巴卷曲。如果在很多小的步骤中而非仅在一个步骤中添加和去除冷冻保护剂,可适当保护精子的功能。特定的冷冻保护剂能降低细胞内的左旋肉碱和谷氨酸的浓度,而不是肌醇和山梨醇的浓度。在多步中添加或者去除冷冻保护剂比在一步中进行好,因为粘液的渗透依赖于精子中原始细胞内左旋肉碱和谷氨酸的总量。总之,在多步中添加或者去除丙三醇和丙二醇可以最好地保持精子的质量。因为丙三醇和丙二醇与降低的细胞内谷氨酸浓度有关。在牛精子中,谷氨酸看来可以调控冷冻保护剂导致的细胞膨胀。     

A large vaccine-derived poliovirus outbreak on Madura Island--Indonesia, 2005

Between June and October 2005, 45 laboratory-confirmed type 1 vaccine-derived poliovirus (VDPV) cases were identified on Madura Island in Indonesia. Genetic sequencing data on VDPV isolates were consistent with replication and circulation for up to approximately 2 years. Concurrent circulation with type 1 wild poliovirus (WPV) enabled comparisons of VDPV and WPV cases and found that clinical and epidemiological features of both were similar. Attack rates for VDPV were as high as those for WPV. Of 41 VDPV case patients with known vaccination status, 25 (61%) had received zero oral polio vaccine (OPV) doses. Low population immunity due to low routine OPV coverage in rural areas and the absence of WPV circulation for more than a decade were major predisposing factors for the emergence of VDPV. Suboptimal surveillance and a limited initial immunization response may have contributed to widespread circulation. Sensitive surveillance and prompt high-quality immunization responses are recommended to prevent the spread of VDPVs.     

Combined intensive nutrition education and micronutrient powder supplementation improved nutritional status of mildly wasted children on Nias Island, Indonesia

To assess the impact of intensive nutrition education (INE) with or without the provision of micronutrient powder (MNP) on the nutritional status of mildly wasted children in Nias, Indonesia, two groups of mildly wasted (>=-1.5 to <-1.0 WHZ) children aged >=6 to <60 months in the Church World Service (CWS) project areas were assigned by village randomization to receive INE (n=64) or INE+MNP (n=51) in a weekly program. Another two groups of mildly wasted children who were living at a clear distance from INE and INE+MNP villages were selected to receive a monthly non-intensive nutrition education program (NNE) with or without MNP (n=50 both respectively). WHZ, weight, height, haemoglobin (Hb) level, and morbidity data were assessed at admission, during the study, and at individual discharge. Children's weight gain (g/kg body weight/day) was highest in INE+MNP group (2.2±2.1), followed by INE (1.1±0.9), NNE+MNP (0.3±0.5) and NNE (0.3±0.4) group. In both MNP intervention groups (INE+MNP, NNE+MNP), supplements significantly increased Hb value (g/L) of respective children (10.0±10.0; p<0.001 and 3.0±8.0; p<0.05 respectively). Proportion of children who reached discharge criterion was highest among the INE+MNP (70.6%; n=36), followed by INE (64.1%; n=41), NNE+MNP (26.0%; n=13), and NNE (20.0%; n=10) groups (p<0.001). Shortest length of stay until recovery was observed among children in the INE+MNP group (29.9 days), followed by INE (40.0 days), NNE+MNP (80.6 days), and NNE (86.2 days) respectively (p<0.001). Weekly intensive nutrition education supported by MNP supplementation produced the best results regarding weight gain and haemoglobin status of mildly wasted children.