Challenges and prospects in the public health research system in the occupied Palestinian territory: a qualitative study

Background

A public health research system is the bedrock of health systems to improve population health, system responsiveness, and equity. An international concern, referred to as the 10/90 gap, is that less than 10% of global funds are devoted to diseases or conditions that account for 90% of the global disease burden, particularly in developing countries. Palestinian health research is progressing, but it is not sufficiently investigated, with a remarkable knowledge gap on its conceptualisation, stewardship, stakeholders, and capacity and resources. The aim of this study was to understand the Palestinian public health research system by investigating challenges related to the system components that need to be strengthened.

Laboratory and field trials at Ifakara (Kilombero District, Tanzania) on the plant molluscicide Swartzia madagascariensis

The molluscicidal activity of crushed seed pods of Swartzia madagascariensis was assessed by laboratory and field trials. Mature dry seed pods were ground and extracted in tap water for 24 h. Water extracts exerted a significant molluscicidal activity against Bulinus globosus up to dilutions of 100 mg of ground pods per litre. The chromatographically isolated saponin (1) responsible for the molluscicidal activity showed a toxicity of LC 100 at 3 mg/l after exposure of B. globosus and Biomphalaria glabrata for 24 h. Saponin (1) could be identified by FAB-MS and 13C-NMR-spectroscopy as oleanolic acid-3-O-beta-D-glucuronopyranosyl (1----3)-alpha-L-rhamnopyranoside. Two field trials with S. madagascariensis pod extracts in ponds (60 and 160 m3) harbouring dense populations of B. globosus compared well with the laboratory findings and showed the efficiency of the molluscicide in a natural habitat. A single application of the plant molluscicide significantly reduced the populations of B. globusus. The toxicity of S. madagascariensis pod extracts to non-target organisms remains an obstacle for its use in certain situations where schistosomiasis control is envisaged and where S. madagascariensis is found. However, S. madagascariensis is a valid candidate molluscicide which may be applied in selected epidemiological settings as part of integrated schistosomiasis control measures.     

Functional expression of the Chlorella hexose transporter in Schizosaccharomyces pombe

Schizosaccharomyces pombe cells were transformed with an S. pombe expression vector containing a full-length cDNA of the Chlorella hexose transporter. The transformed cells accumulated 3-O-methylglucose up to 10-fold, whereas wild-type S. pombe and control transformants could only equilibrate this sugar analogue. In a pH-jump experiment, in which extracellular pH was lowered by 1.9 units, the accumulation ratio was increased in transformed cells but not in control cells. This result indicates that the gene product, Chlorella H+/glucose-symporter protein, and a pH gradient suffice for active sugar uptake. Km values for glucose, 6-deoxyglucose, and 3-O-methylglucose of 1.5 x 10(-5) M, 2.7 x 10(-4) M, and 1.0 x 10(-3) M, respectively, were identical in Chlorella and in S. pombe cells transformed with Chlorella cDNA and approximately 100-fold lower than those of the endogenous transport system of S. pombe.     

Specificity of human immunodeficiency virus (LAV/HTLV-III)-reactive antibodies in African sera from southeastern Tanzania

The prevalence of antibodies to human immunodeficiency virus (HIV = LAV/HTLV-III) in a rural population from the Ifakara area in southeastern Tanzania was investigated. Sera from 286 individuals collected from 1982 to 1984 in connection with a study on liver disorders were tested by an ELISA. Fifty-two (18.2%) of the sera were found positive. While the positives were largely confirmed by one commercial ELISA, they were completely negative by two others. Confirmatory testing by Western blot and competition Western blot showed that the reactivity detected by more sensitive of these assays was largely due to IgG antibodies binding to the HIV core (gag) proteins p17, its precursor p55 and, in some cases, p24. These tests also indicated, however, that the reactive antibodies could not have been elicited by HIV, but possibly by an unknown retrovirus or another cross-reactive agent. Thus, by 1984, the area investigated was largely free of HIV infection, but a significant proportion of its population may harbor another retrovirus of unknown pathogenicity.     

Mitral annular calcification in the elderly – Quantitative assessment

PurposeTo determine the reliability of subjective and objective quantification of mitral annular calcification (MAC) in elderly patients with severe aortic stenosis, to define quantitative sex- and age-related reference values of MAC, and to correlate quantitative MAC with mitral valve disease.MethodsIn this retrospective, IRB-approved study, we included 559 patients (268 females, median age 81 years, inter-quartile range 77–85 years) with severe aortic stenosis undergoing CT. Four independent readers performed subjective MAC categorization as follows: no, mild, moderate, and severe MAC. Two independent readers performed quantitative evaluation of MAC using the Agatston score method (Agatston_MAC). Mitral valve disease was determined by echocardiography.ResultsSubjective MAC categorization showed high inter-reader agreement for no (k ?= ?0.88) and severe MAC (k ?= ?0.75), whereas agreement for moderate (k ?= ?0.59) and mild (k ?= ?0.45) MAC was moderate. Intra-reader agreement for subjective MAC categorization was substantial (k ?= ?0.69 and 0.62). Inter- and intra-reader agreement for Agatston_MAC were excellent (ICC ?= ?0.998 and 0.999, respectively), with minor inconsistencies in MAC involving the left ventricular outflow tract/aortic valve. There were significantly more women than men with MAC (n ?= ?227, 85% versus n ?= ?209, 72%; p ?< ?0.001), with a significantly higher Agatston_MAC (median 597, range 81–2055 versus median 244; range 0–1565; p ?< ?0.001), particularly in patients ≥85 years of age. Agatston_MAC showed an area-under-the-curve of 0.84 to diagnose mitral stenosis, whereas there was no association of Agatston_MAC with mitral regurgitation (p ?> ?0.05).ConclusionsOur study in elderly patients with severe aortic stenosis shows that quantitative MAC scoring is more reliable than subjective MAC assessment. Women show higher Agatston_MAC scores than men, particularly in the elderly population. Agatston_MAC shows high accuracy to diagnose mitral stenosis.     

A note on the bone age at which patients with true isolated growth hormone deficiency enter puberty.

Nineteen boys with true isolated growth hormone deficiency developed the first stages of puberty at an average bone age of 12.0"years" (Tanner Whitehouse Method 2, RUS score). The average chronological age was 15.0 years. Seven similar girls entered puberty at 10.9"years" in bone age and 13.7 years in chronological age. The means and ranges of bone age at beginning of puberty of these patients are very close to those of normal children.