Y-STR profiling in two Afghanistan populations

Afghanistan's unique geostrategic position in Eurasia has historically attracted commerce, conflict and conquest to the region. It was also an important stop along the Silk Road, connecting the far eastern civilizations with the western world. Nevertheless, limited genetic studies have been performed in Afghan populations. In this study, 17 Y-chromosomal short tandem repeat (Y-STR) loci were typed to evaluate their forensic and population genetic applications in 189 unrelated Afghan males geographically partitioned along the Hindu Kush Mountain range into north (N=44) and south (N=145) populations. North Afghanistan (0.9734, 0.9905) exhibits higher haplotype diversity than south Afghanistan (0.9408, 0.9813) at both the minimal 9-loci and 17-loci Yfiler haplotypes, respectively. The overall haplotype diversity for both Afghan populations at 17 Y-STR loci is 0.9850 and the corresponding value for the minimal 9-loci haplotypes is 0.9487. A query using of the most frequent Afghan Yfiler haplotype (7.98%) against the worldwide Y-STR haplotype reference database (YHRD) returned no profile match, indicating a high power of discrimination with 17 Y-STR loci. A median-joining network based on 15 Y-STR loci displays limited haplotype sharing between the two Afghan populations, possibly due to the Hindu Kush Mountain range serving as a natural barrier to gene flow between the two regions.     

Early outcome in renal transplantation from large donors to small and size-matched recipients - a porcine experimental model

Kidney transplantation from a large donor to a small recipient, as in pediatric transplantation, is associated with an increased risk of thrombosis and DGF. We established a porcine model for renal transplantation from an adult donor to a small or size-matched recipient with a high risk of DGF and studied GFR, RPP using MRI, and markers of kidney injury within 10 h after transplantation. After induction of BD, kidneys were removed from ～63-kg donors and kept in cold storage for ～22 h until transplanted into small (～15 kg, n = 8) or size-matched (n = 8) recipients. A reduction in GFR was observed in small recipients within 60 min after reperfusion. Interestingly, this was associated with a significant reduction in medullary RPP, while there was no significant change in the size-matched recipients. No difference was observed in urinary NGAL excretion between the groups. A significant higher level of HO-1 mRNA was observed in small recipients than in donors and size-matched recipients indicating cortical injury. Improvement in early graft perfusion may be a goal to improve short- and long-term GFR and avoid graft thrombosis in pediatric recipients.     

Human rabies post exposure prophylaxis in Bhutan, 2005-2008: trends and risk factors

The aim of this study was to understand the use and distribution of human rabies post exposure prophylaxis (PEP) vaccine in Bhutan and to identify risk factors for receiving an incomplete course of the vaccine. We analyzed post exposure treatment records from 28 medical hospitals from 2005 to 2008. Males (59%) accounted for significantly more PEP events than females (41%) across all age groups (P < 0.001). Children - particularly 5-9 years of age - received more rabies PEP than other age groups. Animal bite and non-bite accounted for 27% (n = 2239) and 16% (n = 1303) of rabies PEP, respectively, whilst 57% (n = 4773) of the PEP events had no recorded information about the reasons for post exposure treatment. Post exposure treatment was provided throughout the year with a higher number during the winter and spring months. The number of PEP events significantly (P < 0.001) increased between 2005 and 2008, from <1000 to >2800 events, respectively. Significantly (P < 0.001) more PEP events were reported from the southern parts of Bhutan that are endemic for rabies or those areas in eastern Bhutan that have reported rabies outbreaks than other parts of Bhutan. Forty percent (n = 3360) of the patients received an incomplete course of vaccine (<5-doses of vaccine intramuscular). Results suggest that patients with animal bite injury were less likely to receive an incomplete vaccine course than non-bite recipients, and patients presented to hospitals in rabies endemic or outbreak areas were less likely to receive an incomplete course than in non-rabies areas or rabies free areas. Similarly, patients presenting to hospitals for PEP during spring and summers months were less likely to receive an incomplete vaccine course than those during other seasons. Public education campaigns need to be conducted in Bhutan to reduce dog bite incidents and also to prevent mass exposures to rabies. A thorough assessment of each individual case based on the WHO guidelines would reduce unnecessary PEP (and therefore costs) in Bhutan.     

西藏居民卫生服务可及性影响因素及对策研究

文章借助第四次国家卫生服务调查数据,分析影响西藏居民卫生服务可及性的因素,进而提出相应建议。     

Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress

Meditation practices may impact physiological pathways that are modulated by stress and relevant to disease. While much attention has been paid to meditation practices that emphasize calming the mind, improving focused attention, or developing mindfulness, less is known about meditation practices that foster compassion. Accordingly, the current study examined the effect of compassion meditation on innate immune, neuroendocrine and behavioral responses to psychosocial stress and evaluated the degree to which engagement in meditation practice influenced stress reactivity. Sixty-one healthy adults were randomized to 6 weeks of training in compassion meditation (n=33) or participation in a health discussion control group (n=28) followed by exposure to a standardized laboratory stressor (Trier social stress test [TSST]). Physiologic and behavioral responses to the TSST were determined by repeated assessments of plasma concentrations of interleukin (IL)-6 and cortisol as well as total distress scores on the Profile of Mood States (POMS). No main effect of group assignment on TSST responses was found for IL-6, cortisol or POMS scores. However, within the meditation group, increased meditation practice was correlated with decreased TSST-induced IL-6 (r(p)=-0.46, p=0.008) and POMS distress scores (r(p)=-0.43, p=0.014). Moreover, individuals with meditation practice times above the median exhibited lower TSST-induced IL-6 and POMS distress scores compared to individuals below the median, who did not differ from controls. These data suggest that engagement in compassion meditation may reduce stress-induced immune and behavioral responses, although future studies are required to determine whether individuals who engage in compassion meditation techniques are more likely to exhibit reduced stress reactivity.     

Reemergence of rabies in Chhukha district, Bhutan, 2008

From January through July 2008, rabies reemerged in the Chhukha district of southwestern Bhutan. To clarify the distribution and direction of spread of this outbreak, we mapped reported cases and conducted directional tests (mean center and standard deviational ellipse). The outbreak resulted in the death of 97 animals (42 cattle, 52 dogs, and 3 horses). Antirabies vaccine was given free of charge to ≈674 persons suspected to have been exposed. The outbreak spread south to north and appeared to follow road networks, towns, and areas of high human density associated with a large, free-roaming, dog population. The outbreak was controlled by culling free-roaming dogs. To prevent spread into the interior of Bhutan, a well-coordinated national rabies control program should be implemented in disease-endemic areas.     

Geographical distribution of the incidence of gastric cancer in Bhutan

AIM: To estimate the prevalence of gastric cancer(GC) in a cohort of patients diagnosed with GC and to compare it with patients diagnosed with all other types of gastro-intestinal(GI) cancer during the same period.METHODS: Between 2008 and 2013,five-year period,the medical records of all GI cancer patients who underwent medical care and confirm diagnosis of cancer were reviewed at the National Referral Hospital,Thimphu which is the only hospital in the country where surgical and cancer diagnosis can be made. Demographic information,type of cancer,and the year of diagnosis were collected.RESULTS: There were a total of 767 GI related cancer records reviewed during the study period of which 354(46%) patients were diagnosed with GC. There were 413 patients with other GI cancer including; esophagus,colon,liver,rectum,pancreas,gall bladder,cholangiocarcinoma and other GI tract cancers. The GC incidence rate is approximately 0.9/10000 per year(367 cases/5years per 800000 people). The geographic distribution of GC was the lowest in the south region of Bhutan 0.3/10000 per year compared to the central region 1.4/10000 per year,Eastern region 1.2/10000 per year,and the Western region 1.1/10000 per year. Moreover,GC in the South part was significantly lower than the other GI cancer in the same region(8% vs 15%; OR = 1.8,95%CI: 1.3-3.1,P = 0.05). Among GC patients,38% were under the age of 60 years,mean age at diagnosis was 62.3(± 12.1) years with male-to-female ratio 1:0.5. The mean age among patients with all other type GI cancer was 60 years(± 13.2) and male-tofemale ratio of 1:0.7. At time of diagnosis of GC,342(93%) were at stage 3 and 4 of and by the year 2013; 80(23%) GC patients died compared to 31% death among patients with the all other GI cancer(P = 0.08).CONCLUSION: The incidence rate of GC in Bhutan is twice as high in the United States but is likely an underestimate rate because of unreported and undiagnosed cases in the villages. The high incidence of GC in Bhutan could be attributed to the high prevalence of Helicobacter pylori infection that we previously reported. The lowest incidence of GC in Southern part of the country could be due to the difference in the ethnicity as most of its population is of Indian and Nepal origin. Our current study emphasizes on the importance for developing surveillance and prevention strategies for GC in Bhutan.     

Precision Public Health and Structural Racism in the United States: Promoting Health Equity in the COVID-19 Pandemic Response

The COVID-19 pandemic has revealed deeply entrenched structural inequalities that resulted in an excess of mortality and morbidity in certain racial and ethnic groups in the United States. Therefore, this paper examines from the US perspective how structural racism and defective data collection on racial and ethnic minorities can negatively influence the development of precision public health (PPH) approaches to tackle the ongoing COVID-19 pandemic. Importantly, the effects of structural and data racism on the development of fair and inclusive data-driven components of PPH interventions are discussed, such as with the use of machine learning algorithms to predict public health risks. The objective of this viewpoint is thus to inform public health policymaking with regard to the development of ethically sound PPH interventions against COVID-19. Particular attention is given to components of structural racism (eg, hospital segregation, implicit and organizational bias, digital divide, and sociopolitical influences) that are likely to hinder such approaches from achieving their social justice and health equity goals.