Socio-economic status, urbanization, and cardiometabolic risk factors among middle-aged adults in Tanzania

OBJECTIVE

This study was conducted to examine the associations between socioeconomic status, urbanization, and cardio-metabolic risk factors in Tanzania.

METHODS

Participants were 209 adults (45-66 years) in Dar es Salaam, Tanzania. A structured questionnaire was used to evaluate socioeconomic status and behavioral characteristics, including income, education, occupation, residence (urban, rural, mixed), dietary factors, and smoking. Blood samples were collected and analyzed to measure lipid profiles and fasting glucose levels. Cardiometabolic risk factors were defined using World Health Organization criteria.

RESULTS

Urban residence and higher socioeconomic status were associated with decreased intake of traditional staple food (ugali), and increased consumption of meat products and beverages. Higher socioeconomic status was associated with a significant 3.5-kg/m2 higher BMI (p = 0.0001) and 8 cm higher waist circumference (p < 0.001), and a three-fold increase in the risk of obesity. Urban residence was associated with poorer lipid profile, including significantly higher total cholesterol, increased LDL cholesterol, but lower triglycerides, compared to rural residence. The prevalence of metabolic syndrome was high (38%), and was associated with increased socioeconomic status.

CONCLUSION

Urban residence and higher socioeconomic status were important correlates of cardiometabolic risk factors, including obesity and poorer lipid profile. Primary prevention and health screening strategies are needed to target cardiometabolic risk factors in urban areas, to reduce the burden of cardiovascular disease in Tanzania.

Clinically driven design of multi-scale cancer models: the ContraCancrum project paradigm

The challenge of modelling cancer presents a major opportunity to improve our ability to reduce mortality from malignant neoplasms, improve treatments and meet the demands associated with the individualization of care needs. This is the central motivation behind the ContraCancrum project. By developing integrated multi-scale cancer models, ContraCancrum is expected to contribute to the advancement of in silico oncology through the optimization of cancer treatment in the patient-individualized context by simulating the response to various therapeutic regimens. The aim of the present paper is to describe a novel paradigm for designing clinically driven multi-scale cancer modelling by bringing together basic science and information technology modules. In addition, the integration of the multi-scale tumour modelling components has led to novel concepts of personalized clinical decision support in the context of predictive oncology, as is also discussed in the paper. Since clinical adaptation is an inelastic prerequisite, a long-term clinical adaptation procedure of the models has been initiated for two tumour types, namely non-small cell lung cancer and glioblastoma multiforme; its current status is briefly summarized.

Effect of sputtering power on structure, adhesion strength and corrosion resistance of nitrogen doped diamond-like carbon thin films

Nitrogen doped diamond-like carbon (DLC:N) thin films were deposited on highly conductive p-Si substrates using a DC magnetron sputtering deposition system. The DLC:N films were characterized using X-ray photoelectron spectroscopy (XPS), micro-Raman spectroscopy, atomic force microscopy (AFM), contact angle measurement and micro-scratch test. The XPS and Raman results indicated that the sputtering power significantly influenced the properties of the films in terms of bonding configuration in the films. The corrosion performance of the DLC:N films was investigated in a 0.6 M NaCl solution by means of potentiodynamic polarization testing. It was found that the corrosion performance of the films could be enhanced by higher sputtering powers.

Effect of working pressure on corrosion behavior of nitrogen doped diamond-like carbon thin films deposited by DC magnetron sputtering

Nitrogen doped diamond-like carbon thin films were deposited on highly conductive p-silicon(100) substrates using a DC magnetron sputtering deposition system by varying working pressure in the deposition chamber. The bonding structure, adhesion strength, surface roughness and corrosion behavior of the films were investigated by using X-ray photoelectron spectroscopy, micro-Raman spectroscopy, micro-scratch test, atomic force microscopy and potentiodynamic polarization test. A 0.6 M NaCl electrolytic solution was used for the corrosion tests. The optimum corrosion resistance of the films was found at a working pressure of 7 mTorr at which a good balance between the kinetics of the sputtered ions and the surface mobility of the adatoms promoted a microstructure of the films with fewer porosities.

Cytotoxic T lymphocyte antigen 4 immunoglobulin modified dendritic cells attenuate allergic airway inflammation and hyperresponsiveness by regulating the development of T helper type 1 (Th1)/Th2 and Th2/regulatory T cell subsets in a murine model of asthma

T helper type 2 (Th2) and regulatory T cells (T(reg) ) have been postulated to have critical roles in the pathogenesis of allergic asthma. Cytotoxic T lymphocyte antigen 4 immunoglobulin (CTLA4Ig) gene-modified dendritic cells (DC-CTLA4Ig) have the potential to reduce Th2 cells and induce T(reg) cells. In the present study, we evaluated the therapeutic effects and potential mechanisms of the adoptive transfer of DC-CTLA4Ig into mice in an experimental model of asthma. BALB/c mice were sensitized with ovalbumin (OVA) and challenged with aerosolized OVA for 7 days. Just prior to the first challenge, DC-CTLA4Ig, DCs or DCs infected with DC-green fluorescent protein (GFP) were injected intravenously into mice. The administration of DC-CTLA4Ig reduced airway hyperresponsiveness, relieved asthmatic airway inflammation and decreased the numbers of esosinophils in the BALF in OVA-sensitized/challenged mice. In addition, DC-CTLA4Ig altered the balance of Th1/Th2 cytokine production in the lungs with increased interferon (IFN)-γ levels and decreased interleukin (IL)-4 levels, decreased the percentage of Th2 and increased both the percentage of Th1 and T(reg) cells in the lungs of OVA-sensitized/challenged mice. This research demonstrates that DC-CTL4Ig reduces airway hyperresponsiveness effectively and prevents airway inflammation in OVA-sensitized/challenged mice, which is due most probably to attenuated secretion of Th2 cytokines and increased secretion of Th1 cytokines in the local airway, and the correction of the pulmonary imbalance between Th1/Th2 cells and Th2/T(reg) cells.

SBRT outcomes for primary and metastatic liver lesions

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Background: Stereotactic body radiation therapy (SBRT) permits precise delivery of 1-5 high doses of radiation to liver tumors with low risk of toxicity. This study aims to evaluate local control and overall survival (OS) in patients treated with SBRT for primary and metastatic liver lesions.

Methods: From 2006 to 2010, 62 patients with 106 liver lesions (71 metastatic, 35 primary) were treated with SBRT. Lesions were most commonly from primary hepatocellular carcinoma (29%), or colorectal (23%), breast (8%), or esophageal metastases (8%). Patients were heavily pretreated: 51% received ≥1 prior form of liver-directed therapy and 54% received ≥1 prior systemic therapy regimen. The number of active hepatic lesions at the time of SBRT was 1 in 49%, 2 in 23%, 3 in 22%, and ≥4 in 7%. Of the metastatic lesions, 42% were accompanied by active extrahepatic disease. Of the primary liver lesions, 69% were Child-Pugh class A, 26% class B, and 6% class C. Median gross tumor volume (GTV) was 8.8 cm3 (range 0.2-222.4). Median biological equivalent prescription dose (BED10) was 100 Gy (42.6-180). The majority of patients received either 3 or 5 fractions (47% and 48%, respectively).

Results: Median follow-up for all lesions was 18 months (4.6-46.8). Local tumor control was observed in 92/106 treated lesions with 1- and 2-yr local control rates of 88% and 74%. No correlation was found between local control and lesion type (primary vs metastatic), lesion size, or prior liver directed therapy. Median survival for all patients was 25.2 months, with 1- and 2-year OS of 81% and 52%. Survival was longer among patients with metastatic lesions compared to primary lesions (2-yr OS 63% vs 29%, HR 0.46, p=0.02). The number of active hepatic lesions was an independent prognostic factor for survival (HR 1.77, p=0.002). For patients with metastatic liver lesions, the presence of active extrahepatic disease yielded significantly worse survival (2-yr OS 37% vs 83%). Among HCC patients, a lower CLIP score was associated with improved survival with 2-yr OS of 55% for CLIP score 0, 44% for score 1, 17% for score 2, and 0% for score 3. No patients experienced RILD.

Conclusions: Treatment of liver tumors with SBRT provides excellent local control, necessitating further improvements in systemic therapy.

No significant financial relationships to disclose.

Treatment with peginterferon versus interferon in Chinese patients with chronic hepatitis C

Higher sustained virological response (SVR) rates after treating with peginterferon than after treating with interferon have been obtained in some randomized clinical trials (RCTs) in Chinese patients with chronic hepatitis C (CHC). However, the numbers of patients included in these clinical trials were too small to draw a clear conclusion. Therefore, a new meta-analysis including a large number of patients was needed to compare peginterferon with interferon in the treatment of Chinese CHC patients. A search of Medline, the China National Knowledge Infrastructure, the Wanfang Database, and the China Biomedical Database for relevant articles published between 1966 and 2009 was performed. RCTs comparing the use of peginterferon and interferon for the treatment of Chinese patients with CHC were assessed. Of the 236 studies screened, 18 RCTs including 1,148 patients (659 treated with peginterferon therapy and 489 treated with interferon therapy) were analyzed. The total SVR rates obtained in patients treated with peginterferon were significantly higher than those obtained in patients treated with interferon (64% vs. 40%; relative risk, 1.56; 95% confidence interval: 1.28-1.91; p < 0.01), but the difference between the peginterferon α-2b and interferon α-2b treatments was not significant. Withdrawal rates were similar between patients treated with peginterferon and interferon. Chinese patients with CHC have a greater likelihood of achieving an SVR with peginterferon α-2a.

Frameshift and novel mutations in FUS in familial amyotrophic lateral sclerosis and ALS/dementia

OBJECTIVE

Amyotrophic lateral sclerosis (ALS) is a progressive paralytic disorder caused by degeneration of motor neurons. Mutations in the FUS gene were identified in patients with familial ALS (FALS) and patients with sporadic ALS (SALS) from a variety of genetic backgrounds. This work further explores the spectrum of FUS mutations in patients with FALS and patients with FALS with features of frontotemporal dementia (FALS/FTD) or parkinsonism and dementia (FALS/PD/DE).

METHODS

All exons of the FUS gene were sequenced in 476 FALS index cases negative for mutations in SOD1 and TARDBP. A total of 561-726 controls were analyzed for genetic variants observed. Clinical data from patients with FUS mutations were compared to those of patients with known SOD1 and TARDBP mutations.

RESULTS

We identified 17 FUS mutations in 22 FALS families, 2 FALS/FTD families, and 1 FALS/PD/DE family from diverse genetic backgrounds; 11 mutations were novel. There were 4 frameshift, 1 nonsense, and 1 possible alternate splicing mutation. Patients with FUS mutations appeared to have earlier symptom onset, a higher rate of bulbar onset, and shorter duration of symptoms than those with SOD1 mutations.

CONCLUSIONS

FUS gene mutations are not an uncommon cause in patients with FALS from diverse genetic backgrounds, and have a prevalence of 5.6% in non-SOD1 and non-TARDBP FALS, and approximately 4.79% in all FALS. The pathogenicity of some of these novel mutations awaits further studies. Patients with FUS mutations manifest earlier symptom onset, a higher rate of bulbar onset, and shorter duration of symptoms.

Corrosion behavior of aluminum doped diamond-like carbon thin films in NaCl aqueous solution

Aluminum doped diamond-like carbon (DLC:Al) thin films were deposited on n-Si(100) substrates by co-sputtering a graphite target under a fixed DC power (650 W) and an aluminum target under varying DC power (10-90 W) at room temperature. The structure, adhesion strength and surface morphology of the DLC:Al films were characterized by X-ray photoelectron spectroscopy (XPS), micro-scratch testing and atomic force microscopy (AFM), respectively. The corrosion performance of the DLC:Al films was investigated by means of potentiodynamic polarization testing in a 0.6 M NaCl aqueous solution. The results showed that the polarization resistance of the DLC:Al films increased from about 18 to 30.7 k(omega) though the corrosion potentials of the films shifted to more negative values with increased Al content in the films.

Structure, adhesive strength and electrochemical performance of nitrogen doped diamond-like carbon thin films deposited via DC magnetron sputtering

Nitrogen doped diamond-like carbon (DLC:N) thin films were deposited on p-Si (100) substrates by DC magnetron sputtering with different nitrogen flow rates at a substrate temperature of about 100 degrees C. The chemical bonding structure of the films was characterized by X-ray photoelectron spectroscopy (XPS) and micro-Raman spectroscopy. The adhesive strength and surface morphology of the films were studied using micro-scratch tester and scanning electron microscope (SEM), respectively. The electrochemical performance of the films was evaluated by potentiodynamic polarization testing and linear sweep voltammetry. The electrolytes used for the electrochemical tests were deaerated and unstirred 0.47 M KCl aqueous solution for potentiodynamic polarization testing and 0.2 M KOH and 0.1 M KCl solutions for voltammetric analysis. It was found that the DLC:N films could well passivate the underlying substrates though the corrosion resistance of the films decreased with increased nitrogen content in the films. The DLC:N films showed wide potential windows in the KOH solution, in which the detection ability of the DLC:N films to trace lead of about 1 x 10(-3) M Pb(2+) was also tested.

A practical method for quantifying atherosclerotic lesions in rabbits

The rabbit has been widely used for the study of human atherosclerosis; however, the method for analysis of the atherosclerotic lesions has not been standardized between laboratories. The present study reports a practical method for quantifying the changes that occur in aortic atherosclerosis of rabbits. Male Japanese white rabbits were fed with either a standard chow or a diet containing 10% fat and 0.3% cholesterol for 16 weeks. Plasma concentrations of glucose, insulin, total cholesterol, triglycerides and high-density lipoprotein were measured. Aortic atherosclerotic lesions were assessed in quantitative fashion using an image analysis system that measured (1) the gross area of the entire aorta affected by atherosclerosis as defined by Sudan IV staining, (2) the microscopical intimal lesion defined by the elastic van Gieson stain and (3) the infiltration of macrophages and smooth muscle cell proliferation as determined immunohistochemically. The rabbits developed severe aortic atherosclerosis without apparent abnormality of glucose metabolism. The quantitative method described here will be useful for the further investigation of atherosclerosis in rabbits.

A phase 2 multiple ascending dose trial of bapineuzumab in mild to moderate Alzheimer disease

BACKGROUND

Bapineuzumab, a humanized anti-amyloid-beta (Abeta) monoclonal antibody for the potential treatment of Alzheimer disease (AD), was evaluated in a multiple ascending dose, safety, and efficacy study in mild to moderate AD.

METHODS

The study enrolled 234 patients, randomly assigned to IV bapineuzumab or placebo in 4 dose cohorts (0.15, 0.5, 1.0, or 2.0 mg/kg). Patients received 6 infusions, 13 weeks apart, with final assessments at week 78. The prespecified primary efficacy analysis in the modified intent-to-treat population assumed linear decline and compared treatment differences within dose cohorts on the Alzheimer's Disease Assessment Scale-Cognitive and Disability Assessment for Dementia. Exploratory analyses combined dose cohorts and did not assume a specific pattern of decline.

RESULTS

No significant differences were found in the primary efficacy analysis. Exploratory analyses showed potential treatment differences (p < 0.05, unadjusted for multiple comparisons) on cognitive and functional endpoints in study "completers" and APOE epsilon4 noncarriers. Reversible vasogenic edema, detected on brain MRI in 12/124 (9.7%) bapineuzumab-treated patients, was more frequent in higher dose groups and APOE epsilon4 carriers. Six vasogenic edema patients were asymptomatic; 6 experienced transient symptoms.

CONCLUSIONS

Primary efficacy outcomes in this phase 2 trial were not significant. Potential treatment differences in the exploratory analyses support further investigation of bapineuzumab in phase 3 with special attention to APOE epsilon4 carrier status.

CLASSIFICATION OF EVIDENCE

Due to varying doses and a lack of statistical precision, this Class II ascending dose trial provides insufficient evidence to support or refute a benefit of bapineuzumab.