Injury-related mortality among adolescents: findings from a teaching hospital's post mortem data

<p>Abstract</p> <p>Background</p> <p>Injuries are noted to be an important cause of death among adolescents. There is however limited data on the injury related deaths among adolescents in Ghana.</p> <p>Findings</p> <p>Using data from post-mortem records derived from the Department of Pathology of the Korle-Bu Teaching Hospital (KBTH), Accra Ghana from 2001 to 2003, the causes of injury related deaths among adolescents 10 to 19 years were analyzed by gender and age groups 10 to 14 and 15 to 19 years. There were 151 injury-related deaths constituting 17% of the autopsies performed among adolescents in the study period. The male-to-female ratio was 2.1:1. Drowning was the most common cause of death (37%) in the study population. This was followed by road traffic accidents (RTA) (33%). Over 70% of the RTA victims were pedestrians knocked downed by a vehicle. Deaths from electrocution, poisoning, burns, stab/gunshot, hanging and other miscellaneous causes (example blast injury, traumatic injury from falling debris, fall from height) made up the remaining 30% of the injury related mortality. Among males and in both age categories, drowning was the leading cause of death. In females, the highest mortality was from road traffic accidents accounting for almost half (49%) of the deaths; significantly more than that occurring in males (25%, p = .004).</p> <p>Conclusions</p> <p>Findings from Korle-Bu Teaching Hospital post-mortem data on adolescents show that drowning and road traffic accidents are the leading causes of injury-related mortality. Appropriate injury reducing interventions are needed to facilitate a decrease in these preventable deaths.</p

Childhood trauma fatality and resource allocation in injury control programs in a developing country

BACKGROUND: Only a few studies have addressed the trimodal distribution of childhood trauma fatalities in lesser developed countries. We conducted this study to evaluate pre-hospital, Emergency Department (ED) and in-hospital distribution of childhood injury-related death for each mechanism of injury in Tehran, Iran. This information will be used for the efficient allocation of the limited injury control resources in the city. METHODS: We used Tehran's Legal Medicine Organization (LMO) database. This is the largest and the most complete database that receives information about trauma fatalities from more than 100 small and large hospitals in Tehran. We reviewed all the medical records and legal documents of the deceased registered in LMO from September 1999 to September 2000. Demographic and injury related characteristics of the children 15 years old or younger were extracted from the records. RESULTS: Ten percent of the 4,233 trauma deaths registered in LMO occurred among children 15 years old or younger. Motor vehicle crashes (MVCs) (50%), burns (18%), falls (6%) and poisonings (6%) were the most common mechanisms of unintentional fatal injuries. Prehospital, emergency department and hospital deaths comprised 42%, 20% and 37% of the trauma fatalities, respectively. While, more than 80% of fatal injuries due to poisoning and drowning occurred in prehospital setting, 92% of burn-related fatalities happened after hospital admission. CONCLUSION: Injury prevention is the single most important solution for controlling trauma fatalities due to poisoning and drowning. Improvements in the quality of care in hospitals and intensive care units might substantially alleviate the magnitude of the problem due to burns. Improvements in prehospital and ED care might significantly decrease MVC and falls-related fatalities

Leptin-signaling inhibition results in efficient anti-tumor activity in estrogen receptor positive or negative breast cancer

Introduction: We have shown previously that treatment with pegylated leptin peptide receptor antagonist 2 (PEG-LPrA2) reduced the expression of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor type 2 (VEGFR2) and growth of 4T1-breast cancer (BC) in syngeneic mice. In this investigation, PEG-LPrA2 was used to evaluate whether the inhibition of leptin signaling has differential impact on the expression of pro-angiogenic and pro-proliferative molecules and growth of human estrogen receptor-positive (ER+) and estrogen receptor-negative (ER-) BC xenografts hosted by immunodeficient mice. Methods: To test the contribution of leptin signaling to BC growth and expression of leptin-targeted molecules, PEG-LPrA2 treatment was applied to severe immunodeficient mice hosting established ER+ (MCF-7 cells; ovariectomized/supplemented with estradiol) and ER- (MDA-MB231 cells) BC xenografts. To further assess leptin and PEG-LPrA2 effects on ER+ and ER- BC, the expression of VEGF and VEGFR2 (protein and mRNA) was investigated in cell cultures. Results: PEG-LPrA2 more effectively reduced the growth of ER+ (>40-fold) than ER- BC (twofold) and expression of pro-angiogenic (VEGF/VEGFR2, leptin/leptin receptor OB-R, and IL-1 receptor type I) and pro-proliferative molecules (proliferating cell nuclear antigen and cyclin D1) in ER+ than in ER- BC. Mouse tumor stroma in ER+ BC expressed high levels of VEGF and leptin that was induced by leptin signaling. Leptin upregulated the transcriptional expression of VEGF/VEGFR2 in MCF-7 and MDA-MB231 cells. Conclusions: These results suggest that leptin signaling plays an important role in the growth of both ER+ and ER- BC that is associated with the leptin regulation of pro-angiogenic and pro-proliferative molecules. These data provide support for the potential use of leptin-signaling inhibition as a novel treatment for ER+ and ER- BC

Beyond humanization and de-immunization: tolerization as a method for reducing the immunogenicity of biologics

Immune responses to some monoclonal antibodies (mAbs) and biologic proteins interfere with their efficacy due to the development of anti-drug antibodies (ADA). In the case of mAbs, most ADA target ‘foreign’ sequences present in the complementarity determining regions (CDRs). Humanization of the mAb sequence is one approach that has been used to render biologics less foreign to the human immune system. However, fully human mAbs can also drive immunogenicity. De-immunization (removing epitopes) has been used to reduce biologic protein immunogenicity. Here, we discuss a third approach to reducing the immunogenicity of biologics: introduction of Treg epitopes that stimulate Treg function and induce tolerance to the biologic protein. Supplementing humanization (replacing xenosequences with human) and de-immunization (reducing T effector epitopes) with tolerization (introducing Treg epitopes) where feasible, as a means of improving biologics ‘quality by design’, may lead to the development of ever more clinically effective, but less immunogenic, biologics

Massless geodesics in AdS5×Y(p,q)AdS_5\times Y(p,q) as a superintegrable system

A Carter like constant for the geodesic motion in the $Y(p,q)$ Einstein-Sasaki geometries is presented. This constant is functionally independent with respect to the five known constants for the geometry. Since the geometry is five dimensional and the number of independent constants of motion is at least six, the geodesic equations are superintegrable. We point out that this result applies to the configuration of massless geodesic in $AdS_5\times Y(p,q)$ studied by Benvenuti and Kruczenski, which are matched to long BPS operators in the dual N=1 supersymmetric gauge theory.Comment: 20 pages, no figures. Small misprint is corrected in the Killing-Yano tensor. No change in any result or conclusion

Effect of cathodic hydrogen charging on the wear behavior of 5754 Al alloy

This research work is focused on investigating the effect of hydrogen uptake on the structural and tribological properties of 5754 Al alloy. The aim is to understand the synergism between hydrogen uptake and wear. In particular, hydrogen was incorporated into the surface via galvanostatic polarization in a 3 M HCl aqueous solution. The incorporation of hydrogen into the surface layers of that alloy and for the selected charging conditions, led to blistering. Aluminum hydrides were not detected by X-ray diffraction in the hydrogen charged samples, but the hydrogen content in the surface layers was quantified by elastic recoil detection analysis. A hardening of surface layers after hydrogen incorporation was observed. The sliding wear resistance of that alloy against an alumina countermaterial was found to vary considerably, depending on the hydrogen charging conditions, the synergetic effect between hydrogen charging and friction, and the formation of a tribolayer at the contacting interface.status: publishe

Abstract P5-09-08: Information needs and Internet use of breast cancer patients in Mexico

Abstract Introduction: Information seeking is critical for the decision making of individuals undergoing cancer diagnosis and treatment. The information needs of breast cancer (BC) patients and whether they use online resources to obtain it are largely unknown, particularly in developing countries with scarce educational resources and poor Internet access. Additionally, the influence of age on the use of online BC resources has not been explored. In this study, we aim to describe the information needs of BC patients in Mexico, and to analyze the difference in such needs between age groups. Patients and Methods: A cross-sectional survey was conducted from March to May 2015 amongst women with BC undergoing treatment or follow-up at the National Cancer Institute in Mexico City. Demographic data (age, place of residence, occupation and level of education), Internet use and access (e-mail, social networks, tablet and/or smartphone use) and need of information sources (printed and online materials) were collected. Patients were asked which particular aspects of BC they would like to see highlighted in online educational resources. Patients were divided into three age groups (≤ 40 years [y], 41-64 y and ≥ 65 y). Chi-square test was used for comparison between group characteristics, and Student's t test to detect differences in information needs between groups. Results: 325 patients were invited, 15 refused to answer and 310 provided completed surveys. Median age was 47 y (19-87), 220 (72.6%) were housewives, and 181 (58.4%) had less than undergraduate education. 163 (52.6%) had Internet access, 139 (45%) had e-mail, 133 (43%) had a social network profile and 178 (57.6%) owned a smartphone/tablet. Regarding information needs, 94.5% (n = 241) believed printed materials should be available, while 93.2% (n = 287) thought online resources would be useful and 78% (n = 241) expressed the desire to have an online forum with other patients. Women ≤ 40 y were more likely to have Internet access (p &amp;lt; 0.0001), e-mail account (p &amp;lt; 0.0001), social network profiles (p &amp;lt; 0.0001) and tablets/smartphones (p &amp;lt; 0.0001). Although there was no difference in the perceived need for printed materials between age groups (p = 0.26), women ≥ 65 y were less likely to believe online resources would be useful (90.8 vs. 97.3%; p = 0.01). 21.6% (n = 67) of patients mentioned diet and exercise as the most important aspect they would like to see in a website, followed by survivorship (19.7%; n = 61), and treatment (14.5%; n = 45). Women ≤ 40 y were significantly more interested in learning about the adverse effects of treatment than their older counterparts (12.4 vs. 3%; p &amp;lt; 0.001). There was no difference between age groups regarding other aspects of perceived information needs. Conclusions: Despite having a poor educational background and low rates of Internet access, almost all the surveyed women were interested in obtaining online BC information, regardless of age. Perceived information needs and preferences do not differ greatly between age groups, although young women are more likely to want information about adverse effects. Supplying patients with appropriate and accessible online educational resources addressing their information needs is essential, and healthcare providers should strive to accomplish this goal. Citation Format: Villarreal-Garza C, Platas A, Bargalló-Rocha JE, Aguilar-González CN, Ortega-Leonard LV, Martínez-Cannon BA, Ramos-Elías P, Soto-Perez-de-Celis E. Information needs and Internet use of breast cancer patients in Mexico. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-09-08.</jats:p

Metabolic engineering of Escherichia coli for enhanced arginine biosynthesis

BACKGROUND: Arginine is a high-value product, especially for the pharmaceutical industry. Growing demand for environmental-friendly and traceable products have stressed the need for microbial production of this amino acid. Therefore, the aim of this study was to improve arginine production in Escherichia coli by metabolic engineering and to establish a fermentation process in 1-L bioreactor scale to evaluate the different mutants. RESULTS: Firstly, argR (encoding an arginine responsive repressor protein), speC, speF (encoding ornithine decarboxylases) and adiA (encoding an arginine decarboxylase) were knocked out and the feedback-resistant argA214 or argA215 were introduced into the strain. Three glutamate independent mutants were assessed in bioreactors. Unlike the parent strain, which did not excrete any arginine during glucose fermentation, the constructs produced between 1.94 and 3.03 g/L arginine. Next, wild type argA was deleted and the gene copy number of argA214 was raised, resulting in a slight increase in arginine production (4.11 g/L) but causing most of the carbon flow to be redirected toward acetate. The V216A mutation in argP (transcriptional regulator of argO, which encodes for an arginine exporter) was identified as a potential candidate for improved arginine production. The combination of multicopy of argP216 or argO and argA214 led to nearly 2-fold and 3-fold increase in arginine production, respectively, and a reduction of acetate formation. CONCLUSIONS: In this study, E. coli was successfully engineered for enhanced arginine production. The ∆adiA, ∆speC, ∆speF, ∆argR, ∆argA mutant with high gene copy number of argA214 and argO produced 11.64 g/L of arginine in batch fermentation, thereby demonstrating the potential of E. coli as an industrial producer of arginine