Free health care for under-fives, expectant and recent mothers? Evaluating the impact of Sierra Leone's free health care initiative.

This study evaluates the impact of Sierra Leone's 2010 Free Health Care Initiative (FHCI). It uses two nationally representative surveys to identify the impact of the policy on utilisation of maternal care services by pregnant women and recent mothers as well as the impact on curative health care services and out-of-pocket payments for consultation and prescription in children under the age of 5 years. A Regression Discontinuity Design (RDD) is applied in the case of young children and a before-after estimation approach, adjusted for time trends in the case of expectant and recent mothers. Our results suggest that children affected by the FHCI have a lower probability of incurring any health expenditure in public, non-governmental and missionary health facilities. However, a proportion of eligible children are observed to incur some health expenditure in participating facilities with no impact of the policy on the level of out-of-pocket health expenditure. Similarly, no impact is observed with the utilisation of services in these facilities. Utilisation of informal care is observed to be higher among non-eligible children while in expectant and recent mothers, we find substantial but possibly transient increases in the use of key maternal health care services in public facilities following the implementation of the FHCI. The diminishing impact on utilisation mirrors experience in other countries that have implemented free health care initiatives and demonstrates the need for greater domestic and international efforts to ensure that resources are sufficient to meet increasing demand and monitor the long run impact of these policies

Induction of Heme Oxygenase-1, Biliverdin Reductase and H-Ferritin in Lung Macrophage in Smokers with Primary Spontaneous Pneumothorax: Role of HIF-1α

Few data concern the pathophysiology of primary spontaneous pneumothorax (PSP), which is associated with alveolar hypoxia/reoxygenation. This study tested the hypothesis that PSP is associated with oxidative stress in lung macrophages. We analysed expression of the oxidative stress marker 4-HNE; the antioxidant and anti-inflammatory proteins heme oxygenase-1 (HO-1), biliverdin reductase (BVR) and heavy chain of ferritin (H-ferritin); and the transcription factors controlling their expression Nrf2 and HIF-1alpha, in lung samples from smoker and nonsmoker patients with PSP (PSP-S and PSP-NS), cigarette smoke being a risk factor of recurrence of the disease.mRNA was assessed by RT-PCR and proteins by western blot, immunohistochemistry and confocal laser analysis. 4-HNE, HO-1, BVR and H-ferritin were increased in macrophages from PSP-S as compared to PSP-NS and controls (C). HO-1 increase was associated with increased expression of HIF-1alpha mRNA and protein in alveolar macrophages in PSP-S patients, whereas Nrf2 was not modified. To understand the regulation of HO-1, BVR and H-ferritin, THP-1 macrophages were exposed to conditions mimicking conditions in C, PSP-S and PSP-NS patients: cigarette smoke condensate (CS) or air exposure followed or not by hypoxia/reoxygenation. Silencing RNA experiments confirmed that HIF-1alpha nuclear translocation was responsible for HO-1, BVR and H-ferritin induction mediated by CS and hypoxia/reoxygenation.PSP in smokers is associated with lung macrophage oxidative stress. The response to this condition involves HIF-1alpha-mediated induction of HO-1, BVR and H-ferritin

The Synergistic Effect of Concomitant Schistosomiasis, Hookworm, and Trichuris Infections on Children's Anemia Burden

Polyparasitic infections have been recognized as the norm in many tropical developing countries, but the significance of this phenomenon for helminth-associated morbidities is largely unexplored. Earlier studies have suggested that multi-species, low-intensity parasitic infections were associated with higher odds of anemia among school-age children relative to their uninfected counterparts or those with one low-intensity infection. However, specific studies of the nature of interactions between helminth species in the mediation of helminth-associated morbidities are lacking. This study quantifies the extent to which polyparasitic infections have more than the sum of adverse effects associated with individual infections in the context of childhood anemia. This study found that the risk of anemia is amplified beyond the sum of risks for individual infections in children simultaneously exposed to 1) hookworm and schistosomiasis, and 2) hookworm and trichuris, and suggests that combined treatment for some geohelminth species and schistosomiasis could yield greater than additive benefits for the reduction of childhood anemia in helminth-endemic areas. However, more studies to understand the full range of interactions between parasitic species in their joint effects on helminth-associated morbidities will be necessary to better predict the impact of any future public health intervention

A rare loss-of-function variant of ADAM17 is associated with late-onset familial Alzheimer disease

Common variants of about 20 genes contributing to AD risk have so far been identified through genome-wide association studies (GWAS). However, there is still a large proportion of heritability that might be explained by rare but functionally important variants. One of the so far identified genes with rare AD causing variants is ADAM10. Using whole-genome sequencing we now identified a single rare nonsynonymous variant (SNV) rs142946965 [p.R215I] in ADAM17 co-segregating with an autosomal-dominant pattern of late-onset AD in one family. Subsequent genotyping and analysis of available whole-exome sequencing data of additional case/control samples from Germany, UK, and USA identified five variant carriers among AD patients only. The mutation inhibits pro-protein cleavage and the formation of the active enzyme, thus leading to loss-of-function of ADAM17 alpha-secretase. Further, we identified a strong negative correlation between ADAM17 and APP gene expression in human brain and present in vitro evidence that ADAM17 negatively controls the expression of APP. As a consequence, p.R215I mutation of ADAM17 leads to elevated Aß formation in vitro. Together our data supports a causative association of the identified ADAM17 variant in the pathogenesis of AD

Euclid: Early Release Observations of ram-pressure stripping in the Perseus cluster: Detection of parsec-scale star formation within the low surface brightness stripped tails of UGC 2665 and MCG +07-07-070

\ua9 2025 EDP Sciences. All rights reserved.Euclid is delivering optical and near-infrared imaging data over 14 000 deg2 on the sky at spatial resolution and surface brightness levels that can be used to understand the morphological transformation of galaxies within groups and clusters. Using the Early Release Observations (ERO) of the Perseus cluster, we demonstrate the capability offered by Euclid in studying the nature of perturbations for galaxies in clusters. Filamentary structures are observed along the discs of two spiral galaxies, UGC 2665 and MCG +07-07-070, with no extended diffuse emission expected from tidal interactions at surface brightness levels of a30 mag arcseca 2. The detected features exhibit a good correspondence in morphology between optical and near-infrared wavelengths, with a surface brightness of a25 mag arcseca 2, and the knots within the features have sizes of a 100 pc, as observed through IE imaging. Using the Euclid, CFHT, UVIT, and LOFAR 144 MHz radio continuum observations, we conducted a detailed analysis to understand the origin of the detected features. We constructed the Euclid IEaYE, YEaHE, and CFHT u ar, g ai colour-colour plane and show that these features contain recent star formation events, which are also indicated by their Hα and NUV emissions. Euclid colours alone are insufficient for studying stellar population ages in unresolved star-forming regions, which require multi-wavelength optical imaging data. There are features with red colours that can be explained by dust being stripped along with the gas in these regions. The morphological shape, orientation, and mean age of the stellar population, combined with the presence of extended radio continuum cometary tails can be consistently explained if these features formed during a recent ram-pressure stripping event. This result further confirms the exceptional qualities of Euclid in the study of galaxy evolution in dense environments

<em>Euclid</em>: the potential of slitless infrared spectroscopy: a z = 5.4 quasar and new ultracool dwarfs

\ua9 2025 The Author(s). We demonstrate the potential of Euclid \u27s slitless spectroscopy to discover high-redshift (5$]]&gt;) quasars and their main photometric contaminant, ultracool dwarfs. Sensitive infrared spectroscopy from space is able to efficiently identify both populations, as demonstrated by Euclid Near-Infrared Spectrometer and Photometer Red Grism (NISP) spectra of the newly discovered quasar EUCL J181530.01652054.0, as well as several ultracool dwarfs in the Euclid Deep Field North and the Euclid Early Release Observation field Abell 2764. The ultracool dwarfs were identified by cross-correlating their spectra with templates. The quasar was identified by its strong and broad and emission lines in the NISP 1206-1892 nm spectrum, and confirmed through optical spectroscopy from the Large Binocular Telescope. The NISP Blue Grism (NISP) 926-1366 nm spectrum confirms and emission. NISP can find bright quasars at and, redshift ranges that are challenging for photometric selection due to contamination from ultracool dwarfs. EUCL J181530.01652054.0 is a high-excitation, broad absorption line quasar detected at 144 MHz by the LOw-Frequency Array (W Hz). The quasar has a bolometric luminosity of and is powered by a black hole. The discovery of this bright quasar is noteworthy as fewer than one such object was expected in the 20 deg surveyed. This finding highlights the potential and effectiveness of NISP spectroscopy in identifying rare, luminous high-redshift quasars, previewing the census of these sources that Euclid\u27s slitless spectroscopy will deliver over about deg of the sky