| 1. |
- Aydin, Osman, et al.
(author)
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EU FP7 INFSO-ICT-317669 METIS, D 4.1 Summary on preliminary trade-off investigations and first set of potential network-level solutions
- 2013
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Reports (other academic/artistic)abstract
- METIS WP4 covers research activities in network-level aspects of the advancement of wireless network technologies towards the year 2020 and beyond. The aim is to develop novel network-level technology concepts to address the challenges foreseen in future scenarios with regard to interference, traffic and mobility management issues. Moreover, another task of this work package is to propose functional enablers which can support the above potential solutions.This document provides* a report of the ongoing progress in WP4 regarding the research topics agreed upon in IR 4.1,* a high level description of the proposed concepts and approaches adopted by different partners.More specifically, the document describes, first set of potential network-level solutions and presents some first research results in order to position them with regards to the state of the art approaches. It also gives an overview of research activities to be considered later in WP4.
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| 2. |
- Aydin, Osman, et al.
(author)
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EU FP7 INFSO-ICT-317669 METIS, D4.2 Final report on trade-off investigations
- 2014
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Reports (other academic/artistic)abstract
- Research activities in METIS WP4 include several aspects related to the network-level of future wireless communication networks. Thereby, a large variety of scenarios is considered and solutions are proposed to serve the needs envisioned for the year 2020 and beyond. This document provides vital findings about several trade-offs that need to be leveraged when designing future network-level solutions. In more detail, it elaborates on the following trade-offs:• Complexity vs. Performance improvement• Centralized vs. Decentralized• Long time-scale vs. Short time-scale• Information Interflow vs. Throughput/Mobility enhancement• Energy Efficiency vs. Network Coverage and CapacityOutlining the advantages and disadvantages in each trade-off, this document serves as a guideline for the application of different network-level solutions in different situations and therefore greatly assists in the design of future communication network architectures.
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| 3. |
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| 4. |
- Carraminana, Albert, et al.
(author)
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Rationale and Study Design for an Individualized Perioperative Open Lung Ventilatory Strategy in Patients on One-Lung Ventilation (iPROVE-OLV)
- 2019
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In: Journal of Cardiothoracic and Vascular Anesthesia. - : W B SAUNDERS CO-ELSEVIER INC. - 1053-0770 .- 1532-8422. ; 33:9, s. 2492-2502
-
Journal article (peer-reviewed)abstract
- Objective: The aim of this clinical trial is to examine whether it is possible to reduce postoperative complications using an individualized perioperative ventilatory strategy versus using a standard lung-protective ventilation strategy in patients scheduled for thoracic surgery requiring one-lung ventilation. Design: International, multicenter, prospective, randomized controlled clinical trial. Setting: A network of university hospitals. Participants: The study comprises 1,380 patients scheduled for thoracic surgery. Interventions: The individualized group will receive intraoperative recruitment maneuvers followed by individualized positive end-expiratory pressure (open lung approach) during the intraoperative period plus postoperative ventilatory support with high-flow nasal cannula, whereas the control group will be managed with conventional lung-protective ventilation. Measurements and Main Results: Individual and total number of postoperative complications, including atelectasis, pneumothorax, pleural effusion, pneumonia, acute lung injury; unplanned readmission and reintubation; length of stay and death in the critical care unit and in the hospital will be analyzed for both groups. The authors hypothesize that the intraoperative application of an open lung approach followed by an individual indication of high-flow nasal cannula in the postoperative period will reduce pulmonary complications and length of hospital stay in high-risk surgical patients. (C) 2019 Published by Elsevier Inc.
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| 5. |
- Clark, Andrew G., et al.
(author)
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Evolution of genes and genomes on the Drosophila phylogeny
- 2007
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In: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 450:7167, s. 203-218
-
Journal article (peer-reviewed)abstract
- Comparative analysis of multiple genomes in a phylogenetic framework dramatically improves the precision and sensitivity of evolutionary inference, producing more robust results than single-genome analyses can provide. The genomes of 12 Drosophila species, ten of which are presented here for the first time (sechellia, simulans, yakuba, erecta, ananassae, persimilis, willistoni, mojavensis, virilis and grimshawi), illustrate how rates and patterns of sequence divergence across taxa can illuminate evolutionary processes on a genomic scale. These genome sequences augment the formidable genetic tools that have made Drosophila melanogaster a pre-eminent model for animal genetics, and will further catalyse fundamental research on mechanisms of development, cell biology, genetics, disease, neurobiology, behaviour, physiology and evolution. Despite remarkable similarities among these Drosophila species, we identified many putatively non-neutral changes in protein-coding genes, non-coding RNA genes, and cis-regulatory regions. These may prove to underlie differences in the ecology and behaviour of these diverse species.
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| 6. |
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| 7. |
- Johnson, Louis Banka, et al.
(author)
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Radiation enteropathy and leucocyte-endothelial cell reactions in a refined small bowel model
- 2004
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In: BMC Surgery. - : Springer Science and Business Media LLC. - 1471-2482. ; 4
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Leucocyte recruitment and inflammation are key features of high dose radiation-induced tissue injury. The inflammatory response in the gut may be more pronounced following radiotherapy due to its high bacterial load in comparison to the response in other organs. We designed a model to enable us to study the effects of radiation on leucocyte-endothelium interactions and on intestinal microflora in the murine ileum. This model enables us to study specifically the local effects of radiation therapy. METHOD: A midline laparotomy was performed in male C57/Bl6 mice and a five-centimetre segment of ileum is irradiated using the chamber. Leucocyte responses (rolling and adhesion) were then analysed in ileal venules 2 - 48 hours after high dose irradiation, made possible by an inverted approach using intravital fluorescence microscopy. Furthermore, intestinal microflora, myeloperoxidase (MPO) and cell histology were analysed. RESULTS: The highest and most reproducible increase in leucocyte rolling was exhibited 2 hours after high dose irradiation whereas leucocyte adhesion was greatest after 16 hours. Radiation reduced the intestinal microflora count compared to sham animals with a significant decrease in the aerobic count after 2 hours of radiation. Further, the total aerobic counts, Enterobacteriaceae and Lactobacillus decreased significantly after 16 hours. In the radiation groups, the bacterial count showed a progressive increase from 2 to 24 hours after radiation. CONCLUSION: This study presents a refinement of a previous method of examining mechanisms of radiation enteropathy, and a new approach at investigating radiation induced leucocyte responses in the ileal microcirculation. Radiation induced maximum leucocyte rolling at 2 hours and adhesion peaked at 16 hours. It also reduces the microflora count, which then starts to increase steadily afterwards. This model may be instrumental in developing strategies against pathological recruitment of leucocytes and changes in intestinal microflora in the small bowel after radiotherapy.
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| 8. |
- Lindblad-Toh, Kerstin, et al.
(author)
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Genome sequence, comparative analysis and haplotype structure of the domestic dog.
- 2005
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In: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 438:7069, s. 803-19
-
Journal article (peer-reviewed)abstract
- Here we report a high-quality draft genome sequence of the domestic dog (Canis familiaris), together with a dense map of single nucleotide polymorphisms (SNPs) across breeds. The dog is of particular interest because it provides important evolutionary information and because existing breeds show great phenotypic diversity for morphological, physiological and behavioural traits. We use sequence comparison with the primate and rodent lineages to shed light on the structure and evolution of genomes and genes. Notably, the majority of the most highly conserved non-coding sequences in mammalian genomes are clustered near a small subset of genes with important roles in development. Analysis of SNPs reveals long-range haplotypes across the entire dog genome, and defines the nature of genetic diversity within and across breeds. The current SNP map now makes it possible for genome-wide association studies to identify genes responsible for diseases and traits, with important consequences for human and companion animal health.
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| 9. |
- Montelius, Caroline, et al.
(author)
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Feeding spinach thylakoids to rats modulates the gut microbiota, decreases food intake and affects the insulin response
- 2013
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In: Journal of Nutritional Science. - : Cambridge University Press (CUP). - 2048-6790. ; 2
-
Journal article (peer-reviewed)abstract
- Thylakoid membranes derived from green leaf chloroplasts affect appetite-regulating hormones, suppress food intake, reduce blood lipids and lead to a decreased body weight in animals and human subjects. Thylakoids also decrease the intestinal in vitro uptake of methyl-glucose in the rat. The aim of this study was to investigate the effect of dietary thylakoids on the gut microbiota composition, mainly the taxa of lactobacilli and bifidobacteria, in rats fed either a thylakoid-enriched diet or a control diet for 10 d. At the same time, a glucose-tolerance test in the same rats was also performed. Food intake was significantly decreased in the thylakoid-fed rats compared with the control-fed rats over the 10-d study. An oral glucose tolerance test after 10 d of thylakoid- or control-food intake resulted in significantly reduced plasma insulin levels in the thylakoid-fed rats compared with the control-fed rats, while no difference was observed for blood glucose levels. Analysis of gut bacteria showed a significant increase of lactobacilli on the ileal mucosa, specifically Lactobacillus reuteri, in the rats fed the thylakoid diet compared with rats fed the control diet, while faecal lactobacilli decreased. No difference in bifidobacteria between the thylakoid and control groups was found. Analyses with terminal restriction fragment length polymorphism and principal component analysis of faeces demonstrated different microbial populations in the thylakoid- and control-fed animals. These findings indicate that thylakoids modulate the gut microbial composition, which might be important for the regulation of body weight and energy metabolism.
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| 10. |
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| 11. |
- Osman, Nadia
(author)
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Effects of Probiotics and Plant Components on Murine Experimental Colitis and Acute Liver Failure
- 2006
-
Doctoral thesis (other academic/artistic)abstract
- Acute liver failure is accompanied by a high rate of bacterial septic complications. High portal level of lipopolysaccharide (LPS) can lead to a pronounced secretion by Kupffer cells of pro-inflammatory mediators which have been shown to be early and important mediators of liver injury. Pathogenesis of inflammatory bowel disease (IBD) is complex; involving environmental, genetic, microbial, and immunological factors and treatment should target components mediate the inflammatory response. Probiotics and the non-absorbable carbohydrates as well as the fruit or vegetable extracts with high content of antioxidants could decrease the severity of liver failure and colonic inflammation. Three animal models were used, liver injury induced by D-galactosamine or by D-galactosamine and endotoxin, and colitis-induced by dextran sulfate sodium (DSS). Our aim is to study the physiological effects of some bacterial strains with probiotic potential and plant components with potential beneficial effects, in relation to inflammation. The administration of certain strains of Lactobacillus and Bifidobacterium significantly improves the Disease Activity Index (DAI) in the DSS colitis model, reduces bacterial translocation and Enterobacteriaceae count in the colon. L. plantarum DSM 9843, Bifidobacterium sp. 3B1, and B. infantis DSM 15158 seem to have the best effect. Oral administration of bifidobacteria and raftilose synergy 1 in an experimental colitis produced an anti-inflammatory effect (reducing DAI, bacterial translocation, MPO, IL-1? and MDA). Major differences in effect were observed between the two tested strains of B. infantis with regard to MDA and succinic acid concentration as well as bacterial translocation rate in synbiotic combinations, B. infantis DSM 15159 seemed superior. L. plantarum strains (DSM 9843 and DSM 15313) and rose hip supplementation attenuates the inflammation, improves the intestinal barrier function and the antioxidative capacity, and facilitates the recovery of the inflamed tissue in an experimental colitis, through amelioration of the production of the inflammatory mediators as well as the production of different substances . The administration of L. plantarum DSM 15313, L. fermentum 35D and blueberry, alone and in combination, significantly improves the colitis disease activity index, reduces bacterial translocation to extra-intestinal sites and reduces inflammation. All test-strains except L. paracasei DSM 13434 inhibited bacterial translocation to the liver. L. paracasei translocated to the liver, and also failed to decrease the load of Enterobacteriaceae in cecum. L. plantarum DSM 9843 and B. infantis DSM 15158 were most effective at protecting the liver during injury. Thus, there are major effectual differences between strains/species. In contrast, the phylogenetically most diverse strains, L. plantarum DSM 9843 and B. infantis DSM 15158 exercised the same good effects. Blueberry and probiotics exert protective effects on acute liver injury to different extents. They reduced the hepatocytes liver injury, the inflammation and the pro-inflammatory cytokines, and improved the barrier functions and antioxidant activity. In conclusion the effects of the probiotics and prebiotics on the intestinal micro-ecology are important and it produces a balance in the microbial environment with a reduction in the potentially pathogenic organisms. Their effects could be through direct and indirect effects on microflora ecology, barrier functions, cellular proliferation and antioxidant activity as well as the production of different substances. All that could affect the local and systemic immunity and lipid peroxidation. Thus probiotics and prebiotics may exert their effects via diverse mechanisms and there are effectual differences between probiotic strains.
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| 12. |
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| 13. |
- Osman, Nadia, et al.
(author)
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Endotoxin- and D-galactosamine-induced liver injury improved by the administration of Lactobacillus, Bifidobacterium and blueberry
- 2007
-
In: Digestive and Liver Disease. - : Elsevier BV. - 1590-8658. ; 39:9, s. 849-856
-
Journal article (peer-reviewed)abstract
- Background. D-galactosamine together with lipopolysaccharide can lead to a pronounced secretion by Kupffer cells of pro-inflammatory mediators, which have been shown to be early and important mediators of liver injury. Probiotics and dietary supplementation with fruit or vegetable extracts with high content of antioxidants, such as blueberry, could be beneficial in protecting against hepatotoxicity. Aims. To investigate whether blueberry and probiotics could attenuate liver injury induced by D-galactosamine and lipopolysaccharide. Subjects. Sprague-Dawley rats were used. Methods. Six experimental groups: acute liver injury control and five groups of liver injury treated by blueberry alone or by each of the probiotics strains (Lactobacillus plantarum DSM 15313 and Bifidobacterium infantis DSM 15159) with and without blueberry. Samples were collected 24 h after induction for bacterial test, liver function test, short chain fatty acids, myeloperoxidase, cytokines, malondialdehyde and glutathione. Results. Alanine aminotransferase levels decreased significantly in all groups compared to liver injury control and DSM 15313 groups. Bilirubin, liver TNF-alpha, myeloperoxidase and acetic acid in cecum content decreased significantly in all groups, while liver glutathione values increased significantly in all groups compared to liver injury control. Liver IL-1 beta and bacterial translocation to the liver and mesenteric lymph nodes decreased significantly in all groups except B. infantis DSM 15159 group compared to the liver injury control. Enterobacteriaceae count in cecum decreased significantly in the groups with blueberry plus probiotics compared to the other groups. Conclusion. Blueberry and probiotics exert protective effects on acute liver injury. They reduce the hepatocytes injury, the inflammation and the pro-inflammatory cytokines, and improve the barrier functions and antioxidant activity. (c) 2007 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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| 14. |
- Osman, Nadia, et al.
(author)
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Modulation of the effect of dextran sulfate sodium-induced acute colitis by the administration of different probiotic strains of Lactobacillus and Bifidobacterium
- 2004
-
In: Digestive Diseases and Sciences. - 1573-2568. ; 49:2, s. 320-327
-
Journal article (peer-reviewed)abstract
- The pathogenic mechanism of inflammatory bowel diseases is not fully understood but colonic microflora including Lactobacillus and Bifidobacterium species may affect the induction of colonic inflammation. In this study the relative efficacy of different probiotic organisms in the prevention of colitis was compared in an induced rat colitis model. Three Lactobacillus strains and two Bifidobacterium strains were fed to Sprague-Dawley rats for 7 days prior to offering the rats 5% dextran sulfate sodium (DSS) in their drinking water to induce colitis and the administration of the probiotics continued for 7 days with the DSS. Colitis severity was assessed daily using a disease activity index (DAI). Samples were collected 7 days after colitis induction for intestinal bacterial flora and bacterial translocation. The DAI decreased significantly on days 4, 5, 6, and 7 in the Lactobacillus plantarum DSM 9843, Bifidobacterium sp. 3B1, and Bifidobacterium infantis DSM 15158 groups compared to the colitis control. It decreased significantly on days 5, 6, and 7 in the Bifidobacterium infantis DSM 15158 group compared to the Lactobacillus paracaesi DSM 13434 and Lactobacillus gasseri 5B3 groups. It also decreased significantly on day 7 in the L. plantarum DSM 9843 group compared to the L. gasseri 5B3 group. Bacterial translocation to the mesenteric lymph nodes decreased significantly in all treatment groups compared to the colitis control. Enterobacteriaceae bacterial translocation to the liver decreased in all treatment groups compared to the colitis control. Administration of certain strains of Lactobacillus and Bifidobacterium significantly improves the DAI and reduces bacterial translocation, and L. plantarum DSM 9843, Bifidobacterium sp. 3B1, and Bifidobacterium infantis DSM 15158 seem to have the best effect.
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| 15. |
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| 16. |
- Osman, Nadia, et al.
(author)
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Probiotic strains of Lactobacillus and Bifidobacterium affect the translocation and intestinal load of Enterobacteriaceae differently after D-galactosamine-induced liver injury in rats
- 2005
-
In: Microbial Ecology in Health and Disease. - : Informa UK Limited. - 0891-060X .- 1651-2235. ; 17:1, s. 40-46
-
Journal article (peer-reviewed)abstract
- In an acute liver injury model we compared the effects of different Lactobacillus and Bifidobacterium strains on bacterial translocation, intestinal load of Enterobacteriaceae and the extent of liver injury. This was an experimental study carried out in an university hospital in Sweden. Sprague-Dawley rats were divided into six groups: liver injury control and five groups of liver injury with administration of three different Lactobacillus and two Bifidobacterium strains (orally twice daily for 8 days). Liver injury was induced on the eighth day by intraperitoneal injection of D-galactosamine (1.1 g/kg body weight). The main outcome measures were samples collected 24 h after injury. Liver enzymes and bilirubin serum levels, bacterial translocation (to arterial and portal blood, liver and mesenteric lymph nodes), intestinal load of Enterobacteriaceae in relation to lactobacilli and the total bacterial load were evaluated and randomly amplified polymorphic DNA (RAPD) analysis of translocating bacteria was carried out. Lactobacillus plantarum DSM 9843, Lactobacillus gasseri 5B3 and Bifidobacterium infantis DSM 15158 decreased bacterial translocation to the liver compared with the liver injury control group. Lactobacillus paracasei DSM 13434 translocated to the liver. The Enterobacteriaceae count in the caecum decreased in the L. plantarum DSM 9843, L. gasseri 5B3, Bifidobacterium ‘urinalis’ 3B1 and B. infantis DSM 15158 groups, while all the administered probiotics decreased it in the colon. The levels of alanine aminotransferase (ALT) and bilirubin were significantly lower in the L. plantarum DSM 9843 and B. infantis DSM 15158 groups compared with the liver injury control group. All test strains except L. paracasei DSM 13434 inhibited translocation to the liver. Instead, L. paracasei was found in the liver and it also failed to decrease the load of Enterobacteriaceae in caecum. The best strains in protecting the liver during injury were L. plantarum DSM 9843 and B. infantis DSM 15158, as reflected by bilirubin and liver enzymes. Thus, there are major effectual differences between strains/species. In contrast, the phylogenetically most diverse strains, L. plantarum DSM 9843 and B. infantis DSM 15158, exercised the same effects.
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| 17. |
- Osman, Nadia, et al.
(author)
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Probiotics and Blueberry Attenuate the Severity of Dextran Sulfate Sodium (DSS)-Induced Colitis.
- 2008
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In: Digestive Diseases and Sciences. - : Springer Science and Business Media LLC. - 1573-2568 .- 0163-2116. ; 53, s. 2464-2473
-
Journal article (peer-reviewed)abstract
- We studied the anti-inflammatory properties of probiotic strains and blueberry in a colitis model. The disease activity index (DAI) was significantly lower on days 9 and 10 in all groups compared to the colitis control. Myeloperoxidase (MPO) and bacterial translocation to the liver and to the mesenteric lymph nodes (MLN) decreased significantly in all groups compared to colitis control. Cecal Enterobacteriaceae count decreased significantly in blueberry with and without probiotics compared to the other groups. Lactobacillus plantarum reisolated from the cecal content in the presence of blueberry, contrary to Lactobacillus fermentum. Colonic MDA decreased significantly in all groups, except the L. fermentum group, compared to the colitis control. The cecal concentration of acetic, propionic, and butyricbutyric acid was significantly higher in the L. plantarum group, while the L. fermentum group yielded the highest concentration of lactic acid compared with all other groups. Lactobacillus plantarum DSM 15313, Lactobacillus fermentum 35D, and blueberry alone and in combination improve the DAI, reduce bacterial translocation, and reduce inflammation.
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| 18. |
- Polistena, Andrea, et al.
(author)
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Matrilysin Expression Related to Radiation and Microflora Changes in Murine Bowel.
- 2011
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In: The Journal of surgical research. - : Elsevier BV. - 1095-8673 .- 0022-4804. ; 167, s. 137-143
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Matrilysin (MMP-7) elevation after radiotherapy is shown in humans. Matrilysin regulates certain cytokines and the production of bactericidal proteins when the mucosa is exposed to bacterial antigens. We investigate the effect of irradiation on matrilysin and microflora in murine bowel, after modulation with antibiotics. METHODS: Animals were divided into two different groups a radiation group (72 animals) and sham radiation group (36 animals). Animals were divided into smaller groups of six according to radiation dose (19 or 38 Gy or sham). Seven days before radiotherapy ampicillin 500 mg/kg/d was administered intramuscularly, in the antibiotic groups. An exteriorized segment of ileum was subjected to single high dose radiation (19 or 38 Gy). Samples were collected 2, 24, and 48 h and analyzed for microflora, MIP-2, TGF-β, and MMP-7. RESULTS: The combination of antibiotics and irradiation leads to an early significant reduction of bacteria, down-regulates MIP-2, up-regulates TGF-β and elevation of MMP-7 to levels achieved by antibiotics or irradiation alone. Lactobacilli were reduced to non-existent levels after antibiotics. CONCLUSIONS: Pretreatment with Ampicillin before irradiation and laparotomy in a murine model leads to Matrilysin over-expression as achieved by radiotherapy alone. Microfloral regulation does not affect MMP-7 stimulation after surgical or radiological trauma. Radiotherapy overrides the effect of antibiotics leading to an up-regulation of MMP-7, TGF-β and MIP-2 expression between 24 h and 48 h.
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| 19. |
- Tembe, Nelson, et al.
(author)
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Reference Values for Clinical Laboratory Parameters in Young Adults in Maputo, Mozambique
- 2014
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In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 9:5
-
Journal article (peer-reviewed)abstract
- Background: Clinical laboratory reference values from North American and European populations are currently used in most Africans countries due to the absence of locally derived reference ranges, despite previous studies reporting significant differences between populations. Our aim was to define reference ranges for both genders in 18 to 24 year-old Mozambicans in preparation for clinical vaccine trials.Methods: A cross-sectional study including 257 volunteers (102 males and 155 females) between 18 and 24 years was performedat a youth clinic in Maputo, Mozambique. All volunteers were clinically healthy and human immunodeficiency virus, Hepatitis B virus and syphilis negative. Median and 95% reference ranges were calculated for immunological, hematological and chemistry parameters. Ranges were compared with those reported based on populations in other African countries and the US. The impact of applying US NIH Division of AIDS (DAIDS) toxicity tables was assessed.Results: The immunology ranges were comparable to those reported for the US and western Kenya. There were significant gender differences in CD4(+) T cell values 713 cells/mu L in males versus 824 cells/mu L in females (p < 0.0001). Hematologic values differed from the US values but were similar to reports of populations in western Kenya and Uganda. The lower and upper limits of the ranges for hemoglobin, hematocrit, red blood cells, white blood cells and lymphocytes were somewhat lower than those from these African countries. The chemistry values were comparable to US values, with few exceptions. The upper limits for ALT, AST, bilirubin, cholesterol and triglycerides were higher than those from the US. DAIDStables for adverse events predicted 297 adverse events and 159 (62%) of the volunteers would have been excluded.Conclusion: This study is the first to determine normal laboratory parameters in Mozambique. Our results underscore the necessity of establishing region-specific clinical reference ranges for proper patient management and safe conduct of clinical trials.
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| 20. |
- Viegas, Edna Omar, et al.
(author)
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Incidence of HIV and the Prevalence of HIV, Hepatitis B and Syphilis among Youths in Maputo, Mozambique : A Cohort Study
- 2015
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:3
-
Journal article (peer-reviewed)abstract
- Background: Prevalence of HIV in Mozambique among individuals aged 15-49 years is 11.5%. The HIV prevalence is higher in women than in men across the country, peaking at ages 25-29 years and 35-39 years, respectively. In this study, we aimed at determining the prevalence and incidence of HIV, prevalence of Hepatitis B (HBV), and prevalence of syphilis in youths. We also characterized a cohort of youths for future participation in phase I/II HIV vaccine trials.Methods: The study was conducted at a youth clinic in Maputo Central Hospital from August 2009 to October 2011. Youths of both genders aged 18-24 years (n = 1380) were screened for HIV using a sequential algorithm of two immunochromatographic assays, HBV using an enzyme linked immunosorbant test, and syphilis using a treponemal immunochromatographic strip test. The HIV seronegative participants (n = 1309) were followed-up for 12 months with quarterly study visits. The clinical and behavioral data were collected using structured questionnaires. The HIV seroconversions were confirmed by a molecular assay.Results: The study population was female dominant (76.8%). All participants had a formal education, with 44.6% studying for technical or higher education degrees. The mean age at sexual debut was 16.6 years (SD: +/-1.74), with 85.6% reporting more than one sexual partner in life. The screening showed the prevalence of HIV, HBV, and syphilis at 5.1% (95% CI: 3.97-6.31), 12.2% (95% CI 10.5%-14.0%), and 0.36% (95% CI 0.15%-0.84%), respectively. The HIV incidence rate was found to be 1.14/100 person years (95% CI: 0.67-1.92). Retention rates were stable throughout the study being 85.1% at the last visit.Conclusion: Incidence of HIV in this cohort of youths in Maputo was relatively low. Also, the prevalence of HIV and syphilis was lower than the national values in this age group. However, the HBV prevalence was higher than in previous reports in the country.
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| 21. |
- Wang, Haidong, et al.
(author)
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Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015
- 2016
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In: The Lancet. - 0140-6736 .- 1474-547X. ; 388:10053, s. 1459-1544
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Journal article (peer-reviewed)abstract
- BACKGROUND: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures.METHODS: We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).FINDINGS: Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4-61·9) in 1980 to 71·8 years (71·5-72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7-17·4), to 62·6 years (56·5-70·2). Total deaths increased by 4·1% (2·6-5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8-18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6-16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9-14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1-44·6), malaria (43·1%, 34·7-51·8), neonatal preterm birth complications (29·8%, 24·8-34·9), and maternal disorders (29·1%, 19·3-37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death.INTERPRETATION: At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems.
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