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Non-communicable diseases are increasing in developing countries and control of diabetes and hypertension is needed to reduce rates of the leading causes of morbidity and mortality, stroke and ischaemic heart disease. We evaluated a programme in Cambodia, financed by a revolving drug fund, which utilizes Peer Educators to manage diabetes and hypertension in the community. We assessed clinical outcomes and retention in the programme. For all people enrolled in the programme between 2007 and 2016, the average change in blood pressure (BP) and percentage with controlled hypertension (BP < 140/

The royal court was the major center of political power in Merovingian Gaul. Following the late Roman model, it became an administrative center, from whence the kingdom was ruled and to which aristocrats flocked in order to serve the king, or in hope for honors and promotion. As such, the Merovingian court encompassed both the ruler’s military retinue and the kingdom’s highest bureaucrats. It also housed the meetings of the king’s royal council, which also functioned as the highest court where political and judicial conflicts were managed and resolved. As the center of political power and the stage for the administration of justice and the settlement of disputes, the Merovingian court generated a sense of authority and consensus politics that served as a symbolic unifier in an otherwise factional reality.

OBJECTIVES: The Household Food Insecurity Access Scale (HFIAS) is widely used though it has limited cross-cultural applicability. Among families with underweight children in three Cambodian districts, the HFIAS-derived prevalence of moderate/severe food insecurity was about 45%, though interviewers reported that caregivers have difficulty understanding the questions.This study seeks to develop a locally appropriate tool for measuring household food security in Cambodia. METHODS: Caregivers of children ages 6–24 months were screened using the Household Hunger Scale. Following Coping Strategies Index (CSI) guidance, three focus group discussions (FGD) were held with 25 food insecure caregivers from 10 villages. Participants developed a list of coping strategies in response to the question, “What do you do when you do not have enough food, and do not have enough money to buy food?” By consensus, participants weighted coping strategies in order of increasing severity. Strategies were assessed for inclusion using CSI criteria. The research and local teams combined the three lists into a single tool maintaining much of the local vocabulary. RESULTS: FGD 1 identified 16 coping strategies: one was excluded because it could not be done readily, and two were combined. FGD 2 identified 16: one was excluded because it was not repeatable, and four were combined into two. FGD 3 identified 19: six were combined into three. Seven strategies were identified in all three FGDs and seven were identified in two FGDs. Four strategies were identified in only one FGD. The resulting index is comprised of 18 coping strategies. Three strategies were weighted least severe (1). Example: “Eat rice without fish or meat.” Seven were weighted somewhat severe (2). Example: “Make food last longer by eating smaller portions and keeping it for longer than intended.” Five were weighted as more severe (3). Example: “Sell or consume seed stock held for next season.” Three strategies were weighted as most severe (4). Example: “Borrow rice or money from a lender or employer with high interest.” CONCLUSIONS: Context-specific coping strategies may be useful in measuring food security in Cambodia. Future research is needed to examine the validity of this tool in comparison to established food insecurity experiences scales. FUNDING SOURCES: World Vision Hong Kong. SUPPORTING TABLES, IMAGES AND/OR GRAPHS

Human malignant glioma cells are characterized by local invasion. In the present study, we investigated the role of osteopontin (OPN) in the invasiveness of human glioma cells isolated from grade IV tumors. We found that the expression levels of OPN in these cell lines paralleled matrix metalloproteinase-2 (MMP-2) expression and cell invasiveness potential. When U87MG glioma cells (with a high-OPN expression level) were stably transformed with specific small hairpin RNA to knock down OPN expression, MMP-2 secretion, cell invasiveness, and tumor growth in implanted brains were dramatically reduced. Conversely, forced expression of OPN in GBM-SKH glioma cells (which expressed OPN at a low level) increased MMP-2 secretion, enhanced cell invasiveness, and increased tumor growth in a rodent xenograft model. Expression of OPN was associated with increased expression of vimentin and decreased expression of glial fibrillary acidic protein. Treatment of glioma cells with 5-aza-2′-deoxycytidine (5-aza-dC) suppressed OPN expression in a concentration-dependent manner. Suppression of OPN expression by 5-aza-dC was associated with reductions in MMP-2 secretion, vimentin expression, cell invasion, intravasation, and tumor growth. These data suggest that OPN may play important roles in regulating cell invasion in glioma cells and that 5-aza-dC may serve as a therapeutic agent for human gliomas.

A predator–prey model with disease infection in both populations is proposed to account for the possibility of a contagious disease crossing species barrier from prey to predator. We obtain several threshold parameters from local analysis of various equilibria of the proposed system as well as coupled conditions on these threshold parameters which determine the stability of these equilibria. One of the coupled conditions, in the form of an ecological threshold number for the predator–prey ecosystem, always determines the coexistence of predators and prey. The other condition, in the form of a disease basic reproduction number, dictates whether the disease will become endemic in the ecosystem. Under one combination of these coupled conditions, a highly infectious disease could drive the predators to extinction when predators and prey would have coexisted without the disease. For another combination of the conditions, the predation of the more vulnerable infected prey could cause the disease to be eradicated in the ecosystem, in some case even approaching a disease-free periodic solution, when the disease would have otherwise remained endemic in the prey population in the absence of predation. This indicates that the presence of disease in both predators and prey could either promote or impair coexistence, and its precise impact needs to be explored specifically in each particular situation. By considering disease infection in both populations, our model also yields more complex dynamics, allowing for the possibility of bistability and periodic oscillation, in either disease-free or endemic states, in the ecosystem for which the conditions are obtained analytically and with the help of numerical simulations.