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BACKGROUND: Pulmonary hypertension (PH) is associated with aberrant sympathoexcitation leading to right ventricular failure (RVF), arrhythmias, and death. Microglial activation and neuroinflammation have been implicated in sympathoexcitation in experimental PH. We recently reported the first evidence of thoracic spinal cord (TSC) neuroinflammation in PH rats. Here, we hypothesize that PH is associated with increased cardiopulmonary afferent signaling leading to TSC-specific neuroinflammation and sympathoexcitation. Furthermore, inhibition of TSC neuroinflammation rescues experimental PH and RVF. METHODS: We performed transcriptomic analysis and its validation on the TSC of monocrotaline (n=8) and Sugen hypoxia (n=8) rat models of severe PH-RVF. A group of monocrotaline rats received either daily intrathecal microglial activation inhibitor minocycline (200 μg/kg per day, n=5) or PBS (n=5) from day 14 through 28. Echocardiography and right ventricle-catheterization were performed terminally. Real-time quantitative reverse transcription PCR, immunolocalization, microglia+astrocyte quantification, and terminal deoxynucleotidyl transferase dUTP nick end labeling were assessed. Plasma catecholamines were measured by ELISA. Human spinal cord autopsy samples (Control n=3; pulmonary arterial hypertension n=3) were assessed to validate preclinical findings. RESULTS: Increased cardiopulmonary afferent signaling was demonstrated in preclinical and clinical PH. Our findings delineated common dysregulated genes and pathways highlighting neuroinflammation and apoptosis in the remodeled TSC and highlighted increased sympathoexcitation in both rat models. Moreover, we validated significantly increased microglial and astrocytic activation and CX3CL1 expression in TSC of human pulmonary arterial hypertension. Finally, amelioration of TSC neuroinflammation by minocycline in monocrotaline rats inhibited microglial activation, decreased proinflammatory cytokines, sympathetic nervous system activation and significantly attenuated PH and RVF. CONCLUSIONS: Targeting neuroinflammation and associated molecular pathways and genes in the TSC may yield novel therapeutic strategies for PH and RVF.

BackgroundRight ventricular (RV) dysfunction is a significant prognostic determinant of morbidity and mortality in pulmonary arterial hypertension (PAH). Despite the importance of RV function in PAH, the underlying molecular mechanisms of RV dysfunction secondary to PAH remain unclear. We aim to identify and compare molecular determinants of RV failure using RNA sequencing of RV tissue from 2 clinically relevant animal models of PAH.MethodsWe performed RNA sequencing on RV from rats treated with monocrotaline or Sugen with hypoxia/normoxia. PAH and RV failure were confirmed by catheterization and echocardiography. We validated the RV transcriptome results using quantitative real-time polymerase chain reaction, immunofluorescence, and Western blot. Immunohistochemistry and immunofluorescence were performed on human RV tissue from control (n=3) and PAH-induced RV failure patients (n=5).ResultsWe identified similar transcriptomic profiles of RV from monocrotaline- and Sugen with hypoxia-induced RV failure. Pathway analysis showed genes enriched in epithelial-to-mesenchymal transition, inflammation, and metabolism. Histological staining of human RV tissue from patients with RV failure secondary to PAH revealed significant RV fibrosis and endothelial-to-mesenchymal transition, as well as elevated cellular communication network factor 2 (top gene implicated in epithelial-to-mesenchymal transition/endothelial-to-mesenchymal transition) expression in perivascular areas compared with normal RV.ConclusionsTranscriptomic signature of RV failure in monocrotaline and Sugen with hypoxia models showed similar gene expressions and biological pathways. We provide translational relevance of this transcriptomic signature using RV from patients with PAH to demonstrate evidence of epithelial-to-mesenchymal transition/endothelial-to-mesenchymal transition and protein expression of cellular communication network factor 2 (CTGF [connective tissue growth factor]). Targeting specific molecular mechanisms responsible for RV failure in monocrotaline and Sugen with hypoxia models may identify novel therapeutic strategies for PAH-associated RV failure.

High-quality teaching is central to the higher education sector. Its pursuit has become heightened with increasing competition across institutions and opportunities to study globally through various modes. This systematic meta-review provides a synthesis of evidence relating to the methods used to assess and enhance the quality of teaching practice within higher education. Key words, synonyms and subject headings were used to search six electronic databases between January 2009 and August 2019. Titles and abstracts of publications were screened and full text articles assessed against the eligibility criteria. Findings were extracted and integrated in a narrative synthesis. Thirteen review articles, revealed that the use of teaching quality: student feedback data, self-assessment tools, peer review of teaching (formative and summative) and the use of teaching portfolios. We report evidence related to the effectiveness of each of these approaches and that a multi-modal approach may be most effective but requires consideration of resourcing.

Larval zebrafish possess a number of molecular and genetic advantages for rigorous biological analyses of learning and memory. These advantages have motivated the search for novel forms of memory in these animals that can be exploited for understanding the cellular and molecular bases of vertebrate memory formation and consolidation. Here, we report a new form of behavioral sensitization in zebrafish larvae that is elicited by an aversive chemical stimulus [allyl isothiocyanate (AITC)] and that persists for ≥30 min. This form of sensitization is expressed as enhanced locomotion and thigmotaxis, as well as elevated heart rate. To characterize the neural basis of this nonassociative memory, we used transgenic zebrafish expressing the fluorescent calcium indicator GCaMP6 (Chen et al., 2013); because of the transparency of larval zebrafish, we could optically monitor neural activity in the brain of intact transgenic zebrafish before and after the induction of sensitization. We found a distinct brain area, previously linked to locomotion, that exhibited persistently enhanced neural activity following washout of AITC; this enhanced neural activity correlated with the behavioral sensitization. These results establish a novel form of memory in larval zebrafish and begin to unravel the neural basis of this memory.

In this study, water samples collected from Karnaphuli River, Chittagong, Bangladesh, were analyzed to assess physicochemical parameters to identify the possible potential sources of pollutants. Physicochemical parameters such as pH, alkalinity, acidity, conductivity, TDS, turbidity, total hardness, BOD, COD, ammoniacal-nitrogen, and sodium and chloride were varied from 3.05 to 9.34, 36.50 to 182.50 mg/L as CaCO3, 0.00 to 78.00 mg/L as CaCO3, 9.75 to 13.11 mS/cm, 6.36 to 10.40 g/L, 6.70 to 150.30 NTU, 1.37×103 to 1.95×103 mg/L as CaCO3, 5.50 to 45.50 mg/L as O2, 10.00 to 185.00 mg/L as O2, 0.00 to 12.60 mg/L as NH3-N, 2.27×103 to 2.92×103 mg/L and 3.12×103 to 4.60×103 mg/L in the water samples, respectively. Acidity, TDS, turbidity, total hardness, BOD, COD, and sodium were all very high near the TSP fertilizer factory’s point source (site-2), while pH, alkalinity, NH3-N, and chloride were very high at KAFCO (site-11). At site-11, BOD and COD levels were also elevated. The results indicate that untreated fertilizer effluents contaminated river water significantly. Pearson correlation matrix for physicochemical parameters and sodium and chloride was also calculated to confirm the potential sources of pollutants in the river water. TSP plant effluent has been shown to cause acidity, TDS, turbidity, BOD, COD and sodium in river water, whereas ammonia-urea plants are found to cause high pH, alkalinity, NH3-N, as well as BOD and COD in the Karnaphuli River.

For older people, physical inactivity increases fall risk as well as other preventable health conditions. Despite the well-documented benefits of physical activity, uptake and adherence continue to challenge efforts aimed at increasing physical activity and reducing falls. Nested within a randomized controlled trial, this study reports on the factors influencing the physical activity behavior of people, aged between 70 and 90 years, engaged in StandingTall, a home-based balance exercise program proven to reduce falls in the community. The perception of aging, physical activity in older age, and the delivery of exercise were identified as major themes, with the perception of aging an overarching theme influencing both preferences for physical activity in older age and exercise delivery. Findings demonstrate the importance of considering the role of aging, the influence aging has on physical activity and exercise behavior, and how aging influences the delivery and design of exercise programs including falls prevention activities for older people. [ABSTRACT FROM AUTHOR]

Sediment samples collected from the river Shitalakhya, Bangladesh, were analyzed using atomic absorption spectroscopy (AAS) to investigate site-to-site (spatial) and seasonal (i.e., dry, pre-monsoon, post-monsoon) variation of Cr, Mn, Ni, Cu and Zn. The mean concentrations of Cr, Mn, Ni, Cu and Zn were 22.37 ± 6.09, 612.59 ± 160.08, 54.11 ± 11.21, 50.36 ± 9.40 and 103.62 ± 62.74 mg/kg in the dry, 31.58 ± 5.22, 569.71 ± 112.16, 58.35 ± 7.82, 49.93 ± 17.36 and 110.88 ± 95.83 mg/kg in the pre-monsoon and 18.09± 6.32, 567.02 ± 115.55, 50.89 ± 6.58, 39.75 ± 4.56 and 55.22 ± 11.33 mg/kg in the post-monsoon, respectively. Based on the metals’ concentrations, no considerable difference was observed among the three seasons, but the concentrations were slightly elevated in the dry and pre-monsoon compared to that in the post-monsoon with respect to site-to-site variation. Among the metals examined, concentrations of Ni and Cu were elevated because of the use of oxides of these heavy metals as catalysts in the ammonia plant. The following statistical indices i.e., Pearson correlation matrix, geo-accumulation index (Igeo), contamination factor (Cf), degree of contamination (Cd), pollution load index (PLI) and ecological risk potential (RI) factors were taken into account to assess the heavy metals contamination of the sediments. According to the values of the statistical indices for Cr, Mn, Ni, Cu and Zn, it is concluded that the study area was with low contamination while concentrations of Ni and Cu were higher than the Threshold Effect Level (TEL) and Toxicity Reference Value (TRV) values suggesting unsafe to use the sediments for vegetation and other uses.

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The peripheral rivers of Dhaka city became highly polluted because of industrialization and urbanization to a greater extent in the last few decades. Thus, an attempt has been taken to measure 48 elements in water of the river Buriganga using the ICP-MS method for the first time. Accordingly, it could be the reference values for future research in Bangladesh. Out of the 48 elements, the following metals are given more attention because of their detrimental effects on living organisms and for discussing their aquatic chemistry in polluted water body: Be, Na, Al, Cr, Mn, Fe, Ni, Cu, Zn, Cd, Ba, Hg, Pb, Bi and U. Results revealed that metals’ concentrations in water in the monsoon were less than that of the winter, however, Cr and Fe were found at below detection limits in the winter that is unexpected. Physicochemical parameters of the river water such as pH, dissolved oxygen play vital roles for hydrolysis reactions in the stagnant water body. Hydrolyzed products of metal ions having low values of solubility products ( K sp ), for example, iron(III)hydroxide, chromium(III)hydroxide, phase out through precipitation reactions. This study also detects and quantifies total concentrations of Hg and U in water of the river Buriganga for the first time. PCA and correlation matrix results provided potential sources of the relevant metals. Mechanisms of hydrolysis and precipitation reactions for metal ions in the polluted river water are also discussed.

< p>Cultivated fishes are major protein and microelement sources for all sorts of people in Bangladesh due to its availability and affordability. Since heavy metals are persistent in the aquatic environment, these metals can accumulate in the food chain. Cultivated fishes containing heavy metals can cause a carcinogenic and non-carcinogenic risk to human as it biologically accumulates heavy metals from commercial feeds. This study was designed to access the content of heavy metals in the flesh of some cultivated fish species through consuming commercial fish feeds available in Bangladesh and potential health risk calculation for consumers due to intake daily. The concentration (mg/kg, dry weight) range of heavy metals like; Pb (4.56- 7.08), Cd (0.23- 1.28), Cr (4.00-7.08), Cu (11.23- 20.62), As (0.08- 0.34), Hg (0.05- 0.34) in selected commercial fish feeds and Pb (4.35-8.03), Cd (0.87- 1.35), Cr (4.71-8.98), Cu (14.00- 31.80), As (0.17- 0.28), Hg (0.08- 0.41) in fishes were accessed by inductive coupled plasma optical emission spectroscopy (ICP-OES). The recorded concentration value for selected metals in fish tissues and feeds were also compared with the safe limit proposed by World health organization (WHO, 1995), Food and Agricultural Organization (FAO, 1983), European Union (EU, 2001). This study also estimated the carcinogenic and non- carcinogenic risk due to daily consumption of these cultivated fishes for a certain age.

BackgroundThe importance of physical activity in improving physical and mental health has been emphasized in many studies. Researchers in Saudi Arabia have reported an increase in physical inactivity among Saudis, especially among University female population. Current efforts in the field in Saudi Arabia have yet to explore barriers and facilitators that influence female University student's participation in physical activity. This study aims to provide an assessment of the situation regarding physical activity among female University students in Saudi Arabia.MethodsThis mixed method study preceded a participatory action research initiative. The first part of the mixed method consisted of a cross-sectional survey of 375 female University students in Saudi Arabia who completed the short form of the International Physical Activity Questionnaire. The second part consisted of semi-structured, in-depth interviews with 14 female University students and 16 female exercise trainers.ResultsResults showed that most participants (91%) spent more time in walking activity compared to moderate (66%) and vigorous activity (57%) for at least 10 min at a time over a period of 7 days. Results showed that 70% of participants did not meet the WHO recommendation of 150 min per week of moderate activity, while around 62% of participants did not meet the WHO recommendation of 75 min per week of vigorous activity. Barriers to participation included limited facilities for physical activities, academic workload, gender role, and the need to adhere to cultural standards. Facilitators included valuing positive results, general health concerns, and family support.ConclusionKnowledge gained from this study might support organizations and public health authorities to develop physical activity interventions that better address Saudi women's perceived needs. These findings are an important contribution to current knowledge in light of recent advances in women's rights in Saudi Arabia.

Aim: Assisting women with a history of gestational diabetes mellitus (GDM) to adopt healthy lifestyles is a priority for diabetes prevention. The aim of this study was to develop and evaluate measures that can be used to assess the efficacy of behavior change interventions in this group. Method: Measures of psychosocial influences on physical activity and diet were derived from formative research and examination of established instruments. Item reduction by principal components analysis was undertaken following telephone survey administration to 160 women with recent GDM, and the internal reliability and construct validity of the derived scales were assessed. Test-retest reliability was assessed in another sample of 97 women. Results: Scales with acceptable internal reliability were developed for physical activity outcome expectancies (a = 0.82), perceived barriers (a = 0.75), encouragement (a = 0.76) and self-efficacy (a = 0.82), weight control attitudes (a = 0.90), and diabetes-related fear (a = 0.70). Construct validity in relation to physical activity participation was found for the encouragement and self-efficacy scales. The weight control attitudes scale showed construct validity in relation to fruit and vegetable intake. The test-retest reliability of most scales was moderate to good (weighted ? = 0.55-0.69). Conclusion: Reliable and valid measures relevant to the psychosocial needs of women with GDM have been developed with a multiethnic population. These will assist future evidence generation, particularly in relation to the adoption of physical activity, which has been a challenging area of lifestyle intervention to date.

The utilization of perinatal care services among women experiencing intimate partner violence (IPV) and male alcohol use is a major problem. Adequate and regular perinatal care is essential through the continuum of pregnancy to mitigate pregnancy and birth complications. The aim of this study is to determine the association between IPV and male alcohol use and the receipt of perinatal care in Nepal. This study used pooled data from 2011 and 2016 Nepal Demographic and Health Surveys (NDHS). A total of 3067 women who interviewed for domestic violence module and had most recent live birth 5 years prior surveys were included in the analysis. Multivariable logistic regression analysis was performed to determine the association between IPV and male alcohol use and the receipt of perinatal care. Of the total women interviewed, 22% reported physical violence, 14% emotional violence, and 11% sexual violence. Women who were exposed to physical violence were significantly more likely to report non-usage of institutional delivery [adjusted Odds Ratio (aOR) = 1.30 (95% Cl: 1.01, 1.68)] and skilled delivery assistants [aOR = 1.43 (95% Cl: 1.10, 1.88)]. Non-attendance of 4 or more skilled antenatal care visits was associated with a combination of alcohol use by male partner and exposure to emotional [aOR = 1.42 (95% Cl: 1.01, 2.00)] and physical violence [aOR = 1.39 (95% Cl: 1.03, 1.88)]. The negative association between IPV and perinatal care suggests it is essential to develop comprehensive community-based interventions which integrates IPV support services with other health services to increase the uptake of perinatal care through the continuum of pregnancy.

Background: Local non-governmental organisations (NGOs) provide mental health and psychosocial services (MHPSS) to over 1 million Rohingya refugees in Bangladesh. To provide insights to inform the development of MHPSS services in populations targeted in ethnic cleansing campaigns, we undertook a project that aimed to identify how refugees' understanding of the justice process is linked to their psychosocial wellbeing. Methods: We conducted two focus groups and 13 in-depth qualitative interviews with Rohingya refugees residing in camps in Bangladesh. Refugees were recruited from the MHPSS work area of a local NGO—Friends in Village Development, Bangladesh—where a new intensive care programme for people who have experienced sexual and physical violence in Myanmar is being developed. We used baseline intake data to select participants who were known to be from a Myanmar village that suffered violence and who had a potential need for intensive psychological therapy because of direct exposure to violence. A brief interview guide included questions about refugees' understanding of the general concept of justice, of the justice process as applied to their situation, and of the emotional impact caused by justice being realised or denied. Interviews were recorded, transcribed, and translated. Two coders analysed transcripts for key themes based on a codebook using grounded theory. Findings: Between Nov 1, 2018, and Aug 30, 2019, we interviewed ten male participants and 12 female participants aged between 10 years and 60 years. All had either experienced or witnessed violence when their villages were attacked. Respondents' concepts of justice included: a descriptive account of conflict resolution processes, noted to be culturally variable and often corrupt; and an aspirational account of full restoration of rights within their homeland. Some mentioned retributive punishment, but it was not emphasised. Participants acknowledged distress when thinking about a lack of justice, as well as a possibility of inner peace through achieving justice, but noted that even full restoration of their rights could not completely resolve the effects of the violence. Refugees reported inconsistent access to updates about repatriation, and media outlets, such as international news websites and social media sites, were not routinely accessible. Interpretation: MHPSS programmes can potentially enhance refugee wellbeing by providing education, access to news updates, and advocacy surrounding the justice process. A further understanding of how concepts of justice may inform MHPSS programming is important to improve refugee care worldwide. Funding: The Institute for Public Health, Washington University in St Louis, MO, USA and Washington University in St Louis Division of Infectious Diseases, School of Medicine, MO, USA.

Abstract Background Results from a previous study showed that 40 to 60% of the price of off-patent medicines in Vietnam was typically spent to induce prescribers to use the medicines, and to persuade procurement officers within hospitals to buy them. In this article we examine how and why inducements were paid by the pharmaceutical industry to health care providers in Vietnam. Methods We use a theoretically informed analysis to understand pharmaceutical companies’ account of giving inducements and prescribers’ account of taking them, elicited through in-depth interviews. Results Analysis of the emergent concepts derived from our qualitative data led to viewing the constructs from the theoretical framework of opportunities; pressures; and rationalization within a hierarchy of systemic factors and individual factors. Economic survival pressures in an imperfectly competitive market reportedly encouraged pharmaceutical companies and prescribers to be linked financially. Although individual factors such as professional ethics and personal values influenced doctors’ responses to corrupt practices, entrenched systemic issues, including lack of transparency, accountability, poor enforcement of legislation and prevalence of corruption emerged as important factors supporting corrupt practice or even making it very difficult for individuals to opt out of corrupt practices. Conclusions Our theoretically informed analysis of inducements provides an in-depth understanding of an angle of corruption in Vietnam’s health sector, showing the need for multifaceted strategies in the fight against corruption in the health sector. Remedial strategies need to address both systemic and individual factors including interventions to relieve dependencies for survival of health care services on the corrupt system.

Adolescent-friendly health programs have been in place in Nepal since 2008, yet uptake of the services for sexual and reproductive health remains suboptimal. For uptake of these services to improve, a rich understanding is needed of the factors impacting their acceptance and utilization from the perspectives of adolescents, health care staff, and key community informants. This study applied a qualitative research design involving six focus groups with 52 adolescents and in-depth interviews with 16 adolescents, 13 key informants, and 9 health care providers from six adolescent-friendly health facilities in Nepal. Thematic analysis was conducted for data analysis. The key themes identified as barriers include access issues due to travel, institutional health care barriers, perceived lack of privacy and confidentiality, and the unprofessional attitudes of staff towards the sexual health needs of adolescents. These themes are underpinned by gendered ideology and a moral framework around the sexual behavior of adolescents. Interview responses suggested that health care providers take a policing role in prescribing adolescents' conformity to this moral framework in their delivery of reproductive health care and services. While physical access to health services may be problematic for some adolescents, this is not the priority issue. Attention needs to be given to increasing the capacity of health care providers to deliver services without imposing their own and socially sanctioned moral frameworks around adolescent sexual behavior. Such capacity building should include training that is experiential and emphasizes the importance of confidentiality and non-judgmental attitudes.