Search

The transitivity of solar radiation in the atmosphere varies greatly depending on location, time of day, earth-to-sun distance, angle of incidence, and other variables. Solar radiation has an impact on climate change and can be used as energy. So, its modelling will help plan and design policies for climate change and the sustainable use of energy. This study aimed to investigate solar energy patterns and trends on the Earth's surface via solar radiation absorption by cloud cover. Data on solar radiation absorption from 133 stations between the years 1998 and 2020 across the United States were downloaded from the National Solar Radiation Database (NSRDB) website. A linear regression model was used to model solar absorption by cloud and factor analysis was used to group the regions by reducing the spatial correlation of solar radiation absorption. After that, a multivariate regression model was utilized to investigate average changes. There were seven regions obtained from factor analysis. All regions showed a seasonal pattern, with the peak in December to January and the lowest level in June to July. The north, north-east, or south-east of the country experienced an increase in solar radiation absorption, while the north-west, central, and south of the country experienced a decrease. The overall average absorption increased by 0.015%. The patterns and trends of solar radiation by location and time help climate scientists make better decisions. It is also useful to manage renewable energy sources, which will lead policymakers to make better policies. [ABSTRACT FROM AUTHOR]

Purpose: The Rayong oil spill incident of 2013 leaked over 50,000 barrels of crude oil into the Gulf of Thailand. This study assessed trends and changes in the haematological, renal, and hepatic indices among the Rayong oil spill clean-up workers 5 years after the spill. Methods: Haematological, renal, and hepatic indices measured for 570 oil spill clean-up workers at baseline and annually during 5-year follow-ups were analysed. Haemoglobin (Hb), haematocrit (Hct), white blood cell (WBC) count, red blood cell (RBC) count, and platelet count for haematological function, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) for hepatic function, and creatinine (Cr) and blood urea nitrogen (BUN) for renal function were assessed. The longitudinal measures of haematological, renal and hepatic indices were analysed using analysis of variance for repeated measures. The generalised estimating equations (GEE) were used to assess trends of these indices and associated factors, including exposure level. Results: Increasing trends were observed per year for WBC (0.52 ± 0.03 × 103 cells/μL), Cr (0.01 ± 0.00 mg/dL), platelet (0.31 × 103 μL per year), and BUN (0.24 ± 0.03 mg/dL). Decreasing trends of aspartate aminotransferase (AST) were observed (1.54 ± 0.21 IU/L per year). Clean-up workers with high exposure to the oil spill had a significantly higher average of WBC and lower average of BUN than low-exposure and unknown-exposure workers. Gender and age were significantly associated with creatinine changes. Conclusion: Results of this study show the differences between baseline and follow-up haematological, renal, and hepatic indices and trends of these indices. The long-term changes in the indices in this study show worsening renal functions after oil spill and possibility of cardiovascular effects. These findings contribute to expanding knowledge on the long-term health effects of oil spills. [ABSTRACT FROM AUTHOR]

Land surface temperature (LST) is a significant factor in surface energy balance and global climatology studies. Land cover (LC) and elevation are two factors that affect the change of LST, and their effects depend on different geography. This study aims to demonstrate an alternative approach to examine the change of LST during 20 years (2001 to 2020) on Taiwan Island and to investigate the effect of LC change and elevation on a decadal trend of LST using a linear model that adjusting for each determinate factor. MODIS LST and LC data, as well as GMTED2010 elevation product, were downloaded available website. The natural cubic spline function was used to model annual seasonal patterns in LST. Linear regression model was used to estimate decadal change of long-term LST time series. Weighted sum contrasts linear regression was used to assess the effect of LC transformation and elevation on the decadal LST change by comparing adjusting mean of all factors. The adopted analysis method was an appropriate approach to assess categorical factors than those based on treatment contrasts, requiring specifying a control group to compare means and confidence intervals. Results showed that there was an increase in LST for most of the island. The average daytime and nighttime LST trends were 0.12 and 0.31 °C/decade, respectively. However, areas in the southern part of the north–south direction mountain range show a statistically significant increase in LST in both daytime and nighttime. The major landslides caused this noticeable change of surface temperature due to the catastrophic damage of typhoon Morakot in 2009. The results also revealed that the different pattern of LC change has a significant effect on daytime LST, but not on nighttime LST trends. The elevation above 600 m had affected both daytime and nighttime LSTs. [ABSTRACT FROM AUTHOR]

The objective of this study is to examine the correctness of reported causes of deaths in children and estimate deaths from perinatal originating conditions (ICD-10, chapter block P) and congenital malformations (ICD-10, chapter block Q) in Thailand. The subset of Thai deaths of children under 5 years old (149 from a total of 9964 deaths) in a 2005 Verbal Autopsy (VA) study was selected as a sample; the data from 1996 - 2009 were used as the target population for this study. Three different logistic regression models were conducted for 3 outcomes of interest: deaths from Perinatal Originating Conditions (POC), deaths from Congenital Malformations (CM) and from other causes including the effects of province, sex and the location of death. This study found no difference in the probability of dying from the POC and CM by sex and province. As expected, the study found significant differences in reporting the correct causes of death inside and outside the hospital. Nearly 90 % of deaths from both POC and CM that occurred in hospital were reported correctly. In contrast, only 60 and 70 %, of these causes of deaths that occurred outside hospital were reported correctly. The number of child deaths from POC in the 14 year period was estimated at 36,838 and from CM was estimated at 26,806. These estimations of deaths from POC are 1.49 times more and from CM are 2.18 times higher than the reported numbers. [ABSTRACT FROM AUTHOR]

This study aimed to identify factors associated with severe injury and mortality from road traffic accidents (RTA) among motorcycle and car users in southern Thailand. The data were obtained from the Office of Disease Prevention and Control, Thailand, for years 2008-2013. Chi-squared tests were used to assess associations between determinants and outcomes and these associations were then estimated after adjusting for possible confounding with other factors using logistic regression. Severe injury and mortality contributed 11.6% and 5% to RTA of motorcycle users, and 14.3% and 7.5% for car users. Among motorcycle users, male gender, older age, and not wearing a helmet increased severe injury and mortality rates, whereas drivers had more severe injuries than passengers. Older car users had higher severe injury and mortality rates, whereas not fastening seat belts had higher mortality. Safety device use should be made mandatory for both drivers and passengers. Male motorcycle users and the elderly should be focused on. [ABSTRACT FROM AUTHOR]

Background: Malaria remains a serious health problem in the southern border provinces of Thailand. The issue areas can be identified using an appropriate statistical model. This study aimed to investigate malaria for its spatial occurrence and incidence rate in the southernmost provinces of Thailand. Methods: The Thai Office of Disease Prevention and Control, Ministry of Public Health, provided total hospital admissions of malaria cases from 2008 to 2020, which were classified by age, gender, and sub-district of residence. Sixty-two sub-districts were excluded since they had no malaria cases. A logistic model was used to identify spatial occurrence patterns of malaria, and a log-linear regression model was employed to model the incidence rate after eliminating records with zero cases. Results: The overall occurrence rate was 9.8% and the overall median incidence rate was 4.3 cases per 1,000 population. Malaria occurence peaked at young adults aged 20–29, and subsequently fell with age for both sexes, whereas incidence rate increased with age for both sexes. Malaria occurrence and incidence rates fluctuated; they appeared to be on the decline. The area with the highest malaria occurrence and incidence rate was remarkably similar to the area with the highest number of malaria cases, which were mostly in Yala province's sub-districts bordering Malaysia. Conclusions: Malaria is a serious problem in forest-covered border areas. The correct policies and strategies should be concentrated in these areas, in order to address this condition. [ABSTRACT FROM AUTHOR]

Introduction: Varied reasons existed for not offering reperfusion therapy in ST elevation myocardial infarction and results in poor outcomes, and if related factors could be delineated, corrective measures can be attempted. Method: We compared variables between participants not receiving reperfusion therapy and those receiving single reperfusion therapy. Multivariate analysis examined the contribution of nonreperfusion therapy to death and factors related to it. Results: Nonreperfusion therapy was older and had a lower frequency of typical chest pain, but more dyspnea, and post cardiac resuscitation. They had more heart failure and death. Nonreperfusion therapy was an independent factor related to cardiac death, and factors related to nonreperfusion therapy were age, type of hospital, presenting features on admission (dyspnea and post cardiac resuscitation), lack of typical chest pain, and not being referred to. Conclusion: Nonreperfusion therapy had 2 to 3 times higher in-hospital mortality. Factors related to not offering reperfusion therapy, aside from age, appeared to be amendable to better management. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic inequalities in health and their determinants have been studied extensively over the past few decades. However, the role of parenting style and parents' couple relationships in explaining mental health inequalities is limited. Therefore, this study aims to investigate the distributional impact of parenting style (angry parenting, consistent parenting, and inductive parenting) and parents' couple relationships (e.g., argumentative, happy relationships) on socioeconomic inequalities and by extension on mental health status of Australian children and adolescents. Methods: This study utilized data from the Longitudinal Study of Australian Children (Waves 1–7), specifically focusing on intact biological parent families, while excluding single-parent and blended-family households. We applied the decomposition index and the Blinder Oaxaca method to investigate the extent of the contribution and temporal impact of parenting style and parents' couple relationships on the mental health status of Australian children and adolescents. Results: This study revealed that poor parenting style is the single most important factor that leads to developing mental health difficulties in children and adolescents, especially from low socioeconomic status, and it contributes almost 52% to socioeconomic inequalities in mental health status. Conversely, household income, maternal education, employment status, and parents' couple relationships contributed 28.04%, 10.67%, 9.28%, and 3.34%, respectively, to mental health inequalities in children and adolescents. Conclusion: Overall, this study underscores the importance of parenting style and parents' couple relationships as significant predictors of mental health outcomes in children and adolescents. These results highlight the need for targeted interventions to support families from low socioeconomic backgrounds to address the significant mental health inequalities observed in the study population. [ABSTRACT FROM AUTHOR]

Tuna is a renewable resource that has been managed regionally, but its worldwide capacity for regeneration is still little known. A time-series dataset of tuna catches was used to develop nonlinear univariate models for monitoring the sustainability of tuna catches. Two approaches were compared: 1) fitting an ARIMA-spline model to the volume of annual tuna catches and 2) combining neural networks with an ARIMA model to fit the annual changes in volume. These models offer competitive forecasting performance with small percentage errors. By averaging results of the best model developed in each of these approaches, our ensemble forecast predicts that world tuna catches will reach the optimal level of 5.09 million tons in 2025, remain stable thereafter until 2033, and start decreasing about 0.78 % annually. These models could be used by regional fishery management groups to discover discrepancies between such projections and other science-based estimations of the maximum sustainable output. [ABSTRACT FROM AUTHOR]

Chikungunya fever (CHIKF) has re-emerged in the southernmost Thailand and presents a significant threat to public health. The problem areas can be identified using appropriate statistical models. This study aimed to determine the geographic epidemic patterns and high-risk locations. Data on CHIKF's case characteristics, including age, gender, and residence sub-district, were obtained from the Office of Disease Prevention and Control of Thailand from 2008 to 2020. A logistic model was applied to detect illness occurrences. After removing records with no cases, a log-linear regression model was used to determine the incidence rate. The results revealed that two large-scale infections occurred in the southernmost provinces of Thailand between 2008 and 2010, and again between 2018 and 2020, indicating a 10-year epidemic cycle. The CHIKF occurrence in the first and second outbreaks was 28.4% and 15.5%, respectively. In both outbreaks of occurrence CHIKF, adolescents and working-age groups were the most infected groups but the high incidence rate of CHIKF was elderly groups. The first outbreak had a high occurrence and incidence rate in 39 sub-districts, the majority of which were in Narathiwat province, whilst the second outbreak was identified in 15 sub-districts, the majority of which were in Pattani province. In conclusion, the CHIKF outbreak areas can be identified and addressed by combining logistic and log-linear models in a two-step process. The findings of this study can serve as a guide for developing a surveillance strategy or an earlier plan to manage or prevent the CHIKF outbreak. [ABSTRACT FROM AUTHOR]

This study aims to identify the distribution of marriages among adolescents, aged 10 to 19 years, throughout Nepal. Data were obtained from the 2011 Nepal Demographic and Health Survey. Chi-square tests and logistic regression analyses were used to identify the main determinants of adolescent marriages (AMs). Of a total 11,967 weighted samples, 9.3% of adolescents (95% CI, 8–10%) were found to have been married; a significantly higher percentage of these were female. The variability of AMs varied among the regions of Nepal, with a higher percentage occurring in the Western Mountain, Mid-Western Hill, and Central Terai areas. AMs were also more likely to have occurred among poorer households. The findings show a substantial differences of AMs in different geographic areas and demographic levels in Nepal. [ABSTRACT FROM AUTHOR]

Background: The purpose of the present paper was to evaluate the clinical features of primary vesico-ureteral reflux (VUR) in Thai children. Methods: Children with primary VUR attending in the Nephrology Division, Department of Pediatrics, Prince of Songkla University between 1987–2002 were studied. Results: Sixty-five girls and 60 boys with primary VUR were evaluated. Age of diagnosis was significantly younger in boys than girls (median 0.6 and 2.2 years respectively, P < 0.001). In 73% of boys and 34% of girls VUR diagnosis was made in the first year of life. Hydronephrosis was found in 22% of boys and 8% of girls ( P = 0.004). Five per cent of children who had VUR grades I–III had hydronephrosis (6/121). Only children who had VUR grades IV and V had significant hydronephrosis: 33% (14/42) and 53% (10/19), respectively. Bilateral VUR was 60% overall and was significantly more common in boys (70% vs 40% P < 0.028), found in grades I–V at 33%, 61%, 60%, 65%, and 77%, respectively. Of 200 refluxing ureters, the total numbers of VUR grades I–V were 32, 37, 67, 45 and 19 respectively. VUR grade was significantly different by age ( P = 0.014) but not by left–right side or sex. Conclusion: Primary VUR occurs equally in boys and girls, but in boys at a younger age. Bilateral VUR and hydronephrosis were significantly more common in boys, and VUR in boys was more severe. But hydronephrosis is a poor indicator for VUR screening even in high-grade VUR. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the outcome of primary vesicoureteral reflux (VUR) using conservative treatment. Methods: Eighty-seven children with primary VUR who had been treated with a conservative medical regimen and monitored through a yearly cystogram were recruited for the study. The study was conducted at the Pediatric Nephrology Clinic in Songklanagarind Hospital, the major tertiary care center in southern Thailand. Statistical analyses using Kaplan–Meier survival curves, chi-squared test, Fisher’s exact test and multivariate analysis with Cox regression were performed. Results: The study group consisted of 41 boys and 46 girls, with a total of 133 VUR. The age of the boys was significantly lower than that of the girls ( P < 0.001). Resolution of the low grades (grades I–III) of VUR was significantly more frequent than that of the high grades (grades IV–V) (68/95, 72% vs 14/38, 37%; P < 0.001). Using the Kaplan–Meier survival analysis and log-rank test, the resolutions of VUR in boys versus girls, and age <1 years versus ≥1 years were not significantly different ( P = 0.2252 and 0.4756, respectively). Low-grade VUR and unilateral VUR had significantly higher probabilities of resolution than high-grade VUR and bilateral VUR, respectively ( P = 0.0041 and 0.0467, respectively). Multivariate Cox regression analysis indicated that among low-grade VUR, boys and unilateral VUR had significantly higher probabilities of resolution. Among the high-grade VUR, neither sex nor laterality had a significant effect on the probabilities of VUR resolution. Conclusion: This study offers more evidence that children with low-grade VUR have a higher chance of reflux resolution if they are boys and have only unilateral VUR. There is still no good guide for resolution of reflux in children with high-grade VUR. [ABSTRACT FROM AUTHOR]

Background: Descriptive analyses of 2009–2016 were performed using the data of the Universal Coverage Scheme (UCS) which covers nearly 70 percent of the Thai population. The analyses described the time and geographical trends of nationwide admission rates of type 2 diabetes mellitus (T2DM) and its complications, including chronic kidney disease (CKD), myocardial infarction, cerebrovascular diseases, retinopathy, cataract, and diabetic foot amputation. Methods and findings: The database of T2DM patients aged 15–100 years who were admitted between 2009 and 2016 under the UCS and that of the UCS population were retrieved for the analyses. The admitted cases of T2DM were extracted from the database using disease codes of principal and secondary diagnoses defined by the International Classification of Diseases 9th and 10th Revisions. The T2DM admission rates in 2009–2016 were the number of admissions divided by the number of the UCS population. The standardized admission rates (SARs)were further estimated in contrast to the expected number of admissions considering age and sex composition of the UCS population in each region. A linearly increased trend was found in T2DM admission rates from 2009 to 2016. Female admission rates were persistently higher than that of males. In 2016, an increase in the T2DM admission rates was observed among the older ages relative to that in 2009. Although the SARs of T2DM were generally higher in Bangkok and central regions in 2009, except that with CKD and foot amputation which had higher trends in northeastern regions, the geographical inequalities were fairly reduced by 2016. Conclusion: Admission rates of T2DM and its major complications increased in Thailand from 2009 to 2016. Although the overall geographical inequalities in the SARs of T2DM were reduced in the country, further efforts are required to improve the health system and policies focusing on risk factors and regions to manage the increasing T2DM. [ABSTRACT FROM AUTHOR]

There appear to be ethnic disparities in frequencies of diabetic complications in type 2 diabetic patients and such data from Asian countries are relatively few and limited. Thai type 2 diabetic patients who attended the diabetic clinic at Prince of Songkla University hospital during January–December 1997 and had no history of coronary heart disease (CHD) and stroke were studied to determine cause of death and to establish the incidence of and risk factors for cardiovascular disease (CVD). All patients were followed to death or to the end of year 2001. End-points included death from any cause, fatal and nonfatal CHD, fatal and nonfatal stroke and lower-extremity amputation. There were 229 patients who were followed for 4.2±0.7 (S.D.) years (range: 0.6–5.0) with total follow-up period 958.2 patient-years. Twenty-nine patients died during follow-up; the total mortality rate was 30.3 (95%CI 20.2–43.4)/1000 patient-years. Of these, 9(9.4/1000 patient-years; 95%CI 4.3–17.8) died from sepsis, 7(7.3/1000 patient-years; 95%CI 2.9–15.0) from CVD, 5(5.2/1000 patient-years; 95%CI 2.7–12.2) from end-stage renal disease, 3(3.1/1000 patient-years; 95%CI 0.6–9.2) from malignancy and 1(1.0/1000 patient-years; 95%CI 0.03–5.8) from peripheral vascular disease. The incidences of fatal and nonfatal CHD as well as fatal and nonfatal stroke were 21.4(95%CI 13.0–33.0)/1000 and 12.8(95%CI 6.6–22.4)/1000 patient-years, respectively whereas the incidence of lower-extremity amputation was 4.3(95%CI 1.2–10.9)/1000 patient-years. Age, the presence of proteinuria and serum HDL-C&les;0.9 mmol/l were independent risk factors of CHD with the respective Hazard ratios 1.09(95%CI: 1.02–1.17; P=0.016), 4.41(95%CI: 1.18–16.45; P=0.027) and 3.91(95%CI: 1.20–12.80; P=0.024). In conclusion, sepsis and CVD were the major causes of death accounting for ∼50% of total mortality in Thai type 2 diabetic patients. Age, the presence of proteinuria and low HDL-C were independent risk factors for the development of CHD. The mortality from and the incidence of CHD in Thai type 2 diabetic patients are lower than those reported from Caucasian populations but the incidence of stroke appears to be higher. These findings need to be confirmed by a large-scale population-based study. [Copyright &y& Elsevier]

Locally implantable antibiotic beads have been approved for their efficacy in treating chronic osteomyelitis. This study aimed to compare the in vitro elution characteristics of commercial antibiotic cement (Septopal[sup ®]) with those of custom-made gentamicin cement and gentamicin-loaded plaster of Paris. Septopal[sup ®] had a better inhibitive effect than custom-made gentamicin cement and gentamicin-loaded plaster of Paris for both S. aureus and P. aeruginosa at one month. The elution of gentamicin from Septopal[sup ®] declined gradually over one month in contrast to those of custom-made gentamicin cement and gentamicin-loaded plaster of Paris, which had a burst effect of elution and showed a small amount of gentamicin after one week. There was a significantly higher total amount of gentamicin eluted from Septopal[sup ®] than from other types of noncommercially prepared beads. The variability of the inhibitive effect of custom-made gentamicin cement was more pronounced than those of Septopal[sup ®] and gentamicin-loaded plaster of Paris groups. In conclusion, Septopal[sup ®] has a better elution characteristic than custom-made gentamicin cement and gentamicin-loaded plaster of Paris in the in vitro study. [ABSTRACT FROM AUTHOR]

Context: Head injuries are the leading cause of traumatic morbidity and mortality. Timely proper management can reduce the mortality rate. Aims: This study aimed to examine the effects of a fast-track system on reducing head injury mortality using the data in Southern Thailand. Settings and Design: A retrospective study of data from the medical records of severe head injury patients admitted to Hatyai Hospital from October 2012 to May 2017. Subjects and Methods: The records of subjects were selected for participants aged more than 11 years, having Glasgow Coma Score (GCS) <9, no injuries in other organs, and neither hypoxemia nor hypotension. A total of 193 participants fulfilling these criteria were analyzed. Of these, 108 participants were managed in the fast track. Statistical Analysis Used: The fast-track group was compared with normal track participants by using logistic regression after preliminary analysis to identify the risk factors using the Chi-squared tests. Results: After adjustment for confounders, namely acute subdural hematoma, linear skull fracture and diffuse brain injury, and mortality in the fast-track group (13%) was significantly lower than that in the nonfast track group (22.4%). Conclusions: Using the fast-track system can reduce mortality from severe head injuries and should be implemented in the health services system. [ABSTRACT FROM AUTHOR]

This study aimed at examining the factors that contribute to nursing productivity in public hospitals in Surabaya. Data relating to the respondents' characteristics and their productivity were collected using a questionnaire incorporating the Behaviorally Anchored Rating Scale. The samples were drawn from 31 nurses form the emergency room (ER) and 29 nurses from the intensive care unit (ICU) wards of a public hospital in Surabaya, Indonesia, of whom, 52 nurses participated voluntarily and indicated their willingness to respond by signing an informed consent form. The chi-square and Fisher's exact test was used to determine associations between the determinants (demographic characteristics, lifestyle and nutritional status) and productivity and the strength of association was identified by using logistic regression. The results from this study found that gender had borderline significant and duration of work experience had a significant association with nurse productivity. Therefore, gender and duration of working experience are factors which should be taken into consideration when managing human resources working in ERs and ICUs while basic nursing competencies are clearly also important factors in maintaining productivity. [ABSTRACT FROM AUTHOR]

Land Surface Temperature (LST) assessment can explain temperature variation, which may be influenced by factors such as elevation, land cover, and the normalized difference vegetation index (NDVI). In this study, a multiple linear regression model of LST variation was constructed based on data from the Moderate Resolution Imaging Spectroradiometer (MODIS) aboard NASA's Terra satellite, relating to the period, 2000-2018. The highest LST variation of nearly 1.3 °C/decade was found in savanna areas while the lowest variation was in the evergreen broadleaf forest and woody savanna, which experienced a decrease of 2.1 °C/decade. The overall mean change of LST was -0.4 °C/decade and the regression model with LST as the dependent variable and elevation, land cover type, and NVDI as independent variables produced an R square of0.376. The variation in LST was different depending upon the NDVI. [ABSTRACT FROM AUTHOR]

Land surface temperature (LST) is one of the important factors in the physics of land surface processes to ensure the temperature change in the environment. Sumatra is one of the biggest islands in Indonesia that is suffering from deforestation. The objective of this study was to determine LST changes in Sumatra Island from 2000-2019. LST-day data for each region of Sumatra island were analyzed with cubic spline to see the seasonal pattern and get the LST changing value. The highest LST-day change was in the central region of Sumatra Island which was 0.3842 °C/decade (Z: 8.51, 95% CI: 0.296, 0.473). The lowest LST-day change was in the central north region of Sumatra Island which was –0.1574 °C/decade (Z: –3.022, 95% CI: –0.2596, –0.055). The overall LST-day change was 0.1621 °C/decade (Z: –3.022, 95% CI: –0.2596, –0.055). [ABSTRACT FROM AUTHOR]

Background: Female Sex Workers (FSWs) are main drivers of the HIV epidemic in Nepal. The work environment of sex work in Nepal is differentiated into establishment based (e.g. massage parlors, dance restaurants, hotels and lodges) and street based (e.g. streets, parks and markets). The study compares HIV, syphilis and risk behaviours among establishment-based FSWs and street-based FSWs in Kathmandu Valley of Nepal. Materials and Methods: Cross-sectional bio-behavioral surveys in 2006, 2008, 2011 and 2015 aimed to sample 2093 FSWs using two stage cluster sampling in the Kathmandu valley. Statistical analysis used chisquared tests and logistic regression models to assess differences of HIV, syphilis and risk behaviors among street-based FSWs and establishment-based FSWs. Results: The study included 39.7% street-based FSWs and 60.3% establishment-based FSWs. The street-based FSWs had lower education levels, older age groups, separated, longer duration of sex work and inconsistent condom used with clients than establishment-based FSWs (p<0.05). Establishment-based FSWs were lower exposure to HIV intervention programs and pervasive alcohol consumption and use of drugs (p<0.05). The multivariate analysis showed that street-based FSWs were more likely of HIV test (aOR=1.25, 95%CI=1.04, 1.49), HIV (aOR=4.72, 95%CI=2.19, 10.15) and syphilis (aOR=7.96, 95%CI=3.49, 18.15) than establishmentbased FSWs. Conclusion: Street-based FSWs possessed higher risk behaviour and have higher HIV and syphilis prevalence. HIV prevention interventions targeting FSWs should consider risks and vulnerability of street-based FSWs. [ABSTRACT FROM AUTHOR]

Background/Aims: To investigate the effects of bone marrow stromal cells (BMSCs) and underlying mechanisms in traumatic brain injury (TBI). Methods: Cultured BMSCs from green fluorescent protein-transgenic mice were isolated and confirmed. Cultured BMSCs were immediately transplanted into the regions surrounding the injured-brain site to test their function in rat models of TBI. Neurological function was evaluated by a modified neurological severity score on the day before, and on days 7 and 14 after transplantation. After 2 weeks of BMSC transplantation, the brain tissue was harvested and analyzed by microarray assay. And the coronal brain sections were determined by immunohistochemistry with mouse anti-growth-associated protein-43 kDa (anti-GAP-43) and anti-synaptophysin to test the effects of transplanted cells on the axonal regeneration in the host brain. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay and Western blot were used to detect the apoptosis and expression of BAX and BAD. Results: Microarray analysis showed that BMSCs expressed growth factors such as glial cell-line derived neurotrophic factor (GDNF). The cells migrated around the injury sites in rats with TBI. BMSC grafts resulted in an increased number of GAP-43-immunopositive fibers and synaptophysin-positive varicosity, with suppressed apoptosis. Furthermore, BMSC transplantation significantly downregulated the expression of BAX and BAD signaling. Moreover, cultured BMSC transplantation significantly improved rat neurological function and survival. Conclusion: Transplanted BMSCs could survive and improve neuronal behavior in rats with TBI. Mechanisms of neuroprotection and regeneration were involved, which could be associated with the GDNF regulating the apoptosis signals through BAX and BAD. © 2016 The Author(s) Published by S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective To identify the possible association between C(-106)T polymorphism of the aldose reductase (ALR) gene and diabetic retinopathy (DR) in a cohort of Chinese patients with type 2 diabetes mellitus (T2DM). Methods From November 2009 to September 2010, patients with T2DM were recruited and assigned to DR group or diabetic without retinopathy (DWR) group according to the duration of diabetes and the grading of 7-field fundus color photographs of both eyes. Genotypes of the C(-106)T polymorphism (rs759853) in ALR gene were analyzed using the MassARRAY genotyping system and an association study was performed. Results A total of 268 T2DM patients (129 in the DR group and 139 in the DWR group) were included in this study. No statistically significant differences were observed between the 2 groups in the age of diabetes onset ( P =0.10) and gender ( P =0.78). The success rate of genotyping for the study subjects was 99.6% (267/268), with one case of failure in the DR group. The frequencies of the T allele in the C(-106)T polymorphism were 16.0% (41/256) in the DR group and 19.4% (54/278) in the DWR group ( P =0.36). There was no significant difference in the C(-106)T genotypes between the 2 groups ( P =0.40). Compared with the wild-type genotype, odds ratio (OR) for the risk of DR was 0.7 (95% CI, 0.38-1.3) for the heterozygous CT genotype and 0.76 (95% CI, 0.18-3.25) for the homozygous TT genotype. The risk of DR was positively associated with microalbuminuria (OR=4.61; 95% CI, 2.34-9.05) and insulin therapy (OR=3.43; 95% CI, 1.94-6.09). Conclusions Microalbuminuria and insulin therapy are associated with the risk of DR in Chinese patients with T2DM. C(-106)T polymorphism of the ALR gene may not be significantly associated with DR in Chinese patients with T2DM. [ABSTRACT FROM AUTHOR]

Aim: To compare the mortality, morbidity of emergency and elective cesarean section with vaginal delivery among Asian teaching hospitals Methods: Hospital based prospective study at 12 centers of 9 countries. Results: 12 591 vaginal deliveries, 3062 elective and 4328 emergency cesarean section were followed up to 5 days postpartum. Maternal deaths (95% CI) per 1000 births among vaginal deliveries being 0.47 (0.17, 1.03) was not significantly different from 0.31 (0.01, 1.73) of elective cesarean section and both rates were significantly lower than 2.87 (1.53, 4.91) per 1000 births of emergency section. The vaginal delivery group had significantly lower incidences of all major complication except significantly higher chance of secondary operations and non-significantly different risk for endometritis. Corresponding neonatal mortality per 1000 deliveries among the three groups were 7 (5.6, 8.6), 2.2 (0.9, 4.6) and 12.4 (9.3, 16.2) ( P < 0.001). Vaginal delivery also had higher rates of severe asphyxia and palsy than elective cesarean section. Conclusion: Maternal complications were increased by cesarean delivery but elective section may reduce neonatal complication. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association between primary vesicoureteral reflux (VUR) and renal scarring in children using 99 m Technetium-labelled dimercaptosuccinic acid (DMSA). Methods: Children attending at Songklanagarind Hospital from 1987 to 2002 were evaluated. Results: Ages at diagnosis of VUR in 46 boys and 52 girls were 1.1 ± 1.6 and 2.9 ± 2.5 years, median 0.6 and 2.3 years, respectively ( P < 0.001). DMSA scans were performed at 4.1 ± 3.6 years. Renal parenchymal damage was detected in 34 kidneys (22%) of 154 demonstrated refluxing ureters, and one kidney (2%) of 42 non-refluxing ureters ( P = 0.002). Of 79 refluxing ureters in boys and 75 refluxing ureters in girls, there were 25 and nine renal scars, respectively (32% and 12%, P = 0.003). Renal scars in VUR grades I–V were 11%, 7%, 12%, 44% and 64%, respectively ( P < 0.001). Multivariate analysis revealed that high grade VUR ( P < 0.001), age of diagnosis of VUR greater than 5 years ( P = 0.001), and male gender ( P = 0.002) were the most significant risk factors for renal scarring. Conclusion: High-grade VUR, age of diagnosis of VUR greater than 5 years and male gender were the most significant risk factors for renal scarring. [ABSTRACT FROM AUTHOR]

In order to study the relationships of body fat distribution, insulin sensitivity and cardiovascular risk factors in lean, healthy non-diabetic Thai men and women, 32 healthy, non-diabetic subjects, 16 men and 16 women, with respective mean age 28.4±6.6 (S.D.) and 32.8±8.9 years, mean BMI 21.0±2.8 and 21.2±3.7 kg/m2, were measured for total body fat and abdominal fat by dual energy X-ray absorptiometry (DEXA), anthropometry and insulin sensitivity by euglycemic hyperinsulinemic clamp. Cardiovascular risk factors included fasting and post-glucose challenge plasma glucose and insulin, blood pressure, lipid profile, fibrinogen and uric acid. For similar age and BMI, men had a lower amount and percent of total body fat, but had a higher proportion of abdominal/total body fat than women. In men, insulin sensitivity, as determined by glucose infusion rate during euglycemic hyperinsulinemic clamp, was inversely correlated with total body fat, abdominal fat, BMI and waist circumference, whereas only total body fat, but not abdominal fat, BW and hip circumference were inversely correlated with insulin sensitivity in women. No cardiovascular risk factors, except area under the curve (AUC), of plasma insulin in women correlated with insulin sensitivity when adjusted for total body fat. After age adjustment, total body fat was better correlated with fasting and AUC of plasma glucose and insulin in men and with systolic blood pressure as well as triglyceride levels in women. Only HDL-C in men was better correlated with abdominal fat. In conclusion, there were sex-differences in body fat distribution and its relationship with insulin sensitivity and cardiovascular risk factors in lean, healthy non-diabetic Thai subjects. Total body fat was a major determinant of insulin sensitivity in both men and women, abdominal fat may play a role in men only. Body fat, not insulin sensitivity, was associated with cardiovascular risk factors in these lean subjects. [Copyright &y& Elsevier]