Intervention based on BASNEF model increases exclusive breastfeeding in preterm infants in Iran: a randomized controlled trial

Background

The objective of this study is to determine the effect of a consultation model, Beliefs, Attitudes, Subjective Norms and Enabling Factors (BASNEF), and the counselling steps using GATHER-Greet clients, Ask clients about themselves, Tell clients about their choices, Help clients choose, Explain what to do, and Return for follow-up-on the continuation rates of exclusive breastfeeding in mothers of premature infants.

Methods

This is a randomized controlled clinical trial carried out on 124 mothers with premature infants hospitalized in Fatemieh Hospital, city of Hamadan, in 2014. Participants were randomly assigned to either the intervention or control groups. The initial demographic questionnaire carried out in both groups included three questions about the continuation of exclusive breastfeeding, BASNEF, a checklist related to the lactation performance documented by mothers and the weight gain of their infants. Five breastfeeding consultation sessions based on the BASNEF model and counselling steps using GATHER, were held for the mothers in the intervention group for five consecutive days. Then follow-up weight gain and the questionnaire completion were performed in both groups at 1, 2, 3 and 4 months after the intervention.

Results

Baseline characteristics were similar in the two groups. There were no significant differences between both groups in the rate of exclusive breastfeeding, lactation performance and infant weight at baseline. The intervention group had significantly higher rates of exclusive breastfeeding, 72.6% versus the control group of 16.1%, at the end of the 4 month follow-up. Also the intervention group had significantly higher mean scores of lactation performance (8.62?±?2.08 vs 6.40?±?1.84 in the control group) and infant weight (5694.80?±?779.43 vs 4760.17?±?859.12 in the control group) at the end of the 4 month follow-up.

Conclusion

Breastfeeding consultation of mothers based on the BASNEF model and using GATHER counselling steps increased the rate of exclusive breastfeeding, lactation performance and weight gain of premature infants. Therefore, breastfeeding counselling sessions are recommended for all mothers of premature infants.

Trial registration

Iranian Registry of Clinical Trials number IRCT2014111013405N6 and date registered, January 5, 2015.

     

Red cell enzyme polymorphisms in three Iranian population samples: Tabriz,Yazd, Mashhad

Three population samples from Iran (Tabriz, Yazd, Mashhad) have been typed for four enzyme group polymorphisms: ACP1, ESD, AK, and PGD. The phenotype and allele frequencies are presented and compared with other Iranian populations. The AK allele frequencies do not show significant intergroup heterogeneity, whereas ACP1, ESD and PGD allele frequencies disclose obvious heterogeneity. The possible reasons therefore are discussed.     

Ethnic and Geographic Differentiation of Helicobacter pylori within Iran

The bacterium Helicobacter pylori colonizes the human stomach, with individual infections persisting for decades. The spread of the bacterium has been shown to reflect both ancient and recent human migrations. We have sequenced housekeeping genes from H. pylori isolated from 147 Iranians with well-characterized geographical and ethnic origins sampled throughout Iran and compared them with sequences from strains from other locations. H. pylori from Iran are similar to others isolated from Western Eurasia and can be placed in the previously described HpEurope population. Despite the location of Iran at the crossroads of Eurasia, we found no evidence that the region been a major source of ancestry for strains across the continent. On a smaller scale, we found genetic affinities between the H. pylori isolated from particular Iranian populations and strains from Turks, Uzbeks, Palestinians and Israelis, reflecting documented historical contacts over the past two thousand years.     

Crystal structure of human group X secreted phospholipase A2. Electrostatically neutral interfacial surface targets zwitterionic membranes

The crystal structure of human group X (hGX) secreted phospholipase A2 (sPLA2) has been solved to a resolution of 1.97 A. As expected the protein fold is similar to previously reported sPLA2 structures. The active site architecture, including the positions of the catalytic residues and the first and second shell water around the Ca2+ cofactor, are highly conserved and remarkably similar to the group IB and group IIA enzymes. Differences are seen in the structures following the (1-12)-N-terminal helix and at the C terminus. These regions are proposed to interact with the substrate membrane surface. The opening to the active site slot is considerably larger in hGX than in human group IIA sPLA2. Furthermore, the electrostatic surface potential of the hGX interfacial-binding surface does not resemble that of the human group IIA sPLA2; the former is highly neutral, whereas the latter is highly cationic. The cationic residues on this face of group IB and IIA enzymes have been implicated in membrane binding and in k(cat*) allostery. In contrast, hGX does not show activation by the anionic charge at the lipid interface when acting on phospholipid vesicles or short-chain phospholipid micelles. Together, the crystal structure and kinetic results of hGX supports the conclusion that it is as active on zwitterionic as on anionic interfaces, and thus it is predicted to target the zwitterionic membrane surfaces of mammalian cells.     

Interfacial kinetic and binding properties of the complete set of human and mouse groups I,II, V,X, and XII secreted phospholipases A2

Expression of the full set of human and mouse groups I, II, V, X, and XII secreted phospholipases A(2) (sPLA(2)s) in Escherichia coli and insect cells has provided pure recombinant enzymes for detailed comparative interfacial kinetic and binding studies. The set of mammalian sPLA(2)s display dramatically different sensitivity to dithiothreitol. The specific activity for the hydrolysis of vesicles of differing phospholipid composition by these enzymes varies by up to 4 orders of magnitude, and yet all enzymes display similar catalytic site specificity toward phospholipids with different polar head groups. Discrimination between sn-2 polyunsaturated versus saturated fatty acyl chains is <6-fold. These enzymes display apparent dissociation constants for activation by calcium in the 1-225 microm range, depending on the phospholipid substrate. Analysis of the inhibition by a set of 12 active site-directed, competitive inhibitors reveals a large variation in the potency among the mammalian sPLA(2)s, with Me-Indoxam being the most generally potent sPLA(2) inhibitor. A dramatic correlation exists between the ability of the sPLA(2)s to hydrolyze phosphatidylcholine-rich vesicles efficiently in vitro and the ability to release arachidonic acid when added exogenously to mammalian cells; the group V and X sPLA(2)s are uniquely efficient in this regard.     

Cytosolic phospholipase A2-alpha is necessary for platelet-activating factor biosynthesis, efficient neutrophil-mediated bacterial killing, and the innate immune response to pulmonary infection: cPLA2-alpha does not regulate neutrophil NADPH oxidase activity

The role of a cytosolic phospholipase A(2)-alpha (cPLA(2)-alpha) in neutrophil arachidonic acid release, platelet-activating factor (PAF) biosynthesis, NADPH oxidase activation, and bacterial killing in vitro, and the innate immune response to bacterial infection in vivo was examined. cPLA(2)-alpha activity was blocked with the specific cPLA(2)-alpha inhibitor, Pyrrolidine-1 (human cells), or by cPLA(2) -alpha gene disruption (mice). cPLA(2)-alpha inhibition or gene disruption led to complete suppression of neutrophil arachidonate release and PAF biosynthesis but had no effect on neutrophil NADPH oxidase activation, FcgammaII/III or CD11b surface expression, primary or secondary granule secretion, or phagocytosis of Escherichia coli in vitro. In contrast, cPLA(2)-alpha inhibition or gene disruption diminished neutrophil-mediated E. coli killing in vitro, which was partially rescued by exogenous arachidonic acid or PAF but not leukotriene B(4). Following intratracheal inoculation with live E. coli in vivo, pulmonary PAF biosynthesis, inflammatory cell infiltration, and clearance of E. coli were attenuated in cPLA(2)-alpha(-/-) mice compared with wild type littermates. These studies identify a novel role for cPLA(2)-alpha in the regulation of neutrophil-mediated bacterial killing and the innate immune response to bacterial infection.     

Physical function continues to improve when clinical remission is sustained in rheumatoid arthritis patients

IntroductionTo investigate the course of functional status assessed by health assessment questionnaire (HAQ) in rheumatoid arthritis (RA) patients with sustained clinical remission (REM).MethodsIn recent RA clinical trials, we identified patients with subsequent visits of ≥24 weeks in clinical REM according to the disease activity score using 28-joint counts including C-reactive protein (DAS28) (≤2.6), or simplified disease activity index (SDAI) (≤3.3). Area under the curve (AUC) and mean HAQ scores throughout the time in sustained REM were compared using t test, analyses of variance (ANOVA) and adjusted general linear modeling (GLM) with repeated measures. In Cox regression analyses, the time to regain full physical function was modeled. Sensitivity analyses were performed in patients of sustained SDAI low disease activity (LDA; SDAI ≤11).ResultsA total of 610 out of 4364 patients achieved sustained DAS28 REM (14 %) and 252 SDAI REM (5.8 %). ANOVA testing for linear trend showed significant decrease of mean HAQ from week 0 (start of REM) to week 24, regardless of REM criteria used. AUC of HAQ throughout 24 weeks of REM was higher in DAS28 compared to SDAI REM (p ≤0.01). GLM adjusting for covariates showed significant decrease of monthly HAQ scores from week 0 to 24 (DAS28: 0.276, 0.243, 0.229, 0.222, 0.219, 0.209 to 0.199; p = 0.0001; SDAI: 0.147, 0.142, 0.149, 0.129, 0.123, 0.117 to 0.114; p = 0.029). Similarly, a decrease of HAQ over time was found in patients of sustained SDAI LDA. In DAS28 REM, the chance of regaining full physical function was higher for female (hazard ratio HR [95 % confidence interval]: 1.41 [1.13–1.76]) and early RA patients (disease duration ≤2 years: HR 1.29 [1.01–1.65]); in SDAI REM no significant differences were found.ConclusionsPhysical function continues to improve if the target of REM or LDA is sustained. The stringency of the remission criteria determines achievement of the best possible functional improvement.

Electronic supplementary material

The online version of this article (doi:10.1186/s13075-015-0719-x) contains supplementary material, which is available to authorized users.     

Alteration in REM sleep and sleep spindles’ characteristics by a model of immobilization stress in rat

Sleep and Biological Rhythms - Investigation of sleep spindles’ oscillations is increasingly considered as a major avenue of inquiry in analyzing the microarchitecture of sleep. Previous...     

Recombinant production and properties of binding of the full set of mouse secreted phospholipases A2 to the mouse M-type receptor

To date, 12 secreted phospholipases A2 (sPLA2s) have been identified in the mouse species and divided into three structural collections (I/II/V/X, III, and XII). On the basis of their different molecular properties and tissue distributions, each sPLA2 is likely to exert distinct functions by acting as an enzyme or ligand for specific soluble proteins or receptors, among which the M-type receptor is the best-characterized target. Here, we present the properties of binding of the full set of mouse sPLA2s to the mouse M-type receptor. All enzymes have been produced in Escherichia coli or insect cells, and their properties of binding to the cloned and native M-type receptor have been determined. sPLA2s IB, IIA, IIE, IIF, and X are high-affinity ligands (K0.5 = 0.3-3 nM); sPLA2s IIC and V are low-affinity ligands (K0.5 = 30-75 nM), and sPLA2s IID, III, XIIA, and XIIB bind only very weakly or do not bind to the M-type receptor (K0.5 > 100 nM). Three exogenous parvoviral group XIII PLA2s and two fungal group XIV sPLA2s do not bind to the receptor. Together, these results indicate that the mouse M-type receptor is selective for only a subset of mouse sPLA2s from the group I/II/V/X structural collection. Binding of mouse sPLA2s to a recombinant soluble mouse M-type receptor leads in all cases to inhibition of enzymatic activity, and the extent of deglycosylation of the receptor decreases yet does not abolish sPLA2 binding. The physiological meaning of binding of sPLA2 to the M-type receptor is discussed on the basis of our current knowledge of sPLA2 functions.     

Micromorphological studies of the leaf epidermis of Iranian Cotoneaster Medik

In this study, micromorphological features of the leaf epidermal cells of 17 species of Iranian Cotoneaster were determined. The studied species were compared with each other and with phylogenetic relationships established by previous studies. Three populations of C. integerrimus and C. multiflorus were studied as representatives of C. subgen. Cotoneaster and Chaenopetalum, respectively. To evaluate quantitative and qualitative characters, multiple correspondence analysis (MCA) and factor analysis of mixed data (FAMD) were performed. Finally, relationships among the taxa were illustrated by hierarchical clustering analysis. Three stomatal types were identified, i.e. anomocytic, stephanocytic and actino‐stephanocytic. The wax and cuticle density was higher in species from semi‐moist habitats than in those from dry and semi‐dry habitats. The patterns formed by the anticlinal walls of the epidermal cells were sinuous, repand and straight‐curved. Interestingly, there was a significant relationship between the length of leaves, the density of the indumentum and the pattern formed by the anticlinal cell walls. The leaves of species with large leaves also have lower hair density and more curved anticlinal cell walls. It appears probable that climatic conditions affected the evolution of leaf micro‐morphological characters during the early diversification of the genus, but that these characters have subsequently been permanently fixed by phylogenetic constraints and thus appear diagnostic for extant species.