Patterns and Predictors of Smokeless Tobacco Use among Adults in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey

Background

Although smokeless tobacco (SLT) use is prevalent in South Asian countries including Bangladesh, information about the pattern and correlates of SLT use is scarce. This study described the pattern and predictors of SLT use among Bangladeshi adults.

Methods

The data for this study were derived from the International Tobacco Control Policy Evaluation Bangladesh (ITC BD) Survey, a prospective cohort survey of a nationally representative sample of smokers and non-smokers, conducted during November 2011 and May 2012. The study included 5522 adults aged 15 or above. We used multiple logistic regression models to identify predictors of SLT use.

Results

Of the respondents (N = 5522), 20% were SLT users. In general, SLT use was significantly higher among women, the illiterate and residents of the Dhaka slums or non-tribal/non-border areas outside Dhaka; SLT use increased with age. Several attitudinal factors were also associated with SLT use. Multivariable logistic regression analyses revealed several predictors of SLT use: being female (OR = 1.96, 95% confidence interval, CI: 1.18–3.24), an increasing age, being a resident of a Dhaka slum (OR = 5.86; 95% CI: 3.73–9.21) or non-tribal/non-border areas outside Dhaka (OR = 3.42; 95% CI: 1.94–6.03), being illiterate (OR = 3.37; 95% CI: 1.99–5.71), holding positive opinion towards societal approval of SLT use (OR = 5.84; 95% CI: 3.38–10.09), holding positive opinion towards SLT use by women (OR = 2.63; 95% CI: 1.53–4.54), believing that SLT is addictive (OR = 2.96; 95% CI: 1.51–5.81), and believing SLT is less harmful than bidi (OR = 2.22; 95% CI: 1.36–3.62).

Conclusion

The findings suggest that coordinated efforts of governmental and non-governmental organizations, targeting both smoked tobacco and SLT use reduction and cessation, could be modified to reach each level of population including those who are marginalized, female, less educated and elderly. As most tobacco control programs in Bangladesh target mainly cigarette or bidi smoking, coordinated programs are needed that will also include SLT use within the tobacco control policy and prevention strategies.     

China's One-Child Policy and the Empowerment of Urban Daughters

Urban daughters have benefited from the demographic pattern produced by China's one–child policy. In the system of patrilineal kinship that has long characterized most of Chinese society, parents had little incentive to invest in their daughters. Singleton daughters, however, enjoy unprecedented parental support because they do not have to compete with brothers for parental investment. Low fertility enabled mothers to get paid work and, thus, gain the ability to demonstrate their filiality by providing their own parents with financial support. Because their mothers have already proven that daughters can provide their parents with old age support, and because singletons have no brothers for their parents to favor, daughters have more power than ever before to defy disadvantageous gender norms while using equivocal ones to their own advantage. [Keywords: gender, family, fertility, demography, China]     

Comparative Characterization of Cells from the Various Compartments of the Human Umbilical Cord Shows that the Wharton’s Jelly Compartment Provides the Best Source of Clinically Utilizable Mesenchymal Stem Cells

The human umbilical cord (UC) is an attractive source of mesenchymal stem cells (MSCs) with unique advantages over other MSC sources. They have been isolated from different compartments of the UC but there has been no rigorous comparison to identify the compartment with the best clinical utility. We compared the histology, fresh and cultured cell numbers, morphology, proliferation, viability, stemness characteristics and differentiation potential of cells from the amnion (AM), subamnion (SA), perivascular (PV), Wharton’s jelly (WJ) and mixed cord (MC) of five UCs. The WJ occupied the largest area in the UC from which 4.61 ± 0.57 x 10⁶ /cm fresh cells could be isolated without culture compared to AM, SA, PV and MC that required culture. The WJ and PV had significantly lesser CD40+ non-stem cell contaminants (26-27%) compared to SA, AM and MC (51-70%). Cells from all compartments were proliferative, expressed the typical MSC-CD, HLA, and ESC markers, telomerase, had normal karyotypes and differentiated into adipocyte, chondrocyte and osteocyte lineages. The cells from WJ showed significantly greater CD24+ and CD108+ numbers and fluorescence intensities that discriminate between MSCs and non-stem cell mesenchymal cells, were negative for the fibroblast-specific and activating-proteins (FSP, FAP) and showed greater osteogenic and chondrogenic differentiation potential compared to AM, SA, PV and MC. Cells from the WJ offer the best clinical utility as (i) they have less non-stem cell contaminants (ii) can be generated in large numbers with minimal culture avoiding changes in phenotype, (iii) their derivation is quick and easy to standardize, (iv) they are rich in stemness characteristics and (v) have high differentiation potential. Our results show that when isolating MSCs from the UC, the WJ should be the preferred compartment, and a standardized method of derivation must be used so as to make meaningful comparisons of data between research groups.     

EXPERIMENTAL EVIDENCE SUPPORTS THE USE OF δ15N CONTENT OF THE OPPORTUNISTIC GREEN MACROALGA ENTEROMORPHA INTESTINALIS (CHLOROPHYTA) TO DETERMINE NITROGEN SOURCES TO ESTUARIES1

One assumption underlying the use of stable nitrogen isotopes (δ¹⁵N) for determining nitrogen (N) sources is that the δ¹⁵N of primary producers reflects N sources in a predictable manner. To test this assumption, we conducted two experiments. First, we varied δ¹⁵N with constant concentration of NO₃^? or NH₄⁺ to determine whether either nutrient is preferentially selected by the macroalga Enteromorpha intestinalis (L. Link) and if isotopic ratio affected selectivity. Tissue δ¹⁵N increased with δ¹⁵N supplied for both NO₃^? and NH₄⁺ but sequestering of ¹⁵NH₄⁺ was more rapid than for ¹⁵NO₃^?; in addition, some evidence suggested that high relative abundance of ¹⁵N may have decreased NO₃^? uptake. Second, we held δ¹⁵N constant and varied concentrations of either NO₃^? or NH₄⁺ to determine whether fractionation is concentration dependent. Uptake of N was described by a Michaelis‐Menten equation for both NO₃^? and NH₄⁺, with higher V_max and K_1/2 for NH₄⁺ than for NO₃^?. There was no relationship between N concentration and tissue δ¹⁵N for either NO₃^? or NH₄⁺; therefore, no selection for ¹⁴N over ¹⁵N occurred. This study demonstrated that accumulation of ¹⁵N in macroalgal tissue was predictable over a range of water δ¹⁵N values and N concentrations, suggesting that E. intestinalis may be used to assess the availability of N sources to estuarine and coastal communities. However, caution must be used when interpreting tissue δ¹⁵N depending on the primary inorganic form of N available.     

Expression of Hypoxic Marker Carbonic Anhydrase IX Predicts Poor Prognosis in Resectable Hepatocellular Carcinoma

Carbonic anhydrase IX (CA-IX), a hypoxia marker, correlates with tumor progression in a variety of human cancers. However, the role of CA-IX in hepatocellular carcinomas (HCCs) remains largely unknown. We examined the expression of 277 unifocal, resectable, primary HCC tumors using immunohistochemistry. The CA-IX protein was expressed in 110 of the 227 (48.5%) HCC tumors. The expression of CA-IX correlated with younger age (P = 0.0446), female sex (P = 0.0049), high serum α-fetoprotein levels (P<1x10^-6), larger tumor size (P = 0.0031), high tumor grade P<1x10^-6) and high tumor stage (P = 1.5x10^-6). Patients with HCC tumors that expressed CA-IX were more likely to have lower 5-year disease-free survival (DFS; P = 0.0001) and 5-year overall survival (OS; P<1x10^-6). The multivariate analysis indicated that CA-IX expression was an independent predictor for high tumor stage (P = 0.0047) and DFS (P = 0.0456), and a borderline predictor for OS (P = 0.0762). Furthermore, CA-IX expression predicted poor DFS and OS in patients with high tumor stage (P = 0.0004 and P<1x10^-6, respectively). Interestingly, CA-IX expression might contribute to the worse prognosis of female patients with advanced HCCs. Our study indicates the expression of the CA-IX protein is a crucial predictor of poor prognosis in resectable HCC, and it is also an unfavorable prognostic predictor in HCC patients with high tumor stage.     

The first description of population density and habitat use of the mainland clouded leopard Neofelis nebulosa within a logged-primary forest in South East Asia

The mainland clouded leopard (Neofelis nebulosa) is classified as vulnerable under the IUCN Red List, meaning that it faces a high risk of extinction in the wild. However, hardly any ecological research has been published on this species apart from several radiotelemetry studies in Thailand and Nepal, and one camera-trapping study in India. Here we present findings on the clouded leopard from a camera-trapping study conducted in Temengor forest reserve (a logged-over forest) and Royal Belum State Park (a primary forest) within Peninsular Malaysia. Using the spatially-explicit capture-recapture method, the density from Temengor forest reserve and Royal Belum State Park was estimated at 3.46 ± SE 1.00 and 1.83 ± SE 0.61, respectively. Clouded leopard habitat use was found to be highly influenced by the availability of small and medium prey species and therefore intrinsically highlights the potential conservation importance of species such as pig-tailed macaques, porcupine, mouse deer and small carnivores. These findings provide the first estimates of density and habitat use of this species in a logged-primary forest from both Peninsular Malaysia and South East Asia. Our study provides important baseline information on clouded leopards and contributes to filling up the knowledge gap that exists in understanding the population ecology of this species, not only within Peninsular Malaysia, but also on a regional level.     

Cytotoxic mechanisms of panduratin A on A375 melanoma cells: A quantitative and temporal proteomics analysis

Melanoma is a lethal form of skin cancer with rising global incidence. However, limited treatment options are available for advanced melanoma and this is further compounded by the development of resistance toward existing drugs. Panduratin A (PA), a cyclohexanyl chalcone found in Boesenbergia rotunda, was investigated for its cytotoxic potentials against human malignant melanoma A375 cells. Our initial findings revealed that mitochondrion is the primary acting site of PA on A375 cancer cells and the cytotoxic mechanisms of PA were further investigated using a temporal quantitative proteomics approach by iTRAQ 2D‐LC‐MS/MS. Comprehensive proteomics analysis identified 296 proteins that were significantly deregulated in PA‐treated A375 cells and revealed the involvement of mitochondrial oxidative phosphorylation, secretory and ER stress pathway, and apoptosis. We further confirmed that the PA‐induced apoptosis was mediated by prolonged ER stress at least in part via the PERK/eIF2α/ATF4/CHOP pathway. Pretreatment with cycloheximide, an ER stress inhibitor rescued PA‐induced cell death, which was accompanied by the suppression of ER‐stress‐related HSPA5 and CHOP proteins. The present study provides comprehensive mechanistic insights into the cytotoxic mechanisms of PA.