Risk Factors for Loss to Follow-Up among People Who Inject Drugs in a Risk Reduction Program at Karachi,Pakistan. A Case-Cohort Study

Introduction

Retention of male people who inject drugs (PWIDs) is a major challenge for harm reduction programs that include sterile needle/syringe exchange in resource-limited settings like Pakistan. We assessed the risk factors for loss to follow-up among male PWIDs enrolled in a risk reduction program in Karachi, Pakistan.

Methods

We conducted a prospective cohort study among 636 HIV-uninfected male PWIDs enrolled during March-June 2009 in a harm reduction program for the estimation of incidence rate. At 24 months post-enrollment, clients who had dropped out of the program were defined as lost to follow-up and included as cases for case-cohort study.

Results

The median age of the participants was 29 years (interquartile range: 23–36). Active outreach accounted for 76% (483/636) of cohort recruits. Loss to follow-up at 24 months was 25.5% (162/636). In multivariable logistic regression, younger age (AOR: 0.97, 95% CI: 0.92–0.99, p = 0.028), clients from other provinces than Sindh (AOR: 1.49, 95% CI: 1.01–2.22, p = 0.046), having no formal education (AOR: 3.44, 95% CI: 2.35–4.90, p<0.001), a history of incarceration (AOR: 1.68, 95% CI: 1.14–2.46, p<0.008), and being homeless (AOR: 1.47, 95% CI: 1.00–2.19, p<0.049) were associated with loss to follow-up.

Conclusions

Our cohort retained 74.5% of male PWIDs in Karachi for 24 months. Its loss to follow up rate suggested substantial ongoing programmatic challenges. Programmatic enhancements are needed for the highest risk male PWIDs, i.e., younger men, men not from Sindh Province, men who are poorly educated, formerly incarcerated, and/or homeless.     

Synthesis and antimicrobial activity of 7-fluoro-3-aminosteroids

A series of 7-fluoro-3-aminosteroids were synthesized and their in vitro antimicrobial activities were evaluated against Gram-positive and Gram-negative bacteria. The nucleophilic fluorination of several 7beta-hydroxysteroids by diethylaminosulfur trifluoride in n-pentane, followed by reductive amination of the resulting 7-fluoro-3-ketosteroids with spermidine in the presence of NaBH(3)CN, afforded 7-fluoro-3-aminosteroids in high yield. Compound 25 showed the highest antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pyogenes, and Escherichia coli.     

Effect of aniline coupling on kinetic and thermodynamic properties of Fusarium solani glucoamylase

Purified glucoamylase (GA) from Fusarium solani was chemically modified by cross-linking with aniline hydrochloride in the presence of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) for 1 [aniline-coupled glucoamylase-1 (ACG-1)], 7 (ACG-7), and 13 min (ACG-13). The aniline coupling of GA had a profound enhancing effect on temperature, pH optima, and pK _a’s of active site residues. The specificity constants (K _cat/K _m) of native, ACG-1, ACG-7, and ACG-13 were 136, 244, 262, and 208 at 55°C for starch, respectively. The enthalpy of activation (ΔH*) and free energy of activation (ΔG*) for soluble starch hydrolysis were lower for the chemically modified forms compared to native GA. Proteolysis of ACGs by α-chymotrypsin and subtilisin resulted in activation.     

Genome-wide identification,evolution and expression analysis of cyclic nucleotide-gated channels in tobacco (Nicotiana tabacum L.)

Tobacco (Nicotiana tabacum) serve as the top leading commercial, non-food, and model crop worldwide. Cyclic nucleotide-gated channels (CNGCs) are ligand-gated, calcium-permeable, divalent, cation-selective channels, involved in important biological functions. Here, we systematically characterized thirty-five CNGC genes in the genome of Nicotiana tabacum, and classified into four phylogenetic groups. Evolutionary analysis showed that NtabCNGC family of N. tabacum originated from the parental genome of N. sylvestris and N. tomentosiformis, and further expanded via tandem and segmental duplication events. Tissue-specific expression analysis showed that twenty-three NtabCNGC genes are involved in the development of various tobacco tissues. Subsequent RT-qPCR analyses indicated that these genes are sensitive towards external abiotic and biotic stresses. Notable performances were exhibited by group-I and IV CNGC genes against black shank, Cucumber mosaic virus, Potato virus Y, cold, drought, and cadmium stresses. Our analyses also suggested that NtabCNGCs can be regulated by phosphorylation and miRNAs, and multiple light, temperature, and pathogen-responsive cis-acting regulatory elements present in promotors. These results will be useful for elaborating the biological roles of NtabCNGCs in tobacco growth and development.     

Rice-associated antagonistic bacteria suppress the Fusarium fujikoroi causing rice bakanae disease

BioControl - Rice bakanae disease, caused by Fusarium fujikoroi, is an economically important disease that poses a threat to rice cultivation. It causes serious yield losses quantitatively and...     

Weight Loss and Impact on Quality of Life in Parkinson’s Disease

IntroductionWeight loss is common in Parkinson’s Disease (PD) and sometimes may precede the diagnosis. Weight loss is associated with multiple factors but its impact on health-related quality of life (HRQL) in PD remains unknown. We sought to investigate the factors associated with weight change and to quantify its effect on HRQL.MethodsThe National Parkinson Foundation Quality Improvement Initiative (NPF-QII) data was used to analyze PD patients longitudinally between two visits, separated by 12±6 months. Multiple linear regression analyses were used to assess the associations between baseline covariates and body weight change per month, and to evaluate whether, and to what degree, Parkinson’s Disease Questionnaire (PDQ-39) scores were affected.ResultsA higher Hoehn & Yahr stage, higher number of comorbidities, older age, lower MOCA estimate, and higher rate of levodopa usage were observed in patients who lost weight. Multivariate regression analysis indicated that age and levodopa usage were significantly associated with weight loss. Furthermore, monthly body weight loss was significantly associated with HRQL decline in PD patients. Loss of 1 lb (0.45 kg) per month was associated with a decline in QOL: an increase of 0.5% in PDQ-39 Summary Index score (p=0.004), and 1.1% and 1.5% increases in the mobility and ADL dimensions, respectively.ConclusionWeight loss in PD is common and seems to correlate with worsened HRQL. Awareness of factors associated with weight loss and its relation to HRQL may help practitioners improve patient management and expectations.     

On the snow leopard Trails: Occupancy pattern and implications for management in the Pamir

The snow leopard (Panthera uncia) inhabits one of the most challenging environments on Earth, referred to as the ‘third pole’. Only a fraction of its vast range has been explored thus far, owing to myriad of barriers inflicted by the remote terrain and socio-ecological realities of the landscapes. Understanding distribution patterns of species is essential to devise practical management measures. This study aimed to understand the distribution pattern and factors influencing occupancy of snow leopard in the Pamir Mountain range through sign-based occupancy modelling. Our study confirmed that the Pamir range is a snow leopard stronghold, with occupancy estimated at 0.57 ± 0.02. The topographic features positively influenced the detection probability (p = 0.37 ± 0.005) of snow leopards. Occupancy was influenced by mean annual precipitation (β = -6.12 ± 1.8), density of roads (β = -1.61 ± 0.6) and water sources (β = 0.74 ± 0.4). Our findings underpin that sign-based distribution surveys provide vigorous scientific knowledge about elusive species and merit replication being used for other species. We propose to redefine the protected area boundaries based on ecological knowledge and encourage transboundary cooperation to safeguard snow leopards at a landscape scale.