The effectiveness of the peer-delivered Thinking Healthy PLUS (THPP+) Program for maternal depression and child socioemotional development in Pakistan: study protocol for a randomized controlled trial

BackgroundThe negative effects of perinatal depression on the mother and child start early and persist throughout the lifecourse (Lancet 369(9556):145–57, 2007; Am J Psychiatry 159(1):43-7, 2002; Arch Dis Child 77(2):99–101, 1997; J Pak Med Assoc 60(4):329; J Psychosoma Res 49(3):207–16, 2000; Clin Child Fam Psychol Rev 14(1):1–27, 2011). Given that 10–35 % of children worldwide are exposed to perinatal depression in their first year of life (Int Rev Psychiatry 8(1):37–54, 1996), mitigating this intergenerational risk is a global public health priority (Perspect Public Health 129(5):221–7, 2009; Trop Med Int Health 13(4):579–83, 2008; Br Med Bull 101(1):57–79, 2012). However, it is not clear whether intervention with depressed women can have long-term benefits for the mother and/or her child. We describe a study of the effectiveness of a peer-delivered depression intervention delivered through 36 postnatal months, the Thinking Healthy Program Peer-delivered PLUS (THPP+) for women and their children in rural Pakistan.Methods/designThe THPP+ study aims are: (1) to evaluate the effects of an extended 36-month perinatal depression intervention on maternal and index child outcomes using a cluster randomized controlled trial (c-RCT) and (2) to determine whether outcomes among index children of perinatally depressed women in the intervention arm converge with those of index children born to perinatally nondepressed women. The trial is designed to recruit 560 pregnant women who screened positive for perinatal depression (PHQ-9 score ≥10) from 40 village clusters, of which 20 receive the THPP+ intervention. An additional reference group consists of 560 perinatally nondepressed women from the same 40 clusters as the THPP+ trial. The women in the nondepressed group are not targeted to receive the THPP+ intervention; but, by recruiting pregnant women from both intervention and control clusters, we are able to evaluate any carryover effects of the THPP+ intervention on the women and their children. Perinatally depressed women in the THPP+ intervention arm receive bimonthly group-based sessions. Primary outcomes are 3-year maternal depression and 3-year child development indicators. Analyses are intention-to-treat and account for the clustered design.DiscussionThis trial, together with the reference group, has the potential to further our understanding of the early developmental lifecourse of children of both perinatally depressed and perinatally nondepressed women in rural Pakistan and to determine whether intervening with women’s depression in the perinatal period can mitigate the negative effects of maternal depression on 36-month child development.

Trial registration

THPP-P ClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT02111915","term_id":"NCT02111915"}}NCT02111915 (registered on 9 April 2014).THPP+ ClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT02658994","term_id":"NCT02658994"}}NCT02658994 (registered on 21 January 2016).Sponsor: Human Development Research Foundation (HDRF).

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-016-1530-y) contains supplementary material, which is available to authorized users.     

Detecting the native ligand orientation by interfacial rigidity: SiteInterlock

Understanding the physical attributes of protein‐ligand interfaces, the source of most biological activity, is a fundamental problem in biophysics. Knowing the characteristic features of interfaces also enables the design of molecules with potent and selective interactions. Prediction of native protein‐ligand interactions has traditionally focused on the development of physics‐based potential energy functions, empirical scoring functions that are fit to binding data, and knowledge‐based potentials that assess the likelihood of pairwise interactions. Here we explore a new approach, testing the hypothesis that protein‐ligand binding results in computationally detectable rigidification of the protein‐ligand interface. Our SiteInterlock approach uses rigidity theory to efficiently measure the relative interfacial rigidity of a series of small‐molecule ligand orientations and conformations for a number of protein complexes. In the majority of cases, SiteInterlock detects a near‐native binding mode as being the most rigid, with particularly robust performance relative to other methods when the ligand‐free conformation of the protein is provided. The interfacial rigidification of both the protein and ligand prove to be important characteristics of the native binding mode. This measure of rigidity is also sensitive to the spatial coupling of interactions and bond‐rotational degrees of freedom in the interface. While the predictive performance of SiteInterlock is competitive with the best of the five other scoring functions tested, its measure of rigidity encompasses cooperative rather than just additive binding interactions, providing novel information for detecting native‐like complexes. SiteInterlock shows special strength in enhancing the prediction of native complexes by ruling out inaccurate poses. Proteins 2016; 84:1888–1901. © 2016 Wiley Periodicals, Inc.     

Circadian variations in self-monitoring,a component of executive functions

The objective of this study was to identify circadian rhythms in self-monitoring, a component of executive functions. Participants were 10 undergraduate students, age: 18.5 ± 2.68 years, two male and eight female. They were recorded on a 30-h constant routine protocol; rectal temperature was recorded every minute and performance on a tracking task was assessed every 100 min. Self-monitoring indicators were adjustments of responses to random changes of speed and trajectory of a circle moving on the computer screen. Participants showed better accuracy during the afternoon, with decreases in the morning (06:20 and 08:00 h). These variations showed a phase delay of 2:29 ± 2:19 h with respect to the circadian rhythm of body temperature. In conclusion, there are circadian variations in self-monitoring. The decline in this component of executive functions could cause serious accidents among people working or studying during a morning shift, as well as commuting to and from work or school.     

Population Dynamics and Damage Potential of Meloidogyne hapla to Rose Rootstock Species

The relationship between initial population densities (Pi) of Meloidogyne hapla on growth of three rose rootstocks (Rosa corymbifera ‘Laxa’, R. multiflora and R. canina ‘Inermis’) and nematode population development was studied. Each plant species was inoculated with ranges of nematode densities of 0, 0.062, 0.125, 0.25, 0.50, 1, 2, 4, 8, 16, 32, 64 and 128 second‐stage juvenile/g soil and were allowed to grow for 9 weeks. Seinhorst yield model was fitted to total fresh biomass data of the rootstocks. The tolerance limits (T) were 0.04, 0.09 and 0.01 J2/g soil and the minimum yield (m) 0.65, 0.47 and 0.43 for R. corymbifera ‘Laxa’, R. multiflora and R. canina ‘Inermis’, respectively. The reproductive factor (Pf/Pi) was highest at low initial nematode densities for all rootstocks and then decreased to below maintenance level with increasing initial population densities. Root gall severity consistently increased with initial nematode population density. Furthermore, number of root galling showed a strong positive relationship with final nematode population per gram root fresh weight. The relation between Pi and Pf was also fitted to the Seinhorst population model (Pf = (M*Pi)/Pi + M/a). Rosa multiflora supported the population of M. hapla to a maximum population density (M) of 27.53 J2/g soil with an estimated average maximum multiplication rate (a) of 24.39. For R. corymbifera ‘Laxa’ and R. canina, the maximum multiplication rate was 4.34 and 3.62 and the maximum population density 6.08 and 4.78 J2/g dry soil, respectively. Hence, it was demonstrated that all three rootstocks were susceptible to even low initial nematode densities and therefore are considered good hosts for M. hapla.     

水体盐度对中华绒螯蟹成体雄蟹渗透压调节和生理代谢的影响

为研究长期不同水体盐度对中华绒螯蟹(Eriocheir sinensis以下简称河蟹)成体雄蟹渗透压调节和生理代谢的影响, 在不同水体盐度条件下(0、6、12和18)对河蟹雄体进行为期60d的养殖实验, 并分别检测其渗透调节及生理代谢相关指标。结果显示: (1)血清渗透压、Na+、Mg2+和Cl-含量随水体盐度上升而显著上升(P0.05), K+和Ca2+含量有上升趋势, 但各盐度组差异不显著(P0.05); 无论何组雄蟹, 其血清渗透压均显著高于对应的水体渗透压; (2)0组雄蟹后鳃Na+/K+-ATP酶活性显著高于其他组(P0.05), 其他各组间差异不显著(P0.05); (3)就血清生理代谢指标而言, 12组雄蟹血清中甘油三酯(TG)含量显著高于其他组(P0.05), 而尿酸(UA)、葡萄糖(Glu)、丙二醛(MDA)含量和超氧化物歧化酶(SOD)活性相对较低; 所有组尿素(Urea)、碱性磷酸酶(ALP)含量差异不显著(P0.05); (4)就肝胰腺生理代谢指标而言, 6组肝胰腺MDA含量和-谷氨酰转肽酶(-GT)活力最低, 12组酸性磷酸酶(ACP)和-GT活性显著高于其他盐度组(P0.05)。因此, 适当提高水体盐度可提高河蟹成体雄蟹的血清渗透压及其主要离子含量, 同时降低其后鳃中Na+/K+-ATP酶活性。肝胰腺和血清代谢指标暗示12盐度组雄体的代谢水平相对较低, 具有较强的免疫性能和抗氧化能力。     

肠道噬菌体组与人体健康

噬菌体作为肠道微生物群落的重要组成部分,自生命初期即定植于肠道,在不同生命时期均以较为稳定的状态存在于人体。目前已知的肠道噬菌体主要是DNA噬菌体,且大多以前噬菌体形式存在。肠道噬菌体可通过多种机制优化其宿主微生物群的结构和组成,并以多种方式直接或间接影响人体的生理状态,其结构变化与多种疾病相关。利用测序方法,能够直接获取噬菌体组信息。本文基于噬菌体组的相关研究,综述了肠道噬菌体组与人体健康相关的研究进展,并对该领域的研究方法和发展方向做出展望。     

我国少数民族孕产妇孕期保健及其健康现状综述

孕产妇孕期保健及孕产妇健康对促进安全分娩和优生优育起着十分重要的作用,随着我国孕产妇保健工作的进一步完善及国家二胎政策的实施,现代临床医学所倡导的优生优育的观念已逐渐被社会广泛认可。然而,我国少数民族地区多有经济落后、地理位置偏僻、思想观念陈旧等问题,导致我国少数民族孕产妇孕期保健水平还比较低下,孕产妇健康状况有待改善。为预防少数民族地区出生缺陷,降低出生缺陷率,提高优生率,提高少数民族地区出生人口素质,通过完善医疗制度,改善医疗环境,合理营养干预及加强家庭访视等相关健康教育促进孕期保健,提高孕前检查的依从性,实现优生,孕产期健康教育可以降低整个孕期出现的危险因素,本文对我国少数民族的孕产妇孕期保健及健康做一综述。     

Ethical issues associated with HIV phylogenetics in HIV transmission dynamics research: A review of the literature using the Emanuel Framework

The reduced costs of DNA sequencing and the use of such data for HIV‐1 clinical management and phylogenetic analysis have led to a massive increase of HIV‐1 sequences in the last few years. Phylogenetic analysis has shed light on the origin, spread and characteristics of HIV‐1 epidemics and outbreaks. Phylogenetic analysis is now also being used to advance our knowledge of the drivers of HIV‐1 transmission in order to design effective interventions. However, HIV phylogenetic analysis presents unique ethical challenges, which have not been fully explored. This review presents an analysis of what appear to be key ethical issues in HIV phylogenetics in the hope of stimulating further conceptual and empirical work in this rapidly emerging area. We structure the review using the Emanuel Framework, a systematic, holistic framework, which has been adapted for use in developing countries, which bear the brunt of the HIV‐1 pandemic.     

Effects of probiotic supplementation on performance traits,bone mineralization,cecal microbial composition,cytokines and corticosterone in laying hens

Recent researches have showed that probiotics promote bone health in humans and rodents. The objective of this study was to determine if probiotics have the similar effects in laying hens. Ninety-six 60-week-old White Leghorn hens were assigned to four-hen cages based on their BW. The cages were randomly assigned to 1 of 4 treatments: a layer diet mixed with a commercial probiotic product (containing Enterococcus faecium, Pediococcus acidilactici, Bifidobacterium animalis and Lactobacillus reuteri) at 0, 0.5, 1.0 or 2.0 g/kg feed (Control, 0.5×, 1.0× and 2.0×) for 7 weeks. Cecal Bifidobacterium spp. counts were higher in all probiotic groups (P<0.001) compared with the control group. The percentage of unmarketable eggs (cracked and shell-less eggs) was decreased in both 0.5× and 2.0× groups compared with the control group (P=0.02), mainly due to the reduction of shell-less eggs (P=0.05). The increases in tibial and femoral mineral density and femoral mineral content (P=0.04, 0.03 and 0.02, respectively), with a concomitant trend of increases in humerus mineral density and tibial mineral content (P=0.07 and 0.08, respectively), occurred in the 2.0× group. However, the bone remodeling indicators of circulating osteocalcin and c-terminal telopeptide of type I collagen were similar among all groups (P>0.05). In addition, the plasma concentrations of cytokines (interleukin-1β, interleukin-6, interleukin-10, interferon-γ and tumor necrosis factor-α) and corticosterone as well as the levels of heterophil to lymphocyte ratio were similar between the 2.0× group and the control group (P>0.05). In line with these findings, no differences of cecal tonsil mRNA expressions of interleukin-1β, interleukin-6 and lipopolysaccharide-induced tumor necrosis factor-α factor were detected between these two groups (P>0.05). These results suggest that immune cytokines and corticosterone may not involve in the probiotic-induced improvement of eggshell quality and bone mineralization in laying hens. In conclusion, the dietary probiotic supplementation altered cecal microbiota composition, resulting in reduced shell-less egg production and improved bone mineralization in laying hens; and the dietary dose of the probiotic up to 2.0× did not cause negative stress reactions in laying hens.     

Genetic (co)variances between milk mineral concentration and chemical composition in lactating Holstein-Friesian dairy cows

Milk mineral concentration is important from both the perspective of processing milk into dairy products and its nutritive value for human consumption. Precise estimates of genetic parameters for milk mineral concentration are lacking because of the considerable resources required to collect vast phenotypes quantities. The milk concentration of calcium (Ca), potassium (K), magnesium (Mg), sodium (Na) and phosphorus (P) in the present study was quantified from mid-IR spectroscopy on 12 223 test-day records from 1717 Holstein-Friesian cows. (Co)variance components were estimated using random regressions to model both the additive genetic and within-lactation permanent environmental variances of each trait. The coefficient of genetic variation averaged across days-in-milk (DIM) was 6.93%, 3.46%, 6.55%, 5.20% and 6.68% for Ca, K, Mg, Na and P concentration, respectively; heritability estimates varied across lactation from 0.31±0.05 (5 DIM) to 0.67±0.04 (181 DIM) for Ca, from 0.18±0.03 (60 DIM) to 0.24±0.05 (305 DIM) for K, from 0.08±0.03 (15 DIM) to 0.37±0.03 (223 DIM) for Mg, from 0.16±0.03 (30 DIM) to 0.37±0.04 (305 DIM) for Na and from 0.21±0.04 (12 DIM) to 0.57±0.04 (211 DIM) for P. Genetic correlations within the same trait across different DIM were almost unity between adjacent DIM but weakened as the time interval between pairwise compared DIM lengthened; genetic correlations were weaker than 0.80 only when comparing both peripheries of the lactation. The analysis of the geometry of the additive genetic covariance matrix revealed that almost 90% of the additive genetic variation was accounted by the intercept term of the covariance functions for each trait. Milk protein concentration and mineral concentration were, in general, positively genetically correlated with each other across DIM, whereas milk fat concentration was positively genetically correlated throughout the entire lactation with Ca, K and Mg; the genetic correlation with fat concentration changed from negative to positive with Na and P at 243 DIM and 50 DIM, respectively. Genetic correlations between somatic cell score and Na ranged from 0.38±0.21 (5 DIM) to 0.79±0.18 (305 DIM). Exploitable genetic variation existed for all milk minerals, although many national breeding objectives are probably contributing to an indirect positive response to selection in milk mineral concentration.