Effect of fermentation on nutrient composition, antinutrients, and mineral bioaccessibility of finger millet based Injera: A traditional Ethiopian food.

Finger millet, like other cereals, contains high amounts of antinutrients that bind minerals, making them unavailable for absorption. This study explores the effect of traditional fermentation on nutritional, antinutritional, and subsequent mineral bioaccessibility (specifically iron, zinc, and calcium) of finger millet based Injera. Samples of fermented dough and Injera prepared from light brown and white finger millet varieties were analyzed for nutritional composition, antinutritional content, and mineral bioaccessibility following standard procedures. With some exceptions, the proximate composition of fermented dough was significantly affected by fermentation time. Compared to unfermented flour, the phytate and condensed tannin content significantly (p < 0.05) decreased for fermented dough and Injera samples. A strong decline in phytate and condensed tannin content was observed in white finger millet Injera as fermentation time increased, compared to light brown finger millet based Injera. The mineral bioaccessibility of Injera prepared from finger millet and maize composite flour increased with fermentation time, leading to a significant increase in bioaccessible iron, zinc, and calcium, ranging from 15.4-40.0 %, 26.8-50.8 %, and 60.9-88.5 %, respectively. The results suggest that traditional fermentation can be an effective method to reduce phytate and condensed tannin content, simultaneously increasing the bioaccessibility of minerals in the preparation of finger millet based Injera.

Testing and Treatment Interventions in Community Settings Key to Controlling a Recent Human Immunodeficiency Virus Outbreak Among People Who Inject Drugs in Glasgow: A Modeling Study.

BACKGROUND: A human immunodeficiency virus (HIV) outbreak was identified among people who inject drugs (PWID) in Glasgow in 2015, with >150 diagnoses by the end of 2019. The outbreak response involved scaling up HIV testing and improving HIV treatment initiation and retention. METHODS: We parameterized and calibrated a dynamic, deterministic model of HIV transmission among PWID in Glasgow to epidemiological data. We use this model to evaluate HIV testing and treatment interventions. We present results in terms of relative changes in HIV prevalence, incidence, and cases averted. RESULTS: If the improvements in both testing and treatment had not occurred, we predict that HIV prevalence would have reached 17.8% (95% credible interval [CrI], 14.1%-22.6%) by the beginning of 2020, compared to 5.9% (95% CrI, 4.7%-7.4%) with the improvements. If the improvements had been made on detection of the outbreak in 2015, we predict that peak incidence would have been 26.2% (95% CrI, 8.8%-49.3%) lower and 62.7% (95% CrI, 43.6%-76.6%) of the outbreak cases could have been averted. The outbreak could have been avoided if the improvements had already been in place. CONCLUSIONS: Our modeling suggests that the HIV testing and treatment interventions successfully brought the HIV outbreak in Glasgow under control by the beginning of 2020.

Mortality among individuals prescribed opioid-agonist therapy in Scotland, UK, 2011-20: a national retrospective cohort study.

BACKGROUND: Drug-related death (DRD) rate in Scotland, UK, has increased rapidly to one of the highest in the world. Our aim was to examine the extent to which opioid-agonist therapy (OAT) in Scotland is protective against drug-related mortality and how this effect has varied over time. METHODS: We included individuals in Scotland with opioid use disorder who received at least one OAT prescription between Jan 1, 2011, and Dec 31, 2020. We calculated drug-related mortality rates and used Quasi-Poisson regression models to estimate trends over time and by OAT exposure, adjusting for potential confounding. FINDINGS: In a cohort of 46 453 individuals prescribed OAT with a total of 304 000 person-years of follow-up, DRD rates more than trebled from 6·36 per 1000 person-years (95% CI 5·73-7·01) in 2011-12 to 21·45 (20·31-22·63) in 2019-20. DRD rates were almost three and a half times higher (hazard ratio 3·37; 95% CI 1·74-6·53) for those off OAT compared with those on OAT after adjustment for confounders. However, confounder adjusted DRD risk increased over time for both people off and on OAT. INTERPRETATION: Drug-related mortality rates among people with opioid use disorders in Scotland increased between 2011 and 2020. OAT remains protective but is insufficient on its own to slow the increase in DRD risk for people who are opioid dependent in Scotland. FUNDING: Scottish Government Drug Deaths Taskforce, Public Health Scotland, and National Institute for Health and Care Research.