Progress Toward Hepatitis B Control and Elimination of Mother-to-Child Transmission of Hepatitis B Virus - World Health Organization African Region, 2016-2021.

Chronic hepatitis B virus (HBV) infection is one of the leading causes of cirrhosis and liver cancer. In 2019, approximately 1.5 million persons newly acquired chronic HBV infection; among these, 990,000 (66%) were in the World Health Organization (WHO) African Region (AFR). Most chronic HBV infections are acquired through mother-to-child transmission (MTCT) or during early childhood, and approximately two thirds of these infections occur in AFR. In 2016, the World Health Assembly endorsed the goal of elimination of mother-to-child transmission (EMTCT) of HBV, documented by ≥90% coverage with both a timely hepatitis B vaccine (HepB) birth dose (HepB-BD) and 3 infant doses of HepB (HepB3), and ≤0.1% hepatitis B surface antigen (HBsAg) seroprevalence among children aged ≤5 years. In 2016, the WHO African Regional Committee endorsed targets for a 30% reduction in incidence (≤2% HBsAg seroprevalence in children aged ≤5 years) and ≥90% HepB3 coverage by 2020. By 2021, all 47 countries in the region provided HepB3 to infants beginning at age 6 weeks, and 14 countries (30%) provided HepB-BD. By December 2021, 16 (34%) countries achieved ≥90% HepB3 coverage, and only two (4%) achieved ≥90% timely HepB-BD coverage. Eight countries (17%) conducted nationwide serosurveys among children born after the introduction of HepB to assess HBsAg seroprevalence: six countries had achieved ≤2% seroprevalence, but none had achieved ≤0.1% seroprevalence among children. The development of immunization recovery plans following the COVID-19 pandemic provides an opportunity to accelerate progress toward hepatitis B control and EMTCT, including introducing HepB-BD and increasing coverage with timely HepB-BD and HepB3 vaccination. Representative HBsAg serosurveys among children and a regional verification body for EMTCT of HBV will be needed to monitor progress.

The voltage-dependent potassium channel subunit Kv2.1 regulates insulin secretion from rodent and human islets independently of its electrical function.

AIMS/HYPOTHESIS: It is thought that the voltage-dependent potassium channel subunit Kv2.1 (Kv2.1) regulates insulin secretion by controlling beta cell electrical excitability. However, this role of Kv2.1 in human insulin secretion has been questioned. Interestingly, Kv2.1 can also regulate exocytosis through direct interaction of its C-terminus with the soluble NSF attachment receptor (SNARE) protein, syntaxin 1A. We hypothesised that this interaction mediates insulin secretion independently of Kv2.1 electrical function. METHODS: Wild-type Kv2.1 or mutants lacking electrical function and syntaxin 1A binding were studied in rodent and human beta cells, and in INS-1 cells. Small intracellular fragments of the channel were used to disrupt native Kv2.1-syntaxin 1A complexes. Single-cell exocytosis and ion channel currents were monitored by patch-clamp electrophysiology. Interaction between Kv2.1, syntaxin 1A and other SNARE proteins was probed by immunoprecipitation. Whole-islet Ca(2+)-responses were monitored by ratiometric Fura red fluorescence and insulin secretion was measured. RESULTS: Upregulation of Kv2.1 directly augmented beta cell exocytosis. This happened independently of channel electrical function, but was dependent on the Kv2.1 C-terminal syntaxin 1A-binding domain. Intracellular fragments of the Kv2.1 C-terminus disrupted native Kv2.1-syntaxin 1A interaction and impaired glucose-stimulated insulin secretion. This was not due to altered ion channel activity or impaired Ca(2+)-responses to glucose, but to reduced SNARE complex formation and Ca(2+)-dependent exocytosis. CONCLUSIONS/INTERPRETATION: Direct interaction between syntaxin 1A and the Kv2.1 C-terminus is required for efficient insulin exocytosis and glucose-stimulated insulin secretion. This demonstrates that native Kv2.1-syntaxin 1A interaction plays a key role in human insulin secretion, which is separate from the channel's electrical function.

State-dependent spike-timing relationships between hippocampal and prefrontal circuits during sleep.

Cortico-hippocampal interactions during sleep are believed to reorganize neural circuits in support of memory consolidation. However, spike-timing relationships across cortico-hippocampal networks-key determinants of synaptic changes-are poorly understood. Here we show that cells in prefrontal cortex fire consistently within 100 ms after hippocampal cells in naturally sleeping animals. This provides evidence at the single cell-pair level for highly consistent directional interactions between these areas within the window of plasticity. Moreover, these interactions are state dependent: they are driven by hippocampal sharp-wave/ripple (SWR) bursts in slow-wave sleep (SWS) and are sharply reduced during REM sleep. Finally, prefrontal responses are nonlinear: as the strength of hippocampal bursts rises, short-latency prefrontal responses are augmented by increased spindle band activity and a secondary peak approximately 100 ms later. These findings suggest that SWR events are atomic units of hippocampal-prefrontal communication during SWS and that the coupling between these areas is highly attenuated during REM sleep.

Comparison of analgesics in ameliorating the pain of circumcision.

OBJECTIVE: Our objective was to compare two methods of pain control during neonatal circumcision: a sucrose-dipped pacifier and an analgesic cream (EMLA). STUDY DESIGN: This study was conducted in our well-baby nursery where 80 male infants were placed into one of four groups: control (water-dipped pacifier only), sucrose alone, EMLA alone, or sucrose and EMLA. Heart rate, oxygen saturation, systolic and diastolic blood pressure, and crying time were measured as indicators of pain. The primary data analysis was a 2 x 2 factorial analysis of variance with repeated measures. RESULTS: Physiologic and behavioral parameters indicated significantly (p < 0.05) decreased pain response in all treatment groups compared with that in the control group. The combination of sucrose and EMLA was most effective in reducing pain responses; sucrose alone was significantly less effective. There were no side effects of treatment. CONCLUSION: Pain during neonatal circumcision can be optimally ameliorated by combined use of a sucrose-dipped pacifier and a local analgesic cream.

Prestige, possessions, and progeny : Cultural goals and reproductive success among the bakkarwal.

It has been suggested by some that the acquisition of symbolic capital in terms of honor, prestige, and power translates into an accumulation of material capital in terms of tangible belongings, and that on the basis of these goods high reproductive success may be achieved. However, data on completed fertility rates over more than one generation in so-called traditional societies have been rare. Ethnographic and demographic data presented here on the pastoral Bakkarwal of northern India largely corroborate the hypothesis concerning the interdependence between the attainment of various cultural goals and differential reproduction rates and indicate that the numbers of (especially male) surviving offspring and siblings are crucial to a man's position in society.

Phase II study of AMSA and doxorubicin to treat metastatic breast cancer.

Twenty-two evaluable patients with metastatic breast cancer were treated with a combination of 4-(acridinylamino)methanesulfon-m-anisidide (AMSA) and doxorubicin. All patients but one had received prior therapy with fluorouracil, cyclophosphamide, and methotrexate. Eight patients had partial responses (36%) with a median time to treatment failure of 6 months. Two patients (9%) showed minor responses, and their times to progression were 4 and 6 months. The response rates obtained with this drug combination were similar to those observed in earlier studies using doxorubicin alone.

Feeding ecology and nutrition of an eastern gorilla group in the Mt. Kahuzi Region (République du Zaïre).

An eastern gorilla group of the Mt. Kahuzi region (République du Zaïre) was studied over 15 months. Its migration route was determined, and the various biotopes it visited are described. A record was made of its main food plants, and of the plant parts eaten. For nine important food plants the protein content, the concentration of the individual amino acids and the water content were measured for the plant parts eaten and for those not eaten. For some of these plant parts the Na, K, Ca and Mg content were also determined. No general correlation between food selection and one or several of these factors could be found. The development and value of a traditionally determined mixed diet is discussed.