Socioeconomic inequalities in child and adolescent mental health in Australia: the role of parenting style and parents' relationships.

BACKGROUND: Socioeconomic inequalities in health and their determinants have been studied extensively over the past few decades. However, the role of parenting style and parents' couple relationships in explaining mental health inequalities is limited. Therefore, this study aims to investigate the distributional impact of parenting style (angry parenting, consistent parenting, and inductive parenting) and parents' couple relationships (e.g., argumentative, happy relationships) on socioeconomic inequalities and by extension on mental health status of Australian children and adolescents. METHODS: This study utilized data from the Longitudinal Study of Australian Children (Waves 1-7), specifically focusing on intact biological parent families, while excluding single-parent and blended-family households. We applied the decomposition index and the Blinder Oaxaca method to investigate the extent of the contribution and temporal impact of parenting style and parents' couple relationships on the mental health status of Australian children and adolescents. RESULTS: This study revealed that poor parenting style is the single most important factor that leads to developing mental health difficulties in children and adolescents, especially from low socioeconomic status, and it contributes almost 52% to socioeconomic inequalities in mental health status. Conversely, household income, maternal education, employment status, and parents' couple relationships contributed 28.04%, 10.67%, 9.28%, and 3.34%, respectively, to mental health inequalities in children and adolescents. CONCLUSION: Overall, this study underscores the importance of parenting style and parents' couple relationships as significant predictors of mental health outcomes in children and adolescents. These results highlight the need for targeted interventions to support families from low socioeconomic backgrounds to address the significant mental health inequalities observed in the study population.

Statistical modeling for identifying chikungunya high-risk areas of two large-scale outbreaks in Thailand's southernmost provinces.

Chikungunya fever (CHIKF) has re-emerged in the southernmost Thailand and presents a significant threat to public health. The problem areas can be identified using appropriate statistical models. This study aimed to determine the geographic epidemic patterns and high-risk locations. Data on CHIKF's case characteristics, including age, gender, and residence sub-district, were obtained from the Office of Disease Prevention and Control of Thailand from 2008 to 2020. A logistic model was applied to detect illness occurrences. After removing records with no cases, a log-linear regression model was used to determine the incidence rate. The results revealed that two large-scale infections occurred in the southernmost provinces of Thailand between 2008 and 2010, and again between 2018 and 2020, indicating a 10-year epidemic cycle. The CHIKF occurrence in the first and second outbreaks was 28.4% and 15.5%, respectively. In both outbreaks of occurrence CHIKF, adolescents and working-age groups were the most infected groups but the high incidence rate of CHIKF was elderly groups. The first outbreak had a high occurrence and incidence rate in 39 sub-districts, the majority of which were in Narathiwat province, whilst the second outbreak was identified in 15 sub-districts, the majority of which were in Pattani province. In conclusion, the CHIKF outbreak areas can be identified and addressed by combining logistic and log-linear models in a two-step process. The findings of this study can serve as a guide for developing a surveillance strategy or an earlier plan to manage or prevent the CHIKF outbreak.

Reproductive characteristics of the hermaphroditic four-finger threadfin, Eleutheronema tetradactylum (Shaw, 1804), in tropical coastal waters.

This study investigated the reproductive traits of the hermaphroditic four-finger threadfin, Eleutheronema tetradactylum, along the coasts of Thailand during January to December 2021. Fish samples were collected from Pattani Bay, Thailand to assess the sex ratio, gonadosomatic index (GSI), maturity stage and fecundity. Additional fish samples were also collected from other areas to evaluate the length and weight at first sex change (Ls50 and Ws50) and length at first maturity (Lm50). The overall sex ratio for male and female was 1:0.69 with male being predominant throughout the year. Threadfin fish spawn the whole year round with peaks during moderate rainy and heavy rainy seasons. Histological examination confirmed its protandrous hermaphrodite posing multiple spawning habits. The average fecundity was 1.85 × 105 ± 1.05 × 105 eggs and positively related with standard length, body weight, gonad weight, and egg diameter (p < 0.05). The Ls50 and Ws50 were 27.58 cm and 419.39 g, and 29.71 cm and 457.28 g, for fish from Pattani Bay and Samut Prakan province, respectively. The Lm50 of male from Pattani Bay and Samut Prakan province were 25.78 cm and 25.56 cm, respectively, which were larger than those from Satun and Nakhon Sri Thammarat provinces. The Lm50 of females from Pattani Bay was smaller than that from Samut Prakan province. This study provided fundamental information on the reproductive characteristics of E. tetradactylum, which can be implemented to support management of natural fish stock and aquaculture development.

Feeding habits of four-finger threadfin fish, Eleutheronema tetradactylum, and its diet interaction with co-existing fish species in the coastal waters of Thailand.

This study assessed the feeding habits of four-finger threadfin fish, Eleutheronema tetradactylum, and its diet relationship with other fish species in the tropics. Fish samples were collected from four locations along the coastal regions of Thailand. A whole year field sampling event was conducted to investigate the diet relationship of threadfin fish with other ten co-existing fish species in Pattani Bay during January 2021 and January 2022. E. tetradactylum was an active and specific predator with significant diet shift during ontogeny. Specifically, the juvenile fish fed largely on zooplankton especially Acetes/shrimp postlarvae, and small sized-fish fed on penaeid shrimps, while medium and large-sized fish shifted their diets to a combination of penaeid shrimp, fish and squid. Size and sex of fish as well as site of collection significantly affected gut fullness index and average number of food type (p < 0.05). Transitional sex fish predated almost entirely on other fishes (87.2%), whereas male and female fish fed mainly on penaeid shrimp (66.5%) and other fish (51.3%), respectively. Fish size and mouth opening controlled the size of prey, with the larger fish with larger mouth-opening fed primarily on the larger size of prey. Moreover, E. tetradactylum shared its diets inclusively with Epinephelus coioides, Johnius belangerii, Scomberomorus commerson, Scomberoides lysan, Otolithes ruber and Lutjanus russelli. Penaeid shrimp and teleost fish were the main food types shared by these fishes. This study provided important information on the feeding habits of E. tetradactylum and its diet relationship with other co-existing fish species living in the same habitat of a tropical coastal region.

Latent Trajectories of Haematological, Hepatic, and Renal Profiles after Oil Spill Exposure: A Longitudinal Analysis.

Exposure to polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs) in crude oil has carcinogenic effects on various organ systems. This longitudinal cohort study examined the effects of oil spill exposure on the haematological, hepatic, and renal profiles of Rayong oil spill clean-up workers. The sample included 869 clean-up workers from the Rayong oil spill. Latent class mixture models were used to investigate and classify the longitudinal trajectories and trends of the haematological, hepatic, and renal indices. Subgroup analysis was used to evaluate the association between the urinary metabolites of PAHs and VOCs and haematological, hepatic, and renal parameters. Most clean-up workers (97.6%) had increasing levels of white blood cells (WBCs) (0.03 × 103 cells/µL), 94.90% of the workers had a significantly increasing trend of blood urea nitrogen (0.31 mg/dL per year), and 87.20% had a significantly increasing trend of serum creatinine (0.01 mg/dL per year). A high-decreasing trend of WBCs was seen in 2.42% (-0.73 × 103 per year). Post-exposure changes in haematological, renal, and hepatic profiles are present in workers exposed to the Rayong oil spill. This indicates possible long-term health complications and worsening renal function after exposure to PAHs and VOCs in crude oil.

Modelling malaria in southernmost provinces of Thailand: a two-step process for analysis of highly right-skewed data with a large proportion of zeros.

BACKGROUND: Malaria remains a serious health problem in the southern border provinces of Thailand. The issue areas can be identified using an appropriate statistical model. This study aimed to investigate malaria for its spatial occurrence and incidence rate in the southernmost provinces of Thailand. METHODS: The Thai Office of Disease Prevention and Control, Ministry of Public Health, provided total hospital admissions of malaria cases from 2008 to 2020, which were classified by age, gender, and sub-district of residence. Sixty-two sub-districts were excluded since they had no malaria cases. A logistic model was used to identify spatial occurrence patterns of malaria, and a log-linear regression model was employed to model the incidence rate after eliminating records with zero cases. RESULTS: The overall occurrence rate was 9.8% and the overall median incidence rate was 4.3 cases per 1,000 population. Malaria occurence peaked at young adults aged 20-29, and subsequently fell with age for both sexes, whereas incidence rate increased with age for both sexes. Malaria occurrence and incidence rates fluctuated; they appeared to be on the decline. The area with the highest malaria occurrence and incidence rate was remarkably similar to the area with the highest number of malaria cases, which were mostly in Yala province's sub-districts bordering Malaysia. CONCLUSIONS: Malaria is a serious problem in forest-covered border areas. The correct policies and strategies should be concentrated in these areas, in order to address this condition.

Haematological, renal, and hepatic function changes among Rayong oil spill clean-up workers: a longitudinal study.

PURPOSE: The Rayong oil spill incident of 2013 leaked over 50,000 barrels of crude oil into the Gulf of Thailand. This study assessed trends and changes in the haematological, renal, and hepatic indices among the Rayong oil spill clean-up workers 5 years after the spill. METHODS: Haematological, renal, and hepatic indices measured for 570 oil spill clean-up workers at baseline and annually during 5-year follow-ups were analysed. Haemoglobin (Hb), haematocrit (Hct), white blood cell (WBC) count, red blood cell (RBC) count, and platelet count for haematological function, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) for hepatic function, and creatinine (Cr) and blood urea nitrogen (BUN) for renal function were assessed. The longitudinal measures of haematological, renal and hepatic indices were analysed using analysis of variance for repeated measures. The generalised estimating equations (GEE) were used to assess trends of these indices and associated factors, including exposure level. RESULTS: Increasing trends were observed per year for WBC (0.52 ± 0.03 × 103 cells/µL), Cr (0.01 ± 0.00 mg/dL), platelet (0.31 × 103 µL per year), and BUN (0.24 ± 0.03 mg/dL). Decreasing trends of aspartate aminotransferase (AST) were observed (1.54 ± 0.21 IU/L per year). Clean-up workers with high exposure to the oil spill had a significantly higher average of WBC and lower average of BUN than low-exposure and unknown-exposure workers. Gender and age were significantly associated with creatinine changes. CONCLUSION: Results of this study show the differences between baseline and follow-up haematological, renal, and hepatic indices and trends of these indices. The long-term changes in the indices in this study show worsening renal functions after oil spill and possibility of cardiovascular effects. These findings contribute to expanding knowledge on the long-term health effects of oil spills.

Hospital admission for type 2 diabetes mellitus under the Universal Coverage Scheme in Thailand: A time- and geographical-trend analysis, 2009-2016.

BACKGROUND: Descriptive analyses of 2009-2016 were performed using the data of the Universal Coverage Scheme (UCS) which covers nearly 70 percent of the Thai population. The analyses described the time and geographical trends of nationwide admission rates of type 2 diabetes mellitus (T2DM) and its complications, including chronic kidney disease (CKD), myocardial infarction, cerebrovascular diseases, retinopathy, cataract, and diabetic foot amputation. METHODS AND FINDINGS: The database of T2DM patients aged 15-100 years who were admitted between 2009 and 2016 under the UCS and that of the UCS population were retrieved for the analyses. The admitted cases of T2DM were extracted from the database using disease codes of principal and secondary diagnoses defined by the International Classification of Diseases 9th and 10th Revisions. The T2DM admission rates in 2009-2016 were the number of admissions divided by the number of the UCS population. The standardized admission rates (SARs)were further estimated in contrast to the expected number of admissions considering age and sex composition of the UCS population in each region. A linearly increased trend was found in T2DM admission rates from 2009 to 2016. Female admission rates were persistently higher than that of males. In 2016, an increase in the T2DM admission rates was observed among the older ages relative to that in 2009. Although the SARs of T2DM were generally higher in Bangkok and central regions in 2009, except that with CKD and foot amputation which had higher trends in northeastern regions, the geographical inequalities were fairly reduced by 2016. CONCLUSION: Admission rates of T2DM and its major complications increased in Thailand from 2009 to 2016. Although the overall geographical inequalities in the SARs of T2DM were reduced in the country, further efforts are required to improve the health system and policies focusing on risk factors and regions to manage the increasing T2DM.

Factors Contributing to Nurse Productivity in Public Hospitals in Surabaya, Indonesia.

This study aimed at examining the factors that contribute to nursing productivity in public hospitals in Surabaya. Data relating to the respondents' characteristics and their productivity were collected using a questionnaire incorporating the Behaviorally Anchored Rating Scale. The samples were drawn from 31 nurses form the emergency room (ER) and 29 nurses from the intensive care unit (ICU) wards of a public hospital in Surabaya, Indonesia, of whom, 52 nurses participated voluntarily and indicated their willingness to respond by signing an informed consent form. The chi-square and Fisher's exact test was used to determine associations between the determinants (demographic characteristics, lifestyle and nutritional status) and productivity and the strength of association was identified by using logistic regression. The results from this study found that gender had borderline significant and duration of work experience had a significant association with nurse productivity. Therefore, gender and duration of working experience are factors which should be taken into consideration when managing human resources working in ERs and ICUs while basic nursing competencies are clearly also important factors in maintaining productivity.

Determinants of severe injury and mortality from road traffic accidents among motorcycle and car users in Southern Thailand.

This study aimed to identify factors associated with severe injury and mortality from road traffic accidents (RTA) among motorcycle and car users in southern Thailand. The data were obtained from the Office of Disease Prevention and Control, Thailand, for years 2008-2013. Chi-squared tests were used to assess associations between determinants and outcomes and these associations were then estimated after adjusting for possible confounding with other factors using logistic regression. Severe injury and mortality contributed 11.6% and 5% to RTA of motorcycle users, and 14.3% and 7.5% for car users. Among motorcycle users, male gender, older age, and not wearing a helmet increased severe injury and mortality rates, whereas drivers had more severe injuries than passengers. Older car users had higher severe injury and mortality rates, whereas not fastening seat belts had higher mortality. Safety device use should be made mandatory for both drivers and passengers. Male motorcycle users and the elderly should be focused on.

Effect of using a head injury fast-track system on reducing the mortality rate among severe head injury patients in Southern Thailand: A retrospective study with historical control.

CONTEXT: Head injuries are the leading cause of traumatic morbidity and mortality. Timely proper management can reduce the mortality rate. AIMS: This study aimed to examine the effects of a fast-track system on reducing head injury mortality using the data in Southern Thailand. SETTINGS AND DESIGN: A retrospective study of data from the medical records of severe head injury patients admitted to Hatyai Hospital from October 2012 to May 2017. SUBJECTS AND METHODS: The records of subjects were selected for participants aged more than 11 years, having Glasgow Coma Score (GCS) <9, no injuries in other organs, and neither hypoxemia nor hypotension. A total of 193 participants fulfilling these criteria were analyzed. Of these, 108 participants were managed in the fast track. STATISTICAL ANALYSIS USED: The fast-track group was compared with normal track participants by using logistic regression after preliminary analysis to identify the risk factors using the Chi-squared tests. RESULTS: After adjustment for confounders, namely acute subdural hematoma, linear skull fracture and diffuse brain injury, and mortality in the fast-track group (13%) was significantly lower than that in the nonfast track group (22.4%). CONCLUSIONS: Using the fast-track system can reduce mortality from severe head injuries and should be implemented in the health services system.

Estimation of under-5 child mortality rates in 52 low-migration countries.

Reduction of the under-5 mortality rate is a target of the Sustainable Development Goals. Therefore, this study aimed to estimate under-5 child mortality rates in 52 low-migration countries using population data. The study utilized population data from the US Census Bureau from 1990 to 2015. The method involved first estimating mortality rates for countries with negligible net migration and then applying these rates to countries with matching mortality profiles, where it is reasonable to assume that migration is negligible for children under the age of 5 years. The highest child mortality was concentrated in the African region, followed by Asia and the Western region. However, steady progress in child mortality trends was concentrated in low-income countries. This simple method demonstrated that child mortality has significantly improved in high-income countries, followed by middle- and low-income countries. To reduce the under-5 mortality rates even further in these 52 countries, there is a need to accelerate equitable plans and policies related to child health to promote children's longevity and survival.

Factors Associated With Stillbirth Among Pregnant Women in Nepal.

OBJECTIVES: Stillbirth is a common adverse pregnancy outcome that represents a distressing and traumatic event for women and their partners. The aim of this study was to identify factors associated with stillbirth in ever-pregnant women in Nepal. METHODS: This study utilized the individual women's dataset from the Nepal Demographic and Health Survey, conducted in 2016. The dependent variable of interest was whether women had at least 1 stillbirth during their lifetime. The associations between independent variables and the dependent variable of the study were analyzed using a multiple logistic regression model. RESULTS: Among 8918 ever-pregnant women aged 15-49 years, 488 had experienced at least 1 stillbirth during their lifetime, representing 5.5% of the total. After adjusting each factor for the confounding effects of other factors, maternal age, maternal education, place of residence, and sub-region remained significantly associated with having experienced stillbirth. CONCLUSIONS: Stillbirth continues to be a major problem among women, especially those with higher maternal age, those who are illiterate, and residents of certain geographical regions. To minimize stillbirth in Nepal, plans and policies should be focused on women with low education levels and residents of rural areas, especially in the western mountain and far-western hill regions.

Neonatal mortality at the neonatal unit: the situation at a teaching hospital in Ghana.

BACKGROUND: The first 28 days of life- the neonatal period is the most vulnerable time for a child's survival. Globally, neonatal mortality has seen a downward trend in recent years. The main objective of this study was to determine the percentage of neonatal mortality and to provide information on factors associated with neonatal mortality at the neonatal unit of a tertiary health facility or teaching hospital. METHODS: Data of neonates admitted to the neonatal in-patient unit of the Komfo Anokye Teaching Hospital (KATH) in Ghana from January 2013 to May 2014 were analyzed. Logistic regression model was performed to assess the association between neonatal mortality and predictors. RESULTS: A total of 5,195 neonatal admissions were recorded. The overall percentage of neonatal mortality was 20.2%. Infants with very low birth weight, having 5-minute Apgar score lower than 4, newborns with pre-term delivery, being referred from other health facilities, and being diagnosed with respiratory distress and birth asphyxia had a higher percentage of neonatal mortality. CONCLUSION: The mortality at the neonatal in-patient unit at the Komfo Anokye Teaching Hospital in Ghana is very high. There is the need for continuous attention and interventions to help reduce the risk of mortality among neonates admitted to the facility.

Sexual risk behaviors, HIV, and syphilis among female sex workers in Nepal.

PURPOSE: Female sex workers (FSWs) are a key-affected population susceptible to acquiring HIV and sexually transmitted infections (STIs), as well as transmitting the virus to others. The aim of the study was to assess HIV and syphilis prevalence among FSWs in Nepal and to examine factors associated with it. MATERIALS AND METHODS: The study was based on Integrated Biological and Behavioral Surveillance (IBBS) surveys among FSWs in Nepal from 2004 to 2015. Statistical analysis used chi-squared test to assess statistically significant risk factors for HIV and syphilis. Logistic regression models were used to identify the most important determinants for each outcome. RESULTS: A total of 5,958 FSWs were tested, and among them, 100 (1.7%) were HIV positive and 230 (3.9%) were syphilis positive. The multivariate analysis revealed that syphilis was higher among those street-based, aged ≥35 years, illiterate, and with a duration of sex work of >3 years. HIV was higher among those aged ≥35 years, illiterate, street-based, and with a duration of sex work >3 years. Syphilis was strongly correlated with HIV. CONCLUSION: HIV epidemic among FSWs in Nepal appears in the stagnant trend, whereas STI epidemic has increased in recent years. The high influencing factors for HIV and syphilis prevalence were advanced age, street-based, lower education, and longer duration of sex work. Urgent efforts, as part of routine HIV/STI prevention and intervention, are required to reduce the high burden of syphilis among FSWs.

MODELING FOR DEMOGRAPHIC AND REGIONAL PREVALENCE AND TRENDS OF SMOKING IN THAI MALES.

This study aimed to describe using national survey data the demographic and regional prevalence and trends of smoking in Thai males during the past 25 years. Data from eight national surveys conducted by the National Statistics Office from 1986 to 2011 were used to examine the prevalence of smoking. Males aged 15 and older were included in this study. Logistic regression was used to model smoking patterns, according to year of survey, age group, urbanization, and Public Health Area (PHA). The prevalence of smoking among males aged 15 years and older in 2011 was 38.4%. Sharply increasing smoking prevalence was found in the 15-24 years-old age group in all surveys. Before survey year 1999, the prevalence of smoking started to level off near retirement age, and subsequently, it leveled off after 40 years of age. The prevalence of smoking in all age groups decreased after 1986 except in the 15-19 years-old age group. Higher prevalence of smoking was found in rural areas. Males from the Northeast and the lower South regions had the highest prevalence. More effective anti-smoking policies should focus on males aged below 25 years to reduce the increasing prevalence of smoking in this group.

EPIDEMIOLOGICAL PATTERNS OF TRANSPORT ACCIDENT MORTALITY IN THAILAND.

This study aimed to explore patterns of transport accident mortality in Thailand between 2004 and 2009. Vital Registration (VR) data were obtained from the Thai Ministry of Public Health and corrected causes of death were derived from Verbal Autopsy (VA) data collected in 2005. A total of 136,164 deaths were analyzed. Poisson regression was used for identifying mortality patterns with respect to gender-age groups and province-year groups. Regression coefficients were used to classify mortality trends for the 76 provinces. The estimated number of transport accident deaths was 2.2 times higher than VR records. The mean estimated transport accident mortality rate was 34.5 per 100,000 population. The estimated transport accident mortality rates were highest among males aged 20-29 years and in the central region, lower northern region and Nakhon Ratchasima Province in the northeastern region. The patterns of transport accident mortality rates were separated into nine groups. Increasing trends were found in three provinces in the northern region, four provinces in the central and eastern regions and five provinces in the southern region. Nine models developed for these nine groups may be helpful for estimating future transport accident mortality rates in Thailand and developing appropriate responses.

The diurnal variation pattern of choroidal thickness in macular region of young healthy female individuals using spectral domain optical coherence tomography.

AIM: To investigate the pattern of diurnal variations of choroidal thickness of macular region of healthyindividuals. METHODS: A prospective study of 32 healthy female subjects was conducted. Each subject underwent 1) a questionnaire on daily schedule, 2) the Pittsburgh Sleep Quality Index questionnaire (PSQI), and 3) ocular examinations including an eye dominance test, fundus photography, and sequential optical coherence tomography (OCT) imaging, on two separate days at five fixed 3h time intervals. Choroidal thickness was measured by two masked graders. RESULTS: A significant diurnal variation of choriodal thickness at fovea (P<0.001), at 500 µm nasal (P<0.001), temporal to fovea (P=0.01) or 1500 µm nasal to fovea (P=0.001) was observed. The median choroidal thickness peaked at 11:00 at fovea (P=0.01), at 500 µm nasal (P=0.009) and temporal (P=0.03) to fovea. The median amplitude of foveal choroidal thickness was 20.5 µm (13, 31) and 20.0 µm (12.5, 28.2) for the first and second series of measurements, respectively. The greater amplitude of foveal choroidal thickness was associated with thickner initial foveal choroidal thickness [0.05 (0.03, 0.08), P=0.01], dominant eye [10.51 (4.02, 14.60), P=0.04] in the multivariate linear regression. CONCLUSION: Our data show a significant diurnal variation of the choroidal thickness at fovea, at 500 µm nasal and temporal to fovea and 1500 µm nasal to fovea. Thicker initial foveal choroidal thickness and being dominant eye may influence the amplitude of foveal choroidal thickness.

C-reactive protein and diabetic retinopathy in Chinese patients with type 2 diabetes mellitus.

AIM: To investigate the relationship between C-reactive protein (CRP) and diabetic retinopathy (DR) in a cohort of Chinese patients with type 2 diabetes mellitus (T2DM). METHODS: Community-based observational cohort study. There were 1131 participants recruited from November 2009 to September 2011 in Desheng community in urban Beijing. Patients diagnosed T2DM were recruited and underwent a standardized evaluation consisting of a questionnaire, ocular and anthropometric examinations and laboratory investigation. The presence and severity of DR were assessed by seven fields 30° color fundus photographs. Subjects were then classified into groups with no DR, any DR, or vision-threatening DR. CRP was analyzed from serum of study subjects. RESULTS: A total of 1007 patients with T2DM were included for analysis, including 408 (40.5%) men and 599 (59.5%) women. The median CRP level was 1.5 mg/L for women and 1.1 mg/L for men (P=0.004, OR 0.37, 95% CI 0.18-0.74). After adjusting for possible covariates, higher levels of CRP were associated with lower prevalence of any DR (P=0.02, OR 0.55, 95% CI 0.35-0.89), but not associated with vision-threatening DR (P=0.62, OR 0.78, 95% CI 0.28-2.14). After stratification by sex, the inverse association between CRP and DR was found to be statistically significant in men (P=0.006, OR 0.35, 95% CI 0.16-0.73), but not in women (P=0.58, OR 0.88, 95% CI 0.29-1.16). CONCLUSION: The data drawn from a Chinese population with T2DM suggest that increasing CRP levels may be inversely associated with development of DR.

Bone Marrow Stromal Cells Promote Neuronal Restoration in Rats with Traumatic Brain Injury: Involvement of GDNF Regulating BAD and BAX Signaling.

BACKGROUND/AIMS: To investigate the effects of bone marrow stromal cells (BMSCs) and underlying mechanisms in traumatic brain injury (TBI). METHODS: Cultured BMSCs from green fluorescent protein-transgenic mice were isolated and confirmed. Cultured BMSCs were immediately transplanted into the regions surrounding the injured-brain site to test their function in rat models of TBI. Neurological function was evaluated by a modified neurological severity score on the day before, and on days 7 and 14 after transplantation. After 2 weeks of BMSC transplantation, the brain tissue was harvested and analyzed by microarray assay. And the coronal brain sections were determined by immunohistochemistry with mouse anti-growth-associated protein-43 kDa (anti-GAP-43) and anti-synaptophysin to test the effects of transplanted cells on the axonal regeneration in the host brain. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay and Western blot were used to detect the apoptosis and expression of BAX and BAD. RESULTS: Microarray analysis showed that BMSCs expressed growth factors such as glial cell-line derived neurotrophic factor (GDNF). The cells migrated around the injury sites in rats with TBI. BMSC grafts resulted in an increased number of GAP-43-immunopositive fibers and synaptophysin-positive varicosity, with suppressed apoptosis. Furthermore, BMSC transplantation significantly downregulated the expression of BAX and BAD signaling. Moreover, cultured BMSC transplantation significantly improved rat neurological function and survival. CONCLUSION: Transplanted BMSCs could survive and improve neuronal behavior in rats with TBI. Mechanisms of neuroprotection and regeneration were involved, which could be associated with the GDNF regulating the apoptosis signals through BAX and BAD.