Method: Thirty-five full-length pk41 sequences from clinical isolates of Malaysia along with four laboratory lines (along with H-strain) were downloaded from public databases. For comparative analysis between species, orthologous P41 genes from P. falciparum, P. vivax, P. coatneyi and P. cynomolgi were also downloaded. Genetic diversity, polymorphism, haplotype and natural selection were determined using DnaSP 5.10 software. Phylogenetic relationships between Pk41 genes were determined using MEGA 5.0 software.
Results: Analysis of 39 full-length pk41 sequences along with the H-strain identified 36 SNPs (20 non-synonymous and 16 synonymous substitutions) resulting in 31 haplotypes. Nucleotide diversity across the full-length gene was low and was similar to its ortholog in P. vivax; pv41. Domain-wise amino acid analysis of the two s48/45 domains indicated low level of polymorphisms for both the domains, and the glutamic acid rich region had extensive size variations. In the central domain, upstream to the glutamate rich region, a unique two to six (K-E)n repeat region was identified within the clinical isolates. Overall, the pk41 genes were indicative of negative/purifying selection due to functional constraints. Domain-wise analysis of the s48/45 domains also indicated purifying selection. However, analysis of Tajima's D across the genes identified non-synonymous SNPs in the s48/45 domain II with high positive values indicating possible epitope binding regions. All the 6-cysteine residues within the s48/45 domains were conserved within the clinical isolates indicating functional conservation of these regions. Phylogenetic analysis of full-length pk41 genes indicated geographical clustering and identified three subpopulations of P. knowlesi; one originating in the laboratory lines and two originating from Sarawak, Malaysian Borneo.
Conclusion: This is the first study to report on the polymorphism and natural selection of pk41 genes from clinical isolates of Malaysia. The results reveal that there is low level of polymorphism in both s48/45 domains, indicating that this antigen could be a potential vaccine target. However, genetic and molecular immunology studies involving higher number of samples from various parts of Malaysia would be necessary to validate this antigen's candidacy as a vaccine target for P. knowlesi.
Methods: The sample of current cross-sectional study includes 212 patients with coronary artery disease (CAD) in Iran evaluated from Jan to Jun 2017. The required data were gathered using Beck's Depression Inventory (BDI) questionnaire, Buss and Perry's Aggression Questionnaire (BPAQ), and Hudson's Marital Satisfaction Index (HMSI). The data were analysed using Pearson's correlation coefficient and structural equation modeling (SEM) using SPSS20 and AMOS software.
Results: The mean age of participants (68.4% male) was 58.5 ± 8.9. The results show that there is a significant positive relationship between all the variables (P < 0.05). The results of the model show that marital stress cannot directly predict depression (P = 0.586). However, through aggression, marital stress can significantly predict 18% of the variance of depression (P < 0.001).
Conclusions: Not directly, but indirectly through aggression, marital stress can significantly predict increased depression among patients with CAD. The physiological and psychological pathways of the findings can be discussed.
Methods: A two-way repeated measures study was conducted on 14 healthy older adults and 14 older adults with balance impairment, who were recruited from the community in Chiang Rai, Thailand. Their walking performance was assessed using a four-metre walking test at their preferred gait speed and while walking under two further gait conditions, in randomised order: dual task walking and dual task walking with a simulated traffic light. Each participant was tested individually, with the testing taking between 15 and 20 minutes to perform, including two-minute rest periods between walking conditions. Two Kinect cameras recorded the spatio-temporal parameters using MFU gait analysis software. Each participant was tested for each condition twice. The mean parameters for each condition were analysed using a two-way repeated measures analysis of variance (ANOVA) with participant group and gait condition as factors.
Result: There was no significant between-group effect for walking speed, stride length and cadence. There were also no significant effects between gait condition and stride length or cadence. However, the effect between gait condition and walking speed was found to be significant [F(1.557, 40.485) = 4.568,P= 0.024, [Formula: see text]].
Conclusion: An audio-visual cue (simulated traffic light) was found to influence walking speed in both healthy older adults and in older adults with balance impairment. The results suggest that audio-visual cues could be incorporated into healthy lifestyle promotion in older adults with balance impairment.
METHODS: This experimental study was done on a sample of 86 caregivers of elderly with dementia in 2018. The study sample was selected from memory clinic of Taleghani Hospital and randomly assigned into groups (intervention n = 43, control n = 43 groups). The well-being was measured using the World Health Organization - Five Well-Being Index (WHO-5), before and two months after the intervention. Cyberspace-based educational intervention was conducted for one month. The SPSS software version 23 was employed in data analysis.
RESULTS: The mean age of the caregivers in the intervention and control groups were (M = 51.95, SD = 10.90) and (M = 51.36, SD = 15.12) respectively. No significant difference was found between two groups in terms of age, gender and level of education. The results of analysis showed that while the well-being of the intervention group was significantly increased (t (38) = -11.38, P<0.001) the well-being in the control group was significantly reduced ( t(36) =4.71 , P<0.001).
CONCLUSION: The findings showed that cyberspace-based education can improve the well-being of caregivers of the elderly with dementia.
METHODS: A retrospective audit of heart transplant recipients (n = 87) treated with tacrolimus was performed. Relevant data were collected from the time of transplant to discharge. The concordance of tacrolimus dosing and monitoring according to hospital guidelines was assessed. The observed and software-predicted tacrolimus concentrations (n = 931) were compared for the first 3 weeks of oral immediate-release tacrolimus (Prograf) therapy, and the predictive performance (bias and imprecision) of the software was evaluated.
RESULTS: The majority (96%) of initial oral tacrolimus doses were guideline concordant. Most initial intravenous doses (93%) were lower than the guideline recommendations. Overall, 36% of initial tacrolimus doses were administered to transplant recipients with an estimated glomerular filtration rate of <60 mL/min/1.73 m despite recommendations to delay the commencement of therapy. Of the tacrolimus concentrations collected during oral therapy (n = 1498), 25% were trough concentrations obtained at steady-state. The software displayed acceptable predictions of tacrolimus concentration from day 12 (bias: -6%; 95%confidence interval, -11.8 to 2.5; imprecision: 16%; 95% confidence interval, 8.7-24.3) of therapy.
CONCLUSIONS: Tacrolimus dosing and monitoring were discordant with the guidelines. The Bayesian forecasting software was suitable for guiding tacrolimus dosing after 11 days of therapy in heart transplant recipients. Understanding the factors contributing to the variability in tacrolimus pharmacokinetics immediately after transplant may help improve software predictions.