Articles: School of Nursing

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1H NMR-based metabolomics study on repeat dose toxicity of fine particulate matter in rats after intratracheal instillation
(Elsevier, 2017-07) Zhang, Y.; Hu, H.; Shi, Y.; Yang, X.; Cao, L.; Wu, J.; Asweto, Collins O.; Feng, L.; Duan, J.; Sun, Z.
Systemic metabolic effects and toxicity mechanisms of ambient fine particulate matter (PM2.5) remain uncertain. In order to investigate the mechanisms in PM2.5 toxicity, we explored the endogenous metabolic changes and possible influenced metabolic pathways in rats after intratracheal instillation of PM2.5 by using a 1H nuclear magnetic resonance (NMR)-based metabolomics approach. Liver and kidney histopathology examinations were also performed. Chemical characterization demonstrated that PM2.5 was a complex mixture of elements. Histopathology showed cellular edema in liver and glomerulus atrophy of the PM2.5 treated rats. We systematically analyzed the metabolites changes of serum and urine in rats using 1H NMR techniques in combination with multivariate statistical analysis. Significantly reduced levels of lactate, alanine, dimethylglycine, creatine, glycine and histidine in serum, together with increased levels of citrate, arginine, hippurate, allantoin and decreased levels of allthreonine, lactate, alanine, acetate, succinate, trimethylamine, formate in urine were observed of PM2.5 treated rats. The mainly affected metabolic pathways by PM2.5 were glycine, serine and threonine metabolism, glyoxylate and dicarboxylate metabolism, citrate cycle (TCA cycle), nitrogen metabolism and methane metabolism. Our study provided important information on assessing the toxicity of PM2.5 and demonstrated that metabolomics approach can be employed as a tool to understand the toxicity mechanism of complicated environmental pollutants.
Cardiovascular health risk posed by polycyclic aromatic hydrocarbon and ultrafine particles.
(2018-01) Asweto, Collins O.
There is increased cardiovascular disease incidence attributed to ambient air pollution. It is estimated that ischaemic heart disease and stroke account for 80% of ambient air pollutionrelated early deaths. The most deleterious are the ultrafine particles (UFPs) which have more prominent potential health threat, since they can act as carriers of other strong air pollutant such as polycyclic aromatic hydrocarbons (PAHs). UFPs are small in size, hence can easily penetrate and reach cardiovascular tissues and organs. To understand their mechanisms, studies on UFPs and PAHs induced cardiovascular diseases were reviewed. The studies showed that UFPs and PAHs initiate events in atherogenesis including oxidative stress, expression of cell adhesion molecules on the surface of the endothelium, inflammation, and endothelial dysfunction. Endothelial dysfunction is associated with cardiovascular diseases such as hypertension, coronary artery disease, chronic heart failure, and peripheral vascular disease. The current review provides useful information on deleterious effect of UFP and PAH exposure on cardiovascular system. Thus advancing knowledge on UFP and PAH toxicity underscores the importance of the cardiovascular effects of air pollutants.
Cellular pathways involved in silica nanoparticles induced apoptosis: A systematic review of in vitro studies.
(Elsevier, 2017-12) Asweto, Collins O.; Wu, J.; Alzain, M. A.; Hu, H.; Andrea, S.; Feng, L.; Yeng, X.; Duan, J.; Sun, Z.
Silica nanoparticles (SiNPs) have been found to pass through biological barriers and get distributed in the human body. They induce cell apoptosis via various mechanisms in body organs. To understand these mechanisms, we carried out systematic review of in vitro studies on SiNPs-induced cell apoptosis. Office of Health Assessment and Translation approach for Systematic Review and Evidence Integration was used to identify 14 studies dating from the year 2000 to current. Four studies showed an increase in DNA damage, cell cycle arrest, proapoptotic factors and decrease in antiapoptotic factors resulting to apoptosis. Eight studies showed induction of mitochondrial dysfunction, Bax upregulation, Bcl-2 downregulation, and caspase-3, -7, -9 activities increase. Increase in FADD, TNFR1 and Bid proteins was observed in one study, while the other NO production and caspase-3 activity was increased. These studies found the potency of SiNPs to induce cell apoptosis through DNA damage, mitochondrial, tumor necrosis factor, and nitric oxide related pathways.
Co-exposure to amorphous silica nanoparticles and benzo[a]pyrene at low level in human bronchial epithelial BEAS-2B cells
(SpringerLink, 2016-11) Wu, J.; Shi, Y.; Asweto, Collins O.; Lin, F.; Xiaozhe, Y.; Zhang, Y.; Duan, J.; Sun, Z.
Both ultrafine particles (UFP) and polycyclic aromatic hydrocarbons (PAHs) are widely present in the environment, thus increasing their chances of exposure to human in the daily life. However, the study on the combined toxicity of UFP and PAHs on respiratory system is still limited. In this study, we examined the potential interactive effects of silica nanoparticles (SiNPs) and benzo[a]pyrene (B[a]P) in bronchial epithelial cells (BEAS-2B). Cells were exposed to SiNPs and B[a]P alone or in combination for 24 h. Co-exposure to SiNPs and B[a]P enhanced the malondialdehyde (MDA) contents and reduced superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities significantly, while the reactive oxygen species (ROS) generation had a slight increase in the exposed groups compared to the control but not statistically significant. Cell cycle arrest induced by the co-exposure showed a significant percentage increase in G2/M phase cells and a decrease in G0/G1 phase cells. In addition, there was a significant increase in BEAS-2B cells multinucleation as well as DNA damage. Cellular apoptosis was markedly increased even at the low-level co-exposure. Our results suggest that co-exposure to SiNPs and B[a]P exerts synergistic and additive cytotoxic and genotoxic effects.
Comprehensive gene and microRNA expression profiling on cardiovascular system in zebrafish co exposured of SiNPs and MeHg
(Elsevier, 2017-12) Hu, H.; Shi, Y.; Zhang, Y.; Wu, J.; Asweto, Collins O.; Feng, L.; Yang, X.; Duan, J.; Sun, Z.
Air pollution has been shown to increase cardiovascular diseases. However, little attention has been paid to the combined effects of PM and air pollutants on the cardiovascular system. To explore this, a high-throughput sequencing technology was used to determine combined effects of silica nanoparticles (SiNPs) and MeHg in zebrafish. Our study demonstrated that SiNPs and MeHg co-exposure could cause significant changes in mRNA and miRNA expression patterns in zebrafish. The differentially expressed (DE) genes in profiles 17 and 26 of STC analysis suggest that SiNPs and MeHg co-exposure had more proinflammatory and cardiovascular toxicity in zebrafish than single exposure. Major gene functions associated with cardiovascular system in the co-exposed zebrafish were discerned from the dynamic-gene-network, including stxbp1a, celf4, ahr1b and bai2. In addition, the prominently expressed pathway of cardiac muscle contraction was targeted by 3 DE miRNAs identified by the miRNA-pathway-network (dre-miR-7147, dre-miR-26a and dre-miR-375), which included 23 DE genes. This study presents a global view of the combined SiNPs and MeHg toxicity on the dynamic expression of both mRNAs and miRNAs in zebrafish, and could serve as fundamental research clues for future studies, especially on cardiovascular system toxicity.
Does Breast Cancer Risk Awareness Motivate Personal Prevention Practices: Findings from a Community-based Assessment?
(2016-01) Ouma, J.; Olang’, S.; Asweto, Collins O.; Obago, I. T.; Kaseje, D.
Breast cancer, is the leading cause of cancer specific mortality. But nearly 80% of the mortality is preventable by early diagnosis. We assessed knowledge and practice of breast cancer prevention by women in a rural community setting. Data was collected on demographics, family history, knowledge and practice of breast cancer by interviewer administered questionnaire. Knowledge (including knowledge of risk) and practice were measured using a response-based score to a set of 9 and 10 questions respectively. Prevalence odds ratio was calculated to estimate association between independent and outcome variables. Knowledge of breast cancer risk was low (14.2%). Family history and socioeconomic status were significantly associated with knowledge; respondents with more than eight years of school were more likely to have higher knowledge (OR=2.859; CI=1.578-5.178). Practice of prevention was equally low (17.2%). Practice was significantly associated with knowledge; respondents with higher knowledge of prevention were more likely to practice prevention (OR=6.8; CI=3.308-14.104). We propose that community-based risk communication and awareness creating programs may motivate breast cancer prevention practices. Women of lower socio-economic status should especially be targeted with such interventions. There is need to develop these into a sustainable community-based health education program.
Early Mobilization and Physical Activity Improve Stroke Recovery: A Cohort Study of Stroke Inpatients in Kisumu County Referral Hospitals, Kenya
(2016-01) Ogolla, M. M.; Opemo, D. O.; Asweto, Collins O.
Early mobilization in acute stroke care is highly recommended in a range of developed countries policy; however, in developing countries like Kenya, lack of evidence seems to hinder formulation and implementation of policy guideline on early mobilization in acute stroke care. Therefore, to estimate the safe optimal time for early mobilization of stroke patients in Kenya, we conducted a prospective cohort study in two purposively selected health facilities in Kisumu County, Kenya. About 100 stroke patients admitted in medical wards (mean age 59.1±2.3 years, females 61%) were recruited. Barthel Index’ tool was used to assess recovery and physical activity levels. It comprised of scoring scale ranging from 0-100. The participants were categorized as follows: Patients who score between 0 – 30 were considered as mildly recovered, 31 - 60 as moderately recovered and patients who score from 61 – 100 were regarded as fully recovered. Multiple logistic regression model was used to compute adjusted ORs (AOR) of early mobilization and Barthel Index variable, adjusting for age, gender and type of stroke. Early mobilization improves patient recovery. Participants in early mobilization group were more like to independently feed, groom, dress, use toilet, use wheel chair and climb stairs with help compared to late mobilization (p <0.05). Most (76%) participants who were exposed to high physical activity had full recovery than the (5%) bones in low physical activity (p< 0.001). This study provides evidence that early mobilization and high physical activity improves stroke patient recovery.
Effects of increased residential mobility and reduced public spaces Effects of increased residential mobility and reduced public spaces mobility in containing COVID-19 in Africa
(Global Reports, 2020-09) Asweto, Collins O.; Onyango, Patrick O.; Alzain, Mohamed A; Wang, Wei
Background Background The rising COVID-19 crisis threatens to disproportionately hit African countries. As a result, most African governments have temporarily closed schools and non-essential businesses or banned social gatherings to contain the disease. It is therefore important to estimate the level of transmission reduction as a result of these measures. This study aimed at predicting COVID-19 cases in Africa based on COVID-19 community mobility report. Methods Methods Our study focused on 26 African countries whose community mobility data were available online. The number of daily confirmed cases for the period of February 15th, 2020 to May 29th, 2020 for each country was obtained from European Center for Disease Prevention and Control (ECDC) COVID-19 cases geographic distribution data. Multiple linear regression was performed to investigate the relationship between COVID-19 community mobility and confirmed cases. Results Results The maximum public place mobility change was -38.15% with an average of -18.85% (±3.47); residential mobility was at 23.17% with an average of 11. 268% (±1.448). The number of confirmed cases had a significant negative correlation with residential mobility change (r = -0.878, P<0.01) and positive correlation with public place mobility change (r = 0.881, P<0.05). Both mobility changes in public spaces and residential are significant predictors of COVID-19 cases. More specifically, about 1% change in a public place and residential mobility would result in 167 less COVID-19 daily cases, while total lockdown would result in 581 fewer daily cases. Conclusions Conclusions Our analysis shows that a COVID-19 containment strategy that focuses on increasing residential mobility and reducing public spaces mobility is effective. Therefore, the finding supports containment measures that aim to limit the movement of people.
Experience and Perceptions on Preterm Births among Women Attending ANC Clinic at Kisumu County Hospital, Kenya.
(researchjournali, 2018-03) Samba, Benard O.; Ayodo, George; Amimo, Fred; Asweto, Collins O.
Preterm birth is one of the main causes of neonatal death, and it is now the second leading cause of death after pneumonia in children under the age of five. Kenya is estimated to have 12.3% preterm births and 22 neonatal deaths per 1000 live births. It is important to explore the experience and perceptions on preterm births among women attending ANC clinic. A survey was conducted at Kisumu County hospital, Kenya. Focus Group Discussion (FGD) and In Depth Interview (IDI) were used to collect data on preterm birth (PTB) experiences. The four-step iterative process of qualitative data analysis to generate the final interpretation was employed. This study established that mothers are aware of the gestation period (9 months or 39 weeks) in pregnancy, are able to monitor how close they are to the Estimated Date of Delivery (EDD). Mothers with history of PTB or with twin/multiple births had a high risk of premature delivery. Information on PTB was not provided during ANC. ANC services should be expanded to be effective for the detection, treatment or prevention of conditions associated with PTB (serious morbidity or mortality). There is need to investigate the capacity of health care providers to provide quality ANC health information and services with regard to PTB.
Fine particle matters induce DNA damage and G2/M cell cycle arrest in human bronchial epithelial BEAS-2B cells
(SpringerLink, 2017-11) Wu, J.; Shi, Y.; Asweto, Collins O.; Feng, L.; Yang, X.; Zhang, Y.; Hu, H.; Duan, J.; Sun, Z.
There is compelling evidence that exposure to particulate matter (PM) is linked to lung tumorigenesis. However, there is not enough experimental evidence to support the specific mechanisms of PM2.5-induced DNA damage and cell cycle arrest in lung tumorigenesis. In this study, we investigated the toxic effects and molecular mechanisms of PM2.5 on bronchial epithelial (BEAS-2B) cells. PM2.5 exposure reduced cell viability and enhanced LDH activity. The cell growth curves of BEAS-2B cells decreased gradually with the increase in PM2.5 dosage. A significant increase in MDA content and a decrease in GSH-Px activity were observed. The generation of ROS was enhanced obviously, while apoptosis increased in BEAS-2B cells exposed to PM2.5 for 24 h. DNA damage was found to be more severe in the exposed groups compared with the control. For in-depth study, we have demonstrated that PM2.5 stimulated the activation of HER2/ErbB2 while significantly upregulating the expression of Ras/GADPH, p-BRAF/BRAF, p-MEK/MEK, p-ERK/ERK, and c-Myc/GADPH in a dose-dependent manner. In summary, we suggested that exposure to PM2.5 sustained the activation of HER2/ErbB2, which in turn promoted the activation of the Ras/Raf/MAPK pathway and the expression of the downstream target c-Myc. The overexpression of c-Myc may lead to G2/M arrest and aggravate the DNA damage and apoptosis in BEAS-2B after exposure to PM2.5.
Fine particulate matter induces vascular endothelial activation 4 via IL-6 dependent JAK1/STAT3 signaling pathway. Toxicol.
(2016-04) Hu, H.; Wu, J.; Li, Q.; Asweto, Collins O.; Lin, F.; Xiaozhe, Y.; Duan, F.; Duan, J.; Sun, Z.
Exposure to PM2.5 has been strongly linked to endothelial dysfunction. However, the underlying mechanism of PM2.5 on the vascular endothelial function is poorly understood. This study examined the toxic effect and underlying mechanism of PM2.5 on human umbilical vein endothelial cells (HUVECs). Decreased cell viability and increased LDH activity were observed in the PM2.5-treated HUVECs in a dose-dependent manner. The production of ROS, MDA, and the inhibition of SOD activity were also triggered by PM2.5 in HUVECs. In addition, PM2.5 increased the intracellular levels of proinflammatory cytokines (IL-6, TNF-a, IL-1β, IL-8 and CRP), cell adhesion molecules (ICAM-1, VCAM-1) and tissue factor (TF), resulted in endothelial activation. For an in-depth study, the protein levels of IL-6, JAK1 and STAT3 were up-regulated significantly, while the expression of JAK2 and SOCS1 were down-regulated gradually in PM2.5-treated HUVECs in a dose-dependent manner. These results show that PM2.5 triggered endothelial activation via upregulation of the IL-6 dependent JAK1/STAT3 signaling pathway. This will provide new insights into the toxic effects and mechanisms of cardiovascular diseases triggered by ambient air pollution.
Gene expression profiles and bioinformatics analysis of human umbilical vein endothelial cells exposed to PM2.5
(Elsevier, 2017-05) Hu, H.; Asweto, Collins O.; Wu, J.; Shi, Y.; Feng, L.; Yang, X.; Liang, S.; Cao, L.; Duan, J.; Sun, Z.
Cardiovascular system is demonstrated the main target of PM2.5 and the objective of this study was to explore the toxic effect and molecular mechanisms caused by PM2.5 in primary human umbilical vein endothelial cells (HUVECs) using microarray and bioinformatics analysis. The results showed that 591 genes were differentially expressed triggered by PM2.5, of which 174 genes were down-regulated, while 417 genes were up-regulated. Gene ontology analysis revealed that PM2.5 caused significant changes in gene expression patterns, including response to stimuli, immune response, and cellular processes. Pathway analysis and Signal-net analysis suggested that endocytosis, chemokine signaling pathway, RNA transport, protein processing in endoplasmic reticulum (ER) and autophagy regulation were the most critical pathways in PM2.5-induced toxicity in HUVECs. Moreover, gene expression confirmation of LIF, BCL2L1, CSF3, HMOX1, RPS6, PFKFB, CAPN1, HSPBP1, MOGS, PREB, TUBB2A, GABARAP by qRT-PCR indicated that endocytosis might be involved in the cellular uptake of PM2.5 by forming phagosomes, and subsequently inflammation, hypoxia and ER stress was occurred, which finally activated autophagy after PM2.5 exposure in HUVECs. In summary, our data can serve as fundamental research clues for further studies of PM2.5-induced toxicity in HUVECs.
Gene profiles to characterize the combined toxicity induced by low level co-exposure of silica nanoparticles and benzo[a]pyrene using whole genome microarrays in zebrafish embryos.
(Elsevier, 2018-07) Asweto, Collins O.; Hu, H; Liang, S.; Wang, L.; Liu, M.; Yang, H.; Duan, J.; Sun, Z.
Several studies have suggested that air pollutants combine exposure have greater adverse effects. However, limited studies were available on the combined toxicity of silica nanoparticles (SiNPs) and benzo[a]pyrene (B[a]P). The study was to evaluate the toxic effect and mechanisms of low-dose exposure of SiNPs, B[a]P and co-exposure in zebrafish embryos. In this study, zebrafish embryos received intravenous microinjection of SiNPs and B[a]P, and then was used to select differentially expressed genes by microarray analysis. Multiple bioinformatics analyses and STC analysis were done to identify key genes, pathways and biological processes and the expression trend of genes in each group. 1) 3065 differentially expressed genes were identified in zebrafish embryos. 2) These differentially expressed genes were involved in multiple biological processes and cellular processes such as immunity, response to stimuli, cell proliferation, adhesion, signaling transduction, and embryonic development. 3) Dynamic Gene Network analysis was used to identify a subgroup of 26 core genes that involved in multiple biological processes and cellular processes. 4) Pathway analysis and Signal-net analysis indicated that the MAPK signaling pathway, calcium signaling pathway, p53 signaling pathway, PI3k/Akt signaling pathway, and several pathways associated with immune response were the most prominent significant pathways induced by co-exposure of SiNPs and B[a]P in zebrafish embryos. Our study demonstrated that the molecular actions of co-treated with SiNPs and B[a]P on the immune system, inflammatory process and cardiovascular development had more severe toxicity than single exposure
Genome-wide transcriptional analysis of cardiovascular-related genes and pathways induced by PM2. 5 in human myocardial cells.
(2017-04) Feng, L.; Yang, X.; Asweto, Collins O.; Wu, J.; Zhang, Y.; Hu, H.; Shi, Y.; Duan, J.; Sun, Z.
Air pollution has been a major environment-related health threat. Most of the studies on PM2.5 toxicity have verified on the cardiovascular system and endothelial cells. However, researches on PM2.5-induced myocardial-related toxicity are limited. This study aims to fully understand the toxic effects of PM2.5 on human myocardial cell (AC16) and explore its molecular mechanism based on microarray analysis and bioinformatics analysis. Microarray data analysis manifested that PM2.5-induced toxicity affected expression of 472 genes compared with the control group, including 166 upregulated genes and 306 downregulated genes in human myocardial (AC16) cells. GO analysis showed that cellular processes such as immune response, cell maturation, embryonic heart tube morphogenesis, cellular response to electrical stimulus, skeletal muscle tissue regeneration, and negative regulation of signal transduction were upregulated, while regulation of transcription (DNA-dependent), rhythmic process, protein destabilization apoptotic process, and innate immune response were downregulated. The pathway analysis indicates that cell signaling pathways such as cytokine-cytokine receptor interaction, NF-κB signaling pathway, chemokine signaling pathway, endocrine and other factor-regulated calcium reabsorption, HTLV-I infection, and cell adhesion molecules (CAMs) were upregulated, while the TGF-β signaling pathway was downregulated. In addition, Signal-net showed that the TUBA4A, ADRBK2, BRIX1, SMC4, EIF5B, PRMT1, ATG4B, and NDC80 genes were significantly decreased, while the expression of the KRT6B gene was markedly increased compared with the control group. All the genes were verified by qRT-PCR. This study had provided new bioinformatics evidences in PM2.5-induced myocardial tissue toxicity which is necessary for further cardiovascular system toxicity studies.
Glycan Biomarkers for Rheumatoid Arthritis and Its Remission Status in Han Chinese Patients.
(2016-06) Sebastian, A.; Alzain, M. A.; Asweto, Collins O.; Song, H.; Cui, L.; Yu, X.; Ge, S.; Dong, H.; Rao, P.; Wang, H.; Fang, H.; Gao, Q.; Zhang, J.; He, D.; Guo, X.; Song, M.; Wang, Y.; Wang, W.
Rheumatoid arthritis (RA), a systemic, chronic, and progressive inflammatory autoimmune disease, affects up to 1.0% of the world population doubling mortality rate of patients and is a major global health burden. Worrisomely, we lack robust diagnostics of RA and its remission status. Research with the next-generation biomarker technology platforms such as glycomics offers new promises in this context. We report here a clinical case–control study comprising 128 patients suffering from chronic RA (80.22% in remission, 19.78% active clinically) and 195 gender- and age-matched controls, with a view to the putative glycan biomarkers of RA as well as its activity or remission status in Han Chinese RA patients. Hydrophilic interaction liquid chromatography–ultra-performance liquid chromatography (HILIC-UPLC) was used for the analysis of IgG glycans. The regression model identified the glycans that predict RA status, while a receiver operating characteristic (ROC) curve analysis validated the sensitivity and prediction power. Among the total 24 glycan peaks (GP1–GP24), ROC analysis showed only GP1 prediction to be highly sensitive with an area under the curve (AUC) = 0.881. Even though GP21 and GP22 could predict active status among the RA cases (p < 0.05), they had lower sensitivity of prediction with an AUC = 0.658. Taken together, these observations suggest that GP1 might have potential as a putative biomarker for RA in the Han Chinese population, while the change in IgG glycosylation shows association with the RA active and remission states. To the best of our knowledge, this is the first glycomics study with respect to disease activity and remission states in RA.
Integration of community health workers into health systems in developing countries: Opportunities and challenges
(Systematic Review, 2016-01) Asweto, Collins O.; Mohamed, Ali Alzain; Sebastian, Andrea; Rachel, Alexander; Wei, Wang
Background: Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health workers (CHWs). It is imperative that health care systems focus on improving access to quality continuous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness. Objective: To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries. Methods: Six databases were examined for quantitative, qualitative, and mixed-methods studies that included the integration of CHWs, their motivation and supervision, and CHW policy making and implementation in developing countries. Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs. Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized. Results: CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health. Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings. Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work, as well as financial and nonfinancial incentives, motivation, collaborative and supportive supervision, and a manageable workload. Conclusions: For sustainable integration of CHWs into health care systems, high-performing health systems with sound governance, adequate financing, well-organized service delivery, and adequate supplies and equipment are essential. Similarly, competent communities could contribute to better CHW performance through sound governance of community resources, promotion of inclusiveness and cohesion, engagement in participatory decision making, and mobilization of local resources for community welfare.
Low-dose combined exposure of nanoparticles and heavy metal compared with PM2.5 in human myocardial AC16 cells
(Springer, 2017-12) Feng, L.; Yang, X.; Asweto, Collins O.; Wu, Jing; Zhang, Y; Hu, H.; Shi, Y.; Duan, Junchao; Sun, Z.
The co-exposure toxicity mechanism of ultrafine particles and pollutants on human cardiovascular system are still unclear. In this study, the combined effects of silica nanoparticles (SiNPs) and/or carbon black nanoparticles (CBNPs) with Pb(AC)2 compared with particulate matter (PM)2.5 were investigated in human myocardial cells (AC16). Our study detected three different combinations of SiNPs and Pb(AC)2, CBNPs and Pb(AC)2, and SiNPs and CBNPs compared with PM2.5 at low-dose exposure. Using PM2.5 as positive control, our results suggested that the combination of SiNPs and Pb(AC)2/CBNPs could increase the production of reactive oxygen species (ROS), lactate dehydrogenase leakage (LDH), and malondialdehyde (MDA) and decrease the activities of superoxide dismutase (SOD) and glutathione (GSH); induce inflammation by the upregulation of protein CRP and TNF-α, and apoptosis by the upregulation of protein caspase-3, caspase-9, and Bax while the downregulation of protein Bcl-2; and trigger G2/M phase arrest by the upregulation of protein Chk2 and downregulation of protein Cdc2 and cyclin B1. In addition, the combination of CBNPs and Pb(AC)2 induced a significant increase in MDA and reduced the activities of ROS, LDH, SOD, and GSH, with G1/S phase arrest via upregulation of Chk1 and downregulation of CDK6 and cyclin D1. Our data suggested that the additive interaction and synergistic interaction are the major interaction in co-exposure system, and PM2.5 could trigger more severe oxidative stress, G2/M arrest, and apoptosis than either co-exposure or single exposure.
The Malaysian health care system: Ecology, plans, and reforms.
(2016-01) Sebastian, A.; Alzain, M. A.; Asweto, Collins O.; Mahara, G.; Guo, X.; Song, M.; Wang, Y.; Wang, W.
Malaysia is on its way to achieving developed nation status in the next 4 years. Currently, Malaysia is on track for three Millennium Development Goals (MDG1, MDG4, and MDG7). The maternal mortality rate, infant mortality rate, and mortality rate of children younger than 5 years improved from 25.6% (2012) to 6.6% (2013), and 7.7% (2012) per 100,000 live births, respectively whereas immunization coverage for infants increased to an average of 90%. As of 2013 the ratio of physicians to patients improved to 1:633 while the ratio of health facilities to the population was 1:10,272. The current government administration has proposed a reform in the form of the 10th Malaysian Plan coining the term "One Care for One Malaysia" as the newly improved and reorganized health care plan, where efficiency, effectiveness, and equity are the main focus. This review illustrates Malaysia's transition from pre-independence to the current state, and its health and socioeconomic achievement as a country. It aims to contribute knowledge through identifying the plans and reforms by the Malaysian government while highlighting the challenges faced as a nation.
Maternal Autonomy, Distance to Health Care Facility and ANC Attendance Findings from Madiany Division of Siaya County, Kenya
(Science and Education Publishing, 2014-08) Asweto, Collins O.; Aluoch, J. R.; Obonyo, C. O.; Ouma, J. O.
Half a million women die annually from pregnancy related causes. In Kenya, maternal mortality ratio (MMR) remains high in spite of great efforts to improve maternal health care. We studied some factors linked to maternity in a rural community setting. A survey was conducted in the community living in Madiany division of Siaya County, Kenya. We randomly sampled 403 mothers of children under three years old. Variables of interest were antenatal care attendance (ANC), parity, distance from the health facility and women empowerment (autonomy). Nearly 94% of the mothers had at least one ANC visit and 48.6% had completed the recommended four or more ANC visits; about 65.7% initiated ANC at first trimester. Parity, distance to the health facility and autonomy were associated with ANC visits. Mothers with one child had a twice higher chance of at least four ANC visits than those with more than one child. Those living at most 60 minutes travel-time from the health facility were seven times more likely have early ANC initiation and five times more likely to have at least four ANC attendance than those living more than 60 minutes travel-time from the health facility. Autonomy was linked to early initiation of ANC visit. This may indicate that improving maternal care and achieving Millennium Development Goal (MDG) 5 target, it is important to improve coverage of health facilities and implement development programs that empower rural women.
Maternal Vulnerabilities and Disparities in Availability of Antenatal Care Content in Kenya: Analysis of KDHS 2008/9
(Science and Education Publishing, 2017-09) Ouma, James; Asweto, Collins O.
Background: ANC provides the opportunity to detect and treat anomalies of pregnancy and access to preventive maternal and child healthcare. However, detailed information about the actual quality and content of ANC in practice is scanty, especially in developing countries. We analyzed the pattern and content of antenatal care service in Kenya in order to assess the quality of ANC. Methods: We used data from the 2008/9 KDHS, a nationally representative survey of women aged 15-49 years in Kenya. Proportion was used for description purpose while association was determined by bivariate and multivariate analysis in which odds ratio with a 95% confidence interval values were calculated. Results: About 50.9% of women sought ANC services either in health centers or dispensaries but these lower level health facilities had more content gaps. Multivariate analysis indicated that maternal age, regional residence, urban residence, wealth index, education and the media influenced ANC initiation and at least 4 ANC visits. There was a coverage gap existing in terms of iron-folate supplementation (66.1%), tetanus toxoid (66.5%), presumptive/preventive treatment for malaria with SP (38.7%) and education on pregnancy complication (44.3%). Nearly a third of women missed the screening for complication during pregnancy. Conclusion: Disparities exist in provision of ANC components, by type of facility attended, rural-urban and low versus higher income biases. Consequently vulnerable women attending ANC miss important care including screening for complication during pregnancy and labor. Efforts should be designed to improve on supplies to government health centers and dispensaries. Well stocked outreach village clinics with the requirements of a comprehensive antenatal care resource allocation should be used to eliminate service disparities. Government policy should help to increase media penetration amongst the masses and sensitize mothers on the importance of ANC.

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