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4%) knew about modern contraception, only 300 (31.0%) sexually active respondents used modern contraceptives. Knowledge of modern contraception (AOR 0.11; 95% C.I 0.01-0.82, p = 0.03) and being employed (AOR 0.38; 95% C.I 0.15-0.95, p = 0.04) reduced the odds for inconsistent condom use among male SIYPs. For female SIYPs, knowledge of modern contraception reduced the odds for inconsistent condom use (AOR 0.26; 95% C.I 0.08-0.90, p = 0.03), whereas access to SRH information significantly increased the odds for inconsistent condom use (AOR 5.06; 95% C.I 1.67-15.37, p = 0.004). Conclusion Age- and sex- related factors associated with risky sexual behaviors vary among SIYP. Addressing these differences in the delivery of targeted interventions to reduce sexual health risk of SIYP may be required.Background L-Alanyl-L-glutamine (AQ) is a functional dipeptide with high water solubility, good thermal stability and high bioavailability. GSK2578215A in vivo It is widely used in clinical treatment, post-operative rehabilitation, sports health care and other fields. AQ is mainly produced via chemical synthesis which is complicated, time-consuming, labor-intensive, and have a low yield accompanied with the generation of by-products. It is therefore highly desirable to develop an efficient biotechnological process for the industrial production of AQ. Results A metabolically engineered E. coli strain for AQ production was developed by over-expressing L-amino acid α-ligase (BacD) from Bacillus subtilis, and inactivating the peptidases PepA, PepB, PepD, and PepN, as well as the dipeptide transport system Dpp. In order to use the more readily available substrate glutamic acid, a module for glutamine synthesis from glutamic acid was constructed by introducing glutamine synthetase (GlnA). Additionally, we knocked out glsA-glsB to block the first step in glutamine metabolism, and glnE-glnB involved in the ATP-dependent addition of AMP/UMP to a subunit of glutamine synthetase, which resulted in increased glutamine supply. Then the glutamine synthesis module was combined with the AQ synthesis module to develop the engineered strain that uses glutamic acid and alanine for AQ production. The expression of BacD and GlnA was further balanced to improve AQ production. Using the final engineered strain p15/AQ10 as a whole-cell biocatalyst, 71.7 mM AQ was produced with a productivity of 3.98 mM/h and conversion rate of 71.7%. Conclusion A metabolically engineered strain for AQ production was successfully developed via inactivation of peptidases, screening of BacD, introduction of glutamine synthesis module, and balancing the glutamine and AQ synthesis modules to improve the yield of AQ. This work provides a microbial cell factory for efficient production of AQ with industrial potential.Background Determining the effective factors on the adoption of preventive behaviors capable of reducing the risk of skin cancer is an important step in designing interventions to promote these behaviors. Based on the protection motivation theory, the present study is aimed to conduct a path analysis of skin cancer preventive behaviors in rural women to explore these factors. Methods In this cross-sectional study, 243 rural women were randomly selected from the west of Iran to receive a valid and reliable questionnaire assessing constructs from the protection motivation theory, as well as demographic information. Fully completed questionnaires were returned by 230 women and the data were analyzed by SPSS 22 and LISREL8.8. Results Concerning skin cancer preventive behaviors, 27.8% of women wore sun-blocking clothing when working under the sun, 21.7% used sunscreen cream, 5.7% wore a cap, and 4.8% used gloves and sunglasses. Protection motivation theory and per capita income explained 51% of motivation variance and 25% of the variance of skin cancer preventive behaviors. The response efficacy construct was the strongest predictor of the motivation of protection (ß = - 0.44, p less then 0/001). Per-capita income (ß = - 0.34, p less then 0/001) and motivation (ß = - 0.33, p less then 0/001) were the strongest predictors of these behaviors. Conclusions This study showed that protection motivation theory is efficient in predicting skin cancer preventive behaviors and the interventions can be designed and implemented by this theory. Proper planning is also necessary for promoting these behaviors among people with low per-capita income.Objectives The influence of physical activity (PA) on the immune system has emerged as a new field of research. Regular PA may promote an anti-inflammatory state in the body, thus contributing to the down-regulation of pro-inflammatory processes related to the onset and progression of multiple diseases. We aimed to assess whether overall PA levels were associated with differences in blood gene expression profiles, in a cohort of middle-aged Norwegian women. We used information from 977 women included in the Norwegian Women and Cancer (NOWAC) Post-genome cohort. Information on PA and covariates was extracted from the NOWAC database. Blood samples were collected using the PAXgene Blood RNA collection system, and gene expression profiles were measured using Illumina microarrays. The R-package limma was used for the single-gene level analysis. For a target gene set analysis, we used the global test R-package with 48 gene sets, manually curated from the literature and relevant molecular databases. Results We found no associations between overall PA levels and gene expression profiles at the single-gene level. Similarly, no gene sets reached statistical significance at adjusted p less then 0.05. In our analysis of healthy, middle-aged Norwegian women, self-reported overall PA was not associated with differences in blood gene expression profiles.Background Coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, was declared a global pandemic by the World Health Organization in March 2020. Case presentation We report a case of a 51-year-old Chinese woman who was evacuated from Wuhan, China and diagnosed with coronavirus disease 2019 infection at a Southern California quarantine facility. Her clinical course was notable for high fevers, night sweats, productive cough, transient leukopenia, lymphopenia, thrombocytopenia, and transaminitis. Evolving hypoxia and infiltrates on chest imaging warranted the trial of an investigational antiviral drug - remdesivir. Our patient recovered and was discharged after 2 weeks of hospitalization. Conclusions This case highlights our patient's clinical course, including diagnostic work-up, medical management, and challenges in defining non-infectivity in a relatively unknown disease.Background Primary care physicians (PCPs) play a pivotal role in the management of illnesses of the digestive tract. The study aim was to assess the adherence of PCPs to the guidelines on the management of Helicobacter pylori (H. pylori) infection and gastroesophageal reflux disease (GERD) in adults. Methods We conducted a cross-sectional study during March-July 2017 using the survey platform of Maccabi Healthcare Services in Israel. The study questionnaire assessed adherence to the Maastricht/Florence guidelines on H. pylori infection and the American College of Gastroenterology guidelines on the management of GERD. We sent the study questionnaires to a random sample of 610 PCPs via electronic mails. We contacted those who did not respond by telephone; eventually 180 physicians completed the survey. Results Ninety (50%) and 60 (36%) of the responders reported using professional guidelines for the diagnosis and management of H. pylori infection and GERD, respectively. Of the 180 participants, 153 (85%) reported referring patients with suspected peptic ulcer disease to H. pylori testing, 109 (61%) reported referring patients with unexplained iron deficiency anemia and 83 (46%) refer relatives of gastric cancer patients. In caring for young patients who have dyspepsia without alarm symptoms, 127 (74%) reported referral to a urea breath test for the diagnosis of H. pylori infection, and 136 (81%) referral to a specialist in gastroenterology if alarm symptoms present. Triple therapy with proton pump inhibitors/clarithromycin/amoxicillin or metronidazole was reported as first-line therapy by 141 (83%) participants. For GERD, 94-98% of the participants followed the appropriate recommendations. Conclusions We identified gaps between the practices of PCPs and the guidelines on H. pylori infection management, while guidelines on GERD management are well adopted. Simplification of the guidelines and exploring barriers towards their implementation by PCPs is warranted.Background The average age of the global population is rising at an increasing rate. There is a disproportional increase in Emergency Department (ED) visits by older people worldwide. In the Brazilian health system, complex and severely ill patients and those requiring specialized urgent procedures are referred to tertiary level care. As far as we know, no other study in Latin America has analyzed the impact of demographic changes in tertiary ED attendance. Aim To describe the sociodemographic characteristics and outcomes of tertiary Brazilian ED users. Methods Design Observational cross-sectional analytic study. Setting Emergency Department, tertiary university hospital, São Paulo, Brazil. Participants patients aged 18 years or older attending a tertiary ED (2009-2013). The primary outcomes were hospitalization and mortality; the secondary outcome was ICU admission. Age was categorized as 'young adults' (18-39y), 'adults' (40-59y), 'young-older adults' (60-79y), and 'old-older adults' (80-109y). Other variab49 (95% CI = 3.15-3.87), 1.27 (1.15-1.39) and 5.93 (5.29-6.66) respectively, with young adults as the reference. Conclusions In tertiary ED, age is an important risk factor for hospitalization and mortality, but not for ICU admission. Old-older people are at the greatest risk and demand further subgroup stratification.Background Multiple Myeloma (MM) is a cancer characterised by the proliferation of malignant plasma cells in the bone marrow. This study examined the treatment preferences of people living with MM compared to the treatment preferences of other groups involved in treatment decision making, including carers, as well as physicians and nurses who treat people living with MM in Australia. Methods Data were collected using discrete choice experiments (DCEs) through an online survey. The DCEs presented participants with a traditional treatment generic choice experiment (e.g., treatment A vs treatment B), focusing on the clinical benefits of treatments and the associated risks. The attributes and levels of the attributes were selected based on previous research, literature review, qualitative research and expert opinion. The DCE data were modelled using a Latent Class Model (LCM). Results The model revealed significant heterogeneity in preferences for treatment attributes. In particular, overall survival, remission period and annual out of pocket cost were the attributes with the most variation. In comparison to people living with MM, carers were less cost-sensitive and more concerned with quality of life (remission period). Physicians and nurses were generally more concerned with overall survival and more cost sensitive than people living with MM. Conclusions This study demonstrated that not all people living with MM valued the same treatment attributes equally. Further, not all groups involved in MM treatment decision making had preference alignment on all treatment attributes. This has important implications for healthcare policy decisions and shared decision making. Results from this study could be used to guide decisions around the value of new MM medicines or the medical plan surrounding the needs of those living with MM, as well as those caring for them.