'The difference in determinants of Chlamydia trachomatis and Mycoplasma genitalium in a sample of young Australian women.'

BACKGROUND Differences in the determinants of Chlamydia trachomatis ('chlamydia') and Mycoplasma genitalium (MG) genital infection in women are not well understood. METHODS A cohort study of 16 to 25 year old Australian women recruited from primary health care clinics, aimed to determine chlamydia and MG prevalence and incidence. Vaginal swabs collected at recruitment were used to measure chlamydia and MG prevalence, organism-load and chlamydia-serovar a cross-sectional analysis undertaken on the baseline results is presented here. RESULTS Of 1116 participants, chlamydia prevalence was 4.9% (95% CI: 2.9, 7.0) (n = 55) and MG prevalence was 2.4% (95% CI: 1.5, 3.3) (n = 27). Differences in the determinants were found - chlamydia not MG, was associated with younger age [AOR:0.9 (95% CI: 0.8, 1.0)] and recent antibiotic use [AOR:0.4 (95% CI: 0.2, 1.0)], and MG not chlamydia was associated with symptoms [AOR:2.1 (95% CI: 1.1, 4.0)]. Having two or more partners in last 12 months was more strongly associated with chlamydia [AOR:6.4 (95% CI: 3.6, 11.3)] than MG [AOR:2.2 (95% CI: 1.0, 4.6)] but unprotected sex with three or more partners was less strongly associated with chlamydia [AOR:3.1 (95%CI: 1.0, 9.5)] than MG [AOR:16.6 (95%CI: 2.0, 138.0)]. Median organism load for MG was 100 times lower (5.7 × 104/swab) than chlamydia (5.6 × 10⁶/swab) (p < 0.01) and not associated with age or symptoms for chlamydia or MG. CONCLUSIONS These results demonstrate significant chlamydia and MG prevalence in Australian women, and suggest that the differences in strengths of association between numbers of sexual partners and unprotected sex and chlamydia and MG might be due to differences in the transmission dynamics between these infections.This project was funded by the Commonwealth of Australia, as part of a National Chlamydia Pilot program that is currently running to test the effectiveness of a number of models for chlamydia testing in Australia. This project will assist in developing possible recommendations for a National Chlamydia Program. The analysis of MG was funded by the National Health and Research Council (research grant number 509144)

Gauge Your Gambling: The Acceptability and Feasibility of a Brief Online Motivational Enhancement for Non-Treatment Seeking Problem Gamblers

Those who struggle to control their gambling have been shown to experience a number of adverse consequences. Despite these difficulties, only a small percentage of problematic gamblers ever seek gambling treatment or services. As technology advances there is growing evidence that brief online interventions may be efficacious with this population. The present study tested the feasibility and acceptability of a new brief online intervention for those who struggle with their gambling. The intervention was theoretically based on the Health Belief Model, the Transtheoretical Model, and Motivational Interviewing. Participants completed a series of questionnaires about their gambling behaviours, perceived control over gambling, beliefs about their gambling problems, motivation for change and change efforts, and experienced and expected consequences of continued gambling. They also received personalized and normative comparison feedback. The development and administration of the online intervention was inexpensive relative to in person services but did encountered several technical difficulties. In total, 204 participants provided some data. Of those who accessed the website approximately two-thirds were experiencing one or more symptoms of Gambling Disorder. Participants generally found the website acceptable, however, there was a high within-intervention attrition rate. Most participants were in the contemplation stage of change and had low perceived gambling refusal self-efficacy. Perceived severity and perceived benefits from the Health Belief Model were found to account for 76% of the variance in the intent to seek help. There was a small partial mediation effect for readiness to change on the relationship between perceived severity and the intent to seek help. There was insufficient follow-up data to support statistical analysis of outcome variables. The website attracted the target population for the most part, however, future researchers will want to consider methods of increasing engagement and follow-up in this population such as increased incentives. Participants rated the website positively and case study data at follow-up suggest that further testing of brief online interventions such as Gauge Your Gambling is warranted

Disease suppression in Zinnia elegans integrating chemical and cultural management strategies

Zinnia elegans Jacq. is prized for its large flowers, wide diversity in flower color, plant form and ease of culture. Many cultivars of Z elegans have been developed by plant breeders since the plant\u27s introduction to culture in Europe around 1796. In the last twenty years, however, zinnias have become more widely known for their disease problems than for their garden attributes. The overall objective of this research was to determine whether cultivar selection and cultural practices during commercial production as well as in the landscape can affect the development and suppression of three pathogens: Altemahazinniae Rape, Erysiphecichoracearum DC ex Merat, and Xanthomonas campestris pv. zinniae (syn. X. nigromaculansl. sp. zinniae Hopkins and Dowson) on the popular bedding plant and cutflower. Zinnia elegans. This research consisted of three studies: 1) field cultivar trials, 2) pregermination seed treatment, and 3) field irrigation Practices. The objective of the field cultivar trials study was to determine if any of the 57 cultivars of zinnia grown under uniform field conditions showed resistance to foliar pathogens. At week 4, all cultivars showed signs of being infected with Altemaria blight and bacterial leaf and flower spot, but disease severity was low enough to make them acceptable in the landscape. Powdery mildew was not a factor at week 4. At week 10, eleven cultivars were judged acceptable in the landscape with regard to all three pathogens. By week 17, none of the 57 cultivars tested was considered acceptable in the landscape due to disease severity from one or more pathogens. In the pre-germination seed treatment study, seeds of seventeen cultivars of zinnia were treated with one of eight treatments and planted in 16.5 cm diameter (1180 cc) plastic pots containing soilless growing medium, placed on greenhouse benches, and allowed to grow until plants reached flowering stage. The objective of this study was to determine the effect of seven commercial greenhouse disinfectants, fungicides and biological control agents on seed germination and disease suppression during greenhouse production. It was found that pre-germination had no effect on plant height, number of buds and flowers, long-term survival of plants in the study, or disease incidence or severity for the three diseases studied. Pre-germination seed treatment did have a significant negative effect on germination percentage for some treatments. In the irrigation field practices study, seventeen cultivars of zinnia were subjected to either sub-irrigation, overhead-sprinkler irrigation or natural rainfall to determine if irrigation method affects disease incidence and severity of foliar disease. It was found that regardless of irrigation method, all cultivars were rendered unacceptable in the landscape by either Alternaria blight and/or bacterial leaf and flower spot by week 6 of the study. While watering regime had little consequence in disease severity, overhead irrigation produced greater disease severity than drip irrigation or the control for Alternaria blight and bacterial leaf and flower spot. For powdery mildew, drip irrigation produced greater disease severity than overhead irrigation or the control

Predictive validity of the Oxford digital multiple errands test (OxMET) for functional outcomes after stroke

The Oxford Digital Multiple Errands Test (OxMET) is a brief computer-tablet based cognitive screen, intended as an ecologically valid assessment of executive dysfunction. We examined aspects of predictive validity in relation to functional outcomes. Participants (≤ 2 months post-stroke) were recruited from an English-speaking stroke rehabilitation in-patient setting. Participants completed OxMET. The Barthel Index, Therapy Outcome Measure (TOMS), and modified Rankin Scale (mRS) were collected from medical notes. Participants were followed up after 6-months and completed the Nottingham Extended Activities of Daily Living (NEADL) scale. 117 participants were recruited (M = 26.18 days post-stroke (SD = 25.16), mean 74.44yrs (SD  = 12.88), median NIHSS 8.32 (IQR = 5-11)). Sixty-six completed a follow-up (M = 73.94yrs (SD  = 12.68), median NIHSS 8 (IQR = 4-11)). Significant associations were found between TOMS and mRS. At 6-month follow up, we found a moderate predictive relationship between the OxMET accuracy and NEADL (R2 = .29, p

Cost-effectiveness and budget impact of the microprocessor-controlled knee C-Leg in transfemoral amputees with and without diabetes mellitus

Background: The safe use of a prosthesis in activities of daily living is key for transfemoral amputees. However, the number of falls varies significantly between different prosthetic device types. This study aims to compare medical and economic consequences of falls in transfemoral amputees who use the microprocessor-controlled knee joint C-Leg with patients who use non-microprocessor-controlled (mechanical) knee joints (NMPK). The main objectives of the analysis are to investigate the cost-effectiveness and budget impact of C-Legs in transfemoral amputees with diabetes mellitus (DM) and without DM in Germany. Methods: A decision-analytic model was developed that took into account the effects of prosthesis type on the risk of falling and fall-related medical events. Cost-effectiveness and budget impact analyses were performed separately for transfemoral amputees with and without DM. The study took the perspective of the statutory health insurance (SHI). Input parameters were derived from the published literature. Univariate and probabilistic sensitivity analyses (PSA) were performed to investigate the impact of changes in individual input parameter values on model outcomes and to explore parameter uncertainty. Results: C-Legs reduced the rate of fall-related hospitalizations from 134 to 20 per 1000 person years (PY) in amputees without DM and from 146 to 23 per 1000 PY in amputees with DM. In addition, the C-Leg prevented 15 or 14 fall-related death per 1000 PY. Over a time horizon of 25 years, the incremental cost-effectiveness ratio (ICER) was 16,123 Euro per quality-adjusted life years gained (QALY) for amputees without DM and 20,332 Euro per QALY gained for amputees with DM. For the period of 2020–2024, the model predicted an increase in SHI expenditures of 98 Mio Euro (53 Mio Euro in prosthesis users without DM and 45 Mio Euro in prosthesis users with DM) when all new prosthesis users received C-Legs instead of NMPKs and 50% of NMPK user whose prosthesis wore out switched to C-Legs. Results of the PSA showed moderate uncertainty and a probability of 97–99% that C-Legs are cost-effective at an ICER threshold of 40,000 Euro (˜ German GDP per capita in 2018) per QALY gained. Conclusion: Results of the study suggest that the C-Leg provides substantial additional health benefits compared with NMPKs and is likely to be cost-effective in transfemoral amputees with DM as well as in amputees without DM at an ICER threshold of 40,000 Euro per QALY gained. © 2020, The Author(s)

The epistemology of the SARS-CoV-2 test

We investigate the epistemological consequences of a positive SARS-CoV-2 test for two relevant hypotheses: (i) V is the hypothesis that an individual has been infected with SARS-CoV-2; (ii) C is the hypothesis that SARS-CoV-2 is the sole cause of flu-like symptoms in a given patient. We ask two fundamental epistemological questions regarding each hypothesis: First, given a positive SARS-CoV-2 test, what should we believe about the hypothesis and to what degree? Second, how much evidence does a positive test provide for a hypothesis against its negation? We respond to each question within a formal Bayesian framework. We construe degree of confirmation as the difference between the posterior probability of the hypothesis and its prior, and the strength of evidence for a hypothesis against its alternative in terms of their likelihood ratio. We find that for realistic assumptions about the base rate of infected individuals, P(V)≲20%, positive tests having low specificity (75%) would not raise the posterior probability for V to more than 50%. Furthermore, if the test specificity is less than 88.1%, even a positive test having 95% sensitivity would only yield weak to moderate evidence for V against ¬V. We also find that in plausible scenarios, positive tests would only provide weak to moderate evidence for C unless the tests have a high specificity. One has thus to be careful in ascribing the symptoms or death of a positively tested patient to SARS-CoV-2, if the possibility exists that the disease has been caused by another pathogen

The epistemology of the SARS-CoV-2 test

We investigate the epistemological consequences of a positive SARS-CoV-2 test for two relevant hypotheses: (i) V is the hypothesis that an individual has been infected with SARS-CoV-2; (ii) C is the hypothesis that SARS-CoV-2 is the sole cause of flu-like symptoms in a given patient. We ask two fundamental epistemological questions regarding each hypothesis: First, given a positive SARS-CoV-2 test, what should we believe about the hypothesis and to what degree? Second, how much evidence does a positive test provide for a hypothesis against its negation? We respond to each question within a formal Bayesian framework. We construe degree of confirmation as the difference between the posterior probability of the hypothesis and its prior, and the strength of evidence for a hypothesis against its alternative in terms of their likelihood ratio. We find that for realistic assumptions about the base rate of infected individuals, P(V)≲20%, positive tests having low specificity (75%) would not raise the posterior probability for V to more than 50%. Furthermore, if the test specificity is less than 88.1%, even a positive test having 95% sensitivity would only yield weak to moderate evidence for V against ¬V. We also find that in plausible scenarios, positive tests would only provide weak to moderate evidence for C unless the tests have a high specificity. One has thus to be careful in ascribing the symptoms or death of a positively tested patient to SARS-CoV-2, if the possibility exists that the disease has been caused by another pathogen

Mr volumetry study of hippocampus and temporal lobe in malay adults with normal mri brain in HUSM

Introduction: Volumetry of hippocampus and temporal lobe has been paid attention more and more along with advanced in MRI. Magnetic resonance imaging (MRI) is a non-invasive and provides detailed, accurate morphology of hippocampus and also temporal lobe. MR volumetry of these two structures is important as they are affected by several disease processes. Establishing a normative data for a population is essential so as to refer and diagnose particular illness. There are computer aided automated and semi-automated method available for MR volumetry. This study used manual method for the normative data of hippocampus and temporal lobe. Volumetric MRI analysis is more sensitive than T2-weighted imaging to atrophy associated with hippocampal sclerosis. It also distinguish volume loss from space occupying lesion as well as may predict a good prognosis following surgery for epilepsy (Bronen, Cheung et al. 1991). The purpose of this study is to obtain hippocampal and temporal lobes volumes in normal Malay adults as a normative database. Hence, it can be a reference in diagnosing diseases related with these two structures. Objectives: The aims of this study is to determine the volume of hippocampus and temporal lobe in Malay adult with normal MRI brain. Methods and materials: This was a cross sectional observational study to determine volume of hippocampus and temporal lobe in Malay adult with normal MRI brain. The age of the patients was range from 21 to 49 years old. The study period was from February 2008 until June 2009 and 51 subjects were included. Majority of them were normal volunteers, and some were patients who had normal MRI brain. MRI of brain and temporal lobe series were performed using a Signa Horizon LX 1.0 Tesla from the Generic Electric Company. Oblique coronal sections perpendicular to the axis of hippocampus were done with 4mm slice thickness and 1mm gap. T1, T2, FLAIR and SPGR series were done. Hippocampal and temporal lobevolumetry were performed. The mean and standard deviation (SD) of hippocampus and temporal lobe volume were calculated using SPSS version 17. Results: Mean and standard deviation of the total hippocampus volume of normal adult was 6.43 cm3 (0.80) for all subjects. Mean total hippocampus volume was 6.62 cm3 (0.87) in male and 6.27 cm3 (0.71) for female. Mean and standard deviation of hippocampus were 3.35 cm3 (0.46) on the right and 3.01 cm3 (0.45) on the left side. Mean hippocampal volume for the right side for male subjects is ranging from 3.21 cm3 (0.44) to 3.54 cm3 (0.35) and for the left side is from 2.95 cm3 (0.30) to 3.32 cm3 (0.42). Mean hippocampal volume for the right side for female subjects is ranging from 3.07 cm3 (0.47) to 3.42 cm3 (0.30) and for the left side is from 2.80 cm3 (0.36) to 3.08 cm3 (0.25). Mean total temporal lobe volume for all subjects was 161.28 cm3 (19.48). Mean total temporal lobe volume for male and female were 169.23 cm³ (19.40) and 153.63 cm³ (16.54) respectively. Mean temporal lobe volume for the right side is ranging from 79.18 cm³ (8.25) to 87.25 cm³ (11.11) and for the left side is from 76.79 cm³ (9.42) to 84.55 cm³ (11.04). There was significant correlation between volume of hippocampus and volume of temporal lobe (r = 0.475, p < 0.01). Conclusion: These normative data for hippocampus and temporal lobe were useful reference for Malay population. There was significantly larger right hippocampus as compared to left hippocampal volume. There is fairly good association between the temporal lobe and hippocampal volume within normal adult with normal MRI brain

Constitutional Law - Prisoners\u27 Rights - Recognition That Involuntary Exposure to Environmental Tobacco Smoke May Constitute Cruel and Unusual Punishment - Avery v. Powell

This Note will analyze how the Avery Court reached its conclusion. In addition, this Note will examine Avery\u27s reliance on the Rhodes v. Chapman standard. The main thrust of this Note will be to demonstrate the widespread recognition of the harmful effects of ETS and how the Avery Court used that recognition to acknowledge plaintiff\u27s cause of action