Five-year impact of repeated praziquantel treatment on subclinical morbidity due to Schistosoma japonicum in China

We report the 5-year impact (1996-2001) of repeated praziquantel chemotherapy on subclinical morbidity related to Schistosoma japonicum infection. We repeated stool examinations and hepatosplenic ultrasonography in a cohort of 120 individuals living on an island with endemic infection in Dongting Lake, China. Prevalence of schistosome infection fell by 43% and intensity (geometric mean eggs per gram) declined by 80% over the 5 years. However, transmission persisted at a dangerously high rate of 13% per year for re-infection or new infection in the cohort. The prevalence of left-lobe enlargement and dilated portal vein fell significantly (P 0.05). However, endpoint infection was even more strongly associated with left-lobe enlargement (57% versus 15%, P < 0.01). The proportions of subjects with improved parenchymal and periportal fibrosis were much higher than the proportions of subjects that progressed (P < 0.05). Reduction of prevalence and intensity of infection, and improvement of subclinical morbidity, were benefits of repeated treatments. Further research is needed to understand why some patients developed fibrosis despite substantial reductions in egg counts and to evaluate the functional importance of residual subclinical morbidity after chemotherapy-based control in the lake and marshland area of Chin

Richard S. Smith v. Rocky Mountain Helicopters : Brief of Respondent

BRIEF OF RESPONDENT AND CROSS APPELLANT Appeal from the Fourth Judicial District Court Of Utah County Honorable Boyd L. Park, District Judg

Points to consider in cardiovascular disease risk management among patients with rheumatoid arthritis living in South Africa, an unequal middle income country

ABSTRACT: Background: It is plausible that optimal cardiovascular disease (CVD) risk management differs in patients with rheumatoid arthritis (RA) from low or middle income compared to high income populations. This study aimed at producing evidence-based points to consider for CVD prevention in South African RA patients. Methods: Five rheumatologists, one cardiologist and one epidemiologist with experience in CVD risk management in RA patients, as well as two patient representatives, two health professionals and one radiologist, one rheumatology fellow and 11 rheumatologists that treat RA patients regularly contributed. Systematic literature searches were performed and the level of evidence was determined according to standard guidelines. Results: Eighteen points to consider were formulated. These were grouped into 6 categories that comprised overall CVD risk assessment and management (n=4), and specific interventions aimed at reducing CVD risk including RA control with disease modifying anti-rheumatic drugs, glucocorticoids and non-steroidal anti-inflammatory drugs (n=3), lipid lowering agents (n=8), antihypertensive drugs (n=1), low dose aspirin (n=1) and lifestyle modification (n=1). Each point to consider differs partially or completely from recommendations previously reported for CVD risk management in RA patients from high income populations. Currently recommended CVD risk calculators do not reliably identify South African black RA patients with very high-risk atherosclerosis as represented by carotid artery plaque presence on ultrasound. Conclusions: Our findings indicate that optimal cardiovascular risk management likely differs substantially in RA patients from low or middle income compared to high income populations. There is an urgent need for future multicentre longitudinal studies on CVD risk in black African patients with RA.The first meeting held amongst local Rheumatologists was funded by the South African Arthritis and Rheumatology Association. The studies by Professor González-Gay have been supported by grants from “Fondo de Investigaciones Sanitarias” PI06/0024, PS09/00748, PI12/00060, PI15/00525, PI18/00043, and RD12/0009/0013 and RD16/0012 (RIER) from “Instituto de Salud Carlos III” (ISCIII) (Spain), co-funded by FEDER funds

There and back again: molecular phylogenetics of the Brazilian endemic Psyllocarpus (Rubiaceae: Spermacoceae) supports a circumscription of the genus based on its original concept

The Spermacoce clade (tribe Spermacoceae) is one of the most taxonomically complex groups in Rubiaceae due to the unclear delimitation of Borreria and Spermacoce, in which several smaller genera are phylogenetically intermingled. One of these genera is the Brazilian endemic Psyllocarpus, whose circumscription was broadened, thereby including two sections. Psyllocarpus sect. Psyllocarpus, being based on the original genus delineation, includes nine species, distributed in the Cerrado and campo rupestre of eastern Brazil, whereas P. sect. Amazonica comprises three species, occurring in the Amazonian campinas. Furthermore, P. intermedius was not classified in any of these sections when it was later described. In order to test the monophyly of Psyllocarpus and assess its relationships to other genera, we conducted phylogenetic analyses, sampling across the whole Spermacoce clade, including nearly all Psyllocarpus species. A combined nuclear ribosomal (ETS and ITS) and plastid (rps16 and trnLtrnF) dataset was generated, representing 124 species (ca 25% of the species in the clade) in 15 genera (ca 65%). Various methodologies were applied to investigate the degree of incongruence among markers and address the lack of resolution and low support values for some branches. Our results revealed that Psyllocarpus is not monophyletic. Psyllocarpus campinorum (from P . sect. Amazonica) and P intermedius are situated as distinct lineages in the Spermacoce clade, yet do not belong to Psyllocarpus. Members of section Psyllocarpus form a strongly supported clade sister to Staelia and was recovered with high to maximum support across different datasets and inference methods. Therefore, Psyllocarpus has to be circumscribed based on its original concept, excluding P. sect. Amazonica and P. intermedius. This establishes the genus as a monophyletic and easily diagnosable taxon, characterized by terete leaves, homostylous flowers, a bilobate calyx, included stamens and style, and compressed, septifragally dehiscent capsules with a persistent septum

Survival or Sustainability? Contributions of Innovatively-Managed News Ventures to the Future of Egyptian Journalism

In the repressive political climate prevailing in Egypt in 2013-15, news ventures aspiring to high standards of reporting were forced to innovate. This paper analyses three Egyptian start-ups that experimented with novel revenue streams and news services during that period, to gain insights into their approaches to managing journalism. In the process it compares different criteria for assessing sustainability and concludes that, in adverse political environments, narrow economic measures of profitability and survival may give a misleading picture as to the sustainability of the kind of journalism conducive to democratic practice. Operating collaboratively, transparently and ethically may slow productivity and profitability in the short term while laying stronger foundations for durable relations among media teams, as well as with readers and advertisers, in the long run

Kidney function, endothelial activation and atherosclerosis in black and white Africans with rheumatoid arthritis

OBJECTIVE: To determine whether kidney function independently relates to endothelial activation and ultrasound determined carotid atherosclerosis in black and white Africans with rheumatoid arthritis (RA). METHODS: We calculated the Jelliffe, 5 Cockcroft-Gault equations, Salazar-Corcoran, Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rate (EGFR) equations in 233 (112 black) RA patients. RESULTS: The CKD-EPI eGFR was 0.1 for comparisons of AUC (SE)) for the other 8 equations. Based on optimal eGFR cutoff values with sensitivities and specificities ranging from 42 to 60% and 70 to 91% respectively, as determined in ROC curve analysis, a low eGFR increased the odds ratio for plaque 2.2 to 4.0 fold. CONCLUSION: Reduced kidney function is independently associated with atherosclerosis and endothelial activation in black and white Africans with RA, respectively. CKD is highly prevalent in black Africans with RA. Apart from the MDRD, eGFR equations are useful in predicting carotid plaque presence, a coronary heart disease equivalent, amongst black African RA patients

Variants of CTGF are associated with hepatic fibrosis in Chinese, Sudanese, and Brazilians infected with Schistosomes

Abnormal fibrosis occurs during chronic hepatic inflammations and is the principal cause of death in hepatitis C virus and schistosome infections. Hepatic fibrosis (HF) may develop either slowly or rapidly in schistosome-infected subjects. This depends, in part, on a major genetic control exerted by genes of chromosome 6q23. A gene (connective tissue growth factor [CTGF]) is located in that region that encodes a strongly fibrogenic molecule. We show that the single nucleotide polymorphism (SNP) rs9402373 that lies close to CTGF is associated with severe HF (P = 2 × 10−6; odds ratio [OR] = 2.01; confidence interval of OR [CI] = 1.51–2.7) in two Chinese samples, in Sudanese, and in Brazilians infected with either Schistosoma japonicum or S. mansoni. Furthermore, SNP rs12526196, also located close to CTGF, is independently associated with severe fibrosis (P = 6 × 10−4; OR = 1.94; CI = 1.32–2.82) in the Chinese and Sudanese subjects. Both variants affect nuclear factor binding and may alter gene transcription or transcript stability. The identified variants may be valuable markers for the prediction of disease progression, and identify a critical step in the development of HF that could be a target for chemotherapy

Multiple-instrument polyphonic music transcription using a temporally constrained shift-invariant model

A method for automatic transcription of polyphonic music is proposed in this work that models the temporal evolution of musical tones. The model extends the shift-invariant probabilistic latent component analysis method by supporting the use of spectral templates that correspond to sound states such as attack, sustain, and decay. The order of these templates is controlled using hidden Markov model-based temporal constraints. In addition, the model can exploit multiple templates per pitch and instrument source. The shift-invariant aspect of the model makes it suitable for music signals that exhibit frequency modulations or tuning changes. Pitch-wise hidden Markov models are also utilized in a postprocessing step for note tracking. For training, sound state templates were extracted for various orchestral instruments using isolated note samples. The proposed transcription system was tested on multiple-instrument recordings from various datasets. Experimental results show that the proposed model is superior to a non-temporally constrained model and also outperforms various state-of-the-art transcription systems for the same experiment

Power-based Model for Temperature Prediction in FSW

Abstract This paper describes a thermal numerical model accessible to all users for predicting temperature in friction stir welding from the power, material thermal properties, process parameters, tool, and plate dimensions. Starting with the information obtained from the machine, power or torque, the heat flux is modeled as a circular moving source with a diameter equal to that of the shoulder. The model calibrated in a specific setup (CNC machine) successfully predicted without recalibration the weld temperature field in another one (robot). The simple thermal model was applied without recalibration to data available in the literature to test its effectiveness. The results obtained with this model are promising, although more tests are needed to cover all possible varieties of tool geometries and material thickness. If extended over a broader range of configurations (i.e., process parameters and tool-workpiece geometries), it could be a handy tool for all FSW users. The tool may help study the thermal cycles in the heat affected zone that influence final mechanical properties and make it easier to identify optimal parameters if the desired optimal peak temperatures are determined.Advanced THermomechanical mOdelling of Refractory lining