High prevalence of childhood multi-drug resistant tuberculosis in Johannesburg, South Africa: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>There are limited data on the prevalence of multi-drug resistant tuberculosis (MDR-TB), estimated at 0.6-6.7%, in African children with tuberculosis. We undertook a retrospective analysis of the prevalence of MDR-TB in children with <it>Mycobacterium tuberculosis </it>(MTB) at two hospitals in Johannesburg, South Africa.</p> <p>Methods</p> <p>Culture-confirmed cases of MTB in children under 14 years, attending two academic hospitals in Johannesburg, South Africa during 2008 were identified and hospital records of children diagnosed with drug-resistant TB were reviewed, including clinical and radiological outcomes at 6 and 12 months post-diagnosis. Culture of <it>Mycobacterium tuberculosis </it>complex (MTB) was performed using the automated liquid broth MGIT™ 960 method. Drug susceptibility testing (DST) was performed using the MGIT™ 960 method for both first and second-line anti-TB drugs.</p> <p>Results</p> <p>1317 children were treated for tuberculosis in 2008 between the two hospitals where the study was conducted. Drug susceptibility testing was undertaken in 148 (72.5%) of the 204 children who had culture-confirmed tuberculosis. The prevalence of isoniazid-resistance was 14.2% (n = 21) (95%CI, 9.0-20.9%) and the prevalence of MDR-TB 8.8% (n = 13) (95%CI, 4.8-14.6%). The prevalence of HIV co-infection was 52.1% in children with drug susceptible-TB and 53.9% in children with MDR-TB. Ten (76.9%) of the 13 children with MDR-TB received appropriate treatment and four (30.8%) died at a median of 2.8 months (range 0.1-4.0 months) after the date of tuberculosis investigation.</p> <p>Conclusions</p> <p>There is a high prevalence of drug-resistant tuberculosis in children in Johannesburg in a setting with a high prevalence of HIV co-infection, although no association between HIV infection and MDR-TB was found in this study. Routine HIV and drug-susceptibility testing is warranted to optimize the management of childhood tuberculosis in settings such as ours.</p

Unexposed populations and potential COVID-19 hospitalisations and deaths in European countries as per data up to 21 November 2021.

We estimate the potential remaining COVID-19 hospitalisation and death burdens in 19 European countries by estimating the proportion of each country's population that has acquired immunity to severe disease through infection or vaccination. Our results suggest many European countries could still face high burdens of hospitalisations and deaths, particularly those with lower vaccination coverage, less historical transmission and/or older populations. Continued non-pharmaceutical interventions and efforts to achieve high vaccination coverage are required in these countries to limit severe COVID-19 outcomes

A 2017 Horizon Scan of Emerging Issues for Global Conservation and Biological Diversity

We present the results of our eighth annual horizon scan of emerging issues likely to affect global biological diversity, the environment, and conservation efforts in the future. The potential effects of these novel issues might not yet be fully recognized or understood by the global conservation community, and the issues can be regarded as both opportunities and risks. A diverse international team with collective expertise in horizon scanning, science communication, and conservation research, practice, and policy reviewed 100 potential issues and identified 15 that qualified as emerging, with potential substantial global effects. These issues include new developments in energy storage and fuel production, sand extraction, potential solutions to combat coral bleaching and invasive marine species, and blockchain technology.Cambridge Conservation Initiative, funded by the Natural Environment Research Council and the Royal Society for the Protection of Birds, Arcadia, Natural Environment Research Council (Grant ID: NE/N014472/1

Cardiac anisotropy in boundary-element models for the electrocardiogram

The boundary-element method (BEM) is widely used for electrocardiogram (ECG) simulation. Its major disadvantage is its perceived inability to deal with the anisotropic electric conductivity of the myocardial interstitium, which led researchers to represent only intracellular anisotropy or neglect anisotropy altogether. We computed ECGs with a BEM model based on dipole sources that accounted for a “compound” anisotropy ratio. The ECGs were compared with those computed by a finite-difference model, in which intracellular and interstitial anisotropy could be represented without compromise. For a given set of conductivities, we always found a compound anisotropy value that led to acceptable differences between BEM and finite-difference results. In contrast, a fully isotropic model produced unacceptably large differences. A model that accounted only for intracellular anisotropy showed intermediate performance. We conclude that using a compound anisotropy ratio allows BEM-based ECG models to more accurately represent both anisotropies

Vertical integration in production and services: development in transaction cost economics

In this paper, we first establish the core, fundamental concepts of Williamson's TCE, examining the different governance structures or the institutional alternatives that TCE theory proposes. We go on to describe some critical considerations and theoretical proposals that correspond fundamentally to Williamson's heuristic model, the integration of incentives in organizational forms, idiosyncratic demand, and how the concept of transaction is conceived in general.Peris-Ortiz, M.; Bonet, F.; Rueda Armengot, C. (2011). Vertical integration in production and services: development in transaction cost economics. Service Business. 5(1):87-97. doi:10.1007/s11628-011-0103-0S879751Alchian A (1965) The basic of some recent advances in the theory of management of the firm. J Ind Econ 14:30–41Alchian A (1969) Corporate management and property rights. In: Manne GH (ed) Economic Policy and Regulation of Corporate Securities. American Enterprise Institute of Public Policy Research, Washington, DCAlchian A, Demsetz H (1972) Production, information cost, and economic organization. Am Econ Rev 62:777–795Arrow KJ (1959) Toward a theory of price adjustment. In: Abramovitz M et al (eds) The allocation of resources. Stanford University Press, Stanford, CA, pp 41–51Arrow KJ (1973) Information and economic behaviour. Federation of Swedish Industries, StockholmArrow KJ (1974) The limits of organizations. W. W. Norton, New YorkBain J (1956) Barriers to new competition. Harvard University Press, Cambridge, MABain J (1958) Industrial organization, 2nd edn. John Wiley & Sons, New YorkBarnard CI (1938) The functions of the executive. Cambridge University Press, Cambridge, MAChandler AC Jr. (1962) Strategy and structure. MIT Press, Cambridge, MAChandler AC Jr. (1977) The visible hand. Harvard University Press, Cambridge, MACoase RH (1937) The nature of the firm. Economica 4:386–405Coase RH (1972) Industrial organization: a proposal for research. In: Victor RF (ed) Policy issues and research opportunities in industrial organization. National Bureau of Economic Research, New York, pp 59–73Coase RH (1991) The institutional structure of production. Prize Lecture to the Memory of Alfred Nobel, December 9, 1991, http://www.nobel.se/economics/laureates/1991/coase-lecture.htmlCyert RM, March JG (1963) A behavioural theory of the firm. Prentice-Hall, Englewood Cliffs, NJDemsetz H (1967) Toward a theory of property rights. Am Econ Rev 57:347–359Demsetz H (1991) The theory of the firm revisited. In: Williamson O, Winter S (eds) The nature of the firm: origins, evolution, and development. Oxford University Press, New York, pp 159–178Galbraith JR (1993) The value-adding corporation: matching structure with strategy. In: Galbraith JR, Lawler III EE and Associates (eds) Organizing for the future. Jossey-Bass Publishers, San Francisco, pp 15–42Li J-M, Yang J-S, Wu HH (2009) Analysis of competence differences among frontline employees from various service typologies. Serv Ind J 29(12):1763–1778Ouchi WG (1979) A conceptual framework for the design of organizational control mechanism. Manag Sci 25(9):833–848Ouchi WG (1980) Markets, bureaucracies, and clans. Admin Sci Q 25:120–142Palmer M, Owens M, De Kervenoael R (2010) Paths of the least resistance: understanding how motives form in international retail joint venturing. Serv Ind J 30(6):965–989Robinson J (1933) The economics of imperfect competition. Macmillan, LondonSafón V (2009) The moderating effect of the technological level of industry on the relationship between innovation and corporate reputation. Int Entrep Manag J 5(4):515–526Simon HA (1947) Administrative behavior. Macmillan, New YorkSimon HA (1962) The architecture of complexity. Proc Am Philos Soc 106:467–482Simon HA (1973) Applying information technology to organization design. Public Admin Rev 33:268–278Un CA, Romero-Martínez AM, Montoro-Sánchez A (2009) Determinants of R&D collaboration of service firms. Serv Bus 3:373–394Warren L, Patton D, Bream D (2009) Knowledge acquisition processes during the incubation of new high technology firms. Int Entrep Manag J 5(4):481–495Williamson OE (1975) Markets and hierarchies: analysis and antitrust implication. Free Press, New YorkWilliamson OE (1979) Transaction-cost economics: the governance of contractual relations. J Law Econ 22:3–61Williamson OE (1981) The modern corporation: origins, evolution, attributes. J Econ Lit 19:1537–1568Williamson OE (1985) The economic institutions of capitalism. Free Press, New YorkWilliamson OE (1991) Comparative economic organization: the analysis of discrete structural alternatives. Admin Sci Q 36:269–296Williamson OE (1993) Calculativeness trust and economic organization. J Law Econ 36:453–486Williamson OE (1996) The mechanisms of governance. Oxford University Press, New York, pp 250–278Williamson OE (1999) Strategy research: governance and competence perspectives. Strateg Manag J 20:1087–1108Williamson OE (2000) The new institutional economics: taking stock, looking ahead. J Econ Lit 38:595–613Williamson OE (2003) Examining economic organization through the lens of contract. Ind Corp Change 12(4):917–938Williamson OE (2005) Transaction cost economics and business administration. Scand J Manag 21:19–40Williamson OE (2008) Outsourcing: transaction cost economics and supply chain management. J Supply Chain Manag 44(2):5–16Williamson OE, Bhargava WH (1986) Assessing and classifying the internal structure and control apparatus of the modern corporation. In: Williamson OE (ed) Economic organization. Firms, markets and policy control. Wheatsheaf Books, Great Britain, Brighton, pp 54–8

Color-to-Grayscale: Does the Method Matter in Image Recognition?

In image recognition it is often assumed the method used to convert color images to grayscale has little impact on recognition performance. We compare thirteen different grayscale algorithms with four types of image descriptors and demonstrate that this assumption is wrong: not all color-to-grayscale algorithms work equally well, even when using descriptors that are robust to changes in illumination. These methods are tested using a modern descriptor-based image recognition framework, on face, object, and texture datasets, with relatively few training instances. We identify a simple method that generally works best for face and object recognition, and two that work well for recognizing textures

“Having diabetes shouldn’t stop them”: healthcare professionals’ perceptions of physical activity in children with Type 1 diabetes

Background Healthcare professionals (HCP) working with children who have Type 1 Diabetes Mellitus (T1DM) have an important role in advising about and supporting the control of blood glucose level in relation to physical activity. Regular physical activity has known benefits for children with T1DM, but children with chronic conditions may face barriers to participation. The perceptions of HCPs were explored in an effort to understand what influences physical activity in children with T1DM and to inform the practice of those working with children who have T1DM. Methods Semi-structured interviews with 11 HCPs involved in the care of children with T1DM in the UK were conducted. Interviews were recorded, transcribed verbatim and data were analysed using thematic analysis. Results The factors perceived to influence participation in physical activity are presented as five major themes and eleven sub-themes. Themes included the positive influence of social support, the child’s motivation to be active, the potential for formal organisations such as school and diabetes clinic to support physical activity, the challenges faced by those who have T1DM and the perceived barriers to HCPs fulfilling their role of promoting physical activity. Conclusions Healthcare professionals recognised their role in helping children with T1DM and their parents to incorporate physical activity into diabetes management and everyday life, but perceived barriers to the successful fulfilment of this role. The findings highlight the potential for clinical and non-clinical supportive systems to be sensitive to these challenges and facilitate children’s regular participation in physical activity

Investigation of K14/K5 as a stem cell marker in the limbal region of the bovine cornea

Background: Identification of stem cells from a corneal epithelial cell population by specific molecular markers has been investigated previously. Expressions of P63, ABCG2 and K14/K5 have all been linked to mammalian corneal epithelial stem cells. Here we report on the limitations of K14/K5 as a limbal stem cell marker. Methodology/Principal Findings: K14/K5 expression was measured by immunohistochemistry, Western blotting and Real time PCR and compared between bovine epithelial cells in the limbus and central cornea. A functional study was also included to investigate changes in K5/14 expression within cultured limbal epithelial cells undergoing forced differentiation. K14 expression (or its partner K5) was detected in quiescent epithelial cells from both the limbal area and central cornea. K14 was localized predominantly to basal epithelial cells in the limbus and suprabasal epithelial cells in the central cornea. Western blotting revealed K14 expression in both limbus and central cornea (higher levels in the limbus). Similarly, quantitative real time PCR found K5, partner to K14, to be expressed in both the central cornea and limbus. Following forced differentiation in culture the limbal epithelial cells revealed an increase in K5/14 gene/protein expression levels in concert with a predictable rise in a known differentiation marker. Conclusions/Significance: K14 and its partner K5 are limited not only to the limbus but also to the central bovine cornea epithelial cells suggesting K14/K5 is not limbal specific in situ. Furthermore K14/K5 expression levels were not lowered (in fact they increased) within a limbal epithelial cell culture undergoing forced differentiation suggesting K14/K5 is an unreliable maker for undifferentiated cells ex vivo