171 research outputs found

    Sex-based differences in clearance of chronic Plasmodium falciparum infection.

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    Multiple studies have reported a male bias in incidence and/or prevalence of malaria infection in males compared to females. To test the hypothesis that sex-based differences in host-parasite interactions affect the epidemiology of malaria, we intensively followed Plasmodium falciparum infections in a cohort in a malaria endemic area of eastern Uganda and estimated both force of infection (FOI) and rate of clearance using amplicon deep-sequencing. We found no evidence of differences in behavioral risk factors, incidence of malaria, or FOI by sex. In contrast, females cleared asymptomatic infections at a faster rate than males (hazard ratio [HR]=1.82, 95% CI 1.20 to 2.75 by clone and HR = 2.07, 95% CI 1.24 to 3.47 by infection event) in multivariate models adjusted for age, timing of infection onset, and parasite density. These findings implicate biological sex-based differences as an important factor in the host response to this globally important pathogen

    Structural insights into Clostridium perfringens delta toxin pore formation

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    Clostridium perfringens Delta toxin is one of the three hemolysin-like proteins produced by C. perfringens type C and possibly type B strains. One of the others, NetB, has been shown to be the major cause of Avian Nectrotic Enteritis, which following the reduction in use of antibiotics as growth promoters, has become an emerging disease of industrial poultry. Delta toxin itself is cytotoxic to the wide range of human and animal macrophages and platelets that present GM2 ganglioside on their membranes. It has sequence similarity with Staphylococcus aureus β-pore forming toxins and is expected to heptamerize and form pores in the lipid bilayer of host cell membranes. Nevertheless, its exact mode of action remains undetermined. Here we report the 2.4 Å crystal structure of monomeric Delta toxin. The superposition of this structure with the structure of the phospholipid-bound F component of S. aureus leucocidin (LukF) revealed that the glycerol molecules bound to Delta toxin and the phospholipids in LukF are accommodated in the same hydrophobic clefts, corresponding to where the toxin is expected to latch onto the membrane, though the binding sites show significant differences. From structure-based sequence alignment with the known structure of staphylococcal α-hemolysin, a model of the Delta toxin pore form has been built. Using electron microscopy, we have validated our model and characterized the Delta toxin pore on liposomes. These results highlight both similarities and differences in the mechanism of Delta toxin (and by extension NetB) cytotoxicity from that of the staphylococcal pore-forming toxins

    Essentials in Accident and Emergency Medicine Radiation Injury: Response and Treatment

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    The discovery of radiation has enabled great healthcare advances as well as catastrophic injury. This paper reviews major historical incidents of public radiation exposure and the evolution of standards affecting today’s public and health care workers. Current patient care and response assessment to radiation exposure are reviewed. The strengths of modern radiation therapy and the need for continuous process improvements to ensure optimal patient care and secure safe environments are identified. The discovery of radiation has brought significant scientific achievements as well as catastrophic injury

    The Journalists of the Future meet Entrepreneurial Journalism

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    Journalism is undergoing a strong restructuring of its labour market due to the consequences of the economic crisis and the technological innovations. Discussions on the search for new formulas for job creation are centred on the emergence of entrepreneurial journalism. Spain is a paradigmatic example of this phenomenon because between 2008 and 2014, 454 news media outlets were created. The rise of entrepreneurial journalism raises many questions and challenges that affect all areas of journalism. One is their introduction in journalism education and the views of journalism students. The aim of this article is to analyse the perceptions regarding entrepreneurship held by those who will be future journalists and who are now receiving their education in the classroom. Our goal is to find out what knowledge journalism students have about entrepreneurship and the skills that are deemed essential. We evaluate the willingness of journalism students to develop their own business project and the major barriers and obstacles. The methodology uses a quantitative approach based on surveys in Spain (N=184). The results suggest an increase of the willingness in students to engage in entrepreneurship. However, students also have a negative and disenchanted view of journalism as they progress in their studies.This research was supported by the Universitat Jaume I de Castelló [grant number PI11A2013– 12]

    Persistent parasitemia despite dramatic reduction in malaria incidence after 3 rounds of indoor residual spraying in Tororo, Uganda.

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    Background:Indoor residual spraying of insecticide (IRS) has been associated with reductions in the incidence of malaria, but its impact on malaria parasitemia is unclear. Methods:We followed 469 participants from August 2011 to May 2016 in Tororo, Uganda, a historically high malaria transmission setting. Three rounds of IRS with bendiocarb were implemented from December 2014 to December 2015. Symptomatic malaria episodes were identified by passive surveillance. Parasitemia was identified by active surveillance every 1-3 months using microscopy and P.falciparum-specific loop-mediated isothermal amplification. Results:IRS was associated with a significant decline in the incidence of symptomatic malaria irrespective of age (episodes per person per year reduced from 3.98 to 0.13 in children <5 years, 2.30 to 0.15 in children 5 - 10 years, and 0.41 to 0 in adults, p<0.001 for all). IRS significantly reduced the prevalence of parasitemia, however, the prevalence remained high (58.5% to 11.3% in children <5, 73.3% to 23.7% in children 5 - 10 years, and 52.2% to 15.4% in adults, p<0.001 for all). Discussion:Although IRS was associated with significant reductions in the incidence of malaria and prevalence of parasitemia, a proportion of the population remained parasitemic, providing a potential reservoir for malaria transmission

    Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY

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    © 2018 The Author(s). Background: To increase the uptake of key clinical recommendations for non-surgical management of knee osteoarthritis (OA) and improve patient outcomes, we developed a new model of service delivery (PARTNER model) and an intervention to implement the model in the Australian primary care setting. We will evaluate the effectiveness and cost-effectiveness of this model compared to usual general practice care. Methods: We will conduct a mixed-methods study, including a two-arm, cluster randomised controlled trial, with quantitative, qualitative and economic evaluations. We will recruit 44 general practices and 572 patients with knee OA in urban and regional practices in Victoria and New South Wales. The interventions will target both general practitioners (GPs) and their patients at the practice level. Practices will be randomised at a 1:1 ratio. Patients will be recruited if they are aged =45 years and have experienced knee pain =4/10 on a numerical rating scale for more than three months. Outcomes are self-reported, patient-level validated measures with the primary outcomes being change in pain and function at 12 months. Secondary outcomes will be assessed at 6 and 12 months. The implementation intervention will support and provide education to intervention group GPs to deliver effective management for patients with knee OA using tailored online training and electronic medical record support. Participants with knee OA will have an initial GP visit to confirm their diagnosis and receive management according to GP intervention or control group allocation. As part of the intervention group GP management, participants with knee OA will be referred to a centralised multidisciplinary service: the PARTNER Care Support Team (CST). The CST will be trained in behaviour change support and evidence-based knee OA management. They will work with patients to develop a collaborative action plan focussed on key self-management behaviours, and communicate with the patients' GPs. Patients receiving care by intervention group GPs will receive tailored OA educational materials, a leg muscle strengthening program, and access to a weight-loss program as appropriate and agreed. GPs in the control group will receive no additional training and their patients will receive usual care. Discussion: This project aims to address a major evidence-to-practice gap in primary care management of OA by evaluating a new service delivery model implemented with an intervention targeting GP practice behaviours to improve the health of people with knee OA. Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12617001595303, date of registration 1/12/2017

    Introductory programming: a systematic literature review

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    As computing becomes a mainstream discipline embedded in the school curriculum and acts as an enabler for an increasing range of academic disciplines in higher education, the literature on introductory programming is growing. Although there have been several reviews that focus on specific aspects of introductory programming, there has been no broad overview of the literature exploring recent trends across the breadth of introductory programming. This paper is the report of an ITiCSE working group that conducted a systematic review in order to gain an overview of the introductory programming literature. Partitioning the literature into papers addressing the student, teaching, the curriculum, and assessment, we explore trends, highlight advances in knowledge over the past 15 years, and indicate possible directions for future research

    Multiwavelength Observations of A0620-00 in Quiescence

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    [Abridged.] We present multiwavelength observations of the black hole binary system, A0620-00. Using the Cosmic Origins Spectrograph on the Hubble Space Telescope, we have obtained the first FUV spectrum of A0620-00. The observed spectrum is flat in the FUV and very faint (with continuum fluxes \simeq 1e - 17 ergs/cm^2/s/A). We compiled the dereddened, broadband spectral energy distribution of A0620-00 and compared it to previous SEDs as well as theoretical models. The SEDs show that the source varies at all wavelengths for which we have multiple samples. Contrary to previous observations, the optical-UV spectrum does not continue to drop to shorter wavelengths, but instead shows a recovery and an increasingly blue spectrum in the FUV. We created an optical-UV spectrum of A0620-00 with the donor star contribution removed. The non-stellar spectrum peaks at \simeq3000 {\deg}A. The peak can be fit with a T=10,000 K blackbody with a small emitting area, probably originating in the hot spot where the accretion stream impacts the outer disk. However, one or more components in addition to the blackbody are needed to fit the FUV upturn and the red optical fluxes in the optical-UV spectrum. By comparing the mass accretion rate determined from the hot spot luminosity to the mean accretion rate inferred from the outburst history, we find that the latter is an order of magnitude smaller than the former, indicating that \sim90% of the accreted mass must be lost from the system if the predictions of the disk instability model and the estimated interoutburst interval are correct. The mass accretion rate at the hot spot is 10^5 the accretion rate at the black hole inferred from the X-ray luminosity. To reconcile these requires that outflows carry away virtually all of the accreted mass, a very low rate of mass transfer from the outer cold disk into the inner hot region, and/or radiatively inefficient accretion.Comment: ApJ, accepte
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