Spatiotemporal epidemiology of rabies at an interface between domestic dogs and wildlife in South Africa

We characterized the spatiotemporal epidemiology of rabies from January 2009 through March 2014 across the interface between a wildlife reserve and communal livestock farming area in South Africa. Brain tissue from 344 animals of 28 different species were tested for lyssavirus antigen. Of these, 146 (42.4%) samples tested positive, of which 141 (96.6%) came from dogs. Brain samples of dogs were more likely to test positive for lyssavirus antigen if they were found and destroyed in the reserve, compared to samples originating from dogs outside the reserve (65.3% vs. 45.5%; odds ratio (OR) = 2.26, 95% confidence interval (CI) = 1.27–4.03), despite rabies surveillance outside the reserve being targeted to dogs that have a higher index of suspicion due to clinical or epidemiological evidence of infection. In the reserve, dogs were more likely to test positive for rabies if they were shot further from villages (OR = 1.42, 95% CI 1.18–1.71) and closer to water points (OR = 0.41, 95% CI 0.21–0.81). Our results provide a basis for refinement of existing surveillance and control programs to mitigate the threat of spillover of rabies to wildlife populations.http://www.nature.com/srepam2019Veterinary Tropical Disease

Sensitivity and specificity of the FAMACHA© system in Suffolk sheep and crossbred Boer goats

Sheep and goats are the species of farm animal with the highest growth rate in Paraná State. The main problems facing Paraná State flocks are gastrointestinal parasites and anthelmintic resistance. One of the newest resources used to slow down the development of anthelmintic resistance is the FAMACHA(©) system, a selective method useful for controlling gastrointestinal verminosis in small ruminants. The purpose of the present research was to evaluate the sensitivity and specificity of the FAMACHA(©) system in sheep and goats and to compare the results for both species. The conjunctivae of 83 Suffolk ewes and 60 adult crossbred Boer does were evaluated by the same trained person using the FAMACHA(©) system. The packed cell value (PCV) served as the gold standard for clinical FAMACHA(©) evaluation. To calculate the sensitivity and specificity of the FAMACHA(©) system, different criteria were adopted in turn: animals classified as FAMACHA(©) (F(©)) 4 and 5, or 3, 4 and 5, were considered to be anemic (positive test), and animals classified as F(©)1, 2 and 3, or 1 and 2 were considered to be non-anemic (negative test). Three standard values of PCV, namely ≤19%, ≤18% or ≤15%, were used to confirm anemia. At all cut-off levels, the sensitivity increased if F(©)3 animals were included as being anemic. However, changes in levels of sensitivity were associated with reciprocal changes in specificity. The sensitivity was higher for sheep than for goats, excepting when the criteria included PCV≤18 and F(©)3, F(©)4 and F(©)5 were considered positive. In contrast, the specificity was always lower in sheep for any criteria adopted. Other than in goats, using the ≤15 cut-off level for sheep, it is possible to opt not to drench the animals that were shown to be F(©)3 because the sensitivity is still high, indicating that few animals that should have been drenched were overlooked. In goats, in contrast, the low sensitivity at all cut-off levels made it too risky to leave F(©)3 animals undrenched. Even though the number of correct treatments for goats was always higher than that for sheep, the opposite was true for the kappa index for all the criteria tested. Therefore, the FAMACHA(©) system is suitable for the identification of anemic animals of both species. It is necessary that all small ruminants classified as FAMACHA(©) level 3 are also treated to increase the sensitivity of the method.http://www.elsevier.com/locate/vetparhb2016Veterinary Tropical Disease

Biochemical profile and in vitro neuroprotective properties of Carpobrotus edulis L., a medicinal and edible halophyte native to the coast of South Africa

This work reports the nutritional profile and in vitro neuroprotective properties of leaves of Carpobrotus edulis L, a medicinal and edible succulent species native to the coast of South Africa. Biomass was evaluated for proximate composition and for contents in carotenoids, liposoluble pigments and minerals. Hexane, dichloromethane, ethyl acetate and methanol extracts were prepared by Soxhlet extraction from dried biomass and evaluated for in vitro inhibition of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), capacity to attenuate hydrogen peroxide (H2O2)-induced injury in the human dopaminergic cell line SH-SY5Y and for anti-neuroinflammatory potential on lipopolysaccharide (LPS)-stimulated microglia cells. Extracts were evaluated for antioxidant activity by four complementary methods, total content of phenolics, tannins and flavonoids. Finally the profile of the main phenolic compounds was determined by high performance liquid chromatography with diode array detection (HPLC-DAD). C edulis has a high moisture content, high levels of crude protein, fibre, ash, carotenoids, calcium and iron and a low fat level. The extracts were able to efficiently scavenge the free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH), reduce iron and chelate copper and iron ions, and exhibited different levels of phenolic compounds in the order ethyl acetate > methanol > dichloromethane > hexane. The main compounds detected were gallic and salicylic acids and quercetin, all in the ethyl acetate extract. The extracts allowed a dual and potent inhibition of AChE and BuChE. The dichloromethane and methanol extracts had the strongest capacity to prevent cell death induced by H2O2, and the methanol extract had anti-neuronflammatory properties. All together our results suggest that consumption of leaves of C edulis can contribute for a balanced diet, and that they may add to the improvement of cognitive functions. It also suggests possible novel biotechnological applications of C. edulis such as source of molecules and/or products for the food and/or pharmaceutical industries. Studies aiming to the isolation and identification of the bioactive compounds are already in progress. (C) 2017 SAAB. Published by Elsevier B.V. All rights reserved.Portuguese National BudgetXtremeGourmet project [ALG-01-0247-FEDER-017676]FCT Investigator Programme [IF/00049/2012]info:eu-repo/semantics/publishedVersio

Teaching Feedback to First-year Medical Students: Long-term Skill Retention and Accuracy of Student Self-assessment

Giving and receiving feedback are critical skills and should be taught early in the process of medical education, yet few studies discuss the effect of feedback curricula for first-year medical students. To study short-term and long-term skills and attitudes of first-year medical students after a multidisciplinary feedback curriculum. Prospective pre- vs. post-course evaluation using mixed-methods data analysis. First-year students at a public university medical school. We collected anonymous student feedback to faculty before, immediately after, and 8 months after the curriculum and classified comments by recommendation (reinforcing/corrective) and specificity (global/specific). Students also self-rated their comfort with and quality of feedback. We assessed changes in comments (skills) and self-rated abilities (attitudes) across the three time points. Across the three time points, students’ evaluation contained more corrective specific comments per evaluation [pre-curriculum mean (SD) 0.48 (0.99); post-curriculum 1.20 (1.7); year-end 0.95 (1.5); p = 0.006]. Students reported increased skill and comfort in giving and receiving feedback and at providing constructive feedback (p < 0.001). However, the number of specific comments on year-end evaluations declined [pre 3.35 (2.0); post 3.49 (2.3); year-end 2.8 (2.1)]; p = 0.008], as did students’ self-rated ability to give specific comments. Teaching feedback to early medical students resulted in improved skills of delivering corrective specific feedback and enhanced comfort with feedback. However, students’ overall ability to deliver specific feedback decreased over time

The effect of Aloe ferox Mill. in the treatment of loperamide-induced constipation in Wistar rats

<p>Abstract</p> <p>Background</p> <p>Constipation is the most common gastrointestinal complaint all over the world and it is a risk factor of colorectal cancer. In this study, the efficacy of aqueous leaf extract of <it>Aloe </it><it>ferox </it>Mill. was studied against loperamide-induced constipation in Wistar rats.</p> <p>Methods</p> <p>Constipation was induced by oral administration of loperamide (3 mg/kg body weight) while the control rats received normal saline. The constipated rats were treated with 50, 100 and 200 mg/kg body weight/day of the extract for 7 days during which the feeding characteristics, body weight, fecal properties and gastrointestinal transit ratio were monitored.</p> <p>Results</p> <p>The extract improved intestinal motility, increased fecal volume and normalized body weight in the constipated rats, which are indications of laxative property of the herb with the 200 mg/kg body weight of the extract showing the best efficacy.</p> <p>Conclusion</p> <p>The effect of the extract compares favourably well with senokot, a standard laxative drug. These findings have therefore, lent scientific credence to the folkloric use of the herb as a laxative agent by the people of the Eastern Cape of South Africa.</p

Effectiveness of electronic guideline-based implementation systems in ambulatory care settings - a systematic review

<p>Abstract</p> <p>Background</p> <p>Electronic guideline-based decision support systems have been suggested to successfully deliver the knowledge embedded in clinical practice guidelines. A number of studies have already shown positive findings for decision support systems such as drug-dosing systems and computer-generated reminder systems for preventive care services.</p> <p>Methods</p> <p>A systematic literature search (1990 to December 2008) of the English literature indexed in the Medline database, Embase, the Cochrane Central Register of Controlled Trials, and CRD (DARE, HTA and NHS EED databases) was conducted to identify evaluation studies of electronic multi-step guideline implementation systems in ambulatory care settings. Important inclusion criterions were the multidimensionality of the guideline (the guideline needed to consist of several aspects or steps) and real-time interaction with the system during consultation. Clinical decision support systems such as one-time reminders for preventive care for which positive findings were shown in earlier reviews were excluded. Two comparisons were considered: electronic multidimensional guidelines versus usual care (comparison one) and electronic multidimensional guidelines versus other guideline implementation methods (comparison two).</p> <p>Results</p> <p>Twenty-seven publications were selected for analysis in this systematic review. Most designs were cluster randomized controlled trials investigating process outcomes more than patient outcomes. With success defined as at least 50% of the outcome variables being significant, none of the studies were successful in improving patient outcomes. Only seven of seventeen studies that investigated process outcomes showed improvements in process of care variables compared with the usual care group (comparison one). No incremental effect of the electronic implementation over the distribution of paper versions of the guideline was found, neither for the patient outcomes nor for the process outcomes (comparison two).</p> <p>Conclusions</p> <p>There is little evidence at the moment for the effectiveness of an increasingly used and commercialised instrument such as electronic multidimensional guidelines. After more than a decade of development of numerous electronic systems, research on the most effective implementation strategy for this kind of guideline-based decision support systems is still lacking. This conclusion implies a considerable risk towards inappropriate investments in ineffective implementation interventions and in suboptimal care.</p

Impact of electronic medical record on physician practice in office settings: a systematic review

<p>Abstract</p> <p>Background</p> <p>Increased investments are being made for electronic medical records (EMRs) in Canada. There is a need to learn from earlier EMR studies on their impact on physician practice in office settings. To address this need, we conducted a systematic review to examine the impact of EMRs in the physician office, factors that influenced their success, and the lessons learned.</p> <p>Results</p> <p>For this review we included publications cited in Medline and CINAHL between 2000 and 2009 on physician office EMRs. Studies were included if they evaluated the impact of EMR on physician practice in office settings. The Clinical Adoption Framework provided a conceptual scheme to make sense of the findings and allow for future comparison/alignment to other Canadian eHealth initiatives.</p> <p>In the final selection, we included 27 controlled and 16 descriptive studies. We examined six areas: prescribing support, disease management, clinical documentation, work practice, preventive care, and patient-physician interaction. Overall, 22/43 studies (51.2%) and 50/109 individual measures (45.9%) showed positive impacts, 18.6% studies and 18.3% measures had negative impacts, while the remaining had no effect. Forty-eight distinct factors were identified that influenced EMR success. Several lessons learned were repeated across studies: (a) having robust EMR features that support clinical use; (b) redesigning EMR-supported work practices for optimal fit; (c) demonstrating value for money; (d) having realistic expectations on implementation; and (e) engaging patients in the process.</p> <p>Conclusions</p> <p>Currently there is limited positive EMR impact in the physician office. To improve EMR success one needs to draw on the lessons from previous studies such as those in this review.</p

Room temperature coherent control of coupled single spins in solid

Coherent coupling between single quantum objects is at the heart of modern quantum physics. When coupling is strong enough to prevail over decoherence, it can be used for the engineering of correlated quantum states. Especially for solid-state systems, control of quantum correlations has attracted widespread attention because of applications in quantum computing. Such coherent coupling has been demonstrated in a variety of systems at low temperature1, 2. Of all quantum systems, spins are potentially the most important, because they offer very long phase memories, sometimes even at room temperature. Although precise control of spins is well established in conventional magnetic resonance3, 4, existing techniques usually do not allow the readout of single spins because of limited sensitivity. In this paper, we explore dipolar magnetic coupling between two single defects in diamond (nitrogen-vacancy and nitrogen) using optical readout of the single nitrogen-vacancy spin states. Long phase memory combined with a defect separation of a few lattice spacings allow us to explore the strong magnetic coupling regime. As the two-defect system was well-isolated from other defects, the long phase memory times of the single spins was not diminished, despite the fact that dipolar interactions are usually seen as undesirable sources of decoherence. A coherent superposition of spin pair quantum states was achieved. The dipolar coupling was used to transfer spin polarisation from a nitrogen-vacancy centre spin to a nitrogen spin, with optical pumping of a nitrogen-vacancy centre leading to efficient initialisation. At the level anticrossing efficient nuclear spin polarisation was achieved. Our results demonstrate an important step towards controlled spin coupling and multi-particle entanglement in the solid state

Enrolling adolescents in HIV vaccine trials: reflections on legal complexities from South Africa

<p>Abstract</p> <p>Background</p> <p>South Africa is likely to be the first country in the world to host an adolescent HIV vaccine trial. Adolescents may be enrolled in late 2007. In the development and review of adolescent HIV vaccine trial protocols there are many complexities to consider, and much work to be done if these important trials are to become a reality.</p> <p>Discussion</p> <p>This article sets out essential requirements for the lawful conduct of adolescent research in South Africa including compliance with consent requirements, child protection laws, and processes for the ethical and regulatory approval of research.</p> <p>Summary</p> <p>This article outlines likely complexities for researchers and research ethics committees, including determining that trial interventions meet current risk standards for child research. Explicit recommendations are made for role-players in other jurisdictions who may also be planning such trials. This article concludes with concrete steps for implementing these important trials in South Africa and other jurisdictions, including planning for consent processes; delineating privacy rights; compiling information necessary for ethics committees to assess risks to child participants; training trial site staff to recognize when disclosures trig mandatory reporting response; networking among relevant ethics commitees; and lobbying the National Regulatory Authority for guidance.</p