Podoconiosis in East and West Gojam Zones, Northern Ethiopia

Background: Podoconiosis is a neglected tropical disease (NTD) that is prevalent in red clay soil-covered highlands of tropical Africa, Central and South America, and northern India. It is estimated that up to one million cases exist in Ethiopia. This study aimed to estimate the prevalence of podoconiosis in East and West Gojam Zones of Amhara Region in northern Ethiopia. Methodology/Principal Findings: A cross-sectional household survey was conducted in Debre Eliyas and Dembecha woredas (districts) in East and West Gojam Zones, respectively. The survey covered all 17,553 households in 20 kebeles (administrative subunits) randomly selected from the two woredas. A detailed structured interview was conducted on 1,704 cases of podoconiosis identified in the survey. Results: The prevalence of podoconiosis in the population aged 15 years and above was found to be 3.3% (95% CI, 3.2% to 3.6%). 87% of cases were in the economically active age group (15–64 years). On average, patients sought treatment five years after the start of the leg swelling. Most subjects had second (42.7%) or third (36.1%) clinical stage disease, 97.9% had mossy lesions, and 53% had open wounds. On average, patients had five episodes of acute adenolymphangitis (ALA) per year and spent a total of 90 days per year with ALA. The median age of first use of shoes and socks were 22 and 23 years, respectively. More men than women owned more than one pair of shoes (61.1% vs. 50.5%; x2 = 11.6 p = 0.001). At the time of interview, 23.6% of the respondents were barefoot, of whom about two-thirds were women. Conclusions: This study showed high prevalence of podoconiosis and associated morbidities such as ALA, mossy lesions and open wounds in northern Ethiopia. Predominance of cases at early clinical stage of podoconiosis indicates the potential for reversing the swelling and calls for disease prevention interventions

A feasibility study of signed consent for the collection of patient identifiable information for a national paediatric clinical audit database

Objectives: To investigate the feasibility of obtaining signed consent for submission of patient identifiable data to a national clinical audit database and to identify factors influencing the consent process and its success. Design: Feasibility study. Setting: Seven paediatric intensive care units in England. Participants: Parents/guardians of patients, or patients aged 12-16 years old, approached consecutively over three months for signed consent for submission of patient identifiable data to the national clinical audit database the Paediatric Intensive Care Audit Network (PICANet). Main outcome measures: The numbers and proportions of admissions for which signed consent was given, refused, or not obtained (form not returned or form partially completed but not signed), by age, sex, level of deprivation, ethnicity (South Asian or not), paediatric index of mortality score, length of hospital stay (days in paediatric intensive care). Results: One unit did not start and one did not fully implement the protocol, so analysis excluded these two units. Consent was obtained for 182 of 422 admissions (43%) (range by unit 9% to 84%). Most (101/182; 55%) consents were taken by staff nurses. One refusal (0.2%) was received. Consent rates were significantly better for children who were more severely ill on admission and for hospital stays of six days or more, and significantly poorer for children aged 10-14 years. Long hospital stays and children aged 10-14 years remained significant in a stepwise regression model of the factors that were significant in the univariate model. Conclusion: Systematically obtaining individual signed consent for sharing patient identifiable information with an externally located clinical audit database is difficult. Obtaining such consent is unlikely to be successful unless additional resources are specifically allocated to training, staff time, and administrative support

The Mitotic Checkpoint Complex Requires an Evolutionary Conserved Cassette to Bind and Inhibit Active APC/C

The Spindle Assembly Checkpoint (SAC) ensures genomic stability by preventing sister chromatid separation until all chromosomes are attached to the spindle. It catalyzes the production of the Mitotic Checkpoint Complex (MCC), which inhibits Cdc20 to inactivate the Anaphase Promoting Complex/Cyclosome (APC/C). Here we show that two Cdc20-binding motifs in BubR1 of the recently identified ABBA motif class are crucial for the MCC to recognize active APC/C-Cdc20. Mutating these motifs eliminates MCC binding to the APC/C, thereby abolishing the SAC and preventing cells from arresting in response to microtubule poisons. These ABBA motifs flank a KEN box to form a cassette that is highly conserved through evolution, both in the arrangement and spacing of the ABBA-KEN-ABBA motifs, and association with the amino-terminal KEN box required to form the MCC. We propose that the ABBA-KEN-ABBA cassette holds the MCC onto the APC/C by binding the two Cdc20 molecules in the MCC-APC/C complex.This work was supported by an SFI Starting Investigator Research Grant (13/SIRG/2193) to N.E.D. and a CR UK Programme grant C29/A13678 to J.P. J.P. acknowledges the financial support of Wellcome Trust Grant 092096 and CR UK Grant C6946/A14492 core support to the Gurdon Institute

Are "EIT Waves" Fast-Mode MHD Waves?

We examine the nature of large-scale, coronal, propagating wave fronts (``EIT waves'') and find they are incongruous with solutions using fast-mode MHD plane-wave theory. Specifically, we consider the following properties: non-dispersive single pulse manifestions, observed velocities below the local Alfven speed, and different pulses which travel at any number of constant velocities, rather than at the ``predicted'' fast-mode speed. We discuss the possibility of a soliton-like explanation for these phenomena, and show how it is consistent with the above-mentioned aspects.Comment: to be published in the Astrophysical Journa

Response of canola to low plant populations and evaluation of reseeding options

Non-Peer Reviewe

Integrable Generalisations of the 2-dimensional Born Infeld Equation

The Born-Infeld equation in two dimensions is generalised to higher dimensions whilst retaining Lorentz Invariance and complete integrability. This generalisation retains homogeneity in second derivatives of the field.Comment: 11 pages, Latex, DTP/93/3

Early life diarrhoea and later blood pressure in a developing country: the 1982 Pelotas (Brazil) birth cohort study

Background: It has recently been hypothesised that acute dehydration in early childhood may "programme'' increased blood pressure via salt retention. We examined whether there was an association between episodes of diarrhoea (a proxy for acute dehydration) and later measured blood pressure.Methods: In the 1982 Pelotas birth cohort study (Brazil), parents/carers reported hospital admissions for diarrhoea in the first 12 and 20 months of study members' lives. Blood pressure was subsequently measured directly in adolescence (aged 15, 18, 19 years) and early adulthood (aged 23 years).Results: We found no evidence of an association between diarrhoea in the first 12 months of life and blood pressure measured at any point in adolescence or early adulthood. These findings were unchanged after adjustment for a range of covariates. Equally null results were apparent when diarrhoea admissions in the first 20 months of life, access to home sanitation and use of piped water were the exposures of interest.Conclusions: Early life proxies for dehydration and diarrhoea were unrelated to later blood pressure in this examination, the most comprehensive to date, of the potential association

Quantum integrable system with two color components in two dimensions

The Davey-Stewartson 1(DS1) system[9] is an integrable model in two dimensions. A quantum DS1 system with 2 colour-components in two dimensions has been formulated. This two-dimensional problem has been reduced to two one-dimensional many-body problems with 2 colour-components. The solutions of the two-dimensional problem under consideration has been constructed from the resulting problems in one dimensions. For latters with the $\delta$-function interactions and being solved by the Bethe ansatz, we introduce symmetrical and antisymmetrical Young operators of the permutation group and obtain the exact solutions for the quantum DS1 system. The application of the solusions is discussed.Comment: 14 pages, LaTeX fil

Factors related to discontinued clinic attendance by patients with podoconiosis in southern Ethiopia: a qualitative study

Background Podoconiosis is a lymphoedema of non-infectious cause which results in long-term ill health in affected individuals. Simple, effective treatment is available in certain parts of Ethiopia, but evidence indicates that not all patients continue collecting treatment supplies from clinic sites once started. We used qualitative techniques to explore factors related to discontinued attendance at outreach clinics of a non-government organization in southern Ethiopia. Methods A cross-sectional qualitative study was conducted in four clinic sites through unstructured in-depth interviews, key informant interviews and focus group discussions with the involvement of 88 study subjects. Results Discontinuation of clinic visits is common among podoconiosis patients. The reasons were: remoteness from the clinic sites, unrealistic expectation of ‘special’ aid, worry about increasing stigma, illness and misconceptions about treatment. Conclusions Several of these factors are remediable through community and individual information and education. Appropriate routes to deliver this information must be identified. Certain factors (such as distance to clinic sites and stigma) require substantial expansion of services or liaison with village-level government health services

Proving Termination Starting from the End

We present a novel technique for proving program termination which introduces a new dimension of modularity. Existing techniques use the program to incrementally construct a termination proof. While the proof keeps changing, the program remains the same. Our technique goes a step further. We show how to use the current partial proof to partition the transition relation into those behaviors known to be terminating from the current proof, and those whose status (terminating or not) is not known yet. This partition enables a new and unexplored dimension of incremental reasoning on the program side. In addition, we show that our approach naturally applies to conditional termination which searches for a precondition ensuring termination. We further report on a prototype implementation that advances the state-of-the-art on the grounds of termination and conditional termination.Comment: 16 page