Rapid Detection of Leishmania infantum Infection in Dogs: Comparative Study Using an Immunochromatographic Dipstick Test, Enzyme-Linked Immunosorbent Assay, and PCR

Current zoonotic visceral leishmaniasis (ZVL) control programs in Brazil include the culling of Leishmania infantum-infected reservoir dogs, a strategy that has failed to prevent a rise of canine and human ZVL cases over the past decade. One of the main reasons this strategy has failed is because of a long delay between sample collection, sample analysis, and control implementation. A rapid, sensitive, and specific diagnostic tool would be highly desirable, because it would allow control interventions to be implemented in situ. We compared an immunochromatographic dipstick test to enzyme-linked immunosorbent assay (ELISA) and PCR for detecting L. infantum infections in dogs from an area of ZVL endemicity in Brazil. The dipstick test was shown to have 61 to 75% specificity and 72 to 77% sensitivity, compared to 100% specificity for both ELISA and PCR and 71 to 88% and 51 to 64% sensitivity for ELISA and PCR, respectively. Of the field samples tested, 92 of 175 (53%), 65 of 175 (37%), and 47 of 175 (27%) were positive by dipstick, ELISA, and PCR, respectively. The positive and negative predictive values for the tested dipstick were 58 to 77% and 75%, respectively. Efforts should be made to develop a more specific dipstick test for diagnosis of leishmaniasis, because they may ultimately prove more cost-effective than currently used diagnostic tests when used in mass-screening surveys

Ichnofacies of the Stairway Sandstone fish-fossil beds (Middle Ordovician, Northern Territory, Australia)

The Stairway Sandstone is a 30-560 m thick succession of Middle Ordovician siliciclastic sedimentary rocks within the Amadeus Basin of central Australia, deposited in the epeiric Larapintine Sea of northern peri-Gondwana. The Stairway Sandstone is significant as one of only two known Gondwanan successions to yield articulated arandaspid (pteraspidomorph agnathan) fish. Herein we use the ichnology of the Stairway Sandstone to reveal insights into the shallow marine habitat of these early vertebrates, and compare it with that of other known pteraspidomorph-bearing localities from across Gondwana. The Stairway Sandstone contains a diverse Ordovician ichnofauna including 22 ichnotaxa of Arenicolites, Arthrophycus, Asterosoma, Cruziana, Didymaulichnus, Diplichnites, Diplocraterion,? Gordia, Lockeia, Monocraterion, Monomorphichnus, Phycodes, Planolites, Rusophycus, Skolithos and Uchirites. These ichnofauna provide a well-preserved example of a typical Ordovician epeiric sea assemblage, recording the diverse ethologies of tracemakers in a very shallow marine environment of flashy sediment accumulation and regularly shifting sandy substrates. New conodont data refine the age of the Stairway Sandstone to the early Darriwilian, with ichnostratigraphic implications for the Cruziana rugosa group and Arthrophycus alleghaniensis

Initial Sulfonylurea Use and Subsequent Insulin Therapy in Older Subjects with Type 2 Diabetes Mellitus

BACKGROUND: In type 2 diabetes mellitus (T2DM), progressive loss of beta cell function over time requires treatment intensification and eventually initiation of insulin for many patients. Relative to metformin, a greater rate of decline in beta cell function over time has been observed with sulfonylurea treatment. The present study examined the association between initial monotherapy with metformin or sulfonylurea and subsequent initiation of insulin in older subjects with T2DM. METHODS: In a retrospective cohort study using the GE electronic medical record database, eligible subjects with T2DM included those ≥65 years who received their first prescription of sulfonylurea or metformin as initial monotherapy between January 1, 2003 to December 31, 2008. The follow-up period lasted to the end of 2009 or the subject’s latest data available. Insulin initiation was determined by prescription records. Logistic regression analysis evaluated the likelihood of insulin addition. A Cox regression model estimated time to initiation of insulin. Differences in baseline characteristics were controlled for using propensity score matching. RESULTS: Overall, 12,036 subjects were included in the analysis. Mean age was 75 years and 50% were male. Subjects who initiated with sulfonylurea had a significantly (P < 0.001) higher incidence of insulin addition (2.8% vs. 1.4%) compared to those initiated with metformin within 1 year of follow-up. The likelihood of initiating insulin was higher in subjects initiated with sulfonylurea than with metformin (adjusted odds ratio 1.82, 95% confidence interval [CI] 1.40–2.38; P < 0.001). Sulfonylurea use was also significantly associated with a shorter time to insulin use compared to metformin (adjusted hazards ratio 2.10, 95% CI 1.83–2.39; P < 0.001). CONCLUSION: In a cohort of older subjects with T2DM initiating antihyperglycemic therapy, new users of sulfonylurea monotherapy were more likely to receive insulin therapy and received it earlier than those starting with metformin

Direct health costs of inflammatory polyarthritis 10 years after disease onset:Results from the Norfolk Arthritis Register

Objectives: To explore the change in direct medical costs associated with inflammatory polyarthritis (IP) 10 to 15 years after its onset. Methods: Patients from the Norfolk Arthritis Register who had previously participated in a health economic study in 1999 were traced 10 years later and invited to participate in a further prospective questionnaire-based study. The study was designed to identify direct medical costs and changes in health status over a 6-month period using previously validated questionnaires as the primary source of data. Results: A representative sample of 101 patients with IP from the 1999 cohort provided complete data over the 6-month period. The mean disease duration was 14 years (SD 2.1, median 13.6, interquartile range 12.6–15.4). The mean direct medical cost per patient over the 6-month period was £1496 for IP (inflated for 2013 prices). This compared with £582 (95% CI £355–£964) inflated to 2013 prices per patient with IP 10 years earlier in their disease. The increased cost was largely associated with the use of biologics in the rheumatoid arthritis subgroup of patients (51% of total costs incurred). Other direct cost components included primary care costs (11%), hospital outpatient (19%), day care (12%), and inpatient stay (4%). Conclusion: The direct healthcare costs associated with IP have more than doubled with increasing disease duration, largely as a result of the use of biologics. The results showed a shift in the direct health costs from inpatient to outpatient service use

Zero Threshold for Water Adsorption on MAPbBr3

Hybrid organic-inorganic perovskites (HOIPs) have shown great promise in a wide range of optoelectronic applications. However, this performance is inhibited by the sensitivity of HOIPs to various environmental factors, particularly high levels of relative humidity. This study uses X-ray photoelectron spectroscopy (XPS) to determine that there is essentially no threshold to water adsorption on the in situ cleaved MAPbBr3 (001) single crystal surface. Using scanning tunneling microscopy (STM), it shows that the initial surface restructuring upon exposure to water vapor occurs in isolated regions, which grow in area with increasing exposure, providing insight into the initial degradation mechanism of HOIPs. The electronic structure evolution of the surface was also monitored via ultraviolet photoemission spectroscopy (UPS), evidencing an increased bandgap state density following water vapor exposure, which is attributed to surface defect formation due to lattice swelling. This study will help to inform the surface engineering and designs of future perovskite-based optoelectronic devices

Activity Intensity, Volume, and Norms:Utility and Interpretation of Accelerometer Metrics

This is the author accepted manuscript. The final version is available from Lippincott, Williams & Wilkins via the DOI in this recordPurpose: The physical activity profile can be described from accelerometer data using two population- independent metrics: average acceleration (ACC, volume) and intensity gradient (IG, intensity). This paper aims to: 1) demonstrate how these metrics can be used to investigate the relative contributions of volume and intensity of physical activity for a range of health markers across datasets; and 2) illustrate the future potential of the metrics for generation of age and sexspecific percentile norms. Methods: Secondary data analyses were carried out on five diverse datasets using wrist-worn accelerometers (ActiGraph/GENEActiv/Axivity): children (N=145), adolescent girls (N=1669), office workers (N=114), pre- (N=1218) and post- (N=1316) menopausal women, and adults with type 2 diabetes (T2D) (N=475). Open-source software (GGIR) was used to generate ACC and IG. Health markers were: a) zBMI (children); b) %fat (adolescent girls and adults); c) bone health (pre- and post-menopausal women); and d) physical function (adults with T2D). Results: Multiple regression analyses showed the IG, but not ACC, was independently associated with zBMI/%fat in children and adolescents. In adults, associations were stronger and the effects of ACC and IG were additive. For bone health and physical function, interactions showed associations were strongest if IG was high, largely irrespective of ACC. Exemplar illustrative percentile ‘norms’ showed the expected age-related decline in physical activity, with greater drops in IG across age than ACC. Conclusion: The ACC and IG accelerometer metrics facilitate investigation of whether volume and intensity of physical activity have independent, additive or interactive effects on health markers. Future, adoption of data-driven metrics would facilitate the generation of age- and sexspecific norms that would be beneficial to researchers.National Institute for Health Research (NIHR)Collaboration for leadership in Applied Health Research and Care (CLAHRC) East Midland

Elemental Abundances in the X-Ray Gas of Early-Type Galaxies with XMM and Chandra Observations

The source of hot gas in elliptical galaxies is thought to be due to stellar mass loss, with contributions from supernova events and possibly from infall from a surrounding environment. This picture predicts supersolar values for the metallicity of the gas toward the inner part of the galaxy, which can be tested by measuring the gas phase abundances. We use high-quality data for 10 nearby early-type galaxy from XMM-Newton, featuring both the EPIC and the Reflection Grating Spectrometer, where the strongest emission lines are detected with little blending; some Chandra data are also used. We find excellent consistency in the elemental abundances between the different XMM instruments and good consistency with Chandra. Differences in abundances with aperture size and model complexity are examined, but large differences rarely occur. For a two-temperature thermal model plus a point source contribution, the median Fe and O abundances are 0.86 and 0.44 of the Solar value, while Si and Mg abundances are similar to that for Fe. This is similar to stellar abundances for these galaxies but supernovae were expected to enhance the gas phase abundances considerably, which is not observed.Comment: 35 pages, 10 figures, accepted for publication in Astrophysical Journa