Transmission dynamics of malaria in Nigeria.

Background: Two of the problems of malaria parasite vector control in Nigeria are the diversity of Anopheline vectors and large size of the country. Anopheline distribution and transmission dynamics of malaria were therefore compared between four ecotypes in Nigeria during the rainy season. Methods: Polymerase chain reaction (PCR) was used in molecular identification after morphological identification microscopically. Enzyme linked immunorsorbent assay (ELISA) was used for the blood meal analysis and sporozoite detection. Results: Five species were identified out of 16,410 anophelines collected. An. gambiae s.s made up approximately 29.2%-36.6% of the population in each zone. All five species acted as vectors for P. falciparum. An. gambiae s.s had the highest sporozoite rate. The most infected mosquitoes were found in the rain forest. More blood meals were taken from bovids, except the savannah forest, where 73.3%were on humans and Human Blood index (HBI) was 57.3%. The Entomological inoculation rate (EIR) was a mean of 13.6 ib/p but was highest in the rainforest zone. Conclusions and limitations: This study demonstrates the complex distribution of anophelines and theconsiderable variations in the intensity of malaria transmission in Nigeria. We highlight the need to consider diverse epidemiological situations when planning countrywide control programmes

MIDDAY CLOSURE OF STOMATA IN THE OIL PALM IN MALAYSIA

Ringkasan Penutupan setomata kelapa sau it pada r.raktu tengahari nampaknya telah berlaku ketika masa kemarau di Pahang dan pengairan pula menunjukkan balralra penutupan ini berkurangan. Perulangrn dan kemustahakan pelitupan itu adalah dibincangkan. begitu juga telah dirumuskan yang tegasan lembapan yang cukup guna benar-benar mengurangkan hasii kelapa sarrit itu adal;rh kejadian di Malaysia. lntroduction Symptoms of water s'.ress (droughi) in tlie oii painl have been described by various workers in Africa. The main syntptoms are: 1. The presence of more thau one fully eloirgated but unop:ned spcar in ihe centre of the crown. Broekn-rans (1957; noted that the rate of openine of lea.res during the dry seasoir in Nigeria was apilroximately haif that during the wet season, while the rate of elongaiiorr is more or less unchairgcd. 2. Premature dessication of the lowe r leav,:s (Rees I 9(r I ). R.eduction in yield. Yields in Africa are generallv much lowtr than in South East Asia; this has been attributed either to lower solar radiation. or lo low rainfall in the dry season. D;smarest (1967) showed that in the lvory Coast rainfall is the major lintiting factor. sincc rvitlr irrigetion vields of 22, tonncs frLrit / ha. could be obtained, compared to 5 tons witiiout. trrrigatioir a"ppearcd both io increase scx raiio and to reCuce abortiou rate

Impact of simultaneous retention of micropollutants and laccase on micropollutant degradation in enzymatic membrane bioreactor

© 2018 This study systematically compares the performance of ultrafiltration (UF) and nanofiltration (NF) based enzymatic membrane bioreactors (EMBRs) for the degradation of five micropollutants, namely atrazine, carbamazepine, sulfamethoxazole, diclofenac and oxybenzone to elucidate the impact of effective membrane retention of micropollutants on their degradation. Based on the permeate quality, NF-EMBR achieved 92–99.9% micropollutant removal (i.e., biodegradation + membrane retention), while the removal of these micropollutants by UF-EMBR varied from 20 to 85%. Mass balance analysis revealed that micropollutant degradation was improved by 15–30% in NF-EMBR as compared to UF-EMBR, which could be attributed to the prolonged contact time between laccase and micropollutants following their effective retention by the NF membrane. A small decline in permeate flux was observed during EMBR operation. However, the flux could be recovered by flushing the membrane with permeate

Redo-redo aortic root replacement with a mechanical valved conduit in a patient with von Willebrand's disease: Case report

A 40 year-old female, with a history of cardiac surgery for congenital aortic valve stenosis and von Willebrand's disease (VWD) presented with increasing shortness of breath due to mixed aortic valve dysfunction. With a paucity of such cases in the literature, we describe the successful outcome of a patient with VWD who underwent elective redo-redo aortic root replacement with a mechanical valved conduit. She was given a three-month trial of warfarin pre-operatively to evaluate the extent of bleeding risk. Her post-operative course was uneventful and she was discharged home after six days

Augmented reality applications for cultural heritage using Kinect

AbstractThis paper explores the use of data from the Kinect sensor for performing augmented reality, with emphasis on cultural heritage applications. It is shown that the combination of depth and image correspondences from the Kinect can yield a reliable estimate of the location and pose of the camera, though noise from the depth sensor introduces an unpleasant jittering of the rendered view. Kalman filtering of the camera position was found to yield a much more stable view. Results show that the system is accurate enough for in situ augmented reality applications. Skeleton tracking using Kinect data allows the appearance of participants to be augmented, and together these facilitate the development of cultural heritage applications.</jats:p

Direct Formation of Supermassive Black Holes via Multi-Scale Gas Inflows in Galaxy Mergers

Observations of distant bright quasars suggest that billion solar mass supermassive black holes (SMBHs) were already in place less than a billion years after the Big Bang. Models in which light black hole seeds form by the collapse of primordial metal-free stars cannot explain their rapid appearance due to inefficient gas accretion. Alternatively, these black holes may form by direct collapse of gas at the center of protogalaxies. However, this requires metal-free gas that does not cool efficiently and thus is not turned into stars, in contrast with the rapid metal enrichment of protogalaxies. Here we use a numerical simulation to show that mergers between massive protogalaxies naturally produce the required central gas accumulation with no need to suppress star formation. Merger-driven gas inflows produce an unstable, massive nuclear gas disk. Within the disk a second gas inflow accumulates more than 100 million solar masses of gas in a sub-parsec scale cloud in one hundred thousand years. The cloud undergoes gravitational collapse, which eventually leads to the formation of a massive black hole. The black hole can grow to a billion solar masses in less than a billion years by accreting gas from the surrounding disk.Comment: 26 pages, 4 Figures, submitted to Nature (includes Supplementary Information

Meropenem vs standard of care for treatment of neonatal late onset sepsis (NeoMero1): A randomised controlled trial.

BACKGROUND: The early use of broad-spectrum antibiotics remains the cornerstone for the treatment of neonatal late onset sepsis (LOS). However, which antibiotics should be used is still debatable, as relevant studies were conducted more than 20 years ago, recruited in single centres or countries, evaluated antibiotics not in clinical use anymore and had variable inclusion/exclusion criteria and outcome measures. Moreover, antibiotic-resistant bacteria have become a major problem in many countries worldwide. We hypothesized that efficacy of meropenem as a broad-spectrum antibiotic is superior to standard of care regimens (SOC) in empiric treatment of LOS and aimed to compare meropenem to SOC in infants aged 44 weeks meeting the Goldstein criteria of sepsis, were randomized in a 1:1 ratio to receive meropenem or one of the two SOC regimens (ampicillin+gentamicin or cefotaxime+gentamicin) chosen by each site prior to the start of the study for 8-14 days. The primary outcome was treatment success (survival, no modification of allocated therapy, resolution/improvement of clinical and laboratory markers, no need of additional antibiotics and presumed/confirmed eradication of pathogens) at test-of-cure visit (TOC) in full analysis set. Stool samples were tested at baseline and Day 28 for meropenem-resistant Gram-negative organisms (CRGNO). The primary analysis was performed in all randomised patients and in patients with culture confirmed LOS. Proportions of participants with successful outcome were compared by using a logistic regression model adjusted for the stratification factors. From September 3, 2012 to November 30th 2014, total of 136 patients (instead of planned 275) in each arm were randomized; 140 (52%) were culture positive. Successful outcome at TOC was achieved in 44/136 (32%) in the meropenem arm vs. 31/135 (23%) in the SOC arm (p = 0.087). The respective numbers in patients with positive cultures were 17/63 (27%) vs. 10/77 (13%) (p = 0.022). The main reason of failure was modification of allocated therapy. Treatment emergent adverse events occurred in 72% and serious adverse events in 17% of patients, the Day 28 mortality was 6%. Cumulative acquisition of CRGNO by Day 28 occurred in 4% of patients in the meropenem and 12% in the SOC arm (p = 0.052). CONCLUSIONS: Within this study population, we found no evidence that meropenem was superior to SOC in terms of success at TOC, short term hearing disturbances, safety or mortality were similar in both treatment arms but the study was underpowered to detect the planned effect. Meropenem treatment did not select for colonization with CRGNOs. We suggest that meropenem as broad-spectrum antibiotic should be reserved for neonates who are more likely to have Gram-negative LOS, especially in NICUs where microorganisms producing extended spectrum- and AmpC type beta-lactamases are circulating

Soluble tumor necrosis factor receptor 1 and 2 predict outcomes in advanced chronic kidney disease : a prospective cohort study

Background : Soluble tumor necrosis factor receptors 1 (sTNFR1) and 2 (sTNFR2) have been associated to progression of renal failure, end stage renal disease and mortality in early stages of chronic kidney disease (CKD), mostly in the context of diabetic nephropathy. The predictive value of these markers in advanced stages of CKD irrespective of the specific causes of kidney disease has not yet been defined. In this study, the relationship between sTNFR1 and sTNFR2 and the risk for adverse cardiovascular events (CVE) and all-cause mortality was investigated in a population with CKD stage 4-5, not yet on dialysis, to minimize the confounding by renal function. Patients and methods : In 131 patients, CKD stage 4-5, sTNFR1, sTNFR2 were analysed for their association to a composite endpoint of all-cause mortality or first non-fatal CVE by univariate and multivariate Cox proportional hazards models. In the multivariate models, age, gender, CRP, eGFR and significant comorbidities were included as covariates. Results : During a median follow-up of 33 months, 40 events (30.5%) occurred of which 29 deaths (22.1%) and 11 (8.4%) first non-fatal CVE. In univariate analysis, the hazard ratios (HR) of sTNFR1 and sTNFR2 for negative outcome were 1.49 (95% confidence interval (CI): 1.28-1.75) and 1.13 (95% CI: 1.06-1.20) respectively. After adjustment for clinical covariables (age, CRP, diabetes and a history of cardiovascular disease) both sTNFRs remained independently associated to outcomes (HR: sTNFR1: 1.51, 95% CI: 1.30-1.77; sTNFR2: 1.13, 95% CI: 1.06-1.20). A subanalysis of the non-diabetic patients in the study population confirmed these findings, especially for sTNFR1. Conclusion : sTNFR1 and sTNFR2 are independently associated to all-cause mortality or an increased risk for cardiovascular events in advanced CKD irrespective of the cause of kidney disease

Rationale, design and conduct of a randomised controlled trial evaluating a primary care-based complex intervention to improve the quality of life of heart failure patients: HICMan (Heidelberg Integrated Case Management) : study protocol

Background: Chronic congestive heart failure (CHF) is a complex disease with rising prevalence, compromised quality of life (QoL), unplanned hospital admissions, high mortality and therefore high burden of illness. The delivery of care for these patients has been criticized and new strategies addressing crucial domains of care have been shown to be effective on patients' health outcomes, although these trials were conducted in secondary care or in highly organised Health Maintenance Organisations. It remains unclear whether a comprehensive primary care-based case management for the treating general practitioner (GP) can improve patients' QoL. Methods/Design: HICMan is a randomised controlled trial with patients as the unit of randomisation. Aim is to evaluate a structured, standardized and comprehensive complex intervention for patients with CHF in a 12-months follow-up trial. Patients from intervention group receive specific patient leaflets and documentation booklets as well as regular monitoring and screening by a prior trained practice nurse, who gives feedback to the GP upon urgency. Monitoring and screening address aspects of disease-specific selfmanagement, (non)pharmacological adherence and psychosomatic and geriatric comorbidity. GPs are invited to provide a tailored structured counselling 4 times during the trial and receive an additional feedback on pharmacotherapy relevant to prognosis (data of baseline documentation). Patients from control group receive usual care by their GPs, who were introduced to guidelineoriented management and a tailored health counselling concept. Main outcome measurement for patients' QoL is the scale physical functioning of the SF-36 health questionnaire in a 12-month follow-up. Secondary outcomes are the disease specific QoL measured by the Kansas City Cardiomyopathy questionnaire (KCCQ), depression and anxiety disorders (PHQ-9, GAD-7), adherence (EHFScBS and SANA), quality of care measured by an adapted version of the Patient Chronic Illness Assessment of Care questionnaire (PACIC) and NTproBNP. In addition, comprehensive clinical data are collected about health status, comorbidity, medication and health care utilisation. Discussion: As the targeted patient group is mostly cared for and treated by GPs, a comprehensive primary care-based guideline implementation including somatic, psychosomatic and organisational aspects of the delivery of care (HICMAn) is a promising intervention applying proven strategies for optimal care. Trial registration: Current Controlled Trials ISRCTN30822978