180 research outputs found
What Does Severe Acute Respiratory Syndrome Coronavirus 2 Mean for Global Pneumonia Prevention, Diagnosis, and Treatment?
The Biodiversity and Climate Change Virtual Laboratory: Where ecology meets big data
Advances in computing power and infrastructure, increases in the number and size of ecological and environmental datasets, and the number and type of data collection methods, are revolutionizing the field of Ecology. To integrate these advances, virtual laboratories offer a unique tool to facilitate, expedite, and accelerate research into the impacts of climate change on biodiversity. We introduce the uniquely cloud-based Biodiversity and Climate Change Virtual Laboratory (BCCVL), which provides access to numerous species distribution modelling tools; a large and growing collection of biological, climate, and other environmental datasets; and a variety of experiment types to conduct research into the impact of climate change on biodiversity. Users can upload and share datasets, potentially increasing collaboration, cross-fertilisation of ideas, and innovation among the user community. Feedback confirms that the BCCVL's goals of lowering the technical requirements for species distribution modelling, and reducing time spent on such research, are being met
The effect of anti-retroviral therapy on fracture healing : an in vivo animal model.
A number of anti-retroviral therapies (ART) have been implicated in potentially contributing to HIV-associated bone disease. The aim of this study was to evaluate the effect of combination ART on the fracture healing process. A total of 16 adult male Wistar rats were randomly divided into two groups (n = eight each): Group 1 was given a combination of Tenfovir 30 mg, Lamivudine 30 mg, and Efavirenz 60 mg per day orally, whereas Group 2 was used as a control. After one week of medication preload, all rats underwent a standardized surgical procedure of mid-shaft tibial osteotomy fixed by intramedullary nail with no gap at the fracture site. Progress in fracture healing was monitored regularly for eight weeks. Further evaluations were carried out after euthanasia by micro-CT, mechanically and histologically. Two blinded orthopaedic surgeons used the Radiological Union Scoring system for the Tibia (RUST) to determine fracture healing. The fracture healing process was different between the two groups at week 4 after surgery; only two out of eight rats showed full healing in Group 1 (ART-treated), while seven out of eight rats had bone union in Group 2 (control) (p = 0.040). However, at week eight postoperatively, there was no statistical difference in bone healing; seven out of eight progressed to full union in both groups. This study demonstrated that combination ART resulted in delayed fracture healing at week 4 after surgery in rats, but did not result in the development of nonunion
Maternal mental well-being and recent child illnesses–A cross-sectional survey analysis from Jigawa State, Nigeria
Child health indicators in Northern Nigeria remain low. The bidirectional association between child health and maternal well-being is also poorly understood. We aim to describe the association between recent child illness, socio-demographic factors and maternal mental well-being in Jigawa State, Nigeria. We analysed a cross-sectional household survey conducted in Kiyawa local government area, Jigawa State, from January 2020 to March 2020 amongst women aged 16–49 with at least one child under-5 years. We used two-stage random sampling. First, we used systematic random sampling of compounds, with the number of compounds based on the size of the community. The second stage used simple random sampling to select one eligible woman per compound. Mental well-being was assessed using the Short Warwick-Edinburgh Mental Wellbeing Score (SWEMWBS). We used linear regression to estimate associations between recent child illness, care-seeking and socio-demographic factors, and mental well-being. Overall 1,661 eligible women were surveyed, and 8.5% had high mental well-being (metric score of 25.0–35.0) and 29.5% had low mental well-being (metric score of 7.0–17.9). Increasing wealth quintile (adj coeff: 1.53; 95% CI: 0.91–2.15) not being a subsistence farmer (highest adj coeff: 3.23; 95% CI: 2.31–4.15) and having a sick child in the last 2-weeks (adj coeff: 1.25; 95% CI: 0.73–1.77) were significantly associated with higher mental well-being. Higher levels of education and increasing woman’s age were significantly associated with lower mental well-being. Findings contradicted our working hypothesis that a recently sick child would be associated with lower mental well-being. We were surprised that education and late marriage, which are commonly attributed to women’s empowerment and autonomy, were not linked to better well-being here. Future work could focus on locally defined tools to measure well-being reflecting the norms and values of communities, ensuring solutions that are culturally acceptable and desirable to women with low mental well-being are initiated
Community perceptions matter: a mixed-methods study using local knowledge to define features of success for a community intervention to improve quality of care for children under-5 in Jigawa, Nigeria
Objectives
In this study, we used the information generated by community members during an intervention design process to understand the features needed for a successful community participatory intervention to improve child health.
Design
We conducted a concurrent mixed-methods study (November 2019–March 2020) to inform the design and evaluation of a community–facility linkage participatory intervention.
Setting
Kiyawa Local Government Area (Jigawa State, Nigeria)—population of 230 000 (n=425 villages).
Participants
Qualitative data included 12 community conversations with caregivers of children under-5 (men, older and younger women; n=9 per group), 3 focus group discussions (n=10) with ward development committee members and interviews with facility heads (n=3). Quantitative data comprised household surveys (n=3464) with compound heads (n=1803) and women (n=1661).
Results
We analysed qualitative data with thematic network analysis and the surveys with linear regression—results were triangulated in the interpretation phase. Participants identified the following areas of focus: community health education; facility infrastructure, equipment and staff improvements; raising funds to make these changes. Community involvement, cooperation and empowerment were recognised as a strategy to improve child health, and the presence of intermediate bodies (development committees) was deemed important to improve communication and solve problems between community and facility members. The survey showed functional community relations’ dynamics, with high levels of internal cohesion (78%), efficacy in solving problems together (79%) and fairness of the local leaders (82%).
Conclusions
Combining the results from this study and critical theories on successful participation identified community-informed features for a contextually tailored community–facility link intervention. The need to promote a more inclusive approach to future child health interventions was highlighted. In addition to health education campaigns, the relationship between community and healthcare providers needs strengthening, and development committees were identified as an essential feature for successfully linking communities and facilities for child health.
Trial registration number
ISRCTN39213655
RANK signals from CD4+3− inducer cells regulate development of Aire-expressing epithelial cells in the thymic medulla
Aire-expressing medullary thymic epithelial cells (mTECs) play a key role in preventing autoimmunity by expressing tissue-restricted antigens to help purge the emerging T cell receptor repertoire of self-reactive specificities. Here we demonstrate a novel role for a CD4+3− inducer cell population, previously linked to development of organized secondary lymphoid structures and maintenance of T cell memory in the functional regulation of Aire-mediated promiscuous gene expression in the thymus. CD4+3− cells are closely associated with mTECs in adult thymus, and in fetal thymus their appearance is temporally linked with the appearance of Aire+ mTECs. We show that RANKL signals from this cell promote the maturation of RANK-expressing CD80−Aire− mTEC progenitors into CD80+Aire+ mTECs, and that transplantation of RANK-deficient thymic stroma into immunodeficient hosts induces autoimmunity. Collectively, our data reveal cellular and molecular mechanisms leading to the generation of Aire+ mTECs and highlight a previously unrecognized role for CD4+3−RANKL+ inducer cells in intrathymic self-tolerance
Prevalence of pneumonia and malnutrition among children in Jigawa state, Nigeria: a community-based clinical screening study
Objective:
To estimate the point prevalence of pneumonia and malnutrition and explore associations with household socioeconomic factors. /
Design:
Community-based cross-sectional study conducted in January–June 2021 among a random sample of households across all villages in the study area. /
Setting:
Kiyawa Local Government Area, Jigawa state, Nigeria. /
Participants:
Children aged 0–59 months who were permanent residents in Kiyawa and present at home at the time of the survey. /
Main outcome measures:
Pneumonia (non-severe and severe) defined using WHO criteria (2014 revision) in children aged 0–59 months. Malnutrition (moderate and severe) defined using mid-upper arm circumference in children aged 6–59 months. /
Results:
9171 children were assessed, with a mean age of 24.8 months (SD=15.8); 48.7% were girls. Overall pneumonia (severe or non-severe) point prevalence was 1.3% (n=121/9171); 0.6% (n=55/9171) had severe pneumonia. Using an alternate definition that did not rely on caregiver-reported cough/difficult breathing revealed higher pneumonia prevalence (n=258, 2.8%, 0.6% severe, 2.2% non-severe). Access to any toilet facility was associated with lower odds of pneumonia (aOR: 0.56; 95% CI: 0.31 to 1.01). The prevalence of malnutrition (moderate or severe) was 15.6% (n=1239/7954) with 4.1% (n=329/7954) were severely malnourished. Being older (aOR: 0.22; 95% CI: 0.17 to 0.27), male (aOR: 0.77; 95% CI: 0.66 to 0.91) and having head of compound a business owner or professional (vs subsistence farmer, aOR 0.71; 95% CI: 0.56 to 0.90) were associated with lower odds of malnutrition. /
Conclusions:
In this large, representative community-based survey, there was a considerable pneumonia and malnutrition morbidity burden. We noted challenges in the diagnosis of Integrated Management of Childhood Illness-defined pneumonia in this context
Spectral Imager of the Solar Atmosphere: The First Extreme-Ultraviolet Solar Integral Field Spectrograph Using Slicers
Particle acceleration, and the thermalisation of energetic particles, are fundamental processes across the universe. Whilst the Sun is an excellent object to study this phenomenon, since it is the most energetic particle accelerator in the Solar System, this phenomenon arises in many other astrophysical objects, such as active galactic nuclei, black holes, neutron stars, gamma ray bursts, solar and stellar coronae, accretion disks and planetary magnetospheres. Observations in the Extreme Ultraviolet (EUV) are essential for these studies but can only be made from space. Current spectrographs operating in the EUV use an entrance slit and cover the required field of view using a scanning mechanism. This results in a relatively slow image cadence in the order of minutes to capture inherently rapid and transient processes, and/or in the spectrograph slit ‘missing the action’. The application of image slicers for EUV integral field spectrographs is therefore revolutionary. The development of this technology will enable the observations of EUV spectra from an entire 2D field of view in seconds, over two orders of magnitude faster than what is currently possible. The Spectral Imaging of the Solar Atmosphere (SISA) instrument is the first integral field spectrograph proposed for observations at ∼180 Å combining the image slicer technology and curved diffraction gratings in a highly efficient and compact layout, while providing important spectroscopic diagnostics for the characterisation of solar coronal and flare plasmas. SISA’s characteristics, main challenges, and the on-going activities to enable the image slicer technology for EUV applications are presented in this paper
Fracture healing in patients with human immunodeficiency virus in South Africa
Background:
Human immunodeficiency virus (HIV) reduces bone mineral density, mineralisation and turnover, and may impair fracture healing.
Setting:
This prospective cohort study in South Africa investigated whether HIV infection was associated with impaired fracture healing following trauma.
Methods:
All adults with acute tibia and femur fractures who underwent intermedullary nailing (IM) for fracture fixation between September 2017 and December 2018, at two tertiary hospitals, were followed for a minimum of 12 months post-operatively. The primary outcome was delayed bone union at 6 months (defined by the radiological union scoring system for the tibia [RUST] score <9), and the secondary outcome was non-union (defined as RUST score <9) at 9 months. Multivariable logistic regression models were constructed to investigate associations between HIV status and impaired fracture healing.
Results:
In total, 358 participants, who underwent 395 IM nailings, were enrolled in the study and followed up for 12 months. Seventy-one participants (71/358, 19·8%) were HIV positive (83 IM nailings [83/395], 21.0%). HIV was not associated with delayed fracture healing after IM nailing of the tibia or femur (multivariable odds ratio [OR]: 1·06; 95% confidence interval [CI]: 0·50–2·22). Participants with HIV had a statistically significant lower odds of non-union compared to HIV-negative participants (multivariable OR: 0·17; 95% CI: 0·01–0·92).
Conclusions:
Fractures sustained in HIV-positive individuals can undergo surgical fixation as effectively as those in individuals who are HIV negative, with no increased risk of delayed union or non-union
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