Combined Assessment of Arterial and Venous Anatomy in Lower Limb Ischaemia Using a Single Contrast-Enhanced Magnetic Resonance Scan

AbstractContrast-Enhanced Magnetic Resonance Angiography (CE-MRA) is a non-invasive investigative modality for patients with lower limb arterial insufficiency. When infra-inguinal arterial reconstruction is indicated autologous great saphenous vein is the conduit of choice and adequacy of the vein is often assessed by an additional Duplex ultrasound.We evaluated whether single, high-resolution steady state MR imaging with blood pool contrast agent could generate a sufficiently informative assessment of both venous and arterial anatomy to plan surgery potentially avoiding the need for an additional venous duplex.There was good correlation between CE-MRA, venous duplex and subsequent operative findings

The costs and benefits of a vaccination programme for Haemophilus influenzae type 8 disease

Haemophilus influenzae type b (Hib) infection is a major cause of severe bacterial infection in young children in South Africa and world-wide. These diseases can be prevented by immunisation with conjugate Hib vaccines. In South Africa, unlike some developed countries, Hib vaccines are not part of the routine immunisation schedule. The objective of this study was to measure the expected net benefits from a hypothetical programme of vaccination of the 1992 Cape Town birth cohort (N =46 537). Costs were calculated by summing the estimated direct medical care costs together with the indirect costs of Hib disease. The latter were calculated by valuing human life using alternative, and conservative human capital and willingness-to-pay measures. The difference between Hib disease costs (Le. the benefits which would be gained from a successful vaccination programme) and the costs of the vaccination programme itself (HibTITER, Praxis Biologicals) defined the expected net benefits. In the absence of an immunisation programme, the estimated economic costs of Hib disease in the 1992 Cape Town cohort ranged from R10,7 million to R11 ,8 million. The costs of introducing the vaccine would have amounted to R8,3 million. Had the vaccine been administered to the 1992 birth cohort, benefits would have exceeded costs by between R2,4 million and R3,5 million

Modelling and observation of transionospheric propagation results from ISIS II in preparation for ePOP

The enhanced Polar Outflow Probe (ePOP) is scheduled to be launched as part of the Cascade Demonstrator Small-Sat and Ionospheric Polar Explorer (CASSIOPE) satellite in early 2008. A Radio Receiver Instrument (RRI) on ePOP will receive HF transmissions from various ground-based transmitters. In preparation for the ePOP mission, data from a similar transionospheric experiment performed by the International Satellites for Ionospheric Studies (ISIS) II satellite has been studied. Prominent features in the received 9.303-MHz signal were periodic Faraday fading of signal intensity at rates up to 13 Hz and a time of arrival delay between the O- and X-modes of up to 0.8 ms. Both features occurred when the satellite was above or south of the Ottawa transmitter. Ionospheric models for ray tracing were constructed using both International Reference Ionosphere (IRI) profiles and local peak electron density values from ISIS ionograms. Values for fade rate and differential mode delay were computed and compared to the values observed in the ISIS II data. The computed values showed very good agreement to the observed values of both received signal parameters when the topside sounding <I>fo</I>F2 values were used to scale IRI profiles, but not when strictly modelled IRI profiles were used. It was determined that the primary modifier of the received signal parameters was the <I>fo</I>F2 density and not the shape of the profile. This dependence was due to refraction, at the 9.303-MHz signal frequency, causing the rays to travel larger distances near the peak density where essentially all the mode splitting occurred. This study should assist in interpretation of ePOP RRI data when they are available

Plasma vitamin A and zinc levels in HIV-infected adults in Cape Town, South Africa

A cross-sectional study of 132 adults attending an HIV clinic in Cape Town, South Africa, was conducted to determine predictors of low plasma vitamin A and Zn levels. No patients were on antiretroviral therapy. The possible confounding effect of the acute-phase response was controlled by including C-reactive protein levels in multivariate analysis and by excluding active opportunistic infections. Retinol levels were low (< 1.05 μmol/l) in 39% of patients with early disease (WHO clinical stages I and II) compared with 48 and 79 % of patients with WHO stage III and IV respectively (P<0.01). Plasma Zn levels were low (< 10.7 μmol/l) in 20% of patients with early disease v. 36 and 45 % with stage III and IV disease respectively (P< 0.05). C-reactive protein levels were normal in 63 % of subjects. Weak, positive associations were found between CD4+lymphocyte count and plasma levels of retinol (r 0.27; 95 % CI 0.1, 0.43) and Zn (r 0.31; 95% CI 0.25, 0.46). Multivariate analysis showed the following independent predictors of low retinol levels: WHO stage IV (odds ratio 3.4; 95 % CI 2.1, 5.7) and body weight (odds ratio per 5 kg decrease 1.15; 95% CI, 1-08, 1.25), while only body weight was significantly associated with low Zn levels (OR per 5 kg decrease 1.19; 95% CI 1.09, 1.30). CD4+lymphocyte count <200/μl was not significantly associated with either low retinol or Zn levels. In resource-poor settings, simple clinical features (advanced disease and/or weight loss) are associated with lowered blood concentrations of vitamin A and/or Zn. The clinical significance of low plasma retinol and/or Zn levels is unclear and more research is required to establish the role of multiple micronutrient intervention strategies in HIV disease

Lessons learnt during the national introduction of human papillomavirus (HPV) vaccination programmes in 6 African countries: Stakeholders’ perspectives

Background. Infection with human papillomavirus (HPV) significantly increases the risk of developing cervical cancer later in life. Therefore, globally, HPV vaccines targeted to pre-adolescent and adolescent girls have been on the rise since the licensure in 2006. However, the introduction of HPV vaccines has been relatively slow in Africa. At the end of 2016, only 8 of the 54 countries in Africa were reported to have introduced HPV vaccination at a national level. By 2019, the number of countries had grown marginally to 11.Objectives. To investigate stakeholders’ perspectives on the experiences, challenges and lessons learnt during national HPV vaccine introduction in Africa.Methods. A questionnaire was administered to selected participants from 8 African countries. These countries had successfully introduced HPV vaccination at a national level by the end of 2016. We used in-depth interviews and self-administered online questionnaires for data collection and analysis. Data are presented without naming the country or participants; therefore, readers will not be able to identify the results that are specific to individual countries. Narrative and thematic reporting were used to describe the results.Results. We obtained results from 6 of the 8 targeted countries. The challenges reported during HPV vaccination programmes were: identifying the target population, using a school-based vaccine-delivery strategy, obtaining political support, the need to integrate HPV vaccination with existing school health programmes and engaging multiple stakeholders. These challenges were similar in all 6 countries. The lessons learnt were that a school-based delivery strategy is a successful approach for national HPV vaccination, and that identifying girls for vaccination at schools was less challenging if implemented through a class-based instead of an age-based approach.Conclusions. Most African countries do not have established platforms to deliver vaccines to pre-adolescent and adolescent populations. The successful introduction of the HPV vaccine through school-based vaccination strategies in African countries may have created a platform to deliver other adolescent vaccines. The similarity of the study findings across the 6 participating countries further strengthens the need to document and disseminate the challenges and lessons learnt during HPV vaccine introduction in Africa. Documentation and dissemination of the challenges and lessons learnt are useful to other countries in Africa that plan to introduce an HPV vaccination programme, and possibly other adolescent vaccines.

Neutron interferometric measurement of the scattering length difference between the triplet and singlet states of n-3^3He

We report a determination of the n-$^3$He scattering length difference $\Delta b^{\prime} = b_{1}^{\prime}-b_{0}^{\prime} =$ ($-5.411$ $\pm$ $0.031$ (statistical) $\pm$ $0.039$ (systematic)) fm between the triplet and singlet states using a neutron interferometer. This revises our previous result $\Delta b^{\prime} =$ (-5.610 $\pm$ $0.027$ (statistical) $\pm$ $0.032$ (systematic) fm obtained using the same technique in 2008. This revision is due to a re-analysis of the 2008 experiment that includes a more robust treatment of the phase shift caused by magnetic field gradients near the $^3$He cell. Furthermore, we more than doubled our original data set from 2008 by acquiring six months of additional data in 2013. Both the new data set and a re-analysis of the older data are in good agreement. Scattering lengths of low Z isotopes are valued for use in few-body nuclear effective field theories, provide important tests of modern nuclear potential models and in the case of $^3$He aid in the interpretation of neutron scattering from quantum liquids. The difference $\Delta b^{\prime}$ was determined by measuring the relative phase shift between two incident neutron polarizations caused by the spin-dependent interaction with a polarized $^3$He target. The target $^3$He gas was sealed inside a small, flat windowed glass cell that was placed in one beam path of the interferometer. The relaxation of $^3$He polarization was monitored continuously with neutron transmission measurements. The neutron polarization and spin flipper efficiency were determined separately using $^3$He analyzers and two different polarimetry analysis methods. A summary of the measured scattering lengths for n-$^3$He with a comparison to nucleon interaction models is given

Sports review: A content analysis of the International Review for the Sociology of Sport, the Journal of Sport and Social Issues and the Sociology of Sport Journal across 25 years

The International Review for the Sociology of Sport, the Journal of Sport and Social Issues and Sociology of Sport Journal have individually and collectively been subject to a systematic content analysis. By focusing on substantive research papers published in these three journals over a 25-year time period it is possible to identify the topics that have featured within the sociology of sport. The purpose of the study was to identify the dominant themes, sports, countries, methodological frameworks and theoretical perspectives that have appeared in the research papers published in these three journals. Using the terms, identified by the author(s), that appear in the paper’s title, abstract and/or listed as a key word, subject term or geographical term, a baseline is established to reflect on the development of the sub-discipline as represented by the content of these three journals. It is suggested that the findings illustrate what many of the more experienced practitioners in the field may have felt subjectively. On the basis of this systematic, empirical study it is now possible to identify those areas have received extensive coverage and those which are under-researched within the sociology of sport. The findings are used to inform a discussion of the role of academic journals and the recent contributions made by Michael Silk, David Andrews, Michael Atkinson and Dominic Malcolm on the past, present and future of the ‘sociology of sport’