1,735 research outputs found
Comparison of blood smear microscopy to a rapid diagnostic test for in-vitro testing for P. Falciparum malaria in Kenyan school children
Objective: To compare the diagnostic performance of microscopy using Giemsastained thick and thin blood smears to a rapid malaria dipstick test (RDT) in
detecting P. falciparum malaria in Kenyan school children.
Design: Randomised, controlled feeding intervention trial from 1998-2001.
Setting: Rural Embu district, Kenya. The area is considered endemic for malaria, with
four rainy seasons per year. Chloroquine resistance was estimated in 80% of patients.
Children had a spleen rate of 45%.
Subjects: A sample of 515 rural Kenyan primary school children, aged 7-11 years, who
were enrolled in a feeding intervention trial from 1998-2001. Main outcome measures: Percent positive and negative P. falciparum malaria status, sensitivity, specificity and positive and negative predictive values of RDT.
Results: For both years, the RDT yielded positive results of 30% in children compared
to microscopy (17%). With microscopy as the “gold standard,” RDT yielded a sensitivity
of 81.3% in 1998 and 79.3% in 2000. Specificity was 81.6% in 1998 and 78.3% in 2000.
Positive predictive value was 47.3% in 1998 and 42.6% in 2000, and negative predictive
value was 95.6% in 1998 and 94.9% in 2000.
Conclusion: Rapid diagnostic testing is a valuable tool for diagnosis and can shorten
the interval for starting treatment, particularly where microscopy may not be feasible
due to resource and distance limitations. East African Medical Journal Vol. 85 (11) 2008: pp. 544-54
Expanding dispersal studies at hydrothermal vents through species identification of cryptic larval forms
Author Posting. © The Author(s), 2010. This is the author's version of the work. It is posted here by permission of Springer for personal use, not for redistribution. The definitive version was published in Marine Biology 157 (2010): 1049-1062, doi:10.1007/s00227-009-1386-8.The rapid identification of hydrothermal vent-endemic larvae to the species level is a key
limitation to understanding the dynamic processes that control the abundance and
distribution of fauna in such a patchy and ephemeral environment. Many larval forms
collected near vents, even those in groups such as gastropods that often form a
morphologically distinct larval shell, have not been identified to species. We present a
staged approach that combines morphological and molecular identification to optimize
the capability, efficiency, and economy of identifying vent gastropod larvae from the
northern East Pacific Rise (NEPR). With this approach, 15 new larval forms can be
identified to species. A total of 33 of the 41 gastropod species inhabiting the NEPR, and
26 of the 27 gastropod species known to occur specifically in the 9° 50’ N region, can be
identified to species. Morphological identification efforts are improved by new
protoconch descriptions for Gorgoleptis spiralis, Lepetodrilus pustulosus, Nodopelta
subnoda, and Echinopelta fistulosa. Even with these new morphological descriptions, the
majority of lepetodrilids and peltospirids require molecular identification. Restriction
fragment length polymorphism digests are presented as an economical method for
identification of five species of Lepetodrilus and six species of peltospirids. The
remaining unidentifiable specimens can be assigned to species by comparison to an
expanded database of 18S ribosomal DNA. The broad utility of the staged approach was
exemplified by the revelation of species-level variation in daily planktonic samples and
the identification and characterization of egg capsules belonging to a conid gastropod
Gymnobela sp. A. The improved molecular and morphological capabilities nearly double
the number of species amenable to field studies of dispersal and population connectivity.Funding was provided by as Woods Hole Oceanographic Institution Deep Ocean
Exploration Institute grant to L.M and S. Beaulieu, National Science Foundation grants
OCE-0424953, OCE-9712233, and OCE-9619605 to L.M, OCE-0327261 to T.S., and
OCE-0002458 to K. Von Damm, and a National Defense Science and Engineering
Graduate fellowship to D.A
Anticonvulsant drug actions on neurons in cell culture
Two actions of clinically used antiepileptic drugs have been studied using mouse neurons in primary dissociated cell culture. The antiepileptic drugs phenytoin, carbamazepine and valproic acid were demonstrated to limit sustained high frequency repetitive firing of action potentials at free serum concentratons that are achieved in patients being treated for epilepsy. Furthermore, an active metabolite of carbamazepine also limited sustained high frequency repetitive firing while inactive metabolites of phenytoin and carbamazepine did not limit sustained high frequency repetitive firing. Phenobarbital and clinically used benzodiazepines limited sustained high frequency repetitive firing of action potentials, but only at concentrations achieved during the treatment of generalized tonic-clonic status epilepticus. Ethosuximide did not limit sustained high frequency repetitive firing even at concentrations four times those achieved in the serum of patients treated for generalized absence seizures. Phenobarbital and clinically used benzodiazepines enhanced postsynaptic GABA responses at concentrations achieved free in the serum during treatment of generalized tonic-clonic or generalized absence seizures. However, phenytoin, carbamazepine, valproic acid and ethosuximide did not modify postsynaptic GABA responses at therapeutic free serum concentrations. These results suggest that the ability of antiepileptic drugs to block generalized tonicclonic seizures and generalized tonic-clonic status epilepticus may be related to their ability to block high frequency repetitive firing of neurons. The mechanism underlying blockade of myoclonic seizures may be related to the ability of antiepileptic drugs to enhance GABAergic synaptic transmission. The mechanism underlying management of generalized absence seizures remains unclear.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41657/1/702_2005_Article_BF01243417.pd
The effectiveness and satisfaction of web-based physiotherapy in people with spinal cord injury: a pilot randomised controlled trial
Study Design: Pilot randomised controlled trial.
Objectives: The aims of this study were to evaluate the effectiveness and participant satisfaction of web-based physiotherapy for people with Spinal Cord Injury (SCI).
Setting: Community patients of a national spinal injury unit in a university teaching hospital, Scotland, UK.
Methods: Twenty-four participants were recruited and randomised to receive eight weeks of web-based physiotherapy (intervention), twice per week, or usual care (control). Individual exercise programmes were prescribed based upon participant’s abilities. The intervention was delivered via a website (www.webbasedphysio.com) and monitored and progressed remotely by the physiotherapist.
Results: Participants logged on to the website an average of 1.4±0.8 times per week. Between-group differences, although not significant were more pronounced for the 6 minute walk test. Participants were positive about using web-based physiotherapy and stated they would be happy to use it again and would recommend it to others. Overall it was rated as either good or excellent.
Conclusions: Web-based physiotherapy was feasible and acceptable for people with SCI. Participants achieved good compliance with the intervention, rated the programme highly and beneficial for health and well-being at various states post injury. The results of this study warrant further work with a more homogenous sample
Neurolymphomatosis mimicking neurosarcoidosis: a case report
<p>Abstract</p> <p>Introduction</p> <p>Both neurosarcoidosis and central nervous system lymphoma can be very difficult to diagnose. We describe the case of a patient in whom neurosarcoidosis was strongly suspected, but who was eventually found to have lymphoma. We believe the case to be of interest and practical value to neurologists, oncologists and internists with an interest in inflammatory diseases.</p> <p>Case presentation</p> <p>A diagnosis of neurosarcoidosis was considered in a 49-year-old Caucasian man on the basis of the following symptoms and indications: a cough, bilateral hilar lymphadenopathy confirmed by thoracic computed tomography, the development of an S1 radiculopathy, cerebrospinal fluid abnormalities (raised protein level), bilateral lung hilar and lachrymal gland uptake on a gallium scan, and erythema nodosum confirmed with skin biopsy. These were followed by the development of multiple cranial neuropathies, including seventh nerve palsy. Exhaustive further investigations yielded no evidence for an alternative diagnosis. Treatments with steroids, cyclophosphamide, intravenous immunoglobulin and finally infliximab were of no benefit. He eventually developed cutaneous nodules, a biopsy of which revealed lymphoma that proved resistant to therapy.</p> <p>Conclusion</p> <p>Constant diagnostic vigilance is required in disorders such as neurosarcoidosis.</p
Physical and mental health comorbidity is common in people with multiple sclerosis: nationally representative cross-sectional population database analysis
<b>Background</b> Comorbidity in Multiple Sclerosis (MS) is associated with worse health and higher mortality. This study aims to describe clinician recorded comorbidities in people with MS. <p></p>
<b>Methods</b> 39 comorbidities in 3826 people with MS aged ≥25 years were compared against 1,268,859 controls. Results were analysed by age, gender, and socioeconomic status, with unadjusted and adjusted Odds Ratios (ORs) calculated using logistic regression. <p></p>
<b>Results</b> People with MS were more likely to have one (OR 2.44; 95% CI 2.26-2.64), two (OR 1.49; 95% CI 1.38-1.62), three (OR 1.86; 95% CI 1.69-2.04), four or more (OR 1.61; 95% CI 1.47-1.77) non-MS chronic conditions than controls, and greater mental health comorbidity (OR 2.94; 95% CI 2.75-3.14), which increased as the number of physical comorbidities rose. Cardiovascular conditions, including atrial fibrillation (OR 0.49; 95% CI 0.36-0.67), chronic kidney disease (OR 0.51; 95% CI 0.40-0.65), heart failure (OR 0.62; 95% CI 0.45-0.85), coronary heart disease (OR 0.64; 95% CI 0.52-0.71), and hypertension (OR 0.65; 95% CI 0.59-0.72) were significantly less common in people with MS. <p></p>
<b>Conclusion</b> People with MS have excess multiple chronic conditions, with associated increased mental health comorbidity. The low recorded cardiovascular comorbidity warrants further investigation
Intervention planning and modification of the BUMP intervention: a digital intervention for the early detection of raised blood pressure in pregnancy
Background: Hypertensive disorders in pregnancy, particularly pre-eclampsia, pose a substantial health risk for both maternal and foetal outcomes. The BUMP (Blood Pressure Self-Monitoring in Pregnancy) interventions are being tested in a trial. They aim to facilitate the early detection of raised blood pressure through self-monitoring. This article outlines how the self-monitoring interventions in the BUMP trial were developed and modified using the person-based approach to promote engagement and adherence.
Methods: Key behavioural challenges associated with blood pressure self-monitoring in pregnancy were identified through synthesising qualitative pilot data and existing evidence, which informed guiding principles for the development process. Social cognitive theory was identified as an appropriate theoretical framework. A testable logic model was developed to illustrate the hypothesised processes of change associated with the intervention. Iterative qualitative feedback from women and staff informed modifications to the participant materials.
Results: The evidence synthesis suggested women face challenges integrating self-monitoring into their lives and that adherence is challenging at certain time points in pregnancy (for example, starting maternity leave). Intervention modification included strategies to address adherence but also focussed on modifying outcome expectancies, by providing messages explaining pre-eclampsia and outlining the potential benefits of self-monitoring.
Conclusions: With an in-depth understanding of the target population, several methods and approaches to plan and develop interventions specifically relevant to pregnant women were successfully integrated, to address barriers to behaviour change while ensuring they are easy to engage with, persuasive and acceptable
Field evidence for the upwind velocity shift at the crest of low dunes
Wind topographically forced by hills and sand dunes accelerates on the upwind
(stoss) slopes and reduces on the downwind (lee) slopes. This secondary wind
regime, however, possesses a subtle effect, reported here for the first time
from field measurements of near-surface wind velocity over a low dune: the wind
velocity close to the surface reaches its maximum upwind of the crest. Our
field-measured data show that this upwind phase shift of velocity with respect
to topography is found to be in quantitative agreement with the prediction of
hydrodynamical linear analysis for turbulent flows with first order closures.
This effect, together with sand transport spatial relaxation, is at the origin
of the mechanisms of dune initiation, instability and growth.Comment: 13 pages, 6 figures. Version accepted for publication in
Boundary-Layer Meteorolog
Improved annotation of 3' untranslated regions and complex loci by combination of strand-specific direct RNA sequencing, RNA-seq and ESTs
The reference annotations made for a genome sequence provide the framework
for all subsequent analyses of the genome. Correct annotation is particularly
important when interpreting the results of RNA-seq experiments where short
sequence reads are mapped against the genome and assigned to genes according to
the annotation. Inconsistencies in annotations between the reference and the
experimental system can lead to incorrect interpretation of the effect on RNA
expression of an experimental treatment or mutation in the system under study.
Until recently, the genome-wide annotation of 3-prime untranslated regions
received less attention than coding regions and the delineation of intron/exon
boundaries. In this paper, data produced for samples in Human, Chicken and A.
thaliana by the novel single-molecule, strand-specific, Direct RNA Sequencing
technology from Helicos Biosciences which locates 3-prime polyadenylation sites
to within +/- 2 nt, were combined with archival EST and RNA-Seq data. Nine
examples are illustrated where this combination of data allowed: (1) gene and
3-prime UTR re-annotation (including extension of one 3-prime UTR by 5.9 kb);
(2) disentangling of gene expression in complex regions; (3) clearer
interpretation of small RNA expression and (4) identification of novel genes.
While the specific examples displayed here may become obsolete as genome
sequences and their annotations are refined, the principles laid out in this
paper will be of general use both to those annotating genomes and those seeking
to interpret existing publically available annotations in the context of their
own experimental dataComment: 44 pages, 9 figure
From Principle to Practice: Bridging the Gap in Patient Profiling
The standard clinical coagulation assays, activated partial thromboplastin time (aPTT) and prothrombin time (PT) cannot predict thrombotic or bleeding risk. Since thrombin generation is central to haemorrhage control and when unregulated, is the likely cause of thrombosis, thrombin generation assays (TGA) have gained acceptance as “global assays” of haemostasis. These assays generate an enormous amount of data including four key thrombin parameters (lag time, maximum rate, peak and total thrombin) that may change to varying degrees over time in longitudinal studies. Currently, each thrombin parameter is averaged and presented individually in a table, bar graph or box plot; no method exists to visualize comprehensive thrombin generation data over time. To address this need, we have created a method that visualizes all four thrombin parameters simultaneously and can be animated to evaluate how thrombin generation changes over time. This method uses all thrombin parameters to intrinsically rank individuals based on their haemostatic status. The thrombin generation parameters can be derived empirically using TGA or simulated using computational models (CM). To establish the utility and diverse applicability of our method we demonstrate how warfarin therapy (CM), factor VIII prophylaxis for haemophilia A (CM), and pregnancy (TGA) affects thrombin generation over time. The method is especially suited to evaluate an individual's thrombotic and bleeding risk during “normal” processes (e.g pregnancy or aging) or during therapeutic challenges to the haemostatic system. Ultimately, our method is designed to visualize individualized patient profiles which are becoming evermore important as personalized medicine strategies become routine clinical practice
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