Examining the early distribution of the artemisinin-resistant Plasmodium falciparum kelch13 R561H mutation in areas of higher transmission in Rwanda

BACKGROUND: Artemisinin resistance mutations in Plasmodium falciparum kelch13 (Pfk13) have begun to emerge in Africa, with Pfk13-R561H being the first reported in Rwanda in 2014, but limited sampling left questions about its early distribution and origin. METHODS: We genotyped P. falciparum positive dried blood spot (DBS) samples from a nationally representative 2014-2015 Rwanda Demographic Health Surveys (DHS) HIV study. DBS were subsampled from DHS sampling clusters with >15% P. falciparum prevalence, as determined by rapid testing or microscopy done during the DHS study (n clusters = 67, n samples = 1873). RESULTS: We detected 476 parasitemias among 1873 residual blood spots from a 2014-2015 Rwanda Demographic Health Survey. We sequenced 351 samples: 341/351 were wild-type (97.03% weighted), and 4 samples (1.34% weighted) harbored R561H that were significantly spatially clustered. Other nonsynonymous mutations found were V555A (3), C532W (1), and G533A (1). CONCLUSIONS: Our study better defines the early distribution of R561H in Rwanda. Previous studies only observed the mutation in Masaka as of 2014, but our study indicates its presence in higher-transmission regions in the southeast of the country at that time

Strategic Paradigms of Social and Environmental Balance

Complaints about the socio-environmental relationship have become prominent, requiring the academy to deepen its studies on the strategic paradigms of sustainability. The objective of this essay is to study the conceptions of strategic paradigms along the path of social and environmental balance, with the specific objectives of raising the paradigms under social, economic, environmental and institutional aspects (1), analyzing the strategic paradigms that can favorably promote equilibrium (2), and critiquing the discourse of society, aiming at social and environmental balance (3). The elaboration of this work is based on the Institutionalist Theory that prescribes the set of individual behaviors, beliefs and values, processed in accordance with the individuals’ perception, and in their interpretative capacity of the reality in which they are inserted. This qualitative research is elaborated through the Method of Content Analysis, and applies procedures of bibliographical survey and documentary treatment of the social discourse that substantiates sustainable paradigms. As a result of the critical analysis, it is verified that the discourses and behaviors of the social agents do not contribute to the social-environmental balance. Then, new proposals of strategic paradigms which are useful for reflective actions and universal meanings are incorporated here. The expectation is to redirect the individual to behavioral reflections, through a learning that is coherent with the confrontation of the planetary emergency. It is also indicated for the spirit of preservation and conservation of the environment, in which the relationship with the social, economic and institutional will bring the desired balance for generations. This study represents those interested in the discussion about the socio-environmental relationship, and those involved in learning about sustainability and orientation towards ethical posture

Características hematológicas de bovinos (Bos taurus) sadios da raça Pantaneira.

O gado Pantaneiro é a raça brasileira local adaptada às condições extremas de temperatura, umidade e qualidade das pastagens naturais do Pantanal. Com o objetivo de conhecer seus aspectos fisiológicos, foi determinado o perfil hematológico utilizando indivíduos clinicamente sadios. Para isso foram examinadas 293 amostras de sangue colhidas em duas propriedades, no Mato Grosso e Mato Grosso do Sul. Estes animais foram divididos, de acordo com a faixa etária, em cinco grupos: G1, G2, G3, G4 e G5. Estudou-se o eritrograma e o leucograma, submetendo os resultados à estatística descritiva e comparativa para determinação da relação com a idade e sexo.bitstream/item/79836/1/BP104.pd

Enzimas séricas e parâmetros bioquímicos de bovinos (Bos taurus) sadios da raça pantaneira.

Os colonizadores trouxeram para o Brasil sua cultura, técnicas de produção agropecuária e animais domésticos. No Pantanal, esse processo evoluiu para a formação do bovino Pantaneiro, raça naturalizada local, exemplo de adaptabilidade ao meio ambiente. Porém esses animais vêm sendo gradativamente substituídos por zebuínos desde o final do século XIX, em cruzamentos absorventes que resultaram em risco de extinção dessa população. Para conservar e expandir esse patrimônio genético é necessário conhecer os parâmetros fisiológicos da raça, que podem auxiliar na interpretação de aspectos clínicos, sanitários e metabólicos desses animais. Este trabalho teve o objetivo de estabelecer os valores de referência para atividade sérica da aspartato aminotransferase (AST), fosfatase alcalina (ALP), gama glutamiltransferase (GGT) e creatino quinase (CK). Também foram quantificados os níveis de bilirrubina, proteína total, globulinas, albumina, uréia, creatinina, glicose, colesterol e fibrinogênio, além da sua correlação com as variáveis, idade e sexo. Para isso, foram colhidas amostras de sangue de 263 animais, em duas propriedades rurais do Pantanal de Mato Grosso e Mato Grosso do Sul. Esses indivíduos foram classificados em cinco grupos, de acordo com a faixa etária. Os dados obtidos foram submetidos à estatística descritiva e posteriormente utilizaram-se testes não paramétricos para comparação de medianas. Os resuiltados descritos levam a conclusão de que o aumento da idade cursa com elevação da AST e com a diminuição de ALP e GGT. Além disso, os maiores valores de CK são detectados no período entre 3 a 11 meses, para em seguida ocorrer diminuição. A idade tem relação com todos os parâmetros bioquímicos, exceto a bilirrubina indireta, sendo que o aumento da idade cursa com a elevação da proteína total, creatinina, uréia, colesterol e fibrinogênio e com a diminuição de bilirrubinas total e direta, albumina e glicose. As fêmeas apresentaram valores maiores de uréia e colesterol, enquanto os machos tiveram níveis maiores de glicose e fibrinogênio.bitstream/item/54532/1/BP106.pd

Mefloquine Exposure Induces Cell Cycle Delay and Reveals Stage-Specific Expression of the pfmdr1 Gene

Drug-resistant Plasmodium falciparum malaria is a major public health problem. An elevated pfmdr1 gene copy number (CN) is known to decrease parasite sensitivity to the commonly used antimalarial mefloquine (MFQ). To understand the relationship between pfmdr1 CN and mefloquine resistance, we evaluated pfmdr1 transcript levels in three P. falciparum strains with different CNs in the presence and absence of MFQ. Parasite strains with multiple pfmdr1 gene copies exhibited higher relative transcript levels than single-copy parasites, and MFQ induced pfmdr1 expression above the levels without treatment in all three strains evaluated. Concomitant morphology analyses of the sampled cultures revealed that MFQ treatment of synchronized ring-stage parasites induced a delay in parasite maturation through the intraerythrocytic cycle. pfmdr1 expression peaks in the ring stage, and MFQ could be causing increased transcription by delaying parasite maturation. However, pretreatment with mefloquine did not affect the artemisinin in vitro half-maximal inhibitory concentration (IC50). These results suggest that MFQ-induced increases in pfmdr1 expression are the direct result of the maturation delay at the ring stage but that this change in expression does not affect the antimalarial activity of artemisinin

REDUCE-IT USA: Results From the 3146 Patients Randomized in the United States.

BackgroundSome trials have found that patients from the United States derive less benefit than patients enrolled outside the United States. This prespecified REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl - Intervention Trial) subgroup analysis was conducted to determine the degree of benefit of icosapent ethyl in the United States.MethodsREDUCE-IT randomized 8179 statin-treated patients with qualifying triglycerides ≥135 and <500 mg/dL and low-density lipoprotein cholesterol >40 and ≤100 mg/dL and a history of atherosclerosis or diabetes mellitus to icosapent ethyl 4 g/d or placebo. The primary composite end point was cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or hospitalization for unstable angina. The key secondary composite end point was cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. A hierarchy was prespecified for examination of individual and composite end points.ResultsA total of 3146 US patients (38.5% of the trial) were randomized and followed for a median of 4.9 years; 32.3% were women and 9.7% were Hispanic. The primary composite end point occurred in 24.7% of placebo-treated patients versus 18.2% of icosapent ethyl-treated patients (hazard ratio [HR], 0.69 [95% CI, 0.59-0.80]; P=0.000001); the key secondary composite end point occurred in 16.6% versus 12.1% (HR, 0.69 [95% CI, 0.57-0.83]; P=0.00008). All prespecified hierarchical end points were meaningfully and significantly reduced, including cardiovascular death (6.7% to 4.7%; HR, 0.66 [95% CI, 0.49-0.90]; P=0.007), myocardial infarction (8.8% to 6.7%; HR, 0.72 [95% CI, 0.56-0.93]; P=0.01), stroke (4.1% to 2.6%; HR, 0.63 [95% CI, 0.43-0.93]; P=0.02), and all-cause mortality (9.8% to 7.2%; HR, 0.70 [95% CI, 0.55-0.90]; P=0.004); for all-cause mortality in the US versus non-US patients, Pinteraction=0.02. Safety and tolerability findings were consistent with the full study cohort.ConclusionsWhereas the non-US subgroup showed significant reductions in the primary and key secondary end points, the US subgroup demonstrated particularly robust risk reductions across a variety of individual and composite end points, including all-cause mortality.Clinical trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01492361

Desempenho de bezerros pantaneiros criados em pastagens nativas do Pantanal Sul-Mato-Grossense.

O objetivo deste experimento foi avaliar a influência do sexo, mês de nascimento e idade da vaca sobre o ganho de peso e a relação vaca/ bezerro de bovinos Pantaneiros mantidos em pastagens nativas do Pantanal Sul-Mato-Grossense. The aim of this trail was to evaluate the influence of gender, birth month and calf age on the calves weight gain and cow/calf ratio of Pantaneiro beef cattle raised on native pastures of Sul-Mato-Grossense Pantanal, Brazil

Reproductive Performances of a cameroonian dual-purpose local chicken strain fed pelleted diets containing graded levels of cassava and sweet potato meal as an energy substitute for maize.

The continuous rising price of maize due to an increasing competition between humans and livestock requires palliative measures to sustain animal production. cassava-sweet potato meal combination can be used as a substitute for maize in feeding chicken. This study aimed at improving poultry productivity through the enhancement of the reproductive performances of Cameroon Kabir chickens fed pelleted diets of graded levels inclusion of cassava-sweet potato meal as an energy substitute for maize.315 Kabir chickens (270 hens and 45 rosters) of 23 weeks of age, were randomly allocated to five treatments T1, T2, T3, T4 and T5 with graded levels of cassava-sweet potato meal as energy substitute for maize, and eggs were collected for the evaluation of laying performances and characteristics. Fertility and hatchability were also evaluated across four successive batches of incubations. The eggs? weight was significantly (P<0.05) different between treatments at weeks 2, 4, 5 and 12, highly significant (P<0.01) at week 9, and very highly significant (P<0.001) at week 6, 7, 8 and 10. The highest number of eggs laid, egg weight and mass were recorded in chicken receiving 25% (T2) replacement of maize with cassava and sweet potato meal, followed by T4 (75%), T5 (100%), T3 (50%) while T1, receiving control diet without cassava and sweet potato meal performed less for all the parameters. Generally, the trend of the feed conversion ratio was decreasing with increasing the inclusion level of cassava and sweet potato meal. The egg index showed significant differences in weeks 6 and 12, while week 2 showed high significant difference between the treatments. T2 (25%) recorded the highest fertility, while animals receiving control ration without maize substitution recorded the highest hatchability. In general, incorporation of 25% of fifty-fifty percent weight to weight of cassava and sweet potato meal can be recommended for reproduction in chicken without affecting neither the hatchability nor the physical characteristics of the eggs, though hatchability will require better attention

Assessing Surgical Task Load and Performance: A Comparison of Simulation and Maritime Operation

The article of record as published may be found at http://dx.doi.org/10.1093/milmed/usz297This study examined the effects of simulated and actual vessel motion at high seas on task load and surgical performance. Methods: This project was performed in phases. Phase I was a feasibility study. Phase II utilized a motion base simulator to replicate vessel motion. Phase III was conducted aboard the U.S. Naval Ship Brunswick. After performing surgical tasks on a surgical simulation mannequin, participants completed the Surgical Task Load Index (TLX) designed to collect workload data. Simulated surgeries were evaluated by subject matter experts. Results: TLX scores were higher in Phase III than Phase II, particularly at higher sea states. Surgical performance was not significantly different between Phase II (84%) and Phase III (89%). Simulated motions were comparable in both phases. Conclusions: Simulated motion was not associated with a significant difference in surgical performance or deck motion, suggesting that this simulator replicates the conditions experienced during surgery at sea on the U.S. Naval Ship Brunswick. However, Surgical TLX scores were dramatically different between the two phases, suggesting increased workload at sea, which may be the result of time at sea, the stress of travel, or other factors. Surgical performance was not affected by sea state in either phase.Bureau of Medicine USN; OPNAV N-81 Assessments Division, Medical Analysis Branch; Navy Advanced Medical Development; Naval Surface Warfare Center, PC.Phase I of this study was sponsored by the Office of Naval Research. Phase II was sponsored by the Office of the Chief of Naval Operations (OPNAV) N-81 Assessments Division, Medical Analysis Branch (N813). Phase III was sponsored by the OPNAV N-81 (N813) and Navy Advanced Medical Development (AMD).Bureau of Medicine USN; OPNAV N-81 Assessments Division, Medical Analysis Branch; Navy Advanced Medical Development; Naval Surface Warfare Center, PC.Phase I of this study was sponsored by the Office of Naval Research. Phase II was sponsored by the Office of the Chief of Naval Operations (OPNAV) N-81 Assessments Division, Medical Analysis Branch (N813). Phase III was sponsored by the OPNAV N-81 (N813) and Navy Advanced Medical Development (AMD)

Evaluating malaria prevalence and land cover across varying transmission intensity in Tanzania using a cross-sectional survey of school-aged children

BACKGROUND: Transmission of malaria in sub-Saharan Africa has become increasingly stratified following decades of malaria control interventions. The extent to which environmental and land cover risk factors for malaria may differ across distinct strata of transmission intensity is not well known and could provide actionable targets to maximize the success of malaria control efforts. METHODS: This study used cross-sectional malaria survey data from a nationally representative cohort of school-aged children in Tanzania, and satellite-derived measures for environmental features and land cover. Hierarchical logistic regression models were applied to evaluate associations between land cover and malaria prevalence within three distinct strata of transmission intensity: low and unstable, moderate and seasonal, and high and perennial. RESULTS: In areas with low malaria transmission, each 10-percentage point increase in cropland cover was associated with an increase in malaria prevalence odds of 2.44 (95% UI: 1.27, 5.11). However, at moderate and higher levels of transmission intensity, no association between cropland cover and malaria prevalence was detected. Small associations were observed between greater grassland cover and greater malaria prevalence in high intensity settings (prevalence odds ratio (POR): 1.10, 95% UI: 1.00, 1.21), and between greater forest cover and reduced malaria prevalence in low transmission areas (POR: 0.74, 95% UI: 0.51, 1.03), however the uncertainty intervals of both estimates included the null. CONCLUSIONS: The intensity of malaria transmission appears to modify relationships between land cover and malaria prevalence among school-aged children in Tanzania. In particular, greater cropland cover was positively associated with increased malaria prevalence in areas with low transmission intensity and presents an actionable target for environmental vector control interventions to complement current malaria control activities. As areas are nearing malaria elimination, it is important to re-evaluate environmental risk factors and employ appropriate interventions to effectively address low-level malaria transmission