A Cross-sectional Study on Factors Associated With Perforated Peptic Ulcer Disease in Adults Presenting to UTH, Lusaka

Objective: To determine the various clinical and epidemiological factors associated with peptic ulcer perforation in adults at UTH.A pilot study for an impending broader controlled study.Design: Ahospital-based cross-sectional study.Participants: 35 adult patients all of whom were diagnosed at laparotomy as having perforated, benign peptic ulcers, confirmed histologically.Setting: University Teaching Hospital, Lusaka, Zambia.Results: It was shown that there was a male preponderance (85.7%).The mean age was 39.9 years and the peak range to perforate was 16-45 years (68.6%). Most patients were Lusaka –based (82.8%), and came from a middle income background (62.8%). Clinically, the most frequent presenting complaint was abdominal pain (62.8%), and 57.2% of patients had symptoms lasting 24 hours or less. Furthermore, the commonest blood group was group O+(33.2%),with 40% confirming history of use of NSAIDs. 57% were regular alcohol drinkers and 34% were cigarette smokers. Also, a further 32% of patients were found to be HIV positive and 84.2% had no previous peptic ulcer history. Gastric perforations were by far the commonest anatomical site (82.8%) followed by duodenal (14.3%). Postoperative hospital stay prolonging 10 days was 51.4%, and 37% died after surgery.Conclusion: Perforated peptic ulcers occur more in males below 45 years old, most of whom are middle income earners and Lusaka -based. A third of the study group tested positive for HIV and more than half confirmed being regular alcohol drinkers. About a third confirmed smoking cigarettes. The majority of patients denied history of previous peptic ulcer disease. Nearly half the group confirmed usage of NSAIDs and about a third were Blood group O+. Gastric perforations were in the greater majority with half the patients prolonging hospital stay for more than 10 days. Mortality following surgery was high (37%). A larger study group ought to be recruited for definitive conclusions to be made

Hospital sink traps as a potential source of the emerging multidrug-resistant pathogen Cupriavidus pauculus: characterization and draft genome sequence of strain MF1

This is the final version. Available on open access from the Microbiology Society via the DOI in this recordData availability: This project has been deposited at DDBJ/ENA/GenBank under the accession JAIQWY000000000 within BioProject PRJNA762702. The version described in this paper is version JAIQWY010000000. The contig sequences can be found under accession numbers JAIQWY010000001–JAIQWY010000005. Raw sequence data have been deposited under accession numbers SRX13365403 and SRX13365404. Four supplementary tables are available with the online version of this article.Introduction. Cupriavidus pauculus is historically found in soil and water but has more recently been reported to cause human infection and death. Hospital sink traps can serve as a niche for bacterial persistence and a platform for horizontal gene transfer, with evidence of dissemination of pathogens in hospital plumbing systems driving nosocomial infection.Gap Statement. This paper presents the first C. pauculus strain isolated from a hospital sink trap. There are only six genome assemblies available on NCBI for C. pauculus; two of these are PacBio/Illumina hybrids. This paper presents the first ONT/Illumina hybrid assembly, with five contigs. The other assemblies available consist of 37, 38, 111 and 227 contigs. This paper also presents data on biofilm formation and lethal dose in Galleria mellonella; there is little published information describing these aspects of virulence.Aim. The aims were to identify the isolate found in a hospital sink trap, characterize its genome, and assess whether it could pose a risk to human health.Methodology. The genome was sequenced, and a hybrid assembly of short and long reads produced. Antimicrobial susceptibility was determined by the broth microdilution method. Virulence was assessed by measuring in vitro biofilm formation compared to Pseudomonas aeruginosa and in vivo lethality in Galleria mellonella larvae.Results. The isolate was confirmed to be a strain of C. pauculus, with a 6.8 Mb genome consisting of 6468 coding sequences and an overall G+C content of 63.9 mol%. The genome was found to contain 12 antibiotic resistance genes, 8 virulence factor genes and 33 metal resistance genes. The isolate can be categorized as resistant to meropenem, amoxicillin, amikacin, gentamicin and colistin, but susceptible to cefotaxime, cefepime, imipenem and ciprofloxacin. Clear biofilm formation was seen in all conditions over 72 h and exceeded that of P. aeruginosa when measured at 37 °C in R2A broth. Lethality in G. mellonella larvae over 48 h was relatively low.Conclusion. The appearance of a multidrug-resistant strain of C. pauculus in a known pathogen reservoir within a clinical setting should be considered concerning. Further work should be completed to compare biofilm formation and in vivo virulence between clinical and environmental strains, to determine how easily environmental strains may establish human infection. Infection control teams and clinicians should be aware of the emerging nature of this pathogen and further work is needed to minimize the impact of contaminated hospital plumbing systems on patient outcomes

Muscle metabolic and neuromuscular determinants of fatigue during cycling in different exercise intensity domains.

This is the author accepted manuscript. The final version is available from American Physiological Society via the DOI in this record.The lactate or gas exchange threshold (GET) and the critical power (CP) are closely associated with human exercise performance. We tested the hypothesis that the limit of tolerance (Tlim) during cycle exercise performed within the exercise intensity domains demarcated by GET and CP is linked to discrete muscle metabolic and neuromuscular responses. Eleven males performed a ramp incremental exercise test, 4-5 severe-intensity (SEV; >CP) constant-work-rate (CWR) tests until Tlim, a heavy-intensity (HVY; GET) CWR test until Tlim, and a moderate-intensity (MOD; 0.05) muscle metabolic milieu (i.e., low pH and [PCr] and high [lactate]) was attained at Tlim (~2-14 min) for all SEV exercise bouts. The muscle metabolic perturbation was greater at Tlim following SEV compared to HVY, and also following SEV and HVY compared to MOD (all P0.05). Neural drive to the VL increased during SEV (4±4%; P0.05). During SEV and HVY, but not MOD, the rates of change in M-wave amplitude and neural drive were correlated with changes in muscle metabolic ([PCr], [lactate]) and blood ionic/acid-base status ([lactate], [K(+)]) (P<0.05). The results of this study indicate that the metabolic and neuromuscular determinants of fatigue development differ according to the intensity domain in which the exercise is performed

Effect of Split Gate Size on the Electrostatic Potential and 0.7 Anomaly within Quantum Wires on a Modulation-Doped GaAs/AlGaAs Heterostructure

© 2016 American Physical Society. © 2016 American Physical Society.We study 95 split gates of different size on a single chip using a multiplexing technique. Each split gate defines a one-dimensional channel on a modulation-doped GaAs/AlGaAs heterostructure, through which the conductance is quantized. The yield of devices showing good quantization decreases rapidly as the length of the split gates increases. However, for the subset of devices showing good quantization, there is no correlation between the electrostatic length of the one-dimensional channel (estimated using a saddle-point model) and the gate length. The variation in electrostatic length and the one-dimensional subband spacing for devices of the same gate length exceeds the variation in the average values between devices of different lengths. There is a clear correlation between the curvature of the potential barrier in the transport direction and the strength of the "0.7 anomaly": the conductance value of the 0.7 anomaly reduces as the barrier curvature becomes shallower. These results highlight the key role of the electrostatic environment in one-dimensional systems. Even in devices with clean conductance plateaus, random fluctuations in the background potential are crucial in determining the potential landscape in the active device area such that nominally identical gate structures have different characteristics

Cross-cultural generalizability of suicide first aid actions: an analysis of agreement across expert consensus studies from a range of countries and cultures

Background A number of Delphi expert consensus studies have been carried out with different countries and cultural groups to develop guidelines on how a member of the public should provide assistance to a person who is suicidal. The present study aimed to determine whether cross-culturally generalizable suicide first aid actions are possible by comparing agreement across these Delphi studies. Methods Data on endorsement rates for items were compared across six Delphi studies. These studies involved panels of professionals and consumer advocates from English-speaking countries, professionals from Sri Lanka, professionals from Japan, professionals from India, professionals from the Philippines, and professionals and consumer advocates in refugee and immigrant mental health. Correlations were calculated between item endorsement rates across panels. Results There were 18 items that were highly endorsed across all eight of the Delphi panels and an additional 15 items highly endorsed across the panels from the three lower middle-income countries (India, Philippines and Sri Lanka). Correlations across panels in item endorsement rates were all 0.60 or above, but were higher between panels from countries that are socioeconomically similar. Conclusions There is broad agreement across the diverse expert panels about what are appropriate suicide first aid actions for members of the public, indicating that cross-cultural generalizability is possible. However, there is also some cultural specificity, indicating the need for local tailoring

Seeing two faces together: preference formation in humans and rhesus macaques

Humans, great apes and old world monkeys show selective attention to faces depending on conspecificity, familiarity, and social status supporting the view that primates share similar face processing mechanisms. Although many studies have been done on face scanning strategy in monkeys and humans, the mechanisms influencing viewing preference have received little attention. To determine how face categories influence viewing preference in humans and rhesus macaques (Macaca mulatta), we performed two eye-tracking experiments using a visual preference task whereby pairs of faces from different species were presented simultaneously. The results indicated that viewing time was significantly influenced by the pairing of the face categories. Humans showed a strong bias towards an own-race face in an Asian–Caucasian condition. Rhesus macaques directed more attention towards non-human primate faces when they were paired with human faces, regardless of the species. When rhesus faces were paired with faces from Barbary macaques (Macaca sylvanus) or chimpanzees (Pan troglodytes), the novel species’ faces attracted more attention. These results indicate that monkeys’ viewing preferences, as assessed by a visual preference task, are modulated by several factors, species and dominance being the most influential

Plasmacytoid dendritic cells orchestrate innate and adaptive anti-tumor immunity induced by oncolytic coxsackievirus A21

Background: The oncolytic virus, coxsackievirus A21 (CVA21), has shown promise as a single agent in several clinical trials and is now being tested in combination with immune checkpoint blockade. Combination therapies offer the best chance of disease control; however, the design of successful combination strategies requires a deeper understanding of the mechanisms underpinning CVA21 efficacy, in particular, the role of CVA21 anti-tumor immunity. Therefore, this study aimed to examine the ability of CVA21 to induce human anti-tumor immunity, and identify the cellular mechanism responsible. Methods: This study utilized peripheral blood mononuclear cells from i) healthy donors, ii) Acute Myeloid Leukemia (AML) patients, and iii) patients taking part in the STORM clinical trial, who received intravenous CVA21; patients receiving intravenous CVA21 were consented separately in accordance with local institutional ethics review and approval. Collectively, these blood samples were used to characterize the development of innate and adaptive anti-tumor immune responses following CVA21 treatment. Results: An Initial characterization of peripheral blood mononuclear cells, collected from cancer patients following intravenous infusion of CVA21, confirmed that CVA21 activated immune effector cells in patients. Next, using hematological disease models which were sensitive (Multiple Myeloma; MM) or resistant (AML) to CVA21-direct oncolysis, we demonstrated that CVA21 stimulated potent anti-tumor immune responses, including: 1) cytokine-mediated bystander killing; 2) enhanced natural killer cell-mediated cellular cytotoxicity; and 3) priming of tumor-specific cytotoxic T lymphocytes, with specificity towards known tumor-associated antigens. Importantly, immune-mediated killing of both MM and AML, despite AML cells being resistant to CVA21-direct oncolysis, was observed. Upon further examination of the cellular mechanisms responsible for CVA21-induced anti-tumor immunity we have identified the importance of type I IFN for NK cell activation, and demonstrated that both ICAM-1 and plasmacytoid dendritic cells were key mediators of this response. Conclusion: This work supports the development of CVA21 as an immunotherapeutic agent for the treatment of both AML and MM. Additionally, the data presented provides an important insight into the mechanisms of CVA21-mediated immunotherapy to aid the development of clinical biomarkers to predict response and rationalize future drug combinations

“F*ck it! Let’s get to drinking – poison our livers!”: a thematic analysis of alcohol content in contemporary YouTube music videos

Purpose: To describe the portrayal of alcohol content in popular YouTube music videos. Methods: We used inductive thematic analysis to explore the lyrics and visual imagery in 49 UK Top 40 songs and music videos previously found to contain alcohol content, and watched by many British adolescents aged between 11-18 years, and to examine if branded content contravened alcohol industry advertising codes of practice. Results: The analysis generated three themes. First, alcohol content was associated with sexualised imagery or lyrics and the objectification of women. Second, alcohol was associated with image, lifestyle and sociability. Finally, some videos showed alcohol overtly encouraging excessive drinking and drunkenness, including those containing branding, with no negative consequences to the drinker. Conclusion: Our results suggest that YouTube music videos promote positive associations with alcohol use. Further, several alcohol companies adopt marketing strategies in the video medium that are entirely inconsistent with their own or others agreed advertising codes of practice. We conclude that, as a harm reduction measure, policies should change to prevent adolescent exposure to the positive promotion of alcohol and alcohol branding in music videos