Infant feeding practices in a high HIV prevalence rural district of KwaZulu-Natal, South Africa

Aim: To describe infant feeding practices at birth and at 14 weeks post-partum in the Ugu-North Health District, KwaZulu-Natal, South Africa.Methods: A prospective, cohort study design was used. Mothers who delivered over a one-month period were interviewed at birth and14 weeks later. Results: Initially, 168 mothers were interviewed within 24 hours of delivery, of whom 117 (70%) were contactable at 14 weeks post-partum. The vast majority (96%) initiated breast-feeding at birth. At birth, less than one-third (55/168 [32.7%]) of mothers declared an intention to both breast and formula (mix) feed in the next 14 weeks, but by the 14th week post-partum over three-quarters (89/117 [76.1%]) actually practised mixed feeding. At 14 weeks, the prevalence of exclusive breast-feeding was 18%: 52% of infants were offered water and 73% solids. The majority (20/23 [87%]) of HIV infected mothers chose to breastfeed their infants at birth. Nevertheless, they were significantly more likely to formula feed their infants compared to HIV negative mothers (3/23 [13.0%] vs 2/145 [1.4%], OR 10.73, 95% CI 1.34 – 99.16, p = 0.02). By 14 weeks, only 11% of HIV positive mothers were still exclusively breast-feeding, while almost two-thirds (12/19 [63%]) practised mixed feeding. This change was mainly ascribed to their need to return to school (40%) or to work (20%). Conclusions: Most infants were fed inappropriately by 14 weeks of age. The failure to maintain exclusive breast-feeding, despite high initiation rates, is of greatest concern. Routine prevention of mother-to-child transmission of HIV services was ineffective in influencing mothers to follow any feeding regimen exclusively

Understanding the role of patient and public involvement in renal dietetic research

The objective was to consult patients on a proposed recruitment strategy to a patient and public involvement exercise. We wanted to explore the reasoning and willingness of patients to become co-researchers within a grant application. Eighteen people using the renal health service informed the consultation by action research so that their experiences could be used to guide the overall methodology. Twelve people took part in semi-structured interviews. NVIVO 10 and Framework Analysis were used to interpret emerging themes from the data. The recruitment strategy, informed by research expertise, became an experience-based expert design. The design took into account the limitations of attendance, the informational and physical needs of these service users. Service users wanted to share their experiences with people who would listen and were in a position to help make the changes. This gave them a sense of purpose and autonomy in their treatment and helped them cope with living with renal disease in society. However, feelings of doubt as to whether they could personally ‘make a difference’ as a co-researcher, were common. Consulting service users enabled the research team to recruit more people to interviews to explore motivation considering the unique personal and social needs of this service user group. Service users may need additional and continued support if they are to successfully take part in a clinical study research advisory group

Thinking Aloud: Stress and Coping in Junior Cricket Batsmen during Challenge and Threat States

The present study examined stress and coping of cricket batsmen during challenge and threat states using the Think-Aloud method. Ten male elite-level junior cricket batsmen took part in the study. A repeated measures design was implemented, with participants verbalizing while both in (a) a threat state and (b) a challenge state. Participants were required to score 36 runs in 30 balls during the threat and challenge conditions. Verbalizations were subsequently transcribed verbatim and analyzed for stressors, coping strategies, and any other reoccurring themes. A paired-samples t-test was conducted to examine differences in the number of verbalizations made for each theme between conditions. Ten secondary themes were grouped into four primary themes; these included (a) stressors, (b) problem-focused coping, (c) emotion-focused coping, and (d) gathering information. There were significant differences( p≤0.05) between stressor verbalizations, with significantly more verbalizations made by participants during a threat state. No significant differences were found between any other themes. Thus, during a threat state, participants reported significantly more stressor verbalizations compared to a challenge state, while there were no significant differences in coping strategies reported (p>0.05). This finding offers a potential explanation for why athletic performance diminishes when in a threat state, as athletes then experience a greater number of stressors but do not report engaging in more coping strategies

UBE2QL1 is Disrupted by a Constitutional Translocation Associated with Renal Tumor Predisposition and is a Novel Candidate Renal Tumor Suppressor Gene

Investigation of rare familial forms of renal cell carcinoma (RCC) has led to the identification of genes such as VHL and MET that are also implicated in the pathogenesis of sporadic RCC. In order to identify a novel candidate renal tumor suppressor gene, we characterized the breakpoints of a constitutional balanced translocation, t(5;19)(p15.3;q12), associated with familial RCC and found that a previously uncharacterized gene UBE2QL1 was disrupted by the chromosome 5 breakpoint. UBE2QL1 mRNA expression was downregulated in 78.6% of sporadic RCC and, although no intragenic mutations were detected, gene deletions and promoter region hypermethylation were detected in 17.3% and 20.3%, respectively, of sporadic RCC. Reexpression of UBE2QL1 in a deficient RCC cell line suppressed anchorage-independent growth. UBE2QL1 shows homology to the E2 class of ubiquitin conjugating enzymes and we found that (1) UBE2QL1 possesses an active-site cysteine (C88) that is monoubiquitinated in vivo, and (2) UBE2QL1 interacts with FBXW7 (an F box protein providing substrate recognition to the SCF E3 ubiquitin ligase) and facilitates the degradation of the known FBXW7 targets, CCNE1 and mTOR. These findings suggest UBE2QL1 as a novel candidate renal tumor suppressor gen

Nerve excitability in the rat forelimb: a technique to improve translational utility

Background Nerve excitability testing by threshold-tracking is the only available method to study axonal ion channel function and membrane potential in the clinical setting. The measures are, however, indirect and the interpretation of neuropathic changes remains challenging. The same multiple measures of axonal excitability were adapted to further explore the pathophysiological changes in rodent disease models under pharmacologic and genetic manipulations. These studies are typically limited to the investigation of the “long nerves” such as the tail or the tibial nerves. New method We introduce a novel setup to explore the ulnar nerve excitability in rodents. We provide normative ulnar data in 11 adult female Long Evans rats under anaesthesia by comparison with tibial and caudal nerves. Additionally, these measures were repeated weekly on 3 occasions to determine the repeatability of these tests. Results Nerve excitability assessment of ulnar nerve proved to be a longitudinally repeatable measure of axonal function mature in rats, as were measures in tibial and caudal nerves. Comparison with existing method: Ulnar nerve motor excitability measures were different from the caudal and tibial excitability measures. Most notably, ulnar nerve showed the largest threshold changes during both depolarizing and hyperpolarizing threshold electrotonus. Conclusions Ulnar nerves demonstrate a distinct nerve excitability profile than the caudal and tibial nerves which could have functional and pathological implications

Proposals on Kaplan–Meier plots in medical research and a survey of stakeholder views: KMunicate

OBJECTIVES: To examine reactions to the proposed improvements to standard Kaplan–Meier plots, the standard way to present time-to-event data, and to understand which (if any) facilitated better depiction of (1) the state of patients over time, and (2) uncertainty over time in the estimates of survival. DESIGN: A survey of stakeholders’ opinions on the proposals. SETTING: A web-based survey, open to international participation, for those with an interest in visualisation of time-to-event data. PARTICIPANTS: 1174 people participated in the survey over a 6-week period. Participation was global (although primarily Europe and North America) and represented a wide range of researchers (primarily statisticians and clinicians). MAIN OUTCOME MEASURES: Two outcome measures were of principal importance: (1) participants’ opinions of each proposal compared with a ‘standard’ Kaplan–Meier plot; and (2) participants’ overall ranking of the proposals (including the standard). RESULTS: Most proposals were more popular than the standard Kaplan–Meier plot. The most popular proposals in the two categories, respectively, were an extended table beneath the plot depicting the numbers at risk, censored and having experienced an event at periodic timepoints, and CIs around each Kaplan–Meier curve. CONCLUSION: This study produced a high response number, reflecting the importance of graphics for time-to-event data. Those producing and publishing Kaplan–Meier plots—both authors and journals—should, as a starting point, consider using the combination of the two favoured proposals

Advances in pultiple-pulse radio-frequency-gradient imaging of solids

Magnetic resonance imaging (MRI) has become the premier tool for the non-destructive evaluation of soft tissue in living systems [1]. Established liquid-state MRI strategies are generally found to be inappropriate for the imaging of rigid solids, because the linewidth for nuclear magnetic resonance in solids is orders-of-magnitude larger than in liquids. Methods currently under development for the NMR imaging of solids either involve the use of very large (fringe-field) magnetic field gradients to encode spatial information over very short periods of time [2], or employ multiple-pulse line-narrowing techniques that prolong a solid’s apparent transverse relaxation time [3–7]. In the latter methods, the magnetic field gradients may be much weaker, but must generally be pulsed synchronously with the line-narrowing sequence. The benefits of implementing this are improved sensitivity and spectroscopic resolution

A Study of Archiving Strategies in Multi-Objective PSO for Molecular Docking

Molecular docking is a complex optimization problem aimed at predicting the position of a ligand molecule in the active site of a receptor with the lowest binding energy. This problem can be formulated as a bi-objective optimization problem by minimizing the binding energy and the Root Mean Square Deviation (RMSD) difference in the coordinates of ligands. In this context, the SMPSO multi-objective swarm-intelligence algorithm has shown a remarkable performance. SMPSO is characterized by having an external archive used to store the non-dominated solutions and also as the basis of the leader selection strategy. In this paper, we analyze several SMPSO variants based on different archiving strategies in the scope of a benchmark of molecular docking instances. Our study reveals that the SMPSOhv, which uses an hypervolume contribution based archive, shows the overall best performance.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

“It’s the end of the world as we know it (and I feel fine)” - The use of Rational Emotive Behavior Therapy (REBT) to increase function and reduce irrational beliefs of an injured athlete

In this chapter, we present the case of “Andrew”, an elite male professional rugby union player in his early 20s, who suffered a series of severe knee injuries and experienced a number of negative psychological reactions, including heightened stress and anxiety, as a consequence. Humanistic counseling and REBT, specifically the ABCDE and “badness scale” techniques, were used to change Andrew’s beliefs regarding his injury, from his pre-intervention perceptions – that the injury he had was a catastrophe – to more rational beliefs, emphasizing that it might be bad but it was not “the end of the world”, post-intervention. The second part of the chapter reflects upon the use of REBT in supporting the recovery of injured athletes more generally and how the practitioners’ experience has influenced subsequent delivery of REBT techniques. Specific topics discussed in the chapter include: factors influencing psychological recovery from injury, the methods used in the REBT sessions, and the specific outcomes that resulted from the use of the intervention with Andrew. The practitioners’ reflections on the use of REBT techniques, such as the way they may be used as part of broader injury rehabilitation programs, are also discussed