Accuracy of Malaria Rapid Diagnostic Tests in Community Studies and their Impact on Treatment of Malaria in an Area with Declining Malaria Burden in North-Eastern Tanzania.

Despite some problems related to accuracy and applicability of malaria rapid diagnostic tests (RDTs), they are currently the best option in areas with limited laboratory services for improving case management through parasitological diagnosis and reducing over-treatment. This study was conducted in areas with declining malaria burden to assess; 1) the accuracy of RDTs when used at different community settings, 2) the impact of using RDTs on anti-malarial dispensing by community-owned resource persons (CORPs) and 3) adherence of CORPs to treatment guidelines by providing treatment based on RDT results. Data were obtained from: 1) a longitudinal study of passive case detection of fevers using CORPs in six villages in Korogwe; and 2) cross-sectional surveys (CSS) in six villages of Korogwe and Muheza districts, north-eastern, Tanzania. Performance of RDTs was compared with microscopy as a gold standard, and factors affecting their accuracy were explored using a multivariate logistic regression model. Overall sensitivity and specificity of RDTs in the longitudinal study (of 23,793 febrile cases; 18,154 with microscopy and RDTs results) were 88.6% and 88.2%, respectively. In the CSS, the sensitivity was significantly lower (63.4%; χ2=367.7, p<0.001), while the specificity was significantly higher (94.3%; χ2=143.1, p<0.001) when compared to the longitudinal study. As determinants of sensitivity of RDTs in both studies, parasite density of<200 asexual parasites/μl was significantly associated with high risk of false negative RDTs (OR≥16.60, p<0.001), while the risk of false negative test was significantly lower among cases with fever (axillary temperature ≥37.5 °C) (OR≤0.63, p≤0.027). The risk of false positive RDT (as a determinant of specificity) was significantly higher in cases with fever compared to afebrile cases (OR≥2.40, p<0.001). Using RDTs reduced anti-malarials dispensing from 98.9% to 32.1% in cases aged ≥5 years. Although RDTs had low sensitivity and specificity, which varied widely depending on fever and parasite density, using RDTs reduced over-treatment with anti-malarials significantly. Thus, with declining malaria prevalence, RDTs will potentially identify majority of febrile cases with parasites and lead to improved management of malaria and non-malaria fevers

Future directions in international financial integration research. A crowdsourced perspective

This paper is the result of a crowdsourced effort to surface perspectives on the present and future direction of international finance. The authors are researchers in financial economics who attended the INFINITI 2017 conference in the University of Valencia in June 2017 and who participated in the crowdsourcing via the Overleaf platform. This paper highlights the actual state of scientific knowledge in a multitude of fields in finance and proposes different directions for future research

FOXO Regulates Organ-Specific Phenotypic Plasticity In Drosophila

Phenotypic plasticity, the ability for a single genotype to generate different phenotypes in response to environmental conditions, is biologically ubiquitous, and yet almost nothing is known of the developmental mechanisms that regulate the extent of a plastic response. In particular, it is unclear why some traits or individuals are highly sensitive to an environmental variable while other traits or individuals are less so. Here we elucidate the developmental mechanisms that regulate the expression of a particularly important form of phenotypic plasticity: the effect of developmental nutrition on organ size. In all animals, developmental nutrition is signaled to growing organs via the insulin-signaling pathway. Drosophila organs differ in their size response to developmental nutrition and this reflects differences in organ-specific insulin-sensitivity. We show that this variation in insulin-sensitivity is regulated at the level of the forkhead transcription factor FOXO, a negative growth regulator that is activated when nutrition and insulin signaling are low. Individual organs appear to attenuate growth suppression in response to low nutrition through an organ-specific reduction in FOXO expression, thereby reducing their nutritional plasticity. We show that FOXO expression is necessary to maintain organ-specific differences in nutritional-plasticity and insulin-sensitivity, while organ-autonomous changes in FOXO expression are sufficient to autonomously alter an organ's nutritional-plasticity and insulin-sensitivity. These data identify a gene (FOXO) that modulates a plastic response through variation in its expression. FOXO is recognized as a key player in the response of size, immunity, and longevity to changes in developmental nutrition, stress, and oxygen levels. FOXO may therefore act as a more general regulator of plasticity. These data indicate that the extent of phenotypic plasticity may be modified by changes in the expression of genes involved in signaling environmental information to developmental processes

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Synthesis, co-ordination chemistry and crystallographic studies of somebis(aminophosphines)

1,2-Bis(diphenylphosphinoamino)benzene 1 and 3,4-bis(diphenylphosphinoamino)toluene 2 have been prepared; 1 is oxidised by sulfur or selenium to C6H4(NHPPh2S)(2)-1,2 3 and C6H4(NHPPh2Se)(2)-1,2 4 and by sulfur and selenium to C6H4(NHPPh2S)(NHPPh2Se)-1,2 5. The napthalene compounds C10H6(NHPPh2S)(2)-1,8 6, C10H6(NHPPh2Se)(2)-1,8 7, C10H6(NHPPh2S)(NHPPh2Se)-1,8 8 and the ethane compound C2H4(NHPPh2S)(2)-1,2 9 have also been prepared. The co-ordination of 2 to Mo-0, Pd-II, Pt-II and Au-I, i.e. in cis-[Mo(CO)(4)L], cis-[MCl2L] (M = Pd or Pt) and [(AuCl)(2)L] [L = MeC6H3(NHPPh2)(2)-3,4] is also described. The crystals structures of representative examples have been determined.</p

Translated Evidence-Based Mental Health Toolkit for Skilled Nursing Facilities

More than 500,000 adults with a serious mental illness (SMI) receive long term care (LTC) in a skilled nursing facility (SNF) (Grabowski, Aschbrenner, Feng, & Mor, 2009). Residents who live in SNFs may experience limited access to meaningful occupations. The SNFs’ institutionalized structure may perpetuate a lack of autonomy and stigma for residents with a SMI (Sullivan & Williams, 2017). Occupational therapy (OT) services provided in a SNF are often limited to therapeutic exercises, therapeutic activities, and activities of daily living skills (Rafeedie, Metzler, & Lamb, 2018). OT practitioners are not utilizing mental health interventions. Although SNFs are not traditionally considered a primary mental health setting, increased numbers of residents with SMI (527 U.S. 581, 1999) have resulted in a need for OT practitioners to redefine their role in the SNF to include mental health interventions. Utilizing effective approaches that consider the residents’ needs and preferences, while accommodating for the rigidity of the SNF environment can improve mental health (Choi, Ransom, Wyllie, 2008). Therefore, this project includes evidence-based mental health assessments and interventions using the recovery approach as a guideline to best practice (Noyes & Lannigan, 2019). Evidence-based assessments and interventions were organized into a toolkit for OT practitioners to use in a SNF and address the needs of the residents with a SMI. The toolkit was presented in a workshop for OT practitioners working in SNFs. The goal of the project is to provide evidence-based tools for OT practitioners to utilize as part of their mental health interventions in SNFs

Translated Evidence Based Mental Health Interventions for Adults with Serious Mental Illness

During the residents’ stay in a long term care (LTC) facility, the resident lacks access to meaningful occupations. Living in a LTC facility presents a number of difficulties related to the institutionalized environment that may result in the loss of their old lifestyle (Sullivan & Williams, 2017). Thus the LTC environment impacts routines and meaningful occupations for the residents in a SNF. The institutionalized structure within a SNF may perpetuate a lack of autonomy and stigma for residents with a SMI (Choi, Ransom, Wyllie, 2008; Sullivan & Williams, 2017). Furthermore based on the literature, the OT practitioners’ role in a SNF focuses on areas such as activities of daily living skills and fall prevention (Rafeedie, Metzler, & Lamb, 2018). OT practitioners can redefine their role in the SNF to include mental health interventions. The Practice Guidelines for Adults with SMI (2012) outlines best practice using the recovery approach. Finding effective approaches that considers the residents’ preferences while acknowledging the rigidity in the institutional environment in a SNF can improve mental health care (Choi, Ransom, Wyllie, 2008). Therefore, this project will identify and select the most current evidence-based mental health assessments and interventions using the PEO model and recovery approach as a guideline (Brown, 2012; SAMHSA, 2013). The findings will be synthesized into a toolkit for OT practitioners to use in the context of a SNF and address the needs of the residents with a SMI. The toolkit consists of the Canadian Occupational Performance Measure, Modified Interest Checklists, Wellness Recovery Action Plan, Goal Attainment Scale, and suggestions for Life Skill groups. The goal of the project is to contribute to the OT field by providing a foundation for other OT practitioners, who can continue utilizing mental health interventions in settings that do not primarily address mental health

Synthesis and coordination chemistry of RC(E)NHPPh2 (E = O or S; R = H2N, Ph, or Py): X-ray structure of [Pt{H2NC(S)NHPPh2}2] 2Cl 0.5MeOH

H2NC(S)NHPPh2 1, H2NC(O)NHPPh2, PhC(O)NHPPh2 2, and (C5H4N)C(O)NHPPh2 3 were prepared from reaction of PPh2Cl with thiourea, urea, benzamide, and nicotinamide, respectively. Compound 1 reacts readily with [PtCl2(COD)] to form [Pt{H2NC(S)NHPPh2}(2)](2+) 2Cl(-)0.5MeOH 4. X-ray crystallography of 4 revealed the platinum atom is coordinated through sulphur and phosphorus atoms forming two five-membered rings which consist of five different atoms in a planar conformation ie. 4 can be classed as a 'true' heterocycle. 4 adopts a hydrogen bonded structure using all of the available N-H protons and the chloride counterions to form a sheetlike array with the phenyl rings of the phosphorus centres lying above and below the 'sheets'. (C) 1999 Elsevier Science Ltd. All rights reserved.</p