Diagnosis of enteric fever in the emergency department: a retrospective study from Pakistan

Background:Enteric fever is one of the top differential diagnoses of fever in many parts of the world. Generally, the diagnosis is suspected and treatment is initiated based on clinical and basic laboratory parameters.Aims: The present study identifies the clinical and laboratory parameters predicting enteric fever in Patients visiting the emergency department of a tertiary care hospital in Pakistan.Methods:This is a retrospective chart review of all adult Patients with clinically suspected enteric fever admitted to the hospital through the emergency department during a 5-year period (2000-2005).Results:A total of 421 emergency department Patients were admitted to the hospital with suspected enteric fever. There were 53 cases of blood culture-positive enteric fever and 296 disease-negative cases on culture. The mean age in the blood culture-positive group was 27 years (SD: 10) and in the group with negative blood culture for enteric fever, 35 years (SD: 15) with a male to female ratio of 1:0.6 in both groups. Less than half (48%) of all Patients admitted with suspected enteric fever had the discharge diagnosis of enteric fever, of which only 13% of the Patients had blood culture/serologically confirmed enteric fever. None of the common clinical and laboratory parameters differed between enteric fever-positive Patients and those without it.Conclusion:Commonly cited clinical and laboratory parameters were not able to predict enteric fever

Prediction of peptide and protein propensity for amyloid formation

Understanding which peptides and proteins have the potential to undergo amyloid formation and what driving forces are responsible for amyloid-like fiber formation and stabilization remains limited. This is mainly because proteins that can undergo structural changes, which lead to amyloid formation, are quite diverse and share no obvious sequence or structural homology, despite the structural similarity found in the fibrils. To address these issues, a novel approach based on recursive feature selection and feed-forward neural networks was undertaken to identify key features highly correlated with the self-assembly problem. This approach allowed the identification of seven physicochemical and biochemical properties of the amino acids highly associated with the self-assembly of peptides and proteins into amyloid-like fibrils (normalized frequency of β-sheet, normalized frequency of β-sheet from LG, weights for β-sheet at the window position of 1, isoelectric point, atom-based hydrophobic moment, helix termination parameter at position j+1 and ΔGº values for peptides extrapolated in 0 M urea). Moreover, these features enabled the development of a new predictor (available at http://cran.r-project.org/web/packages/appnn/index.html) capable of accurately and reliably predicting the amyloidogenic propensity from the polypeptide sequence alone with a prediction accuracy of 84.9 % against an external validation dataset of sequences with experimental in vitro, evidence of amyloid formation

The population genomics of begomoviruses: global scale population structure and gene flow

<p>Abstract</p> <p>Background</p> <p>The rapidly growing availability of diverse full genome sequences from across the world is increasing the feasibility of studying the large-scale population processes that underly observable pattern of virus diversity. In particular, characterizing the genetic structure of virus populations could potentially reveal much about how factors such as geographical distributions, host ranges and gene flow between populations combine to produce the discontinuous patterns of genetic diversity that we perceive as distinct virus species. Among the richest and most diverse full genome datasets that are available is that for the dicotyledonous plant infecting genus, <it>Begomovirus</it>, in the Family Geminiviridae. The begomoviruses all share the same whitefly vector, are highly recombinogenic and are distributed throughout tropical and subtropical regions where they seriously threaten the food security of the world's poorest people.</p> <p>Results</p> <p>We focus here on using a model-based population genetic approach to identify the genetically distinct sub-populations within the global begomovirus meta-population. We demonstrate the existence of at least seven major sub-populations that can further be sub-divided into as many as thirty four significantly differentiated and genetically cohesive minor sub-populations. Using the population structure framework revealed in the present study, we further explored the extent of gene flow and recombination between genetic populations.</p> <p>Conclusions</p> <p>Although geographical barriers are apparently the most significant underlying cause of the seven major population sub-divisions, within the framework of these sub-divisions, we explore patterns of gene flow to reveal that both host range differences and genetic barriers to recombination have probably been major contributors to the minor population sub-divisions that we have identified. We believe that the global <it>Begomovirus </it>population structure revealed here could facilitate population genetics studies into how central parameters of population genetics namely selection, recombination, mutation, gene flow, and genetic drift shape the global begomovirus diversity.</p

Phase 2 of CATALISE: a multinational and multidisciplinary Delphi consensus study of problems with language development: Terminology

BACKGROUND: Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology. METHODS: The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members. On this basis they can either revise their views or make a case for their position. The statements are then revised based on panel feedback, and again rated by and commented on by the panel. In this study, feedback from a second round was used to prepare a final set of statements in narrative form. The panel included 57 individuals representing a range of professions and nationalities. RESULTS: We achieved at least 78% agreement for 19 of 21 statements within two rounds of ratings. These were collapsed into 12 statements for the final consensus reported here. The term ‘Language Disorder’ is recommended to refer to a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis. The term, ‘Developmental Language Disorder’ (DLD) was endorsed for use when the language disorder was not associated with a known biomedical aetiology. It was also agreed that (a) presence of risk factors (neurobiological or environmental) does not preclude a diagnosis of DLD, (b) DLD can co-occur with other neurodevelopmental disorders (e.g. ADHD) and (c) DLD does not require a mismatch between verbal and nonverbal ability. CONCLUSIONS: This Delphi exercise highlights reasons for disagreements about terminology for language disorders and proposes standard definitions and nomenclature

An investigation into haematological and serum chemistry parameters of rabbits in Trinidad

[EN] Blood samples were collected from a total of 70 rabbits at three locations in Trinidad. The locations were the University Field Station (n=46), the School of Veterinary Medicine (n=11), and the Eastern Caribbean Institute of Agriculture and Forestry (n=13). Complete blood counts and serum chemistry determinations were done for each sample. Values obtained were compared to reference ranges in the literature. The effects of gender, maturity (juveniles vs. adults), breed (New Zealand White vs. Mixed), and rabbitry on all parameters were examined. Mixed rabbits were crossbreds consisting of at least two breeds: New Zealand White, Californian, Checkered Giant. A comparison was made between values for haemoglobin, packed cell volume, mean corpuscular haemoglobin concentration, and white blood cell count, obtained by manual and automated methods. Most values obtained were within the ranges of those in the literature with the exception of urea (5.5?7.0 mmol/L), albumin (50.56?52.98 g/L) and creatine phosphokinase (CPK) (572.70?821.98 U/L). Albumin and CPK concentrations were higher and urea lower (P<0.05) for the present study. Significant differences (P<0.05) between automated and manual values were found for haemoglobin (Hb), packed cell volume (PCV), and mean corpuscular haemoglobin concentration (MCHC), with values for automated methods being higher for Hb and MCHC and lower for PCV. For the leukon, husbandry practices had an effect on neutrophil, eosinophil, basophil, lymphocyte, and platelet values while maturity influenced neutrophil and lymphocyte counts (P<0.05). The automated white blood cell count (WBCa) was affected by breed (P<0.05). In the case of the erythron, husbandry practices affected automated PCV and MCHC values, and red blood cell counts (RBC)(P<0.05). Maturity influenced automated Hb and PCV values, and RBC (P<0.05). Mixed breeds had higher automated Hb, PCV and RBC values than New Zealand White rabbits (P<0.05). Male rabbits had higher values than females for manual and automated Hb, manual and automated PCV, and RBC (P<0.05). For serum chemistry, husbandry practices had an effect on potassium (K), phosphorus (P), creatinine, bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), amylase and calcium (P<0.05). Phosphorus, AST, cholesterol and glucose were higher for juveniles; while chloride was higher for adult rabbits (P<0.05). Only CPK was affected by breed, with the mixed breed having higher values than New Zealand White rabbits (P<0.05). Males had higher values for potassium, total protein, and albumin, while females had higher values for cholesterol (P<0.05). Haematology and serum chemistry reference intervals obtained in this study may therefore be considered useful baseline values for domestic rabbit populations in the Caribbean.Burnett, N.; Mathura, K.; Metivier, K.; Holder, R.; Brown, G.; Campbell, M. (2011). An investigation into haematological and serum chemistry parameters of rabbits in Trinidad. World Rabbit Science. 14(3):175-187. doi:10.4995/wrs.2006.556SWORD17518714

Brain‐derived neurotropic factor polymorphisms, traumatic stress, mild traumatic brain injury, and combat exposure contribute to postdeployment traumatic stress

Abstract Background: In addition to experiencing traumatic events while deployed in a combat environment, there are other factors that contribute to the development of posttraumatic stress disorder (PTSD) in military service members. This study explored the contribution of genetics, childhood environment, prior trauma, psychological, cognitive, and deployment factors to the development of traumatic stress following deployment. Methods: Both pre‐ and postdeployment data on 231 of 458 soldiers were analyzed. Postdeployment assessments occurred within 30 days from returning stateside and included a battery of psychological health, medical history, and demographic questionnaires; neurocognitive tests; and blood serum for the D2 dopamine receptor (DRD2), apolipoprotein E (APOE), and brain‐derived neurotropic factor (BDNF) genes. Results: Soldiers who screened positive for traumatic stress at postdeployment had significantly higher scores in depression (d = 1.91), anxiety (d = 1.61), poor sleep quality (d = 0.92), postconcussion symptoms (d = 2.21), alcohol use (d = 0.63), traumatic life events (d = 0.42), and combat exposure (d = 0.91). BDNF Val66 Met genotype was significantly associated with risk for sustaining a mild traumatic brain injury (mTBI) and screening positive for traumatic stress. Predeployment traumatic stress, greater combat exposure and sustaining an mTBI while deployed, and the BDNF Met/Met genotype accounted for 22% of the variance of postdeployment PTSD scores (R 2 = 0.22, P < 0.001). However, predeployment traumatic stress, alone, accounted for 17% of the postdeployment PTSD scores. Conclusion: These findings suggest predeployment traumatic stress, genetic, and environmental factors have unique contributions to the development of combat‐related traumatic stress in military service members