Response of Grape and Wine Phenolic Composition in Vitis vinifera L. cv. Merlot to Variation in Grapevine Water Status

Grape and wine phenolic composition was monitored over two consecutive seasons in Vitis vinifera cv. Merlotfollowing application of irrigation treatments that produced seasonal average stem water potentials rangingbetween -0.7 MPa and -1.4 MPa. Fresh weight of berries was significantly reduced in response to water deficit,primarily due to decreases in pericarp weight. Increases in the concentration of grape anthocyanins andflavonols in response to water deficit were found when expressed per unit grape berry fresh weight. Skin-derivedtannin concentration in grape berries was not affected by the irrigation treatments. The concentration of grapederivedphenolics was monitored during five days of fermentation in a small-lot winemaking experiment. Duringfermentation, the concentration of anthocyanins and flavonols in wine were highest in the non-irrigated and lowfrequency-irrigated treatments, which was reflected in changes in the wine colour of ferments. Finished winesfrom non-irrigated and low frequency irrigated grapevines showed increases in bisulphite-resistant pigmentswhen compared with those irrigated at a high frequency, but differences in phenolic composition were minor.Increases in bisulphite-resistant pigments were associated with increases in vitisin A and polymeric pigmentin the first and second seasons of the study respectively. Ageing of wines for an 18-month period increasedbisulphite-resistant pigments, and treatment differences in wine colour density were enhanced, such thatincreases in both parameters were associated with the non-irrigated and low-frequency-irrigated treatments

Vitamin D status and supplementation in adult patients receiving extracorporeal membrane oxygenation

The prevalence of vitamin D deficiency in critical illness is known to be high and associated with adverse clinical outcomes. Patients receiving extracorporeal membrane oxygenation (ECMO) may be at increased risk of vitamin D deficiency due to high severity of acute illness. Challenges with drug dosing in ECMO patients are recognised due to increased volume of distribution and drug absorption to circuit components. To describe the prevalence of vitamin D deficiency in ECMO patients and the effect of intramuscular dosing of cholecalciferol on levels of vitamin D metabolites, and to compare these data with intensive care unit (ICU) patients not receiving ECMO, two prospective studies were performed sequentially: an observational study of 100 consecutive ICU patients and an interventional study assessing effects of intramuscular cholecalciferol in 50 ICU patients. The subgroup of patients who required ECMO support in each of these studies was analysed and compared to patients who did not receive ECMO. Twenty-four ECMO patients, 12 from the observational study and 12 from the interventional study (who received intramuscular cholecalciferol) were studied-21/24 (88%) ECMO patients were vitamin D deficient at baseline compared to 65/126 (52%) of non-ECMO patients (P=0.006). Of the 12 ECMO patients who received cholecalciferol, six patients (50%) achieved correction of deficiency compared to 36/38 (95%) non-ECMO patients (P=0.001). The prevalence of vitamin D deficiency is higher in ECMO patients compared to other critically ill adults. Correction of deficiency with single dose cholecalciferol is not reliable;higher or repeated doses should be considered to correct deficiency

Implementation of an electronic monitoring and evaluation system for the antiretroviral treatment programme in the Cape Winelands district, South Africa: a qualitative evaluation

BACKGROUND: A pragmatic three-tiered approach to monitor the world's largest antiretroviral treatment (ART) programme was adopted by the South African National Department of Health in 2010. With the rapid expansion of the programme, the limitations of the paper-based register (tier 1) were the catalyst for implementation of the stand-alone electronic register (tier 2), which offers simple digitisation of the paper-based register. This article engages with theory on implementation to identify and contextualise enabling and constraining factors for implementation of the electronic register, to describe experiences and use of the register, and to make recommendations for implementation in similar settings where standardisation of ART monitoring and evaluation has not been achieved. METHODS: We conducted a qualitative evaluation of the roll-out of the register. This comprised twenty in-depth interviews with a diverse sample of stakeholders at facility, sub-district, and district levels of the health system. Facility-level participants were selected across five sub-districts, including one facility per sub-district. Responses were coded and analysed using a thematic approach. An implementation science framework guided interpretation of the data. Results & DISCUSSION: We identified the following seven themes: 1) ease of implementation, 2) perceived value of an electronic M&E system, 3) importance of stakeholder engagement, 4) influence of a data champion, 5) operational and logistical factors, 6) workload and role clarity, and 7) importance of integrating the electronic register with routine facility monitoring and evaluation. Interpreting our findings through an implementation theory enabled us to construct the scaffolding for implementation across the five facility-settings. This approach illustrated that implementation was not a linear process but occurred at two nodes: at the adoption of the register for roll-out, and at implementation at facility-level. CONCLUSION: In this study we found that relative advantage of an intervention and stakeholder engagement are critical to implementation. We suggest that without these aspects of implementation, formative and summative outcomes of implementation at both the adoption and coalface stages of implementation would be negatively affected

Implementation of a performance-grade bitumen specification in South Africa

CITATION: Bredenhann S. J. et al. 2019. Implementation of a performance-grade bitumen specification. Journal of the South African Institution of Civil Engineers, 61(3):20-31. doi:10.17159/2309-8775/2019/v61n3a3The original publication is available at https://saice.org.za/journal/saice-journal-publication-issues/South Africa has been experiencing higher traffic volumes and heavier loads over the past several years. This has been accompanied by an increase in premature asphalt failures. Selection of the appropriate asphalt binder is critical for improving performance. Empirical bitumen testing has increasingly failed to relate test results to pavement performance, as the traffic volume and loading have changed. Moreover, empirical tests cannot effectively characterise polymer-modified bitumens that are increasingly being used in South Africa. This changing environment calls for the establishment of specifications based on fundamental engineering properties which relate to actual pavement performance. This paper discusses the fundamental principles of the performance grade (PG) specification being introduced in South Africa. It explains how these fundamental principles create a rational framework for the specification, and present a clear set of compliance criteria to ensure the optimal selection of bituminous binders. The reasons for transitioning to a PG specification are discussed, along with the basis of the specification, rheological concepts, measurements required to characterise bituminous binders, and the simulation of ageing in relation to durability. The framework of the specification, including test procedures, provisional compliance limits and mandatory reporting of test results as an interim measure, are discussed in this paper. Finally, some test results received to date for selected typical South African binders are reported and evaluated. These results indicate that current binders being used in South Africa can easily conform to the proposed PG specification in terms of deformation requirements without any disruption to the processes of the refineries or secondary manufacturers. The fatigue properties of binders are still under evaluation and thus not included in the specification framework. Only information gathered will inform the final decision.https://saice.org.za/journal/saice-journal-publication-issues/Publisher’s versio

Inhibitor of serine peptidase 2 enhances Leishmania major survival in the skin through control of monocytes and monocyte-derived cells

Leishmania major is the causative agent of the neglected tropical disease, cutaneous leishmaniasis. In the mouse, protective immunity to Leishmania is associated with inflammatory responses. Here, we assess the dynamics of the inflammatory responses at the lesion site during experimental long-term, low-dose intradermal infection of the ear, employing noninvasive imaging and genetically modified L. major Significant infiltrates of neutrophils and monocytes occurred at 1-4 d and 2-4 wk, whereas dermal macrophage and dendritic cell (DC) numbers were only slightly elevated in the first days. Quantitative whole-body bioluminescence imaging of myeloperoxidase activity and the quantification of parasite loads indicated that the Leishmania virulence factor, inhibitor of serine peptidase 2 (ISP2), is required to modulate phagocyte activation and is important for parasite survival at the infection site. ISP2 played a role in the control of monocyte, monocyte-derived macrophage, and monocyte-derived DC (moDC) influx, and was required to reduce iNOS expression in monocytes, monocyte-derived cells, and dermal DCs; the expression of CD80 in moDCs; and levels of IFN-γ in situ. Our findings indicate that the increased survival of L. major in the dermis during acute infection is associated with the down-regulation of inflammatory monocytes and monocyte-derived cells via ISP2.-Goundry, A., Romano, A., Lima, A. P. C. A., Mottram, J. C., Myburgh, E. Inhibitor of serine peptidase 2 enhances Leishmania major survival in the skin through control of monocytes and monocyte-derived cells

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.

OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012." DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development. METHODS: The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable. RESULTS: The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations, and 18 were best-practice statements. No recommendation was provided for four questions. CONCLUSIONS: Substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality

COSMIC: An Ethernet-based Commensal, Multimode Digital Backend on the Karl G. Jansky Very Large Array for the Search for Extraterrestrial Intelligence

The primary goal of the search for extraterrestrial intelligence (SETI) is to gain an understanding of the prevalence of technologically advanced beings (organic or inorganic) in the Galaxy. One way to approach this is to look for technosignatures: remotely detectable indicators of technology, such as temporal or spectral electromagnetic emissions consistent with an artificial source. With the new Commensal Open-Source Multimode Interferometer Cluster (COSMIC) digital backend on the Karl G. Jansky Very Large Array (VLA), we aim to conduct a search for technosignatures that is significantly more comprehensive, more sensitive, and more efficient than previously attempted. The COSMIC system is currently operational on the VLA, recording data, and designed with the flexibility to provide user-requested modes. This paper describes the hardware system design, the current software pipeline, and plans for future development.Comment: 30 pages, 17 figures. Accepted for publication in A

Lessons for TB from the COVID-19 response: qualitative data from Brazil, India and South Africa

BACKGROUND: Brazil, India and South Africa are among the top 30 high TB burden countries globally and experienced high rates of SARS-CoV-2 infection and mortality. The COVID-19 response in each country was unprecedented and complex, informed by distinct political, economic, social and health systems contexts. While COVID-19 responses have set back TB control efforts, they also hold lessons to inform future TB programming and services. METHODS: This was a qualitative exploratory study involving interviews with TB stakeholders (n = 76) in Brazil, India and South Africa 2 years into the COVID-19 pandemic. Interview transcripts were analysed using an inductive coding strategy. RESULTS: Political will – whether national or subnational – enabled implementation of widespread prevention measures during the COVID-19 response in each country and stimulated mobile and telehealth service delivery innovations. Participants in all three countries emphasised the importance of mobilising and engaging communities in public health responses and noted limited health education and information as barriers to implementing TB control efforts at the community level. CONCLUSIONS: Building political will and social mobilisation must become more central to TB programming. COVID-19 has shown this is possible. A similar level of investment and collaborative effort, if not greater, as that seen during the COVID-19 pandemic is needed for TB through multi-sectoral partnerships