Proceedings of a Joint Meeting held between The Norwegian Society of Infectious Diseases and the Royal Society of Tropical Medicine and Hygiene, Oslo, 20th June 2008

The Royal Society of Tropical Medicine and Hygiene (RSTMH) has a tradition of holding joint meetings with fellow European Societies, providing opportunities to facilitate discussion, exchange information, foster mutual interests and develop collaboration between the societies’ members and fellows. This paper presents the proceedings from a scientific meeting that was held between The RSTMH and the Norwegian Infectious Diseases Society at Ulleval University Hospital, Oslo on 20th June 2008. Three speakers from each society gave state-of-the-art lectures in their areas of expertise and the meeting ended with a series of case presentations

Spatial compression impairs prism adaptation in healthy individuals

Neglect patients typically present with gross inattention to one side of space following damage to the contralateral hemisphere. While prism-adaptation (PA) is effective in ameliorating some neglect behaviors, the mechanisms involved and their relationship to neglect remain unclear. Recent studies have shown that conscious strategic control (SC) processes in PA may be impaired in neglect patients, who are also reported to show extraordinarily long aftereffects compared to healthy participants. Determining the underlying cause of these effects may be the key to understanding therapeutic benefits. Alternative accounts suggest that reduced SC might result from a failure to detect prism-induced reaching errors properly either because (a) the size of the error is underestimated in compressed visual space or (b) pathologically increased error-detection thresholds reduce the requirement for error correction. The purpose of this study was to model these two alternatives in healthy participants and to examine whether SC and subsequent aftereffects were abnormal compared to standard PA. Each participant completed three PA procedures within a MIRAGE mediated reality environment with direction errors recorded before, during and after adaptation. During PA, visual feedback of the reach could be compressed, perturbed by noise, or represented veridically. Compressed visual space significantly reduced SC and aftereffects compared to control and noise conditions. These results support recent observations in neglect patients, suggesting that a distortion of spatial representation may successfully model neglect and explain neglect performance while adapting to prisms

Spatial compression impairs prism adaptation in healthy individuals

Neglect patients typically present with gross inattention to one side of space following damage to the contralateral hemisphere. While prism-adaptation (PA) is effective in ameliorating some neglect behaviors, the mechanisms involved and their relationship to neglect remain unclear. Recent studies have shown that conscious strategic control (SC) processes in PA may be impaired in neglect patients, who are also reported to show extraordinarily long aftereffects compared to healthy participants. Determining the underlying cause of these effects may be the key to understanding therapeutic benefits. Alternative accounts suggest that reduced SC might result from a failure to detect prism-induced reaching errors properly either because (a) the size of the error is underestimated in compressed visual space or (b) pathologically increased error-detection thresholds reduce the requirement for error correction. The purpose of this study was to model these two alternatives in healthy participants and to examine whether SC and subsequent aftereffects were abnormal compared to standard PA. Each participant completed three PA procedures within a MIRAGE mediated reality environment with direction errors recorded before, during and after adaptation. During PA, visual feedback of the reach could be compressed, perturbed by noise, or represented veridically. Compressed visual space significantly reduced SC and aftereffects compared to control and noise conditions. These results support recent observations in neglect patients, suggesting that a distortion of spatial representation may successfully model neglect and explain neglect performance while adapting to prisms

The Atomic-Scale Structure of Amorphous Hydrogenated Carbon

The structure of a common batch of amorphous hydrogenated carbon samples (a-C:H) has been studied in detail using time of flight neutron diffraction, inelastic neutron scattering, NMR and molecular dynamics (MD) simulation. Supplementary work has included differential scanning calorimetry (DSC), infrared (1R) spectroscopy and combustion analysis. A summary of the results is presented as evidence for a new structural model for a-C:H

Tailoring consent to context: designing an appropriate consent process for a biomedical study in a low income setting

Background Currently there is increasing recognition of the need for research in developing countries where disease burden is high. Understanding the role of local factors is important for undertaking ethical research in developing countries. We explored factors relating to information and communication during the process of informed consent, and the approach that should be followed for gaining consent. The study was conducted prior to a family-based genetic study among people with podoconiosis (non-filarial elephantiasis) in southern Ethiopia. Methodology/Principal Findings We adapted a method of rapid assessment validated in The Gambia. The methodology was entirely qualitative, involving focus-group discussions and in-depth interviews. Discussions were conducted with podoconiosis patients and non-patients in the community, fieldworkers, researchers, staff of the local non-governmental organisation (NGO) working on prevention and treatment of podoconiosis, and community leaders. We found that the extent of use of everyday language, the degree to which expectations of potential participants were addressed, and the techniques of presentation of information had considerable impact on comprehension of information provided about research. Approaching podoconiosis patients via locally trusted individuals and preceding individual consent with community sensitization were considered the optimal means of communication. Prevailing poverty among podoconiosis patients, the absence of alternative treatment facilities, and participants' trust in the local NGO were identified as potential barriers for obtaining genuine informed consent. Conclusions Researchers should evaluate the effectiveness of consent processes in providing appropriate information in a comprehensible manner and in supporting voluntary decision-making on a study-by-study basis

An atomic scale comparison of the reaction of Bioglass® in two types of simulated body fluid

A class of melt quenched silicate glasses, containing calcium, phosphorus and alkali metals, and having the ability to promote bone regeneration and to fuse to living bone, is produced commercially as Bioglass. The changes in structure associated with reacting the bioglass with a body fluid simulant (a buffered Tris(hydroxymethyl)aminomethane growth medium solution or a blood plasma-like salt simulated body fluid) at 37°C have been studied using both high energy and grazing incidence x-ray diffraction. This has corroborated the generic conclusions of earlier studies based on the use of calcia–silica sol-gel glasses whilst highlighting the important differences associated with glass composition; the results also reveal the more subtle effects on reaction rates of the choice of body fluid simulant. The results also indicate the presence of tricalcium phosphate crystallites deposited onto the surface of the glass as a precursor to the growth of hydroxyapatite, and indicates that there is some preferred orientation to their growth

Impact of social stigma on the process of obtaining informed consent for genetic research on podoconiosis: a qualitative study

Background The consent process for a genetic study is challenging when the research is conducted in a group stigmatized because of beliefs that the disease is familial. Podoconiosis, also known as 'mossy foot', is an example of such a disease. It is a condition resulting in swelling of the lower legs among people exposed to red clay soil. It is a very stigmatizing problem in endemic areas of Ethiopia because of the widely held opinion that the disease runs in families and is untreatable. The aim of this study was to explore the impact of social stigma on the process of obtaining consent for a study on the genetics of podoconiosis in Southern Ethiopia. Methods We adapted a rapid assessment tool validated in The Gambia. The methodology was qualitative involving focus-group discussions (n = 4) and in-depth interviews (n = 25) with community members, fieldworkers, researchers and staff of the Mossy Foot Treatment and Prevention Association (MFTPA) working on prevention and treatment of podoconiosis. Results We found that patients were afraid of participation in a genetic study for fear the study might aggravate stigmatization by publicizing the familial nature of the disease. The MFTPA was also concerned that discussion about the familial nature of podoconiosis would disappoint patients and would threaten the trust they have in the organization. In addition, participants of the rapid assessment stressed that the genetic study should be approved at family level before prospective participants are approached for consent. Based on this feedback, we developed and implemented a consent process involving community consensus and education of fieldworkers, community members and health workers. In addition, we utilized the experience and established trust of the MFTPA to diminish the perceived risk. Conclusion The study showed that the consent process developed based on issues highlighted in the rapid assessment facilitated recruitment of participants and increased their confidence that the genetic research would not fuel stigma. Therefore, investigators must seek to assess and address risks of research from prospective participants' perspectives. This involves understanding the issues in the society, the culture, community dialogues and developing a consent process that takes all these into consideration

The role of the A C395 IFNGR1 mutation in determining susceptibility to intracellular infection in Malta

Background: The first human mycobacterial susceptibility gene was identified amongst four children on the island of Malta in 1995. All affected children were homozygous for a nonsense mutation at position 395 of the interferon gamma receptor 1 (IFNGR1) gene, and all but one died of overwhelming mycobacterial infection. The population of Malta has high rates of infection with intracellular pathogens; leishmania, brucellosis and tuberculosis are all endemic, while leprosy, which was previously endemic, has only recently been eradicated. We hypothesised that heterozygous carriers of the IFNGR1 gene mutation, while resistant to infection with poorly pathogenic organisms, may have increased susceptibility to infection with more virulent pathogens. Methodology and Result: Screening patients with a past history of intracellular infection and healthy newborns for the presence of the IFNGR1 A->C395 mutation, using sequence specific primer PCR, did not identify any carriers of the mutation. Conclusion: These results suggest that the IFNGR1 mutation is unlikely to be of public health significance on Malta.peer-reviewe

Prediction of HLA class II alleles using SNPs in an African population

BACKGROUND: Despite the importance of the human leukocyte antigen (HLA) gene locus in research and clinical practice, direct HLA typing is laborious and expensive. Furthermore, the analysis requires specialized software and expertise which are unavailable in most developing country settings. Recently, in silico methods have been developed for predicting HLA alleles using single nucleotide polymorphisms (SNPs). However, the utility of these methods in African populations has not been systematically evaluated. METHODOLOGY/PRINCIPAL FINDINGS: In the present study, we investigate prediction of HLA class II (HLA-DRB1 and HLA-DQB1) alleles using SNPs in the Wolaita population, southern Ethiopia. The subjects comprised 297 Ethiopians with genome-wide SNP data, of whom 188 had also been HLA typed and were used for training and testing the model. The 109 subjects with SNP data alone were used for empirical prediction using the multi-allelic gene prediction method. We evaluated accuracy of the prediction, agreement between predicted and HLA typed alleles, and discriminative ability of the prediction probability supplied by the model. We found that the model predicted intermediate (two-digit) resolution for HLA-DRB1 and HLA-DQB1 alleles at accuracy levels of 96% and 87%, respectively. All measures of performance showed high accuracy and reliability for prediction. The distribution of the majority of HLA alleles in the study was similar to that previously reported for the Oromo and Amhara ethnic groups from Ethiopia. CONCLUSIONS/SIGNIFICANCE: We demonstrate that HLA class II alleles can be predicted from SNP genotype data with a high level of accuracy at intermediate (two-digit) resolution in an African population. This finding offers new opportunities for HLA studies of disease epidemiology and population genetics in developing countrie

Renfrew Close Rain Gardens – Year two monitoring and project evaluation report, May 2017.

The Renfrew Close rain gardens are a community scale, sustainable drainage (SuDs) scheme, in the London Borough of Newham. This was the first large scale retrofit of a raingarden in the borough and was implemented through a partnership consisting of the Environment Agency, the London Borough of Newham, Groundwork London and Thames Water. The Sustainability Research institute at UEL has monitored the hydrological performance of the rain gardens over two years. The report presents results obtained from the second year of monitoring, covering the period of April 2015 – March 2017, and comments on the basin performance and lessons learned over the two years