Giant urinary bladder calculus: Case report

A vertical calculus weighing more than 100 g is categorised as a giant urinary bladder stone. Giant urinary bladder stones are very rare and very few cases have been reported in English literature and only one case from Africa. This is a case report of a patient with a giant urinary bladder calculus presenting as a rectal tumour. The stone was removed by open cystolithotomy. Possible etiological factors and imaging modalities are discussed

Genetic characterization of influenza A(H3N2) viruses circulating in coastal Kenya, 2009-2017

Background Influenza viruses evolve rapidly and undergo immune driven selection, especially in the hemagglutinin (HA) protein. We report amino acid changes affecting antigenic epitopes and receptor‐binding sites of A(H3N2) viruses circulating in Kilifi, Kenya, from 2009 to 2017. Methods Next‐generation sequencing (NGS) was used to generate A(H3N2) virus genomic data from influenza‐positive specimens collected from hospital admissions and health facility outpatients presenting with acute respiratory illness to health facilities within the Kilifi Health and Demographic Surveillance System. Full‐length HA sequences were utilized to characterize A(H3N2) virus genetic and antigenic changes. Results From 186 (90 inpatient and 96 outpatient) influenza A virus‐positive specimens processed, 101 A(H3N2) virus whole genomes were obtained. Among viruses identified in inpatient specimens from 2009 to 2015, divergence of circulating A(H3N2) viruses from the vaccine strains A/Perth/16/2009, A/Texas/50/2012, and A/Switzerland/9715293/2013 formed 6 genetic clades (A/Victoria/208/2009‐like, 3B, 3C, 3C.2a, 4, and 7). Among viruses identified in outpatient specimens from 2015 to 2017, divergence of circulating A(H3N2) viruses from vaccine strain A/Hong Kong/4801/2014 formed clade 3C.2a, subclades 3C.2a2 and 3C.2a3, and subgroup 3C.2a1b. Several amino acid substitutions were associated with the continued genetic evolution of A(H3N2) strains in circulation. Conclusions Our results suggest continuing evolution of currently circulating A(H3N2) viruses in Kilifi, coastal Kenya and suggest the need for continuous genetic and antigenic viral surveillance of circulating seasonal influenza viruses with broad geographic representation to facilitate prompt and efficient selection of influenza strains for inclusion in future influenza vaccines

Aboveground Net Primary Productivity in Grazed and Ungrazed pastures: Grazing Optimisation Hypothesis or Local Extinction of Vegetation Species

The controversy that has surrounded herbivory studies in the last few decades prompted our investigation to establish the extent to which herbivore optimisation hypothesis or compensatory growth evidence is real. We used the traditional movable cage method to collect primary productivity data on herbage, functional groups and key individual grass species in various controlled large herbivore treatments in an east African savanna. The herbivore treatments in triplicate blocks included cattle, wild herbivores with and without mega herbivores and combinations of cattle and wild herbivores also with and without mega herbivores. The findings revealed that at herbage level, most grazed treatments (four out of five) had higher productivity than the ungrazed control and three showed grazing optimisation curve at sixth polynomial degree between monthly productivity and grazing intensity (1-g/ng). At functional group level forbs productivity was higher in the ungrazed control than in any of the grazed treatments while at individual grass species level _Themeda triandra_ productivity was higher in all grazed treatments than in ungrazed control. We conclude against presence of herbivore optimisation hypothesis at herbage, functional group and species level because of lack of attributable grazing effect in grazed treatments that matches complex ecological effects in the ungrazed treatment

College-aged women in the United States that play overhand throwing sports have masculine digit ratios

Athletic prowess in both males and females is negatively correlated with the ratio between the lengths of the second and fourth fingers (2D:4D), a correlate of prenatal testosterone exposure. Because multiple lines of evidence suggest that prenatal testosterone exposure is associated with sports interest, motivation, and athletic performance we measured the digit ratios of 77 non-athletes, 103 varsity athletes, and 78 club sport athletes to test 8 hypotheses about the relationship between digit ratio and the athletic behavior of collegeage women in the USA. Using independent samples t-tests, we found no significant differences between the digit ratios of women that (1) were athletes and non-athletes, (2) were varsity or club sport athletes, (3) had played or were currently playing individual or team sports, (4) played contact and non-contact sports, (5) played sports involving a ball and those that do not, (6) played sports where the outcome was determined by a score or the outcome of direct physical competition or subjectively by judges, or (7) were starters or reserves on their teams. However, women that played overhand throwing sports softball and water polo had significantly smaller digit ratios than did women that played other sports. These differences were not due to scaling effects. The independent samples t-test results were supported by subsequent Monte Carlo bootstrap, Bayesian, Random Forest, and multiple linear regression analyses. We suggest that the organizational consequences of prenatal testosterone exposure may influence the anatomy and physiology of women that leads to success playing overhand throwing sports

Supercluster states and phase transitions in aggregation-fragmentation processes

We study the evolution of aggregates triggered by collisions with monomers that either lead to the attachment of monomers or the break-up of aggregates into constituting monomers. Depending on parameters quantifying addition and break-up rates, the system falls into a jammed or a steady state. Supercluster states (SCSs) are very peculiar non-extensive jammed states that also arise in some models. Fluctuations underlie the formation of the SCSs. Conventional tools, such as the van Kampen expansion, apply to small fluctuations. We go beyond the van Kampen expansion and determine a set of critical exponents quantifying SCSs. We observe continuous and discontinuous phase transitions between the states. Our theoretical predictions are in good agreement with numerical results.Comment: 19 pages, 15 figure

A hierarchical, fuzzy inference approach to data filtration and feature prioritization in the connected manufacturing enterprise

In manufacturing, the technology to capture and store large volumes of data developed earlier and faster than corresponding capabilities to analyze, interpret, and apply it. The result for many manufacturers is a collection of unanalyzed data and uncertainty with respect to where to begin. This paper examines big data as both an enabler and a challenge for the connected manufacturing enterprise and presents a framework that sequentially tests and selects independent variables for training applied machine learning models. Unsuitable features are discarded, and each remaining feature receives a crisp numeric output and a linguistic label, both of which are measures of the feature’s suitability. The framework is tested using three datasets employing time series, binary, and continuous input data. Results of filtered models are compared to results obtained by base, unfiltered sets of features using a proposed metric of performance-size ratio. Framework results outperform base feature sets in all tested cases, and the proposed future research will be to implement it in a case study in the electronic assembly manufacture

Human metapneumovirus prevalence and patterns of subgroup persistence identified through surveillance of pediatric pneumonia hospital admissions in coastal Kenya, 2007–2016

Background Human metapneumovirus (HMPV) is an important respiratory pathogen that causes seasonal epidemics of acute respiratory illness and contributes significantly to childhood pneumonia. Current knowledge and understanding on its patterns of spread, prevalence and persistence in communities in low resource settings is limited. Methods We present findings of a molecular-epidemiological analysis of nasal samples from children < 5 years of age admitted with syndromic pneumonia between 2007 and 2016 to Kilifi County Hospital, coastal Kenya. HMPV infection was detected using real-time RT-PCR and positives sequenced in the fusion (F) and attachment (G) genes followed by phylogenetic analysis. The association between disease severity and HMPV subgroup was assessed using Fisher’s exact test. Results Over 10 years, 274/6756 (4.1%) samples screened were HMPV positive. Annual prevalence fluctuated between years ranging 1.2 to 8.7% and lowest in the recent years (2014–2016). HMPV detections were most frequent between October of one year to April of the following year. Genotyping was successful for 205/274 (74.8%) positives revealing clades A2b (41.0%) and A2c (10.7%), and subgroups B1 (23.4%) and B2 (24.9%). The dominance patterns were: clade A2b between 2007 and 11, subgroup B1 between 2012 and 14, and clade A2c in more recent epidemics. Subgroup B2 viruses were present in all the years. Temporal phylogenetic clustering within the subgroups for both local and global sequence data was seen. Subgroups occurring in each epidemic season were comprised of multiple variants. Pneumonia severity did not vary by subgroup (p = 0.264). In both the F and G gene, the sequenced regions were found to be predominantly under purifying selection. Conclusion Subgroup patterns from this rural African setting temporally map with global strain distribution, suggesting a well-mixed global virus transmission pool of HMPV. Persistence in the local community is characterized by repeated introductions of HMPV variants from the global pool. The factors underlying the declining prevalence of HMPV in this population should be investigated

Assessment of knowledge, attitudes and practices of infant feeding in the context of HIV: A case study from western Kenya

Guidelines for infant feeding options among HIV-positive mothers are changing with informative research. Cultural factors, socialisation processes, gender dimensions and socio-economic status within communities should be considered in recommending feasible and sustainable options. The objective of this study was to assess the knowledge, attitudes and practices with regards to infant feeding in the context of HIV. A cross-sectional study was conducted between November 2003 and January 2004. The study was carried out in Kosirai Division, Nandi-North District, in western Kenya. The target population was community members aged 18 - 45 years and key informants aged 18 years and above. Structured questionnaires and in-depth interviews were used to collect data. Multistage and snowball sampling methods were used to identify study participants. Quantitative data were analysed using the SPSS statistical package for social scientists (Version 12). Cross-tabulations were calculated and Pearson’s chi-square test used to test significance of relationships between categorical variables. Recorded qualitative data were transcribed and coded. Themes were developed and integrated. A generation of concepts was used to organise the presentation into summaries, interpretations and text. A total of 385 individuals participated in the survey, 50% of whom were women. There were 30 key informants. Farming was the main source of income but half of the women (49.7%) had no income. Most of the respondents (85.5%) knew of breastfeeding as a route of HIV transmission with sex (p=0.003) and age (p=0.000) being highly associated with this knowledge. Breastfeeding wasthe norm although exclusive breastfeeding was not practised. Cow’s milk, the main breast milk substitute, was reported as being given to infants as early as two weeks. It was the most popular (93.5%) infant feeding option in the context of HIV/AIDS. Heating expressed milk, wet nursing and milk banks were least preferred. Thus, the social, cultural and psychological complexity of infant feeding practices should be taken into account when advocating appropriate infant feeding options. Further research is required to determine the safety of using cow’s milk as an infant feeding option. Community engagement, including education and awareness strategies, specific to the benefits of exclusive breastfeeding as a mechanism to reduce the risk of HIV transmission is urgently needed

The roles of community seed banks in climate change adaption

Although community level seed-saving initiatives have been around for about 30 years, until recently they have received little attention in the scientific literature on climate change adaptation and plant genetic resources. Based on research experiences from various countries, this article argues that community seed banks can enhance the resilience of farmers, in particular of communities and households most affected by climate change. Community seed banks can secure improved access to, and availability of, diverse, locally adapted crops and varieties, and enhance related indigenous knowledge and skills in plant management, including seed selection, treatment, storage, multiplication, and distribution

Predictors of HIV Antiretroviral Treatment Failure among Patients Attending a Semi - Urban HIV Clinic– Kenya, 2012: Can Social Support Help?

Background: HIV antiretroviral treatment [ART] failure increases morbidity and mortality. In Kenya, use of treatment supporter, HIV serostatus disclosure, and support groups are believed to reduce the risk of treatment failure by improving adherence. Methods: We conducted a case-control study to identify factors associated with clinical or immunologic indicators of treatment failures. Cases and controls were adult patients attending a semi-urban HIV clinic who initiated ART at least six months prior to the study. Cases were patients who had a] a decline in CD4 count [below baseline or 30% from highest value since ART initiation] or b] unimproved CD4 counts or c] a World Health Organization [WHO] stage III or IV opportunistic infection. Controls did not meet either immunologic or clinical criteria for treatment failure. Information was obtained through face-to-face interviews medical chart reviews. Results: We enrolled 52 cases and 104 controls. Twenty-eight [53%] cases and 71 [70%] controls were women, and median age was 44 years [range: 38-50 years] among cases and 43 years [range: 38-49 years] among controls. Discontinued ART for 2 weeks or more [adjusted odds ratio [AOR] 8.9, 95% confidence interval [CI] 1.4-57.4] and alcohol use [AOR 7.2, 95% CI 1.1-45.5] were found to significantly increase the risk of ART failure. Compared to men who discontinued ART for less than 2 weeks, women who discontinued ART for less than 2 weeks had reduced risk [AOR 0.4, 95% CI 0.2-0.9] while those who discontinued for two weeks or more had a greater risk [AOR 12.97, 95% CI 1.5-111.8] of developing ART failure. Social support factors were not associated with treatment failure. Conclusions: Discontinuing ART and alcohol use were identified to be modifiable factors associated with clinical or immunologic criteria of ART failure. Interventions with proven efficacy at reducing alcohol use and increasing continuous ART should be implemented.Key words: Antiretroviral treatment failure, HIV, AIDS, adherence, alcohol, Keny