Tumor necrosis factor alpha antagonist drugs and leishmaniasis in Europe.

Leishmaniasis is endemic in Europe and the prevalence of latent infection in the Mediterranean region is high. Reports describing opportunistic leishmaniasis in European patients treated with tumor necrosis factor (TNF) alpha antagonist drugs are rapidly accumulating. For other granulomatous infections, risk of opportunistic disease varies by mode of TNF-alpha antagonism. This study explores whether this may also be the case for leishmaniasis. We ascertained the relative frequency of exposure to different TNF antagonist drugs among published cases of opportunistic leishmaniasis in Europe and compared this with the prescription of these drugs in Europe. We found that risk of opportunistic leishmaniasis is higher in patients receiving anti-TNF monoclonal antibodies (infliximab or adalimumab) compared with patients treated with the TNF-receptor construct etanercept. Clinicians may want to consider these observations, which suggest that etanercept should be favoured over anti-TNF monoclonal antibodies in individuals living in or visiting areas endemic for leishmaniasis until evidence from prospective research is available. A European adverse event reporting system is required to identify rare opportunistic infections associated with immunosuppressive and immunomodulatory biotherapies

Simulation of distortion due to machining of thin-walled components

The distortion of components is strongly related to the residual stress state induced by manufacturing processes like heat treatment, forming or machining. Each process step affects the initial stress state of the following process step. When removing material during machining, the component establishes a new stress equilibrium. Stresses are redistributed causing the component geometry to adjust. Especially for thin-walled components distortion potential is high. Gaining knowledge about the influence of initial loads and the release of distortion during machining processes helps to increase product quality and efficiency. The influences of different initial stress states and different machining parameters on the amount of distortion are examined using both FEM simulations and experiments. A thin-walled T-profile made of aluminum alloy Al 7075-T6 serves as test specimen. A bending process applies a load to initialize a repeatable and defined residual stress state. A groove was machined afterwards into the plastically deformed work piece to trigger stress redistribution and a release of distortion. Different loads with 35 to 45 kN and two different geometries of a groove were used. The amount of initial stress has a significant effect on the distortion potential which could be quantified in the study. Simulations show the same behavior as the experiments and the results match very well especially for a high load

Import of community-associated, methicillin-resistant Staphylococcus aureus to Europe through skin and soft-tissue infection in intercontinental travellers, 2011-2016

Objectives: Recently, following import by travel and migration, epidemic community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has caused nosocomial outbreaks in Europe, sometimes with a fatal outcome. We describe clinico-epidemiological characteristics of CA-MRSA detected by the European Network for the Surveillance of imported S. aureus (www.staphtrav.eu) from May 2011 to November 2016. Methods: Sentinel surveillance at 13 travel clinics enrolling patients with travel-associated skin and soft-tissue infection (SSTI) and analysing lesion and nose swabs at one central laboratory. Results: A total of 564 independent case-patients with SSTI were enrolled and had 374 (67%) S. aureus-positive lesions, of which 14% (51/374) were MRSA. The majority of CA-MRSA isolates from SSTI were Panton-Valentine leucocidin (PVL)-positive (43/51, 84%). The risk of methicillin-resistance in imported S. aureus varied by travel region (p Conclusions: Travel-associated CA-MRSA SSTI is a transmissible condition that leads to medical consultations and colonization of the infected host. (c) 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Process Combination of VPP-LED and Vacuum Die Casting for Producing Complex Ceramic 3D-MID

Future developments lead to increasing demands on mechatronic integrated devices (MID). Therefore, ceramics have to be used as substrate material and conductor tracks have to be located in the interior of components to be sufficiently protected. A process combination of vat photopolymerization (VPP-LED) and vacuum die casting is investigated for realizing such structures. First, optimized process parameters are derived by studying the filling behavior of straight capillaries. Subsequently, the results are transferred to complex additively manufactured substrates to derive design guidelines

Multiplicity of Plasmodium falciparum infection following intermittent preventive treatment in infants

ABSTRACT: BACKGROUND: Intermittent preventive treatment in infants with sulphadoxine-pyrimethamine (IPTi-SP) reduces malaria morbidity by 20% to 33%. Potentially, however, this intervention may compromise the acquisition of immunity, including the tolerance towards multiple infections with Plasmodium falciparum. METHODS: Plasmodium falciparum isolates were obtained from children participating in two Ghanaian IPTi-SP trials (Tamale, Afigya Sekyere) at 15 months of age, i.e., six months after they had received the second dose of IPTi-SP or placebo. By typing the polymorphic merozoite surface protein 1 (msp1) and msp2 genes, multiplicity of infection (MOI) was assessed in 389 isolates. A total of additional 133 samples were collected in Tamale at 3, 6, 9, and 12 months of age. Comparisons of MOI between groups were done by non-parametric statistical tests. RESULTS: The number of distinguishable P. falciparum clones (MOI) ranged between one and six. Mean MOI in Tamale was stable at 2.13 - 2.17 during the first year of life, and increased to 2.57 at age 15 months (P = 0.01). At no age did MOI differ between the IPTi-SP and placebo groups (each, P [greater than or equal to] 0.5). At 15 months of age, i.e., six months after the second dose, MOI was very similar for children who had received IPTi or placebo (means, 2.25 vs. 2.33; P = 0.55) as was the proportion of polyclonal infections (69.6% vs. 69.7%; P = 0.99). Adjusting for study site, current and prior malaria, parasite density, and season did not change this finding. CONCLUSIONS: IPTi-SP appears to have no impact on the multiplicity of infection during infancy and thereafter. This suggests that tolerance of multiple infections, a component of protective immunity in highly endemic areas, is not affected by this interventio

Cliophysics: Socio-political Reliability Theory, Polity Duration and African Political (In)stabilities

Quantification of historical sociological processes have recently gained attention among theoreticians in the effort of providing a solid theoretical understanding of the behaviors and regularities present in sociopolitical dynamics. Here we present a reliability theory of polity processes with emphases on individual political dynamics of African countries. We found that the structural properties of polity failure rates successfully capture the risk of political vulnerability and instabilities in which 87.50%, 75%, 71.43%, and 0% of the countries with monotonically increasing, unimodal, U-shaped and monotonically decreasing polity failure rates, respectively, have high level of state fragility indices. The quasi-U-shape relationship between average polity duration and regime types corroborates historical precedents and explains the stability of the autocracies and democracies.Comment: 4 pages, 3 figures, 1 tabl

A limit model for thermoelectric equations

We analyze the asymptotic behavior corresponding to the arbitrary high conductivity of the heat in the thermoelectric devices. This work deals with a steady-state multidimensional thermistor problem, considering the Joule effect and both spatial and temperature dependent transport coefficients under some real boundary conditions in accordance with the Seebeck-Peltier-Thomson cross-effects. Our first purpose is that the existence of a weak solution holds true under minimal assumptions on the data, as in particular nonsmooth domains. Two existence results are studied under different assumptions on the electrical conductivity. Their proofs are based on a fixed point argument, compactness methods, and existence and regularity theory for elliptic scalar equations. The second purpose is to show the existence of a limit model illustrating the asymptotic situation.Comment: 20 page