Inter-city travel between Cape Town and Atlantis can we bridge the gap

The emergence and growth of Atlantis to date, as well as the planned development rate until the end of the century, is considered in this article with reference to the policy of deconcentration and industrial growth. As a result of an estimated underperformance of certain types of jobs in Atlantis on the one hand, but on the other hand, due to the normal interaction between adjacent urban complexes, it is expected that healthier transport needs will arise between Atlantis and the Cape Metropolitan Area. Apart from the transport of goods, for which a basic road system already exists and for which a good railway line is envisaged, inter-urban passenger transport, and especially commuter traffic, is expected to undergo particularly robust growth. The expected growth in inter-urban traffic demand and characteristics with regard to distribution of discs and mode distribution is discussed in detail. The impact of passenger transport on the necessary infrastructure between Atlantis and Cape Town and on urban development north of the Cape Metropolitan Area is discussed by comparison between bus and rail transport. An overview is given of the financial implications of bus and rail transport, based on the forecasted traffic application. Finally, we are discussing ways of using the available infrastructure to meet the needs, in the face of a lack of finance

Inequities in energy-balance related behaviours and family environmental determinants in European children : baseline results of the prospective EPHE evaluation study

Background: Tackling inequalities in overweight, obesity and related determinants has become a top priority for the European research and policy agendas. Although it has been established that such inequalities accumulate from early childhood onward, they have not been studied extensively in children. The current article discusses the results of an explorative analysis for the identification of inequalities in behaviours and their determinants between groups with high and low socio-economic status. Methods: This study is part of the Epode for the Promotion of Health Equity (EPHE) evaluation study, the overall aim of which is to assess the impact and sustainability of EPODE methodology to diminish inequalities in childhood obesity and overweight. Seven community-based programmes from different European countries (Belgium, Bulgaria, France, Greece, Portugal, Romania, The Netherlands) participate in the EPHE study. In each of the communities, children aged 6-8 years participated, resulting in a total sample of 1266 children and their families. A parental self-administrated questionnaire was disseminated in order to assess the socio-economic status of the household, selected energy balance-related behaviours (1. fruit and vegetable consumption; 2. soft drink/fruit juices and water consumption; 3. screen time and 4. sleep duration) of the children and associated family environmental determinants. The Mann-Whitney U test and Pearson's chi-square test were used to test differences between the low and high education groups. The country-specific median was chosen as the cut-off point to determine the educational level, given the different average educational level in every country. Results: Children with mothers of relatively high educational level consumed fruits and vegetables more frequently than their peers of low socio-economic status. The latter group of children had a higher intake of fruit juices and/or soft drinks and had higher screen time. Parental rules and home availability were consistently different between the two socio-economic groups in our study in all countries. However we did not find a common pattern for all behaviours and the variability across the countries was large. Conclusions: Our findings are indicative of socio-economic inequalities in our samples, although the variability across the countries was large. The effectiveness of interventions aimed at chancing parental rules and behaviour on health inequalities should be studied

Effect of enrichment of maize meal with nicotinic acid and riboflavin upon the Vitamin and protein nutritional status of young school-going and pre-school children

A series of experiments was undertaken to investigate the feasibility of enriching maize meal with nicotinic acid and riboflavin. First the necessary level of enrichment was established and then the efficacy of such enrichment of maize was tested in the field on children and young adults. This report deals with the results of an experiment designed to establish whether such an enrichment scheme would have any detrimental effects on· young growing children with marginal protein calorie malnutrition. As in the previous experiments, a marked improvement in the nicotinic acid and riboflavin status was found in the experimental group. These biochemical findings were in conformity with the improvement in clinical status found. Moreover, such enrichment did not have any noticeable adverse effects. The hypothesis that vitamin enrichment could cause growth stimulation, and thus aggravate an existing marginal protein deficiency state, could not in any way be substantiated. The enrichment of maize meal with riboflavin and nicotinic acid during milling has been shown conclusively to be highly effective in improving the vitamin nutritional status while at the same time not harming the protein nutritional status of young children. Since the previous experiments proved it to be economically and technologically feasible, it is now strongly recommended that such an enrichment scheme be introduced on a national basis with the least possible delay.S. Afr. Med. J., 48, 1641 (1974)

Current issues in medically assisted reproduction and genetics in Europe: research, clinical practice, ethics, legal issues and policy. European Society of Human Genetics and European Society of Human Reproduction and Embryology.

In March 2005, a group of experts from the European Society of Human Genetics and European Society of Human Reproduction and Embryology met to discuss the interface between genetics and assisted reproductive technology (ART), and published an extended background paper, recommendations and two Editorials. Seven years later, in March 2012, a follow-up interdisciplinary workshop was held, involving representatives of both professional societies, including experts from the European Union Eurogentest2 Coordination Action Project. The main goal of this meeting was to discuss developments at the interface between clinical genetics and ARTs. As more genetic causes of reproductive failure are now recognised and an increasing number of patients undergo testing of their genome before conception, either in regular health care or in the context of direct-to-consumer testing, the need for genetic counselling and preimplantation genetic diagnosis (PGD) may increase. Preimplantation genetic screening (PGS) thus far does not have evidence from randomised clinical trials to substantiate that the technique is both effective and efficient. Whole-genome sequencing may create greater challenges both in the technological and interpretational domains, and requires further reflection about the ethics of genetic testing in ART and PGD/PGS. Diagnostic laboratories should be reporting their results according to internationally accepted accreditation standards (International Standards Organisation - ISO 15189). Further studies are needed in order to address issues related to the impact of ART on epigenetic reprogramming of the early embryo. The legal landscape regarding assisted reproduction is evolving but still remains very heterogeneous and often contradictory. The lack of legal harmonisation and uneven access to infertility treatment and PGD/PGS fosters considerable cross-border reproductive care in Europe and beyond. The aim of this paper is to complement previous publications and provide an update of selected topics that have evolved since 2005

A depauperate immune repertoire precedes evolution of sociality in bees

Background Sociality has many rewards, but can also be dangerous, as high population density and low genetic diversity, common in social insects, is ideal for parasite transmission. Despite this risk, honeybees and other sequenced social insects have far fewer canonical immune genes relative to solitary insects. Social protection from infection, including behavioral responses, may explain this depauperate immune repertoire. Here, based on full genome sequences, we describe the immune repertoire of two ecologically and commercially important bumblebee species that diverged approximately 18 million years ago, the North American Bombus impatiens and European Bombus terrestris. Results We find that the immune systems of these bumblebees, two species of honeybee, and a solitary leafcutting bee, are strikingly similar. Transcriptional assays confirm the expression of many of these genes in an immunological context and more strongly in young queens than males, affirming Bateman’s principle of greater investment in female immunity. We find evidence of positive selection in genes encoding antiviral responses, components of the Toll and JAK/STAT pathways, and serine protease inhibitors in both social and solitary bees. Finally, we detect many genes across pathways that differ in selection between bumblebees and honeybees, or between the social and solitary clades. Conclusions The similarity in immune complement across a gradient of sociality suggests that a reduced immune repertoire predates the evolution of sociality in bees. The differences in selection on immune genes likely reflect divergent pressures exerted by parasites across social contexts

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Diagnosis of Human Visceral Pentastomiasis

Visceral pentastomiasis in humans is caused by the larval stages (nymphs) of the arthropod-related tongue worms Linguatula serrata, Armillifer armillatus, A. moniliformis, A. grandis, and Porocephalus crotali. The majority of cases has been reported from Africa, Malaysia, and the Middle East, where visceral pentastomiasis may be an incidental finding in autopsies, and less often from China and Latin America. In Europe and North America, the disease is only rarely encountered in immigrants and long-term travelers, and the parasitic lesions may be confused with malignancies, leading to a delay in the correct diagnosis. Since clinical symptoms are variable and serological tests are not readily available, the diagnosis often relies on histopathological examinations. This laboratory symposium focuses on the diagnosis of this unusual parasitic disease and presents its risk factors and epidemiology

A novel approach to estimate the distribution, density and at-sea risks of a centrally-placed mobile marine vertebrate

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.Formulating management strategies for mobile marine species is challenging, as knowledge is required of distribution, density, and overlap with putative threats. As a step towards assimilating knowledge, ecological niche models may identify likely suitable habitats for species, but lack the ability to enumerate species densities. Traditionally, this has been catered for by sightings-based distance sampling methods that may have practical and logistical limitations. Here we describe a novel method to estimate at-sea distribution and densities of a marine vertebrate, using historic aerial surveys of Gabonese leatherback turtle (Dermochelys coriacea) nesting beaches and satellite telemetry data of females at sea. We contextualise modelled patterns of distribution with putative threat layers of boat traffic, including fishing vessels and large ship movements, using Vessel Monitoring System (VMS) and Automatic Identification System (AIS) data. We identify key at-sea areas in which protection for inter-nesting leatherback turtles could be considered within the coastal zone of Gabonese Exclusive Economic Zone (EEZ). Our approach offers a holistic technique that merges multiple datasets and methodologies to build a deeper and insightful knowledge base with which to manage known activities at sea. As such, the methodologies presented in this study could be applied to other species of sea turtles for cumulative assessments; and with adaptation, may have utility in defining critical habitats for other central-place foragers such as pinnipeds, or sea bird species. Although our analysis focuses on a single species, we suggest that putative threats identified within this study (fisheries, seismic activity, general shipping) likely apply to other mobile marine vertebrates of conservation concern within Gabonese and central African coastal waters, such as olive ridley sea turtles (Lepidochelys olivacea), humpback dolphins (Sousa teuszii) and humpback whales (Megaptera novaeangliae).We thank the following for support and funding: CARPE (Central African Regional Program for the Environment, Darwin Initiative, EAZA ShellShock Campaign, Gabon Sea Turtle Partnership with funding from the Marine Turtle Conservation Fund (United States Fish and Wildlife Service, U.S. Department of the Interior), Harvest Energy, Large Pelagics Research Centre at the University of Massachusetts (Boston), NERC, Vaalco Energy and the Wildlife Conservation Society. We are sincerely grateful to the field teams and logistics staff who assisted in the aerial and ground surveys and with field-site assistance. BJG and MJW receive funding from the Natural Environment Research Council (NE/J012319/1), the European Union and the Darwin Initiative