Designing of a Community-based Translation Center

Interfaces that support multi-lingual content can reach a broader community. We wish to extend the reach of CITIDEL, a digital library for computing education materials, to support multiple languages. By doing so, we hope that it will increase the number of users, and in turn the number of resources. This paper discusses three approaches to translation (automated translation, developer-based, and community-based), and a brief evaluation of these approaches. It proposes a design for an online community translation center where volunteers help translate interface components and educational materials available in CITIDEL.Comment: 8 pages, 4 figure

Sudden unexpected death in an infant with L-2-hydroxyglutaric aciduria

Inherited metabolic disorders are the cause of a small but significant number of sudden unexpected deaths in infancy. We report a girl who suddenly died at 11months of age, during an intercurrent illness. Autopsy showed spongiform lesions in the subcortical white matter, in the basal ganglia, and in the dentate nuclei. Investigations in an older sister with developmental delay, ataxia, and tremor revealed l-2-hydroxyglutaric aciduria and subcortical white matter changes with hyperintensity of the basal ganglia and dentate nuclei at brain magnetic resonance imaging. Both children were homozygous for a splice site mutation in the L2HGDH gene. Sudden death has not been reported in association with l-2-hydroxyglutaric aciduria so far, but since this inborn error of metabolism is potentially treatable, early diagnosis may be importan

Tuberculosis in the San Diego-Tijuana Border Region: Time for Bi-National Community-Based Solutions

The close geographical proximity of San Diego and Tijuana, the stark contrast between their distinct economies and levels of socio-economic development, and the ease and magnitude of cross-border exchange between these two metropolitan areas, demand our undivided attention. According to the San Diego Association of Governments (SANDAG), over 60 million persons cross into San Diego from Tijuana at the San Ysidro border crossing each year. In fact, many have come to agree that the San Diego-Tijuana border region does not identify with one particular country, but rather has a broader identity of its own. The blending of economic, social and cultural activities in this region charges us to find bi-national solutions to the unique bi-national issues facing the region. One such regional issue we must confront is that of tuberculosis (TB). Both California and Baja California have TB incidence rates that are much higher than the national rates of their respective countries. Furthermore, Tijuana reports approximately 4 times as many new TB cases per year than does San Diego. There is an urgent need to confront this disparity, and address the issue of bi-national TB control in the San Diego-Tijuana border region to find sustainable, community-based solutions that will benefit both Mexico and the United States. Importantly, as an air-borne infection, successful models of TB control will have applicability to other emerging diseases threats that require cross-border solutions, such as H1N1.TB is a subtle and complex chronic infectious disease that can remain dormant for years after the initial infection. Once active or reactivated, TB often takes weeks or months to be diagnosed correctly, allowing for ongoing exposure and transmission to others. The World Health Organization (WHO) estimates that 2 billion people, or one-third of the global population, are currently infected with the M. tuberculosis bacilli. Of those infected, it is estimated that 1 in 10 will develop the active, contagious form of disease at some time in their lives, and those with active TB will infect an average of 10 to 15 people per year if they are not treated. Likely an underestimate, over 600 cases of pulmonary TB were confirmed and reported annually in Tijuana in 2006 and 2007 with an overall rate of 46 per 100,000 inhabitants, which is substantially higher than rates in neighboring Mexican states. In the last decade, there has been an average of over 300 new TB cases per year in San Diego County, of which nearly 40% were born in Mexico. This estimate is likely to understate the influence of Mexico on the TB case load in San Diego, since USborn, Hispanic TB cases are not identified in TB surveillance data as being of Mexican origin. Nevertheless, these cases have significant interaction with Mexico when they, or their contacts, cross the border for social, cultural and economic reasons. Prior to the discovery in 1946 that streptomycin cured TB, the disease claimed the lives of half its victims. Hopes of eradicating TB grew when a 6-month course of daily drug treatment was found to be highly effective for curing TB and rates of disease began to drop worldwide. However, interrupted or inconsistent treatment, combined with the AIDS epidemic, led to the emergence of drug resistant strains of TB bacteria that could no longer be cured with first-line antibiotics, and rates of TB began to increase in the 1980s. To date, the WHO and other agencies have documented cases of TB that are resistant to standard first-line antibiotics and second-line antibiotics in all regions of the world, including the US-Mexico border region. This reverses years of progress in TB control as successful management of drug resistance requires more sophisticated laboratory capacity, educated personnel and access to significantly more expensive drugs. Importantly, drug resistance is completely preventable with appropriate diagnosis that includes drug sensitivity testing and programs like directly observed therapy (DOT) that ensure patients are on proper treatment regimens and do not interrupt therapy or miss doses. Until a vaccine or single-dose treatment is discovered, our best hope for preventing TB from returning to an untreatable disease depends on accurately diagnosing and completely treating patients with TB.Like the disease itself, the costs of TB are complex and difficult to quantify. The direct costs can be described in terms of infrastructure - diagnostic laboratories and equipment, clinic and hospital units appropriately designed for infection control, and surveillance systems; personnel - trained laboratory technicians, informed healthcare providers, DOT workers, contact investigators, and surveillance system managers; and consumables - laboratory reagents, anti-TB medications, infection control supplies, and educational materials. Indirect costs include lost wages for those infected, decreased productivity by employers, and disruption to the community affected by contact tracing activities. We estimate that TB costs in San Diego amount to be at least $21.3 million annually, which includes approximately$12.7 million in lost earnings for patients due to their disease. Beyond the loss of earned wages is the loss by San Diego employers in productivity. Workforce productivity is impacted in several ways by TB. Most significant is that TB symptoms are slow to develop and many infected individuals continue day-to-day activities for weeks or months before their disease is detected, potentially exposing large numbers of contacts at work, home and in the community to TB. This results in additional infections in the workplace and disruptions due to the extensive contact tracing activities that need to take place after a workplace infection. The costs presented here include the major measurable factors and costs to San Diego, but, while high, are certainly an underestimate of total costs. They do not include the substantial hidden costs of lost productivity to employers or other more subtle losses like loss of income to school districts due to scheduled absences for children with TB; nor do they account for other social costs related to stigmatization or infected individuals and their contacts. Importantly, there is consensus for what constitutes a comprehensive TB control program: the WHO DOTS program. This strategy includes early detection of cases, contact tracing, accurate diagnosis through bacterial culture and drug sensitivity testing, uninterrupted access to effective drugs, and DOT. Although incidence rates are declining globally and domestically, the number of cases worldwide is increasing due to population growth and the emergence of resistance threatens to reverse the advances to date. Thus, there is an urgent call by multiple political and professional organizations for a coordinated global response. While the San Diego-Tijuana region is impacted by the growing challenges of TB, this is a preventable and treatable disease and there is tremendous potential to contribute and participate in an international mobilization of public health, clinical personnel, business leaders and communities to effectively combat the disease.Economic analyses clearly indicate that US investment in TB control in Mexico can be a cost-effective means of controlling TB in the United States. Given the epidemiology of TB in the San Diego- Tijuana border such economic benefits are likely to be true for this bi-national region. While this is so, the active involvement of both private businesses and governmental agencies will be required to make this a reality. Successful working models in which businesses located in high TB-incidence areas have taken a lead role in TB control programs already exist through the work of member companies of the Global Business Coalition for HIV, Tuberculosis and Malaria (GBC). This novel approach to address emerging high impact threats through private-public partnerships provides a promising model that can be adopted in the US-Mexico border region

Design and Characterisation of a Randomized Food Intervention That Mimics Exposure to a Typical UK Diet to Provide Urine Samples for Identification and Validation of Metabolite Biomarkers of Food Intake

Poor dietary choices are major risk factors for obesity and non-communicable diseases, which places an increasing burden on healthcare systems worldwide. To monitor the effectiveness of healthy eating guidelines and strategies, there is a need for objective measures of dietary intake in community settings. Metabolites derived from specific foods present in urine samples can provide objective biomarkers of food intake (BFIs). Whilst the majority of biomarker discovery/validation studies have investigated potential biomarkers for single foods only, this study considered the whole diet by using menus that delivered a wide range of foods in meals that emulated conventional UK eating patterns. Fifty-one healthy participants (range 19–77 years; 57% female) followed a uniquely designed, randomized controlled dietary intervention, and provided spot urine samples suitable for discovery of BFIs within a real-world context. Free-living participants prepared and consumed all foods and drinks in their own homes and were asked to follow the protocols for meal consumption and home urine sample collection. This study also assessed the robustness, and impact on data quality, of a minimally invasive urine collection protocol. Overall the study design was well-accepted by participants and concluded successfully without any drop outs. Compliance for urine collection, adherence to menu plans, and observance of recommended meal timings, was shown to be very high. Metabolome analysis using mass spectrometry coupled with data mining demonstrated that the study protocol was well-suited for BFI discovery and validation. Novel, putative biomarkers for an extended range of foods were identified including legumes, curry, strongly-heated products, and artificially sweetened, low calorie beverages. In conclusion, aspects of this study design would help to overcome several current challenges in the development of BFI technology. One specific attribute was the examination of BFI generalizability across related food groups and across different preparations and cooking methods of foods. Furthermore, the collection of urine samples at multiple time points helped to determine which spot sample was optimal for identification and validation of BFIs in free-living individuals. A further valuable design feature centered on the comprehensiveness of the menu design which allowed the testing of biomarker specificity within a biobank of urine samples

Vascular Health in American Football Players: Cardiovascular Risk Increased in Division III Players

Studies report that football players have high blood pressure (BP) and increased cardiovascular risk. There are over 70,000 NCAA football players and 450 Division III schools sponsor football programs, yet limited research exists on vascular health of athletes. This study aimed to compare vascular and cardiovascular health measures between football players and nonathlete controls. Twenty-three athletes and 19 nonathletes participated. Vascular health measures included flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT). Cardiovascular measures included clinic and 24 hr BP levels, body composition, VO2 max, and fasting glucose/cholesterol levels. Compared to controls, football players had a worse vascular and cardiovascular profile. Football players had thicker carotid artery IMT (0.49 ± 0.06 mm versus 0.46 ± 0.07 mm) and larger brachial artery diameter during FMD (4.3 ± 0.5 mm versus 3.7 ± 0.6 mm), but no difference in percent FMD. Systolic BP was significantly higher in football players at all measurements: resting (128.2 ± 6.4 mmHg versus 122.4 ± 6.8 mmHg), submaximal exercise (150.4 ± 18.8 mmHg versus 137.3 ± 9.5 mmHg), maximal exercise (211.3 ± 25.9 mmHg versus 191.4 ± 19.2 mmHg), and 24-hour BP (124.9 ± 6.3 mmHg versus 109.8 ± 3.7 mmHg). Football players also had higher fasting glucose (91.6 ± 6.5 mg/dL versus 86.6 ± 5.8 mg/dL), lower HDL (36.5±11.2 mg/dL versus 47.1±14.8 mg/dL), and higher body fat percentage (29.2±7.9% versus 23.2±7.0%). Division III collegiate football players remain an understudied population and may be at increased cardiovascular risk

European Society for Immunodeficiencies (ESID) and European Reference Network on Rare Primary Immunodeficiency, Autoinflammatory and Autoimmune Diseases (ERN RITA) Complement Guideline : Deficiencies, Diagnosis, and Management

This guideline aims to describe the complement system and the functions of the constituent pathways, with particular focus on primary immunodeficiencies (PIDs) and their diagnosis and management. The complement system is a crucial part of the innate immune system, with multiple membrane-bound and soluble components. There are three distinct enzymatic cascade pathways within the complement system, the classical, alternative and lectin pathways, which converge with the cleavage of central C3. Complement deficiencies account for similar to 5% of PIDs. The clinical consequences of inherited defects in the complement system are protean and include increased susceptibility to infection, autoimmune diseases (e.g., systemic lupus erythematosus), age-related macular degeneration, renal disorders (e.g., atypical hemolytic uremic syndrome) and angioedema. Modern complement analysis allows an in-depth insight into the functional and molecular basis of nearly all complement deficiencies. However, therapeutic options remain relatively limited for the majority of complement deficiencies with the exception of hereditary angioedema and inhibition of an overactivated complement system in regulation defects. Current management strategies for complement disorders associated with infection include education, family testing, vaccinations, antibiotics and emergency planning.Peer reviewe

Adiabatic Quantum Support Vector Machines

Adiabatic quantum computers can solve difficult optimization problems (e.g., the quadratic unconstrained binary optimization problem), and they seem well suited to train machine learning models. In this paper, we describe an adiabatic quantum approach for training support vector machines. We show that the time complexity of our quantum approach is an order of magnitude better than the classical approach. Next, we compare the test accuracy of our quantum approach against a classical approach that uses the Scikit-learn library in Python across five benchmark datasets (Iris, Wisconsin Breast Cancer (WBC), Wine, Digits, and Lambeq). We show that our quantum approach obtains accuracies on par with the classical approach. Finally, we perform a scalability study in which we compute the total training times of the quantum approach and the classical approach with increasing number of features and number of data points in the training dataset. Our scalability results show that the quantum approach obtains a 3.5--4.5 times speedup over the classical approach on datasets with many (millions of) features

Both/And: Mixed methods analysis of network composition, communication patterns, and socio-economic support within social networks of transgender women involved in sex work in Lima, Peru

IntroductionSocial networks contribute to normative reinforcement of HIV prevention strategies, knowledge sharing, and social capital, but little research has characterized the social networks of transgender women (TW) in Latin America. We conducted a mixed methods analysis of three network clusters of TW in Lima, Peru, to evaluate network composition, types of support exchanged, and patterns of communication.MethodsWe recruited TW residing in or affiliated with three "casas trans" (houses shared among TW) in Lima between April-May 2018. Eligible participants were 18 or older, self-reported HIV-negative, and reported recent intercourse with a cis-male partner. Participants completed demographic questionnaires, social network interviews, and semi-structured interviews to assess egocentric network structures, support exchanged, and communication patterns. Quantitative and qualitative data were analyzed using Stata v14.1 and Atlas.ti, respectively.ResultsOf 20 TW, median age was 26 years and 100% reported involvement in commercial sex work. Respondents identified 161 individuals they interacted with in the past month (alters), of whom 33% were TW and 52% family members. 70% of respondents reported receiving emotional support from family, while 30% received financial support and instrumental support from family. Of the 13 (65%) respondents who nominated someone as a source of HIV prevention support (HPS), the majority (69%) nominated other TW. In a GEE regression analysis adjusted for respondent education and region of birth, being a family member was associated with lower likelihood of providing financial support (aOR 0.21, CI 0.08-0.54), instrumental support (aOR 0.16, CI 0.06-0.39), and HPS (aOR 0.18, CI 0.05-0.64). In qualitative interviews, most respondents identified a cis-female family member as their most trusted and closest network member, but other TW were more often considered sources of day-to-day support, including HPS.ConclusionTW have diverse social networks where other TW are key sources of knowledge sharing and support, and family members may also represent important and influential components. Within these complex networks, TW may selectively solicit and provide support from different network alters according to specific contexts and needs. HIV prevention messaging could consider incorporating network-based interventions with TW community input and outreach efforts for supportive family members

Developing a food exposure and urine sampling strategy for dietary exposure biomarker validation in free-living individuals

SCOPE: Dietary choices modulate the risk of chronic diseases and improving diet is a central component of public health strategies. Food-derived metabolites present in urine could provide objective biomarkers of dietary exposure. To assist biomarker validation we aimed to develop a food intervention strategy mimicking a typical annual diet over a short period of time and assessed urine sampling protocols potentially suitable for future deployment of biomarker technology in free-living populations. METHODS AND RESULTS: Six different menu plans representing comprehensively a typical UK annual diet that were split into two dietary experimental periods. Free-living adult participants (n = 15 and n = 36, respectively) were provided with all their food, as a series of menu plans, over a period of 3 consecutive days. Multiple spot urine samples were collected and stored at home. CONCLUSION: We established a successful food exposure strategy following a conventional UK eating pattern, which was suitable for biomarker validation in free-living individuals. The urine sampling procedure was acceptable for volunteers and delivered samples suitable for biomarker quantification. Our study design provides scope for validation of existing biomarker candidates and potentially for discovery of new biomarker-leads and should help inform the future deployment of biomarker technology for habitual dietary exposure measurement