Bilharzioma of the fallopian tube - a case report

A case report on bilharziasis of the Fallopian tube as diagnosed in a Caucasian woman in Zimbabwe.We present a 37 year old, Caucasian woman who presented to a gynaecologist with a history of amenorrhea and subsequent per vaginal bleeding. In her gynaecological history, she was Gravida 3, Para 2, and her youngest child was 12 years old. Her periods had always been regular and she had a copper T contraceptive device in situ. She missed her period and subsequently had a PV bleed. She was found to have an incomplete abortion, for which a D&C and removal of the IUCD, as well as ligation fallopian tubes was arranged. At laparoscopy, she was found to have a 30mm “tumour at” the fimbrial end of her left fallopian tube. A mini-laparotomy was performed to remove the “tumour”, and seedlings on the contralateral fallopian tube, adjacent ovary as well as on the uterine surface. Peritoneal nodules were also seen but no peritoneal fluid was evident. The “tumour” was resected, and the following day post-operatively, the patient was counselled for a TAH and BSO and consent was obtained

Integration of Sugar Markets between Swaziland and its Major Trading Partners

The study was designed to examine the extent of market integration between Swaziland sugar markets and its major trading partners (i.e., South Africa, EU and USA) using monthly export sugar price data from January 2001 to December 2013. Price series were tested for stationarity with the Augmented Dickey-Fuller (ADF) test and it was found that all prices were integrated of order one I (1). Zivot and Andrews test was used to determine the structural break in the price series and it revealed that the Swaziland and USA price break was in August, 2009 while for the EU price break was in October, 2008. Price relationships were examined in one period (entire period) and two sub-periods (before structural break and after structural break). The Johansen’s cointegration test revealed long-run integration for almost all the pairs of sugar markets, except for the USA in the full sample period. The integrations between the markets shows a significant improvement after the structural break. The Vector Error Correction model (VECM) estimates showed that the Swaziland’s  export market prices adjust significantly to the short-run shocks that appeared in the South African’s and EU’s sugar market for the entire period while when the structural breaks period was allowed it adjusts significantly before the break for the South African’s market. Swaziland’s market only adjusts significantly to the EU and USA market shocks after the structural break. The overall coefficient of the adjustment parameter has been very low due to high government interventions in the sugar sector by the Swaziland trading partners which is an impediment to the efficient market functioning. It is therefore suggested that interventions of the respective governments should be reduced for efficient functioning of the markets Keywords: sugar, trading partners, cointegration, stationarity, structural brea

Taking up the cudgels against gay rights? Trends and trajectories in African Christian theologies on homosexuality

Against the background of the HIV epidemic and the intense public controversy on homosexuality in African societies, this article investigates the discourses of academic African Christian theologians on homosexuality. Distinguishing some major strands in African theology, that is, inculturation, liberation, women’s and reconstruction theology, the article examines how the central concepts of culture, liberation, justice, and human rights function in these discourses. On the basis of a qualitative analysis of a large number of publications, the article shows that stances of African theologians are varying from silence and rejection to acceptance. Although many African theologians have taken up the cudgels against gay rights, some “dissident voices” break the taboo and develop more inclusive concepts of African identity and African Christianity

Rapid Diagnostic Test Performance Assessed Using Latent Class Analysis for the Diagnosis of Plasmodium falciparum Placental Malaria.

Placental malaria causes low birth weight and neonatal mortality in malaria-endemic areas. The diagnosis of placental malaria is important for program evaluation and clinical care, but is compromised by the suboptimal performance of current diagnostics. Using placental and peripheral blood specimens collected from delivering women in Malawi, we compared estimation of the operating characteristics of microscopy, rapid diagnostic test (RDT), polymerase chain reaction, and histopathology using both a traditional contingency table and a latent class analysis (LCA) approach. The prevalence of placental malaria by histopathology was 13.8%; concordance between tests was generally poor. Relative to histopathology, RDT sensitivity was 79.5% in peripheral and 66.2% in placental blood; using LCA, RDT sensitivities increased to 93.7% and 80.2%, respectively. Our results, if replicated in other cohorts, indicate that RDT testing of peripheral or placental blood may be suitable approaches to detect placental malaria for surveillance programs, including areas where intermittent preventive therapy in pregnancy is not used

One-Time Compilation of Device-Level Instructions for Quantum Subroutines

A large class of problems in the current era of quantum devices involve interfacing between the quantum and classical system. These include calibration procedures, characterization routines, and variational algorithms. The control in these routines iteratively switches between the classical and the quantum computer. This results in the repeated compilation of the program that runs on the quantum system, scaling directly with the number of circuits and iterations. The repeated compilation results in a significant overhead throughout the routine. In practice, the total runtime of the program (classical compilation plus quantum execution) has an additional cost proportional to the circuit count. At practical scales, this can dominate the round-trip CPU-QPU time, between 5% and 80%, depending on the proportion of quantum execution time. To avoid repeated device-level compilation, we identify that machine code can be parametrized corresponding to pulse/gate parameters which can be dynamically adjusted during execution. Therefore, we develop a device-level partial-compilation (DLPC) technique that reduces compilation overhead to nearly constant, by using cheap remote procedure calls (RPC) from the QPU control software to the CPU. We then demonstrate the performance speedup of this on optimal pulse calibration, system characterization using randomized benchmarking (RB), and variational algorithms. We execute this modified pipeline on real trapped-ion quantum computers and observe significant reductions in compilation time, as much as 2.7x speedup for small-scale VQE problems

Culturally Adapted Interventions in Mental Health: Global Position Statement

The preponderance of western psychological concepts are often relied upon to conceptualise health-related phenomena. It is hardly surprising therefore that despite the availability of a number of interventions, studies have concluded that outcomes for minority cultural groups are not as good as for Caucasian people (western Europe and North America) in many high and middle income countries (HMIC). The evidence base of most psychosocial interventions is yet to be established in Low and Middle Income Countries (LMICs). There has been a propensity in some quarters to view low and middle income countries as passive beneficiaries of mental health knowledge, rather than as contributors or partners in knowledge production and development. A move towards a more equal bilateral relationship is called for, which should lead to better service provision. This Position Statement aims to highlight the current position and need for culturally adapted interventions. It is a global call for action to achieve a standardised mechanism to achieve parity of access and outcomes across all cultural groups regardless of country of residence

Inflammation Adjustment by Two Methods Decreases the Estimated Prevalence of Zinc Deficiency in Malawi.

Serum zinc concentration (SZC) is used widely to assess population-level zinc status. Its concentration decreases during inflammatory responses, which can affect the interpretation of the results. This study aimed to re-estimate the prevalence of zinc deficiency in Malawi based on the 2015-2016 Malawi Micronutrient Survey (MNS) data, by adjusting SZC measures with markers of inflammation. SZC and inflammation data from 2760 participants were analysed. Adjustments were made using: (1) The Internal Correction Factor (ICF) method which used geometric means, and (2) The Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) method, which used linear regression. Mean SZC values increased significantly when adjustments were made by either ICF or BRINDA (p < 0.001). The national prevalence of zinc deficiency decreased from 62% to 59%, after ICF adjustment, and to 52% after BRINDA adjustment. ICF and BRINDA values of SZC were highly correlated (p < 0.001, r = 0.99), but a Bland-Altman plot showed a lack of agreement between the two methods (bias of 2.07 µg/dL). There was no association between the adjusted SZC and stunting, which is a proxy indicator for zinc deficiency. Inflammation adjustment of SZC, using ICF or BRINDA, produces lower estimates of zinc deficiency prevalence, but the lack of agreement between the adjustment methods warrants further research. Furthermore, the lack of association between SZC and stunting highlights the need to explore other biomarkers and proxies of population zinc assessment. This study demonstrates the importance of considering inflammatory confounders when reporting SZC, to ensure accuracy and to support policy decision making