3,118 research outputs found

    Helminth infection and metabolic disease: Strongyloides stercoralis infection and type 2 diabetes mellitus in an Aboriginal community

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    Recent years have seen an upsurge in interest in the relationship between helminth infections and metabolic diseases such as insulin resistance and type 2 diabetes mellitus (T2DM). Limited clinical and laboratory studies have suggested that chronic helminth infections may protect against the development of T2DM, and have suggested an immunometabolic mechanism for such an effect. Aims: This thesis seeks to examine the relationship between Strongyloides stercoralis infection and T2DM in an Australian Aboriginal community, and to examine the importance of this relationship in the context of efforts to treat and control this infection. Methods: The thesis reports on a cross sectional observational study of adults attending the health centres in an Aboriginal community, testing them for both strongyloides infection and T2DM, and establishing the nature of the relationship between these two conditions. A cohort of infected and un-infected subjects is thereby established and followed over a three-year period, enabling characterization of both the treatment outcomes for this infection at 6 months and three years in the context of T2DM, and the effects that treatment for strongyloides has on subsequent metabolic parameters. In addition, the relationship between S. stercoralis infection, T2DM and eosinophilia is examined, and limited studies into the cytokine responses in treated individuals are performed Results: The study demonstrates a strong negative association between pre-existing S. stercoralis infection and T2DM. It shows T2DM is a predictor of treatment failure for S. stercoralis at 6 months, and demonstrates that eosinophilia is not a reliable predictor of S stercoralis infection in this community, but is a more constant finding in those patients with S. stercoralis and T2DM. The three-year follow up shows that ivermectin is an extremely effective treatment for S. stercoralis infection in this community, and demonstrates that treatment of S. stercoralis infection is associated with an increased risk of developing T2DM and impaired glucose tolerance when compared to an uninfected and untreated group. Conclusions: The thesis provides evidence to support a protective effect for S. stercoralis infection against T2DM and suggests an immunometabolic model to explain the negative association which has been found. These findings are discussed in the context of ongoing efforts to control and eliminate strongyloides infection in Australian Aboriginal communities

    Reliability of a Shuttle reaction timer

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    Reaction, movement, and task times refer to the times needed to initially respond to a stimulus, make the specific movement, and complete the entire task. This study evaluated the reliability of a simple reaction timer designed to mimic a Space Shuttle task (turning on an overhead switch)

    Trying again to fail-first

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    For constraint satisfaction problems (CSPs), Haralick and Elliott [1] introduced the Fail-First Principle and defined in it terms of minimizing branch depth. By devising a range of variable ordering heuristics, each in turn trying harder to fail first, Smith and Grant [2] showed that adherence to this strategy does not guarantee reduction in search effort. The present work builds on Smith and Grant. It benefits from the development of a new framework for characterizing heuristic performance that defines two policies, one concerned with enhancing the likelihood of correctly extending a partial solution, the other with minimizing the effort to prove insolubility. The Fail-First Principle can be restated as calling for adherence to the second, fail-first policy, while discounting the other, promise policy. Our work corrects some deficiencies in the work of Smith and Grant, and goes on to confirm their finding that the Fail-First Principle, as originally defined, is insufficient. We then show that adherence to the fail-first policy must be measured in terms of size of insoluble subtrees, not branch depth. We also show that for soluble problems, both policies must be considered in evaluating heuristic performance. Hence, even in its proper form the Fail-First Principle is insufficient. We also show that the ā€œFFā€ series of heuristics devised by Smith and Grant is a powerful tool for evaluating heuristic performance, including the subtle relations between heuristic features and adherence to a policy

    Helminth coinfection and COVID-19: an alternate hypothesis

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    [Extract] In their recently published commentary, Bradbury and colleagues [1] drew attention to the possible negative interactions between helminth infection and COVID-19 severity in helminth-endemic regions. Helminth infections are known to be powerful modulators of the human immune response, and numerous studies now highlight the effects this may have on human infectious, inflammatory, and metabolic diseases. We believe, however, that any interaction between pre-existing helminth infection and the subsequent severity of COVID-19 need not necessarily be a negative one, and theoretical and empirical evidence suggests that helminths may indeed have a mitigating effect

    Basic level scene understanding: categories, attributes and structures

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    A longstanding goal of computer vision is to build a system that can automatically understand a 3D scene from a single image. This requires extracting semantic concepts and 3D information from 2D images which can depict an enormous variety of environments that comprise our visual world. This paper summarizes our recent efforts toward these goals. First, we describe the richly annotated SUN database which is a collection of annotated images spanning 908 different scene categories with object, attribute, and geometric labels for many scenes. This database allows us to systematically study the space of scenes and to establish a benchmark for scene and object recognition. We augment the categorical SUN database with 102 scene attributes for every image and explore attribute recognition. Finally, we present an integrated system to extract the 3D structure of the scene and objects depicted in an image.Google U.S./Canada Ph.D. Fellowship in Computer VisionNational Science Foundation (U.S.) (grant 1016862)Google Faculty Research AwardNational Science Foundation (U.S.) (Career Award 1149853)National Science Foundation (U.S.) (Career Award 0747120)United States. Office of Naval Research. Multidisciplinary University Research Initiative (N000141010933

    Outcome Predictors in Treatment of Yaws

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    To estimate failure rates after treatment with benzathine penicillin and to identify determinants of failure that affected outcomes for yaws, we conducted a cohort study of 138 patients; treatment failed in 24 (17.4%). Having low initial titers on Venereal Disease Research Laboratory test and living in a village where yaws baseline incidence was high were associated with increased likelihood of treatment failure

    Hyperendemic dengue transmission and identification of a locally evolved DENV-3 lineage, Papua New Guinea 2007-2010

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    Background Dengue is endemic in the Western Pacific and Oceania and the region reports more than 200,000 cases annually. Outbreaks of dengue and severe dengue occur regularly and movement of virus throughout the region has been reported. Disease surveillance systems, however, in many areas are not fully established and dengue incidence is underreported. Dengue epidemiology is likely least understood in Papua New Guinea (PNG), where the prototype DENV-2 strain New Guinea C was first isolated by Sabin in 1944 but where routine surveillance is not undertaken and little incidence and prevalence data is available. Methodology/Principal findings Serum samples from individuals with recent acute febrile illness or with non-febrile conditions collected between 2007ā€“2010 were tested for anti-DENV neutralizing antibody. Responses were predominantly multitypic and seroprevalence increased with age, a pattern indicative of endemic dengue. DENV-1, DENV-2 and DENV-3 genomes were detected by RT-PCR within a nine-month period and in several instances, two serotypes were identified in individuals sampled within a period of 10 days. Phylogenetic analysis of whole genome sequences identified a DENV-3 Genotype 1 lineage which had evolved on the northern coast of PNG which was likely exported to the western Pacific five years later, in addition to a DENV-2 Cosmopolitan Genotype lineage which had previously circulated in the region. Conclusions/Significance We show that dengue is hyperendemic in PNG and identify an endemic, locally evolved lineage of DENV-3 that was associated with an outbreak of severe dengue in Pacific countries in subsequent years, although severe disease was not identified in PNG. Additional studies need to be undertaken to understand dengue epidemiology and burden of disease in PNG

    Health state preferences are equivalent in the United States and Trinidad and Tobago

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    To derive preference weights in Trinidad and Tobago for Quality of Well-being Scale (QWB) health states in order to calculate QWB scores that can be compared to scores calculated from US-derived preference weights. The comparison was to determine whether the QWB scores from these different preference weights would lead to similar conclusions. We conducted in-person household interviews to elicit preferences for 65 health states using a probability sample of 235 adults from Port of Spain, Chaguanas and San Fernando, Trinidad and Tobago. A regression model with correction for within-person clustering of observations was used to obtain preference weights based on case judgments on a 0 (dead) to 10 (ā€œperfect healthā€) scale. The independent variables were the components of the QWB entered as indicator (0, 1) variables. One hundred and nineteen (51%) respondents provided ratings. The respondents that provided ratings were demographically no different from those that did not. The QWB response patterns were very similar using Trinidad and US weights. The mean (SD) QWB score was 0.750 (0.130) for female respondents and 0.784 (0.125) for male respondents using Trinidad coefficients (t 2, 233 = āˆ’2.05, P = 0.04) and 0.747 (0.131) for female respondents and 0.783 (0.126) for male respondents using US weights (t 2, 233 = āˆ’2.17, P = 0.03). Overall, we found the US and Trinidad and Tobago weights were highly similar and that the choice of either set of weights would lead to similar conclusions

    The changing of the guard: groupwork with people who have intellectual disabilities

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    This paper considers the impact of service systems on group activities. It describes an inter-professional groupwork project facilitated by a social worker and a community nurse. The project provided an emancipatory experience for a group of adults who had intellectual disabilities. The group was charged with the task of reviewing and updating the recruitment and interview processes used by a 'Learning Disability Partnership Board', when employing new support workers. The paper begins with a brief history of intellectual disability and provides a context to the underpinning philosophical belief that people should be encouraged and supported to inhabit valued social roles no matter what disability they may have. It then identifies the ways in which the sponsoring health, education and social care services impacted on the creation and development of a groupwork project. It might have been expected that the nature of the intellectual disability would have been the major influence on group process. However the paper reveals that organisational constraints had a significant impact on group functioning. Issues including, staffing budgets and transport contracts impacted on group process and function. The results of the project show how, with adequate support, people with intellectual disability can make important decisions that have long-reaching impacts on the services
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