Die liberalisme en sy invloed in Suid-Afrika II

Die liberale rigting van die negentiende eeu was ’n wye wêreldbegewing wat in alle lande tot openbaring gekom het en sy invloed laat voel hetop elke terrein van die lewe. Veel van die koorsagtige bedrywigheid watdie geestelewe van die vorige eeu kenmerk, moet toegeskrywe word aandie besieling van die liberalisme wat tot elke lewenskring deurgedring hetmet ’n vaste program en ’n eie ideaal

A Finite Element Model for Describing the Effect of Muscle Shortening on Surface EMG

A finite-element model for the generation of single fiber action potentials in a muscle undergoing various degrees of fiber shortening is developed. The muscle is assumed fusiform with muscle fibers following a curvilinear path described by a Gaussian function. Different degrees of fiber shortening are simulated by changing the parameters of the fiber path and maintaining the volume of the muscle constant. The conductivity tensor is adapted to the muscle fiber orientation. In each point of the volume conductor, the conductivity of the muscle tissue in the direction of the fiber is larger than that in the transversal direction. Thus, the conductivity tensor changes point-by-point with fiber shortening, adapting to the fiber paths. An analytical derivation of the conductivity tensor is provided. The volume conductor is then studied with a finite-element approach using the analytically derived conductivity tensor. Representative simulations of single fiber action potentials with the muscle at different degrees of shortening are presented. It is shown that the geometrical changes in the muscle, which imply changes in the conductivity tensor, determine important variations in action potential shape, thus affecting its amplitude and frequency content. The model provides a new tool for interpreting surface EMG signal features with changes in muscle geometry, as it happens during dynamic contractions

Variations in size compositions of populations of Upogebia africana (Ortmann) (Decapoda, Crustacea) within the Swartkops estuary and possible influencing factors

The size frequencies of various populations of the mud prawn Upogebia africana sampled within the Swartkops estuary were determined and the size compositions of these populations varied along the length of the estuary, as well as vertically within the intertidal zone. Ovigerous prawns were recorded from sites representing the extremes in population structures and their mean sizes differed significantly (P < 0,05) from each other. The variations in the size compositions were therefore attributed to differences in the growth of the prawns, rather than a spatial separation of adults and juveniles. The mean sizes of the adult prawns from the various stations were determined and plotted against factors such as water temperatures and salinities, nitrogen and organic contents of the substrata, population densities and distances of the populations from the estuarine mouth. The latter factor, which was used to give a relative measure of the exposure (in terms of duration and current velocity) of the populations to the flow of water entering the estuary during flood tides, gave the most significant (P < 0,01) correlation with the mean size of the adult prawns and could satisfactorily account for patterns observed

A Finite Element Model for Describing the Effect of Muscle Shortening on Surface EMG

A finite-element model for the generation of single fiber action potentials in a muscle undergoing various degrees of fiber shortening is developed. The muscle is assumed fusiform with muscle fibers following a curvilinear path described by a Gaussian function. Different degrees of fiber shortening are simulated by changing the parameters of the fiber path and maintaining the volume of the muscle constant. The conductivity tensor is adapted to the muscle fiber orientation. In each point of the volume conductor, the conductivity of the muscle tissue in the direction of the fiber is larger than that in the transversal direction. Thus, the conductivity tensor changes point-by-point with fiber shortening, adapting to the fiber paths. An analytical derivation of the conductivity tensor is provided. The volume conductor is then studied with a finite-element approach using the analytically derived conductivity tensor. Representative simulations of single fiber action potentials with the muscle at different degrees of shortening are presented. It is shown that the geometrical changes in the muscle, which imply changes in the conductivity tensor, determine important variations in action potential shape, thus affecting its amplitude and frequency content. The model provides a new tool for interpreting surface EMG signal features with changes in muscle geometry, as it happens during dynamic contractions

Safety and immunogenicity of H1/IC31®, an adjuvanted TB subunit vaccine, in HIV-infected adults with CD4+ lymphocyte counts greater than 350 cells/mm3: a phase II, multi-centre, double-blind, randomized, placebo-controlled trial.

BACKGROUND: Novel tuberculosis vaccines should be safe, immunogenic, and effective in various population groups, including HIV-infected individuals. In this phase II multi-centre, double-blind, placebo-controlled trial, the safety and immunogenicity of the novel H1/IC31 vaccine, a fusion protein of Ag85B-ESAT-6 (H1) formulated with the adjuvant IC31, was evaluated in HIV-infected adults. METHODS: HIV-infected adults with CD4+ T cell counts >350/mm3 and without evidence of active tuberculosis were enrolled and followed until day 182. H1/IC31 vaccine or placebo was randomly allocated in a 5:1 ratio. The vaccine was administered intramuscularly at day 0 and 56. Safety assessment was based on medical history, clinical examinations, and blood and urine testing. Immunogenicity was determined by a short-term whole blood intracellular cytokine staining assay. RESULTS: 47 of the 48 randomised participants completed both vaccinations. In total, 459 mild or moderate and 2 severe adverse events were reported. There were three serious adverse events in two vaccinees classified as not related to the investigational product. Local injection site reactions were more common in H1/IC31 versus placebo recipients (65.0% vs. 12.5%, p = 0.015). Solicited systemic and unsolicited adverse events were similar by study arm. The baseline CD4+ T cell count and HIV viral load were similar by study arm and remained constant over time. The H1/IC31 vaccine induced a persistent Th1-immune response with predominately TNF-α and IL-2 co-expressing CD4+ T cells, as well as polyfunctional IFN-γ, TNF-α and IL-2 expressing CD4+ T cells. CONCLUSION: H1/IC31 was well tolerated and safe in HIV-infected adults with a CD4+ Lymphocyte count greater than 350 cells/mm3. The vaccine did not have an effect on CD4+ T cell count or HIV-1 viral load. H1/IC31 induced a specific and durable Th1 immune response. TRIAL REGISTRATION: Pan African Clinical Trials Registry (PACTR) PACTR201105000289276

Pitfalls of Single Measurement Screening for Diabetes and Hypertension in Community-Based Settings

Background: Cross-sectional screening programs are used to detect and refer individuals with non-communicable diseases to healthcare services. We evaluated the positive predictive value of cross-sectional measurements for Diabetes Mellitus (DM) and hypertension (HTN) as part of a community-based disease screening study, ‘Vukuzazi’ in rural South Africa. Methods: We conducted community-based screening for HTN and DM using the World Health Organization STEPS protocol and glycated haemoglobin A1c (HbA1c) testing, respectively. Nurses conducted follow-up home visits for confirmatory diagnostic testing among individuals with a screening BP above 140/90 mmHg and/or HbA1c above 6.5% at the initial screen, and without a prior diagnosis. We assessed the positive predictive value of the initial screening, compared to the follow up measure. We also sought to identify a screening threshold for HTN and DM with greater than 90% positive predictive value. Results: Of 18,027 participants enrolled, 10.2% (1,831) had a screening BP over 140/90 mmHg. Of those without a prior diagnosis, 871 (47.6%) received follow-up measurements. Only 51.2% (451) of those with completed follow-up measurements had a repeat BP>140/90 mmHg at the home visit and were referred to care. To achieve a 90% correct referral rate, a systolic BP threshold of 192 was needed at first screening. For DM screening, 1,615 (9.0%) individuals had an HbA1c > 6.5%, and of those without a prior diagnosis, 1,151 (71.2%) received a follow-up blood glucose. Of these, only 34.1% (395) met criteria for referral for DM. To ensure a 90% positive predictive value i.e. a screening HbA1c of >16.6% was needed. Conclusions: A second home-based screening visit to confirm a diagnosis of DM and HTN reduced health system referrals by 48% and 66%, respectively. Two-day screening programmes for DM and HTN screening might save individual and healthcare resources and should be evaluated carefully in future cost effectiveness evaluations

Effect of HIV on the frequency and number of Mycobacterium tuberculosis-specific CD4+ T cells in blood and the airways in latent tuberculosis infection

HIV-1 infection substantially increases the risk of developing tuberculosis (TB). There is extensive depletion of Mycobacterium tuberculosis (M.tuberculosis)-specific CD4+ T cells in blood in early HIV infection, but little is known about responses in the lungs at this stage. Given that mucosal organs are a principal target for HIV-mediated CD4 destruction, we investigated M.tuberculosis-specific responses in bronchoalveolar lavage (BAL), in persons with latent TB infection and untreated HIV-1 co-infection with preserved CD4 counts. M.tuberculosis-specific CD4+ cytokine responses (IFN-, TNF- and IL-2) were discordant in frequency and function between BAL and blood. Responses in BAL were 15-fold lower in HIV-infected compared to uninfected persons (p=0.048), whilst blood responses were 2-fold lower (p=0.006). However, an increase in T cells in the airways in HIV-infected persons resulted in the overall number of M.tuberculosis-specific CD4+ cells in BAL being similar. Our study highlights the important insights gained from studying TB immunity at the site of disease during HIV infection