Relapsing fever, a disappearing cause of fever and maternal death in Sengerema, Tanzania, east Africa

Objective: To study the incidence of tick borne relapsing fever (TBRF) during the last 50 years, once like malaria an endemic disease in Sengerema, Tanzania.Design: By analyzing the annual reports, focusing on the number of admissions, maternal deaths, blood smears of patients with fever for Borrelia.Setting: Sengerema district, Tanzania.Subject: Admissions in Sengerema Hospital due to TBRF.Main Outcome Measures: From 1960 to 2010, we analyzed the incidence of TBRF.Result: Forty annual admissions in the sixties/seventies, 200 in the eighties (range from 37 in 1964 to 455 in 1988), dropping to 30 in the nineties. For the last nine years no Borrelia spirochetes were found in blood smears at the laboratory anymore and no admissions for TBRF were  registered. The number of maternal deaths due to relapsing fever  decreased simultaneously; the last one recorded was in 2002.Conclusion: During the last century, we have witnessed the disappearing of tick borne relapsing fever in Sengerema. Increase of gold mining,  improved local economy, housing and standards of living after the nineties resulted in an almost complete eradication of the incidence of TBRF

Symptom attribution and presentation in general practice after an extreme life event

Background. A serious life event is likely to shape attributions relating to symptoms experienced afterwards. While they may play an important role in prognosis and seeking care, such perceptions have hardly been studied among survivors of a disaster. Objective. To investigate the association between self-reported health problems that have been attributed to an extreme life event and the symptoms presented to GPs. Methods. A two-wave longitudinal survey (2–3 weeks and 18 months) among survivors of a fireworks disaster was combined with a continuous morbidity surveillance in general practice. Symptoms attributed to the disaster reported in an open-ended question in the two waves were analysed using descriptive statistics. Differences in presented symptoms over time were analysed using logistic multilevel analysis. Results. More than half of the respondents reported health problems, which were, in their opinion, related to the disaster. Psychological problems were most frequently reported in association with the disaster, and in contrast to physical attributed symptoms, presentation of these problems in general practice decreased over time. In the total sample, musculoskeletal symptoms were less frequently presented in the longer term. Survivors who attributed symptoms to the disaster at both waves or after 18 months only most often presented such symptoms to the GP. Conclusion. Survivors attributed psychological problems and physical symptoms to the disaster at short-term and midterm post-disaster. Most of these survivors presented such symptoms to the GP. Attribution of symptoms to an extreme life event such as a disaster may therefore require special attention from the GP. (aut. ref

Kinetic simulation of an extreme ultraviolet radiation driven plasma near a multilayer mirror

Future generation lithog. tools will use extreme UV radiation to enable the printing of sub-50 nm features on silicon wafers. The extreme UV radiation, coming from a pulsed discharge, photoionizes the low pressure background gas in the tool. A weakly ionized plasma is formed, which will be in contact with the optical components of the lithog. device. In the plasma sheath region ions will be accelerated towards the surfaces of multilayer mirrors. A self-consistent kinetic particle-in-cell model has been applied to describe a radiation driven plasma. The simulations predict the plasma parameters and notably the energy at which ions impact on the plasma boundaries. We have studied the influence of photoelectron emission from the mirror on the sheath dynamics and on the ion impact energy. Furthermore, the ion impact energy distribution has been convoluted with the formula of Yamamura and Tawara [At. Data Nucl. Data Tables 62, 149 (1996)] for the sputter yield to obtain the rate of phys. sputtering. The model predicts that the sputter rate is dominated by the presence of doubly ionized argon ions. [on SciFinder (R)

Bidirectional and passive optical field to microwave field quantum converter with high bandwidth

The conversion between microwave photons and optical photons with quantum coherence is important for quantum communication and computation. In this paper, we report a proposal using an ensemble of atoms coupled to microwave and optical resonators. Input photons to one resonator are converted into output photons in the other resonator without active operation. Usually the conversion is only optimized at certain frequency. In our proposal, we find that the efficiency is almost a constant and can be close to 100% in a large interval of frequency, i.e. a high-bandwidth conversion can be realized with our proposal.Comment: 6 pages, 4 figure

Biobanking and consenting to research: a qualitative thematic analysis of young people's perspectives in the North East of England

BACKGROUND: Biobanking biospecimens and consent are common practice in paediatric research. We need to explore children and young people's (CYP) knowledge and perspectives around the use of and consent to biobanking. This will ensure meaningful informed consent can be obtained and improve current consent procedures. METHODS: We designed a survey, in co-production with CYP, collecting demographic data, views on biobanking, and consent using three scenarios: 1) prospective consent, 2) deferred consent, and 3) reconsent and assent at age of capacity. The survey was disseminated via the Young Person's Advisory Group North England (YPAGne) and participating CYP's secondary schools. Data were analysed using a qualitative thematic approach by three independent reviewers (including CYP) to identify common themes. Data triangulation occurred independently by a fourth reviewer. RESULTS: One hundred two CYP completed the survey. Most were between 16-18 years (63.7%, N = 65) and female (66.7%, N = 68). 72.3% had no prior knowledge of biobanking (N = 73). Acceptability of prospective consent for biobanking was high (91.2%, N = 93) with common themes: 'altruism', 'potential benefits outweigh individual risk', 'frugality', and '(in)convenience'. Deferred consent was also deemed acceptable in the large majority (84.3%, N = 86), with common themes: 'altruism', 'body integrity' and 'sample frugality'. 76.5% preferred to reconsent when cognitively mature enough to give assent (N = 78), even if parental consent was previously in place. 79.2% wanted to be informed if their biobanked biospecimen is reused (N = 80). CONCLUSION: Prospective and deferred consent acceptability for biobanking is high among CYP in the UK. Altruism, frugality, body integrity, and privacy are the most important themes. Clear communication and justification are paramount to obtain consent. Any CYP with capacity should be part of the consenting procedure, if possible

Task Force 7: Training Guidelines for Research in Pediatric Cardiology

Aim of the study. The aim of the study was to analyze the benefit from adjuvant radiotherapy in patients with vulvar cancer and a single positive node without extra capsular spread. Materials and methods. The Study population comprised data of 75 patients with vulvar cancer and one lymph node metastasis. The patients were treated in three different university centers in Amsterdam, Groningen and Rotterdam between 1984 and 2005. Results. Out of 75 patients, 31 (41%) were treated with adjuvant radiotherapy. Both disease-free survival (DFS) and disease-specific survival (DSS) were comparable between the groups who did and who did not receive adjuvant radiotherapy (HR 0.98, 95% CI 0.45-2.14, p=0.97 and HR = 1.02, 95% CI 0.42-2.47, p = 0.96). Conclusion. We could not demonstrate any beneficial effect of adjuvant radiotherapy in the group Of patients with one intra capsular metastasis. (C) 2009 Elsevier Inc. All rights reserved

Расчёт напряженно-деформированного состояния виброизоляторов сложной формы

Розглянуто пружно-деформований стан гумових віброізоляторів з урахуванням контактної взаємодії з деталями конструкції.Stress-strain state of rubber vibroinsulators is considered, taking into account contact interaction with construction parts

An Easy-to-Use Prognostic Model for Survival Estimation for Patients with Symptomatic Long Bone Metastases

BACKGROUND: A survival estimation for patients with symptomatic long bone metastases (LBM) is crucial to prevent overtreatment and undertreatment. This study analyzed prognostic factors for overall survival and developed a simple, easy-to-use prognostic model. METHODS: A multicenter retrospective study of 1,520 patients treated for symptomatic LBM between 2000 and 2013 at the radiation therapy and/or orthopaedic departments was performed. Primary tumors were categorized into 3 clinical profiles (favorable, moderate, or unfavorable) according to an existing classification system. Associations between prognostic variables and overall survival were investigated using the Kaplan-Meier method and multivariate Cox regression models. The discriminatory ability of the developed model was assessed with the Harrell C-statistic. The observed and expected survival for each survival category were compared on the basis of an external cohort. RESULTS: Median overall survival was 7.4 months (95% confidence interval [CI], 6.7 to 8.1 months). On the basis of the independent prognostic factors, namely the clinical profile, Karnofsky Performance Score, and presence of visceral and/or brain metastases, 12 prognostic categories were created. The Harrell C-statistic was 0.70. A flowchart was developed to easily stratify patients. Using cutoff points for clinical decision-making, the 12 categories were narrowed down to 4 categories with clinical consequences. Median survival was 21.9 months (95% CI, 18.7 to 25.1 months), 10.5 months (95% CI, 7.9 to 13.1 months), 4.6 months (95% CI, 3.9 to 5.3 months), and 2.2 months (95% CI, 1.8 to 2.6 months) for the 4 categories. CONCLUSIONS: This study presents a model to easily stratify patients with symptomatic LBM according to their expected survival. The simplicity and clarity of the model facilitate and encourage its use in the routine care of patients with LBM, to provide the most appropriate treatment for each individual patient. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence