Knowledge, attitudes and practices of oral health care workers in Lesotho regarding the management of patients with oral manifestations of HIV/AIDS

Lesotho has the third highest prevalence of HIV in the world with an estimated 23% of the adult population infected. At least 70% of people living with HIV/AIDS (PLWHA) have presented with oral manifestation of HIV as the first sign of the disease. Oral health workers regularly encounter patients presenting with oral lesions associated with HIV disease and therefore need to have adequate knowledge of these conditions for diagnosis and management. The aim of the present study was to determine the knowledge, attitudes and practices of oral health care workers (OHCW) of Lesotho regarding the management of oral manifestations of HIV/AIDS. A descriptive cross-sectional survey was conducted on all 46 OHCW in 26 public and private care facilities in all ten districts of Lesotho. A self - administered questionnaire was used to gather information. The response rate was 100%. Nearly all (94.7%) agreed that oral lesions are common in people living with HIV and/or AIDS. The majority (91.3%) named oral candidiasis (OC) as the most common lesion found in PLWHA while Kaposi's Sarcoma (KS) (34.7%) and Oral Hairy Leukoplakia (OHL) (32.6%) were mentioned as the least common oral lesions of HIV. Most correctly identified the images of oral candidiasis (97.8%), angular cheilitis (86.9%) and herpes zoster (80.4%). Only 16.7% felt they had comprehensive knowledge of oral HIV lesions, although 84.8% reported having previously received training. Almost three quarters (71%) reported that there was no need to treat HIV positive patients differently from HIV negative patients. OHCW in Lesotho demonstrated high confidence levels in their competence in managing dental patients with oral lesions associated with HIV, however, they lacked an in-depth knowledge in this regard. Amongst this group there is a need for comprehensive training with regards to diagnosis and management of oral lesions of HIV including the training of other cadres of health care workers together with nurses and community health workers.DHE

L-band synthetic aperture radar imagery performs better than optical datasets at retrieving woody fractional cover in deciduous, dry savannahs

Woody canopy cover (CC) is the simplesttwo dimensional metric for assessing the presence ofthe woody component in savannahs, but detailed validated maps are not currently available in southern African savannahs. A number of international EO programs (including in savannah landscapes) advocate and use optical LandSAT imagery for regional to country-wide mapping of woody canopy cover. However, previous research has shown that L-band Synthetic Aperture Radar (SAR) provides good performance at retrieving woody canopy cover in southern African savannahs. This study’s objective was to evaluate, compare and use in combination L-band ALOS PALSAR and LandSAT-5 TM, in a Random Forest environment, to assess the benefits of using LandSAT compared to ALOS PALSAR. Additional objectives saw the testing of LandSAT-5 image seasonality, spectral vegetation indices and image textures for improved CC modelling. Results showed that LandSAT-5 imagery acquired in the summer and autumn seasons yielded the highest single season modelling accuracies (R2 between 0.47 and 0.65), depending on the year but the combination of multi-seasonal images yielded higher accuracies (R2 between 0.57 and 0.72). The derivation of spectral vegetation indices and image textures and their combinations with optical reflectance bands provided minimal improvement with no optical-only result exceeding the winter SAR L-band backscatter alone results (R2 of ∼0.8). The integration of seasonally appropriate LandSAT-5 image reflectance and L-band HH and HV backscatter data does provide a significant improvement for CC modelling at the higher end of the model performance (R2 between 0.83 and 0.88), but we conclude that L-band only based CC modelling be recommended for South African regionshttp://www.elsevier.com/locate/jag2017-10-31hb2016Geography, Geoinformatics and Meteorolog

Hyper-temporal C-band SAR for baseline woody structural assessments in deciduous savannas

Savanna ecosystems and their woody vegetation provide valuable resources and ecosystem services. Locally calibrated and cost effective estimates of these resources are required in order to satisfy commitments to monitor and manage change within them. Baseline maps of woody resources are important for analyzing change over time. Freely available, and highly repetitive, C-band data has the potential to be a viable alternative to high-resolution commercial SAR imagery (e.g., RADARSAT-2, ALOS2) in generating large-scale woody resources maps. Using airborne LiDAR as calibration, we investigated the relationships between hyper-temporal C-band ASAR data and woody structural parameters, namely total canopy cover (TCC) and total canopy volume (TCV), in a deciduous savanna environment. Results showed that: the temporal filter reduced image variance; the random forest model out-performed the linear model; while the TCV metric consistently showed marginally higher accuracies than the TCC metric. Combinations of between 6 and 10 images could produce results comparable to high resolution commercial (C- & L-band) SAR imagery. The approach showed promise for producing a regional scale, locally calibrated, baseline maps for the management of deciduous savanna resources, and lay a foundation for monitoring using time series of data from newer C-band SAR sensors (e.g., Sentinel1).Greg Asner, through the CAO campaign and acknowledged partners, provided funding for the LiDAR acquisition and LiDAR processing, as well as interpretation and review of the results.http://www.mdpi.com/journal/remotesensingam2016Electrical, Electronic and Computer EngineeringGeography, Geoinformatics and Meteorolog

Savannah woody structure modelling and mapping using multi-frequency (X-, C- and L-band) synthetic aperture radar data

Structural parameters of the woody component in African savannahs provide estimates of carbon stocks that are vital to the understanding of fuelwood reserves, which is the primary source of energy for 90% of households in South Africa (80% in Sub-Saharan Africa) and are at risk of over utilisation. The woody component can be characterised by various quantifiable woody structural parameters, such as tree cover, tree height, above ground biomass (AGB) or canopy volume, each been useful for different purposes. In contrast to the limited spatial coverage of ground-based approaches, remote sensing has the ability to sense the high spatio-temporal variability of e.g. woody canopy height, cover and biomass, as well as species diversity and phenological status – a defining but challenging set of characteristics typical of African savannahs. Active remote sensing systems (e.g. Light Detection and Ranging – LiDAR; Synthetic Aperture Radar – SAR), on the other hand, may be more effective in quantifying the savannah woody component because of their ability to sense within-canopy properties of the vegetation and its insensitivity to atmosphere and clouds and shadows. Additionally, the various components of a particular target’s structure can be sensed differently with SAR depending on the frequency or wavelength of the sensor being utilised. This study sought to test and compare the accuracy of modelling, in a Random Forest machine learning environment, woody above ground biomass (AGB), canopy cover (CC) and total canopy volume (TCV) in South African savannahs using a combination of X-band (TerraSAR-X), C-band (RADARSAT-2) and L-band (ALOS PALSAR) radar datasets. Training and validation data were derived from airborne LiDAR data to evaluate the SAR modelling accuracies. It was concluded that the L-band SAR frequency was more effective in the modelling of the CC (coefficient of determination or R2 of 0.77), TCV (R2 of 0.79) and AGB (R2 of 0.78) metrics in Southern African savannahs than the shorter wavelengths (X- and C-band) both as individual and combined (X + C-band) datasets. The addition of the shortest wavelengths also did not assist in the overall reduction of prediction error across different vegetation conditions (e.g. dense forested conditions, the dense shrubby layer and sparsely vegetated conditions). Although the integration of all three frequencies (X + C + L-band) yielded the best overall results for all three metrics (R2 = 0.83 for CC and AGB and R2 = 0.85 for TCV), the improvements were noticeable but marginal in comparison to the L-band alone. The results, thus, do not warrant the acquisition of all three SAR frequency datasets for tree structure monitoring in this environment.Council for Scientific and Industrial Research (CSIR) – South Africa, the Department of Science and Technology, South Africa (Grant Agreement DST/CON 0119/2010, Earth Observation Application Development in Support of SAEOS) and the European Union’s Seventh Framework Programme (FP7/2007-2013, Grant Agreement No. 282621, AGRICAB) for funding this study. The Xband StripMap TerraSAR-X scenes were acquired under a proposal submitted to the TerraSAR-X Science Service of the German Aerospace Center (DLR). The C-band Quad-Pol RADARSAT-2 scenes were provided by MacDonald Dettwiler and Associates Ltd. – Geospatial Services Inc. (MDA GSI), the Canadian Space Agency (CSA), and the Natural Resources Canada’s Centre for Remote Sensing (CCRS) through the Science and Operational Applications Research (SOAR) programme. The L-band ALOS PALSAR FBD scenes were acquired under a K&C Phase 3 agreement with the Japanese Aerospace Exploration Agency (JAXA). The Carnegie Airborne Observatory is supported by the Avatar Alliance Foundation, John D. and Catherine T. MacArthur Foundation, Gordon and Betty Moore Foundation, W.M. Keck Foundation, the Margaret A. Cargill Foundation, Mary Anne Nyburg Baker and G. Leonard Baker Jr., and William R. Hearst III. The application of the CAO data in South Africa is made possible by the Andrew Mellon Foundation, Grantham Foundation for the Protection of the Environment, and the endowment of the Carnegie Institution for Science.http://www.elsevier.com/locate/isprsjprs2016-07-31hb201

Enhanced stability of the square lattice of a classical bilayer Wigner crystal

The stability and melting transition of a single layer and a bilayer crystal consisting of charged particles interacting through a Coulomb or a screened Coulomb potential is studied using the Monte-Carlo technique. A new melting criterion is formulated which we show to be universal for bilayer as well as for single layer crystals in the case of (screened) Coulomb, Lennard--Jones and 1/r^{12} repulsive inter-particle interactions. The melting temperature for the five different lattice structures of the bilayer Wigner crystal is obtained, and a phase diagram is constructed as a function of the interlayer distance. We found the surprising result that the square lattice has a substantial larger melting temperature as compared to the other lattice structures. This is a consequence of the specific topology of the defects which are created with increasing temperature and which have a larger energy as compared to the defects in e.g. a hexagonal lattice.Comment: Accepted for publication in Physical Review

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings: Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation: Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding: Bill & Melinda Gates Foundation

The child posttraumatic stress disorder checklist in a sample of South African youth

To address the diverse health effects of posttraumatic stress disorder (PTSD) in youth, reliable and valid screening and diagnostic instruments that can be adapted to the specific context in which they are used, are required. Here, we assessed the psychometric properties (factorial validity, concurrent validity, and internal consistency) of the Child PTSD Checklist in treatment-seeking youth using secondary data. The scale demonstrated high internal consistency (Cronbach > = 0.93). Exploratory factor analysis revealed a three-factor structure (anxiety and avoidance, anger and dissociation, and depressive symptoms) that accounted for 41.9% of the total variance. Concurrent validity was fair between the Child PTSD Checklist and the diagnostic Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version when assessing for PTSD. The Child PTSD Checklist seems to be a promising tool for assessing PTSD in trauma-exposed youth in clinic settings. However, further studies are needed to address the checklist's broader utility.

No association between cumulative traumatic experiences and sex in risk for posttraumatic stress disorder among human immunodeficiency virus-positive adults

This study examined the association between the type and number of traumatic experiences and the conditional risk for posttraumatic stress disorder (PTSD), stratified by sex, in human immunodeficiency virus (HIV). We evaluated 465 (114 male and 350 female) HIV-positive adults attending HIV clinics in Cape Town, South Africa. Demographic and clinical data were collected, and the participants were screened for current PTSD and traumatic event exposure using the Mini-International Neuropsychiatric Interview and the Life Events Checklist, respectively. The highest attributable risk for PTSD was derived from sexual assault (17.4%) and transport accidents (16.9%). Only sexual assault was significantly (p = 0.002) associated with current PTSD. Although sex had no effect on the prediction of current PTSD, HI infected men tended to experience more lifetime traumas than HIV-infected women, with the men having significantly higher rates of exposure than women to physical assault (p = 0.018) and assault with a weapon (p = 0.001). These data highlight the importance of considering trauma type in contributing to the burden of PTSD in HIV-infected adults.

An enzyme-initiated Smiles rearrangement enables the development of an assay of MshB, the GlcNAc-Ins deacetylase of mycothiol biosynthesis

MshB is the N-acetyl-1-d-myo-inosityl-2-amino-2-deoxy-d-glucopyranoside (GlcNAc-Ins) deacetylase active as one of the enzymes involved in the biosynthesis of mycothiol (MSH), a protective low molecular weight thiol present only in Mycobacterium tuberculosis and other actinomycetes. In this study, structural analogues of GlcNAc-Ins in which the inosityl moiety is replaced by a chromophore were synthesized and evaluated as alternate substrates of MshB, with the goal of identifying a compound that would be useful in high-throughput assays of the enzyme. In an unexpected and surprising finding one of the GlcNAc-Ins analogues is shown to undergo a Smiles rearrangement upon MshB-mediated deacetylation, uncovering a free thiol group. We demonstrate that this chemistry can be exploited for the development of the first continuous assay of MshB activity based on the detection of thiol formation by DTNB (Ellman's reagent); such an assay should be ideally suited for the identification of MshB inhibitors by means of high-throughput screens in microplates. © The Royal Society of Chemistry 2012

Hyper-Temporal C-Band SAR for Baseline Woody Structural Assessments in Deciduous Savannas

Savanna ecosystems and their woody vegetation provide valuable resources and ecosystem services. Locally calibrated and cost effective estimates of these resources are required in order to satisfy commitments to monitor and manage change within them. Baseline maps of woody resources are important for analyzing change over time. Freely available, and highly repetitive, C-band data has the potential to be a viable alternative to high-resolution commercial SAR imagery (e.g., RADARSAT-2, ALOS2) in generating large-scale woody resources maps. Using airborne LiDAR as calibration, we investigated the relationships between hyper-temporal C-band ASAR data and woody structural parameters, namely total canopy cover (TCC) and total canopy volume (TCV), in a deciduous savanna environment. Results showed that: the temporal filter reduced image variance; the random forest model out-performed the linear model; while the TCV metric consistently showed marginally higher accuracies than the TCC metric. Combinations of between 6 and 10 images could produce results comparable to high resolution commercial (C- & L-band) SAR imagery. The approach showed promise for producing a regional scale, locally calibrated, baseline maps for the management of deciduous savanna resources, and lay a foundation for monitoring using time series of data from newer C-band SAR sensors (e.g., Sentinel1)