Idiopathic CD4+ T-lymphocytopenia with cryptococcal meningitis: first case report from Cambodia.

We report on a patient with cryptococcal meningitis with CD4+ T-lymphocytopenia and no evidence of HIV infection

Sound and light from fractures in scintillators

Prompted by intriguing events observed in certain particle-physics searches for rare events, we study light and acoustic emission simultaneously in some inorganic scintillators subject to mechanical stress. We observe mechanoluminescence in ${Bi}_4{Ge}_{3}{O}_{12}$, ${CdWO}_{4}$ and ${ZnWO}_{4}$, in various mechanical configurations at room temperature and ambient pressure. We analyze how the light emission is correlated to acoustic emission during fracture. For ${Bi}_4{Ge}_{3}{O}_{12}$, we set a lower bound on the energy of the emitted light, and deduce that the fraction of elastic energy converted to light is at least $3 \times 10^{-5}$

Continuing Professional Development: Needs, Facilitators and Barriers of Registered Nurses in India in Rural and Remote Settings: Findings from a Cross Sectional Survey

Background: Nurses constitute a major portion of the health care workforce in India. A priority to develop pre and post registration nurse education in India has increasingly been highlighted in nursing and health policy imperatives in recent years. Nurses are often the only health care professionals in primary and secondary care within rural and remote healthcare settings in India. They are confronted with the dual challenge of resource constraints and rapidly changing disease profile with little or no access to continuing professional development.  Objectives: 1) To identify key continuing professional development priorities of registered nurses working in remote and rural health care settings in India. 2) To identify barriers and facilitators to continuing professional development as perceived by registered nurses working in these settings. 3) To identify preferred modes of continuing professional development by registered nurses working in remote and rural health care settings in India.  Design: Quantitative Design.  Setting: Two large health care facilities in remote and rural parts of India.  Participants: Registered Nurses working in two large not for profit health care organisations participated in the study. Nursing assistants and student nurses were excluded from the study. 368 participants consented to participate in the survey and 271 (73.6%) participants completed the survey.  Methods: A questionnaire based cross sectional survey was undertaken as part of the Continuing Professional Development needs assessment among registered nurses working in rural and remote settings.  Results: Continuing Professional Development priorities included training on clinical competencies focussed on managing emergency situations related to non-communicable diseases [50%], managerial competencies related to ethical dilemmas [60%] such as support for families with financial difficulties accessing health care [17.8%], women undergoing abortions [14.6%], or those with HIV infection [12.9%]. Preferred modes for Continuing Professional Development included conference attendance [54%], skills training [48%] and in-house training [32%]. Key facilitators for Continuing Professional Development included, professional development [77%], personal interest [42%], opportunities for professional engagement with colleagues [39%], the need to reduce knowledge and skill gap [36%] and career progression [28%]. Geographic distance [59%], low staffing levels [51%], cost [43%], domestic responsibilities [40%], and work commitments [39%] were reported as key barriers to Continuing Professional Development.  Conclusions: The findings from this survey, the first of its kind in India, provides evidence on priorities, barriers and facilitators for continuing professional development of registered nurses working in rural and remote settings in India

Estudo do consumo alimentar: em busca de uma abordagem multidisciplinar

Mudanças nos hábitos alimentares têm sido observadas nas últimas décadas, em vários países, revelando a complexidade dos modelos de consumo e de seus fatores determinantes. Assim, a adoção de uma abordagem multidisciplinar e comparativa, onde os vários aspectos da alimentação (econômicos, sociais, culturais e nutricionais) possam ser avaliados, faz-se ainda mais necessária, de modo a permitir a elucidação dos mecanismos responsáveis por essas mudanças e suas conseqüências, nos diferentes contextos socioeconômicos. Foram analisadas as contribuições de várias áreas de conhecimento ao estudo da situação alimentar e discutidos os enfoques dados a esse tema no contexto dos países do Norte e do Sul e, mais especificamente, para o caso brasileiro. Propõe-se a análise do consumo alimentar a partir da noção de "sistemas alimentares", numa perspectiva histórica. Trata-se de considerar os diferentes agentes sociais (produtores, distribuidores, consumidores e o Estado), suas lógicas, suas estratégias e as relações que se estabelecem entre eles, ao longo do tempo, visando assim à compreensão do processo através do qual os hábitos alimentares se constroem e evoluem.Changes in eating habits have been observed in many countries in recent decades revealing the complexity of consumption models and their determining factors. Thus it is that the adoption of a multidisciplinary and comparative approach by which the various aspects of eating habits (economic, social, cultural and nutritional) may be assessed so as to permit the elucidation of the mechanisms responsible for these changes and their consequences in different socio-economic contexts, becomes even more necessary. The contributions of the various areas of knowledge to the study of the nutritional situation are here analysed and the approach to this theme in countries of the North and the South is discussed, as is, specifically, the situation in Brazil. Finally, the analysis of the consumption of food-stuffs on the basis of the notion of "food systems", within a historical perspective, is proposed. The various social agents (producers, distributors, consumers, State), their systems of logic, their strategies and the relationships which they establish among themselves over time are taken into account in such a way as to make possible an understanding of the process by which eating habits are constructed and developed

Discovery of optical pulsations in V2116 Ophiuchi/GX 1+4

We report the detection of pulsations with $\sim 124$ s period in V2116 Oph, the optical counterpart of the low-mass X-ray binary GX 1+4. The pulsations are sinusoidal with modulation amplitude of up to 4% in blue light and were observed in ten different observing sessions during 1996 April-August using a CCD photometer at the 1.6-m and 0.6-m telescopes of Laborat\'orio Nacional de Astrof\'{\i}sica, in Brazil. The pulsations were also observed with the $UBVRI$ fast photometer. With only one exception the observed optical periods are consistent with those observed by the BATSE instrument on board the Compton Gamma Ray Observatory at the same epoch. There is a definite correlation between the observability of pulsations and the optical brightness of the system: V2116~Oph had $R$ magnitude in the range $15.3-15.5$ when the pulsed signal was detected, and $R = 16.0-17.7$ when no pulsations were present. The discovery makes GX 1+4 only the third of $\sim 35$ accretion-powered X-ray pulsars to be firmly detected as a pulsating source in the optical. The presence of flickering and pulsations in V2116 Oph adds strong evidence for an accretion disk scenario in this system. The absolute magnitude of the pulsed component on 1996 May 27 is estimated to be $M_V \sim -1.5$. The implied dimensions for the emitting region are 1.1 R_{\sun}, 3.2 R_{\sun}, and 7.0 R_{\sun}, for black-body spectral distributions with $T = 10^5$ K, $2 \times 10^4$ K, and $1 \times 10^4$ K, respectively.Comment: 9 pages, 3 figures in PostScript, latex, accepted for publication on the Astrophysical Journal Letter

Current Understanding of the Anatomy, Physiology, and Magnetic Resonance Imaging of Neurofluids: Update From the 2022 “<scp>ISMRM</scp> Imaging Neurofluids Study group” Workshop in Rome

Neurofluids is a term introduced to define all fluids in the brain and spine such as blood, cerebrospinal fluid, and interstitial fluid. Neuroscientists in the past millennium have steadily identified the several different fluid environments in the brain and spine that interact in a synchronized harmonious manner to assure a healthy microenvironment required for optimal neuroglial function. Neuroanatomists and biochemists have provided an incredible wealth of evidence revealing the anatomy of perivascular spaces, meninges and glia and their role in drainage of neuronal waste products. Human studies have been limited due to the restricted availability of noninvasive imaging modalities that can provide a high spatiotemporal depiction of the brain neurofluids. Therefore, animal studies have been key in advancing our knowledge of the temporal and spatial dynamics of fluids, for example, by injecting tracers with different molecular weights. Such studies have sparked interest to identify possible disruptions to neurofluids dynamics in human diseases such as small vessel disease, cerebral amyloid angiopathy, and dementia. However, key differences between rodent and human physiology should be considered when extrapolating these findings to understand the human brain. An increasing armamentarium of noninvasive MRI techniques is being built to identify markers of altered drainage pathways. During the three‐day workshop organized by the International Society of Magnetic Resonance in Medicine that was held in Rome in September 2022, several of these concepts were discussed by a distinguished international faculty to lay the basis of what is known and where we still lack evidence. We envision that in the next decade, MRI will allow imaging of the physiology of neurofluid dynamics and drainage pathways in the human brain to identify true pathological processes underlying disease and to discover new avenues for early diagnoses and treatments including drug delivery.Evidence level: 1Technical Efficacy: Stage

An Alternating GluN1-2-1-2 Subunit Arrangement in Mature NMDA Receptors

NMDA receptors (NMDARs) form glutamate-gated ion channels that play a critical role in CNS physiology and pathology. Together with AMPA and kainate receptors, NMDARs are known to operate as tetrameric complexes with four membrane-embedded subunits associating to form a single central ion-conducting pore. While AMPA and some kainate receptors can function as homomers, NMDARs are obligatory heteromers composed of homologous but distinct subunits, most usually of the GluN1 and GluN2 types. A fundamental structural feature of NMDARs, that of the subunit arrangement around the ion pore, is still controversial. Thus, in a typical NMDAR associating two GluN1 and two GluN2 subunits, there is evidence for both alternating 1/2/1/2 and non-alternating 1/1/2/2 arrangements. Here, using a combination of electrophysiological and cross-linking experiments, we provide evidence that functional GluN1/GluN2A receptors adopt the 1/2/1/2 arrangement in which like subunits are diagonal to one another. Moreover, based on the recent crystal structure of an AMPA receptor, we show that in the agonist-binding and pore regions, the GluN1 subunits occupy a “proximal” position, closer to the central axis of the channel pore than that of GluN2 subunits. Finally, results obtained with reducing agents that differ in their membrane permeability indicate that immature (intracellular) and functional (plasma-membrane inserted) pools of NMDARs can adopt different subunit arrangements, thus stressing the importance of discriminating between the two receptor pools in assembly studies. Elucidating the quaternary arrangement of NMDARs helps to define the interface between the subunits and to understand the mechanism and pharmacology of these key signaling receptors

Basement membrane proteins as a substrate for efficient Trypanosoma brucei differentiation in vitro

The ability to reproduce the developmental events of trypanosomes that occur in their mammalian host in vitro offers significant potential to assist in understanding of the underlying biology of the process. For example, the transition from bloodstream slender to bloodstream stumpy forms is a quorum-sensing response to the parasite-derived peptidase digestion products of environmental proteins. As an abundant physiological substrate in vivo, we studied the ability of a basement membrane matrix enriched gel (BME) in the culture medium to support differentiation of pleomorphic Trypanosoma brucei to stumpy forms. BME comprises extracellular matrix proteins, which are among the most abundant proteins found in connective tissues in mammals and known substrates of parasite-released peptidases. We previously showed that two of these released peptidases are involved in generating a signal that promotes slender-to-stumpy differentiation. Here, we tested the ability of basement membrane extract to enhance parasite differentiation through its provision of suitable substrates to generate the quorum sensing signal, namely oligopeptides. Our results show that when grown in the presence of BME, T. brucei pleomorphic cells arrest at the G0/1 phase of the cell cycle and express the differentiation marker PAD1, the response being restricted to differentiation-competent parasites. Further, the stumpy forms generated in BME medium are able to efficiently proceed onto the next life cycle stage in vitro, procyclic forms, when incubated with cis-aconitate, further validating the in vitro BME differentiation system. Hence, BME provides a suitable in vitro substrate able to accurately recapitulate physiological parasite differentiation without the use of experimental animals