Nurses\u27 Alumnae Association Bulletin - Volume 6 Number 10

Financial Report Calendar of Events Attention, Class of 1945! Miss Shafer Retires Review of the Alumnae Association Meetings Institutional Staff Nurses\u27 Section Report of Staff Activites - 1948-1949 The Staff Stockings! Stockings! Stockings! Pop-Up Toaster It\u27s Not Too Soon Any White Elephants? Private Duty Section The Jefferson Hospital Private Duty Nurses\u27 Register Report for Barton Memorial Hospital Progress of the Orthopedic Department Just Under the Date Line Pediatrics at Jefferson Controlled Respiration in Anesthesia Anesthesia Progress Physical Advances at Jefferson During the Past Year The White Haven Division The Clara Melville Scholarship Fund The Relief Fund The Busy Year for the Nurses\u27 Home Committee of the Women\u27s Board The Gray Ladies Memories Lost Miscellaneous Items Medical College News Marriages Births Deaths Condolences Prizes District No. 1 Dues Help! Help! Help! Jap Prison School Spurs Nurse to Win University Degree Twenty Ways to Kill an Organization The Bulletin Committee Attention, Alumnae New Addresse

Magnetic resonance imaging findings in Kenyans and South Africans with active convulsive epilepsy: an observational study

Objective: Focal epilepsy is common in low- and middle-income countries. The frequency and nature of possible underlying structural brain abnormalities have, however, not been fully assessed. Methods: We evaluated the possible structural causes of epilepsy in 331 people with epilepsy (240 from Kenya and 91 from South Africa) identified from community surveys of active convulsive epilepsy. Magnetic resonance imaging (MRI) scans were acquired on 1.5-Tesla scanners to determine the frequency and nature of any underlying lesions. We estimated the prevalence of these abnormalities using Bayesian priors (from an earlier pilot study) and observed data (from this study). We used a mixed-effect modified Poisson regression approach with the site as a random effect to determine the clinical features associated with neuropathology. Results: MRI abnormalities were found in 140 of 240 (modeled prevalence = 59%, 95% confidence interval [CI]: 53%–64%) of people with epilepsy in Kenya, and in 62 of 91 (modeled prevalence = 65%, 95% CI: 57%–73%) in South Africa, with a pooled modeled prevalence of 61% (95% CI: 56%–66%). Abnormalities were common in those with a history of adverse perinatal events (15/23 [65%, 95% CI: 43%–84%]), exposure to parasitic infections (83/120 [69%, 95% CI: 60%–77%]) and focal electroencephalographic features (97/142 [68%, 95% CI: 60%–76%]), but less frequent in individuals with generalized electroencephalographic features (44/99 [44%, 95% CI: 34%–55%]). Most abnormalities were potentially epileptogenic (167/202, 82%), of which mesial temporal sclerosis (43%) and gliosis (34%) were the most frequent. Abnormalities were associated with co-occurrence of generalized non-convulsive seizures (relative risk [RR] = 1.12, 95% CI: 1.04–1.25), lack of family history of seizures (RR = 0.91, 0.86–0.96), convulsive status epilepticus (RR = 1.14, 1.08–1.21), frequent seizures (RR = 1.12, 1.04–1.20), and reported use of anti-seizure medication (RR = 1.22, 1.18–1.26). Significance: MRI identified pathologies are common in people with epilepsy in Kenya and South Africa. Mesial temporal sclerosis, the most common abnormality, may be amenable to surgical correction. MRI may have a diagnostic value in rural Africa, but future longitudinal studies should examine the prognostic role

Empowerment: An Idea Whose Time Has Come in Diabetes Education

We have learned much in the past 10 years about how to help patients to acquire diabetes-related knowledge and skills and how to use strategies to help patients change behaviors. However, the application ofknowledge and techniques should be guided by a relevant, coherent, educational philosophy. Empowerment offers a practical conceptual framework for diabetes patient education. Empowering patients provides them with the knowledge, skills, and responsibility to effect change and has the potential to promote overall health and maximize the use of available resources. It is an idea whose time has come for diabetes education.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68779/2/10.1177_014572179101700108.pd

Complex Microbiome Underlying Secondary and Primary Metabolism in the Tunicate-\u3cem\u3eProchloron\u3c/em\u3e Symbiosis

The relationship between tunicates and the uncultivated cyanobacterium Prochloron didemni has long provided a model symbiosis. P. didemni is required for survival of animals such as Lissoclinum patella and also makes secondary metabolites of pharmaceutical interest. Here, we present the metagenomes, chemistry, and microbiomes of four related L. patella tunicate samples from a wide geographical range of the tropical Pacific. The remarkably similar P. didemni genomes are the most complex so far assembled from uncultivated organisms. Although P. didemni has not been stably cultivated and comprises a single strain in each sample, a complete set of metabolic genes indicates that the bacteria are likely capable of reproducing outside the host. The sequences reveal notable peculiarities of the photosynthetic apparatus and explain the basis of nutrient exchange underlying the symbiosis. P. didemni likely profoundly influences the lipid composition of the animals by synthesizing sterols and an unusual lipid with biofuel potential. In addition, L. patella also harbors a great variety of other bacterial groups that contribute nutritional and secondary metabolic products to the symbiosis. These bacteria possess an enormous genetic potential to synthesize new secondary metabolites. For example, an antitumor candidate molecule, patellazole, is not encoded in the genome of Prochloron and was linked to other bacteria from the microbiome. This study unveils the complex L. patella microbiome and its impact on primary and secondary metabolism, revealing a remarkable versatility in creating and exchanging small molecules

Reliability of Rapid Diagnostic Tests in Diagnosing Pregnancy-Associated Malaria in North-Eastern Tanzania.

Accurate diagnosis and prompt treatment of pregnancy-associated malaria (PAM) are key aspects in averting adverse pregnancy outcomes. Microscopy is the gold standard in malaria diagnosis, but it has limited detection and availability. When used appropriately, rapid diagnostic tests (RDTs) could be an ideal diagnostic complement to microscopy, due to their ease of use and adequate sensitivity in detecting even sub-microscopic infections. Polymerase chain reaction (PCR) is even more sensitive, but it is mainly used for research purposes. The accuracy and reliability of RDTs in diagnosing PAM was evaluated using microscopy and PCR. A cohort of pregnant women in north-eastern Tanzania was followed throughout pregnancy for detection of plasmodial infection using venous and placental blood samples evaluated by histidine rich protein 2 (HRP-2) and parasite lactate dehydrogenase (pLDH) based RDTs (Parascreen™) or HRP-2 only (Paracheck Pf® and ParaHIT®f), microscopy and nested Plasmodium species diagnostic PCR. From a cohort of 924 pregnant women who completed the follow up, complete RDT and microscopy data was available for 5,555 blood samples and of these 442 samples were analysed by PCR. Of the 5,555 blood samples, 49 ((proportion and 95% confidence interval) 0.9% [0.7 -1.1]) samples were positive by microscopy and 91 (1.6% [1.3-2.0]) by RDT. Forty-six (50.5% [40.5 - 60.6]) and 45 (49.5% [39.4 - 59.5]) of the RDT positive samples were positive and negative by microscopy, respectively, whereas nineteen (42.2% [29.0 - 56.7]) of the microscopy negative, but RDT positive, samples were positive by PCR. Three (0.05% [0.02 - 0.2]) samples were positive by microscopy but negative by RDT. 351 of the 5,461 samples negative by both RDT and microscopy were tested by PCR and found negative. There was no statistically significant difference between the performances of the different RDTs. Microscopy underestimated the real burden of malaria during pregnancy and RDTs performed better than microscopy in diagnosing PAM. In areas where intermittent preventive treatment during pregnancy may be abandoned due to low and decreasing malaria risk and instead replaced with active case management, screening with RDT is likely to identify most infections in pregnant women and out-performs microscopy as a diagnostic tool

Annual cycles are the most common reproductive strategy in African tropical tree communities

Abstract We present the first cross‐continental comparison of the flowering and fruiting phenology of tropical forests across Africa. Flowering events of 5446 trees from 196 species across 12 sites and fruiting events of 4595 trees from 191 species across 11 sites were monitored over periods of 6 to 29 years and analyzed to describe phenology at the continental level. To study phenology, we used Fourier analysis to identify the dominant cycles of flowering and fruiting for each individual tree and we identified the time of year African trees bloom and bear fruit and their relationship to local seasonality. Reproductive strategies were diverse, and no single regular cycle was found in >50% of individuals across all 12 sites. Additionally, we found annual flowering and fruiting cycles to be the most common. Sub‐annual cycles were the next most common for flowering, whereas supra‐annual patterns were the next most common for fruiting. We also identify variation in different subsets of species, with species exhibiting mainly annual cycles most common in West and West Central African tropical forests, while more species at sites in East Central and East African forests showed cycles ranging from sub‐annual to supra‐annual. Despite many trees showing strong seasonality, at most sites some flowering and fruiting occurred all year round. Environmental factors with annual cycles are likely to be important drivers of seasonal periodicity in trees across Africa, but proximate triggers are unlikely to be constant across the continent.Additional co-authors: Roman M. Wittig, Thomas Breuer, Mireille Breuer‐Ndoundou Hockemba, Crickette M. Sanz, David B. Morgan, Anne E. Pusey, Badru Mugerwa, Baraka Gilagiza, Caroline Tutin, Corneille E. N. Ewango, Douglas Sheil, Edmond Dimoto, Fidèle Baya, Flort Bujo, Fredrick Ssali, Jean‐Thoussaint Dikangadissi, Kim Valenta, Michel Masozera, Michael L. Wilson, Robert Bitariho, Sydney T. Ndolo Ebika, Sylvie Gourlet‐Fleury, Felix Mulindahabi, Colin M. Beal

Facial Mask Use and COVID-19 Protection Measures in Jefferson County, Kentucky: Results from an Observational Survey, November 5−11, 2020

Introduction: The transmission of respiratory infectious diseases such as COVID-19 can significantly decrease by mask-wearing. However, accurate information about the extent and proper use of the facial mask is scarce. This study’s main objective was to observe and analyze mask-wearing behavior and the level of COVID-19 protection measures in indoor public areas (PAs) of Jefferson County, Kentucky. Methods: For conducting the observational survey study, targets were indoor PAs, and zip codes were defined as surveying clusters. The number of selected PAs in each zip code was proportional to the population and the total number of PAs in that zip code. The PA pool in a zip code was divided into four groups, followed by random selection without replacement from each group. Results: A total of 191 PAs were surveyed: 50 of them were grocery stores, 56 were convenience stores or pharmacies, 39 were wine and liquor stores, and 46 were other stores. At least one unmasked and one incorrectly masked staff were observed in 26% and 40% of the sampled PAs, respectively. Also, in 29% and 35% of the PAs, at least one unmasked and one incorrectly masked visitor were observed, respectively. The rates varied by PA size and county district. Eighty percent of unmasked staff and 75% of the unmasked visitors were male. The rate of unmasked males varied from 50% to 100% across districts. About 66% of unmasked staff among all Jefferson County districts were young adults. More than one-fourth of all the PAs provided hand sanitizer for visitors’ use, and only 2% of the PAs provided masks to their visitors. Conclusion: Messaging about mask use and correct usage may need to particularly target the 19-44-year-old male population, as these individuals were the most prevalent among those unmasked and masked incorrectly. Additionally, businesses’ protective measures may depend on their resources to operate in such a manner. Hand sanitizer is easier to offer visitors, while staffing to regularly sanitize carts or funds to provide a sufficient number of wipes, gloves, or masks may present further opportunities for government assistance