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Sample records for imported cases represent

  1. Quantifying Representativeness Importance Values for AmeriFlux Sites

    NASA Astrophysics Data System (ADS)

    Hargrove, W. W.; Hoffman, F. M.

    2005-12-01

    We are using a multivariate statistical clustering analysis to determine how well the current distribution of sites in the AmeriFlux network is representative of the dominant combinations of vegetation, soils, and climate which are present in the conterminous US. Statistical indices based on multivariate representativeness and site importance indicate how well the current network of towers "samples" the population of flux environments within the nation. The same empirical approach provides a repeatable rationale for the selection of additional flux tower sites by determining any number of additional locations such that the representation of the overall network is maximized by their addition. A representativeness importance value for each existing eddy covariance tower to the AmeriFlux network can be calculated. We have statistically created a series of nine sets of flux-relevant ecoregions which divide the conterminous U.S. into a set of areas within which the carbon flux from terrestrial ecosystems is expected to be relatively uniform and homogeneous. Starting with digital GIS layers of factors deemed important in regulating carbon fixation and loss from terrestrial ecosystems, we assembled a set of maps of multivariate factors which describe and characterize the flux environment in each map cell. Then, we used a k-means clustering procedure to classify each map cell into a particular group whose cells have sufficiently similar environments. Because there were as many as 30 environmental descriptors, each with nearly 8 million cells, it was necessary to perform the clustering process on a parallel supercomputer. Because the statistical process is quantitative, the similarity of a selected flux-ecoregion to every other ecoregion in the map can be calculated. Maps can be produced that show the degree of similarity to the chosen flux-ecoregion as a series of gray shades. By sequentially selecting flux ecoregions currently containing an AmeriFlux tower, maps showing

  2. [Imported cases of histoplasmosis].

    PubMed

    Nyffenegger, Laurent; Abbas, Mohamed; Gex, Grégoire; Boffi, Emmanuelle; Schrenzel, Jacques; Bouchuiguir-Wafa, Kalthum; Hirschel, Bernard

    2009-11-25

    Histoplasmosis is a fungal infection that may be opportunistic in the context of HIV. Rare in Europe, it is always imported. The two variants of histoplasmosis are encountered in defined geographic areas: var. capsulatum in Americas, Africa and Asia; and var duboisii in Africa only. In immuno-competent patients, acute infection is often asymptomatic, or it may cause a pulmonary syndrome of variable severity. Among immuno-compromised patients, histoplasmosis is disseminated and life-threatening. Diagnosis is typically made by cultures. The treatment of the disseminated form must be started immediately with anti-fungal therapy and highly active anti-retroviral treatment. In a globalized world, one has to remember the importation of unusual exotic diseases.

  3. 7 CFR 1212.12 - Importer-Handler Representative.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE HONEY PACKERS AND IMPORTERS RESEARCH, PROMOTION, CONSUMER EDUCATION AND INDUSTRY INFORMATION ORDER Honey Packers... importer and first handler, who must import at least 75 percent of the honey they market in the...

  4. 7 CFR 1212.12 - Importer-Handler Representative.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE HONEY PACKERS AND IMPORTERS RESEARCH, PROMOTION, CONSUMER EDUCATION AND INDUSTRY INFORMATION ORDER Honey Packers... importer and first handler, who must import at least 75 percent of the honey they market in the...

  5. 7 CFR 1212.12 - Importer-Handler Representative.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....12 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE HONEY PACKERS AND IMPORTERS RESEARCH, PROMOTION, CONSUMER EDUCATION AND INDUSTRY INFORMATION ORDER Honey...

  6. 7 CFR 1212.12 - Importer-Handler Representative.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ....12 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE HONEY PACKERS AND IMPORTERS RESEARCH, PROMOTION, CONSUMER EDUCATION AND INDUSTRY INFORMATION ORDER Honey...

  7. 7 CFR 1212.12 - Importer-Handler Representative.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ....12 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE HONEY PACKERS AND IMPORTERS RESEARCH, PROMOTION, CONSUMER EDUCATION AND INDUSTRY INFORMATION ORDER Honey...

  8. Determining the relative importance of figures in journal articles to find representative images

    NASA Astrophysics Data System (ADS)

    Müller, Henning; Foncubierta-Rodríguez, Antonio; Lin, Chang; Eggel, Ivan

    2013-03-01

    When physicians are searching for articles in the medical literature, images of the articles can help determining relevance of the article content for a specific information need. The visual image representation can be an advantage in effectiveness (quality of found articles) and also in efficiency (speed of determining relevance or irrelevance) as many articles can likely be excluded much quicker by looking at a few representative images. In domains such as medical information retrieval, allowing to determine relevance quickly and accurately is an important criterion. This becomes even more important when small interfaces are used as it is frequently the case on mobile phones and tablets to access scientific data whenever information needs arise. In scientific articles many figures are used and particularly in the biomedical literature only a subset may be relevant for determining the relevance of a specific article to an information need. In many cases clinical images can be seen as more important for visual appearance than graphs or histograms that require looking at the context for interpretation. To get a clearer idea of image relevance in articles, a user test with a physician was performed who classified images of biomedical research articles into categories of importance that can subsequently be used to evaluate algorithms that automatically select images as representative examples. The manual sorting of images of 50 journal articles of BioMedCentral with each containing more than 8 figures by importance also allows to derive several rules that determine how to choose images and how to develop algorithms for choosing the most representative images of specific texts. This article describes the user tests and can be a first important step to evaluate automatic tools to select representative images for representing articles and potentially also images in other contexts, for example when representing patient records or other medical concepts when selecting

  9. Imported malaria cases in Okinawa Prefecture, Japan.

    PubMed

    Higa, Futoshi; Tateyama, Masao; Tasato, Daisuke; Karimata, Yosuke; Nakamura, Hideta; Miyagi, Kazuya; Haranaga, Shusaku; Hirata, Tetsuo; Hokama, Akira; Cash, Haley L; Toma, Hiromu; Fujita, Jiro

    2013-01-01

    With the increase in global transportation, imported malaria has become a significant public health concern in Japan. In the present study, we retrospectively analyzed all imported malaria cases in Okinawa Prefecture from 1988 to 2012. In that period, 23 patients with imported malaria were admitted to the University of the Ryukyus Hospital. Malaria types observed included Plasmodium falciparum (14 cases), P. vivax (7 cases), combined P. falciparum and P. ovale (1 case), and combined P. vivax and P. malariae (1 case). All cases were resolved by anti-malarial treatment. The clinical data from these patients highlights the importance of collecting patient travel history and ensuring an adequate supply of both diagnostic test and drug treatments in Okinawa.

  10. Neuropsychologist Experts and Civil Capacity Evaluations: Representative Cases.

    PubMed

    Kaufmann, Paul M

    2016-09-01

    Clinical neuropsychologists accept more forensic referrals now and spend more time in forensic consulting than ever before. Recent surveys show weekly hours devoted to forensic consulting increased 97% in the past decade. During the same time period, the number of board certified neuropsychologists more than doubled. Under recently published Specialty Guidelines for Forensic Psychology, clinical neuropsychologists practice forensic psychology when applying scientific, technical, or specialized knowledge of neuropsychology to the law to assist in addressing legal, contractual, or administrative matters. Among those increasingly varied forensic referrals, clinical neuropsychologists are conducting more civil competency and capacity evaluations. Representative cases from three jurisdictions demonstrate how neuropsychologists provide expertize in matters involving testamentary capacity, contractual capacity, business judgments, and job capacity. Case presentations illustrate some of the strengths and weaknesses of neuropsychological evaluation of civil capacities. The article concludes with a "battle of experts" case involving five neuropsychologists with opposing opinions recently heard in a Federal Appellate court. Implications for neuropschology training and forensic competencies are considered. In offering quality services to the legal profession, neuropsychologists support the truth-seeking function of the judiciary, promote justice, protect the profession, and serve public policy. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Sleepiness and Motor Vehicle Crashes in a Representative Sample of Portuguese Drivers: The Importance of Epidemiological Representative Surveys.

    PubMed

    Gonçalves, M; Peralta, A R; Monteiro Ferreira, J; Guilleminault, Christian

    2015-01-01

    Sleepiness is considered to be a leading cause of crashes. Despite the huge amount of information collected in questionnaire studies, only some are based on representative samples of the population. Specifics of the populations studied hinder the generalization of these previous findings. For the Portuguese population, data from sleep-related car crashes/near misses and sleepiness while driving are missing. The objective of this study is to determine the prevalence of near-miss and nonfatal motor vehicle crashes related to sleepiness in a representative sample of Portuguese drivers. Structured phone interviews regarding sleepiness and sleep-related crashes and near misses, driving habits, demographic data, and sleep quality were conducted using the Pittsburgh Sleep Quality Index and sleep apnea risk using the Berlin questionnaire. A multivariate regression analysis was used to determine the associations with sleepy driving (feeling sleepy or falling asleep while driving) and sleep-related near misses and crashes. Nine hundred subjects, representing the Portuguese population of drivers, were included; 3.1% acknowledged falling asleep while driving during the previous year and 0.67% recalled sleepiness-related crashes. Higher education, driving more than 15,000 km/year, driving more frequently between 12:00 a.m. and 6 a.m., fewer years of having a driver's license, less total sleep time per night, and higher scores on the Epworth Sleepiness Scale (ESS) were all independently associated with sleepy driving. Sleepiness-related crashes and near misses were associated only with falling asleep at the wheel in the previous year. Sleep-related crashes occurred more frequently in drivers who had also had sleep-related near misses. Portugal has lower self-reported sleepiness at the wheel and sleep-related near misses than most other countries where epidemiological data are available. Different population characteristics and cultural, social, and road safety specificities may

  12. Imported Case of Melioidosis in Oman: Case Report

    PubMed Central

    Tamtami, Nada AL; Khamis, Faryal; Al-Jardani, Amina

    2017-01-01

    Melioidosis is an infectious disease caused by the bacterium Burkholderia pseudomallei. It is most commonly described in Southeast Asia and Northern Australia and some imported cases in non-endemic areas. We describe the case of a 55-year-old Omani man with fulminant sepsis who worked in Laos, Cambodia. B. pseudomallei was isolated from the patient’s blood and was identified by means of microbiological and biochemical tests. We highlight the importance of careful attention to non-fermentative gram-negative rods in a septic patients who have worked or travelled to Southeast Asia. PMID:28042405

  13. Representing climate change on public service television: A case study.

    PubMed

    Debrett, Mary

    2017-05-01

    Publicly funded broadcasters with a track record in science programming would appear ideally placed to represent climate change to the lay public. Free from the constraints of vested interests and the economic imperative, public service providers are better equipped to represent the scientific, social and economic aspects of climate change than commercial media, where ownership conglomeration, corporate lobbyists and online competition have driven increasingly tabloid coverage with an emphasis on controversy. This prime-time snapshot of the Australian Broadcasting Corporation's main television channel explores how the structural/rhetorical conventions of three established public service genres - a science programme, a documentary and a live public affairs talk show - impact on the representation of anthropogenic climate change. The study findings note implications for public trust, and discuss possibilities for innovation in the interests of better public understanding of climate change.

  14. Interference with Hemozoin Formation Represents an Important Mechanism of Schistosomicidal Action of Antimalarial Quinoline Methanols

    PubMed Central

    Corrêa Soares, Juliana B. R.; Menezes, Diego; Vannier-Santos, Marcos A.; Ferreira-Pereira, Antonio; Almeida, Giulliana T.; Venancio, Thiago M.; Verjovski-Almeida, Sergio; Zishiri, Vincent K.; Kuter, David; Hunter, Roger; Egan, Timothy J.; Oliveira, Marcus F.

    2009-01-01

    Background The parasitic trematode Schistosoma mansoni is one of the major causative agents of human schistosomiasis, which afflicts 200 million people worldwide. Praziquantel remains the main drug used for schistosomiasis treatment, and reliance on the single therapy has been prompting the search for new therapeutic compounds against this disease. Our group has demonstrated that heme crystallization into hemozoin (Hz) within the S. mansoni gut is a major heme detoxification route with lipid droplets involved in this process and acting as a potential chemotherapeutical target. In the present work, we investigated the effects of three antimalarial compounds, quinine (QN), quinidine (QND) and quinacrine (QCR) in a murine schistosomiasis model by using a combination of biochemical, cell biology and molecular biology approaches. Methodology/Principal Findings Treatment of S. mansoni-infected female Swiss mice with daily intraperitoneal injections of QN, and QND (75 mg/kg/day) from the 11th to 17th day after infection caused significant decreases in worm burden (39%–61%) and egg production (42%–98%). Hz formation was significantly inhibited (40%–65%) in female worms recovered from QN- and QND-treated mice and correlated with reduction in the female worm burden. We also observed that QN treatment promoted remarkable ultrastructural changes in male and female worms, particularly in the gut epithelium and reduced the granulomatous reaction to parasite eggs trapped in the liver. Microarray gene expression analysis indicated that QN treatment increased the expression of transcripts related to musculature, protein synthesis and repair mechanisms. Conclusions The overall significant reduction in several disease burden parameters by the antimalarial quinoline methanols indicates that interference with Hz formation in S. mansoni represents an important mechanism of schistosomicidal action of these compounds and points out the heme crystallization process as a valid

  15. Representing ozone extremes in European megacities: the importance of resolution in a global chemistry climate model

    NASA Astrophysics Data System (ADS)

    Stock, Z. S.; Russo, M. R.; Pyle, J. A.

    2014-04-01

    The continuing growth of the world's urban population has led to an increasing number of cities with more than 10 million inhabitants. The higher emissions of pollutants, coupled to higher population density, makes predictions of air quality in these megacities of particular importance from both a science and a policy perspective. Global climate models are typically run at coarse resolution to enable both the efficient running of long time integrations, and the ability to run multiple future climate scenarios. However, when considering surface ozone concentrations at the local scale, coarse resolution can lead to inaccuracies arising from the highly nonlinear ozone chemistry and the sensitivity of ozone to the distribution of its precursors on smaller scales. In this study, we use UM-UKCA, a global atmospheric chemistry model, coupled to the UK Met Office Unified Model, to investigate the impact of model resolution on tropospheric ozone, ranging from global to local scales. We focus on the model's ability to represent the probability of high ozone concentrations in the summer and low ozone concentrations, associated with polluted megacity environments, in the winter, and how this varies with horizontal resolution. We perform time-slice integrations with two model configurations at typical climate resolution (CR, ~150 km) and at a higher resolution (HR, ~40 km). The CR configuration leads to overestimation of ozone concentrations on both regional and local scales, while it gives broadly similar results to the HR configuration on the global scale. The HR configuration is found to produce a more realistic diurnal cycle of ozone concentrations and to give a better representation of the probability density function of ozone values in urban areas such as the megacities of London and Paris. We find the observed differences in model behaviour between CR and HR configurations to be largely caused by chemical differences during the winter and meteorological differences

  16. Representing ozone extremes in European megacities: the importance of resolution in a global chemistry climate model

    NASA Astrophysics Data System (ADS)

    Stock, Z. S.; Russo, M. R.; Pyle, J. A.

    2013-10-01

    The continuing growth of the world's urban population has led to an increasing number of cities with more than 10 million inhabitants. The higher emissions of pollutants, coupled to higher population density, makes predictions of air quality in these megacities of particular importance from both a science and a policy perspective. Global climate models are typically run at coarse resolution to enable both the efficient running of long time integrations, and the ability to run multiple future climate scenarios. However, when considering surface ozone concentrations at the local scale, coarse resolution can lead to inaccuracies arising from the highly non-linear ozone chemistry and the sensitivity of ozone to the distribution of its precursors on smaller scales. In this study, we use UM-UKCA, a global atmospheric chemistry model, coupled to the UK Met Office Unified Model, to investigate the impact of model resolution on tropospheric ozone, ranging from global to local scales. We focus on the model's ability to represent the probability of high ozone concentrations in the summer and low ozone concentrations, associated with polluted megacity environments, in the winter, and how this varies with horizontal resolution. We perform time-slice integrations with two model configurations at typical climate resolution (CR, ~150 km) and at a higher resolution (HR, ~40 km). The CR configuration leads to overestimation of ozone concentrations on both regional and local scales, while it gives broadly similar results to the HR configuration on the global scale. The HR configuration is found to produce a more realistic diurnal cycle of ozone concentrations and to give a better representation of the probability density function of ozone values in urban areas such as the megacities of London and Paris. We discuss the possible causes for the observed difference in model behaviour between CR and HR configurations and estimate the relative contribution of chemical and meteorological

  17. 7 CFR 1212.22 - Qualified national organization representing importer interests.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGRICULTURE HONEY PACKERS AND IMPORTERS RESEARCH, PROMOTION, CONSUMER EDUCATION AND INDUSTRY INFORMATION ORDER Honey Packers and Importers Research, Promotion, Consumer Education, and Industry Information...

  18. 7 CFR 1212.22 - Qualified national organization representing importer interests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGRICULTURE HONEY PACKERS AND IMPORTERS RESEARCH, PROMOTION, CONSUMER EDUCATION AND INDUSTRY INFORMATION ORDER Honey Packers and Importers Research, Promotion, Consumer Education, and Industry Information...

  19. 7 CFR 1212.22 - Qualified national organization representing importer interests.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGRICULTURE HONEY PACKERS AND IMPORTERS RESEARCH, PROMOTION, CONSUMER EDUCATION AND INDUSTRY INFORMATION ORDER Honey Packers and Importers Research, Promotion, Consumer Education, and Industry Information...

  20. 7 CFR 1212.22 - Qualified national organization representing importer interests.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE HONEY PACKERS AND IMPORTERS RESEARCH, PROMOTION, CONSUMER EDUCATION AND INDUSTRY INFORMATION ORDER Honey Packers and Importers Research, Promotion, Consumer Education, and Industry Information Order...

  1. 7 CFR 1212.22 - Qualified national organization representing importer interests.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE HONEY PACKERS AND IMPORTERS RESEARCH, PROMOTION, CONSUMER EDUCATION AND INDUSTRY INFORMATION ORDER Honey Packers and Importers Research, Promotion, Consumer Education, and Industry Information...

  2. The Importance of Living in the Case.

    ERIC Educational Resources Information Center

    Burger, David L.

    A multiple, embedded case study research design was employed to describe and explain the case method pedagogy used by two veteran practioners. The units of analysis were two graduate courses, one a teacher ethics course and the other a business policy course. Information was gathered utilizing precourse and postcourse interviews and a…

  3. Changing Orientations in Sociology; A Representative Selection from an Important Period

    ERIC Educational Resources Information Center

    Osborne, Harold W.

    1970-01-01

    E. Gartly Jaco's Prestige and Esteem and Power Components: An Experimental Analysis", 1953, is reprinted and reviewed as being representative of the turning point in the historical development of sociology away from the philosophical, historical and descriptive orientation. A critique by Jaco is included. (SE)

  4. The Importance of Representing Certain Key Vegetation Canopy Processes Explicitly in a Land Surface Model

    NASA Astrophysics Data System (ADS)

    Napoly, A.; Boone, A. A.; Martin, E.; Samuelsson, P.

    2015-12-01

    Land surface models are moving to more detailed vegetation canopy descriptions in order to better represent certain key processes, such as Carbon dynamics and snowpack evolution. Since such models are usually applied within coupled numerical weather prediction or spatially distributed hydrological models, these improvements must strike a balance between computational cost and complexity. The consequences of simplified or composite canopy approaches can be manifested in terms of increased errors with respect to soil temperatures, estimates of the diurnal cycle of the turbulent fluxes or snow canopy interception and melt. Vegetated areas and particularly forests are modeled in a quite simplified manner in the ISBA land surface model. However, continuous developments of surface processes now require a more accurate description of the canopy. A new version of the the model now includes a multi energy balance (MEB) option to explicitly represent the canopy and the forest floor. It will be shown that certain newly included processes such as the shading effect of the vegetation, the explicit heat capacity of the canopy, and the insulating effect of the forest floor turn out to be essential. A detailed study has been done for four French forested sites. It was found that the MEB option significantly improves the ground heat flux (RMSE decrease from 50W/m2 to 10W/m2 on average) and soil temperatures when compared against measurements. Also the sensible heat flux calculation was improved primarily owing to a better phasing with the solar insulation owing to a lower vegetation heat capacity. However, the total latent heat flux is less modified compared to the classical ISBA simulation since it is more related to water uptake and the formulation of the stomatal resistance (which are unchanged). Next, a benchmark over 40 Fluxnet sites (116 cumulated years) was performed and compared with results from the default composite soil-vegetation version of ISBA. The results show

  5. Congratulations, you have been carefully chosen to represent an important developmental regulator!

    PubMed Central

    Samach, Alon

    2013-01-01

    Background Studying a process in a new species often relies on focusing our attention to a candidate gene, encoding a protein similar to one with a known function. Not all the choices seem to be prudent. Scope This Viewpoint includes an overview of issues that are encountered during research of candidate genes. Defining a match for a gene of interest, deciding whether variation in ESTs or RNAseq data for a certain transcript, represent more than one gene. The problem of incorrect annotation of genes due to incorrect in-silico splicing, is also mentioned. The author's humble opinion on how to deal with these issues is provided. Conclusions The vast amount of new sequence data provides us with great possibilities for giant leaps in our understanding. Still, we cannot afford to skip over the tedious steps required to confirm that we are indeed studying the correct gene, and try to be sure that the complex expression pattern we observe is not a composite of several genes. PMID:22811510

  6. Lassa fever: response to an imported case.

    PubMed

    Zweighaft, R M; Fraser, D W; Hattwick, M A; Winkler, W G; Jordan, W C; Alter, M; Wolfe, M; Wulff, H; Johnson, K M

    1977-10-13

    In February, 1976, a Peace Corps worker returned to the United States from Sierra Leone with an undiagnosed illness later recognized as Lassa fever. To assess the risk of transmission and to contain a potential outbreak, we identified 552 contacts as having had exposure to the patient before the start of strict isolation procedures, and maintained intensive surveillance on these contacts for 21 days. At the end of the surveillance period, no illness had developed in contacts. One month later, a serologic survey among 29 of the contacts judged to be at high risk gave no evidence of infection. In response to the importation of this communicable and highly fatal disease, procedures for the isolation of the patient, the identification, surveillance and management of contacts and the handling of laboratory specimens were developed and implemented. These procedures could be adapted to future introductions of highly contagious diseases.

  7. Active Subduction on Both Coasts of Costa Rica Does not Represent an Important Tsunami Hazard

    NASA Astrophysics Data System (ADS)

    Protti, M.; Gonzalez, V.

    2007-05-01

    Costa Rica, on the southern terminus of the Middle American Trench is being affected by active subduction on both, along the Pacific coast as well as on its Caribbean coast. Three main subduction segments can be recognized along the Pacific coast: 1) under northwestern Costa Rica, off Papagayo Gulf and Nicoya peninsula, the Cocos plate is subducting under the Caribbean plate; 2) under southern Costa Rica (Osa and Burica peninsulas) the Cocos plate subducts under the Panama Block and 3) in the central Pacific coast (between Nicoya and Osa peninsulas) the Cocos plate subducts under a shear zone that marks the transition between the Caribbean and the Cocos plate. Along the Caribbean coast, south of Puerto Limon, the Caribbean plate subducts under the Panama block. Large subduction earthquakes occur under the Nicoya peninsula, Osa peninsula and south of Limon. Most of the rupture area of these large events lies below land so the deformation of the ocean floor is minimal and therefore the tsunamis they generate are small. No large subduction earthquakes occur under the central Pacific coast of Costa Rica due to the subduction of small sea mounts that act as small asperities without potential to accumulate large amounts of slip. For this reason the region between Nicoya and Osa peninsulas is not an important tsunamigenic zone.

  8. An imported case of cystic echinococcosis in the liver.

    PubMed

    Ahn, Keun Soo; Hong, Sung-Tae; Kang, Yu Na; Kwon, Jung Hyeok; Kim, Mi Jeong; Park, Tae Jun; Kim, Yong Hoon; Lim, Tae Jin; Kang, Koo Jeong

    2012-12-01

    A 25-year-old Uzbek male presented with right upper abdominal pain for 20 days. On radiologic studies, a huge cystic mass was noticed in the right liver which was suspected as parasitic. The patient received right hepatic segmentectomy (segment 7), and the surgically resected mass was confirmed as cystic echinococcosis (CE), measuring 10.5 cm in its diameter. The inner surface of the cyst was bile-stained. The patient was discharged on the 8th hospital day, and was rechecked 6 months after the surgical intervention without any evidence of recurrence. The present report describes findings of an imported case of CE which represented ultrasound images of the 'ball of wool'.

  9. Chikungunya in Mississippi: The Health Department Response to Imported Cases.

    PubMed

    Goddard, Jerome; Varnado, Wendy C; Hand, Sheryl; Meyer, Florencia

    2016-05-01

    Chikungunya (CHIK), a newly recognized mosquito-borne disease in the Western Hemisphere, has resulted in well over a million cases since December 2013. Only about a dozen locally-acquired cases thus far have been reported in the U. S. (Florida), but approximately 1500 imported cases have been seen in returning travelers from the Caribbean and Central and South America. Public health officials are concerned that imported cases may lead to infection of local mosquitoes and, thus disease transmission. This paper documents 9 confirmed CHIK cases in Mississippi: 5 resulting from travel to the Dominican Republic, 2 from Haiti, 1 from Honduras, and 1 from Puerto Rico. In addition, the Mississippi State Department of Health response to those cases is presented and discussed.

  10. First case of (imported) babesiosis diagnosed in Canada

    PubMed Central

    Kunimoto, Dennis; Krause, Kevin; Morrison, Doug

    1998-01-01

    This paper describes the first case of babesiosis diagnosed in Canada. This case highlights the need for clinicians to be aware of diseases that may be endemic elsewhere and the importance of a travel history in a patient’s assessment. PMID:22346559

  11. Children's Digital Practices: Case Studies of Children Viewing and Representing with Digital Text

    ERIC Educational Resources Information Center

    Churchill, Daniel; Khoo, Kay Yong

    2012-01-01

    This paper reports on case studies of four primary school children and their digital practices in Hong Kong. The study explored how the participating children view and represent through digital text in the context of their out-of-school technology use. Understanding how these practices extended into their English language classrooms was explicated…

  12. Union Learning Representatives: A Case Study of the Public and Commercial Services Union

    ERIC Educational Resources Information Center

    Alexandrou, Alex; Davies, John Dwyfor; Lee, John

    2005-01-01

    Union Learning Representatives (ULRs) are a relatively recent phenomenon and are a new category of lay representation within the workplace in the United Kingdom. They are part of the present New Labour administration's drive to expand and improve lifelong learning and create the new "learning society"--in this case, particularly amongst…

  13. Children's Digital Practices: Case Studies of Children Viewing and Representing with Digital Text

    ERIC Educational Resources Information Center

    Churchill, Daniel; Khoo, Kay Yong

    2012-01-01

    This paper reports on case studies of four primary school children and their digital practices in Hong Kong. The study explored how the participating children view and represent through digital text in the context of their out-of-school technology use. Understanding how these practices extended into their English language classrooms was explicated…

  14. Occurrence of Anisakis simplex sensu stricto in imported Atlantic mackerel (Scomber scombrus) represents a risk for Turkish consumers.

    PubMed

    Pekmezci, Gokmen Zafer

    2014-08-18

    Anisakid larvae are a prevalent food-borne pathogen that has been found in numerous fish species destined for human consumption. The accidental consumption of infected raw or poorly cooked fish may cause gastroenteric diseases and allergies in humans. In spite of the fact that thorough cooking or freezing kills Anisakis worms, this method does not destroy their allergenic capacity. The presence of A. simplex (s.s.) in seafood products may present a health risk for consumers. In Turkey, Atlantic mackerels are marketed as frozen and mainly imported from Norway. The aim of this study was to identify the Anisakis species found in deep-frozen whole Atlantic mackerel (Scomber scombrus) destined for human consumption in fish markets that imported fish from Norway to Turkey. All Anisakis larvae isolated from imported Atlantic mackerel were identified via morphology as third larvae of Anisakis Type I. The ITS region (ITS-1, 5.8S subunit, ITS-2) was amplified and digested with the restriction enzymes Hinf I and Hha I. Larvae of the genus Anisakis were identified via PCR-RFLP as belonging to Anisakis simplex (s.s.), and this was confirmed by sequencing the cox2 gene. The overall prevalence of Anisakis larvae was 25% (95% confidence limits: 13-41%), and the mean intensity was 19.1 (bootstrap 95% confidence limits: 15.3-25.5). Recognized zoonotic A. simplex (s.s.) larvae found in imported Atlantic mackerel could represent a risk. Those who consume them could acquire parasitic allergies. The results will have an important impact on public health risk assessment in that they suggest reviewing critical control points at the Hazard Analysis Critical Control Point (HACCP) programmer to reduce the risk of anisakid-induced allergies among consumers. Consequently, the present study provides the first data regarding the occurrence of A. simplex (s.s.) larvae in imported Atlantic mackerel in Turkish markets.

  15. Case reports and their importance in Medical Literature.

    PubMed

    Danish, Syed Hasan; Reza, Zawwar; Sohail, Abdul Ahad

    2017-03-01

    It is important to appreciate how case reports have paved the way for modern research. They are still largely considered the first line of evidence. Indeed global endemics such as HIV and Zika Virus have been traced back to initial case reports. Strictly speaking; case reports are anecdotes - a factual story telling about nature's own experiment. Case reports can be characterized by two huge advantages, their ability to present novel, rare cases in a manner that can lead to the expansion in research of such cases and their use in generating new, innovative hypothesis that can be used to direct further research. The aim of this article is to identify the place and purpose of case reports in the current research setting with a focus on highlighting its merits and limitation amongst other things.

  16. Case report: melioidosis imported from West Africa to Europe.

    PubMed

    Cuadros, Juan; Gil, Horacio; Miguel, Julio De; Marabé, Graciela; Gómez-Herruz, Teresa Arroyo Peña; Lobo, Bruno; Marcos, Ruth; Anda, Pedro

    2011-08-01

    We report the first case of imported melioidosis in Spain from a diabetic immigrant who visited West Africa during the rainy season. Because of the unusual presentation of this disease in Africa, clinical and microbiological diagnosis of imported melioidosis from this continent can be very elusive.

  17. Imported Human Rabies Cases Worldwide, 1990–2012

    PubMed Central

    Carrara, Philippe; Parola, Phillipe; Brouqui, Phillipe; Gautret, Philippe

    2013-01-01

    Sixty cases of human rabies in international travelers were reviewed from 1990–2012. A significant proportion of the cases were observed in migrants or their descendants when emigrating from their country of origin or after a trip to visit friends and relatives or for other reasons (43.3%). The cases were not necessarily associated with long-term travel or expatriation to endemic countries; moreover, cases were observed in travelers after short trips of two weeks or less. A predominance of male patients was observed (75.0%). The proportion of children was low (11.7%). Cases from India and Philippines were frequent (16 cases/60). In a significant proportion of cases (51.1%), diagnosis was challenging, with multiple missed diagnoses and transfers from ward to ward before the final diagnosis of rabies. Among the 28 patients whose confirmed diagnosis was obtained ante-mortem, the mean time between hospitalization and diagnosis was 7.7 days (median time: 6.0 days, range 2–30) including four cases with a diagnosis delayed by 15 or more days. In five cases, a patient traveled through one or more countries before ultimately being hospitalized. Three factors played a role in delaying the diagnosis of rabies in a number of cases: (i) a low index of suspicion for rabies in countries where the disease has been eradicated for a long time or is now rare, (ii) a negative history of animal bites or exposure to rabies, and (iii) atypical clinical presentation of the disease. Clinical symptomatology of rabies is complex and commonly confuses physicians. Furthermore, failure in diagnosing imported cases in more developed countries is most likely related to the lack of medical familiarity with even the typical clinical features of the disease. PMID:23658853

  18. Sexual violence and HIV risk behaviors among a nationally representative sample of heterosexual American women: The importance of sexual coercion

    PubMed Central

    Stockman, Jamila K; Campbell, Jacquelyn C; Celentano, David D

    2009-01-01

    Objectives Recent evidence suggests that it is important to consider behavioral-specific sexual violence measures in assessing women’s risk behaviors. This study investigated associations of history and types of sexual coercion on HIV risk behaviors in a nationally representative sample of heterosexually active American women. Methods Analyses were based on 5,857 women aged 18–44 participating in the 2002 National Survey of Family Growth. Types of lifetime sexual coercion included: victim given alcohol or drugs, verbally pressured, threatened with physical injury, and physically injured. Associations with HIV risk behaviors were assessed using logistic regression. Results Of 5,857 heterosexually active women, 16.4% reported multiple sex partners and 15.3% reported substance abuse. A coerced first sexual intercourse experience and coerced sex after sexual debut were independently associated with multiple sex partners and substance abuse; the highest risk was observed for women reporting a coerced first sexual intercourse experience. Among types of sexual coercion, alcohol or drug use at coerced sex was independently associated with multiple sex partners and substance abuse. Conclusions Our findings suggest that public health strategies are needed to address the violent components of heterosexual relationships. Future research should utilize longitudinal and qualitative research to characterize the relationship between continuums of sexual coercion and HIV risk. PMID:19734802

  19. The importance of actions and the worth of an object: dissociable neural systems representing core value and economic value.

    PubMed

    Brosch, Tobias; Coppin, Géraldine; Schwartz, Sophie; Sander, David

    2012-06-01

    Neuroeconomic research has delineated neural regions involved in the computation of value, referring to a currency for concrete choices and decisions ('economic value'). Research in psychology and sociology, on the other hand, uses the term 'value' to describe motivational constructs that guide choices and behaviors across situations ('core value'). As a first step towards an integration of these literatures, we compared the neural regions computing economic value and core value. Replicating previous work, economic value computations activated a network centered on medial orbitofrontal cortex. Core value computations activated medial prefrontal cortex, a region involved in the processing of self-relevant information and dorsal striatum, involved in action selection. Core value ratings correlated with activity in precuneus and anterior prefrontal cortex, potentially reflecting the degree to which a core value is perceived as internalized part of one's self-concept. Distributed activation pattern in insula and ACC allowed differentiating individual core value types. These patterns may represent evaluation profiles reflecting prototypical fundamental concerns expressed in the core value types. Our findings suggest mechanisms by which core values, as motivationally important long-term goals anchored in the self-schema, may have the behavioral power to drive decisions and behaviors in the absence of immediately rewarding behavioral options.

  20. The importance of actions and the worth of an object: dissociable neural systems representing core value and economic value

    PubMed Central

    Coppin, Géraldine; Schwartz, Sophie; Sander, David

    2012-01-01

    Neuroeconomic research has delineated neural regions involved in the computation of value, referring to a currency for concrete choices and decisions (‘economic value’). Research in psychology and sociology, on the other hand, uses the term ‘value’ to describe motivational constructs that guide choices and behaviors across situations (‘core value’). As a first step towards an integration of these literatures, we compared the neural regions computing economic value and core value. Replicating previous work, economic value computations activated a network centered on medial orbitofrontal cortex. Core value computations activated medial prefrontal cortex, a region involved in the processing of self-relevant information and dorsal striatum, involved in action selection. Core value ratings correlated with activity in precuneus and anterior prefrontal cortex, potentially reflecting the degree to which a core value is perceived as internalized part of one’s self-concept. Distributed activation pattern in insula and ACC allowed differentiating individual core value types. These patterns may represent evaluation profiles reflecting prototypical fundamental concerns expressed in the core value types. Our findings suggest mechanisms by which core values, as motivationally important long-term goals anchored in the self-schema, may have the behavioral power to drive decisions and behaviors in the absence of immediately rewarding behavioral options. PMID:21642352

  1. First Two Imported Cases of Zika Virus Infections in Romania.

    PubMed

    Florescu, Simin Aysel; Cotar, Ani Ioana; Popescu, Corneliu Petru; Ceianu, Cornelia Svetlana; Zaharia, Mihaela; Vancea, Geta; Codreanu, Daniel; Badescu, Daniela; Ceausu, Emanoil

    2017-05-01

    We report the first two cases of imported Zika virus (ZIKV) infection in Romanian patients returning from areas with ongoing outbreaks and challenges for laboratory diagnostic; first one with a classical pattern of acute flaviviral infection and the second one with an interesting pattern of a secondary flaviviral (ZIKV) infection in a yellow fever-vaccinated child living abroad in an endemic area.

  2. Preparing for imported Ebola cases in Israel, 2014 to 2015.

    PubMed

    Brosh-Nissimov, Tal; Poles, Lion; Kassirer, Micha; Singer, Roee; Kaliner, Ehud; Shriki, Dikla Dahan; Anis, Emilia; Fogel, Itay; Engelhard, Dan; Grotto, Itamar

    2015-01-01

    During the current outbreak of Ebola virus disease (EVD) in West Africa, preventing exportation of the disease posed many challenges for economically more developed countries. In Israel, although the risk of importing single cases was assumed to be low, the implications of local transmission were great. This article describes the EVD preparedness plan of the Israeli Ministry of Health. Key elements were a sensitive case definition, designation of a single treatment centre for suspected and confirmed cases, construction of a mobile unit using customised negative-pressure tents and a vigorous national training programme. There were no patients with EVD in Israel, but a few suspected cases were assessed. The Israeli plan may provide a template for emergency infectious disease response in other geographically small countries.

  3. Quantifying the relative importance of land cover change from climate and land use in the representative concentration pathways

    NASA Astrophysics Data System (ADS)

    Davies-Barnard, T.; Valdes, P. J.; Singarayer, J. S.; Wiltshire, A. J.; Jones, C. D.

    2015-06-01

    Climate change is projected to cause substantial alterations in vegetation distribution, but these have been given little attention in comparison to land use in the Representative Concentration Pathway (RCP) scenarios. Here we assess the climate-induced land cover changes (CILCC) in the RCPs and compare them to land use land cover change (LULCC). To do this, we use an ensemble of simulations with and without LULCC in Earth System Model HadGEM2-ES (Hadley Centre Global Environmental Model 2) - for RCP2.6, RCP4.5, and RCP8.5. We find that climate change causes an expansion poleward of vegetation that affects more land area than LULCC in all of the RCPs considered here. The terrestrial carbon changes from CILCC are also larger than for LULCC. When considering only forest, the LULCC is larger, but the CILCC is highly variable with the overall radiative forcing of the scenario. The CILCC forest increase compensates 90% of the global anthropogenic deforestation by 2100 in RCP8.5 but just 3% in RCP2.6. Overall, bigger land cover changes tend to originate from LULCC in the shorter term or lower radiative forcing scenarios and from CILCC in the longer term and higher radiative forcing scenarios. The extent to which CILCC could compensate for LULCC raises difficult questions regarding global forest and biodiversity offsetting, especially at different time scales. This research shows the importance of considering the relative size of CILCC to LULCC, especially with regard to the ecological effects of the different RCPs.

  4. Public health response to imported case of poliomyelitis, Australia, 2007.

    PubMed

    Carnie, John A; Lester, Rosemary; Moran, Rodney; Brown, Lynne; Meagher, Julian; Roberts, Jason A; Thorley, Bruce R

    2009-11-01

    Australia, along with 36 other countries in the Western Pacific Region, was declared free of poliomyelitis by the World Health Organization in October 2000. Yet, the persistence of wild poliovirus in the 4 remaining polio-endemic countries-Afghanistan, India, Nigeria, and Pakistan-poses a risk for its importation into all countries declared polio free. We describe the public health response and outcomes resulting from the importation of a wild poliovirus infection in Melbourne, Australia, in July 2007. This response, based on an assessment of the risk for transmission, included offering vaccination with inactivated polio vaccine to the contacts and placing the index patient in isolation and the household contacts in quarantine until consecutive fecal specimens were negative for poliovirus by culture. The experience gained from the polio importation event in Australia may assist other polio-free countries to prepare for, and respond to, a similar event. No secondary clinical cases resulted from this importation.

  5. First Imported Case of Zika Virus Infection into Korea

    PubMed Central

    Jee, Youngmee

    2016-01-01

    Since Zika virus has been spreading rapidly in the Americas from 2015, the outbreak of Zika virus infection becomes a global health emergency because it can cause neurological complications and adverse fetal outcome including microcephaly. Here, we report clinical manifestations and virus isolation findings from a case of Zika virus infection imported from Brazil. The patient, 43-year-old Korean man, developed fever, myalgia, eyeball pain, and maculopapular rash, but not neurological manifestations. Zika virus was isolated from his semen, and reverse-transcriptase PCR was positive for the virus in the blood, urine, and saliva on the 7th day of the illness but was negative on the 21st day. He recovered spontaneously without any neurological complications. He is the first case of Zika virus infection in Korea imported from Brazil. PMID:27366020

  6. First Imported Case of Zika Virus Infection into Korea.

    PubMed

    Jang, Hee-Chang; Park, Wan Beom; Kim, Uh Jin; Chun, June Young; Choi, Su-Jin; Choe, Pyoeng Gyun; Jung, Sook-In; Jee, Youngmee; Kim, Nam-Joong; Choi, Eun Hwa; Oh, Myoung-Don

    2016-07-01

    Since Zika virus has been spreading rapidly in the Americas from 2015, the outbreak of Zika virus infection becomes a global health emergency because it can cause neurological complications and adverse fetal outcome including microcephaly. Here, we report clinical manifestations and virus isolation findings from a case of Zika virus infection imported from Brazil. The patient, 43-year-old Korean man, developed fever, myalgia, eyeball pain, and maculopapular rash, but not neurological manifestations. Zika virus was isolated from his semen, and reverse-transcriptase PCR was positive for the virus in the blood, urine, and saliva on the 7th day of the illness but was negative on the 21st day. He recovered spontaneously without any neurological complications. He is the first case of Zika virus infection in Korea imported from Brazil.

  7. Generalised and abdominal adiposity are important risk factors for chronic disease in older people: results from a nationally representative survey.

    PubMed

    Hirani, V

    2011-06-01

    To look at the trends in prevalence of generalised (body mass index (BMI) ≥ 25 kg/m2) and abdominal obesity (waist circumference (WC) >102 cm, men; > 88 cm, women) among older people from 1993 to 2008, prevalence of chronic disease by overweight/obesity and WC categories in England 2005 and evaluate the association of these measures with chronic diseases. Analyses of nationally representative cross-sectional population surveys, the Health Survey for England (HSE). Non-institutionalised men and women aged ≥ 65 years (in HSE 2005, 1512 men and 1747 women). Height, weight, waist circumference, blood pressure measurements were taken according to standardised HSE protocols. Information collected on socio-demographic, health behaviour and doctor diagnosed health conditions. Generalised obesity and abdominal obesity increased among men and women from 1993 to 2008. In 2005, the HSE 2005 focussed on older people. 72% of men and 68% of women aged over 65 were either overweight or obese. Prevalence of raised WC was higher in women (58%) than in men (46%). The prevalence of diabetes and arthritis was higher in people with generalised obesity in both sexes. Men were more likely to have had a joint replacement and had a higher prevalence of stroke if they were overweight only but women were more likely to have had a joint replacement only if they were obese (13%) and had a higher risk of falls with generalised obesity. The pattern was similar for the prevalence of chronic diseases by raised WC. Multivariate analysis showed that generalised and abdominal obesity was independently associated with risk of hypertension, diabetes and arthritis in both men and women. In women only, there was an association between generalised obesity and having a fall in the last year (OR: 1.5), and between abdominal obesity and having a joint replacement (OR: 1.9, p=0.01). Complications of obesity such as diabetes, hypertension and arthritis, are more common in men and women aged over 65 who are

  8. A case of Plasmodium ovale malaria imported from West Africa.

    PubMed

    Kang, Yunjung; Yang, Jinyoung

    2013-04-01

    Malaria is a parasitic infection caused by Plasmodium species. Most of the imported malaria in Korea are due to Plasmodium vivax and Plasmodium falciparum, and Plasmodium ovale infections are very rare. Here, we report a case of a 24-year-old American woman who acquired P. ovale while staying in Ghana, West Africa for 5 months in 2010. The patient was diagnosed with P. ovale malaria based on a Wright-Giemsa stained peripheral blood smear, Plasmodium genus-specific real-time PCR, Plasmodium species-specific nested PCR, and sequencing targeting 18S rRNA gene. The strain identified had a very long incubation period of 19-24 months. Blood donors who have malaria with a very long incubation period could be a potential danger for propagating malaria. Therefore, we should identify imported P. ovale infections not only by morphological findings but also by molecular methods for preventing propagation and appropriate treatment.

  9. Retroperitoneal liposarcomas: a representative literature review occasioned by a rare case of laterelapse abdominal liposarcoma.

    PubMed

    Pisani, Michela; Al-Buheissi, Salah; Whittlestone, Tim

    2016-05-24

    Soft tissue sarcomas (STS) are rare and heterogeneous tumours representing approximately 0.7%-1% of all adult tumours. In the adults and among the retroperitoneal sarcomas (RPS), Liposarcoma (LS) is the most common variant accounting for 12% -20% of all sarcomas and up to 45% of sarcomas at retroperitoneal localization. A rare case of LS relapsed after 15 years is giving the occasion to review the published literature and emphasise the followings concepts: 1) Despite extensive surgery remains the mainstay of treatment for localized STS at present, anatomical complexity and occult localization result in local recurrence in the majority of patients; 2) The role of imaging and tumour markers is still limited; 3) Indefinite prolonged surveillance is a key point of treatment; 4) Referral to tertiary centres with dedicated Retroperitonal Surgeons and Oncology expertise is mandatory.

  10. Late relapse of imported Plasmodium ovale malaria: a case report.

    PubMed

    Siala, Emna; Gastli, Mondher; Essid, Rym; Jemal, Sana; Ben Abdallah, Rym; Ben Abda, Imène; Aoun, Karim; Bouratbine, Aida

    2015-06-01

    We report the first case of an imported Plasmodium ovale relapse in a Tunisian man who developed malaria three years after leaving sub- Saharan Africa. A 29-year-old Tunisian man consulted in September 2011 because of a fever, myalgia, and headache that had begun eight days earlier and persisted despite treatment with oral antibiotics. On questioning, the patient stated that he had resided three years ago for six months in Ivory Coast, where he acquired malaria. He was treated with artemether-lumefantrine. The patient said he had no recent travel to any other malaria-endemic area and had not received a blood transfusion. A first microscopy of peripheral blood smears was negative for malaria parasites. The diagnosis was established 17 days after onset of symptoms. A repeat microscopic examination of blood smears confirmed the presence of Plasmodium ovale with a parasitemia lower than 0.1%. The patient was treated with artemether lumefantrine, followed by primaquine. This case emphasizes the possibility of relapse of some plasmodial species. It highlights the importance of repeating microscopic examination of blood when the diagnosis of malaria is suspected.

  11. The Importance of Literacy. Hearing before the Committee on Education and the Workforce. House of Representatives, One Hundred Sixth Congress, Second Session (Washington, DC, September 26, 2000).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Education and the Workforce.

    A hearing was held on Tuesday, September 26, 2000, by the U.S. House of Representatives, Committee on Education and the Workforce, Washington, DC, on the importance of literacy. The following U.S. Representatives were present: Goodling, Roukema, Schaffer, Hilleary, Ehlers, Fletcher, Isakson, Kildee, Owens, Payne, Scott, Hinojosa, McCarthy, Kind,…

  12. Case studies on employment-related health inequalities in countries representing different types of labor markets.

    PubMed

    Kim, Il-Ho; Muntaner, Carles; Chung, Haejoo; Benach, Joan

    2010-01-01

    The authors selected nine case studies, one country from each cluster of their labor market inequalities typology, to outline the macro-political and economic roots of employment relations and their impacts on health. These countries illustrate variations in labor markets and health, categorized into a global empirical typology. The case studies illustrated that workers' health is significantly connected with labor market characteristics and the welfare system. For a core country, the labor market is characterized by a formal sector. The labor institutions of Sweden traditionally have high union density and collective bargaining coverage and a universal health care system, which correlate closely with positive health, in comparison with Spain and the United States. For a semi-periphery country, the labor market is delineated by a growing informal economy. Although South Korea, Venezuela, and El Salvador provide some social welfare benefits, a high proportion of irregular and informal workers are excluded from these benefits and experience hazardous working conditions that adversely affect their health. Lastly, several countries in the global periphery--China, Nigeria, and Haiti--represent informal work and severe labor market insecurity. In the absence of labor market regulations, the majority of their workers toil in the informal sector in unsafe conditions with inadequate health care.

  13. Rethinking sources of representative controls for the conduct of case-control studies in minority populations.

    PubMed

    Bandera, Elisa V; Chandran, Urmila; Zirpoli, Gary; McCann, Susan E; Ciupak, Gregory; Ambrosone, Christine B

    2013-05-31

    Recruitment of controls remains a challenge in case-control studies and particularly in studies involving minority populations. We compared characteristics of controls recruited through random digit dialing (RDD) to those of community controls enrolled through churches, health events and other outreach sources among women of African ancestry (AA) participating in the Women's Circle of Health Study, a case-control study of breast cancer. Odds ratios and 95% confidence intervals were also computed using unconditional logistic regression to evaluate the impact of including the community controls for selected variables relevant to breast cancer and for which there were significant differences in distribution between the two control groups. Compared to community controls (n=347), RDD controls (n=207) had more years of education and higher income, lower body mass index, were more likely to have private insurance, and less likely to be single. While the percentage of nulliparous women in the two groups was similar, community controls tended to have more children, have their first child at a younger age, and were less likely to breastfeed their children. Dietary intake was similar in the two groups. Compared to census data, the combination of RDD and community controls seems to be more representative of the general population than RDD controls alone. Furthermore, the inclusion of the community group had little impact on the magnitude of risk estimates for most variables, while enhancing statistical power. Community-based recruitment was found to be an efficient and feasible method to recruit AA controls.

  14. Facility Delivery, Postnatal Care and Neonatal Deaths in India: Nationally-Representative Case-Control Studies

    PubMed Central

    Fadel, Shaza A.; Ram, Usha; Morris, Shaun K.; Begum, Rehana; Shet, Anita; Jotkar, Raju; Jha, Prabhat

    2015-01-01

    Objective Clinical studies demonstrate the efficacy of interventions to reduce neonatal deaths, but there are fewer studies of their real-life effectiveness. In India, women often seek facility delivery after complications arise, rather than to avoid complications. Our objective was to quantify the association of facility delivery and postnatal checkups with neonatal mortality while examining the “reverse causality” in which the mothers deliver at a health facility due to adverse perinatal events. Methods We conducted nationally representative case-control studies of about 300,000 live births and 4,000 neonatal deaths to examine the effect of, place of delivery and postnatal checkup on neonatal mortality. We compared neonatal deaths to all live births and to a subset of live births reporting excessive bleeding or obstructed labour that were more comparable to cases in seeking care. Findings In the larger study of 2004–8 births, facility delivery without postnatal checkup was associated with an increased odds of neonatal death (Odds ratio = 2.5; 99% CI 2.2–2.9), especially for early versus late neonatal deaths. However, use of more comparable controls showed marked attenuation (Odds ratio = 0.5; 0.4–0.5). Facility delivery with postnatal checkup was associated with reduced odds of neonatal death. Excess risks were attenuated in the earlier study of 2001–4 births. Conclusion The combined effect of facility deliveries with postnatal checks ups is substantially higher than just facility delivery alone. Evaluation of the real-life effectiveness of interventions to reduce child and maternal deaths need to consider reverse causality. If these associations are causal, facility delivery with postnatal check up could avoid about 1/3 of all neonatal deaths in India (~100,000/year). PMID:26479476

  15. Imported water risk: the case of the UK

    NASA Astrophysics Data System (ADS)

    Hoekstra, Arjen Y.; Mekonnen, Mesfin M.

    2016-05-01

    While the water dependency of water-scarce nations is well understood, this is not the case for countries in temperate and humid climates, even though various studies have shown that many of such countries strongly rely on the import of water-intensive commodities from elsewhere. In this study we introduce a method to evaluate the sustainability and efficiency of the external water footprint (WF) of a country, with the UK as an example. We trace, quantify and map the UK’s direct and indirect water needs and assess the ‘imported water risk’ by evaluating the sustainability of the water consumption in the source regions. In addition, we assess the efficiency of the water consumption in source areas in order to identify the room for water savings. We find that half of the UK’s global blue WF—the direct and indirect consumption of ground- and surface water resources behind all commodities consumed in the UK—is located in places where the blue WF exceeds the maximum sustainable blue WF. About 55% of the unsustainable part of the UK’s blue WF is located in six countries: Spain (14%), USA (11%), Pakistan (10%), India (7%), Iran (6%), and South Africa (6%). Our analysis further shows that about half of the global consumptive WF of the UK’s direct and indirect crop consumption is inefficient, which means that consumptive WFs exceed specified WF benchmark levels. About 37% of the inefficient part of the UK’s consumptive WF is located in six countries: Indonesia (7%), Ghana (7%), India (7%), Brazil (6%), Spain (5%), and Argentina (5%). In some source countries, like Pakistan, Iran, Spain, USA and Egypt, unsustainable and inefficient blue water consumption coincide. We find that, by lowering overall consumptive WFs to benchmark levels, the global blue WF of UK crop consumption could be reduced by 19%. We discuss four strategies to mitigate imported water risk: become more self-sufficient in food; diversify the import of water-intensive commodities, favouring

  16. [Kampo medicines as useful therapeutic agents in clinical practice of neurology: case reports & representative medicines].

    PubMed

    Ishida, Kazuyuki

    2013-01-01

    Doctors in any department should have at least minimum knowledge of Kampo medicines. However, doctors who specialize in neurology often have inadequate knowledge of Kampo medicines. The efficacy of Kampo medicines in treating intractable diseases such as neurodegenerative diseases is not adequately understood and needs to be investigated in the future. On the other hand, Kampo medicines are often effective for treating common symptoms such as headache, dysesthesia, pain, and vertigo, encountered in daily medical practice. Because many patients suffer from these symptoms, the impact of these symptoms on our society is not small, even though the causes of these symptoms are not crucial. Having the skill to prescribe even a dozen or so Kampo medicines (for example, goshuyuto, goreisan, goshajinkigan, sokeikakketsuto) increases the treatment options and may be very beneficial in daily medical practice. In this article, I provide instructions on the use of representative Kampo medicines and present some case reports to elucidate their use. Amassing and sharing clinical experiences regarding the use of Kampo medicines would strengthen the medical evidences of Kampo medicines.

  17. Regulation of plasmid-encoded isoprene metabolism in Rhodococcus, a representative of an important link in the global isoprene cycle

    PubMed Central

    Crombie, Andrew T; Khawand, Myriam El; Rhodius, Virgil A; Fengler, Kevin A; Miller, Michael C; Whited, Gregg M; McGenity, Terry J; Murrell, J Colin

    2015-01-01

    Emissions of biogenic volatile organic compounds (VOCs) form an important part of the global carbon cycle, comprising a significant proportion of net ecosystem productivity. They impact atmospheric chemistry and contribute directly and indirectly to greenhouse gases. Isoprene, emitted largely from plants, comprises one third of total VOCs, yet in contrast to methane, which is released in similar quantities, we know little of its biodegradation. Here, we report the genome of an isoprene degrading isolate, Rhodococcus sp. AD45, and, using mutagenesis shows that a plasmid-encoded soluble di-iron centre isoprene monooxygenase (IsoMO) is essential for isoprene metabolism. Using RNA sequencing (RNAseq) to analyse cells exposed to isoprene or epoxyisoprene in a substrate-switch time-course experiment, we show that transcripts from 22 contiguous genes, including those encoding IsoMO, were highly upregulated, becoming among the most abundant in the cell and comprising over 25% of the entire transcriptome. Analysis of gene transcription in the wild type and an IsoMO-disrupted mutant strain showed that epoxyisoprene, or a subsequent product of isoprene metabolism, rather than isoprene itself, was the inducing molecule. We provide a foundation of molecular data for future research on the environmental biological consumption of this important, climate-active compound. PMID:25727256

  18. Leprosy in Toronto: an analysis of 184 imported cases.

    PubMed

    Boggild, Andrea K; Correia, Jason D; Keystone, Jay S; Kain, Kevin C

    2004-01-06

    Leprosy is a rare but serious mycobacterial infection. Immigration from areas where the disease is endemic has resulted in the importation of leprosy into countries where it is not endemic and where physicians and health care workers have little or no experience in diagnosis and therapy. In this study we characterized leprosy patients seen in a tropical disease unit that manages most of the reported leprosy cases in Canada. We reviewed the clinical records of all 184 leprosy patients who were referred to the Tropical Disease Unit at Toronto General Hospital between 1979 and 2002 and abstracted demographic and clinical information. Patients were more likely to be male (122 or 66.3%) and of Indian (44 or 23.9%), Filipino (49 or 26.6%) or Vietnamese (37 or 20.1%) origin. Patients experienced symptoms for a mean of 4.8 years before referral to the Tropical Disease Unit. Most had no family history of leprosy (152/172 or 88.4%). Most patients presented with either borderline tuberculoid (80 or 43.5%) or borderline lepromatous (37 or 20.1%) disease. On average, patients presented with 5.8 skin lesions. Upper- and lower-extremity nerve dysfunction was common at presentation, with up to one-third of patients demonstrating either sensory or motor loss. A significantly greater lag time to presentation was observed in patients who emigrated from low-prevalence regions (p < 0.001). Leprosy is a chronic infectious disease that is associated with serious morbidity if left untreated. Leprosy is uncommon in developed countries, but it is important for physicians to have a high index of suspicion when a foreign-born patient presents with chronic dermatitis and peripheral nerve involvement.

  19. The Case for Representative Democracy: What Americans Should Know about Their Legislatures.

    ERIC Educational Resources Information Center

    Rosenthal, Alan; Kurtz, Karl T.; Hibbing, John; Loomis, Burdett

    This guide is a revised and adapted version of a previous monograph, "A New Public Perspective on Representative Democracy: A Guide for Legislative Interns." The guide focuses on civic perspective: how citizens view the political institutions, processes, and people that are fundamental to representative democracy in the United States. It…

  20. Abstracting of Legal Cases: The Potential of Clustering Based on the Selection of Representative Objects.

    ERIC Educational Resources Information Center

    Moens, Marie-Francine; Uyttendaele, Caroline; Dumortier, Jos

    1999-01-01

    The SALOMON project automatically summarizes Belgian criminal cases to improve access to existing and future court decisions. This article gives background information about the texts of the cases and describes the output, design models, and architecture of the SALOMON system. Evaluation of 700 criminal cases demonstrates that the algorithms have…

  1. Preparedness for malaria resurgence in China: case study on imported cases in 2000-2012.

    PubMed

    Feng, Jun; Xia, Zhi-Gui; Vong, Sirenda; Yang, Wei-Zhong; Zhou, Shui-Sen; Xiao, Ning

    2014-01-01

    Malaria is the most important parasitic protozoan infection that has caused serious threats to human health globally. China has had success in reducing the morbidity and mortality of malaria to the lowest level through sustained and large-scale interventions. Although the total number of malaria cases declined gradually, the burden of the imported malaria cases mainly from Southeast Asian and African countries has increased substantially since 2000, posing a severe threat to public health in China. This review explores and analyses the epidemiological characteristics of the imported malaria based on data from 2000 to 2012, in order to provide theoretical bases and insights into effective prevention, avoid the resurgence of malaria in malaria-susceptible areas and develop appropriate strategies to protect people's health in China. This review also intends to offer the useful information of innovative approaches and tools that are required for malaria elimination in various settings.

  2. Are medical breakthroughs declining – The importance of case reports?

    PubMed Central

    Mishra, Sundeep

    2015-01-01

    Case reports are a valuable though oft-underestimated source of clinical knowledge, even wisdom. They are extremely valuable to clinicians faced with new diseases, new investigations, and new therapies, where they provide the initial information, which serves as a basis to plan a detailed comparative study to provide definitive answers. The publication of cases and images-related reports is undoubtedly a gain for all, including medical students, medical teachers, the scientific community, medical professionals, healthcare managers, and patients. PMID:26995410

  3. Are medical breakthroughs declining - The importance of case reports?

    PubMed

    Mishra, Sundeep

    2015-12-01

    Case reports are a valuable though oft-underestimated source of clinical knowledge, even wisdom. They are extremely valuable to clinicians faced with new diseases, new investigations, and new therapies, where they provide the initial information, which serves as a basis to plan a detailed comparative study to provide definitive answers. The publication of cases and images-related reports is undoubtedly a gain for all, including medical students, medical teachers, the scientific community, medical professionals, healthcare managers, and patients.

  4. Representative Nature of Scientific Literacy Themes in a High School Chemistry Course: The Case of Zambia

    ERIC Educational Resources Information Center

    Mumba, Frackson; Hunter, William J. F.

    2009-01-01

    The purpose of this study was to find out how the scientific literacy themes are represented in the current Zambian high school chemistry syllabus, textbooks and grade twelve chemistry examination papers in an attempt to find out whether or not the chemistry course has adequate potential to contribute to the preparation of scientifically literate…

  5. Representative Nature of Scientific Literacy Themes in a High School Chemistry Course: The Case of Zambia

    ERIC Educational Resources Information Center

    Mumba, Frackson; Hunter, William J. F.

    2009-01-01

    The purpose of this study was to find out how the scientific literacy themes are represented in the current Zambian high school chemistry syllabus, textbooks and grade twelve chemistry examination papers in an attempt to find out whether or not the chemistry course has adequate potential to contribute to the preparation of scientifically literate…

  6. A case of Mayaro virus infection imported from French Guiana.

    PubMed

    Llagonne-Barets, Marion; Icard, Vinca; Leparc-Goffart, Isabelle; Prat, Christine; Perpoint, Thomas; André, Patrice; Ramière, Christophe

    2016-04-01

    Emergence of arboviruses is a rising problem in several areas in the world. Here we report a case of Mayaro virus infection that was diagnosed in a French citizen presenting a dengue-like syndrome with prolonged arthralgia following a travel in French Guiana. Diagnosis was based on serological testing, a newly developed specific RT-PCR and sequencing. The real incidence of this viral infection among travelers is poorly known but this case is the first reported in a European area where Aedes albopictus mosquitoes are established, which underscores the necessity to determine the vector competence of the European strain of this mosquito species for Mayaro virus.

  7. A CASE STUDY ILLUSTRATING THE IMPORTANCE OF ACCURATE SITE CHARACTERIZATION

    EPA Science Inventory

    Too frequently, researchers rely on incomplete site characterization data to determine the placement of the sampling wells. They forget that it is these sampling wells that will be used to evaluate the effectiveness of their research efforts. This case study illustrates the eff...

  8. A CASE STUDY ILLUSTRATING THE IMPORTANCE OF ACCURATE SITE CHARACTERIZATION

    EPA Science Inventory

    Too frequently, researchers rely on incomplete site characterization data to determine the placement of the sampling wells. They forget that it is these sampling wells that will be used to evaluate the effectiveness of their research efforts. This case study illustrates the eff...

  9. Definitions Are Important: The Case of Linear Algebra

    ERIC Educational Resources Information Center

    Berman, Abraham; Shvartsman, Ludmila

    2016-01-01

    In this paper we describe an experiment in a linear algebra course. The aim of the experiment was to promote the students' understanding of the studied concepts focusing on their definitions. It seems to be a given that students should understand concepts' definitions before working substantially with them. Unfortunately, in many cases they do…

  10. Design Of Bioremediation Systems For Groundwater (Aerobic and Anaerobic Plus Representative Case Studies)

    EPA Science Inventory

    The attached presentation discusses the fundamentals of bioremediation in the subsurface. The basics of aerobic, cometabolic, and anaerobic bioremediation are presented. Case studies from the Delaware Sand & Gravel Superfund Site, Dover Cometabolic Research Project and the SABR...

  11. Design Of Bioremediation Systems For Groundwater (Aerobic and Anaerobic Plus Representative Case Studies)

    EPA Science Inventory

    The attached presentation discusses the fundamentals of bioremediation in the subsurface. The basics of aerobic, cometabolic, and anaerobic bioremediation are presented. Case studies from the Delaware Sand & Gravel Superfund Site, Dover Cometabolic Research Project and the SABR...

  12. Using standardized patients versus video cases for representing clinical problems in problem-based learning

    PubMed Central

    2016-01-01

    Purpose: The quality of problem representation is critical for developing students’ problem-solving abilities in problem-based learning (PBL). This study investigates preclinical students’ experience with standardized patients (SPs) as a problem representation method compared to using video cases in PBL. Methods: A cohort of 99 second-year preclinical students from Inje University College of Medicine (IUCM) responded to a Likert scale questionnaire on their learning experiences after they had experienced both video cases and SPs in PBL. The questionnaire consisted of 14 items with eight subcategories: problem identification, hypothesis generation, motivation, collaborative learning, reflective thinking, authenticity, patient-doctor communication, and attitude toward patients. Results: The results reveal that using SPs led to the preclinical students having significantly positive experiences in boosting patient-doctor communication skills; the perceived authenticity of their clinical situations; development of proper attitudes toward patients; and motivation, reflective thinking, and collaborative learning when compared to using video cases. The SPs also provided more challenges than the video cases during problem identification and hypotheses generation. Conclusion: SPs are more effective than video cases in delivering higher levels of authenticity in clinical problems for PBL. The interaction with SPs engages preclinical students in deeper thinking and discussion; growth of communication skills; development of proper attitudes toward patients; and motivation. Considering the higher cost of SPs compared with video cases, SPs could be used most advantageously during the preclinical period in the IUCM curriculum. PMID:26923094

  13. Using standardized patients versus video cases for representing clinical problems in problem-based learning.

    PubMed

    Yoon, Bo Young; Choi, Ikseon; Choi, Seokjin; Kim, Tae-Hee; Roh, Hyerin; Rhee, Byoung Doo; Lee, Jong-Tae

    2016-06-01

    The quality of problem representation is critical for developing students' problem-solving abilities in problem-based learning (PBL). This study investigates preclinical students' experience with standardized patients (SPs) as a problem representation method compared to using video cases in PBL. A cohort of 99 second-year preclinical students from Inje University College of Medicine (IUCM) responded to a Likert scale questionnaire on their learning experiences after they had experienced both video cases and SPs in PBL. The questionnaire consisted of 14 items with eight subcategories: problem identification, hypothesis generation, motivation, collaborative learning, reflective thinking, authenticity, patient-doctor communication, and attitude toward patients. The results reveal that using SPs led to the preclinical students having significantly positive experiences in boosting patient-doctor communication skills; the perceived authenticity of their clinical situations; development of proper attitudes toward patients; and motivation, reflective thinking, and collaborative learning when compared to using video cases. The SPs also provided more challenges than the video cases during problem identification and hypotheses generation. SPs are more effective than video cases in delivering higher levels of authenticity in clinical problems for PBL. The interaction with SPs engages preclinical students in deeper thinking and discussion; growth of communication skills; development of proper attitudes toward patients; and motivation. Considering the higher cost of SPs compared with video cases, SPs could be used most advantageously during the preclinical period in the IUCM curriculum.

  14. Cutaneous blastomycosis. An imported case with good response to itraconazole.

    PubMed

    Bonifaz, Alexandro; Morales, Diana; Morales, Neredi; Mercadillo, Patricia; González, Gloria M; Hernández-Hernández, Francisca; Araiza, Javier; Vázquez-González, Denisse

    2016-01-01

    Blastomycosis is a subacute or chronic deep mycosis caused by a dimorphic fungus called Blastomyces dermatitidis, which generally produces a pulmonary form of the disease and, to a lesser extent, extra-pulmonary forms such as cutaneous, osteoarticular and genitourinary, among others. Cutaneous blastomycosis is the second clinical presentation in frequency. It is considered as primary when it begins by inoculation of the fungus due to traumas, and secondary when the lung fails to contain the infection. We present the case of a 57 year-old male who had a 5 year-history of an irregularly shaped verrucous infiltrative plaque related to and insect bite and posterior trauma due to the manipulation of the lesion. B. dermatitidis was identified using direct examination, stains, isolation in culture media, histopathology, and molecular studies. An antifungal susceptibility test was performed using method M38-A2 (CLSI). Clinical and mycological cure was achieved with itraconazole. This cutaneous blastomycosis case acquired in the United States (Indianapolis) is rather interesting and looks quite similar to other mycoses such as coccidioidomycosis or sporotrichosis. The presented case shows one of the multiple issues concerning migration between neighboring countries. Copyright © 2014 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  15. Representing the object of controversy: the case of the molecular clock.

    PubMed

    Dietrich, Michael R

    2007-01-01

    Through a case study of the controversies surrounding the molecular clock, this paper examines the role of visual representation in the dynamics of scientific controversies. Representations of the molecular clock themselves became objects of controversy and so were not a means for closure. Instead visual representations of the molecular clock became tools for the further articulation of an ongoing controversy.

  16. Bovine besnoitiosis in Switzerland: imported cases and local transmission.

    PubMed

    Basso, Walter; Lesser, Maren; Grimm, Felix; Hilbe, Monika; Sydler, Titus; Trösch, Luzia; Ochs, Hansueli; Braun, Ueli; Deplazes, Peter

    2013-12-06

    Bovine besnoitiosis is an economically important disease of cattle, caused by Besnoitia besnoiti (Protozoa, Apicomplexa). A considerable spreading of this parasitic infection has been observed in Europe in the last ten years, mainly related to animal trade. In order to investigate the possibility of B. besnoiti being unnoticed introduced and getting established in Switzerland through the import of breeding cattle from France, a total of 767 animals (650 cattle imported from France and 117 cattle that had contact with B. besnoiti positive cattle in Swiss farms) were screened for antibodies against B. besnoiti by both a commercial ELISA and by the indirect fluorescent antibody test (IFAT). A total of 101 (13.17%) samples showed a positive reaction in ELISA (cut-off: percent of positivity [PP] ≥ 15) and 16 (2.09%) samples had IFAT titers ≥ 1:100. Eight of those samples reacted positive in Western blot (WB), corresponding to five imported Limousin cattle (two cows and one bull from France and two cows from Germany) and to three cattle born in Switzerland (one Limousin heifer born from one of the positive German cows, and two adult Braunvieh cows, that had been in contact with one of the French cows at a Swiss farm). Seven of those animals were subclinically infected and one animal showed only very mild signs. They were subsequently slaughtered, and the serological diagnosis could be confirmed by real-time PCR and/or histopathology in seven animals. The most frequent parasite localizations were the tendons and surrounding connective tissue of the distal limbs and the skin of the head region. Furthermore, B. besnoiti could be successfully isolated in vitro from one French, one German and one Swiss cattle (isolates Bb-IPZ-1-CH, Bb-IPZ-2-CH and Bb-IPZ-3-CH). In the current situation in Switzerland, prophylactic and control measures should include a serological examination of cattle to be imported from endemic areas and the culling of all confirmed positive animals from

  17. Quality of Malaria Case Management in Malawi: Results from a Nationally Representative Health Facility Survey

    PubMed Central

    Steinhardt, Laura C.; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek

    2014-01-01

    Background Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. Methods In April–May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. Results At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Conclusions Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case

  18. Comprehensive Report For Proposed Elevated Temperature Elastic Perfectly Plastic (EPP) Code Cases Representative Example Problems

    SciTech Connect

    Hollinger, Greg L.

    2014-06-01

    Background: The current rules in the nuclear section of the ASME Boiler and Pressure Vessel (B&PV) Code , Section III, Subsection NH for the evaluation of strain limits and creep-fatigue damage using simplified methods based on elastic analysis have been deemed inappropriate for Alloy 617 at temperatures above 1200F (650C)1. To address this issue, proposed code rules have been developed which are based on the use of elastic-perfectly plastic (E-PP) analysis methods and which are expected to be applicable to very high temperatures. The proposed rules for strain limits and creep-fatigue evaluation were initially documented in the technical literature 2, 3, and have been recently revised to incorporate comments and simplify their application. The revised code cases have been developed. Task Objectives: The goal of the Sample Problem task is to exercise these code cases through example problems to demonstrate their feasibility and, also, to identify potential corrections and improvements should problems be encountered. This will provide input to the development of technical background documents for consideration by the applicable B&PV committees considering these code cases for approval. This task has been performed by Hollinger and Pease of Becht Engineering Co., Inc., Nuclear Services Division and a report detailing the results of the E-PP analyses conducted on example problems per the procedures of the E-PP strain limits and creep-fatigue draft code cases is enclosed as Enclosure 1. Conclusions: The feasibility of the application of the E-PP code cases has been demonstrated through example problems that consist of realistic geometry (a nozzle attached to a semi-hemispheric shell with a circumferential weld) and load (pressure; pipe reaction load applied at the end of the nozzle, including axial and shear forces, bending and torsional moments; through-wall transient temperature gradient) and design and operating conditions (Levels A, B and C).

  19. [Parasite identification in the surveillance of imported leishmaniasis cases in Italy].

    PubMed

    Gramiccia, M; Di Muccio, T; Marinucci, M

    2004-06-01

    An accurate Leishmania classification was defined since 1980s by the use of isoenzyme analysis. To date, this procedure still represents the reference identification technique, despite the increasing use of molecular approaches. Studies and surveillance methods on leishmaniases are strongly conditioned by the knowledge and mapping of all the parameters characterizing each nosogeographical entity. On this respect, the identification of parasites from all the actors of the natural life cycle plays a key role. With the increasing population movements and climate changes, novel risk factors could be identified associated to Leishmania geographical distribution and spreading: a) the introduction into Italy of new populations of L. infantum from other countries; b) the introduction of new Leishmania species that may find a suitable milieau to support their life cycle in our country. The objective of this report is to present the surveillance activity on imported leishmaniases by the Leishmania Identification Reference Centre, ISS. Two different methodologies were routinely applied: a) isoenzyme electrophoretic analysis, which requires parasite culture, and b) a number of molecular techniques, used for both diagnosis and parasite identification, differently applied according to the geographical origin of the suspected leishmaniasis case. When possible, both types of methodologies were applied. From 1986 to June 2002, 38 imported cases of leishmaniases were identified: 9 visceral (VL) and 29 cutaneous (CL) cases, of which 22 from the Old and 7 from the New World. Pathology, Leishmania species/zymodeme and geographical origin features are reported in the paper. Seven out of 9 VL patients were HIV positive, of whom 5 detected in the period 1993-1995. This high importation rate can be associated to the general increase in Mediterranean Leishmania/HIV coinfections in that period. Following HAART treatment, VL imported cases became occasional; no introduction of new L. infantum

  20. A probable case of poliomyelitis imported to Malaysia.

    PubMed

    Tay, Chee Geap; Ong, Lai Choo; Goh, Khean Jin; Rahmat, Kartini; Fong, Choong Yi

    2015-12-01

    We report a previously well 10-month-old Somalian girl who acquired asymmetric lower limb weakness in July 2013 in Mogadishu, Banadir, before arriving in Malaysia at 12 months of age. In May 2013, there was a wild poliomyelitis outbreak in that area, as reported by the World Health Organization. Laboratory investigation, including cerebrospinal fluid, was unremarkable, and electrophysiological studies showed active axonal denervation in the left lower limb. The whole spine T2-weighted MRI revealed non-enhancing hyperintensities of the bilateral anterior horn cells, predominantly on the left side at T11-12. The viral isolations from two stool specimens at her presentation to our centre, 2 months after the onset of illness and 2 weeks apart, were negative. Despite lacking the acute virological evidence of poliomyelitis, in view of the girl's clinical, electrophysiological and classical spinal neuroradiological features, together with her temporal relationship with a World Health Organization reported wild poliomyelitis outbreak, we believe these findings are consistent with a diagnosis of imported poliomyelitis. A review at 30 months of age showed persistent left lower limb monoplegia with little recovery. Our patient reiterates the importance of maintaining awareness of wild polio importation, and keeping abreast of the latest news of global poliomyelitis outbreaks when treating patients with flaccid paralysis, even if they arrive from non-endemic poliomyelitis areas.

  1. A Comparative Study of the Trends of Imported Dengue Cases in Korea and Japan 2011 - 2015.

    PubMed

    Miki, Shinichiro; Lee, Won-Chang; Lee, Myeong-Jin

    2017-07-01

    Dengue is a mosquito-borne febrile disease that represents a major public health problem in tropical and subtropical areas. Even though Korea and Japan are not the regions where dengue is epidemic, there have been many imported cases in both countries, and in increasing numbers. A better understanding of the characteristics of the prevalence of dengue and the recent trends in these neighboring countries may provide information to promote improvement and control strategies for both. The present study investigated the epidemiological status of imported dengue cases in Korea and Japan between 2011 and 2015, and compared their characteristics. We analyzed the annual transition of prevalence, geographic origin of dengue infection, and seasonal distribution of occurrence. The raw data on dengue cases in Korea were obtained from the Korea Center for Disease Control and Prevention infectious diseases surveillance website and Korean Statistical Information Service website. Data on dengue cases in Japan were obtained from the National Institute of Infectious Diseases, Japan's Infectious Disease Surveillance Center website. There were 893 reported cases in Korea and 1,054 in Japan between 2011 and 2015. Cumulative incidence per 100,000 overseas travelers from Japan did not substantially differ from that for Korea (1.22 vs. 1.16, respectively), despite Japan's population being roughly 2.5 times larger. These results suggest Koreans engage in overseas travel more than Japanese. For Korea and Japan, Southeast Asia was the region accounting for the most cases of infection (89.4% vs. 75.4%, respectively). Notably, the Philippines and Indonesia were, respectively, the leading origin countries for Korean (38.1%) and Japanese (23.3%) cases. Seasonal distribution shows August and September were the months in which the largest number of cases occurred in Korea and Japan, respectively. These differences evidently derive from characteristics of travel destinations and timing of holidays

  2. Response to imported case of Marburg hemorrhagic fever, the Netherland.

    PubMed

    Timen, Aura; Koopmans, Marion P G; Vossen, Ann C T M; van Doornum, Gerard J J; Günther, Stephan; van den Berkmortel, Franchette; Verduin, Kees M; Dittrich, Sabine; Emmerich, Petra; Osterhaus, Albert D M E; van Dissel, Jaap T; Coutinho, Roel A

    2009-08-01

    On July 10, 2008, Marburg hemorrhagic fever was confirmed in a Dutch patient who had vacationed recently in Uganda. Exposure most likely occurred in the Python Cave (Maramagambo Forest), which harbors bat species that elsewhere in Africa have been found positive for Marburg virus. A multidisciplinary response team was convened to perform a structured risk assessment, perform risk classification of contacts, issue guidelines for follow-up, provide information, and monitor the crisis response. In total, 130 contacts were identified (66 classified as high risk and 64 as low risk) and monitored for 21 days after their last possible exposure. The case raised questions specific to international travel, postexposure prophylaxis for Marburg virus, and laboratory testing of contacts with fever. We present lessons learned and results of the follow-up serosurvey of contacts and focus on factors that prevented overreaction during an event with a high public health impact.

  3. Response to Imported Case of Marburg Hemorrhagic Fever, the Netherlands

    PubMed Central

    Koopmans, Marion P.G.; Vossen, Ann C.T.M.; van Doornum, Gerard J.J.; Günther, Stephan; van den Berkmortel, Franchette; Verduin, Kees M.; Dittrich, Sabine; Emmerich, Petra; Osterhaus, Albert D.M.E.; van Dissel, Jaap T.; Coutinho, Roel A.

    2009-01-01

    On July 10, 2008, Marburg hemorrhagic fever was confirmed in a Dutch patient who had vacationed recently in Uganda. Exposure most likely occurred in the Python Cave (Maramagambo Forest), which harbors bat species that elsewhere in Africa have been found positive for Marburg virus. A multidisciplinary response team was convened to perform a structured risk assessment, perform risk classification of contacts, issue guidelines for follow-up, provide information, and monitor the crisis response. In total, 130 contacts were identified (66 classified as high risk and 64 as low risk) and monitored for 21 days after their last possible exposure. The case raised questions specific to international travel, postexposure prophylaxis for Marburg virus, and laboratory testing of contacts with fever. We present lessons learned and results of the follow-up serosurvey of contacts and focus on factors that prevented overreaction during an event with a high public health impact. PMID:19751577

  4. Life Style Forum: Representative Cases from a Male Juvenile Correctional Facility and a Women's College.

    ERIC Educational Resources Information Center

    Eckstein, Daniel G.

    This paper discusses some of the author's experiences in two sexually homogeneous environments, a male juvenile correctional facility and a four-year womens college, from an Adlerian perspective. Although unrelated, the two populations have important similarities and differences, such as that incarcerated male juveniles and college females often…

  5. Imported case of Marburg hemorrhagic fever - Colorado, 2008.

    PubMed

    2009-12-18

    Marburg hemorrhagic fever (MHF) is a rare, viral hemorrhagic fever (VHF); the causative agent is an RNA virus in the family Filoviridae, and growing evidence demonstrates that fruit bats are the natural reservoir of Marburg virus (MARV). On January 9, 2008, an infectious disease physician notified the Colorado Department of Public Health and Environment (CDPHE) of a case of unexplained febrile illness requiring hospitalization in a woman who had returned from travel in Uganda. Testing of early convalescent serum demonstrated no evidence of infection with agents that cause tropical febrile illnesses, including VHF. Six months later, in July 2008, the patient requested repeat testing after she learned of the death from MHF of a Dutch tourist who had visited the same bat-roosting cave as the patient, the Python Cave in Queen Elizabeth National Park, Uganda. The convalescent serologic testing revealed evidence of prior infection with MARV, and MARV RNA was detected in the archived early convalescent serum. A public health investigation did not identify illness consistent with secondary MHF transmission among her contacts, and no serologic evidence of infection was detected among the six tested of her eight tour companions. The patient might have acquired MARV infection through exposure to bat secretions or excretions while visiting the Python Cave. Travelers should be aware of the risk for acquiring MHF in caves or mines inhabited by bats in endemic areas in sub-Saharan Africa. Health-care providers should consider VHF among travelers returning from endemic areas who experience unexplained febrile illness.

  6. First case of imported Zika virus infection in Spain.

    PubMed

    Bachiller-Luque, Pablo; Domínguez-Gil González, Marta; Álvarez-Manzanares, Jesús; Vázquez, Ana; De Ory, Fernando; Sánchez-Seco Fariñas, M Paz

    2016-04-01

    We report a case of Zika virus (ZIKV) infection in a patient with diarrhea, fever, synovitis, non-purulent conjunctivitis, and with discreet retro-orbital pain, after returning from Colombia in January 2016. The patient referred several mosquito bites. Presence of ZIKV was detected by PCR (polymerase chain reaction) in plasma. Rapid microbiological diagnosis of ZIKV infection is needed in European countries with circulation of its vector, in order to avoid autochthonous circulation. The recent association of ZIKV infection with abortion and microcephaly, and a Guillain-Barré syndrome highlights the need for laboratory differentiation of ZIKV from other virus infection. Women with potential risk for Zika virus infection who are pregnant or planning to become pregnant must mention that fact during prenatal visits in order to be evaluated and properly monitored. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  7. Imported occupational lead poisoning: report of four cases.

    PubMed

    Petracca, M; Scafa, F; Boeri, R; Flachi, Daniela; Candura, S M

    2013-01-01

    In most industrialized countries, occupational lead poisoning has become increasingly rare, however this metal remains a serious health hazard in the rest of the world. We observedfour male patients (aged 35 / 54 years) who had suffered recurrent abdominal pain due to recent lead exposure (for 7 to 13 months) in two Chinese battery recycling plants. On their return to Italy, three of them presented normocytic, normochromic anaemia. The diagnosis was confirmed by high lead levels in the blood and urine, decreased erythrocyte delta-aminolevulinic acid dehydratase (ALA-D), raised erythrocyte zinc protoporphyrin (ZP), and elevated urinary excretion of b-aminolevulinic acid (ALA-U) and porphyrins. Chelation with EDTA resulted in increased urinary lead excretion, improvement of the clinical picture, decreased ZP, and progressive normalization of the other lead biomarkers (Pb-B, ALA-D, ALA-U, urinary porphyrins). Temporary work in developing countries may result in imported lead poisoning. Differential diagnosis of this unusual condition requires careful medical history collection and specific toxicological analysis. Preventive measures for workers going abroad are needed.

  8. Importance of mycological confirmation of clinically suspected cases of tinea corporis, tinea pedis and tinea cruris.

    PubMed

    Omar, Abeer Aly

    2004-01-01

    Tinea corporis, tinea cruris, and tinea pedis are of the most prevalent dermatophytoses. Several conditions that mimic dermatophytoses and atypical and steroid modified forms of the disease usually present difficulties in diagnosis. Hence, the present investigation aimed at studying these conditions on mycological basis. The study included 163 cases clinically diagnosed as having tinea corporis, tinea pedis or tinea cruris. Specimens were taken by skin scraping. Samples were cultured on Sabouraud's dextrose agar and examined microscopically. The results revealed that, only 90.8% of cases were mycologically proven (positive by one or both methods). Most of tinea corporis, tinea pedis and tinea cruris cases (68.9%, 79.1%& 83.9% respectively) were diagnosed by both methods (P>0.05). For cases of tinea corporis and tinea cruris, males were more than females (51.4%, 48.6% and 58.1%, 41.9% respectively) while females exceeded males (72.1%, 27.9% respectively) in cases with tinea pedis (P<0.05). Trichophyton rubrum (T. rubrum) was the most common isolate in all the studied conditions, represented 64.9% in tinea corporis, 53.4 %, for tinea pedis and 64.6% for tinea cruris. T. mentagrophytes var. interdigitale was mostly isolated from cases of tinea pedis (23.3%). The majority of T. violaceum was isolated from cases of tinea corporis (12.2%). The main isolation of E. floccosum was from cases of tinea cruris (16.1%) Microsporum canis (M. canis) was only isolated from one case (1.4%) of tinea corporis while Candida albicans (C. albicans) alone (9.3%) or with T. rubrum (7.0%) was isolated only from cases of interdigital tinea pedis. (P<0.05). The majority of cases of tinea corporis, tinea pedis and tinea cruris had chronic lesions (78.4%, 76.7% and 54.8% respectively) (P<0.05) and received prior therapy for the condition (79.7%, 76.7% and 58.1% respectively, (P>0.05). In conclusion, early accurate diagnosis (on mycological basis) is an important tool to control and reduce the

  9. On the representativeness of coastal aerosol studies to open ocean studies: Mace Head - a case study

    NASA Astrophysics Data System (ADS)

    Rinaldi, M.; Facchini, M. C.; Decesari, S.; Carbone, C.; Finessi, E.; Mircea, M.; Fuzzi, S.; Ceburnis, D.; Ehn, M.; Kulmala, M.; de Leeuw, G.; O'Dowd, C. D.

    2009-12-01

    A unique opportunity arose during the MAP project to compare open ocean aerosol measurements with those undertaken at the Mace Head Global Atmosphere Watch Station, a station used for decades for aerosol process research and long-term monitoring. The objective of the present study is to demonstrate that the key aerosol features and processes observed at Mace Head are characteristic of the open ocean, while acknowledging and allowing for spatial and temporal gradients. Measurements were conducted for a 5-week period at Mace Head and offshore, on the Research Vessel Celtic Explorer, in generally similar marine air masses, albeit not in connected-flow scenarios. The results of the study indicate, in terms of aerosol number size distribution, higher nucleation mode particle concentrations at Mace Head than offshore, pointing to a strong coastal source of new particles that is not representative of the open ocean. The Aitken mode exhibited a large degree of similarity, with no systematic differences between Mace Head and the open ocean, while the accumulation mode showed averagely 35% higher concentrations at Mace Head. The higher accumulation mode concentration can be attributed equally to cloud processing and to a coastal enhancement in concentration. Chemical analysis showed similar or even higher offshore concentrations for dominant species, such as nss-SO4-2, WSOC, WIOC and MSA. Sea salt concentration differences determined a 40% higher supermicron mass at Mace Head, although this difference can be attributed to a higher wind speed at Mace Head during the comparison period. Moreover, the relative chemical composition as a function of size illustrated remarkable similarity. While differences to varying degrees were observed between offshore and coastal measurements, no convincing evidence was found of local coastal effects, apart from nucleation mode aerosol, thus confirming the integrity of previously reported marine aerosol characterisation studies at Mace Head.

  10. The effect of improving task representativeness on capturing nurses’ risk assessment judgements: a comparison of written case simulations and physical simulations

    PubMed Central

    2013-01-01

    Background The validity of studies describing clinicians’ judgements based on their responses to paper cases is questionable, because - commonly used - paper case simulations only partly reflect real clinical environments. In this study we test whether paper case simulations evoke similar risk assessment judgements to the more realistic simulated patients used in high fidelity physical simulations. Methods 97 nurses (34 experienced nurses and 63 student nurses) made dichotomous assessments of risk of acute deterioration on the same 25 simulated scenarios in both paper case and physical simulation settings. Scenarios were generated from real patient cases. Measures of judgement ‘ecology’ were derived from the same case records. The relationship between nurses’ judgements, actual patient outcomes (i.e. ecological criteria), and patient characteristics were described using the methodology of judgement analysis. Logistic regression models were constructed to calculate Lens Model Equation parameters. Parameters were then compared between the modeled paper-case and physical-simulation judgements. Results Participants had significantly less achievement (ra) judging physical simulations than when judging paper cases. They used less modelable knowledge (G) with physical simulations than with paper cases, while retaining similar cognitive control and consistency on repeated patients. Respiration rate, the most important cue for predicting patient risk in the ecological model, was weighted most heavily by participants. Conclusions To the extent that accuracy in judgement analysis studies is a function of task representativeness, improving task representativeness via high fidelity physical simulations resulted in lower judgement performance in risk assessments amongst nurses when compared to paper case simulations. Lens Model statistics could prove useful when comparing different options for the design of simulations used in clinical judgement analysis. The approach

  11. Diagnostic challenges and case management of the first imported case of Plasmodium knowlesi in Sri Lanka.

    PubMed

    Dewanee Ranaweera, A; Danansuriya, Manjula N; Pahalagedera, Kusumawathie; de A W Gunasekera, W M Kumudunayana T; Dharmawardena, Priyani; Mak, Keng Wai; Wong, Pei-Sze Jeslyn; Li, Mei-Zhi Irene; Tan, Cheong Huat; Hapuarachchi, Hapuarachchige C; Herath, Hema D B; Fernando, Deepika

    2017-03-21

    Sri Lanka has achieved 'malaria-free' status and is now in the phase of prevention of re-introduction of malaria. Imported malaria remains a challenge to resurgence of the disease. The diagnostic challenges encountered and the rapid response initiated to manage a Plasmodium infection, which was later confirmed as Plasmodium knowlesi, the first reported case from Sri Lanka, is discussed. An army officer who returned from Malaysia in October 2016 was found to be positive for Plasmodium both by microscopy and rapid diagnostic test (RDT) by the Anti Malaria Campaign Sri Lanka (AMC) during his third visit to a health care provider. Microscopy findings were suspicious of P. knowlesi infection as the smears showed parasite stages similar to both Plasmodium malariae and Plasmodium falciparum. Nested PCR at AMC confirmed Plasmodium genus, but not the species. In the absence of species confirmation, the patient was treated as a case of P. falciparum. The presence of P. knowlesi was later confirmed by a semi-nested PCR assay performed at the Environmental Health Institute, National Environmental Agency in Singapore. The parasite strain was also characterized by sequencing the circumsporozoite gene. Extensive case investigation including parasitological and entomological surveillance was carried out. Plasmodium knowlesi should be suspected in patients returning from countries in the South Asian region where the parasite is prevalent and when blood smear results are inconclusive.

  12. Strategies for recruiting representative samples of Asian Americans for a population-based case-control study.

    PubMed

    Wong, Celeste K; Horn-Ross, Pamela L; Gee, Gilbert C; Shariff-Marco, Salma; Quach, Thu; Allen, Laura; Bautista, Roxanna; La Chica, Patricia Quema; Tseng, Winston; Chang, Pancho; Clarke, Christina A; Yang, Juan; Le, Gem M; Canchola, Alison; Irwin, Melinda L; Lee, Sandra Soo-Jin; Gomez, Scarlett Lin

    2016-10-01

    Data are limited on effective methods for recruiting persons, especially from ethnically diverse populations, into population-based studies. The goal of this study was to evaluate the variation among and representativeness of controls identified using multiple methods for a population-based case-control study of breast cancer among Asian Americans, Native Hawaiians and Pacific Islanders (AANHPIs) in the San Francisco Bay Area. We used a unique combination of targeted recruitment strategies, including address-based sampling, community-based methods, and internet-based and media-based approaches for recruiting controls, frequency matched on age and ethnicity to a population-based sample of cases. To characterise the participating controls, we compared the distribution of sociodemographic characteristics and cancer risk factors between recruitment sources using χ(2) tests. To ensure that the controls we recruited were representative of the underlying at-risk population, we compared characteristics of the controls, by ethnicity and in aggregate, to data from the California Health Interview Survey (CHIS), and adjusted the relative mix of recruitment strategies throughout the study as needed to achieve representativeness. As expected, controls (n=483) recruited by any single method were not representative. However, when aggregated across methods, controls were largely representative of the underlying source population, as characterised by CHIS, with regard to the characteristics under study, including nativity, education, marital status and body mass index. A multimode approach using targeted recruitment strategies is an effective and feasible alternative to using a single recruitment method in identifying a representative, diverse control sample for population-based studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Predicting relationship and life satisfaction from personality in nationally representative samples from three countries: the relative importance of actor, partner, and similarity effects.

    PubMed

    Dyrenforth, Portia S; Kashy, Deborah A; Donnellan, M Brent; Lucas, Richard E

    2010-10-01

    Three very large, nationally representative samples of married couples were used to examine the relative importance of 3 types of personality effects on relationship and life satisfaction: actor effects, partner effects, and similarity effects. Using data sets from Australia (N = 5,278), the United Kingdom (N = 6,554), and Germany (N = 11,418) provided an opportunity to test whether effects replicated across samples. Actor effects accounted for approximately 6% of the variance in relationship satisfaction and between 10% and 15% of the variance in life satisfaction. Partner effects (which were largest for Agreeableness, Conscientiousness, and Emotional Stability) accounted for between 1% and 3% of the variance in relationship satisfaction and between 1% and 2% of the variance in life satisfaction. Couple similarity consistently explained less than .5% of the variance in life and relationship satisfaction after controlling for actor and partner effects.

  14. The first case of Lassa fever imported from Mali to the United Kingdom, February 2009.

    PubMed

    Atkin, S; Anaraki, S; Gothard, P; Walsh, A; Brown, D; Gopal, R; Hand, J; Morgan, D

    2009-03-12

    This is the first case of Lassa fever to be imported from Mali to the United Kingdom. This paper discusses the investigations, the virological analysis, the surveillance and management of contacts undertaken following a case of Lassa fever.

  15. The role of low-energy electrons in focused electron beam induced deposition: four case studies of representative precursors.

    PubMed

    Thorman, Rachel M; Kumar T P, Ragesh; Fairbrother, D Howard; Ingólfsson, Oddur

    2015-01-01

    nature and energy dependence of each process. We then explore the value of studying these processes through comparative gas phase and surface studies for four commonly-used FEBID precursors: MeCpPtMe3, Pt(PF3)4, Co(CO)3NO, and W(CO)6. Through these case studies, it is evident that this combination of studies can provide valuable insight into potential mechanisms governing deposit formation in FEBID. Although further experiments and new approaches are needed, these studies are an important stepping-stone toward better understanding the fundamental physics behind the deposition process and establishing design criteria for optimized FEBID precursors.

  16. The role of low-energy electrons in focused electron beam induced deposition: four case studies of representative precursors

    PubMed Central

    Thorman, Rachel M; Kumar T. P., Ragesh; Fairbrother, D Howard

    2015-01-01

    different nature and energy dependence of each process. We then explore the value of studying these processes through comparative gas phase and surface studies for four commonly-used FEBID precursors: MeCpPtMe3, Pt(PF3)4, Co(CO)3NO, and W(CO)6. Through these case studies, it is evident that this combination of studies can provide valuable insight into potential mechanisms governing deposit formation in FEBID. Although further experiments and new approaches are needed, these studies are an important stepping-stone toward better understanding the fundamental physics behind the deposition process and establishing design criteria for optimized FEBID precursors. PMID:26665061

  17. Representing dispositions

    PubMed Central

    2011-01-01

    Dispositions and tendencies feature significantly in the biomedical domain and therefore in representations of knowledge of that domain. They are not only important for specific applications like an infectious disease ontology, but also as part of a general strategy for modelling knowledge about molecular interactions. But the task of representing dispositions in some formal ontological systems is fraught with several problems, which are partly due to the fact that Description Logics can only deal well with binary relations. The paper will discuss some of the results of the philosophical debate about dispositions, in order to see whether the formal relations needed to represent dispositions can be broken down to binary relations. Finally, we will discuss problems arising from the possibility of the absence of realizations, of multi-track or multi-trigger dispositions and offer suggestions on how to deal with them. PMID:21995952

  18. Spatiotemporal analysis of indigenous and imported dengue fever cases in Guangdong province, China

    PubMed Central

    2012-01-01

    Background Dengue fever has been a major public health concern in China since it re-emerged in Guangdong province in 1978. This study aimed to explore spatiotemporal characteristics of dengue fever cases for both indigenous and imported cases during recent years in Guangdong province, so as to identify high-risk areas of the province and thereby help plan resource allocation for dengue interventions. Methods Notifiable cases of dengue fever were collected from all 123 counties of Guangdong province from 2005 to 2010. Descriptive temporal and spatial analysis were conducted, including plotting of seasonal distribution of cases, and creating choropleth maps of cumulative incidence by county. The space-time scan statistic was used to determine space-time clusters of dengue fever cases at the county level, and a geographical information system was used to visualize the location of the clusters. Analysis were stratified by imported and indigenous origin. Results 1658 dengue fever cases were recorded in Guangdong province during the study period, including 94 imported cases and 1564 indigenous cases. Both imported and indigenous cases occurred more frequently in autumn. The areas affected by the indigenous and imported cases presented a geographically expanding trend over the study period. The results showed that the most likely cluster of imported cases (relative risk = 7.52, p < 0.001) and indigenous cases (relative risk = 153.56, p < 0.001) occurred in the Pearl River Delta Area; while a secondary cluster of indigenous cases occurred in one district of the Chao Shan Area (relative risk = 471.25, p < 0.001). Conclusions This study demonstrated that the geographic range of imported and indigenous dengue fever cases has expanded over recent years, and cases were significantly clustered in two heavily urbanised areas of Guangdong province. This provides the foundation for further investigation of risk factors and interventions in these high

  19. Spatiotemporal analysis of indigenous and imported dengue fever cases in Guangdong province, China.

    PubMed

    Li, Zhongjie; Yin, Wenwu; Clements, Archie; Williams, Gail; Lai, Shengjie; Zhou, Hang; Zhao, Dan; Guo, Yansha; Zhang, Yonghui; Wang, Jinfeng; Hu, Wenbiao; Yang, Weizhong

    2012-06-12

    Dengue fever has been a major public health concern in China since it re-emerged in Guangdong province in 1978. This study aimed to explore spatiotemporal characteristics of dengue fever cases for both indigenous and imported cases during recent years in Guangdong province, so as to identify high-risk areas of the province and thereby help plan resource allocation for dengue interventions. Notifiable cases of dengue fever were collected from all 123 counties of Guangdong province from 2005 to 2010. Descriptive temporal and spatial analysis were conducted, including plotting of seasonal distribution of cases, and creating choropleth maps of cumulative incidence by county. The space-time scan statistic was used to determine space-time clusters of dengue fever cases at the county level, and a geographical information system was used to visualize the location of the clusters. Analysis were stratified by imported and indigenous origin. 1658 dengue fever cases were recorded in Guangdong province during the study period, including 94 imported cases and 1564 indigenous cases. Both imported and indigenous cases occurred more frequently in autumn. The areas affected by the indigenous and imported cases presented a geographically expanding trend over the study period. The results showed that the most likely cluster of imported cases (relative risk = 7.52, p < 0.001) and indigenous cases (relative risk = 153.56, p < 0.001) occurred in the Pearl River Delta Area; while a secondary cluster of indigenous cases occurred in one district of the Chao Shan Area (relative risk = 471.25, p < 0.001). This study demonstrated that the geographic range of imported and indigenous dengue fever cases has expanded over recent years, and cases were significantly clustered in two heavily urbanised areas of Guangdong province. This provides the foundation for further investigation of risk factors and interventions in these high-risk areas.

  20. The importance of perinatal autopsy. Review of the literature and series of cases.

    PubMed

    Şorop-Florea, Maria; Ciurea, Raluca Niculina; Ioana, Mihai; Stepan, Alex Emilian; Stoica, George Alin; Tănase, Florentina; Comănescu, Maria Cristina; Novac, Marius Bogdan; Drăgan, Ioana; Pătru, Ciprian LaurenŢiu; Drăguşin, Roxana Cristina; Zorilă, George Lucian; Cărbunaru, Ovidiu Marian; Oprescu, NuŢi Daniela; Ceauşu, Iuliana; Vlădăreanu, Simona; Tudorache, Ştefania; Iliescu, Dominic Gabriel

    2017-01-01

    Perinatal autopsy remains the gold-standard procedure used to establish the fetal, neonatal or infant abnormalities. Progressively, perinatal pathology has become a specialized field with important roles of audit for fetal prenatal diagnostic tools, in parents counseling regarding future pregnancies, in scientific research, for epidemiology of congenital abnormalities and teaching. The differences between prenatal ultrasound and autopsy reports represent a strong argument for the autopsy examination following termination of pregnancy. The reasons for such discrepancies are related to the ultrasonographic or pathological examination conditions, the type of the anomalies, the expertise and availability of the operators. Several facts led to an undesirable increase of refusals from parents to consent to a conventional invasive autopsy: the centralization of pathology services, the poor counseling provided by non-experts in fetal medicine and the clinicians' over-appreciation of the importance of the ultrasound diagnostic investigation. Although non-invasive alternatives have been tested with promising results, conventional autopsy remains the gold standard technique for the prenatal diagnosis audit. We report and analyze several cases of prenatally diagnosed malformed fetuses with different particularities that underline the necessity of perinatal autopsy. We discuss the antenatal findings and management and post-mortem autopsies in the respective pregnancies.

  1. Crop and agrotechnology influence on CO2 emission in case of representative agrolandscapes of Moscow region, RF

    NASA Astrophysics Data System (ADS)

    Mazirov, Ilya; Vasenev, Ivan; Valentini, Riccardo

    2013-04-01

    Agroecosystems have a very important role in the regional balance of greenhouse gases (GHG). However, the volume of existing data on the different crops and agrotechnologies influence on the GHG emission sharply varies. The European territory of Russia (ETR) is one of regions with strong deficit of this information. At the same time ETR is characterized by high heterogeneity of soil cover patterns, land-use technologies and land agroecological quality. Our research has been done in the fields of Precision farming experiment of Russian Timiryazev State Agrarian University (RTSAU) that soil cover and landscape patterns are typical for Moscow region of RF. The investigated fields include four 1-ha plots with winter wheat and potatoes with versions of traditional tillage and no-till. Each key plot comprises the representative sites for analysis the autotrophic and heterotrophic respiration, and control ones. Carbon dioxide fluxes have been weekly measured in June - September 2012, by the portable infrared system gas analyzer LI-COR LI-6400XT. The carried out research has shown the crop strong influence on the soil CO2 emission. In case of field with winter wheat in June - August it was in 1.5-2.5 times higher (2,93 μmol m-2 s-1) than in potatoes one. The maximum difference has been fixed at the first half of August after the wheat harvest. July is characterize by gradual decrease soil carbon dioxide emission from 1.56 μmol m-2 s-1 to 1.06 μmol m-2 s-1. Comparative analysis of the model sites with differentiation of the autotrophic and heterotrophic respiration showed the absolute dominance of microorganism contribution: 1.56 μmol m-2 s-1 (76.3% of the total respiration). It is especially important that no-till sites have CO2 "microbial" emission in 24.8% less the traditional tillage ones. The carried out in June-September comparative analysis of investigated sites with forest control ones has shown the following set with increasing soil CO2 emission: "winter wheat

  2. A critical analysis of user satisfaction surveys in addiction services: opioid maintenance treatment as a representative case study.

    PubMed

    Trujols, Joan; Iraurgi, Ioseba; Oviedo-Joekes, Eugenia; Guàrdia-Olmos, Joan

    2014-01-01

    Satisfaction with services represents a key component of the user's perspective, and user satisfaction surveys are the most commonly used approach to evaluate the aforementioned perspective. The aim of this discursive paper is to provide a critical overview of user satisfaction surveys in addiction treatment and harm reduction services, with a particular focus on opioid maintenance treatment as a representative case. We carried out a selective critical review and analysis of the literature on user satisfaction surveys in addiction treatment and harm reduction services. Most studies that have reported results of satisfaction surveys have found that the great majority of users (virtually all, in many cases) are highly satisfied with the services received. However, when these results are compared to the findings of studies that use different methodologies to explore the patient's perspective, the results are not as consistent as might be expected. It is not uncommon to find that "highly satisfied" patients report significant problems when mixed-methods studies are conducted. To understand this apparent contradiction, we explored two distinct (though not mutually exclusive) lines of reasoning, one of which concerns conceptual aspects and the other, methodological questions. User satisfaction surveys, as currently designed and carried out in addiction treatment and harm reduction services, do not significantly help to improve service quality. Therefore, most of the enthusiasm and naiveté with which satisfaction surveys are currently performed and interpreted - and rarely acted on in the case of nonoptimal results - should be avoided. A truly participatory approach to program evaluation is urgently needed to reshape and transform patient satisfaction surveys.

  3. A critical analysis of user satisfaction surveys in addiction services: opioid maintenance treatment as a representative case study

    PubMed Central

    Trujols, Joan; Iraurgi, Ioseba; Oviedo-Joekes, Eugenia; Guàrdia-Olmos, Joan

    2014-01-01

    Background Satisfaction with services represents a key component of the user’s perspective, and user satisfaction surveys are the most commonly used approach to evaluate the aforementioned perspective. The aim of this discursive paper is to provide a critical overview of user satisfaction surveys in addiction treatment and harm reduction services, with a particular focus on opioid maintenance treatment as a representative case. Methods We carried out a selective critical review and analysis of the literature on user satisfaction surveys in addiction treatment and harm reduction services. Results Most studies that have reported results of satisfaction surveys have found that the great majority of users (virtually all, in many cases) are highly satisfied with the services received. However, when these results are compared to the findings of studies that use different methodologies to explore the patient’s perspective, the results are not as consistent as might be expected. It is not uncommon to find that “highly satisfied” patients report significant problems when mixed-methods studies are conducted. To understand this apparent contradiction, we explored two distinct (though not mutually exclusive) lines of reasoning, one of which concerns conceptual aspects and the other, methodological questions. Conclusion User satisfaction surveys, as currently designed and carried out in addiction treatment and harm reduction services, do not significantly help to improve service quality. Therefore, most of the enthusiasm and naiveté with which satisfaction surveys are currently performed and interpreted – and rarely acted on in the case of nonoptimal results – should be avoided. A truly participatory approach to program evaluation is urgently needed to reshape and transform patient satisfaction surveys. PMID:24482571

  4. 76 FR 18291 - Culturally Significant Objects Imported for Exhibition Determinations: “Boris Mikhailov: Case...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-01

    ... Culturally Significant Objects Imported for Exhibition Determinations: ``Boris Mikhailov: Case History... Mikhailov: Case History,'' imported from abroad for temporary exhibition within the United States, are of... Art, New York, New York, from on or about May 26, 2011, until on or about September 5, 2011, and at...

  5. Complete Genome Sequence of Zika Virus from the First Imported Case in Mainland China.

    PubMed

    Liu, Lin; Wu, Wei; Zhao, Xiang; Xiong, Ying; Zhang, Shuo; Liu, Xiaoqing; Qu, Jing; Li, Jiandong; Nei, Kai; Liang, Mifang; Shu, Yuelong; Hu, Guoliang; Ma, Xuejun; Li, Dexin

    2016-04-21

    The first case of Zika virus infection was identified in a Chinese traveler returning from Venezuela in February 2016. This report describes the complete genome sequence of Zika virus from the first imported case in China. The genome sequence analysis showed that the Zika virus isolated in this case belongs to the Asian lineage.

  6. Representing nursing guideline with unified modeling language to facilitate development of a computer system: a case study.

    PubMed

    Choi, Jeeyae; Choi, Jeungok E

    2014-01-01

    To provide best recommendations at the point of care, guidelines have been implemented in computer systems. As a prerequisite, guidelines are translated into a computer-interpretable guideline format. Since there are no specific tools to translate nursing guidelines, only a few nursing guidelines are translated and implemented in computer systems. Unified modeling language (UML) is a software writing language and is known to well and accurately represent end-users' perspective, due to the expressive characteristics of the UML. In order to facilitate the development of computer systems for nurses' use, the UML was used to translate a paper-based nursing guideline, and its ease of use and the usefulness were tested through a case study of a genetic counseling guideline. The UML was found to be a useful tool to nurse informaticians and a sufficient tool to model a guideline in a computer program.

  7. Quantifying the relative importance of climate-forced and land-use forced land cover changes in the representative concentration pathways

    NASA Astrophysics Data System (ADS)

    Davies-Barnard, T.; Valdes, P. J.; Singarayer, J. S.; Wiltshire, A.; Jones, C.

    2014-12-01

    Climate change is projected to cause substantial changes in vegetation distribution, but these changes have been given little attention in comparison to anthropogenic land-use change in the Representative Concentration Pathway (RCP) scenarios. Here we compare climate-forced vegetation changes to anthropogenic changes in vegetation from land-use change. To do this, we use an ensemble of simulations with and without anthropogenic land-use change in Earth System Model HadGEM2-ES for RCP2.6, RCP4.5 and RCP8.5. Climate change causes an expansion poleward of vegetation types. This climate-forced land cover change (LCC) affects more area of land than land-use forced land cover change (often referred to as Land-Use forced Land Cover Change, or LULCC) in all of the RCPs considered here. For forest specifically, the climate-forced forest increase compensates 90% of the global anthropogenic deforestation by 2100 in RCP8.5, but just 3% in RCP2.6. The strong relationship between climate-forced LCC and the overall radiative forcing means that the net effect on forest is strongly dependent on the RCP. Carbon emissions from climate-forced LCC are larger than for LULCC. Overall, bigger LCC contributions tend to originate from LULCC in the shorter term or lower radiative forcing scenarios, and from climate changes in the longer term and higher radiative forcing scenarios. The extent to which climate-forced LCC could mitigate LULCC raises difficult questions regarding global forest and biodiversity offsetting, especially at different timescales. This research shows the importance of considering the relative size of climate-forced LCC to LULCC, especially with regard to the net ecological effects of the different RCPs.

  8. Value Arguments in Science Research Articles: Making the Case for the Importance of Research

    ERIC Educational Resources Information Center

    Carter, Michael

    2016-01-01

    It is in the interest of scholarly journals to publish important research and of researchers to publish in important journals. One key to making the case for the importance of research in a scholarly article is to incorporate value arguments. Yet there has been no rhetorical analysis of value arguments in the literature. In the context of…

  9. Value Arguments in Science Research Articles: Making the Case for the Importance of Research

    ERIC Educational Resources Information Center

    Carter, Michael

    2016-01-01

    It is in the interest of scholarly journals to publish important research and of researchers to publish in important journals. One key to making the case for the importance of research in a scholarly article is to incorporate value arguments. Yet there has been no rhetorical analysis of value arguments in the literature. In the context of…

  10. The importance of laboratory re-evaluation in cases of suspected child abuse - A case report.

    PubMed

    Woydt, L; König, C; Bernhard, M K; Nickel, P; Dreßler, J; Ondruschka, B

    2017-09-01

    In order to accurately diagnose child abuse or neglect, a physician needs to be familiar with diseases and medical conditions that can simulate maltreatment. Unrecognized cases of abuse may lead to insufficient child protection, whereas, on the other hand, over-diagnosis could be the cause of various problems for the family and their potentially accused members. Regarding child abuse, numerous cases of false diagnoses with undetected causes of bleeding are described in the scientific literature, but, specifically concerning leukemia in childhood, only very few case reports exist. Here, for the first time, we report a case of a 2-year-old boy who got hospitalized twice because of suspicious injuries and psychosocial conspicuities, in a family situation known for repeated endangerment of the child's well-being. After his first hospitalization with injuries typical for child abuse, but without paraclinical abnormalities, medical inspections were arranged periodically. The child was hospitalized with signs of repeated child abuse again five months later. During second admission, an acute lymphoblastic leukemia was revealed by intermittent laboratory examination, ordered due to new bruises with changes in morphology, identifiable as petechial hemorrhages. This case elucidates the discussion of known cases of leukemia in childhood associated with suspected child abuse in order to provide an overview of possible diseases mimicking maltreatment. To arrange necessary supportive examinations, a skillful interaction between pediatrician and forensic pathologist is crucial in the differentiation between accidental and non-accidental injury. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Increased number of cases of Chikungunya virus (CHIKV) infection imported from the Caribbean and Central America to northern Italy, 2014.

    PubMed

    Rossini, G; Gaibani, P; Vocale, C; Finarelli, A C; Landini, M P

    2016-07-01

    This report describes an increased number of cases of Chikungunya virus (CHIKV) infection imported in northern Italy (Emilia-Romagna region) during the period May-September 2014, indicating that the recent spread of CHIKV and its establishment in the Caribbean and in central America, resulted in a high number of imported cases in Europe, thus representing a threat to public health. From May to September 2014, 14 imported cases of CHIKV infection were diagnosed; the patients were returning to Italy from Dominican Republic (n = 6), Haiti (n = 3), Guadeloupe (n = 2), Martinique (n = 1), Puerto Rico (n = 1) and Venezuela (n = 1). Phylogenetic analysis performed on the envelope protein (E1) gene sequences, obtained from plasma samples from two patients, indicated that the virus strain belongs to the Caribbean clade of the Asian genotype currently circulating in the Caribbean and Americas. The rise in the number of imported cases of CHIKV infection should increase healthcare professionals' awareness of the epidemiological situation and clinical presentation of CHIKV infection in order to enhance surveillance and early diagnosis in the forthcoming season of vector activity in Europe and North America.

  12. Imported Dengue Cases, Weather Variation and Autochthonous Dengue Incidence in Cairns, Australia

    PubMed Central

    Huang, Xiaodong; Williams, Gail; Clements, Archie C. A.; Hu, Wenbiao

    2013-01-01

    Background Dengue fever (DF) outbreaks often arise from imported DF cases in Cairns, Australia. Few studies have incorporated imported DF cases in the estimation of the relationship between weather variability and incidence of autochthonous DF. The study aimed to examine the impact of weather variability on autochthonous DF infection after accounting for imported DF cases and then to explore the possibility of developing an empirical forecast system. Methodology/principal finds Data on weather variables, notified DF cases (including those acquired locally and overseas), and population size in Cairns were supplied by the Australian Bureau of Meteorology, Queensland Health, and Australian Bureau of Statistics. A time-series negative-binomial hurdle model was used to assess the effects of imported DF cases and weather variability on autochthonous DF incidence. Our results showed that monthly autochthonous DF incidences were significantly associated with monthly imported DF cases (Relative Risk (RR):1.52; 95% confidence interval (CI): 1.01–2.28), monthly minimum temperature (oC) (RR: 2.28; 95% CI: 1.77–2.93), monthly relative humidity (%) (RR: 1.21; 95% CI: 1.06–1.37), monthly rainfall (mm) (RR: 0.50; 95% CI: 0.31–0.81) and monthly standard deviation of daily relative humidity (%) (RR: 1.27; 95% CI: 1.08–1.50). In the zero hurdle component, the occurrence of monthly autochthonous DF cases was significantly associated with monthly minimum temperature (Odds Ratio (OR): 1.64; 95% CI: 1.01–2.67). Conclusions/significance Our research suggested that incidences of monthly autochthonous DF were strongly positively associated with monthly imported DF cases, local minimum temperature and inter-month relative humidity variability in Cairns. Moreover, DF outbreak in Cairns was driven by imported DF cases only under favourable seasons and weather conditions in the study. PMID:24349148

  13. Imported dengue cases, weather variation and autochthonous dengue incidence in Cairns, Australia.

    PubMed

    Huang, Xiaodong; Williams, Gail; Clements, Archie C A; Hu, Wenbiao

    2013-01-01

    Dengue fever (DF) outbreaks often arise from imported DF cases in Cairns, Australia. Few studies have incorporated imported DF cases in the estimation of the relationship between weather variability and incidence of autochthonous DF. The study aimed to examine the impact of weather variability on autochthonous DF infection after accounting for imported DF cases and then to explore the possibility of developing an empirical forecast system. Data on weather variables, notified DF cases (including those acquired locally and overseas), and population size in Cairns were supplied by the Australian Bureau of Meteorology, Queensland Health, and Australian Bureau of Statistics. A time-series negative-binomial hurdle model was used to assess the effects of imported DF cases and weather variability on autochthonous DF incidence. Our results showed that monthly autochthonous DF incidences were significantly associated with monthly imported DF cases (Relative Risk (RR):1.52; 95% confidence interval (CI): 1.01-2.28), monthly minimum temperature ((o)C) (RR: 2.28; 95% CI: 1.77-2.93), monthly relative humidity (%) (RR: 1.21; 95% CI: 1.06-1.37), monthly rainfall (mm) (RR: 0.50; 95% CI: 0.31-0.81) and monthly standard deviation of daily relative humidity (%) (RR: 1.27; 95% CI: 1.08-1.50). In the zero hurdle component, the occurrence of monthly autochthonous DF cases was significantly associated with monthly minimum temperature (Odds Ratio (OR): 1.64; 95% CI: 1.01-2.67). Our research suggested that incidences of monthly autochthonous DF were strongly positively associated with monthly imported DF cases, local minimum temperature and inter-month relative humidity variability in Cairns. Moreover, DF outbreak in Cairns was driven by imported DF cases only under favourable seasons and weather conditions in the study.

  14. Conveyance Contact Investigation for Imported Middle East Respiratory Syndrome Cases, United States, May 2014.

    PubMed

    Lippold, Susan A; Objio, Tina; Vonnahme, Laura; Washburn, Faith; Cohen, Nicole J; Chen, Tai-Ho; Edelson, Paul J; Gulati, Reena; Hale, Christa; Harcourt, Jennifer; Haynes, Lia; Jewett, Amy; Jungerman, Robynne; Kohl, Katrin S; Miao, Congrong; Pesik, Nicolette; Regan, Joanna J; Roland, Efrosini; Schembri, Chris; Schneider, Eileen; Tamin, Azaibi; Tatti, Kathleen; Alvarado-Ramy, Francisco

    2017-09-01

    In 2014, the Centers for Disease Control and Prevention conducted conveyance contact investigations for 2 Middle East respiratory syndrome cases imported into the United States, comprising all passengers and crew on 4 international and domestic flights and 1 bus. Of 655 contacts, 78% were interviewed; 33% had serologic testing. No secondary cases were identified.

  15. Assessing the risk of observing multiple generations of Middle East respiratory syndrome (MERS) cases given an imported case.

    PubMed

    Nishiura, H; Miyamatsu, Y; Chowell, G; Saitoh, M

    2015-07-09

    To guide risk assessment, expected numbers of cases and generations were estimated, assuming a case importation of Middle East respiratory syndrome (MERS). Our analysis of 36 importation events yielded the risk of observing secondary transmission events at 22.7% (95% confidence interval: 19.3–25.1). The risks of observing generations 2, 3 and 4 were estimated at 10.5%, 6.1% and 3.9%, respectively. Countries at risk should be ready for highly variable outcomes following an importation of MERS.

  16. Predicting Local Dengue Transmission in Guangzhou, China, through the Influence of Imported Cases, Mosquito Density and Climate Variability

    PubMed Central

    Sang, Shaowei; Yin, Wenwu; Bi, Peng; Zhang, Honglong; Wang, Chenggang; Liu, Xiaobo; Chen, Bin; Yang, Weizhong; Liu, Qiyong

    2014-01-01

    Introduction Each year there are approximately 390 million dengue infections worldwide. Weather variables have a significant impact on the transmission of Dengue Fever (DF), a mosquito borne viral disease. DF in mainland China is characterized as an imported disease. Hence it is necessary to explore the roles of imported cases, mosquito density and climate variability in dengue transmission in China. The study was to identify the relationship between dengue occurrence and possible risk factors and to develop a predicting model for dengue’s control and prevention purpose. Methodology and Principal Findings Three traditional suburbs and one district with an international airport in Guangzhou city were selected as the study areas. Autocorrelation and cross-correlation analysis were used to perform univariate analysis to identify possible risk factors, with relevant lagged effects, associated with local dengue cases. Principal component analysis (PCA) was applied to extract principal components and PCA score was used to represent the original variables to reduce multi-collinearity. Combining the univariate analysis and prior knowledge, time-series Poisson regression analysis was conducted to quantify the relationship between weather variables, Breteau Index, imported DF cases and the local dengue transmission in Guangzhou, China. The goodness-of-fit of the constructed model was determined by pseudo-R2, Akaike information criterion (AIC) and residual test. There were a total of 707 notified local DF cases from March 2006 to December 2012, with a seasonal distribution from August to November. There were a total of 65 notified imported DF cases from 20 countries, with forty-six cases (70.8%) imported from Southeast Asia. The model showed that local DF cases were positively associated with mosquito density, imported cases, temperature, precipitation, vapour pressure and minimum relative humidity, whilst being negatively associated with air pressure, with different time

  17. Predicting local dengue transmission in Guangzhou, China, through the influence of imported cases, mosquito density and climate variability.

    PubMed

    Sang, Shaowei; Yin, Wenwu; Bi, Peng; Zhang, Honglong; Wang, Chenggang; Liu, Xiaobo; Chen, Bin; Yang, Weizhong; Liu, Qiyong

    2014-01-01

    Each year there are approximately 390 million dengue infections worldwide. Weather variables have a significant impact on the transmission of Dengue Fever (DF), a mosquito borne viral disease. DF in mainland China is characterized as an imported disease. Hence it is necessary to explore the roles of imported cases, mosquito density and climate variability in dengue transmission in China. The study was to identify the relationship between dengue occurrence and possible risk factors and to develop a predicting model for dengue's control and prevention purpose. Three traditional suburbs and one district with an international airport in Guangzhou city were selected as the study areas. Autocorrelation and cross-correlation analysis were used to perform univariate analysis to identify possible risk factors, with relevant lagged effects, associated with local dengue cases. Principal component analysis (PCA) was applied to extract principal components and PCA score was used to represent the original variables to reduce multi-collinearity. Combining the univariate analysis and prior knowledge, time-series Poisson regression analysis was conducted to quantify the relationship between weather variables, Breteau Index, imported DF cases and the local dengue transmission in Guangzhou, China. The goodness-of-fit of the constructed model was determined by pseudo-R2, Akaike information criterion (AIC) and residual test. There were a total of 707 notified local DF cases from March 2006 to December 2012, with a seasonal distribution from August to November. There were a total of 65 notified imported DF cases from 20 countries, with forty-six cases (70.8%) imported from Southeast Asia. The model showed that local DF cases were positively associated with mosquito density, imported cases, temperature, precipitation, vapour pressure and minimum relative humidity, whilst being negatively associated with air pressure, with different time lags. Imported DF cases and mosquito density play a

  18. Imported Case of Lassa Fever in Sweden With Encephalopathy and Sensorineural Hearing Deficit

    PubMed Central

    Bråve, Andreas; Lagging, Martin; Dotevall, Leif; Ekqvist, David; Hammarström, Helena; Karlberg, Helen; Lagerqvist, Nina; Sansone, Martina; Tegnell, Anders; Ulleryd, Peter; Studahl, Marie

    2016-01-01

    We describe an imported case of Lassa fever with both encephalopathy and bilateral sensorineural hearing deficit. Absence of fever during hospitalization, initially nonspecific symptoms, and onset of hearing deficit in a late stage of disease probably contributed to delayed diagnosis (14 days after admittance to hospital). The pathogenesis of neurological manifestations of Lassa fever is poorly understood and no specific treatment was given. A total of 118 personnel had close contact with the patient, but no secondary cases occurred. This case highlights the importance of considering Lassa fever as a differential diagnosis in patients with recent travel to endemic areas. PMID:27975074

  19. Imported Case of Lassa Fever in Sweden With Encephalopathy and Sensorineural Hearing Deficit.

    PubMed

    Grahn, Anna; Bråve, Andreas; Lagging, Martin; Dotevall, Leif; Ekqvist, David; Hammarström, Helena; Karlberg, Helen; Lagerqvist, Nina; Sansone, Martina; Tegnell, Anders; Ulleryd, Peter; Studahl, Marie

    2016-10-01

    We describe an imported case of Lassa fever with both encephalopathy and bilateral sensorineural hearing deficit. Absence of fever during hospitalization, initially nonspecific symptoms, and onset of hearing deficit in a late stage of disease probably contributed to delayed diagnosis (14 days after admittance to hospital). The pathogenesis of neurological manifestations of Lassa fever is poorly understood and no specific treatment was given. A total of 118 personnel had close contact with the patient, but no secondary cases occurred. This case highlights the importance of considering Lassa fever as a differential diagnosis in patients with recent travel to endemic areas.

  20. Sequence- and Structure-Based Functional Annotation and Assessment of Metabolic Transporters in Aspergillus oryzae: A Representative Case Study

    PubMed Central

    Raethong, Nachon; Wong-ekkabut, Jirasak; Laoteng, Kobkul; Vongsangnak, Wanwipa

    2016-01-01

    Aspergillus oryzae is widely used for the industrial production of enzymes. In A. oryzae metabolism, transporters appear to play crucial roles in controlling the flux of molecules for energy generation, nutrients delivery, and waste elimination in the cell. While the A. oryzae genome sequence is available, transporter annotation remains limited and thus the connectivity of metabolic networks is incomplete. In this study, we developed a metabolic annotation strategy to understand the relationship between the sequence, structure, and function for annotation of A. oryzae metabolic transporters. Sequence-based analysis with manual curation showed that 58 genes of 12,096 total genes in the A. oryzae genome encoded metabolic transporters. Under consensus integrative databases, 55 unambiguous metabolic transporter genes were distributed into channels and pores (7 genes), electrochemical potential-driven transporters (33 genes), and primary active transporters (15 genes). To reveal the transporter functional role, a combination of homology modeling and molecular dynamics simulation was implemented to assess the relationship between sequence to structure and structure to function. As in the energy metabolism of A. oryzae, the H+-ATPase encoded by the AO090005000842 gene was selected as a representative case study of multilevel linkage annotation. Our developed strategy can be used for enhancing metabolic network reconstruction. PMID:27274991

  1. Effective case presentations--an important clinical skill for nurse practitioners.

    PubMed

    Coralli, Connie H

    2006-05-01

    Effective case presentations are an important component of the nurse practitioner's skills, yet very little literature exists to guide the development of this skill, and frequently little priority is given to teaching this skill during the education of the nurse practitioner. This report discusses the importance of effective case presentations, describes the organization of the presentation, and outlines the appropriate information to be included. The main components of a case presentation-introduction, history of the present illness, physical examination, diagnostic studies, differential diagnosis, management, and summary of the case-are discussed in detail. Examples of a formal and an informal case presentation are presented and used to illustrate key points in the text.

  2. Effective case presentations--an important clinical skill for nurse practitioners.

    PubMed

    Coralli, C H

    1989-01-01

    Effective case presentations are an important component of the nurse practitioner's skills, yet very little literature exists to guide the development of this skill, and frequently little priority is given to teaching this skill during the education of the nurse practitioner. This report discusses the importance of effective case presentations, describes the organization of the presentation, and outlines the appropriate information to be included. The main components of a case presentation--introduction, history of the present illness, physical examination, diagnostic studies, differential diagnosis, management, and summary of the case--are discussed in detail. Examples of a formal and an informal case presentation are presented and used to illustrate key points in the text.

  3. The Role of Imported Cases and Favorable Meteorological Conditions in the Onset of Dengue Epidemics

    PubMed Central

    Shang, Chuin-Shee; Wen, Tzai-Hung; Tsai, Kun-Hsien

    2010-01-01

    Background Travelers who acquire dengue infection are often routes for virus transmission to other regions. Nevertheless, the interplay between infected travelers, climate, vectors, and indigenous dengue incidence remains unclear. The role of foreign-origin cases on local dengue epidemics thus has been largely neglected by research. This study investigated the effect of both imported dengue and local meteorological factors on the occurrence of indigenous dengue in Taiwan. Methods and Principal Findings Using logistic and Poisson regression models, we analyzed bi-weekly, laboratory-confirmed dengue cases at their onset dates of illness from 1998 to 2007 to identify correlations between indigenous dengue and imported dengue cases (in the context of local meteorological factors) across different time lags. Our results revealed that the occurrence of indigenous dengue was significantly correlated with temporally-lagged cases of imported dengue (2–14 weeks), higher temperatures (6–14 weeks), and lower relative humidity (6–20 weeks). In addition, imported and indigenous dengue cases had a significant quantitative relationship in the onset of local epidemics. However, this relationship became less significant once indigenous epidemics progressed past the initial stage. Conclusions These findings imply that imported dengue cases are able to initiate indigenous epidemics when appropriate weather conditions are present. Early detection and case management of imported cases through rapid diagnosis may avert large-scale epidemics of dengue/dengue hemorrhagic fever. The deployment of an early-warning surveillance system, with the capacity to integrate meteorological data, will be an invaluable tool for successful prevention and control of dengue, particularly in non-endemic countries. PMID:20689820

  4. Leishmaniasis, an emerging imported infection: report of 20 cases from Australia.

    PubMed

    Stark, Damien; van Hal, Sebastian; Lee, Rogan; Marriott, Deborah; Harkness, John

    2008-01-01

    Leishmaniasis is a protozoan infection rarely reported in Australia. However, with the advent of increased international tourism and migration of refugees from endemic regions, leishmaniasis has emerged as an increasingly imported infection. We report 20 cases (17 cutaneous, 2 visceral, and 1 post-kala-azar dermal leishmaniasis). These data highlight the range of species causing leishmaniasis imported in Australia and demonstrate the importance of species identification in determining proper treatment.

  5. Correlates of suicide among veterans treated in primary care: case-control study of a nationally representative sample.

    PubMed

    Dobscha, Steven K; Denneson, Lauren M; Kovas, Anne E; Teo, Alan; Forsberg, Christopher W; Kaplan, Mark S; Bossarte, Robert; McFarland, Bentson H

    2014-12-01

    Veterans receiving Veterans Affairs (VA) healthcare have increased suicide risk compared to the general population. Many patients see primary care clinicians prior to suicide. Yet little is known about the correlates of suicide among patients who receive primary care treatment prior to death. Our aim was to describe characteristics of veterans who received VA primary care in the 6 months prior to suicide; and to compare these to characteristics of control patients who also received VA primary care. This was a retrospective case-control study. The investigators partnered with VA operations leaders to obtain death certificate data from 11 states for veterans who died by suicide in 2009. Cases were matched 1:2 to controls based on age, sex, and clinician. Demographic, diagnosis, and utilization data were obtained from VA's Corporate Data Warehouse. Additional clinical and psychosocial context data were collected using manual medical record review. Multivariate conditional logistic regression was used to examine associations between potential predictor variables and suicide. Two hundred and sixty-nine veteran cases were matched to 538 controls. Average subject age was 63 years; 97 % were male. Rates of mental health conditions, functional decline, sleep disturbance, suicidal ideation, and psychosocial stressors were all significantly greater in cases compared to controls. In the final model describing men in the sample, non-white race (OR = 0.51; 95 % CI = 0.27-0.98) and VA service-connected disability (OR = 0.54; 95 % CI = 0.36-0.80) were associated with decreased odds of suicide, while anxiety disorder (OR = 3.52; 95 % CI = 1.79-6.92), functional decline (OR = 2.52; 95 % CI = 1.55-4.10), depression (OR = 1.82; 95 % CI = 1.07-3.10), and endorsement of suicidal ideation (OR = 2.27; 95 % CI = 1.07-4.83) were associated with greater odds of suicide. Assessment for anxiety disorders and functional decline in addition to

  6. Non-imported malaria in non-endemic countries: a review of cases in Spain.

    PubMed

    Velasco, Emilia; Gomez-Barroso, Diana; Varela, Carmen; Diaz, Oliva; Cano, Rosa

    2017-06-29

    Spain declared the elimination of malaria in 1964. In non-endemic areas, the overwhelming majority of malaria cases are acquired abroad, and locally acquired infections are rare events. In Spain, malaria is a statutorily notifiable disease. During these fifty years more than ten thousand malaria cases have been reported, and about 0.8% of them did not have a history of recent travel. In this report, it was carried out a review of the ways in which malaria can be transmitted in non-endemic areas and a short description of the Spanish cases, aggregated by their transmission mechanisms. Four cases contracted malaria by mosquito bites; there were two autochthonous cases and two of "airport malaria". The other 28 cases were: congenital malaria cases, transfusion-transmitted malaria, post-transplant cases, nosocomial transmission and cases in intravenous drug users. In addition, in 1971 there was an outbreak of 54 cases due to exposure to blood or blood products. So, while malaria usually is an imported disease in non-endemic areas, it should not be excluded in the differential diagnosis of persons who have fever of unknown origin, regardless of their travel history.

  7. Representing Curriculum

    ERIC Educational Resources Information Center

    Gaztambide-Fernandez, Ruben

    2009-01-01

    Handbooks denote representative authority, which gives their content normative value and through which editors and authors can emphasize certain views and orientations within a field. The representative authority of a handbook is reinforced in various ways, both obvious and subtle. The "SAGE Handbook of Curriculum and Instruction" is no exception…

  8. Representing Curriculum

    ERIC Educational Resources Information Center

    Gaztambide-Fernandez, Ruben

    2009-01-01

    Handbooks denote representative authority, which gives their content normative value and through which editors and authors can emphasize certain views and orientations within a field. The representative authority of a handbook is reinforced in various ways, both obvious and subtle. The "SAGE Handbook of Curriculum and Instruction" is no exception…

  9. An ongoing measles outbreak linked to a suspected imported case, Ireland, April to June 2016.

    PubMed

    Barrett, Peter; Chaintarli, Katerina; Ryan, Fiona; Cotter, Suzanne; Cronin, Anthony; Carlton, Louise; MacSweeney, Mary; McDonnell, Mairead; Connell, Jeff; Fitzgerald, Rose; Hamilton, Douglas; Ward, Mary; Glynn, Ronan; Migone, Chantal

    2016-07-07

    We report an outbreak of measles which started in April 2016 and which, by 13 June, has resulted in 22 confirmed and five probable measles cases occurring in four regions of Ireland. Genotype B3 was identified. We describe the identification, ongoing investigation and control measures being implemented. This outbreak occurs during a period of very low measles transmission in Ireland, with only one confirmed case (imported) notified in 2016 before this event. This article is copyright of The Authors, 2016.

  10. Blocking Yersiniabactin Import Attenuates Extraintestinal Pathogenic Escherichia coli in Cystitis and Pyelonephritis and Represents a Novel Target To Prevent Urinary Tract Infection

    PubMed Central

    Brumbaugh, Ariel R.; Smith, Sara N.; Subashchandrabose, Sargurunathan; Himpsl, Stephanie D.; Hazen, Tracy H.; Rasko, David A.

    2015-01-01

    The emergence and spread of extended-spectrum beta-lactamases and carbapenemases among common bacterial pathogens are threatening our ability to treat routine hospital- and community-acquired infections. With the pipeline for new antibiotics virtually empty, there is an urgent need to develop novel therapeutics. Bacteria require iron to establish infection, and specialized pathogen-associated iron acquisition systems like yersiniabactin, common among pathogenic species in the family Enterobacteriaceae, including multidrug-resistant Klebsiella pneumoniae and pathogenic Escherichia coli, represent potentially novel therapeutic targets. Although the yersiniabactin system was recently identified as a vaccine target for uropathogenic E. coli (UPEC)-mediated urinary tract infection (UTI), its contribution to UPEC pathogenesis is unknown. Using an E. coli mutant (strain 536ΔfyuA) unable to acquire yersiniabactin during infection, we established the yersiniabactin receptor as a UPEC virulence factor during cystitis and pyelonephritis, a fitness factor during bacteremia, and a surface-accessible target of the experimental FyuA vaccine. In addition, we determined through transcriptome sequencing (RNA-seq) analyses of RNA from E. coli causing cystitis in women that iron acquisition systems, including the yersiniabactin system, are highly expressed by bacteria during natural uncomplicated UTI. Given that yersiniabactin contributes to the virulence of several pathogenic species in the family Enterobacteriaceae, including UPEC, and is frequently associated with multidrug-resistant strains, it represents a promising novel target to combat antibiotic-resistant infections. PMID:25624354

  11. The First Case in Japan of Severe Human Leptospirosis Imported from Vietnam

    PubMed Central

    Mishima, Nobuyuki; Tabuchi, Koichiro; Kuroda, Tomoaki; Nakatani, Issaku; Lamaningao, Pheophet; Miyake, Mari; Kanda, Seiji; Koizumi, Nobuo; Nishiyama, Toshimasa

    2013-01-01

    Leptospirosis is a worldwide zoonosis and common in tropical and subtropical areas with high rainfall. It should be noted as an imported infectious disease although it is sporadic in Japan. Some imported cases already have been reported in Japan and these cases occurred mainly in Southeast Asia. The case discussed in this article is the first reported Japanese case infected in Vietnam. Four days after returning back to Japan after a two-week stay in the mountain area near Hue, in the middle part of Vietnam, the patient suddenly experienced chills, a high fever, sore throat, gastrocnemius pain, and headache. Conjunctival jaundice, renal function disorder, and proteinuria were observed on the third day of onset. Significant increase in antibody titers against serovar Australis and Autumnalis strains was observed in paired serum samples by microscopic agglutination test (MAT). Consequently we recognized this case as a diagnosis of severe leptospirosis (Weil’s disease). Finally, renal function disorder did not deteriorate further, and then the patient recovered after the tenth day of onset with the administration of antibiotics and supportive care without sequelae. We experienced the first imported Japanese case of severe human leptospirosis infection from Vietnam that was successfully treated with ceftriaxone and minocycline. PMID:24505215

  12. Suicide pact by drowning with bound wrists: a case of medico-legal importance.

    PubMed

    Behera, C; Karthik, Krishna; Singh, Hansraj; Deepak, Prakash; Jhamad, Akhilesh R; Bhardwaj, D N

    2014-03-01

    Suicide pacts are uncommon and mainly committed by male-female pairs in a consortial relationship. The victims frequently choose methods such as hanging, poisoning, using a firearm, etc; however, a case of a suicide pact by drowning is rare in forensic literature. We report a case where a male and a female, both young adults, in a relationship of adopted "brother of convenience" were found drowned in a river. The victims were bound together at their wrists which helped with our conclusion this was a suicide pact. The medico-legal importance of wrist binding in drowning cases is also discussed in this article.

  13. Imported chloroquine-resistant Plasmodium vivax in Singapore: case report and literature review.

    PubMed

    Lim, Poh Lian; Mok, Ying Juan; Lye, David C; Leo, Yee Sin

    2010-01-01

    Chloroquine-resistant Plasmodium vivax (CRPV) infection is emerging as a clinically significant problem. Detailed travel history is crucial to the management of imported malarial cases. We report a 58-year-old business traveler who returned from Indonesia and experienced relapse due to CRPV. The epidemiology and diagnostic challenges of CRPV for travel medicine clinicians are reviewed.

  14. Retrospective analysis of the cholera cases imported to France from 1973 to 2005.

    PubMed

    Tarantola, Arnaud; Ioos, Sophie; Rotureau, Brice; Paquet, Christophe; Quilici, Marie-Laure; Fournier, Jean-Michel

    2007-01-01

    The manners of traveling and travelers' vulnerability to infection are changing: increasing numbers of travelers, travels at the extreme ages of life, "backpacker" tourism in close contact with local populations. What is the epidemiologic situation and what are the trends of imported cholera to Metropolitan France? A descriptive retrospective study was undertaken on all the confirmed cases of cholera imported to France, and notified from January 1, 1973, to December 31, 2005, using compulsory notification data from local health departments and information from the National Reference Centre. A total of 129 imported cases of cholera were notified between 1973 and 2005 (3.9 cases/y on average). The geographical sources of infection have changed with time: in the 1980s, 94% of the patients were infected in Maghreb (Morocco and Algeria) but none were in 2000. On the other hand, Asia and West Africa progressively emerged and now predominate. In spite of certain poorly informed data and possible underdetection, the number of cases of importation appears to be low and falling. The patient profile seems to have evolved and increasingly concerns people at the extreme ages of life, living elsewhere than the principal basins of immigration in France, and diagnosis is increasingly made in nonteaching hospitals. The lessons likely to help clinicians will be discussed.

  15. [Clinical analysis of two cases of imported children Zika virus infection in China].

    PubMed

    Zheng, C G; Xu, Y; Jiang, H Q; Yin, Y X; Zhang, J H; Zhu, W J; Liang, X J; Chen, M X; Ye, J W; Tan, L M; Luo, D; Gong, S T

    2016-05-01

    To analyze the clinical characteristics, outcome and diagnosis of two cases of imported children Zika virus infection in China. A retrospective analysis was performed on clinical characteristics, treatment and outcome of two cases of imported children with Zika virus infection in February 2016 in Enping People's Hospital of Guangdong. Two cases of children with imported Zika virus infection resided in an affected area of Venezuela, 8-year-old girl and her 6 year-old brother. The main findings on physical examination included the following manifestations: fever, rash, and conjunctivitis. The rash was first limited to the abdomen, but extended to the torso, neck and face, and faded after 3-4 d. The total number of white blood cells was not high and liver function was normal. The diagnosis of two cases of Zika virus infection was confirmed by the expert group of Guangdong Provincial Center for Disease Control and Prevention, according to the epidemiological history, clinical manifestations and Zika virus nucleic acid detection results.Treatment of Zika virus infection involves supportive care. Two Zika virus infection children had a relatively benign outcome. At present, Zika virus infection in children is an imported disease in China. No specific therapy is available for this disease. Information on long-term outcomes among infants and children with Zika virus disease is limited, routine pediatric care is advised for these infants and children.

  16. Chikungunya in Singapore: imported cases among travelers visiting friends and relatives.

    PubMed

    Lim, Poh Lian; Oh, Helen May-Lin; Ooi, Eng Eong

    2009-01-01

    Chikungunya infections were detected in Singapore among returning travelers who had visited friends and relatives (VFR) in India and Malaysia. These sporadic imported cases occurred over a year before the 2008 chikungunya outbreaks in Singapore, demonstrating the potential for introducing this emerging viral infection into new areas via VFR travel.

  17. A Case Study of the Importance of Practitioner Research for Teacher Development

    ERIC Educational Resources Information Center

    Bartlett, Steve; Burton, Diana; Buckley, Sue

    2005-01-01

    This article considers the important part that practitioner research can play in the professional development of teachers. The case study illustrates how a teacher's interests encouraged her to investigate particular areas of her practice. She read literature about emotional intelligence and devised strategies to enhance her classroom teaching.…

  18. Active Surveillance of Hansen's Disease (Leprosy): Importance for Case Finding among Extra-domiciliary Contacts

    PubMed Central

    Moura, Maria L. N.; Dupnik, Kathryn M.; Sampaio, Gabriel A. A.; Nóbrega, Priscilla F. C.; Jeronimo, Ana K.; do Nascimento-Filho, Jose M.; Miranda Dantas, Roberta L.; Queiroz, Jose W.; Barbosa, James D.; Dias, Gutemberg; Jeronimo, Selma M. B.; Souza, Marcia C. F.; Nobre, Maurício L.

    2013-01-01

    Hansen's disease (leprosy) remains an important health problem in Brazil, where 34,894 new cases were diagnosed in 2010, corresponding to 15.3% of the world's new cases detected in that year. The purpose of this study was to use home visits as a tool for surveillance of Hansen's disease in a hyperendemic area in Brazil. A total of 258 residences were visited with 719 individuals examined. Of these, 82 individuals had had a previous history of Hansen's disease, 209 were their household contacts and 428 lived in neighboring residences. Fifteen new Hansen's disease cases were confirmed, yielding a detection rate of 2.0% of people examined. There was no difference in the detection rate between household and neighbor contacts (p = 0.615). The two groups had the same background in relation to education (p = 0.510), household income (p = 0.582), and the number of people living in the residence (p = 0.188). Spatial analysis showed clustering of newly diagnosed cases and association with residential coordinates of previously diagnosed multibacillary cases. Active case finding is an important tool for Hansen's disease control in hyperendemic areas, enabling earlier diagnosis, treatment, decrease in disability from Hansen's disease and potentially less spread of Mycobacterium leprae. PMID:23516645

  19. Active surveillance of Hansen's Disease (leprosy): importance for case finding among extra-domiciliary contacts.

    PubMed

    Moura, Maria L N; Dupnik, Kathryn M; Sampaio, Gabriel A A; Nóbrega, Priscilla F C; Jeronimo, Ana K; do Nascimento-Filho, Jose M; Miranda Dantas, Roberta L; Queiroz, Jose W; Barbosa, James D; Dias, Gutemberg; Jeronimo, Selma M B; Souza, Marcia C F; Nobre, Maurício L

    2013-01-01

    Hansen's disease (leprosy) remains an important health problem in Brazil, where 34,894 new cases were diagnosed in 2010, corresponding to 15.3% of the world's new cases detected in that year. The purpose of this study was to use home visits as a tool for surveillance of Hansen's disease in a hyperendemic area in Brazil. A total of 258 residences were visited with 719 individuals examined. Of these, 82 individuals had had a previous history of Hansen's disease, 209 were their household contacts and 428 lived in neighboring residences. Fifteen new Hansen's disease cases were confirmed, yielding a detection rate of 2.0% of people examined. There was no difference in the detection rate between household and neighbor contacts (p = 0.615). The two groups had the same background in relation to education (p = 0.510), household income (p = 0.582), and the number of people living in the residence (p = 0.188). Spatial analysis showed clustering of newly diagnosed cases and association with residential coordinates of previously diagnosed multibacillary cases. Active case finding is an important tool for Hansen's disease control in hyperendemic areas, enabling earlier diagnosis, treatment, decrease in disability from Hansen's disease and potentially less spread of Mycobacterium leprae.

  20. Notes from the Field: Imported Cases of Malaria--Puerto Rico, July-October 2015.

    PubMed

    Dirlikov, Emilio; Rodríguez, Carmen; Morales, Shirley; Martínez, Laura Castro; Mendez, Juan B; Sanchez, Anibal Cruz; Burgos, Jesús Hernández; Santiago, Zobeida; Cuevas-Ruis, Rosa Ivette; Camacho, Sheila Adorno; Mercado, Enid Román; Guzmán, Jessica Falcón; Ryff, Kyle; Luna-Pinto, Carolina; Arguin, Paul M; Chenet, Stella M; Silva-Flannery, Luciana; Ljolje, Dragan; Velázquez, Julio Cadiz; Thomas, Dana; Garcia, Brenda Rivera

    2016-04-01

    On July 16 2015, the Puerto Rico Department of Health (PRDH) was notified of a case of malaria, diagnosed by a hospital parasitology laboratory in a student who had traveled to Punta Cana, Dominican Republic, during late June for a school-organized graduation trip. Malaria is a mosquito-borne parasitic infection, characterized by fever, shaking chills, headaches, muscle pains, nausea, general malaise, and vomiting (1). Malaria can be clinically difficult to distinguish from other acute febrile illnesses, and a definitive diagnosis requires demonstration of malaria parasites using microscopy or molecular diagnostic tests. The student's initial diagnosis on July 10 was suspected dengue virus infection. Puerto Rico eliminated local malaria transmission during the mid-1950s (2); however, reintroduction remains a risk because of the presence of a competent vector (Anopheles albimanus) and ease of travel to areas where the disease is endemic, including Hispaniola, the island shared by the Dominican Republic and Haiti, and the only island in the Caribbean with endemic malaria (3). During 2014, the Dominican Republic reported 496 confirmed malaria cases and four associated deaths; Haiti reported 17,662 confirmed cases and nine deaths (4). During 2000-2014, Puerto Rico reported a total of 35 imported malaria cases (range = 0-7 per year); three cases were imported from Hispaniola. During June-August 2015, eight confirmed malaria cases among travelers to the Dominican Republic were reported to CDC's National Malaria Surveillance System (CDC, unpublished data, 2015).

  1. [An imported Chikungunya fever case from New Delhi, India to Ankara, Turkey: the first imported case of Turkey and review of the literature].

    PubMed

    Yağcı Çağlayık, Dilek; Uyar, Yavuz; Korukluoğlu, Gülay; Ertek, Mustafa; Unal, Serhat

    2012-01-01

    Chikungunya virus (CHIKV) is an arthropod-borne alphavirus that causes an acute febrile illness, chikungunya fever. CHIKV virus is geographically distributed in Africa, India, and South-East Asia. Chikungunya fever outbreaks have been reported from India since 2006. The incubation period is 3-7 days, and the disease is characterized by sudden onset of high fever and severe arthralgia. Other symptoms can be rash, headache, fatigue, nausea-vomiting, and myalgias. Here, we report the first Chikungunya case imported from India, New-Delhi to Ankara, Turkey. In December 2010, a 55-year-old female Turkish government employee living in urban area of New Delhi for the last 3 years had sudden onset fever up to 38.4°C for 2 days. Itching rash and arthralgia also developed. Symptomatic treatment was given to patient in New Delhi. She returned to Turkey and was admitted to Hacettepe University Medical Faculty, Department of Internal Medicine, Infectious Diseases Unit, since arthralgia has continued on the 26th day of her complaints. Hepatomegaly and tenosynovitis were detected in her physical examination. Serum sample sent to Refik Saydam National Public Health Agency, Virology Reference and Research Laboratory, yielded negative results for specific IgM and IgG antibodies against Hantavirus and Dengue virus types 1-4; however, the results were positive for CHIKV specific IgM and IgG antibodies by commercial immunofluorescence method (Euroimmun, Germany). CHIKV RNA which was searched by in-house real-time RT-PCR was negative. The second serum sample obtained three weeks later also found positive for CHIKV specific IgM and IgG antibodies. This was the first laboratory confirmed imported Chikungunya case in Turkey. There are predictions regarding the presence of Aedes species mosquitos that can transmit this virus in Turkey. This case report will be an alarming signal for the clinicians in our country to consider Chikungunya fever in the differential diagnosis of patients

  2. Characterization of Influenza A (H7N9) Viruses Isolated from Human Cases Imported into Taiwan

    PubMed Central

    Yang, Ji-Rong; Kuo, Chuan-Yi; Huang, Hsiang-Yi; Wu, Fu-Ting; Huang, Yi-Lung; Cheng, Chieh-Yu; Su, Yu-Ting; Wu, Ho-Sheng; Liu, Ming-Tsan

    2015-01-01

    A novel avian influenza A (H7N9) virus causes severe human infections and was first identified in March 2013 in China. The H7N9 virus has exhibited two epidemiological peaks of infection, occurring in week 15 of 2013 and week 5 of 2014. Taiwan, which is geographically adjacent to China, faces a large risk of being affected by this virus. Through extensive surveillance, launched in April 2013, four laboratory-confirmed H7N9 cases imported from China have been identified in Taiwan. The H7N9 virus isolated from imported case 1 in May 2013 (during the first wave) was found to be closest genetically to a virus from wild birds and differed from the prototype virus, A/Anhui/1/2013, in the MP gene. The other three imported cases were detected in December 2013 and April 2014 (during the second wave). The viruses isolated from cases 2 and 4 were similar in the compositions of their 6 internal genes and distinct from A/Anhui/1/2013 in the PB2 and MP genes, whereas the virus isolated from case 3 exhibited a novel reassortment that has not been identified previously and was different from A/Anhui/1/2013 in the PB2, PA and MP genes. The four imported H7N9 viruses share similar antigenicity with A/Anhui/1/2013, and their HA and NA genes grouped together in their respective phylogenies. In contrast with the HA and NA genes, which exhibited a smaller degree of diversity, the internal genes were heterogeneous and provided potential distinctions between transmission sources in terms of both geography and hosts. It is important to strengthen surveillance of influenza and to share viral genetic data in real-time for reducing the threat of rapid and continuing evolution of H7N9 viruses. PMID:25748033

  3. The importance of the belief that "light" cigarettes are smoother in misperceptions of the harmfulness of "light" cigarettes in the Republic of Korea: a nationally representative cohort study.

    PubMed

    Green, Annika C; Fong, Geoffrey T; Borland, Ron; Quah, Anne C K; Seo, Hong Gwan; Kim, Yeol; Elton-Marshall, Tara

    2015-11-07

    A number of countries have banned misleading cigarette descriptors such as "light" and "low-tar" as called for by the WHO Framework Convention on Tobacco Control. These laws, however, do not address the underlying cigarette design elements that contribute to misperceptions about harm. This is the first study to examine beliefs about "light" cigarettes among Korean smokers, and the first to identify factors related to cigarette design that are associated with the belief that "light" cigarettes are less harmful. We analysed data from Wave 3 of the ITC Korea Survey, a telephone survey of a nationally representative sample of 1,753 adult smokers, conducted October - December 2010. A multinomial logistic regression was used to examine which factors were associated with the belief that "light" cigarettes are less harmful than regular cigarettes. One quarter (25.0 %) of smokers believed that "light" cigarettes are less harmful than regular cigarettes, 25.8 % believed that smokers of "light" brands take in less tar, and 15.5 % held both of these beliefs. By far the strongest predictor of the erroneous belief that "light" cigarettes are less harmful was the belief that "light" cigarettes are smoother on the throat and chest (p < 0.001, OR = 44.8, 95 % CI 23.6-84.9). The strong association between the belief that "light" cigarettes are smoother on the throat and chest and the belief that "light" cigarettes are less harmful, which is consistent with previous research, provides further evidence of the need to not only ban "light" descriptors, but also prohibit cigarette design and packaging features that contribute to the perception of smoothness.

  4. Imported Fenproporex-based Diet Pills from Brazil: A Report of Two Cases

    PubMed Central

    2008-01-01

    Banned amphetamine-based anorectics are illicitly imported into the United States (US), but little is known regarding the harm these diet pills pose to US residents. A 26-year-old woman using imported diet pills presented with a two-year history of intermittent chest pains, palpitations, headaches and insomnia. Urine toxicology screen detected amphetamines and benzodiazepines. Fenproporex and chlordiazepoxide were detected in her pills. Her symptoms resolved after she stopped using diet pills. A 38-year-old man using imported diet pills presented after his occupational urine screen was significantly positive for amphetamine. Fenproporex and fluoxetine were detected in his pills. These cases illustrate the potential harm from imported prescription diet pills that combine fenproporex with benzodiazepines, antidepressants, diuretics, laxatives and other substances. Increasing physicians’ awareness of imported diet pill use may improve care of patients suffering from the pills’ many adverse effects. PMID:19096898

  5. Imported fenproporex-based diet pills from Brazil: a report of two cases.

    PubMed

    Cohen, Pieter A

    2009-03-01

    Banned amphetamine-based anorectics are illicitly imported into the United States (US), but little is known regarding the harm these diet pills pose to US residents. A 26-year-old woman using imported diet pills presented with a two-year history of intermittent chest pains, palpitations, headaches and insomnia. Urine toxicology screen detected amphetamines and benzodiazepines. Fenproporex and chlordiazepoxide were detected in her pills. Her symptoms resolved after she stopped using diet pills. A 38-year-old man using imported diet pills presented after his occupational urine screen was significantly positive for amphetamine. Fenproporex and fluoxetine were detected in his pills. These cases illustrate the potential harm from imported prescription diet pills that combine fenproporex with benzodiazepines, antidepressants, diuretics, laxatives and other substances. Increasing physicians' awareness of imported diet pill use may improve care of patients suffering from the pills' many adverse effects.

  6. The importance of an anthropological scene of crime investigation in the case of burnt remains in vehicles: 3 case studies.

    PubMed

    Porta, Davide; Poppa, Pasquale; Regazzola, Valeria; Gibelli, Daniele; Schillaci, Daniela Roberta; Amadasi, Alberto; Magli, Francesca; Cattaneo, Cristina

    2013-09-01

    Inspection of a crime scene is a crucial step in forensic medicine, and even the methods taught by forensic anthropology are essential. Whereas a thorough inspection can provide crucial information, an approximate inspection can be useless or even harmful. This study reports 3 cases of burnt bodies found inside vehicles between 2006 and 2009 in the outskirts of Milan (Italy). In all 3 cases, the victim was killed by gunshot, and the body was burnt in the vehicle to destroy signs of skeletal injury and prevent identification. In every case, the assistance of forensic anthropologists was requested, but only after the inspection of the body at autopsy showed that the remains were incomplete, thus making it more difficult to determine the identity, cause, and manner of death. A second scene of crime inspection was therefore performed with strict anthropological and adapted archeological methods by forensic anthropologists to perform a more complete recovery, proving how much material had been left behind. These cases clearly show the importance of a proper recovery and of the application of forensic anthropology methods on badly charred bodies and the importance of recovering every fragment of bone: even the smallest fragment can provide essential information. Thus, a precise coordination, a correct and thorough recovery of bone fragments, and an anthropological approach are crucial for many issues: analysis of the scene of crime, reconstruction of the corpse, and reconstruction of the perimortem events.

  7. Cases of Echinococcus granulosus Sensu Stricto Isolated from Polish Patients: Imported or Indigenous?

    PubMed

    Dybicz, Monika; Borkowski, Piotr Karol; Dąbrowska, Julia; Chomicz, Lidia

    2015-01-01

    The cases of nine Polish patients with diagnosed cystic echinococcosis (CE) were examined. A total of nine isolates obtained postoperatively were investigated using PCR and sequencing. The mitochondrial region of nad1 gene was amplified. This PCR and sequencing analysis revealed the presence of Echinococcus canadensis G7 in seven patients and E. granulosus G1 in two patients. These data demonstrate that E. canadensis is the predominant causative agent of human cystic echinococcosis in Poland. E. granulosus G1 detection in Polish patients suggests that the parasite was imported; however it does not exclude the possibility that these cases could have been of Polish origin.

  8. Cases of Echinococcus granulosus Sensu Stricto Isolated from Polish Patients: Imported or Indigenous?

    PubMed Central

    Dybicz, Monika; Borkowski, Piotr Karol; Dąbrowska, Julia; Chomicz, Lidia

    2015-01-01

    The cases of nine Polish patients with diagnosed cystic echinococcosis (CE) were examined. A total of nine isolates obtained postoperatively were investigated using PCR and sequencing. The mitochondrial region of nad1 gene was amplified. This PCR and sequencing analysis revealed the presence of Echinococcus canadensis G7 in seven patients and E. granulosus G1 in two patients. These data demonstrate that E. canadensis is the predominant causative agent of human cystic echinococcosis in Poland. E. granulosus G1 detection in Polish patients suggests that the parasite was imported; however it does not exclude the possibility that these cases could have been of Polish origin. PMID:26491683

  9. Coccidioidomycosis masquerading as skeletal tuberculosis: an imported case and review of coccidioidomycosis in India.

    PubMed

    Capoor, Malini R; Sen, Bishwaroop; Varshney, Parul; Verghese, Mathew; Shivaprakash, M R; Chakrabarti, Arunaloke

    2014-01-01

    We describe a possible imported case of osteo-articular coccidioidomycosis in India. Culture of the computed tomography-guided aspirate revealed the growth of Coccidioides spp., which was identified as Coccidioides posadasii by sequencing of the internal transcribed spacer (ITS) region of rDNA. He was successfully treated with amphotericin B followed by itraconazole. All the previous published reports of coccidioidomycosis cases diagnosed in India are also reviewed in order to increase the awareness of this disease in non-endemic areas.

  10. The assessment of the impact of aviation NOx on ozone and other radiative forcing responses - The importance of representing cruise altitudes accurately

    NASA Astrophysics Data System (ADS)

    Skowron, A.; Lee, D. S.; De León, R. R.

    2013-08-01

    Aviation emissions of NOx result in the formation of tropospheric ozone (warming) and destruction of a small amount of methane (cooling), positive and negative radiative forcing effects. In addition, the reduction of methane results in a small long-term reduction in tropospheric ozone (cooling) and, in addition, a long-term reduction in water vapour in the stratosphere (cooling) from reduced oxidation of methane, both negative radiative forcing impacts. Taking all these radiative effects together, aircraft NOx is still thought to result in a positive (warming) radiative effect under constant emissions assumptions. Previously, comparative modelling studies have focussed on the variability between models, using the same emissions database. In this study, we rather quantify the variability and uncertainty arising from different estimations of present-day aircraft NOx emissions. Six different aircraft NOx emissions inventories were used in the global chemical transport model, MOZART v3. The inventories were normalized to give the same global emission of NOx in order to remove one element of uncertainty. Emissions differed in the normalized cases by 23% at cruise altitudes (283-200 hPa, where the bulk of emission occurs, globally). However, the resultant short-term ozone chemical perturbation varied by 15% between the different inventories. Once all the effects that give rise to positive and negative radiative impacts were accounted for, the variability of net radiative forcing impacts was 94%. Using these radiative effects to formulate a net aviation NOx Global Warming Potential (GWP) for a 100-year time horizon resulted in GWPs ranging from 60 to 4, over an order of magnitude. It is concluded that the detailed placement of emissions at chemically sensitive cruise altitudes strongly affects the assessment of the total radiative impact, introducing a hitherto previously unidentified large fraction of the uncertainty of impacts between different modelling assessments. It

  11. Comparison of autochthonous and imported cases of hepatitis A or hepatitis E.

    PubMed

    Hartl, J; Kreuels, B; Polywka, S; Addo, M; Luethgehetmann, M; Dandri, M; Dammermann, W; Sterneck, M; Lohse, A W; Pischke, S

    2015-07-01

    Hepatitis A and hepatitis E are not limited to tropical countries but are also present in industrialized countries. Both infections share similar clinical features. There is no comparative study evaluating the clinical parameters of autochthonous and imported hepatitis A virus and hepatitis E virus infections. The aim of this study was to determine differences between autochthonous and imported hepatitis A virus (HAV) and hepatitis E virus (HEV) infections. Medical charts of all patients at our center with acute HAV and HEV infections were analyzed retrospectively (n = 50, study period 01/2009 - 08/2013). Peak bilirubin (median 8.6 vs. 4.4 mg/dL, p = 0.008) and ALT levels (median 2998 vs. 1666 IU/mL, p = 0.04) were higher in patients with hepatitis A compared to hepatitis E. In comparison to autochthones hepatitis E cases, patients with imported infections had significantly higher peak values for AST, ALT, bilirubin and INR (p = 0.009, p = 0.002, p = 0.04 and p = 0.049, respectively). In HAV infection, AST levels tended to be higher in imported infections (p = 0.08). (i) It is not possible to differentiate certainly between acute HAV and HEV infections by clinical or biochemical parameters, however, HAV infections might be associated with more cholestasis and higher ALT values. (ii) Imported HEV infections are associated with higher transaminases, INR and bilirubin levels compared to autochthonous cases and (iii) imported HAV infections tend to be associated with higher transaminases in comparison to autochthonous cases. © Georg Thieme Verlag KG Stuttgart · New York.

  12. [Dermatobia hominis furuncular myiasis in a man returning from Latin America: first imported case in Tunisia].

    PubMed

    Kaouech, E; Kallel, K; Belhadj, S; Chaker, E

    2010-04-01

    Human cutaneous myiasis is a common dermatosis in tropical zones. The purpose of this report is to describe the first imported case of furuncular myiasis caused by Dermatobia hominis (human botfly) in Tunisia. The patient was a man returning from Bolivia. Furuncular myiasis was suspected based on epidemiological data and clinical examination showing pruriginous elevated lesions. Diagnosis was confirmed by identification of Dermatobia hominis larvae. Treatment was based mainly on manual removal of larvae. Since furuncular myiasis is unknown in Tunisia, it is important to remember this parasitic disease in differential diagnosis in patients presenting boil-like inflammatory papules following travel to Latin America.

  13. An imported case of cutaneous leishmaniasis caused by Leishmania (Leishmania) donovani in Japan.

    PubMed

    Ito, Kotaro; Takahara, Masakazu; Ito, Makoto; Oshiro, Minoru; Takahashi, Kenzo; Uezato, Hiroshi; Imafuku, Shinichi

    2014-10-01

    Leishmaniasis is a major world health problem, and 12 million people are estimated to be infected in 88 countries. There have been few reports of leishmaniasis in Japan and all were of foreign origin; therefore diagnosis is difficult for Japanese physicians. There are 21 different pathogenic Leishmania species, and identification is obtained by polymerase chain reaction (PCR). Here we report an imported case of leishmaniasis by Leishmania (Leishmania) donovani infection from Sri Lanka. L. (L.) donovani usually causes visceral leishmaniasis, but in this case, the patient manifested cutaneous leishmaniasis. The identification of Leishmania species by PCR and investigation of the patient's background such as nationality and disease endemicity are important for diagnosis and treatment. This is the first report of cutaneous leishmaniasis by L. (L.) donovani in Japan.

  14. The importance of work or productive activity in life care planning and case management

    PubMed Central

    Reid, Christine; Riddick-Grisham, Susan

    2015-01-01

    Abstract INTRODUCTION: The importance of work or productive activity for the well-being, community integration, and quality of life of people living with disabilities is addressed, with implications for life care planning and case management. BACKGROUND: The role of work or productive activity in our society, and consequences of deprivation if rehabilitation services do not address vocational effects of disabilities, is explored. A continuum of productivity options is introduced; types of vocational rehabilitation assessment processes and interventions are described. PURPOSE: The role of vocational rehabilitation services in life care planning and case management is discussed, focusing on quality of life for people living with disabilities. CONCLUSION: Rehabilitation and health care professionals should understand the importance of work or other productive activity, and support the development of appropriate plans to address those needs among people who have disabilities. PMID:26409330

  15. The importance of work or productive activity in life care planning and case management.

    PubMed

    Reid, Christine; Riddick-Grisham, Susan

    2015-01-01

    The importance of work or productive activity for the well-being, community integration, and quality of life of people living with disabilities is addressed, with implications for life care planning and case management. The role of work or productive activity in our society, and consequences of deprivation if rehabilitation services do not address vocational effects of disabilities, is explored. A continuum of productivity options is introduced; types of vocational rehabilitation assessment processes and interventions are described. The role of vocational rehabilitation services in life care planning and case management is discussed, focusing on quality of life for people living with disabilities. Rehabilitation and health care professionals should understand the importance of work or other productive activity, and support the development of appropriate plans to address those needs among people who have disabilities.

  16. Case report: Cutaneous amebiasis: the importance of molecular diagnosis of an emerging parasitic disease.

    PubMed

    Morán, Patricia; Rojas, Liliana; Cerritos, René; Zermeño, Valeria; Valadez, Alicia; de Oca, Griselda Montes; Reyes, Miguel Ángel; González, Enrique; Partida, Oswaldo; Hernández, Eric; Nieves, Miriam; Portillo, Tobías; Gudiño, Marco; Ramiro, Manuel; Ximénez, Cecilia

    2013-01-01

    Cutaneous amebiasis is the least common clinical form of human amebiasis in Mexico, sexual amebiasis was only occasionally observed before the late 1980s. However, in the last few decades, most of the documented cases of cutaneous amebiasis from around the world are sexually transmitted. We present two cases of sexually transmitted genital amebiasis. The molecular characterization of the Entamoeba species in the affected tissues underlines the importance of an etiological diagnosis using specific and sensitive techniques that avoid the rapid destruction of tissues and the irreversible sequelae to the anatomy and function of the affected organs. In addition, for those interested in the study of the human-amoebic disease relationship and its epidemiology, the detection of a new, mixed infection in an invasive case of amebiasis reveals new perspectives in the study of the extraordinarily complex host-parasite relationship in amebiasis.

  17. Importance of a second spasm provocation test: Four cases with an initial negative spasm provocation test.

    PubMed

    Teragawa, Hiroki; Fujii, Yuichi; Uchimura, Yuko; Ueda, Tomohiro

    2017-03-26

    The spasm provocation test (SPT) is an important test in the diagnosis of vasospastic angina (VSA). In many cases, this test is performed as the gold standard test, and VSA is considered not present if the SPT is negative. However, some patients continue to experience chest symptoms despite a negative SPT. In this study, we report four cases in which SPT was repeated to evaluate chest symptoms despite the negative results of the first SPT. Two men in their 70s, one woman in her 60s, and one woman in her 70s, all with chest symptoms, underwent a second SPT at 4, 3, 2, and 3 years, respectively, after the first SPT, which was negative. Three patients had positive results in the second SPT (75%). In conclusion, even when SPT is negative, the diagnosis of VSA should be made with clinical symptoms in consideration. In some cases, a second SPT may be required to confirm the diagnosis of VSA.

  18. Importance of a second spasm provocation test: Four cases with an initial negative spasm provocation test

    PubMed Central

    Teragawa, Hiroki; Fujii, Yuichi; Uchimura, Yuko; Ueda, Tomohiro

    2017-01-01

    The spasm provocation test (SPT) is an important test in the diagnosis of vasospastic angina (VSA). In many cases, this test is performed as the gold standard test, and VSA is considered not present if the SPT is negative. However, some patients continue to experience chest symptoms despite a negative SPT. In this study, we report four cases in which SPT was repeated to evaluate chest symptoms despite the negative results of the first SPT. Two men in their 70s, one woman in her 60s, and one woman in her 70s, all with chest symptoms, underwent a second SPT at 4, 3, 2, and 3 years, respectively, after the first SPT, which was negative. Three patients had positive results in the second SPT (75%). In conclusion, even when SPT is negative, the diagnosis of VSA should be made with clinical symptoms in consideration. In some cases, a second SPT may be required to confirm the diagnosis of VSA. PMID:28400927

  19. Fatal case of imported human rabies in Amadora, Portugal, August 2011.

    PubMed

    Santos, A; Cale, E; Dacheux, L; Bourhy, H; Gouveia, J; Vasconcelos, P

    2012-03-22

    We report on a case of imported human rabies in Portugal, in July 2011 in a woman who presented initially complaining of back pain, without relating exposure to animal bites. She had travelled from Portugal to Bissau, Guinea-Bissau, in April where she had been bitten by a dog on 1 May. She was diagnosed with rabies on 26 July and died two weeks later in spite of being treated following the Milwaukee protocol.

  20. Twenty-four cases of imported zika virus infections diagnosed by molecular methods.

    PubMed

    Alejo-Cancho, Izaskun; Torner, Nuria; Oliveira, Inés; Martínez, Ana; Muñoz, José; Jane, Mireia; Gascón, Joaquim; Requena-Méndez, Ana; Vilella, Anna; Marcos, M Ángeles; Pinazo, María Jesús; Gonzalo, Verónica; Rodriguez, Natalia; Martínez, Miguel J

    2016-10-01

    Zika virus is an emerging flavivirus widely spreading through Latin America. Molecular diagnosis of the infection can be performed using serum, urine and saliva samples, although a well-defined diagnostic algorithm is not yet established. We describe a series of 24 cases of imported zika virus infection into Catalonia (northeastern Spain). Based on our findings, testing of paired serum and urine samples is recommended. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Molecular Epidemiology of Imported Cases of Leishmaniasis in Australia from 2008 to 2014

    PubMed Central

    Roberts, Tamalee; Barratt, Joel; Sandaradura, Indy; Lee, Rogan; Harkness, John; Marriott, Deborah; Ellis, John; Stark, Damien

    2015-01-01

    Leishmaniasis is a vector borne disease caused by protozoa of the genus Leishmania. Human leishmaniasis is not endemic in Australia though imported cases are regularly encountered. This study aimed to provide an update on the molecular epidemiology of imported leishmaniasis in Australia. Of a total of 206 biopsies and bone marrow specimens submitted to St Vincent’s Hospital Sydney for leishmaniasis diagnosis by PCR, 55 were found to be positive for Leishmania DNA. All PCR products were subjected to restriction fragment length polymorphism analysis for identification of the causative species. Five Leishmania species/species complexes were identified with Leishmania tropica being the most common (30/55). Travel or prior residence in a Leishmania endemic region was the most common route of acquisition with ~47% of patients having lived in or travelled to Afghanistan. Cutaneous leishmaniasis was the most common manifestation (94%) with only 3 cases of visceral leishmaniasis and no cases of mucocutaneous leishmaniasis encountered. This report indicates that imported leishmaniasis is becoming increasingly common in Australia due to an increase in global travel and immigration. As such, Australian clinicians must be made aware of this trend and consider leishmaniasis in patients with suspicious symptoms and a history of travel in endemic areas. This study also discusses the recent identification of a unique Leishmania species found in native kangaroos and a potential vector host which could create the opportunity for the establishment of a local transmission cycle within humans. PMID:25734905

  2. Errors in Representing Regional Acid Deposition with Spatially Sparse Monitoring: Case Studies of the Eastern US Using Model Predictions

    EPA Science Inventory

    The current study uses case studies of model-estimated regional precipitation and wet ion deposition to estimate errors in corresponding regional values derived from the means of site-specific values within regions of interest located in the eastern US. The mean of model-estimate...

  3. [Severe imported malaria in adults: a retrospective study of thirteen cases admitted to the Intensive Care Unit in Marrakech].

    PubMed

    El Mezouari, El Mostafa; Belhadj, Ayoub; Ziani, Mohamed; Boughanem, Mohamed; Moutaj, Redouane

    2016-01-01

    Imported malaria is being seen with increasing frequency in non-endemic areas. Severe forms represent 10% of cases of Plasmodium falciparum malaria. In Morocco, more than 50 cases of malaria occur each year, 83% of which with Plasmodium falciparum malaria. All patients with severe malaria admitted to the Intensive Care Unit during the period between 1 November 2009 and 31 December 2015 were enrolled in our study. The main epidemiological data, the reasons for admission, the management and the outcomes of patients were studied. Thirteen patients were included in our study. The average age was 31 years. All patients had been living in sub-Saharan Africa and had no immunity to malaria. Chemoprophylaxis was adequate in 33% of cases. The mean time between symptom onset and treatment initiation was six days. Mean initial parasitemia was 12%. The main reasons for ICU admission included coma (15%), convulsion (07%), respiratory distress 07%), prostration (07%), renal failure (07%), shock associated with jaundice and acidosis (07%) and kidney failure associated with coma (07%). All patients were treated with intravenous quinine loading dose. Mortality rate was 23%. The causes of death were multi-system organ failure and acute respiratory distress syndrome. Mortality associated with severe malaria remains high. The adequacy of chemoprophylaxis associated with early diagnosis and treatment would significantly improve the prognosis of this parasitic infection.

  4. Direct costs of a single case of refugee-imported measles in Kentucky.

    PubMed

    Coleman, Margaret S; Garbat-Welch, Luta; Burke, Heather; Weinberg, Michelle; Humbaugh, Kraig; Tindall, Alicia; Cambron, Janie

    2012-01-05

    Refugees are highly vulnerable populations with limited access to health care services. The United States accepts 50,000-75,000 refugees for resettlement annually. Despite residing in camps and other locations where vaccine-preventable disease outbreaks, such as measles, occur frequently, refugees are not required to have any vaccinations before they arrive in the United States. We estimated the medical and public-health response costs of a case of measles imported into Kentucky by a refugee. The Kentucky Refugee Health Coordinator recorded the time and labor of local, state, and some federal personnel involved in caring for the refugee and implementing the public health response activities. Secondary sources were used to estimate the labor and medical care costs of the event. The total costs to conduct the response to the disease event were approximately $25,000. All costs were incurred by government, either public health department or federal, because refugee health costs are paid by the federal government and the event response costs are covered by the public health department. A potentially preventable case of measles that was imported into the United States cost approximately $25,000 for the public health response. To maintain the elimination of measles transmission in the United States, U.S.-bound refugees should be vaccinated overseas. A refugee vaccination program administered during the overseas health assessment has the potential to reduce the risk of importation of measles and other vaccine-preventable disease and would eliminate costs associated with public health response to imported cases and outbreaks. Published by Elsevier Ltd.

  5. Reference materials and representative test materials to develop nanoparticle characterization methods: the NanoChOp project case

    NASA Astrophysics Data System (ADS)

    Roebben, Gert; Kestens, Vikram; Varga, Zoltan; Charoud-Got, Jean; Ramaye, Yannic; Gollwitzer, Christian; Bartczak, Dorota; Geißler, Daniel; Noble, James; Mazoua, Stéphane; Meeus, Nele; Corbisier, Philippe; Palmai, Marcell; Mihály, Judith; Krumrey, Michael; Davies, Julie; Resch-Genger, Ute; Kumarswami, Neelam; Minelli, Caterina; Sikora, Aneta; Goenaga-Infante, Heidi

    2015-10-01

    This paper describes the production and characteristics of the nanoparticle test materials prepared for common use in the collaborative research project NanoChOp (Chemical and optical characterisation of nanomaterials in biological systems), in casu suspensions of silica nanoparticles and CdSe/CdS/ZnS quantum dots. This paper is the first to illustrate how to assess whether nanoparticle test materials meet the requirements of a 'reference material' (ISO Guide 30:2015) or rather those of the recently defined category of 'representative test material' (ISO TS 16195:2013). The NanoChOp test materials were investigated with small-angle X-ray scattering (SAXS), dynamic light scattering (DLS) and centrifugal liquid sedimentation (CLS) to establish whether they complied with the required monomodal particle size distribution. The presence of impurities, aggregates, agglomerates and viable microorganisms in the suspensions was investigated with DLS, CLS, optical and electron microscopy and via plating on nutrient agar. Suitability of surface functionalization was investigated with attenuated total reflection Fourier transform infrared spectrometry (ATR-FTIR) and via the capacity of the nanoparticles to be fluorescently labeled or to bind antibodies. Between-unit homogeneity and stability were investigated in terms of particle size and zeta potential. This paper shows that only based on the outcome of a detailed characterization process one can raise the status of a test material to representative test material or reference material, and how this status depends on its intended use.

  6. Imported Chikungunya fever case in Greece in June 2014 and public health response

    PubMed Central

    Pervanidou, Danai; Papadopoulou, Elpida; Kavatha, Dimitra; Baka, Agoritsa; Koliopoulos, George; Badieritakis, Evangelos; Michaelakis, Antonios; Gavana, Elpida; Patsoula, Eleni; Tsimpos, Ioannis; Gioksari, Thalia; Kyriazopoulou, Evdoxia; Vakali, Annita; Pavli, Androula; Maltezou, Helena C.; Georgakopoulou, Theano; Hadjichristodoulou, Christos; Kremastinou, Jenny; Papa, Anna

    2016-01-01

    We report about the first imported case of Chikungunya fever in Greece in a Greek traveler returning from the Dominican Republic and the associated public health response. We investigated the case and performed focused epidemiological and entomological investigation in all areas the patient visited during the infectious period, to identify the targeted interventions needed. Entomological investigation revealed the occurrence of the competent vector Aedes albopictus (Diptera: Culicidae) in the environment surrounding the hospital where the patient was admitted and in her workplace. All captured mosquitoes tested negative for Chikungunya virus. We further conducted clinical and laboratory examination of the patient’s co-travelers, gave advice on appropriate personal preventive measures against mosquito bites to the patient and co-travelers and on vector control, and raised awareness among health professionals throughout Greece. The risk of introduction and local transmission of Chikungunya and other arboviruses in Greece and other European countries is present, as the competent vector exists in many parts of Europe. Public health professionals, travel medicine specialists and clinicians should maintain awareness regarding this possibility of importation of arbovirus cases in order to provide the appropriate advice, seek the prompt diagnosis, and implement appropriate interventions. Mobilization of various stakeholders will lead to enhanced epidemiological and entomological surveillance that will allow for improved risk assessment in each area. PMID:27159571

  7. Chikungunya Virus Infection: First Detection of Imported and Autochthonous Cases in Panama

    PubMed Central

    Díaz, Yamilka; Carrera, Jean-Paul; Cerezo, Lizbeth; Arauz, Dimelza; Guerra, Ilka; Cisneros, Julio; Armién, Blas; Botello, Ana Margarita; Araúz, Ana Belén; Gonzalez, Vladimir; López, Yamileth; Moreno, Lourdes; López-Vergès, Sandra; Moreno, Brechla A.

    2015-01-01

    Chikungunya virus (CHIKV) is a mosquito-borne pathogen that was only endemic in Africa and south Asia until 2005 and 2006, when the virus spread into the Indian Ocean islands, Europe, and Asia. Autochthonous CHIKV transmission in the Caribbean islands was reported in December of 2013. In Panama, two febrile cases were detected in May of 2014: one traveling from Haiti, and the other traveling from the Dominican Republic. After other imported cases were detected, the first autochthonous case was reported in August of the same year. We detected CHIKV viral RNA and isolated the virus from serum samples. The phylogenetic analysis of the two imported isolates and one autochthonous CHIKV isolate indicated that the viruses belong to the Asian lineage in the Caribbean clade and are related to viruses recently identified in Saint Martin island, British Virgin Islands, China, and the Philippines. Although the circulating CHIKV lineages in the Americas have not yet been described, our results suggest that the Asian lineage is circulating in most American countries reporting autochthonous infection. PMID:25601996

  8. The first case of imported Borrelia miyamotoi disease concurrent with Lyme disease.

    PubMed

    Oda, Rentaro; Kutsuna, Satoshi; Sekikawa, Yoshiyuki; Hongo, Igen; Sato, Kozue; Ohnishi, Makoto; Kawabata, Hiroki

    2017-05-01

    Borrelia miyamotoi disease (BMD) is an emerging infectious disease caused by B. miyamotoi. Although BMD has been reported in the United States, Europe, and Japan, no case of imported BMD has been described in the world. Here, we report a 63-year-old American man living in Japan who presented with malaise, headache, myalgia, and arthralgia. We suspected Lyme disease because of his travel history to Minnesota and presence of erythema migrans. Serologic analysis supported our diagnosis, and doxycycline was administered for 14 days. However, we also suspected coinfection with BMD because of his fever, elevated liver function test results and his travel history. The patient was seropositive for the immunoglobulin M antibody to recombinant glycerophosphodiester phosphodiesterase, and was diagnosed with coinfection with BMD. This case suggests that BMD should be considered in febrile travelers returning from the Northeastern and Midwestern regions of the United States, and that BMD and Lyme disease coinfection should be considered to detect cases of imported BMD. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  9. Imported Chikungunya fever case in Greece in June 2014 and public health response.

    PubMed

    Tsiodras, Sotirios; Pervanidou, Danai; Papadopoulou, Elpida; Kavatha, Dimitra; Baka, Agoritsa; Koliopoulos, George; Badieritakis, Evangelos; Michaelakis, Antonios; Gavana, Elpida; Patsoula, Eleni; Tsimpos, Ioannis; Gioksari, Thalia; Kyriazopoulou, Evdoxia; Vakali, Annita; Pavli, Androula; Maltezou, Helena C; Georgakopoulou, Theano; Hadjichristodoulou, Christos; Kremastinou, Jenny; Papa, Anna

    2016-03-01

    We report about the first imported case of Chikungunya fever in Greece in a Greek traveler returning from the Dominican Republic and the associated public health response. We investigated the case and performed focused epidemiological and entomological investigation in all areas the patient visited during the infectious period, to identify the targeted interventions needed. Entomological investigation revealed the occurrence of the competent vector Aedes albopictus (Diptera: Culicidae) in the environment surrounding the hospital where the patient was admitted and in her workplace. All captured mosquitoes tested negative for Chikungunya virus. We further conducted clinical and laboratory examination of the patient's co-travelers, gave advice on appropriate personal preventive measures against mosquito bites to the patient and co-travelers and on vector control, and raised awareness among health professionals throughout Greece. The risk of introduction and local transmission of Chikungunya and other arboviruses in Greece and other European countries is present, as the competent vector exists in many parts of Europe. Public health professionals, travel medicine specialists and clinicians should maintain awareness regarding this possibility of importation of arbovirus cases in order to provide the appropriate advice, seek the prompt diagnosis, and implement appropriate interventions. Mobilization of various stakeholders will lead to enhanced epidemiological and entomological surveillance that will allow for improved risk assessment in each area.

  10. [Blastomycosis: report of an imported case in Mexico, with only cutaneous lesions].

    PubMed

    Rodríguez-Mena, Adriana; Mayorga, Jorge; Solís-Ledesma, Guillermo; Barba-Gómez, José

    2010-01-01

    Blastomycosis is a granulomatous infectious disease. It is caused by the dimorphus fungus Blastomyces dermatitidis. It predominates in the United States of America, but in Mexico two systemic imported cases have been reported. Cutaneous primary blastomycosis is a rare clinical presentation, which occurs after traumatic inoculation of the fungus. We present a case of a 54 year old male, born in Guadalajara, Mexico, and living in Chicago, USA, who had two verrucous nodules (8mm in diameter) on the forehead and right nasogenian fold, of 4 weeks progression. We made a histopathological study (hematoxylin and eosin, Gomori Groccot and periodic acid-Schiff stains) and mycology studies (direct microscopic examination, Sabouraud and mycobiotic agar cultures). Multiple studies were made with no evidence of systemic spread. Biopsy showed a dermal inflammatory infiltrate made up of lymphocytes, neutrophils, histiocytes and multinucleated giant cells. A few large, haloed, broad-based budding yeasts were also observed. Direct examination with KOH revealed broad-based budding yeasts, 10μm in diameter. Culture at 35°C yielded a white, pleated colony, which changed into a yellowish cerebriform. Multiple studies were made with no evidence of systemic spread. Itraconazole 200mg qd PO was given over a 2 month period, with a complete clinical and mycological response. This is the first imported case in Mexico of blastomycosis with cutaneous lesions without systemic involvement. Copyright © 2009 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  11. [Evaluation of imported Plasmodium falciparum malaria cases: the use of polymerase chain reaction in diagnosis].

    PubMed

    Demiraslan, Hayati; Erdoğan, Emrah; Türe, Zeynep; Kuk, Salih; Yazar, Süleyman; Metan, Gökhan

    2013-10-01

    Malaria affecting almost half of the world population continues to be an important health problem. Although domestic malaria cases have been decreasing in Turkey recently, cases caused by Plasmodium falciparum have increased due to the frequent travelling to Africa. The aims of this study were to evaluate demographic characteristics, clinical and laboratory findings in cases with falciparum malaria who attended to our clinic in 2012-2013 period, and the impact of polymerase chain reaction (PCR) for diagnosis. Nine patients evaluated were all male with a mean age of 34.3 (age range: 18-48) years, with the history of travel to Africa. Six cases did not take prophylaxis against malaria and other three cases used insufficient time. Mean duration of symptoms after return was 18.4 (range: 1-75) days, and the patients were admitted to the clinic within a mean of 5.2 (range: 1-15) days. Two patients had leucopenia, two patients had anemia, and eight patients had thrombocytopenia on admission. Alanine aminotransferase (ALT) levels in four cases and total bilirubin levels of six cases were over upper normal limits. Definitive diagnosis of cases was performed with the detection of ring and/or gametocytes forms of the parasite in Giemsa-stained peripheral blood smears. Furthermore, samples from seven patients were studied by nested PCR by using genus (Plasmodium rPLU 1 and 5) and species (rFAL 1 and 2, rVIV 1 and 2, rMAL 1 and 2, rOVA 1 and 2) specific primers. All of these seven samples yielded positive results with primers specific for P.falciparum ssrRNA. In the treatment, arthemeter/lumefantrin and doxycycline combination was used in seven patients, while intravenous artesunate and doxycycline combination was given to two patients, resulting with complete cure. Mean duration for the resolving of fever was 3.3 days, and mean duration for clearing the parasitemia from peripheral blood was 4.9 days. Initial ALT values and the duration of fever resolution (-796; p= 0.010), as

  12. The importance of histological evaluation in death investigation: two cases of fatal proximal airway masses.

    PubMed

    Lochmuller, C M; Lochmuller, Christopher M; Pestaner, J

    2011-09-01

    A recent prospective study published in the American Journal of Forensic Medicine and Pathology concluded that routine histopathologic examination lacked value. We disagreed with this assertion as we have found routine microscopic examination to be fruitful by documenting gross findings and by revealing interesting and unexpected findings.We designed a retrospective study to determine the benefit and cost of routine histopathologic examination at our institution. Forensic autopsy cases from January 2004 through June 2007 with lethal gross findings were reviewed to determine the number of cases in which microscopic examination provided the definitive cause of death. Cost was based on the average number of hematoxylin-eosin-stained slides per autopsy.One case was found in which the microscopic findings determined the correct cause of death despite compelling history and the initial impression from the autopsy findings. The cost of routine histopathologic examination during this period was approximately $39,000.We conclude that routine histopathologic examination has value. Despite having a low yield, the information it provides is nonetheless important, and its cost is not prohibitive. Furthermore, there are benefits gained from routine microscopic examination as exemplified in the 2 case reports presented in this article.

  13. The Plasmodium vivax in China: decreased in local cases but increased imported cases from Southeast Asia and Africa.

    PubMed

    Feng, Jun; Xiao, Huihui; Zhang, Li; Yan, He; Feng, Xinyu; Fang, Wen; Xia, Zhigui

    2015-03-05

    Currently the local P. vivax was sharply decreased while the imported vivax malaria increased in China. Despite Southeast Asia was still the main import source of vivax malaria, the trend of Africa become serious, especially for west and central Africa. Herein we have clarified the trend of P. vivax in China from 2004-2012, and made some analysis for the differences of imported vivax back from different regions. There are significantly different of P. vivax between Southeast Asia and Africa, also the difference was observed for different regions in Africa. Additionally, we have explored the possibility for the difference of the P. vivax between migrant workers back from west and central Africa and the prevalence of local population. This reminds us that surveillance and training should be strengthened by medical staffs on the imported P. vivax cases reported especially from west and central Africa, in order to reduce the risk of malaria reintroduction and, specific tools should be developed, as well as the epidemiological study to avoid the misdiagnosis such as P. ovale and P. vivax.

  14. [The importance of early diagnosis and intervention in children diagnosed with reading disorder. Case studies].

    PubMed

    Törö, Krisztina; Balázs, Judit

    2015-06-01

    Reading Disorder (RD) belongs to Specific Learning Disorders within the chapter of Neurodevelopmental Disorders in the Diagnostic and Statistic Manual of Mental Disorders 5th edition. Previous research shows that the time of the diagnosis of RD - early (before starting school) or late - has a great impact on the prognosis. In the current paper we present the cases of two children diagnosed with RD. Our cases demonstrate that if RD is diagnosed in early childhood, the child's and his/her family's quality of life can be influenced in a positive direction, while late recognition of RD might influence the child's and the family's quality of life negatively. For these reasons it is important that experts recognize RD in time, start appropriate treatment and give proper support to children diagnosed with RD and their families.

  15. Case report: rapid ante-mortem diagnosis of a human case of rabies imported into the UK from the Philippines.

    PubMed

    Smith, Jemma; McElhinney, Lorraine; Parsons, Graham; Brink, Nicola; Doherty, Tom; Agranoff, Dan; Miranda, Mary Elizabeth; Fooks, Anthony R

    2003-01-01

    The United Kingdom is free from rabies, with the last human death from indigenous rabies recorded in 1902. However, between 1946 and 2000, 20 deaths were reported in the United Kingdom in people who were bitten and infected while abroad in rabies endemic areas. The rapid diagnosis of suspected human rabies cases influences the use of anti-rabies post-exposure prophylaxis for potential contacts with the victim. In addition, the occurrence of a human rabies case requires urgent investigation to support patient management policies. In May 2001, a case of human rabies imported into the United Kingdom from the Philippines was identified. A 55-year-old man was admitted to University College Hospital, London, with clinical symptoms and a history consistent with exposure to rabies. Saliva, cerebrospinal fluid), and skin biopsies (from the wound site and nape of the neck) were submitted for conventional ante-mortem diagnostic techniques. Established diagnostic techniques, including the fluorescent antibody test (FAT), mouse inoculation test, (MIT) and the rabies tissue culture inoculation test (RTCIT), failed to detect the virus. In contrast, hemi-nested reverse transcription-polymerase chain reaction (RT-PCR), followed by automated sequencing confirmed the presence of classical rabies virus (genotype 1) in both the saliva and skin specimens within 36 hr of sample submission. Subsequent phylogenetic analysis demonstrated that this isolate was closely related to that of canine variants currently circulating in the Philippines. Copyright 2003 Wiley-Liss, Inc.

  16. Predicting Unprecedented Dengue Outbreak Using Imported Cases and Climatic Factors in Guangzhou, 2014

    PubMed Central

    Bi, Peng; Yang, Weizhong; Yang, Zhicong; Xu, Lei; Yang, Jun; Liu, Xiaobo; Jiang, Tong; Wu, Haixia; Chu, Cordia; Liu, Qiyong

    2015-01-01

    Introduction Dengue is endemic in more than 100 countries, mainly in tropical and subtropical regions, and the incidence has increased 30-fold in the past 50 years. The situation of dengue in China has become more and more severe, with an unprecedented dengue outbreak hitting south China in 2014. Building a dengue early warning system is therefore urgent and necessary for timely and effective response. Methodology and Principal Findings In the study we developed a time series Poisson multivariate regression model using imported dengue cases, local minimum temperature and accumulative precipitation to predict the dengue occurrence in four districts of Guangzhou, China. The time series data were decomposed into seasonal, trend and remainder components using a seasonal-trend decomposition procedure based on loess (STL). The time lag of climatic factors included in the model was chosen based on Spearman correlation analysis. Autocorrelation, seasonality and long-term trend were controlled in the model. A best model was selected and validated using Generalized Cross Validation (GCV) score and residual test. The data from March 2006 to December 2012 were used to develop the model while the data from January 2013 to September 2014 were employed to validate the model. Time series Poisson model showed that imported cases in the previous month, minimum temperature in the previous month and accumulative precipitation with three month lags could project the dengue outbreaks occurred in 2013 and 2014 after controlling the autocorrelation, seasonality and long-term trend. Conclusions Together with the sole transmission vector Aedes albopictus, imported cases, monthly minimum temperature and monthly accumulative precipitation may be used to develop a low-cost effective early warning system. PMID:26020627

  17. [An imported dengue Fever case in Turkey and review of the literature].

    PubMed

    Uyar, Yavuz; Aktaş, Eray; Yağcı Çağlayık, Dilek; Ergönül, Onder; Yüce, Ayşe

    2013-01-01

    Dengue fever is an acute viral disease that can affect all age groups in tropical and subtropical countries. The predominant vectors are the mosquitoes namely Aedes aegypti and A.albopictus. Although there have been no case reports in Turkey due to DF, there is seroepidemiological evidence indicating the presence of Dengue virus (DENV) in Turkey. In this case report we presented an imported dengue fever case. The patient was 40 years old, previously healthy male, Switzerland citizen. He had immigrated from Dubai to India two weeks ago and after one week from immigration he attended to a hospital in India because of high fever. The NS1 antigen test (Bio-Rad Laboratories, USA) was found positive and the patient was followed-up with diagnosis of dengue fever in India. During his visit to Turkey, he attended to the hospital for a routine control and his analysis revealed thrombocytopenia (PLT: 48.000/µl), leukopenia (white blood cell: 2800/µL) and elevated liver enzymes (AST: 76 U/L, ALT: 83 U/L). Fever was not detected in follow-up. The patient had petechial rash on his lower extremities. white blood cell and PLT count increased to 4100/µl and 93.000/µl, respectively. Liver function tests revealed a decrease in AST (63 U/L) and ALT (78 U/L) on the third day. The PLT count increased to 150.000/ml. Since the patient had no fever and had normal physical and laboratory findings, he was discharged from the hospital. For the confirmation of dengue fever diagnosis the serum sample was sent to National Public Health Center, Virology Reference and Research Laboratory where IgM and IgG antibodies against DENV types 1-4 were investigated by indirect immunofluorescence method (Euroimmun, Germany). The serum sample yielded positive result at the dilutions of 1/1000 for IgM and 1/10.000 for IgG. The last dilution of type 3 DENV IgM and IgG were determined high density of fluorescein, thus the serotype was identified as "DENV type 3". Travel-related diseases become important

  18. Clinical cases of parasitoses and fungal infections important from medical point of view

    PubMed

    Błaszkowska, Joanna; Góralska, Katarzyna

    Most important infectious diseases which pose a risk to human health and life are associated with parasites transmitted by a variety of arthropod vectors, or from animal to man. Some of these (malaria, toxoplasmosis, leishmaniosis, dirofilariosis, alveococcosis, cystic echinococcosis) still represent a serious public health problem in many regions in the world. This review describes the epidemiological and clinical aspects of important parasitoses and fungal infections from a medical point of view. It should be emphasized that the development of invasive disease depends on both host (susceptibility/resistance) and parasite factors (pathogenicity/virulence); an immunocompromised state can favour opportunistic parasitic infections: toxoplasmosis, cryptosporidiosis, giardiosis, cyclosporidiosis, blastocystosis and strongyloidosis. This article highlights the role of free-living amoebae in the pathogenesis and transmission of human diseases, the high pathogenicity of Echinococcus multilocularis, and the growing importance of ticks as a reservoir and vector for numerous dangerous pathogens (e.g., Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti). It also discusses the diagnostic problems of toxoplasmosis including cross-reactions in serological tests and reviews the search for new drugs and vaccines against toxoplasmosis. Attention is increasingly paid to the role played by the human microbiome in maintaining homeostasis and in the development of fungal infections. This review also presents the most common human superficial fungal infections and the role of Candida albicans infection in the pathogenesis of irritable bowel syndrome.

  19. A case of imported dengue fever from Burkina Faso to Japan in October 2016.

    PubMed

    Hashimoto, Takehiro; Kutsuna, Satoshi; Maeki, Takahiro; Tajima, Shigeru; Takaya, Saho; Katanami, Yuichi; Yamamoto, Kei; Takeshita, Nozomi; Hayakawa, Kayoko; Kato, Yasuyuki; Kanagawa, Shuzo; Ohmagari, Norio

    2017-09-11

    Dengue fever remains underreported in Africa due to lack of awareness among healthcare providers, the presence of other febrile illnesses, and insufficient laboratory testing. We present a case of imported dengue fever from Burkina Faso to Japan, where an outbreak of dengue was reported on October 18, 2016. The phylogenetic analysis revealed that the isolate from our patient belonged to a distinct of sylvatic dengue viruses, suggesting that dengue viruses have been maintained in the mosquitoes and human cycles in Burkina Faso for more than 30 years.

  20. The importance of medico-legal evaluation in a case with intraabdominal gossypiboma.

    PubMed

    Uluçay, Tarik; Dizdar, Mustafa Gökhan; SunayYavuz, Mehmet; Aşirdizer, Mahmut

    2010-05-20

    Data concerning the incidence of gossypiboma tend to fluctuate and is difficult to estimate because of a low reporting rate lest medico-legal implication. Gossypiboma is frequently located in the abdominal and pelvic cavities after gynecologic and upper abdominal surgical operations but can also follow thoracic, orthopedic, and urological and neurosurgical procedures. In medical literature, there are few articles about the medico-legal evaluation of gossypiboma although it is typically subjected to a medico-legal process. In this article, we reported a 22-year-old female case with intraabdominal gossypiboma following a cesarean procedure and discussed the importance of medico-legal evaluation of gossypiboma.

  1. Screening contacts of children with tuberculosis: an important and worthwhile part of case management.

    PubMed

    Fuimaono, A; Vince, J

    1997-06-01

    The outcome of screening the household contacts of 49 newly diagnosed tuberculous children as currently practised in the Paediatric Unit of the Port Moresby General Hospital is described. The screening program generated 182 chest X-rays and 67 Mantoux tests. 32 (39%) of 83 child contacts and 11 (11%) of 99 adults were commenced on antituberculous therapy, and 2 children aged 6 months were started on INAH chemoprophylaxis. Adult contacts were identified in 11 (22%) of the 49 families screened. Such a program is an extremely important part of the case management of children with newly diagnosed tuberculosis and their families.

  2. Experience on the management of the first imported Ebola virus disease case in Senegal

    PubMed Central

    Abdoulaye, Bousso; Moussa, Seydi; Daye, Ka; Boubakar, Badiane Seydou; Cor, Sarr Samba; Idrissa, Talla; Mamadou, Ndiaye El Hadj; Oumar, Ba Ibrahima; Tidiane, Ndour Cheikh; Selly, Ly Mamadou; Tacko, Diop Cheikh; Amadou, Diack Papa; Mandiaye, Loume; Mbaye, Diouf; Marie, Coll-Seck Awa

    2015-01-01

    The Ebola virus disease, as a first epidemic in West Africa, stands as the most deadly one throughout history. Guinea, the source of the epidemic, Sierra Leone and Liberia remain the most strongly affected. That epidemic thoroughly destabilized the health system of those countries. Following Nigeria, Senegal received its first imported case from the neighboring Republic of Guinea. In that sub regional psychotic context, such a situation has been handled and managed starting from the potential of a health system that is already suitably structured. The organization of the response, the management of the communication system and the rigorous monitoring of contacts have been decisive in the control of the epidemic. Our countries have to be prepared in order to face health threats, and that is the reason why the need to empower our health systems is important. PMID:26740836

  3. Importance of the environment in meticillin-resistant Staphylococcus aureus acquisition: the case for hospital cleaning.

    PubMed

    Dancer, Stephanie J

    2008-02-01

    In the UK, we continue to debate the importance of hospital cleaning in relation to increasing numbers of patients acquiring meticillin-resistant Staphylococcus aureus (MRSA). However, there is little direct evidence for the effectiveness of cleaning because it has never been afforded scientific status. Hospital hygiene is usually assessed visually, but this does not necessarily correlate with microbiological risk. A more robust case for hospital cleaning can be presented by considering the evidence for all the stages of the staphylococcal transmission cycle between human beings and their environment. Cleaning has already been accepted as an important factor in the control of other hardy environmental pathogens, such as Clostridium difficile, vancomycin-resistant enterococci, norovirus, and Acinetobacter spp. This Review will show why the removal of dirt might have more impact on the control of MRSA than previously thought. Introduction of additional cleaning services is easier than improvements in hand-hygiene compliance.

  4. Experience on the management of the first imported Ebola virus disease case in Senegal.

    PubMed

    Abdoulaye, Bousso; Moussa, Seydi; Daye, Ka; Boubakar, Badiane Seydou; Cor, Sarr Samba; Idrissa, Talla; Mamadou, Ndiaye El Hadj; Oumar, Ba Ibrahima; Tidiane, Ndour Cheikh; Selly, Ly Mamadou; Tacko, Diop Cheikh; Amadou, Diack Papa; Mandiaye, Loume; Mbaye, Diouf; Marie, Coll-Seck Awa

    2015-01-01

    The Ebola virus disease, as a first epidemic in West Africa, stands as the most deadly one throughout history. Guinea, the source of the epidemic, Sierra Leone and Liberia remain the most strongly affected. That epidemic thoroughly destabilized the health system of those countries. Following Nigeria, Senegal received its first imported case from the neighboring Republic of Guinea. In that sub regional psychotic context, such a situation has been handled and managed starting from the potential of a health system that is already suitably structured. The organization of the response, the management of the communication system and the rigorous monitoring of contacts have been decisive in the control of the epidemic. Our countries have to be prepared in order to face health threats, and that is the reason why the need to empower our health systems is important.

  5. Three Cases of Escherichia coli Meningitis in Chicks Imported to Japan.

    PubMed

    Kasuya, Kazufumi; Shimokubo, Natsumi; Kosuge, Chieko; Takayama, Kou; Yoshida, Eiji; Osaka, Hiroyuki

    2017-03-01

    Three outbreaks of colibacillosis have occurred in chicks during the quarantine period after importation to Japan. All three were derived from three different countries without epidemiologic relevance. Some birds from each infected flock were examined pathologically and bacteriologically. The characteristic histologic finding common to all three cases was severe bacterial meningitis in the central nervous system. Pericarditis, perihepatitis, and omphalitis with bacterial colonies were also observed. The bacterial colonies observed histologically were immunohistochemically positive for Escherichia coli antigens. Escherichia coli was isolated from the organ samples from each outbreak. At least two E. coli isolates were serotyped as O18 and O161, which differed from the popular serotypes in Japan. These results suggest that avian pathogenic E. coli of uncommon serotypes can be imported from outside countries by infected chicks. Colibacillosis should be included in the differential diagnosis when meningitis is histologically observed in chicks.

  6. [The importance of the follow-up in patients operated on for breast cancer. A retrospective analysis of 2482 cases].

    PubMed

    Krengli, M; Pastore, G; Maffei, S

    1993-01-01

    anticipation of diagnosis was 4 months. An increase of survival was observed only in patients with loco-regional recurrences. The results obtained in our study and the literature data confirm the importance of long-term follow-up in the breast cancer patients. Clinical examination and mammography represent the most important modalities of diagnosis for the local and distant relapses and the second neoplasms in the contralateral breast.

  7. The increasing importance of Plasmodium ovale and Plasmodium malariae in a malaria elimination setting: an observational study of imported cases in Jiangsu Province, China, 2011-2014.

    PubMed

    Cao, Yuanyuan; Wang, Weiming; Liu, Yaobao; Cotter, Chris; Zhou, Huayun; Zhu, Guoding; Tang, Jianxia; Tang, Feng; Lu, Feng; Xu, Sui; Gu, Yaping; Zhang, Chao; Li, Julin; Cao, Jun

    2016-09-07

    Following initiation of China's National Malaria Elimination Action Plan in 2010, indigenous malaria infections in Jiangsu Province decreased significantly. Meanwhile imported Plasmodium infections have increased substantially, particularly Plasmodium ovale and Plasmodium malariae. Given the risk for malaria resurgence, there is an urgent need to understand the increase in imported P. ovale and P. malariae infections as China works to achieve national malaria elimination. An observational study of imported malaria cases in Jiangsu Province, China was carried out for the period of 2011-2014. A total of 1268 malaria cases were reported in Jiangsu Province from 2011 to 2014. Although imported Plasmodium falciparum cases (n = 1058) accounted for 83.4 % of all reported cases in Jiangsu, P. ovale cases (14, 19, 30, and 46) and their proportion (3.7, 9.6, 8.8, and 13.0 %) of all malaria cases increased over the 4 years. Similarly, P. malariae cases (seven, two, nine, and 10) and proportion (1.9, 1.0, 2.6, and 2.8 %) of all malaria cases increased slightly during this time. A total of 98 cases of Plasmodium ovale curtisi (47/98, 48 %) and Plasmodium ovale wallikeri (51/98, 52 %) were identified as well. Latency periods were significant among these Plasmodium infections (p = 0.00). Also, this study found that the latency periods of P. ovale sp., P. malariae and Plasmodium vivax were significantly longer than P. falciparum. However, for both P. ovale curtisi and P. ovale wallikeri infections, the latency period analysis was not significant (p = 0.81). Misdiagnosis of both P. ovale and P. malariae was greater than 71.5 and 71.4 %, respectively. The P. ovale cases were misdiagnosed as P. falciparum (35 cases, 32.1 %), P. vivax (43 cases, 39.4 %) by lower levels of CDCs or hospitals. And, the P. malariae cases were misdiagnosed as P. falciparum (ten cases, 35.7 %), P. vivax (nine cases, 32.1 %) and P. ovale sp. (one case, 3.6 %). Geographic distribution of

  8. Comparative analysis of some representative models of viscosity versus pressure in the case of various hydrocarbons and their mixtures

    NASA Astrophysics Data System (ADS)

    Boned, C.; Et-Tahir, A.; Lagourette, B.; Xans, P.; Gao, Guanghua

    1996-01-01

    A critical study of some representative models has been conducted with the experimental determinations of the viscosity of ten pure substances and three binary systems measured as a function of temperature T (25°C, 40°C, 60°C, 80°C, 90°C) and pressure P(≤ 100 MPa). The pure substances were: toluene, p-xylene, m-xylene, o-xylene, methylcyclohexane, methylnaphtalene, decahydronaphtalene, phenyldodecane, heptamethylnonane and tetramethylpentadecane (pristane). The three binaries were: toluene + tetramethylpentadecane, toluene + methylnaphtalene and toluene + heptamethylnonane, for molar fractions x of toluene ranging between 0 and 1. The three binaries are highly “contrasted” systems, i.e. systems in which the viscosities of the pure components are very different for each P, T pair. In all, 547 experimental determinations were carried out, the 279 experimental data for viscosity of the pure substances and 268 data concerning the mixtures ( x ≠ 0 and 1) were used to make a critical analysis of the various representative models, These included an empirical representation of variations of versus T on each isobar, a self-referencing model developed in our laboratory, a corresponding states model with one reference, various mixing rules with or without adjustable parameters, a combination of the self-referencing model and mixing rules, a method based on the Bloomfield and Dewan excess viscosity, and a group contribution method, comparison of the results showed the self-referencing method to be of particular interest, Moreover when coupled with mixing rules without adjustable parameters it was able to account satisfactorily for the variations η( P, T, x) of the mixtures, on the simple basis of knowledge if the viscosity of the components of the system, at 25°C and at atmospheric pressure, For all the binaries an average absolute deviation of 9.5% was observed. Finally it appears that the introduction of the pressure parameter does not alter the usual

  9. Plasmodium vivax PCR genotyping of the first malaria case imported from South Korea into Japan.

    PubMed

    Iwagami, Moritoshi; Itoda, Ichiro; Hwang, Seung-Young; Kho, Weon-Gyu; Kano, Shigeyuki

    2009-02-01

    Although indigenous malaria was successfully eradicated in Japan in 1959, malaria remains one of the most important health concerns in the control of imported infectious diseases. However, in South Korea, the re-emergence of indigenous vivax malaria was reported in 1993 in the Demilitarized Zone (the border region with North Korea), from where a vivax malaria case was imported into Japan in 2002. In this study, we conducted genotyping of the circumsporozoite protein gene, the apical membrane antigen-1 gene, and the merozoite surface protein-1 gene of Plasmodium vivax in one patient, and estimated the geographical origin of the parasites. This estimate was based on the findings of previous studies, which showed the coexistence of at least two distinct genotypes of antigenic molecules of endemic P. vivax in South Korea. One genotype is similar to that of a Chinese strain CH-5, and the other is similar to that of a North Korean isolate. The results of this study showed that the DNA sequences of the patient's P. vivax parasites were similar to those of the North Korean isolate. It may even be possible in the near future for seasonally synchronized North Korean P. vivax parasites to be imported into parts of Japan and to establish breeding populations.

  10. Reference materials and representative test materials to develop nanoparticle characterization methods: the NanoChOp project case.

    PubMed

    Roebben, Gert; Kestens, Vikram; Varga, Zoltan; Charoud-Got, Jean; Ramaye, Yannic; Gollwitzer, Christian; Bartczak, Dorota; Geißler, Daniel; Noble, James; Mazoua, Stephane; Meeus, Nele; Corbisier, Philippe; Palmai, Marcell; Mihály, Judith; Krumrey, Michael; Davies, Julie; Resch-Genger, Ute; Kumarswami, Neelam; Minelli, Caterina; Sikora, Aneta; Goenaga-Infante, Heidi

    2015-01-01

    This paper describes the production and characteristics of the nanoparticle test materials prepared for common use in the collaborative research project NanoChOp (Chemical and optical characterization of nanomaterials in biological systems), in casu suspensions of silica nanoparticles and CdSe/CdS/ZnS quantum dots (QDs). This paper is the first to illustrate how to assess whether nanoparticle test materials meet the requirements of a "reference material" (ISO Guide 30, 2015) or rather those of the recently defined category of "representative test material (RTM)" (ISO/TS 16195, 2013). The NanoChOp test materials were investigated with small-angle X-ray scattering (SAXS), dynamic light scattering (DLS), and centrifugal liquid sedimentation (CLS) to establish whether they complied with the required monomodal particle size distribution. The presence of impurities, aggregates, agglomerates, and viable microorganisms in the suspensions was investigated with DLS, CLS, optical and electron microscopy and via plating on nutrient agar. Suitability of surface functionalization was investigated with attenuated total reflection Fourier transform infrared spectrometry (ATR-FTIR) and via the capacity of the nanoparticles to be fluorescently labeled or to bind antibodies. Between-unit homogeneity and stability were investigated in terms of particle size and zeta potential. This paper shows that only based on the outcome of a detailed characterization process one can raise the status of a test material to RTM or reference material, and how this status depends on its intended use.

  11. Reference materials and representative test materials to develop nanoparticle characterization methods: the NanoChOp project case

    PubMed Central

    Roebben, Gert; Kestens, Vikram; Varga, Zoltan; Charoud-Got, Jean; Ramaye, Yannic; Gollwitzer, Christian; Bartczak, Dorota; Geißler, Daniel; Noble, James; Mazoua, Stephane; Meeus, Nele; Corbisier, Philippe; Palmai, Marcell; Mihály, Judith; Krumrey, Michael; Davies, Julie; Resch-Genger, Ute; Kumarswami, Neelam; Minelli, Caterina; Sikora, Aneta; Goenaga-Infante, Heidi

    2015-01-01

    This paper describes the production and characteristics of the nanoparticle test materials prepared for common use in the collaborative research project NanoChOp (Chemical and optical characterization of nanomaterials in biological systems), in casu suspensions of silica nanoparticles and CdSe/CdS/ZnS quantum dots (QDs). This paper is the first to illustrate how to assess whether nanoparticle test materials meet the requirements of a “reference material” (ISO Guide 30, 2015) or rather those of the recently defined category of “representative test material (RTM)” (ISO/TS 16195, 2013). The NanoChOp test materials were investigated with small-angle X-ray scattering (SAXS), dynamic light scattering (DLS), and centrifugal liquid sedimentation (CLS) to establish whether they complied with the required monomodal particle size distribution. The presence of impurities, aggregates, agglomerates, and viable microorganisms in the suspensions was investigated with DLS, CLS, optical and electron microscopy and via plating on nutrient agar. Suitability of surface functionalization was investigated with attenuated total reflection Fourier transform infrared spectrometry (ATR-FTIR) and via the capacity of the nanoparticles to be fluorescently labeled or to bind antibodies. Between-unit homogeneity and stability were investigated in terms of particle size and zeta potential. This paper shows that only based on the outcome of a detailed characterization process one can raise the status of a test material to RTM or reference material, and how this status depends on its intended use. PMID:26539428

  12. An unusual case of gout in the wrist: the importance of monitoring medication dosage and interaction. A case report.

    PubMed

    Jacobs, Craig L; Stern, Paula J

    2007-10-09

    Gouty arthritis of the wrist is uncommon although gout itself is the most common inflammatory arthritis in older patients. Some known risk factors for the development of gout include trauma, alcohol use, obesity, hyperuricaemia, hypertension and diabetes mellitus. As well, certain medications have been shown to promote the development of gout. These include thiazide diuretics, low dose salicylates and cyclosporine. We present a case of gouty wrist pain possibly precipitated by a medication dosage increase as well as medication interactions. A 77 year old male presented with right wrist pain. Redness and swelling was present at the dorsal aspect of his wrist and range of motion was full with pain at end range upon examination. One week prior, his anti-hypertensive medication dosage had been increased. The patient's situation continued to worsen. Radiographic examination revealed changes consistent with gouty arthritis. It is important for clinicians treating joint conditions to be aware of patients' comorbidities, medication usage and changes in dosages. Education of patients with gout is of prime importance. Clinicians should educate patients that gout may occur at any joint in the body not only the lower limb. Patients should be aware of the signs and symptoms of an acute gouty attack and be made aware that changes in certain medication dosages may precipitate an attack. Awareness of radiographic changes associated with gout is still of importance although these changes are not seen as frequently as they have been in the past due to better control of the disease.

  13. Inversion of the acetabular labrum triggers rapidly destructive osteoarthritis of the hip: representative case report and proposed etiology.

    PubMed

    Fukui, Kiyokazu; Kaneuji, Ayumi; Fukushima, Mana; Matsumoto, Tadami

    2014-12-01

    The pathophysiology of rapidly destructive osteoarthritis (OA) of the hip is unknown. This study documented cases of inversion of the acetabular labrum, which has clinicoradiologic features similar to those of initial-stage rapidly destructive hip OA. Our study was based on a prospective review of data for 9 patients with rapidly destructive hip OA. Intraoperative findings showed that the anterosuperior portion of the acetabular labrum had inverted into the articular space, along with many fragments of articular cartilage, in all patients. Subchondral insufficiency fractures of the femoral heads were seen just under the inverted labra in 8 of the 9 patients. Inversion of the acetabular labrum may be involved in rapid joint-space narrowing and subchondral insufficiency fracture in rapidly destructive hip OA.

  14. Importance of Vigilant Monitoring After Continuous Nerve Block: Lessons From a Case Report

    PubMed Central

    Nair, Gopakumar Sudhakaran; Soliman, Loran Mounir; Maheshwari, Kamal; Esa, Wael Ali Sakr

    2013-01-01

    Introduction Continuous peripheral nerve block achieves good pain control. However, uncontrolled pain despite an effective block in the target areas of the nerve can be an early sign of ischemia. We report a case of iatrogenic injury to the axillary artery during shoulder surgery in a patient who had continuous supraclavicular block and demonstrate how vigilant monitoring helped the diagnosis and resulted in timely management of upper limb ischemia. Case Report A 58-year-old female underwent total revision surgery of her right shoulder under continuous supraclavicular block. Postoperatively, she complained of pain along the medial side of her forearm despite clinical evidence of nerve block. Continuous neurovascular monitoring and timely angiography confirmed axillary artery injury, and subsequent vascular repair saved the patient's limb. Conclusion Iatrogenic injuries to vessels or nerves sometimes occur during orthopedic surgical procedures. Regional anesthesia can mask and delay the onset of these symptoms. Postoperative monitoring and the ability to differentiate between the effects of local anesthetics and the body's response to ischemia are important for avoiding postoperative complications. This case report aims to improve awareness about the need for vigilant monitoring of the distal pulses after peripheral nerve blocks. PMID:23789016

  15. Mayaro virus: imported cases of human infection in São Paulo State, Brazil.

    PubMed

    Coimbra, Terezinha Lisieux M; Santos, Cecília L S; Suzuki, Akemi; Petrella, Selma M C; Bisordi, Ivani; Nagamori, Adélia H; Marti, Antonia T; Santos, Raimundo N; Fialho, Danya M; Lavigne, Shirlene; Buzzar, Marcia R; Rocco, Iray M

    2007-01-01

    Mayaro virus (MAYV) is an arbovirus (Togaviridae: Alphavirus) enzootic in tropical South America and maintained in a sylvan cycle involving wild vertebrates and Haemagogus mosquitoes. MAYV cases occur sporadically in persons with a history of recent activities inside or around forests. This paper reports three cases of MAYV fever detected in men infected in Camapuã, MS, Brazil. Serum samples collected at four days and two months after the onset of the symptoms and examined by hemagglutination inhibition test, revealed monotypic seroconversion to MAYV. Isolation of the virus was obtained from one of the samples by inoculation of the first blood samples into newborn mice. A suspension of the infected mouse brain was inoculated into C6/36 cells culture and the virus was identified by indirect immunofluorescent assay with alphavirus polyclonal antibodies. RT-PCR, performed with RNA extracted from the supernatant of C6/36 infected cells in the presence of alphavirus generic primers as well as specific MAYV primers, confirmed these results. The reported cases illustrate the importance of laboratory confirmation in establishing a correct diagnosis. Clinical symptoms are not always indicative of a disease caused by an arbovirus. Also MAYV causes febrile illness, which may be mistaken for dengue.

  16. Importance of consumer perceptions in fiber-enriched food products. A case study with sponge cakes.

    PubMed

    Tarrega, Amparo; Quiles, Amparo; Morell, Pere; Fiszman, Susana; Hernando, Isabel

    2017-02-22

    Sponge cakes enriched with fiber from different sources (maltodextrin, wheat, apple, blackcurrant and a mixture of potato and Plantago ovata) were studied. Profiling of the different cakes was carried out, first using a check-all-that-apply (CATA) question then evaluating the consumers' likings using a hedonic scale. The consumers also completed a nutrition knowledge (NK) questionnaire that was used to classify them according to their NK level. The instrumental texture of the cakes was evaluated by the texture profile analysis (TPA) method. The consumers' response was not linked to their NK level, but it mainly depended on the importance they gave to the cakes' distinctive sensory characteristics. In general, liking increased for samples considered easy to chew, spongy, soft and sweet, and decreased for samples perceived as tasteless, dry or having a fruity or an odd flavor. The sponge cakes containing maltodextrin or wheat fiber, which mostly resembled a conventional cake, were the most liked in general. Those containing the other three fibers were rejected by part of the consumers, for being tasteless in the case of potato plus Plantago ovata fiber, for being dry and doughy in the case of apple fiber and for having an odd flavor in the case of blackcurrant fiber.

  17. Is perception of quality more important than technical quality in patient video cases?

    PubMed

    Roland, Damian; Matheson, David; Taub, Nick; Coats, Tim; Lakhanpaul, Monica

    2015-08-13

    The use of video cases to demonstrate key signs and symptoms in patients (patient video cases or PVCs) is a rapidly expanding field. The aims of this study were to evaluate whether the technical quality, or judgement of quality, of a video clip influences a paediatrician's judgment on acuity of the case and assess the relationship between perception of quality and the technical quality of a selection of video clips. Participants (12 senior consultant paediatricians attending an examination workshop) individually categorised 28 PVCs into one of 3 possible acuities and then described the quality of the image seen. The PVCs had been converted into four different technical qualities (differing bit rates ranging from excellent to low quality). Participants' assessment of quality and the actual industry standard of the PVC were independent (333 distinct observations, spearmans rho = 0.0410, p = 0.4564). Agreement between actual acuity and participants' judgement was generally good at higher acuities but moderate at medium/low acuities of illness (overall correlation 0.664). Perception of the quality of the clip was related to correct assignment of acuity regardless of the technical quality of the clip (number of obs = 330, z = 2.07, p = 0.038). It is important to benchmark PVCs prior to use in learning resources as experts may not agree on the information within, or quality of, the clip. It appears, although PVCs may be beneficial in a pedagogical context, the perception of quality of clip may be an important determinant of an expert's decision making.

  18. Distribution of human papillomavirus genotypes in invasive cervical cancer in Italy: a representative, single institution case series.

    PubMed

    Sideri, Mario; Cristoforoni, Paolo; Casadio, Chiara; Boveri, Sara; Igidbashian, Sarah; Schmitt, Marcus; Gheit, Tarik; Tommasino, Massimo

    2009-05-29

    Despite worldwide human papillomavirus (HPV) types distribution showed constant rates of HPV 16/18 in cervical cancers, regional variations have been consistently documented. Very little data is available on HPV genotype prevalence among Italian women with invasive cervical cancer. This study aims to determine the HPV type distribution in cervical specimens obtained from Italian women diagnosed with invasive cervical cancer and referred to the European Institute of Oncology (IEO). Two hundred-sixty eight cervical specimens were obtained from patients diagnosed with invasive cervical cancer referred to the European Institute of Oncology between 1996 and 2006. Following preparation, all cervical samples were sent to laboratories at the International Agency for Research on Cancer (IARC, Lyon, France) for DNA extraction and HPV typing by the multiplex PCR/APEX assay. The study population was divided into four groups from different macro regions: (i) Milan and surrounding area (n=57, 21.3%), (ii) northern Italy (n=81, 30.2%), (iii) central Italy (n=64, 23.9%) and (iv) southern Italy (n=66, 24.6%). The present study is the first at our knowledge that examines a fair number of Italian cervical cancers, about one tenth of all estimated cervical cancer cases occurring yearly, distributed across the whole country. Two-hundred and fifty-one patients (93.7%) resulted HPV DNA positive; of these 201 patients (80.1%) presented a single infection, whereas 50 women (19.9%) presented multiple infection. One hundred and eighty-nine specimens (75.3%) tested positive for either HPV 16 or HPV 18, whereas 62 (24.7%) resulted positive for other high-risk HPV genotypes only. The proportion of HPV 16/18 positive invasive cervical cancers was similar for all the four geographical Italian areas considered. A statistically significant association with younger age and earlier stage was observed for HPV 16/18 related invasive cervical cancers. The results demonstrate that the proportion of HPV

  19. Representing Geospatial Environment Observation Capability Information: A Case Study of Managing Flood Monitoring Sensors in the Jinsha River Basin

    PubMed Central

    Hu, Chuli; Guan, Qingfeng; Li, Jie; Wang, Ke; Chen, Nengcheng

    2016-01-01

    Sensor inquirers cannot understand comprehensive or accurate observation capability information because current observation capability modeling does not consider the union of multiple sensors nor the effect of geospatial environmental features on the observation capability of sensors. These limitations result in a failure to discover credible sensors or plan for their collaboration for environmental monitoring. The Geospatial Environmental Observation Capability (GEOC) is proposed in this study and can be used as an information basis for the reliable discovery and collaborative planning of multiple environmental sensors. A field-based GEOC (GEOCF) information representation model is built. Quintuple GEOCF feature components and two GEOCF operations are formulated based on the geospatial field conceptual framework. The proposed GEOCF markup language is used to formalize the proposed GEOCF. A prototype system called GEOCapabilityManager is developed, and a case study is conducted for flood observation in the lower reaches of the Jinsha River Basin. The applicability of the GEOCF is verified through the reliable discovery of flood monitoring sensors and planning for the collaboration of these sensors. PMID:27999247

  20. [A representative case of joint contracture as a main feature of AL amyloid deposits identified in the skeletal muscles].

    PubMed

    Matsumura, Erika; Yamaguchi, Tetsuto; Tomidokoro, Yasushi; Ishii, Akiko; Tamaoka, Akira

    2014-01-01

    A 68-year-old man, with a history of type 2 diabetes mellitus and chronic kidney impairment, had been suffering from progressive knee joint contracture and dysesthesia of the lower extremities for 4 years. When he walked, his knees remained bent owing to contracture of the knee joints. There was no evidence of muscle pseudohypertrophy, intramuscular nodules, or muscle weakness. Clinical examination revealed IgA λ M-protein, reticular high-signal intensity lesions demonstrated by magnetic resonance T2-short TI IR(STIR) imaging of the lower extremity muscles, and a mixture of neurogenic and myogenic changes demonstrated by needle electromyography. A biopsy specimen from the vastus lateralis muscle identified Aλ amyloid deposits around the vessels, establishing a diagnosis of amyloid myopathy based on systemic AL amyloidosis. This case demonstrated that joint contracture and reticular lesions shown by magnetic resonance STIR imaging of the muscles can alert the physician to consider muscle biopsy to investigate deposition of amyloid in the skeletal muscles even in the absence of muscle pseudohypertrophy or weakness, both of which are characteristic of amyloid myopathy.

  1. Representing Geospatial Environment Observation Capability Information: A Case Study of Managing Flood Monitoring Sensors in the Jinsha River Basin.

    PubMed

    Hu, Chuli; Guan, Qingfeng; Li, Jie; Wang, Ke; Chen, Nengcheng

    2016-12-16

    Sensor inquirers cannot understand comprehensive or accurate observation capability information because current observation capability modeling does not consider the union of multiple sensors nor the effect of geospatial environmental features on the observation capability of sensors. These limitations result in a failure to discover credible sensors or plan for their collaboration for environmental monitoring. The Geospatial Environmental Observation Capability (GEOC) is proposed in this study and can be used as an information basis for the reliable discovery and collaborative planning of multiple environmental sensors. A field-based GEOC (GEOCF) information representation model is built. Quintuple GEOCF feature components and two GEOCF operations are formulated based on the geospatial field conceptual framework. The proposed GEOCF markup language is used to formalize the proposed GEOCF. A prototype system called GEOCapabilityManager is developed, and a case study is conducted for flood observation in the lower reaches of the Jinsha River Basin. The applicability of the GEOCF is verified through the reliable discovery of flood monitoring sensors and planning for the collaboration of these sensors.

  2. Molecular and histological tools to diagnose an imported case of American cutaneous leishmaniasis in Cuba.

    PubMed

    Montalvo, Ana M; De Armas, Yaxsier; Fraga, Jorge; Blanco, Orestes; Menéndez, Reinaldo; Montoto, Vicente; Capó de Paz, Virginia

    2015-10-01

    Leishmaniasis represents a polymorphous group of diseases caused by around 20 different species of Leishmania parasite. Increases in the number of cases of leishmaniasis reported as a consequence of the growth in travel and migration are of concern to epidemiologists and are diagnostically challenging in non-endemic areas. Molecular and histological analyses of a paraffin-embedded skin biopsy were used in parallel to detect Leishmania parasites in a Cuban woman with suspicious lesions arriving in Cuba from Venezuela. Primers based on the 18S fragment of ribosomal ribonucleic acid (rRNA) and heat shock protein 70 genes (hsp70) were used for molecular detection. Histological studies detected the presence of the parasite. A small fragment of Leishmania DNA was amplified by polymerase chain reaction (PCR) targeting the 18S fragment using, for the first time, nucleic acid obtained from paraffin-embedded tissue as a template. Amplification of a larger fragment from the hsp70 gene did not occur. The detection of Leishmania DNA from paraffin-embedded tissue by means of 18S-targeted PCR is a feasible approach to diagnosis. In combination with classical methods such as histology, the molecular detection of the parasite was demonstrated to be useful in confirming Leishmania infection in a traveler. © 2015 The International Society of Dermatology.

  3. Do heavy metals existing in abandoned mining sites represent a real health risk? A study case in the SE Spain.

    NASA Astrophysics Data System (ADS)

    Martinez-Sanchez, Maria Jose; Perez-Sirvent, Carmen; García-Lorenzo, Mari Luz; Martínez-López, Salvadora; Perez-Espinosa, Victor; Hernández-Cordoba, Manuel; Bech, Jaime

    2013-04-01

    Mining activities have been carried out for centuries in Sierra Minera (SE Spain) giving rise to a large number of sites distributed throughout the zone in which residues are accumulated. This communication reports studies as regards metal mobilization and analysis of the health risk that could be posed by inhalation, dermic contact or occasional ingestion of this type of sediments. Lead was used as the metal for the studies due to its particular abundance in the zone. A large number of samples were taken and general analytical determinations (pH, particle size, organic matter, equivalent calcium carbonate content and mineralogical composition) were carried out in order its characterization. An in vitro method for obtaining formation on Pb bioaccessibility in these mine waste materials was also carried out. Our results prove that mineral associations, different alteration states and sorption/desorption processes play an important role in the bioavailability of lead. In addition, it is noteworthy that the metal fraction dissolved by the proposed in vitro methodology is lower than 100%, both in the stomach and intestinal phases. Finally an assessment of the risk posed by lead is achieved. To this respect it should be noted that the IRIS database provide cancer slope factor and reference dose, as a way to assess the risk caused by arsenic, cadmium and copper but no for lead, probably due to the wide variety of real situations, and the discrepancy of the sources. The way here suggested is a novelty in this sense, and the results could be extrapolated to other similar zones and be incorporated to the general protocol of risk assessment applied to contaminated sites.

  4. Three cases of imported dengue virus infection from Madeira to Belgium, 2012.

    PubMed

    Cnops, Lieselotte; Franco, Leticia; Van Meensel, Britt; Van den Ende, Jef; Paz Sanchez-Seco, Maria; Van Esbroeck, Marjan

    2014-01-01

    We report three laboratory-confirmed dengue virus (DENV) infections imported to Belgium by travelers returning from Madeira (Portugal). Despite the use of a mosquito-repellent spray as reported by two patients, the infection could not be prevented. Diagnosis was made by antigen detection and real-time reverse transcriptase polymerase chain reaction (RT-PCR) in two cases and by serology 1 month after onset of symptoms in a third one. The responsible virus was identified as DENV serotype 1, American/African genotype (genotype V). The close relationship to isolates from Colombia supports the previous findings that a South American strain originated the outbreak in Madeira in 2012. © 2014 International Society of Travel Medicine.

  5. The importance of process in building an executive leadership team: a case study.

    PubMed

    Zakariasen, Kenneth L

    2006-01-01

    In today's competitive, fast-changing world of healthcare, organizations cannot tolerate ineffective leadership over the long term if they are to remain successful. It is very common for leadership teams to come together and immediately begin to do business...at least to attempt to do what each team member believes the group's business should be. Unfortunately, each person probably has a different idea of what the team's business should be, and how they should go about conducting it. This is a certain recipe for ineffectiveness. The following case study examines how the executive team in a health sciences college approached the development of an effective leadership team, and discusses the importance of process to achieving the desired outcomes. The process so described can be used with any leadership team, but it should always be customized to suit the unique needs and desires of each team.

  6. Molecular Characterization of a Cluster of Imported Malaria Cases in Puerto Rico.

    PubMed

    Chenet, Stella M; Silva-Flannery, Luciana; Lucchi, Naomi W; Dragan, Ljolje; Dirlikov, Emilio; Mace, Kimberly; Rivera-García, Brenda; Arguin, Paul M; Udhayakumar, Venkatachalam

    2017-09-01

    The Caribbean island of Hispaniola is targeted for malaria elimination. Currently, this is the only island with ongoing transmission of malaria in the Caribbean. In 2015, six patients from Puerto Rico and one from Massachusetts, who traveled to Punta Cana, Dominican Republic, were confirmed to be infected with Plasmodium falciparum. Additional molecular analysis was performed at the Centers for Disease Control and Prevention to characterize the drug-resistant alleles and Plasmodium population genetic markers. All specimens carried wildtype genotypes for chloroquine, sulfadoxine-pyrimethamine, and artemisinin resistance genetic markers. A mutation in codon 184 (Y/F) of Pfmdr-1 gene was observed in all samples and they shared an identical genetic lineage as determined by microsatellite analysis. This genetic profile was similar to one previously reported from Hispaniola suggesting that a clonal P. falciparum residual parasite population present in Punta Cana is the source population for these imported malaria cases.

  7. The ionized gas in the CALIFA early-type galaxies. I. Mapping two representative cases: NGC 6762 and NGC 5966

    NASA Astrophysics Data System (ADS)

    Kehrig, C.; Monreal-Ibero, A.; Papaderos, P.; Vílchez, J. M.; Gomes, J. M.; Masegosa, J.; Sánchez, S. F.; Lehnert, M. D.; Cid Fernandes, R.; Bland-Hawthorn, J.; Bomans, D. J.; Marquez, I.; Mast, D.; Aguerri, J. A. L.; López-Sánchez, Á. R.; Marino, R. A.; Pasquali, A.; Perez, I.; Roth, M. M.; Sánchez-Blázquez, P.; Ziegler, B.

    2012-04-01

    in NGC 6762 can be best explained by photoionization by pAGB stars without the need of invoking any other excitation mechanism. In the case of NGC 5966, the presence of a nuclear ionizing source seems to be required to shape the elongated gas emission feature in the "ionization cone" scenario, although ionization by pAGB stars cannot be ruled out. Further study of this object is needed to clarify the nature of its elongated gas structure. Based on observations collected at the Centro Astronómico Hispano Alemán (CAHA) at Calar Alto, operated jointly by the Max-Planck-Institut für Astronomie and the Instituto de Astrofísica de Andalucía (CSIC).

  8. Importance of pharmacogenetics in the treatment of children with attention deficit hyperactive disorder: a case report.

    PubMed

    Tan-Kam, Teerarat; Suthisisang, Chutamanee; Pavasuthipaisit, Chosita; Limsila, Penkhae; Puangpetch, Apichaya; Sukasem, Chonlaphat

    2013-01-01

    This case report highlights the importance of pharmacogenetic testing in the treatment of attention deficit hyperactive disorder (ADHD). A 6-year-old boy diagnosed with ADHD was prescribed methylphenidate 5 mg twice daily (7 am and noon) and the family was compliant with administration of this medication. On the first day of treatment, the patient had an adverse reaction, becoming disobedient, more mischievous, erratic, resistant to discipline, would not go to sleep until midnight, and had a poor appetite. The All-In-One PGX (All-In-One Pharmacogenetics for Antipsychotics test for CYP2D6, CYP2C19, and CYP2C9) was performed using microarray-based and real-time polymerase chain reaction techniques. The genotype of our patient was identified to be CYP2D6*2/*10, with isoforms of the enzyme consistent with a predicted cytochrome P450 2D6 intermediate metabolizer phenotype. Consequently, the physician adjusted the methylphenidate dose to 2.5 mg once daily in the morning. At this dosage, the patient had a good response without any further adverse reactions. Pharmacogenetic testing should be included in the management plan for ADHD. In this case, cooperation between the medical team and the patients' relatives was key to successful treatment.

  9. Dengue is still an imported disease in China: a case study in Guangzhou.

    PubMed

    Sang, Shaowei; Chen, Bin; Wu, Haixia; Yang, Zhicong; Di, Biao; Wang, Lihua; Tao, Xiaoyan; Liu, Xiaobo; Liu, Qiyong

    2015-06-01

    Dengue virus and its four serotypes (DENV 1-4) infect approximately 390 million people worldwide each year, with most cases in tropical and subtropical regions. Because of repeated introduction of DENV from epidemic regions and suitable weather conditions, many regions have shifted from hypo-endemicity to hyper-endemicity over recent decades. Since the first dengue outbreak in 1978, it is crucial to understand the current situation in China over nearly 40 years. The purpose of the study was to examine whether dengue in China was endemic or not, which is essential for relevant dengue control and prevention strategy implementation in China. The study, combining epidemiological characteristics of dengue from the disease notification system, phylogenetic and phylogeographic analyses, showed that all four serotypes had been detected in Guangzhou, China, which was dominated by DENV 1-2. The Maximum Likelihood tree analytic results showed that the virus detected in Guangzhou localized in different clades, except of virus of 2002 and 2003 clustered together. There existed the mutual introductions between Guangzhou and Southeast Asia. Most of the viruses were imported from Southeast Asia and the sources of outbreaks in Guangzhou mainly originated from Thailand, Indonesia, and the Philippines. The study indicates that dengue in China still remains as an imported disease, with the possibility of localization.

  10. Identification and genetic characterization of Zika virus isolated from an imported case in China.

    PubMed

    Liu, Lin; Zhang, Shuo; Wu, De; Song, Jingdong; Li, Aqian; Zhang, Huan; Wu, Wei; Tan, Qiqi; Li, Chuan; Zhang, Quanfu; Zhou, Huiqiong; Liang, Mifang; Ke, Changwen; Li, Dexin

    2017-03-01

    Zika virus (ZIKV) is a reemerging flavivirus that stroke Brazil in 2015 and appeared in China for the first time in 2016. Sequencing and genomic analysis are essential for Zika virus study. However, the complete genome length of Zika virus is still a disputable issue. In this study, we reported the complete genomic sequence of Zika virus strain ZKC2/2016 from an imported case in China, in February 2016. The virus was isolated and virus characteristics were identified by cytopathic effect, quantitative real time-PCR, immunofluorescence assay and electronic microscopy. Next generation sequencing (NGS) technique and 5' and 3' Rapid Amplification cDNA Ends (RACE) PCR were used to sequence the complete genome. The genome length of this newly obtained Zika virus strain is 10,807base pairs (bp). Genetic analysis showed that ZKC2/2016, along with other Chinese Zika virus strains in 2016, formed three clusters within Asian linage. Multiple sequence alignment and prediction of RNA secondary structure of untranslated regions (UTRs) of ZKC2/2016 and several other ZIKV strains indicated that the difference of ZIKV genome length mainly laid in UTRs. Besides, those genomes shorter than 10,790bp were probably incomplete due to lacking conserved secondary RNA structures in untranslated regions which were playing important roles in flavivirus replication. Our findings benefited the disease control of Zika fever in China and the study of Zika virus genome.

  11. Further occurrences of Dohrniphora cornuta (Bigot) (Diptera, Phoridae) in forensic cases indicate likely importance of this species in future cases.

    PubMed

    Disney, R Henry L; Garcia-Rojo, Ana; Lindström, Anders; Manlove, John D

    2014-08-01

    Dohrniphora cornuta (Bigot), an oriental species of scuttle fly, has been transported around the world by man. We report it from forensic cases in England, Spain and Sweden. It is likely to feature in forensic cases elsewhere in the world.

  12. Exploring the importance of quantum effects in nucleation: the archetypical Ne(n) case.

    PubMed

    Unn-Toc, Wesley; Halberstadt, Nadine; Meier, Christoph; Mella, Massimo

    2012-07-07

    The effect of quantum mechanics (QM) on the details of the nucleation process is explored employing Ne clusters as test cases due to their semi-quantal nature. In particular, we investigate the impact of quantum mechanics on both condensation and dissociation rates in the framework of the microcanonical ensemble. Using both classical trajectories and two semi-quantal approaches (zero point averaged dynamics, ZPAD, and Gaussian-based time dependent Hartree, G-TDH) to model cluster and collision dynamics, we simulate the dissociation and monomer capture for Ne(8) as a function of the cluster internal energy, impact parameter and collision speed. The results for the capture probability P(s)(b) as a function of the impact parameter suggest that classical trajectories always underestimate capture probabilities with respect to ZPAD, albeit at most by 15%-20% in the cases we studied. They also do so in some important situations when using G-TDH. More interestingly, dissociation rates k(diss) are grossly overestimated by classical mechanics, at least by one order of magnitude. We interpret both behaviours as mainly due to the reduced amount of kinetic energy available to a quantum cluster for a chosen total internal energy. We also find that the decrease in monomer dissociation energy due to zero point energy effects plays a key role in defining dissociation rates. In fact, semi-quantal and classical results for k(diss) seem to follow a common "corresponding states" behaviour when the proper definition of internal and dissociation energies are used in a transition state model estimation of the evaporation rate constants.

  13. Exploring the importance of quantum effects in nucleation: The archetypical Nen case

    NASA Astrophysics Data System (ADS)

    Unn-Toc, Wesley; Halberstadt, Nadine; Meier, Christoph; Mella, Massimo

    2012-07-01

    The effect of quantum mechanics (QM) on the details of the nucleation process is explored employing Ne clusters as test cases due to their semi-quantal nature. In particular, we investigate the impact of quantum mechanics on both condensation and dissociation rates in the framework of the microcanonical ensemble. Using both classical trajectories and two semi-quantal approaches (zero point averaged dynamics, ZPAD, and Gaussian-based time dependent Hartree, G-TDH) to model cluster and collision dynamics, we simulate the dissociation and monomer capture for Ne8 as a function of the cluster internal energy, impact parameter and collision speed. The results for the capture probability Ps(b) as a function of the impact parameter suggest that classical trajectories always underestimate capture probabilities with respect to ZPAD, albeit at most by 15%-20% in the cases we studied. They also do so in some important situations when using G-TDH. More interestingly, dissociation rates kdiss are grossly overestimated by classical mechanics, at least by one order of magnitude. We interpret both behaviours as mainly due to the reduced amount of kinetic energy available to a quantum cluster for a chosen total internal energy. We also find that the decrease in monomer dissociation energy due to zero point energy effects plays a key role in defining dissociation rates. In fact, semi-quantal and classical results for kdiss seem to follow a common "corresponding states" behaviour when the proper definition of internal and dissociation energies are used in a transition state model estimation of the evaporation rate constants.

  14. Are natural reservoirs important for cholera surveillance? The case of an outbreak in a Brazilian estuary.

    PubMed

    Martinelli Filho, J E; Lopes, R M; Rivera, I N G; Colwell, R R

    2016-09-01

    Paranaguá Bay is one of the largest estuarine systems on the Southern Brazilian coast. The only recorded cholera outbreak in this region since the early 20th century occurred in 1999 and resulted in 467 cases and at least three reported deaths in a population of approx. 150 000 people. This short communication reports historical, unpublished data related to that outbreak. Water, zooplankton and bivalve samples were collected and evaluated using direct fluorescence assay to determine whether Vibrio cholerae serogroups O1 and O139 were present in the estuarine system at that time. Most of the water (83%) and zooplankton samples (75%) were positive for V. cholerae O1, while V. cholerae O139 was not detected. Shellfish (Mytella sp.) were also positive for V. cholerae O1. These results indicate that the estuary, including biological vectors such as copepods and bivalves, comprise an important reservoir of V. cholerae O1 and a probable waterborne pathway for the disease, in addition to contamination with untreated sewage. Despite most of the cholera cases that occurred in Brazil during the 7th pandemic were located in the northern areas of the country, a significant outbreak in Paranaguá, an estuary in the south coast, resulted in at least three deaths in 1999. We report here the detection of Vibrio cholerae O1 in water, zooplankton and bivalve samples during the outbreak, using direct fluorescence assay as an alternative method for the traditional plate culture employed at the time by the Brazilian Sanitary Agency. Results demonstrate that aquatic natural reservoirs comprise a potential route of transmission of cholera, in addition to untreated sewage and routine monitoring is recommended. © 2016 The Society for Applied Microbiology.

  15. Monitoring of clinical and laboratory data in two cases of imported Lassa fever.

    PubMed

    Schmitz, Herbert; Köhler, Bernhard; Laue, Thomas; Drosten, Christian; Veldkamp, Peter J; Günther, Stephan; Emmerich, Petra; Geisen, Hans P; Fleischer, Klaus; Beersma, Matthias F C; Hoerauf, Achim

    2002-01-01

    During 2000, four cases of fatal Lassa fever were imported from Africa to Europe. In two patients, consecutive serum samples were available for monitoring of virus load and cytokine levels in addition to standard laboratory data. Both patients had non-specific early clinical symptoms including high fever. Patient 1 developed multi-organ failure and died of hemorrhagic shock on day 15 of illness, while patient 2 died of respiratory failure due to aspiration without hemorrhage on day 16. Ribavirin was administered to both patients beginning only on day 11. High serum aspartate aminotransferase and lactate dehydrogenase (LDH) levels were remarkable in both patients. Patient 1 had an initial virus load of 10(6) S RNA copies/ml as measured by real-time RT-PCR. Viremia increased steadily and reached a plateau of approximately 10(8)-10(9) copies/ml 4 days before death, while IFN-gamma and TNF-alpha rose to extremely high levels only shortly before death. In contrast, in patient 2 the virus load decreased from 10(7) to 10(6) copies/ml during the late stage of illness which was paralleled by a decrease in the IFN-gamma and TNF-alpha levels. The IL-10 level increased when specific IgM and IgG appeared. These data suggest that a high virus load and high levels of pro-inflammatory cytokines in the late stage of Lassa fever play an important role in the pathogenesis of hemorrhage, multi-organ failure, and shock in Lassa fever.

  16. Clinical Features of Imported Loiasis: A Case Series from the Hospital for Tropical Diseases, London

    PubMed Central

    Saito, Makoto; Armstrong, Margaret; Boadi, Samuel; Lowe, Patricia; Chiodini, Peter L.; Doherty, Tom

    2015-01-01

    We retrospectively analyzed the background, clinical features, and treatment response of 50 cases of imported loiasis who presented between 2000 and 2014 to the Hospital for Tropical Diseases (HTD), London, United Kingdom. Of them, 29 were migrants from, and 21 were visitors to, countries where the disease is endemic. Clinical features differed between these groups. Migrants experienced fewer Calabar swellings (odds ratio [OR] = 0.12), more eye worm (OR = 3.4), more microfilaremia (OR = 3.5), lower filarial antibody levels, and lower eosinophil counts (P < 0.05 for all tests). Among 46 patients who were started on treatment at HTD, 33 (72%) received diethylcarbamazine (DEC) monotherapy as first-line treatment, and among 26 patients who were followed up after treatment, seven (27%) needed a second course of treatment. There were 46 courses of treatment with DEC, and 20 (43%) of them had reactions. All patients with microfilaremia > 3,000 microfilariae/mL and all those with an elevated C-reactive protein (CRP) (≥ 5 mg/L) before treatment had reactions (P = 0.10 and P = 0.01, respectively). These data suggest that monotherapy with DEC may not be the optimal treatment for patients with loiasis, particularly for those with a high microfilarial load. PMID:26101271

  17. The importance of cardiac monitoring in the epilepsy monitoring unit: a case presentation of ictal asystole.

    PubMed

    Agostini, Susan D; Aniles, Ejerzain; Sirven, Joseph; Drazkowski, Joseph F

    2012-09-01

    Ictal asystole may be a potent marker for epilepsy patients at high risk for sudden unexpected death in epilepsy (SUDEP). The use of inpatient long-term video-electroencephalographic (VEEG) monitoring coupled with simultaneous continuous cardiac telemetry is an important tool to detect ictal asystole as well as other significant ictal cardiac arrhythmias. In this paper a case of ictal asystole detected during VEEG is presented. Routine 12-lead EKG was normal upon admission. After antiepileptic medication was tapered, the patient had a typical complex partial seizure with oral automatisms at onset followed by secondary generalization. Ictal onset was noted in left temporal lobe with subsequent spread to the right temporal region. A 20 second period of asystole began just prior to the secondary generalization. During this admission the patient underwent a potentially life-saving pacemaker implantation. The use of cardiac telemetry and baseline EKG are suggested for patients admitted into epilepsy monitoring units as part of the standard epilepsy monitoring protocol.

  18. Learning From Mistakes: Importance of a Multidisciplinary Group, A Case Report

    PubMed Central

    Pezzulla, Donato; Scoglio, Claudio; Capasso, Raffaella; Cioce, Fabrizio; Sica, Assunta; Cappabianca, Salvatore

    2016-01-01

    There have been significant advances in the diagnosis and treatment of breast cancer over the past 20 years, due to increased knowledge about the biology and molecular changes in breast cancer. These advances have increased the complexity of treatment decision-making for individual women, and reinforced the need for a team approach to treatment decision-making. We report the case of an 80-year-old woman with a recidive invasive ductal breast carcinoma of high grade. In October 2015, she discovered an indolent breast bulk through self-examination and in the December of the same year, after the routine staging exams, she undergone a quadrantectomy and a limphoadenectomy. In March 2016, the patient was sent to our structure for a cycle of radiation therapy by her oncologist, even though a suspected lesion was seen on the thoracic wall on recent computed tomography scans. Our aim was to show an example about the importance of collaboration and multidisciplinary group in treating cancer. PMID:28983371

  19. Global trade in ornamental fish from an Australian perspective: the case for revised import risk analysis and management strategies.

    PubMed

    Whittington, R J; Chong, R

    2007-09-14

    ) consistent with government objectives to prevent introduction of pests and diseases, promote development of future aquaculture industries or maintain biodiversity. It is concluded that the risk analysis process described by the Office International des Epizooties under the SPS agreement cannot be used in a meaningful way for current patterns of ornamental fish trade. Transboundary disease incursions will continue and exotic pathogens will become established in new regions as a result of the ornamental fish trade, and this will be an international phenomenon. Ornamental fish represent a special case in live animal trade where OIE guidelines for risk analysis need to be revised. Alternatively, for countries such as Australia with implied very high ALOP, the number of species traded and the number of sources permitted need to be dramatically reduced to facilitate hazard identification, risk assessment and import quarantine controls.

  20. Estimation of the incubation period of influenza A (H1N1-2009) among imported cases: addressing censoring using outbreak data at the origin of importation.

    PubMed

    Nishiura, Hiroshi; Inaba, Hisashi

    2011-03-07

    Empirical estimates of the incubation period of influenza A (H1N1-2009) have been limited. We estimated the incubation period among confirmed imported cases who traveled to Japan from Hawaii during the early phase of the 2009 pandemic (n=72). We addressed censoring and employed an infection-age structured argument to explicitly model the daily frequency of illness onset after departure. We assumed uniform and exponential distributions for the frequency of exposure in Hawaii, and the hazard rate of infection for the latter assumption was retrieved, in Hawaii, from local outbreak data. The maximum likelihood estimates of the median incubation period range from 1.43 to 1.64 days according to different modeling assumptions, consistent with a published estimate based on a New York school outbreak. The likelihood values of the different modeling assumptions do not differ greatly from each other, although models with the exponential assumption yield slightly shorter incubation periods than those with the uniform exposure assumption. Differences between our proposed approach and a published method for doubly interval-censored analysis highlight the importance of accounting for the dependence of the frequency of exposure on the survival function of incubating individuals among imported cases. A truncation of the density function of the incubation period due to an absence of illness onset during the exposure period also needs to be considered. When the data generating process is similar to that among imported cases, and when the incubation period is close to or shorter than the length of exposure, accounting for these aspects is critical for long exposure times. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. Neurocysticercosis in Europe: Still a public health concern not only for imported cases.

    PubMed

    Fabiani, S; Bruschi, F

    2013-10-01

    Neurocysticercosis (NCC), a parasitic disease caused by the larvae of the cestode Taenia solium, is the most frequent parasitic disease of the central nervous system (CNS) in the world and the leading cause of secondary epilepsy in Central and South America, East and South Asia, and sub-Saharan Africa. It is endemic in many low- and middle-income countries of the world. Due to increased travels and immigration, NCC may be diagnosed also in non-endemic areas. In fact, tapeworm carriers from endemic zones can transmit infection to other citizens or arrive already suffering NCC. This phenomenon, occurred first in USA during the last 30 years, has been also observed in Europe, as well as in Australia, Canada, Israel, Japan and Muslim countries of the Arab World. Actually, concerning Europe, although, in some areas only few cases have been described, nevertheless the prevalence of NCC may be considered increasing, especially in Spain and Portugal. We reviewed the literature on the burden of NCC in Europe, by a search of PubMed regarding papers from 1970 to present. We only considered on PubMed published and available papers in English, French, Italian, and Spanish, the languages understood by the authors. One hundred seventy six cases of NCC have been reported in seventeen European countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Netherlands, Sweden, United Kingdom, and Croatia, Norway, Switzerland). A particular epidemic situation is present in Spain and Portugal. In fact, we collected data that show, in Spain, an increasing incidence both in immigrated patients and in those which were born in certain Spanish geographical areas and, in Portugal, prevalence similar to that observed in endemic areas. Globally, it is clear that as a result of increased migrations and travels from endemic regions, NCC is becoming an emerging public health problem in high-income countries, particularly affecting communities where

  2. Oil-import fees. Hearing before the Subcommittee on Fossil and Synthetic Fuels and the Subcommittee on Energy Conservation and Power of the Committee on Energy and Commerce, House of Representatives, Ninety-Ninth Congress, Second Session, March 13, 1986

    SciTech Connect

    Not Available

    1986-01-01

    Testifying on the implications of a possible fee imposed on oil imports were representatives of citizen and labor groups, energy industries and marketers, and utilities. At issue was the advisability of using an oil-import fee to raise revenue, which would artificially inflate domestic oil prices and cause corresponding increases in government spending for entitlements, as well as the impacts of price control. Support for the fee is based on the current low price of oil, but arguments in opposition cite the creation of a new bureaucracy instead of allowing market forces to work. Producers generally seek high prices, while consumers want low prices; but both sides disagree on when it is appropriate to set controls. Materials submitted for the record by witnesses and other interested parties follows the testimony of the seven witnesses.

  3. A case of imported paracoccidioidomycosis: an awkward infection in The Netherlands.

    PubMed

    Van Damme, P A; Bierenbroodspot, F; Telgtt, D S C; Kwakman, J M; De Wilde, P C M; Meis, J F G M

    2006-02-01

    Paracoccidioidomycosis is an important endemic mycosis in South America. In Europe the disease is very rare and only found as infections in travelers to Latin America. We report here the first case encountered in the Netherlands for which the appropriate diagnosis was not attained for several months. A Dutch 60-year-old man presented with a painful ulceration in the buccal mandibular vestibular mucosa of three months duration. While his medical history was uneventful, he had worked, until 8 years prior to his presentation, as a carpenter for 25 years in the jungles of Peru and Ecuador. An aberrant chest radiograph, CT-scan of the lungs and increased erythrocyte sedimentation rate were suggestive of sarcoidosis or a bronchiolitis obliterans organizing pneumonia. There was no improvement in the patient's symptoms despite the use of budesonide and prednisone medication, as well as tuberculosis prophylaxis with isoniazide and rifampicin, and local use of miconazole. Quite to the contrary, as an irritated, irregular hyperemic mucosa and gingiva with ulceration were noticed during this period of time. These precipitated an incisional biopsy through which a mixed inflammatory cellular infiltrate and large yeast cells were found on histopathologic examination. Based on the patient's travel history and the multiple budding yeastlike cells revealed in the biopsy tissue, the diagnosis of paracoccidioidomycosis was finally made. This was supported by the isolation of Paracoccidioides brasiliensis in culture. Antimycotic oral therapy with itraconazole was started and continued for 15 months. At two and five year follow-ups, the patient was asymptomatic. In Europe, it may be expected that diseases that are endemic in other areas will be seen more frequently in countries where the diseases are not routinely encountered. It is most likely that the use of corticosteroid medication, with its inherent immunosuppressive effect, resulted in the reactivation of an infection acquired

  4. Methodology of determining soil structure in important groundwater areas: case studies in Kauvonkangas, Finnish Lapland

    NASA Astrophysics Data System (ADS)

    Kupila, Juho

    2016-04-01

    Finland is fully self-sufficient in clean groundwater and even has a capacity of exportation. There are approx. 6000 groundwater areas with a total yield of 5.4 million m3/day. Currently only 10% of this groundwater resource is in use. For the efficient and safe exploitation of these areas in the future, detailed modeling of soil structure is an important method in groundwater surveys. 3D -models improve the general knowledge of linkage between land use planning and groundwater protection. Results can be used as a base information in water supply service development and when performing the measures needed in case of environmental accidents. Also, when creating the groundwater flow models the collected information is utilized and is usually the main data source. Geological Survey of Finland has carried out soil structure studies in co-operation with authorities, municipalities and the local water suppliers. The main objectives of these projects are to determine the geological structure of groundwater area for estimating the validity of the present exclusion area, the quantity of ground water volume and recharge capability and possible risks to the groundwater. Research areas are usually under an active water supply service. Kauvonkangas groundwater area is located in the municipality of Tervola, in Southern part of Finnish Lapland. Extent of the area is 7.9 km2 and it is an important water source for the local and nearby population centers. There are two active water supply companies in the area. Field studies in the project will include general geological and hydrological mapping, soil drilling with observation pipe installation, test pumping and water sampling. Geophysical measures will play a key-role, including ground penetrating radar (GPR) and gravimetric measurements. Studies will be carried out in spring and summer 2016. The main results will be the models of the bedrock and groundwater level and main characteristics of the soil layers in the area. Results

  5. Pulmonary tuberculosis incidence in Turkish prisons: importance of screening and case finding strategies.

    PubMed

    Öngen, Gül; Börekçi, Şermin; İçmeli, Özlem Saniye; Birgen, Nur; Karagül, Gülsüm; Akgün, Salih; Kılıçaslan, Zeki; Umut, Sema

    2013-01-01

    The purpose of this study was to evaluate the burden of pulmonary tuberculosis in 10 prisons mostly located in the Marmara Region of Turkey, and to compare them with the country incidence. All the inmates in ten prisons mostly located in the four cities in the Marmara Region of Turkey were enrolled in this study. Tuberculosis screening was done between January 2006-January 2007. Radiological screening for tuberculosis was performed by the mobile X-ray system and it was followed by bacteriological analysis of sputum for tuberculosis suspects. Four physicians evaluated the X-rays independently. Four thousand six hundred and fifteen prisoners were detected by radiological screening. Three hundred and one (7%) of them were female and 4314 (93%) were male, age range was between 14-72 years. Age ranges of female and male prisoners were 16-59 and 14-72 respectively. 398/4615 (8.6%) were young adults inmates with an age range of 14-18. Radiological abnormalities consistent with tuberculosis were found in 130 chest X-rays and followed by sputum bacteriology. Smear and culture positive pulmonary tuberculosis diagnosed in five out of 130, were all male with mean age 33 ± 10 years. Tuberculosis prevalence in the prisons was found to be 108/100.000 which was four times higher than the overall incidence of tuberculosis in Turkey in the year which the present study was conducted. Prisoners are one of the most important risk groups with high burden of tuberculosis in Turkey. This result highlights the need for adequate case- finding strategies in prisons.

  6. Imported chikungunya cases in an area newly colonised by Aedes albopictus: mathematical assessment of the best public health strategy.

    PubMed

    Sochacki, Thomas; Jourdain, Frédéric; Perrin, Yvon; Noel, Harold; Paty, Marie-Claire; de Valk, Henriette; Septfons, Alexandra; Simard, Frédéric; Fontenille, Didier; Roche, Benjamin

    2016-05-05

    We aimed to identify the optimal strategy that should be used by public health authorities against transmission of chikungunya virus in mainland France. The theoretical model we developed, which mimics the current surveillance system, predicted that without vector control (VC), the probability of local transmission after introduction of viraemic patients was around 2%, and the number of autochthonous cases between five and 15 persons per hectare, depending on the number of imported cases. Compared with this baseline, we considered different strategies (VC after clinical suspicion of a case or after laboratory confirmation, for imported or autochthonous cases): Awaiting laboratory confirmation for suspected imported cases to implement VC had no significant impact on the epidemiological outcomes analysed, mainly because of the delay before entering into the surveillance system. However, waiting for laboratory confirmation of autochthonous cases before implementing VC resulted in more frequent outbreaks. After analysing the economic cost of such strategies, our study suggested implementing VC immediately after the notification of a suspected autochthonous case as the most efficient strategy in settings where local transmission has been proven. Nevertheless, we identified that decreasing reporting time for imported cases should remain a priority.

  7. [Diagnostic and prognostic importance of laboratory tests in malaria in airports. Study of six recent cases].

    PubMed

    Poupin, F; Baledent, F; Le Bras, J; Adam, M N; Caillet, R; Abecassis, L; Giacomini, T

    1996-04-01

    During the summer 1994, six cases of airport malaria occurred in France, near the Roissy-Charles-de-Gaulle airport. Due to Plasmodium falciparum, all cases underwent rapid and severe deterioration, and in one case, the patient died. The role of laboratory tests is essential to establish the diagnosis of persons who have never resided in the endemic malaria areas and follow up with the patients already under treatment to detect possible complications.

  8. Three Cases of Adolescent Childbearing Decision-Making: The Importance of Ambivalence

    ERIC Educational Resources Information Center

    Bender, Soley S.

    2008-01-01

    Limited information is available about the childbearing decision-making experience by the pregnant adolescent. The purpose of this case study was to explore this experience with three pregnant teenagers. The study is based on nine qualitative interviews. Within-case descriptions applying the theoretical model of decision-making regarding unwanted…

  9. A case of stillbirth: the importance of placental investigation in medico-legal practice.

    PubMed

    Marchetti, Daniela; Belviso, Maura; Fulcheri, Ezio

    2009-03-01

    The authors present a case of stillbirth in which histologic examination of the placenta provides the opportunity to make a definitive diagnosis of a death due to fetal thrombotic vasculopathy (FTV). Establishing the etiology in cases of stillbirth may avoid medical malpractice litigation. The better knowledge of the cause of stillbirths also helped obstetricians to recognize factors that could have prejudiced future pregnancies.

  10. [Different modalities for registering AIDS cases. Their importance for the European epidemic].

    PubMed

    Cernescu, C; Cajal, N

    1988-01-01

    The high number of AIDS cases diagnosed in different European countries imposed to reconsider the opinion that European epidemic is just reflecting the American epidemic. The whole morbidity des not point out the peculiar elements of HIV infection propagation in Europe. The exponential rise of reported case number during 1987 imposes to analyse the new epidemiological situation.

  11. Three Cases of Adolescent Childbearing Decision-Making: The Importance of Ambivalence

    ERIC Educational Resources Information Center

    Bender, Soley S.

    2008-01-01

    Limited information is available about the childbearing decision-making experience by the pregnant adolescent. The purpose of this case study was to explore this experience with three pregnant teenagers. The study is based on nine qualitative interviews. Within-case descriptions applying the theoretical model of decision-making regarding unwanted…

  12. Is Legionellosis Present and Important in Colombia? An Analyses of Cases from 2009 to 2013

    PubMed Central

    Patiño-Barbosa, Andrés Mauricio; Gil-Restrepo, Andrés Felipe; Restrepo-Montoya, Valentina; Villamil-Gomez, Wilmer E.; Cardona-Ospina, Jaime A.

    2017-01-01

    Infection due to Legionella pneumophila has been not studied in Colombia, although it is present. The observational, retrospective study in which the incidence of legionellosis in Colombia, 2009-2013, was estimated based on data extracted from the personal health records system (Registro Individual de Prestación de Servicios, RIPS) using the ICD-10 codes A48.1 (Legionnaires' disease) and A48.2 (Pontiac Fever). Using official population estimates of the National Administrative Department of Statistics (DANE), crude and adjusted incidence rates were estimated (cases / 100,000 pop). During the period, 206 cases were reported (mean of 41.2 per year) for the cumulated national rate of 0.45 cases / 100,000 pop. The clinical form of legionellosis with the highest incidence rates was the non-pneumonic Legionnaires' disease (0.39 cases / 100,000 pop) with women being the main affected (0.42 cases / 100,000 pop). The territory with the highest incidence rate was Bolivar department (1.94 cases / 100,000 pop), followed by La Guajira (1.7 cases / 100,000 pop). Finally, age groups with the highest morbidity were 0-9.999 years old (1.16 cases / 100,000 pop) and system of identification for social subsidies beneficiaries (SISBEN) category with the highest number of total cases was level one (88 cases). According to these results, we can show that legionellosis in Colombia is more common than it could be thought. Nevertheless, cross-sectional and prospective studies should be conducted in our country in order to improve the knowledge of incidence, prevalence, and burden of disease. PMID:28465870

  13. Characterizing the malaria rural-to-urban transmission interface: The importance of reactive case detection.

    PubMed

    Molina Gómez, Karen; Caicedo, M Alejandra; Gaitán, Alexandra; Herrera-Varela, Manuela; Arce, María Isabel; Vallejo, Andrés F; Padilla, Julio; Chaparro, Pablo; Pacheco, M Andreína; Escalante, Ananias A; Arevalo-Herrera, Myriam; Herrera, Sócrates

    2017-07-01

    Reported urban malaria cases are increasing in Latin America, however, evidence of such trend remains insufficient. Here, we propose an integrated approach that allows characterizing malaria transmission at the rural-to-urban interface by combining epidemiological, entomological, and parasite genotyping methods. A descriptive study that combines active (ACD), passive (PCD), and reactive (RCD) case detection was performed in urban and peri-urban neighborhoods of Quibdó, Colombia. Heads of households were interviewed and epidemiological surveys were conducted to assess malaria prevalence and identify potential risk factors. Sixteen primary cases, eight by ACD and eight by PCD were recruited for RCD. Using the RCD strategy, prevalence of 1% by microscopy (6/604) and 9% by quantitative polymerase chain reaction (qPCR) (52/604) were found. A total of 73 houses and 289 volunteers were screened leading to 41 secondary cases, all of them in peri-urban settings (14% prevalence). Most secondary cases were genetically distinct from primary cases indicating that there were independent occurrences. Plasmodium vivax was the predominant species (76.3%, 71/93), most of them being asymptomatic (46/71). Urban and peri-urban neighborhoods had significant sociodemographic differences. Twenty-four potential breeding sites were identified, all in peri-urban areas. The predominant vectors for 1,305 adults were Anopheles nuneztovari (56,2%) and An. Darlingi (42,5%). One An. nuneztovari specimen was confirmed naturally infected with P. falciparum by ELISA. This study found no evidence supporting the existence of urban malaria transmission in Quibdó. RCD strategy was more efficient for identifying malaria cases than ACD alone in areas where malaria transmission is variable and unstable. Incorporating parasite genotyping allows discovering hidden patterns of malaria transmission that cannot be detected otherwise. We propose to use the term "focal case" for those primary cases that lead to

  14. Revisiting the Importance of Knowledge: From Namibia, a Case for Promoting Knowledge by Campaigns to Reduce Stigma

    ERIC Educational Resources Information Center

    Chung, Adrienne H.; Rimal, Rajiv N.

    2015-01-01

    Reducing stigma against people living with HIV is key to encouraging HIV testing, which in turn is an important component in the treatment-as-prevention approach. We analyzed nationally representative survey data of participants aged 15 years and older in Namibia (N = 4,300) to determine whether knowledge about HIV and self-efficacy to protect…

  15. Revisiting the Importance of Knowledge: From Namibia, a Case for Promoting Knowledge by Campaigns to Reduce Stigma

    ERIC Educational Resources Information Center

    Chung, Adrienne H.; Rimal, Rajiv N.

    2015-01-01

    Reducing stigma against people living with HIV is key to encouraging HIV testing, which in turn is an important component in the treatment-as-prevention approach. We analyzed nationally representative survey data of participants aged 15 years and older in Namibia (N = 4,300) to determine whether knowledge about HIV and self-efficacy to protect…

  16. Understanding the Importance of Shape in Thermal Modeling: The Case of 1627 Ivar

    NASA Astrophysics Data System (ADS)

    Crowell, Jenna L.; Howell, Ellen S.; Magri, Christopher; Fernandez, Yanga R.; Nolan, Michael C.; Vervack, Ronald J., Jr.; Marshall, Sean E.

    2016-10-01

    We seek to investigate the compositional surface variation of near Earth asteroids (NEAs). To do this, we employ detailed shape models and near-IR observations, taken over a range of viewing geometries, in order to create thermophysical models. The thermal spectra are therefore linked to regions on the asteroid, and we can seek out a set of thermal parameters that are capable of reproducing the thermal spectra over the entirety of the asteroid's surface. This method also enables us to characterize portions of the asteroid that may have different thermal properties than other regions, in which case there is no single set of thermal parameters that satisfy all of the thermal observations, indicating a heterogeneous surface.We present our findings on 1627 Ivar, an Amor class NEA with a taxonomic type of Sqw [1], and a rotation period of 4.7951689 hr ± 0.0000026 [2]. During Ivar's apparition in 2013, we obtained CCD lightcurves, radar data, and near-IR spectra. Using the software SHAPE, we have used lightcurve and radar data to generate an improved shape model of Ivar [2][3].For the thermophysical modeling, we have used SHERMAN [3,4] to determine which reflective, thermal, and surface properties for Ivar best reproduce our spectra, taken using the SpeX instrument at the NASA IRTF [5]. Input parameters for SHERMAN include the asteroid's IR emissivity, optical scattering law and thermal inertia in order to complete thermal computations based on the shape model. We also compare these results to those created by using the Kaasalainen lightcurve model [6]. Since models created from lightcurve inversion techniques far outnumber those created using radar data, it is important to understand how these two models differ when studying thermal models.References: [1] DeMeo et al. 2009, Icarus 202, 160-180 [2] Crowell et al. 2016, Icarus, in press [3] Crowell et al. 2014, AAS/DPS 46 [4] Howell et al. 2015, AAS/DPS 47 [5] Rayner et al. 2003, PASP 115, 362 [6] Kaasalainen et al. 2004

  17. De novo mutations from sporadic schizophrenia cases highlight important signaling genes in an independent sample.

    PubMed

    Kranz, Thorsten M; Harroch, Sheila; Manor, Orly; Lichtenberg, Pesach; Friedlander, Yechiel; Seandel, Marco; Harkavy-Friedman, Jill; Walsh-Messinger, Julie; Dolgalev, Igor; Heguy, Adriana; Chao, Moses V; Malaspina, Dolores

    2015-08-01

    Schizophrenia is a debilitating syndrome with high heritability. Genomic studies reveal more than a hundred genetic variants, largely nonspecific and of small effect size, and not accounting for its high heritability. De novo mutations are one mechanism whereby disease related alleles may be introduced into the population, although these have not been leveraged to explore the disease in general samples. This paper describes a framework to find high impact genes for schizophrenia. This study consists of two different datasets. First, whole exome sequencing was conducted to identify disruptive de novo mutations in 14 complete parent-offspring trios with sporadic schizophrenia from Jerusalem, which identified 5 sporadic cases with de novo gene mutations in 5 different genes (PTPRG, TGM5, SLC39A13, BTK, CDKN3). Next, targeted exome capture of these genes was conducted in 48 well-characterized, unrelated, ethnically diverse schizophrenia cases, recruited and characterized by the same research team in New York (NY sample), which demonstrated extremely rare and potentially damaging variants in three of the five genes (MAF<0.01) in 12/48 cases (25%); including PTPRG (5 cases), SCL39A13 (4 cases) and TGM5 (4 cases), a higher number than usually identified by whole exome sequencing. Cases differed in cognition and illness features based on which mutation-enriched gene they carried. Functional de novo mutations in protein-interaction domains in sporadic schizophrenia can illuminate risk genes that increase the propensity to develop schizophrenia across ethnicities.

  18. Attributional Change and the Importance of Baseline Recording. A Case Illustration

    ERIC Educational Resources Information Center

    Michie, Lucile E.; And Others

    1976-01-01

    The case study of a 12-year-old girl referred for severe behavioral problems illustrated how attention to baseline measures prevented premature conclusions regarding the impact of a conditioning procedure upon aggresive, acting-out behavior. (Author/SBH)

  19. [Diagnosis and treatment for three imported Plasmodium malariae malaria cases in Henan Province].

    PubMed

    Deng, Yan; Zhou, Rui-Min; Zhang, Hong-Wei; Qian, Dan; Liu, Ying; Chen, Wei-Qi; Zhao, Xu-Dong

    2014-02-01

    Giemsa-stained blood film microscopy, CareStart rapid detection and PCR were used to detect the three cases who returned from Angola and Equatorial Guinea to Henan Province. Onset of malaria symptoms for two patients occurred 15 d and 27 d after their return from Angola, respectively. Two months after returning home, another case relapsed who had suffered from malaria in Equatorial Guinea. All three patients had the symptoms such as irregular fever, headache, chills and so on. Two cases had elevated total bilirubin and splenomegaly. The cases were confirmed as P. malariae infection by microscopic morphological examination. Amplified bands were produced by 18S rRNA nested PCR, which was the same with P. malariae in size, whereas the results of CareStart repaid detection test were all negative. They were cured by using artemisinin-based combination therapy (ACT).

  20. Trends in Dengue Cases Imported into the United States from Pan America 2001–2012

    PubMed Central

    van Dodewaard, Caitlin A.M.; Richards, Stephanie L.

    2015-01-01

    The objective of this study was to improve risk assessments of travel on dengue (DEN) virus (DENV) distribution. We investigated the exposure risk of US citizens traveling to DEN-endemic Pan American countries. The number of DEN cases reported in 51 Pan American countries from 2001 to 2012 was compared to the population of the same countries. The number of US travelers visiting the Pan American countries was categorized by region, and travel-related DEN infections were analyzed. US residents visiting the Dominican Republic exhibited the highest traveler-related DEN incidence. Brazil showed the most DEN cases in its residents (>1 million reported cases in 2010). The number of DEN cases continues to rise as does international travel and the geographic range of potential DENV vectors. DENV risk assessments may be improved by analyzing the possible routes of entry. Underreporting remains an issue for calculating DENV transmission risk by country and region. PMID:26766913

  1. End-of-Life Care Decisions: Importance of Reviewing Systems and Limitations After 2 Recent North American Cases

    PubMed Central

    Burkle, Christopher M.; Benson, Jeffre J.

    2012-01-01

    Two recent and unfortunate North American cases involving end-of-life treatment highlight the difficulties surrounding medical futility conflicts. As countries have explored the greater influence that patients and their representatives may play on end-of-life treatment decisions, the benefits and struggles involved with such a movement must be appreciated. These 2 cases are used to examine the present systems existing in the United States and Canada for resolving end-of-life decisions, including the difficulty in defining medical futility, the role of medical ethics committees, and controversies involving surrogate decision making. PMID:23127734

  2. Imported and autochthonous leprosy presenting in Madrid (1989-2015): A case series and review of the literature.

    PubMed

    Norman, Francesca F; Fanciulli, Chiara; Pérez-Molina, José-Antonio; Monge-Maillo, Begoña; López-Vélez, Rogelio

    2016-01-01

    Leprosy remains infrequent in non-endemic areas. The objective of this study was to describe the cases of leprosy reviewed at a referral unit for imported diseases in Europe and to compare these findings with published data on imported leprosy. Cases of leprosy evaluated at a referral centre are described and salient features of autochthonous and imported cases are compared. A review of the literature on imported leprosy was performed. During the study period, 25 patients with leprosy were followed-up (10 were autochthonous cases and 15 were considered to be imported). Regarding imported cases, the majority were diagnosed in Latin American immigrants (10/15, 67%), mean age was 42 years, there were no differences in gender distribution, estimated average time from arrival in Spain to first visit at the unit was 3 years and from symptom onset to diagnosis was 2 years. Over 80% of imported cases had multibacillary disease and over one third of patients had been previously diagnosed with leprosy. One third had received alternate incorrect diagnoses initially, <50% of patients with imported leprosy completed standard therapy and were considered cured and over one third were lost to follow-up. Leprosy remains a complex disease for healthcare professionals unfamiliar with this infection. Manifestations are polymorphic so misdiagnoses and consequent delays in diagnosis are not infrequent and may lead to resulting disabilities. Early diagnosis and management are essential to prevent sequelae and possible transmission. Improving access to health care, especially for vulnerable groups, would be necessary to advance in the control of this disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Characterizing the malaria rural-to-urban transmission interface: The importance of reactive case detection

    PubMed Central

    Molina Gómez, Karen; Caicedo, M. Alejandra; Gaitán, Alexandra; Herrera-Varela, Manuela; Arce, María Isabel; Vallejo, Andrés F.; Padilla, Julio; Chaparro, Pablo; Pacheco, M. Andreína; Escalante, Ananias A.; Arevalo-Herrera, Myriam

    2017-01-01

    Background Reported urban malaria cases are increasing in Latin America, however, evidence of such trend remains insufficient. Here, we propose an integrated approach that allows characterizing malaria transmission at the rural-to-urban interface by combining epidemiological, entomological, and parasite genotyping methods. Methods/Principal findings A descriptive study that combines active (ACD), passive (PCD), and reactive (RCD) case detection was performed in urban and peri-urban neighborhoods of Quibdó, Colombia. Heads of households were interviewed and epidemiological surveys were conducted to assess malaria prevalence and identify potential risk factors. Sixteen primary cases, eight by ACD and eight by PCD were recruited for RCD. Using the RCD strategy, prevalence of 1% by microscopy (6/604) and 9% by quantitative polymerase chain reaction (qPCR) (52/604) were found. A total of 73 houses and 289 volunteers were screened leading to 41 secondary cases, all of them in peri-urban settings (14% prevalence). Most secondary cases were genetically distinct from primary cases indicating that there were independent occurrences. Plasmodium vivax was the predominant species (76.3%, 71/93), most of them being asymptomatic (46/71). Urban and peri-urban neighborhoods had significant sociodemographic differences. Twenty-four potential breeding sites were identified, all in peri-urban areas. The predominant vectors for 1,305 adults were Anopheles nuneztovari (56,2%) and An. Darlingi (42,5%). One An. nuneztovari specimen was confirmed naturally infected with P. falciparum by ELISA. Conclusions This study found no evidence supporting the existence of urban malaria transmission in Quibdó. RCD strategy was more efficient for identifying malaria cases than ACD alone in areas where malaria transmission is variable and unstable. Incorporating parasite genotyping allows discovering hidden patterns of malaria transmission that cannot be detected otherwise. We propose to use the term

  4. When is connectivity important? A case study of the spatial pattern of sudden oak death

    Treesearch

    A. Ellis; T. Vaclavik; R.K. Meentemeyer

    2010-01-01

    Although connectivity has been examined from many different angles and in many ecological disciplines, few studies have tested in which systems and under what conditions connectivity is important in determining ecological dynamics. Identifying general rules governing when connectivity is important is crucial not only for basic ecology, but also for our ability to...

  5. Communicating natural hazards. The case of marine extreme events and the importance of the forecast's errors.

    NASA Astrophysics Data System (ADS)

    Marone, Eduardo; Camargo, Ricardo

    2013-04-01

    possible to produce short and long term forecasts. While the statistic of extremes is useful for many stakeholders, short term forecasts could be of importance for the whole society. Whatever the case, the prediction errors have to be emphasizes even more than the forecasts. The most common forecast in terms of general public understanding is the weather prediction. Nowadays, general public knows it well enough to properly deal with the uncertainties, because after so many year of not perfect forecasts, society knows the limits. Other coastal hazards deserve to be presented more carefully, and some successful example of the use of the precautionary principle could be observed, for instance, on the Pacific Tsunami alert system. Nowadays, the preparedness of the coastal population is good enough (even in such big and diverse area) not to be bored to run up the hill, most of the times unnecessarily, because they know the uncertainty and accept it. The key issue we, scientists, have to work better at any level, is the need of properly estimate and communicate the uncertainties of our results, cause they are not obvious nor irrelevant.

  6. Representing vision and blindness.

    PubMed

    Ray, Patrick L; Cox, Alexander P; Jensen, Mark; Allen, Travis; Duncan, William; Diehl, Alexander D

    2016-01-01

    There have been relatively few attempts to represent vision or blindness ontologically. This is unsurprising as the related phenomena of sight and blindness are difficult to represent ontologically for a variety of reasons. Blindness has escaped ontological capture at least in part because: blindness or the employment of the term 'blindness' seems to vary from context to context, blindness can present in a myriad of types and degrees, and there is no precedent for representing complex phenomena such as blindness. We explore current attempts to represent vision or blindness, and show how these attempts fail at representing subtypes of blindness (viz., color blindness, flash blindness, and inattentional blindness). We examine the results found through a review of current attempts and identify where they have failed. By analyzing our test cases of different types of blindness along with the strengths and weaknesses of previous attempts, we have identified the general features of blindness and vision. We propose an ontological solution to represent vision and blindness, which capitalizes on resources afforded to one who utilizes the Basic Formal Ontology as an upper-level ontology. The solution we propose here involves specifying the trigger conditions of a disposition as well as the processes that realize that disposition. Once these are specified we can characterize vision as a function that is realized by certain (in this case) biological processes under a range of triggering conditions. When the range of conditions under which the processes can be realized are reduced beyond a certain threshold, we are able to say that blindness is present. We characterize vision as a function that is realized as a seeing process and blindness as a reduction in the conditions under which the sight function is realized. This solution is desirable because it leverages current features of a major upper-level ontology, accurately captures the phenomenon of blindness, and can be

  7. Human dirofilariasis in the eyelid caused by Dirofilaria repens: An imported case.

    PubMed

    Rodríguez-Calzadilla, M; Ruíz-Benítez, M W; de-Francisco-Ramírez, J L; Redondo-Campos, A R; Fernández-Repeto-Nuche, E; Gárate, T; Morchón, R

    2017-09-01

    The case concerns a 33-year-old Ukrainian woman, who came to the Ophthalmology Emergency Service, stating that she had a «worm» under the skin of her upper left eyelid that wriggled at night and bit her. A complete examination revealed a subcutaneous foreign body, which showed a filarial appearance and seemed to crawl under the skin. It was surgically removed to discover a live parasite, PCR-identified as Dirofilaria repens. Humans are accidental hosts in the cycle of Dirofilaria. There are only 8 reported cases of subcutaneous infection in Spain. Due to global warming, D. repens has become an emerging infectious agent in Central Europe countries such as Ukraine. The findings in this case are discussed. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Epidemiologic import of tuberculosis cases whose isolates have similar but not identical IS6110 restriction fragment length polymorphism patterns.

    PubMed

    Cave, M D; Yang, Z H; Stefanova, R; Fomukong, N; Ijaz, K; Bates, J; Eisenach, K D

    2005-03-01

    Isolates of Mycobacterium tuberculosis from patients with epidemiologic links frequently demonstrate identical IS6110 restriction fragment length polymorphism (RFLP) patterns (i.e., RFLP clustering) because they are infected with the same strain. Uncertainty arises with isolates that differ from one another by a few IS6110 hybridizing bands. During the period from 1 January 1996 to 31 December 1999, isolates from 585 tuberculosis (TB) cases were analyzed by RFLP, representing 98.2% of the 596 culture-positive TB cases reported in Arkansas during the study period. Of the 585 cases for which RFLP was available, 419 (71.6%) had an RFLP pattern with more than five copies of IS6110. Of the total 74 clusters, 48 comprised isolates with more than five copies of IS6110 and included 164 cases. Sixty-nine isolates with more than five copies of IS6110 comprising 16 clusters and 60 unique isolates were found to be similar to at least 1 other isolate (differing from it by one or two hybridizing bands). Among the 129 cases whose isolates were similar to other clustered or unique isolates, 16 cases were discovered with epidemiologic links: 14 (15.2%) were among the 92 cases with IS6110 RFLP patterns similar to those in clusters, and 2 (5.2%) were among the 37 unique cases that were similar to another unique case. The isolates from the epidemiologically linked patients shared common spoligotypes; all except one case shared common polymorphic GC-rich sequence (PGRS) patterns. Of the 129 patients whose isolates differed from another by one or two hybridizing IS6110 bands, 101 (78.3%) shared common spoligotypes and 87 (67.4%) shared common PGRS RFLP patterns.

  9. Environmental representative program

    SciTech Connect

    McLeod, B.P.

    1984-05-01

    As new pollution regulations are created and existing regulations are made more complex, it is becoming more important for plant personnel to have a knowlege of the environment. The Environmental Representative Program is designed to train plant personnel and is aimed at preventing fines, citations, and negative publicity. The goal of the program is on-going daily compliance assurance, and is divided into two segments: 1) program initiation (general considerations, representative selection, and authorization by management); and 2) program implementation (requirements training, responsibilities development, incorporation into annual goals, and program maintenance). A discussion of how each part of the program is accomplished is presented.

  10. Risk-based testing of imported animals: A case study for bovine tuberculosis in The Netherlands.

    PubMed

    de Vos, Clazien J; van der Goot, Jeanet A; van Zijderveld, Fred G; Swanenburg, Manon; Elbers, Armin R W

    2015-09-01

    In intra-EU trade, the health status of animals is warranted by issuing a health certificate after clinical inspection in the exporting country. This certificate cannot provide guarantee of absence of infection, especially not for diseases with a long incubation period and no overt clinical signs such as bovine tuberculosis (bTB). The Netherlands are officially free from bTB since 1999. However, frequent reintroductions occurred in the past 15 years through importation of infected cattle. Additional testing (AT) of imported cattle could enhance the probability of detecting an imported bTB infection in an early stage. The goal of this study was to evaluate the effectiveness of risk-based AT for bTB in cattle imported into The Netherlands. A generic stochastic import risk model was developed that simulates introduction of infection into an importing country through importation of live animals. Main output parameters are the number of infected animals that is imported (Ninf), the number of infected animals that is detected by testing (Ndet), and the economic losses incurred by importing infected animals (loss). The model was parameterized for bTB. Model calculations were optimized to either maximize Ndet or to minimize loss. Model results indicate that the risk of bTB introduction into The Netherlands is very high. For the current situation in which Dutch health checks on imported cattle are limited to a clinical inspection of a random sample of 5-10% of imported animals, the calculated annual Ninf=99 (median value). Random AT of 8% of all imported cattle results in Ndet=7 (median value), while the median Ndet=75 if the sampling strategy for AT is optimized to maximize Ndet. However, in the latter scenario, loss is more than twice as large as in the current situation, because only calves are tested for which cost of detection is higher than the expected gain of preventing a possible outbreak. When optimizing the sampling strategy for AT to minimize loss, only breeding

  11. The importance of scientific evaluation of biological evidence--data from eight years of case review.

    PubMed

    Coyle, Heather Miller

    2012-12-01

    In 2009, the National Research Council published a report stating that the addition of more science and technology into the field of forensic science in the United States would be of great benefit to the judicial system. As a starting point to address this NRC report, one needs to make an assessment of the system. One factor that is continuously requested is an estimate of an error rate. In any given scientific area of forensics that is difficult to quantitate except by external review and audits. After eight years of requested defense review of cases with biological and DNA evidence, most cases appear to be scientifically sound in test methods and procedures. However, there were some cases where errors in the forensic science process did occur. This article takes information compiled from those eight years of defense review and summarizes the cases where errors have been discovered and discusses the scientific implications of these errors. The scope of this article is limited to crime scene collection and forensic science laboratory testing of biological materials for body fluid identification and DNA individualization to a source. The greatest value of defense review comes from (a) providing effective balance and independent oversight to the judicial process and (b) collecting data into a format that can be useful as a guide in training programs.

  12. Academic Literacy: The Importance and Impact of Writing across the Curriculum--A Case Study

    ERIC Educational Resources Information Center

    Defazio, Joseph; Jones, Josette; Tennant, Felisa; Hook, Sara Anne

    2010-01-01

    The paper provides case studies of how four faculty members who teach in undergraduate and graduate programs at the Indiana University School of Informatics promote academic literacy throughout the curriculum. The paper describes the writing assignments in several courses, the objectives of these assignments in enhancing the writing skills of…

  13. The Importance of Identity in Policy: The Case for and of Children

    ERIC Educational Resources Information Center

    McDonald, Catherine

    2009-01-01

    This article draws out one of the core reasons why children should be conceived as active agents in research, particularly policy-related research. The main thesis is that policy inevitably projects and, to an extent, constitutes the subject identities of its intended objects--in this case, that of "children". Drawing on several bodies of…

  14. [Bronchogenic cysts. Importance of infection in adults. Study of 12 cases].

    PubMed

    Hernández-Solís, Alejandro; Cruz-Ortiz, Humberto; Gutiérrez-Díaz Ceballos, María Esther; Cicero-Sabido, Raúl

    2015-01-01

    Bronchogenic cyst is a rare congenital malformation and commonly located in the mediastinum and lung parenchyma. To determine the clinical characteristics of the patients with diagnosis of bronchogenic cysts, their location and the infectious bacteria when the cysts are infected. The cases were collected from 1 January 2005 to 1 January 2013, in a third level hospital. The cases with bronchogenic cysts resected by thoracotomy were confirmed by histological study. Age, sex, admission diagnosis, location, size, imagenologic studies, and bacteriological cultures were evaluated. Of the 12 cases with diagnosis of bronchogenic cysts surgically resected by thoracotomy, six were male and six female, with 50% located in lung parenchyma and 50% in mediastinum, one of the latter was para-oesophageal. Bacteriological study of the cystic content demonstrated bacterial infection in seven (58%) cases. Bronchogenic cysts are rare congenital benign lesions. They must be resected because their content might be infected. The histopathology study is necessary to confirm the diagnosis, together with bacteriological examination. Thoracotomy is a safe procedure to resect bronchogenic cysts. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  15. The Importance of Emotional Insight in Cognitive Behaviour Therapy for Anorexia Nervosa: An Adolescent Case Study

    ERIC Educational Resources Information Center

    Rupa, Megha; Girimaji, Satish; Muthuswamy, Selvi; Jacob, Preeti; Ravi, Malavika

    2013-01-01

    Anorexia nervosa is a rare but sever psychiatric disorder in adolescence, with chronicity and death being the most feared consequence. Emotional Insight into one's problem is considered a key determinant of success in therapy. The following case study of a 14-year-old client, describes the process of therapy as it unfolded across 45 sessions. An…

  16. Management and Training across Cultures: Importance of Non-Verbal Communication Strategies--A Case Study.

    ERIC Educational Resources Information Center

    Potoker, Elaine

    Noting that cross-cultural and language barriers pose formidable challenges to managers, a case study examined the application of selective nonverbal communication strategies (nonverbal cues, learning by observation, and the organization of learning) for management and training development efforts within diverse cultural environments. Source…

  17. Uric acid, an important screening tool to detect inborn errors of metabolism: a case series.

    PubMed

    Jasinge, Eresha; Kularatnam, Grace Angeline Malarnangai; Dilanthi, Hewa Warawitage; Vidanapathirana, Dinesha Maduri; Jayasena, Kandana Liyanage Subhashinie Priyadarshika Kapilani Menike; Chandrasiri, Nambage Dona Priyani Dhammika; Indika, Neluwa Liyanage Ruwan; Ratnayake, Pyara Dilani; Gunasekara, Vindya Nandani; Fairbanks, Lynette Dianne; Stiburkova, Blanka

    2017-09-06

    Uric acid is the metabolic end product of purine metabolism in humans. Altered serum and urine uric acid level (both above and below the reference ranges) is an indispensable marker in detecting rare inborn errors of metabolism. We describe different case scenarios of 4 Sri Lankan patients related to abnormal uric acid levels in blood and urine. CASE 1: A one-and-half-year-old boy was investigated for haematuria and a calculus in the bladder. Xanthine crystals were seen in microscopic examination of urine sediment. Low uric acid concentrations in serum and low urinary fractional excretion of uric acid associated with high urinary excretion of xanthine and hypoxanthine were compatible with xanthine oxidase deficiency. CASE 2: An 8-month-old boy presented with intractable seizures, feeding difficulties, screaming episodes, microcephaly, facial dysmorphism and severe neuro developmental delay. Low uric acid level in serum, low fractional excretion of uric acid and radiological findings were consistent with possible molybdenum cofactor deficiency. Diagnosis was confirmed by elevated levels of xanthine, hypoxanthine and sulfocysteine levels in urine. CASE 3: A 3-year-10-month-old boy presented with global developmental delay, failure to thrive, dystonia and self-destructive behaviour. High uric acid levels in serum, increased fractional excretion of uric acid and absent hypoxanthine-guanine phosphoribosyltransferase enzyme level confirmed the diagnosis of Lesch-Nyhan syndrome. CASE 4: A 9-year-old boy was investigated for lower abdominal pain, gross haematuria and right renal calculus. Low uric acid level in serum and increased fractional excretion of uric acid pointed towards hereditary renal hypouricaemia which was confirmed by genetic studies. Abnormal uric acid level in blood and urine is a valuable tool in screening for clinical conditions related to derangement of the nucleic acid metabolic pathway.

  18. A threshold analysis of dengue transmission in terms of weather variables and imported dengue cases in Australia

    PubMed Central

    Huang, Xiaodong; Clements, Archie CA; Williams, Gail; Milinovich, Gabriel; Hu, Wenbiao

    2013-01-01

    Dengue virus (DENV) transmission in Australia is driven by weather factors and imported dengue fever (DF) cases. However, uncertainty remains regarding the threshold effects of high-order interactions among weather factors and imported DF cases and the impact of these factors on autochthonous DF. A time-series regression tree model was used to assess the threshold effects of natural temporal variations of weekly weather factors and weekly imported DF cases in relation to incidence of weekly autochthonous DF from 1 January 2000 to 31 December 2009 in Townsville and Cairns, Australia. In Cairns, mean weekly autochthonous DF incidence increased 16.3-fold when the 3-week lagged moving average maximum temperature was <32 °C, the 4-week lagged moving average minimum temperature was ≥24 °C and the sum of imported DF cases in the previous 2 weeks was >0. When the 3-week lagged moving average maximum temperature was ≥32 °C and the other two conditions mentioned above remained the same, mean weekly autochthonous DF incidence only increased 4.6-fold. In Townsville, the mean weekly incidence of autochthonous DF increased 10-fold when 3-week lagged moving average rainfall was ≥27 mm, but it only increased 1.8-fold when rainfall was <27 mm during January to June. Thus, we found different responses of autochthonous DF incidence to weather factors and imported DF cases in Townsville and Cairns. Imported DF cases may also trigger and enhance local outbreaks under favorable climate conditions. PMID:26038449

  19. Evaluating the Importance of Image-related Text for Ad-hoc and Case-based Biomedical Article Retrieval.

    PubMed

    Simpson, Matthew S; Demner-Fushman, Dina; Thoma, George R

    2010-11-13

    Images and their associated text are an essential source of information in biomedical articles. However, their use in providing evidence for clinical case descriptions has yet to be evaluated in the context of information retrieval. Given the complexity of case-based document retrieval, understanding the importance of images and image-related text is critical for future research into text- and content-based approaches to this problem. In this study, we compare the extent to which image-related text is useful in facilitating document retrieval for both case-based information requests and ad-hoc clinical questions in the domain of family practice. We show that case-based document retrieval is significantly improved with the use of image-related text whereas retrieval for clinical questions is largely unaffected. This suggests that visual evidence is more relevant for the case descriptions used in our study than the clinical questions.

  20. The Quantification of Representative Sequences pipeline for amplicon sequencing: case study on within-population ITS1 sequence variation in a microparasite infecting Daphnia.

    PubMed

    González-Tortuero, E; Rusek, J; Petrusek, A; Gießler, S; Lyras, D; Grath, S; Castro-Monzón, F; Wolinska, J

    2015-11-01

    Next generation sequencing (NGS) platforms are replacing traditional molecular biology protocols like cloning and Sanger sequencing. However, accuracy of NGS platforms has rarely been measured when quantifying relative frequencies of genotypes or taxa within populations. Here we developed a new bioinformatic pipeline (QRS) that pools similar sequence variants and estimates their frequencies in NGS data sets from populations or communities. We tested whether the estimated frequency of representative sequences, generated by 454 amplicon sequencing, differs significantly from that obtained by Sanger sequencing of cloned PCR products. This was performed by analysing sequence variation of the highly variable first internal transcribed spacer (ITS1) of the ichthyosporean Caullerya mesnili, a microparasite of cladocerans of the genus Daphnia. This analysis also serves as a case example of the usage of this pipeline to study within-population variation. Additionally, a public Illumina data set was used to validate the pipeline on community-level data. Overall, there was a good correspondence in absolute frequencies of C. mesnili ITS1 sequences obtained from Sanger and 454 platforms. Furthermore, analyses of molecular variance (amova) revealed that population structure of C. mesnili differs across lakes and years independently of the sequencing platform. Our results support not only the usefulness of amplicon sequencing data for studies of within-population structure but also the successful application of the QRS pipeline on Illumina-generated data. The QRS pipeline is freely available together with its documentation under GNU Public Licence version 3 at http://code.google.com/p/quantification-representative-sequences.

  1. Diagnosis of imported Ugandan typhoid fever based on local outbreak information: A case report.

    PubMed

    Ota, Shinichiro; Maki, Yohei; Mori, Kazuma; Hamamoto, Takaaki; Kurokawa, Atsushi; Ishihara, Masashi; Yamamoto, Takayuki; Imai, Kazuo; Misawa, Kazuhisa; Yuki, Atsushi; Fujikura, Yuji; Maeda, Takuya; Kawana, Akihiko

    2016-11-01

    Re-emerging multidrug-resistant typhoid fever is becoming a worldwide threat, especially in East Africa. At the beginning of 2015, an outbreak of typhoid fever started in the capital city of Uganda, and 1940 suspected cases were reported by 5 March 2015. In this report, we describe a case of typhoid fever caused by a MDR strain with HIV infection and hemoglobin S-syndrome thalassemia in an Ugandan from Kampala City. It is essential to consider MDR strains of Salmonella enterica serovar Typhi infections, including fluoroquinolone-resistant strains, in patients from Africa and Southeast Asia. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  2. An imported case of acute pulmonary coccidioidomycosis in an Italian traveller.

    PubMed

    Corpolongo, A; Giancola, M L; Ghirga, P; Oliva, A; Mencarini, P; Pane, S; Bellagamba, R; Tommasi, C; Antinori, A; Nicastri, E

    2014-10-01

    Coccidioidomycosis is a fungal infection caused by the Coccidioides species, which is endemic in the deserts of the southwestern region of the United States, northern Mexico, and in some areas of Central and South America. We describe a case of pulmonary coccidioidomycosis in a 49-year-old Italian man who came to our hospital with fever and joint and muscle pain 10 days after his return to Italy from Venezuela. Computer Tomography revealed multiple bilateral pulmonary nodules with mediastinal lymphadenopathy. Pulmonary coccidioidomycosis was diagnosed by a serological test, and fluconazole was immediately started. The patient improved within 2 weeks, with complete clinical recovery after 6 months of therapy. This case appears to be part of a large serologically unconfirmed outbreak. In order to provide early diagnosis and treatment, healthcare providers should be aware of coccidioidomycosis, even in travellers returning home from short trips to endemic areas.

  3. The importance of thorough preoperative diagnostics of maxillary ameloblastoma: report of three cases.

    PubMed

    Matijević, Marko; Leović, Dinko; Popić, Bruno; Zubcić, Vedran; Kopić, Vlatko; Prlić, Ante; Siber, Stjepan; Dinjar, Kristijan

    2010-12-01

    Ameloblastoma, especially maxillary, is a rare benign neoplasm of odontogenic origin. Diagnosis of significant number of lesions is usually established postoperatively, because ameloblastoma, especially the unicystic form, mimics wide range of more frequent jaw lesions. From January 1993 to December 2005, three cases of the maxillary ameloblastoma were surgically treated at our Department. The authors present clinical, radiological and pathohistological features of the ameloblastomas in this rare localization with special attention to need of accurate preoperative diagnostics.

  4. The importance of a coordinated restorative and maintenance program following periodontal therapy: a case report.

    PubMed

    Wolffe, G N; Spanauf, A J; Renggli, H H

    1991-04-01

    The problems arising during the maintenance phase of therapy following a combination of periodontal, orthodontic, and restorative treatment are illustrated by this case report. Emphasis is placed on the combined responsibility of the patient, general dental practitioner, and periodontist to recognize signs of recurrent disease at an early stage, thereby allowing corrective measures to be initiated promptly. By applying these principles, even when disease recurs during the maintenance phase, re-treatment is possible and a satisfactory result can be achieved.

  5. Is dilution important: Factitious Total Creatine Kinase in case of Rhabdomyolysis?

    PubMed Central

    Dinakaran, Asha; Ray, Lopamudra

    2016-01-01

    Factitious test reports may result in incorrect diagnosis and incorrect management. Such incorrect diagnosis can be prevented by a vigilant biochemist. We report a case of Rhabdomyolysis presenting with extremely low total Creatine Kinase (CK) levels which was factitious. Running the sample in dilution resulted in a very high value of total CK which could have been missed if the sample was not run in dilution and the diagnosis of Rhabdomyolysis could have been missed. PMID:27891332

  6. Is dilution important: Factitious Total Creatine Kinase in case of Rhabdomyolysis?

    PubMed

    Nanda, Sunil Kumar; Dinakaran, Asha; Ray, Lopamudra

    2016-10-01

    Factitious test reports may result in incorrect diagnosis and incorrect management. Such incorrect diagnosis can be prevented by a vigilant biochemist. We report a case of Rhabdomyolysis presenting with extremely low total Creatine Kinase (CK) levels which was factitious. Running the sample in dilution resulted in a very high value of total CK which could have been missed if the sample was not run in dilution and the diagnosis of Rhabdomyolysis could have been missed.

  7. The interplay of climate, intervention and imported cases as determinants of the 2014 dengue outbreak in Guangzhou.

    PubMed

    Cheng, Qu; Jing, Qinlong; Spear, Robert C; Marshall, John M; Yang, Zhicong; Gong, Peng

    2017-06-01

    Dengue is a fast spreading mosquito-borne disease that affects more than half of the population worldwide. An unprecedented outbreak happened in Guangzhou, China in 2014, which contributed 52 percent of all dengue cases that occurred in mainland China between 1990 and 2015. Our previous analysis, based on a deterministic model, concluded that the early timing of the first imported case that triggered local transmission and the excessive rainfall thereafter were the most important determinants of the large final epidemic size in 2014. However, the deterministic model did not allow us to explore the driving force of the early local transmission. Here, we expand the model to include stochastic elements and calculate the successful invasion rate of cases that entered Guangzhou at different times under different climate and intervention scenarios. The conclusion is that the higher number of imported cases in May and June was responsible for the early outbreak instead of climate. Although the excessive rainfall in 2014 did increase the success rate, this effect was offset by the low initial water level caused by interventions in late 2013. The success rate is strongly dependent on mosquito abundance during the recovery period of the imported case, since the first step of a successful invasion is infecting at least one local mosquito. The average final epidemic size of successful invasion decreases exponentially with introduction time, which means if an imported case in early summer initiates the infection process, the final number infected can be extremely large. Therefore, dengue outbreaks occurring in Thailand, Singapore, Malaysia and Vietnam in early summer merit greater attention, since the travel volumes between Guangzhou and these countries are large. As the climate changes, destroying mosquito breeding sites in Guangzhou can mitigate the detrimental effects of the probable increase in rainfall in spring and summer.

  8. The interplay of climate, intervention and imported cases as determinants of the 2014 dengue outbreak in Guangzhou

    PubMed Central

    Spear, Robert C.; Marshall, John M.; Yang, Zhicong

    2017-01-01

    Dengue is a fast spreading mosquito-borne disease that affects more than half of the population worldwide. An unprecedented outbreak happened in Guangzhou, China in 2014, which contributed 52 percent of all dengue cases that occurred in mainland China between 1990 and 2015. Our previous analysis, based on a deterministic model, concluded that the early timing of the first imported case that triggered local transmission and the excessive rainfall thereafter were the most important determinants of the large final epidemic size in 2014. However, the deterministic model did not allow us to explore the driving force of the early local transmission. Here, we expand the model to include stochastic elements and calculate the successful invasion rate of cases that entered Guangzhou at different times under different climate and intervention scenarios. The conclusion is that the higher number of imported cases in May and June was responsible for the early outbreak instead of climate. Although the excessive rainfall in 2014 did increase the success rate, this effect was offset by the low initial water level caused by interventions in late 2013. The success rate is strongly dependent on mosquito abundance during the recovery period of the imported case, since the first step of a successful invasion is infecting at least one local mosquito. The average final epidemic size of successful invasion decreases exponentially with introduction time, which means if an imported case in early summer initiates the infection process, the final number infected can be extremely large. Therefore, dengue outbreaks occurring in Thailand, Singapore, Malaysia and Vietnam in early summer merit greater attention, since the travel volumes between Guangzhou and these countries are large. As the climate changes, destroying mosquito breeding sites in Guangzhou can mitigate the detrimental effects of the probable increase in rainfall in spring and summer. PMID:28640895

  9. Importance of Accurate Measurements in Nutrition Research: Dietary Flavonoids as a Case Study.

    PubMed

    Harnly, James

    2016-03-01

    Accurate measurements of the secondary metabolites in natural products and plant foods are critical for establishing relations between diet and health. There are as many as 50,000 secondary metabolites that may influence human health. Their structural and chemical diversity presents a challenge to analytical chemistry. With respect to flavonoids, putative identification is accessible, but positive identification and quantification are limited by the lack of standards. Quantification has been tested with use of both nonspecific and specific methods. Nonspecific methods, which include antioxidant capacity methods, fail to provide information on the measured components, suffer from numerous interferences, are not equatable, and are unsuitable for health research. Specific methods, such as LC with diode array and mass spectrometric detection, require the use of internal standards and relative molar response factors. These methods are relatively expensive and require a high level of expertise and experimental verification; however, they represent the only suitable means of relating health outcomes to specific dietary components.

  10. Importance of Accurate Measurements in Nutrition Research: Dietary Flavonoids as a Case Study1234

    PubMed Central

    Harnly, James

    2016-01-01

    Accurate measurements of the secondary metabolites in natural products and plant foods are critical for establishing relations between diet and health. There are as many as 50,000 secondary metabolites that may influence human health. Their structural and chemical diversity presents a challenge to analytical chemistry. With respect to flavonoids, putative identification is accessible, but positive identification and quantification are limited by the lack of standards. Quantification has been tested with use of both nonspecific and specific methods. Nonspecific methods, which include antioxidant capacity methods, fail to provide information on the measured components, suffer from numerous interferences, are not equatable, and are unsuitable for health research. Specific methods, such as LC with diode array and mass spectrometric detection, require the use of internal standards and relative molar response factors. These methods are relatively expensive and require a high level of expertise and experimental verification; however, they represent the only suitable means of relating health outcomes to specific dietary components. PMID:26980821

  11. Redesigning and Transforming: A Case Study of the Role of Semiotic Import in Early Composing Processes

    ERIC Educational Resources Information Center

    Ranker, Jason

    2009-01-01

    In this article, I explore the role of semiotic import (Van Leeuwen, 2005) in the composing processes of three bilingual students (six to seven years old) emerging as writers of English. Using social semiotic (Van Leeuwen, 2005) and design (New London Group, 2000) frameworks, I trace a qualitative "micro-history" of how the students imported…

  12. Redesigning and Transforming: A Case Study of the Role of Semiotic Import in Early Composing Processes

    ERIC Educational Resources Information Center

    Ranker, Jason

    2009-01-01

    In this article, I explore the role of semiotic import (Van Leeuwen, 2005) in the composing processes of three bilingual students (six to seven years old) emerging as writers of English. Using social semiotic (Van Leeuwen, 2005) and design (New London Group, 2000) frameworks, I trace a qualitative "micro-history" of how the students imported…

  13. Outbreak of Hepatitis A in Italy Associated with Frozen Redcurrants Imported from Poland: A Case Study.

    PubMed

    Terio, V; Bottaro, M; Di Pinto, A; Catella, C; Chironna, M; Bozzo, G; Kingsley, D H; Bonerba, E; Morea, A; Martella, V

    2015-09-01

    Hepatitis A virus (HAV) was detected in a batch of imported non-packaged frozen redcurrants purchased in a Bari grocery. Sequence and phylogenetic analysis showed the HAV strain clustered tightly with the HAV strain from the 2013 Italian epidemic, providing additional evidence that frozen redcurrants were the main vehicle of the HAV outbreak.

  14. Case Study of Neuroleptic-Induced Akathisia: Important Implications for Individuals with Mental Retardation.

    ERIC Educational Resources Information Center

    Gross, Edward J.; And Others

    1993-01-01

    Neuroleptic-induced akathisia is a relatively common side effect of neuroleptic medication, characterized by a subjective sense of restlessness; the inability to sit still; and sometimes aggression, anxiety, sleep disturbance, and suicide. The importance of the diagnosis and treatment of neuroleptic-induced akathisia in individuals with mental…

  15. Importance of employee vaccination against influenza in preventing cases in long-term care facilities.

    PubMed

    Wendelboe, Aaron M; Avery, Catherine; Andrade, Bernardo; Baumbach, Joan; Landen, Michael G

    2011-10-01

    Employees of long-term care facilities (LTCFs) who have contact with residents should be vaccinated against influenza annually to reduce influenza incidence among residents. This investigation estimated the magnitude of the benefit of this recommendation. The New Mexico Department of Health implemented active surveillance in all of its 75 LTCFs during influenza seasons 2006-2007 and 2007-2008. Information about the number of laboratory-confirmed cases of influenza and the proportion vaccinated of both residents and direct-care employees in each facility was collected monthly. LTCFs reporting at least 1 case of influenza (defined alternately by laboratory confirmation or symptoms of influenza-like illness [ILI]) among residents were compared with LTCFs reporting no cases of influenza. Regression modeling was used to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between employee vaccination coverage and the occurrence of influenza outbreaks. Covariates included vaccination coverage among residents, the staff-to-resident ratio, and the proportion of filled beds. Seventeen influenza outbreaks were reported during this 2-year period of surveillance. Eleven of these were laboratory confirmed (n = 21 residents) and 6 were defined by ILI (n = 40 residents). Mean influenza vaccination coverage among direct-care employees was 51% in facilities reporting outbreaks and 60% in facilities not reporting outbreaks (P = .12). Increased vaccination coverage among direct-care employees was associated with fewer reported outbreaks of laboratory-confirmed influenza (aOR, 0.97 [95% CI, 0.95-0.99]) and ILI (aOR, 0.98 [95% CI, 0.96-1.00]). High vaccination coverage among direct-care employees helps to prevent influenza in LTCFs.

  16. Primary dengue fever associated with hemophagocytic syndrome: a report of three imported cases, Bordeaux, France.

    PubMed

    Ribeiro, Emmanuel; Kassab, Somar; Pistone, Thierry; Receveur, Marie-Catherine; Fialon, Pierre; Malvy, Denis

    2014-01-01

    The dengue virus is responsible for a wide range of symptoms that can be classified into two distinct syndromes: classical dengue fever and severe dengue fever. Among the complicating forms, hemophagocytic syndrome (HPS) has been previously reported in case series of patients with secondary dengue fever outside of endemic settings. Of note, the occurrence of HPS has not yet been included among the criteria for defining severe dengue fever. We herein present three patients with HPS related to confirmed primary dengue virus infection. Clinicians should therefore consider hemophagocytosis as a complication during severe dengue infection in naïve patients.

  17. Chronic Wounds in Burn Injury: A Case Report on Importance of Biofilms

    PubMed Central

    Ramos-Gallardo, Guillermo

    2016-01-01

    According to the National Institutes of Health and the Center for Disease and Prevention, it is estimated that 65 to 80 percent of the human infectious are caused by biofilms. Antibiotics and drainage of purulent discharge are the main treatment measures. But in chronic infections sometimes these findings are not easy to recognize. Biofilm is an extracellular polymeric conglomeration generally composed of extracellular DNA, proteins, and polysaccharides, which help bacteria to survive into the host. The following case is the example of chronic wound in burn patient, where biofilm gets involved and special attention is given to the relationship biofilm–chronic wound injury in a burn patient. PMID:27579274

  18. Clozapine-induced interstitial nephritis - a rare but important complication: a case report

    PubMed Central

    2009-01-01

    Introduction Given the limited range of effective drug treatments for patients with schizophrenia, increasing numbers of patients, often termed 'treatment-resistant' are prescribed clozapine. While the induction of neutropenia or agranulocytosis by clozapine is well appreciated, other rare potentially fatal adverse reactions may also occur including acute interstitial nephritis as reported in this case. Case presentation A 57-year-old Caucasian woman with treatment-resistant chronic schizophrenia developed acute renal failure following initiation of treatment with clozapine. The adverse reaction occurred after only four doses of the drug had been administered (titrated from 12.5 to 25 mg per day). After clozapine had been withdrawn, the patient's renal function returned to normal with no other changes to medication. The patient had been exposed to clozapine about 4 years previously when she had developed a similar reaction. Conclusion Renal reactions to clozapine are extremely rare but, if not recognized promptly, may prove fatal. Psychiatrists need to be aware of this possible complication when clozapine is initiated. PMID:20126316

  19. Small Fiber Neuropathy in Children: Two Case Reports Illustrating the Importance of Recognition.

    PubMed

    Hoeijmakers, Janneke G J; Faber, Catharina G; Miedema, Carien J; Merkies, Ingemar S J; Vles, Johan S H

    2016-10-01

    Small fiber neuropathy (SFN) is a debilitating condition that often leads to pain and autonomic dysfunction. In the last few decades, SFN has been gaining more attention, particularly in adults. However, literature about SFN in children remains limited. The present article reports the cases of 2 adolescent girls diagnosed with SFN. The first patient (14 years of age) complained about painful itch and tingling in her legs, as well as dysautonomia symptoms for years. She also reported a red/purple-type discoloration of her legs aggravated by warmth and standing, compatible with erythromelalgia. The diagnosis of SFN was confirmed by a reduced intraepidermal nerve fiber density (IENFD) in skin biopsy sample. No underlying conditions were found. Symptomatic neuropathic pain treatment was started with moderate effect. The second patient (16 years of age) developed painful sensations in both feet and hands 6 weeks after an ICU admission for diabetic ketoacidosis, which included dysautonomia symptoms. She also exhibited some signs of erythromelalgia. The patient was diagnosed with predominant SFN (abnormal IENFD and quantitative sensory testing) as well as minor large nerve fiber involvement. Treatment with duloxetine, combined with a rehabilitation program, resulted in a marked improvement in her daily functioning. Although the SFN diagnosis in these 2 cases could be established according to the definition of SFN used in adults, additional diagnostic tools are needed that may be more appropriate for children. Additional information about the course of SFN in children may result in better treatment options. Copyright © 2016 by the American Academy of Pediatrics.

  20. The importance of normative integration in stroke services: case study evidence from Sweden and England.

    PubMed

    Baeza, Juan I; Boaz, Annette; Fraser, Alec; Fulop, Naomi; McKevitt, Christopher; Wolfe, Charles

    2012-11-01

    A number of evidence-based interventions are now available for stroke patients. Good-quality stroke care involves a range of health professionals located across ambulance, hospital, community and primary care services. This study examined the perspectives of health-care workers involved in stroke care in Sweden and England on the integration challenges stroke care presents. Four qualitative case studies were carried out in Sweden and England, including 95 semistructured interviews with clinicians and managers associated with four different hospitals providing specialized stroke services. High levels of organizational, functional, service and clinical integration among clinicians that deliver emergency and acute stroke care were identified. This is frequently lacking among professionals delivering postacute care. These findings are linked to the prevalence or lack of normative and systemic integration in each respective stage of care. Emphasis on the need to treat stroke as an emergency condition in both countries has created a context in which normative and systemic integration often occurs among clinicians that deliver emergency and acute stroke care, aiding the development of organizational, functional, service and clinical integration across the case study sites. In contrast, integration between hospital and community (rehabilitation and general practice) care is frequently less successful.

  1. Diagnosis and management of imported Chikungunya fever in Taiwan: a case report.

    PubMed

    Chang, Ko; Hsieh, Hsiao-Chen; Tsai, Jih-Jin; Lin, Wei-Ru; Lu, Po-Liang; Chen, Yen-Hsu

    2010-05-01

    Chikungunya virus, a mosquito-borne alphavirus, is endemic in Africa and Southeast Asia but is rarely reported in Taiwan. We report the case of a Taiwanese woman who developed Chikungunya fever, which was first diagnosed by a clinician rather than by fever screening at an airport. The woman presented with fever, maculopapular rash, and arthralgia, the triad for the disease, on the day she returned home after a trip to Malaysia. These symptoms are very similar to those of dengue fever, which is endemic in Southern Taiwan. Chikungunya infection was confirmed by reverse transcriptase-polymerase chain reaction and seroconversion on paired serum specimens. For approximately 40 years until 2006, no cases of Chikungunya fever had been found in Taiwan. Clinicians in Taiwan should consider Chikungunya fever as a possible diagnosis for a febrile patient with arthralgia, rash, and a history of travel to an endemic area, such as Africa or Southeast Asia. Copyright (c) 2010 Elsevier. Published by Elsevier B.V. All rights reserved.

  2. Ranavirus-associated mass mortality in imported red tailed knobby newts (Tylototriton kweichowensis): a case report.

    PubMed

    Pasmans, Frank; Blahak, Silvia; Martel, An; Pantchev, Nikola; Zwart, Peer

    2008-05-01

    A mass die-off of imported red tailed knobby newts (Tylototriton kweichowensis) occurred in 2004 in Belgium and the Netherlands. In addition to massive infection with Rhabdias tokyoensis, Ranavirus was isolated from three dead newts examined virologically and the gene coding for the major capsid protein of the virus was sequenced. The isolate showed 99.8% similarity to the published sequence of frog virus 3. Upon experimental infection of axolotls (Ambystoma mexicanum) with this isolate, no marked pathology was noticed and the virus could not be re-isolated at 9weeks post-inoculation. Apart from the possibility of exposure of a non-sensitive host, the mortality episode in the newts may be related to stress resulting from the importation of the newts in breeding condition. This possibility is supported by the presence of degenerating egg-follicles in the females.

  3. Comparability and representativeness of control groups in a case-control study of infant leukemia: a report from the Children's Oncology Group.

    PubMed

    Puumala, Susan E; Spector, Logan G; Robison, Leslie L; Bunin, Greta R; Olshan, Andrew F; Linabery, Amy M; Roesler, Michelle A; Blair, Cindy K; Ross, Julie A

    2009-08-01

    Traditionally, controls in US pediatric cancer studies were selected through random digit dialing. With declining participation and lack of nonparticipant information, random digit dialing (RDD) controls may be substandard. Birth certificate (BC) controls are an alternative, because they are population based and include data from nonparticipants. The authors examined controls collected by random digit dialing and birth certificates for a Children's Oncology Group case-control study of infant leukemia in 1995-2006. Demographic variables were used to assess differences in RDD and BC controls and their representativeness. RDD and BC controls did not differ significantly with regard to maternal variables (age, race, education, marital status, alcohol during pregnancy) or child variables (sex, gestational age, birth weight), but they varied in smoking during pregnancy (22% RDD controls, 12% BC controls) (P = 0.05). The study's combined control group differed significantly from US births: Mothers of controls were more likely to be older (29.8 vs. 27.2 years), white (84% vs. 59%), and married (85% vs. 67%) and to have >16 years of education (37% vs. 25%). Control children were more often full term (88% vs. 81%) and heavier (3,436 vs. 3,317 g). Finally, participating BC mothers were likely to be older and to have more education than nonparticipants. Thus, the study's control groups were comparable but differed from the population of interest.

  4. [A clinical case of unrecognized hemoperitoneum: importance of correct preoperative diagnosis].

    PubMed

    Pagani, C; Conti, L; Picozzi, G

    1994-03-01

    A young caucasian man (16 years old) underwent laparatomy after a diagnosis of acute appendicitis. After anesthetic induction, the patient experienced hypotension and tachycardia. The surgical approach discovered a massive haemoperitoneum subsequent to necrosis of the ileum due to internal herniation. The haemoperitoneum was probable responsible for hypovolemia which justified hypotension and tachycardia, which were reversed by aggressive intraoperative volume infusion. The importance of adequate preoperative diagnosis, in order to treat hypovolemia associated with a massive haemoperitoneum, is stressed.

  5. The importance of histologic parameters of lacteal involvement in cases of canine lymphoplasmacytic enteritis

    PubMed Central

    Rossi, Giacomo; Cerquetella, Matteo; Antonelli, Elisabetta; Pengo, Graziano; Magi, Gian Enrico; Villanacci, Vincenzo; Rostami-Nejad, Mohammad; Spaterna, Andrea; Bassotti, Gabrio

    2015-01-01

    Background: The most frequent form of inflammatory bowel disease (IBD) in dogs is represented histologically, by lymphoplasmacytic enteritis (LPE), a histological category, often associated with other morphologic alterations including lymphangiectasia (LE). However, literature data on this latter topic are quite scarce and have mostly been obtained in single reports or in small series. Aim: We evaluated some morphologic parameters of intestinal villi and lacteals in a large cohort of dogs, and correlated them with serum albumin and cholesterol values. Patients and methods: We investigated 136 dogs (94 with LPE, and 42 with gastrointestinal problems different from IBD) and analyzed their clinical, laboratory (albumin and cholesterol values), endoscopic, and histologic variables. Results: The LPE group showed significantly impaired clinical, laboratory, endoscopic, and histologic variables compared to controls. Affected dogs showed significant correlations between canine inflammatory bowel disease activity index (CIBDAI) scores and endoscopic and histologic variables. Moreover, the grade of hematologic changes were strongly related to the intestinal histologic variables, in particular those concerning villous and lacteals morphology. Conclusion: Dogs with LPE had intestinal histologic abnormalities (height, width, height/width ratio, calculated for both villi and lacteals), whose degree correlated with the severity of hypoalbuminemia and hypocholesterolemia. Evaluation of endoscopic and histologic variables in association to the clinical findings may reveal useful insights for the pathogenesis of LPE and, hopefully, might lead to more targeted therapeutic approaches. PMID:25584174

  6. Worst-Case Scenario Tsunami Hazard Assessment in Two Historically and Economically Important Districts in Eastern Sicily (Italy)

    NASA Astrophysics Data System (ADS)

    Armigliato, A.; Tinti, S.; Pagnoni, G.; Zaniboni, F.; Paparo, M. A.

    2015-12-01

    The portion of the eastern Sicily coastline (southern Italy), ranging from the southern part of the Catania Gulf (to the north) down to the southern-eastern end of the island, represents a very important geographical domain from the industrial, commercial, military, historical and cultural points of view. Here the two major cities of Augusta and Siracusa are found. In particular, the Augusta bay hosts one of the largest petrochemical poles in the Mediterranean, and Siracusa is listed among the UNESCO World Heritage Sites since 2005. This area was hit by at least seven tsunamis in the approximate time interval from 1600 BC to present, the most famous being the 365, 1169, 1693 and 1908 tsunamis. The choice of this area as one of the sites for the testing of innovative methods for tsunami hazard, vulnerability and risk assessment and reduction is then fully justified. This is being developed in the frame of the EU Project called ASTARTE - Assessment, STrategy And Risk Reduction for Tsunamis in Europe (Grant 603839, 7th FP, ENV.2013.6.4-3). We assess the tsunami hazard for the Augusta-Siracusa area through the worst-case credible scenario technique, which can be schematically divided into the following steps: 1) Selection of five main source areas, both in the near- and in the far-field (Hyblaean-Malta escarpment, Messina Straits, Ionian subduction zone, Calabria offshore, western Hellenic Trench); 2) Choice of potential and credible tsunamigenic faults in each area: 38 faults were selected, with properly assigned magnitude, geometry and focal mechanism; 3) Computation of the maximum tsunami wave elevations along the eastern Sicily coast on a coarse grid (by means of the in-house code UBO-TSUFD) and extraction of the 9 scenarios that produce the largest effects in the target areas of Augusta and Siracusa; 4) For each of the 9 scenarios we run numerical UBO-TSUFD simulations over a set of five nested grids, with grid cells size decreasing from 3 km in the open Ionian

  7. An unusual case of murder-suicide: The importance of studying knots.

    PubMed

    D'Ovidio, Cristian; Rosato, Enrica; Carnevale, Aldo

    2017-01-01

    An atypical murder-suicide that involved a married couple over 80 years of age was investigated at the Institute of Legal Medicine of the University of Chieti-Pescara and is presented and discussed here. The whole story allows us to confront the difficulties involved in the discovery of a dead body in water when the circumstantial evidence does not allow any unique interpretation of the facts. The atypical and misleading element appeared to be how the body of the man was tied, with the interpretation inclined towards a homicidal manner of death. It was only by combining the contributions of each of the findings that emerged during the course of the autopsy with the circumstantial evidence from the site inspection that it was possible to reach resolution of this case, which was then identified as a murder-suicide.

  8. The importance of dental care for a child with severe congenital neutropenia: a case report.

    PubMed

    Antonio, Andréa Gonçalves; Alcantara, Paula Cristina da Costa; Ramos, Maria Eliza Barboza; de Souza, Ivete Pomarico Ribeiro

    2010-01-01

    Congenital neutropenia is characterized by a decrease in the absolute number of circulating neutrophils and an increased susceptibility to infections. This paper describes the case history of a child with severe congenital neutropenia who had aggressive periodontitis associated with generalized carious lesions. She had Kostmann syndrome, which is associated with recessive mutation of the HAX-1 gene. She had extensive dental caries, which is not common in patients with Kostmann syndrome. The caries caused oral pain and loss of weight and could have been avoided if the parents had received early oral hygiene instructions, and if the child had received regular, professional dental care. ©2010 Special Care Dentistry Association and Wiley Periodicals, Inc.

  9. The importance of a multidisciplinary approach in the treatment of mutilating electrical injury: a case study.

    PubMed

    Lipový, B; Rihová, H; Kaloudová, Y; Suchánek, I; Gregorová, N; Hokynková, A; Jelínková, Z; Agalarev, V

    2010-01-01

    Electrical burns are not ranked among the most frequent type of injuries, but they have the most devastating potential of all thermal injuries and often cause lifelong stigmatization. Those primarily affected are young males: work injuries predominate. An electrical burn is a specific nosological unit that has multiple acute and chronic abnormal manifestations. In this study we describe the case of a young man who suffered an electrical injury after contact with a high-voltage line (22,000 volts) while paragliding. This contact was followed by a 10 m fall. In our work we present the need for multidisciplinary cooperation along with the opportunities, problems and risks that accompany the treatment of this type of injury.

  10. Imported Plasmodium falciparum malaria in HIV-infected patients: a report of two cases

    PubMed Central

    2012-01-01

    As HIV becomes a chronic infection, an increasing number of HIV-infected patients are travelling to malaria-endemic areas. Association of malaria with HIV/AIDS can be clinically severe. Severe falciparum malaria is a medical emergency that is associated with a high mortality, even when treated in an Intensive Care Unit. This article describes two cases of HIV-positive patients, who returned from malaria-endemic areas and presented a parasitaemia > 5% of erythrocytes and clinical signs of severe falciparum malaria, both with > 350 CD4 cell count/μl, absence of chemoprophylaxis and successful response. Factors like drug interactions and the possible implication of anti-malarial therapy bioavailability are all especially interesting in HIV-malaria co-infections. PMID:22540214

  11. [Importance of the forensic autopsy in the diagnosis of septic shock: a case report].

    PubMed

    Sibón-Olano, A; Sánchez-Rodríguez, E; Payá, M; Barrera-Pérez, E; Salguero-Villadiego, M; Fernández-Rodríguez, A

    2017-08-25

    Septic shock sometimes starts with unspecific symptoms that hamper the clinical diagnosis and, therefore an appropriate treatment. When the septic shock follows a fulminating course with a fatal outcome, the etiological diagnosis has to be conducted post-mortem. Sudden unexpected deaths in children and young adults are frequently the object of medico-legal autopsies. Some sudden unexpected deaths have an infectious origin, which requires further analyses, including microbiology, to establish the cause of death. Here, the case of a fatal septic shock in a 19-month old male infant is presented. After a mild foot injury, an infection by Streptococcus pyogenes progressed to septic shock with a fatal outcome as post-mortem studies demonstrated.

  12. Are akinetes representative of past nostocalean blooms? A case study of their benthic spatio-temporal distribution and potential for germination in a eutrophic lake.

    PubMed

    Legrand, Benjamin; Le Jeune, Anne-Hélène; Colombet, Jonathan; Thouvenot, Antoine; Latour, Delphine

    2017-09-29

    Monitoring of water and surface sediment in a French eutrophic lake (Lake Aydat) was carried out over a 2-year period in order to determine if akinetes in sediment could be representative of the most recent bloom, and to estimate their germination potential. Sediment analysis revealed 2 akinetes species: Dolichospermun macrosporum and Dolichospermun flos-aquae, present in the same ratio as that observed in the pelagic populations. Moreover, similar spatial patterns observed between vegetative cells in the water column and akinete distribution in the sediment suggest that akinetes in sediment may be representative of the previous bloom. However, the relationship between akinetes in the sediment and vegetative cells in the water column is not linear and others factors may interfere. For example, our results highlighted horizontal transport of akinetes during the winter. The benthic overwinter phase does not seem to influence the percentage of intact akinetes which remained stable at approximately 7% and 60% for D. macrosporum and D. flos-aquae, respectively. These percentages may thus be the results of processes that occurred in the water column. The intact overwintering akinetes showed germination rates up to 90% after 72 hours for D. flos-aquae or 144 hours for D. macrosporum The difference in akinetes germination rates between these 2 species demonstrates different ecological strategies which serve to expend the window for germination in time and space and thus optimize colonization of the water column by Nostocalean cyanobacteria.IMPORTANCE Cyanobacteria have the ability to proliferate and form blooms. These blooms can then impact on the local ecology, health and economy. The akinete, a resistant cell type which persists in sediment, is an important intermediate phase between previous and future blooms. We have monitored the water column and the surface sediment of a French eutrophic lake (Lake Aydat) to investigate the relationship between vegetative cells in

  13. Importance of frequency dependent magnetoresistance measurements in analysing the intrinsicality of magnetodielectric effect: A case study

    NASA Astrophysics Data System (ADS)

    Rai, Hari Mohan; Saxena, Shailendra K.; Mishra, Vikash; Kumar, Rajesh; Sagdeo, P. R.

    2017-08-01

    Magnetodielectric (MD) materials have attracted considerable attention due to their intriguing physics and potential future applications. However, the intrinsicality of the MD effect is always a major concern in such materials as the MD effect may arise also due to the MR (magnetoresistance) effect. In the present case study, we report an experimental approach to analyse and separate the intrinsic and MR dominated contributions of the MD phenomenon. For this purpose, polycrystalline samples of LaGa1-xAxO3 (A = Mn/Fe) have been prepared by solid state reaction method. The purity of their structural phase (orthorhombic) has been validated by refining the X-ray diffraction data. The RTMD (room temperature MD) response has been recorded over a frequency range of 20 Hz to 10 MHz. In order to analyse the intrinsicality of the MD effect, FDMR (frequency dependent MR) by means of IS (impedance spectroscopy) and dc MR measurements in four probe geometry have been carried out at RT. A significant RTMD effect has been observed in selected Mn/Fe doped LaGaO3 (LGO) compositions. The mechanism of MR free/intrinsic MD effect, observed in Mn/Fe doped LGO, has been understood speculatively in terms of modified cell volume associated with the reorientation/retransformation of spin-coupled Mn/Fe orbitals due to the application of magnetic field. The present analysis suggests that in order to justify the intrinsic/resistive origin of the MD phenomenon, FDMR measurements are more useful than measuring only dc MR or analysing the trends of magnetic field dependent change in the dielectric constant and tanδ. On the basis of the present case study, we propose that IS (FDMR) alone can be used as an effective experimental tool to detect and analyse the resistive and intrinsic parts contributing to the MD phenomenon.

  14. Response to importation of a case of Ebola virus disease--Ohio, October 2014.

    PubMed

    McCarty, Carolyn L; Basler, Colin; Karwowski, Mateusz; Erme, Marguerite; Nixon, Gene; Kippes, Chris; Allan, Terry; Parrilla, Toinette; DiOrio, Mary; de Fijter, Sietske; Stone, Nimalie D; Yost, David A; Lippold, Susan A; Regan, Joanna J; Honein, Margaret A; Knust, Barbara; Braden, Christopher

    2014-11-21

    On September 30, 2014, the Texas Department of State Health Services reported a case of Ebola virus disease (Ebola) diagnosed in Dallas, Texas, and confirmed by CDC, the first case of Ebola diagnosed in the United States. The patient (patient 1) had traveled from Liberia, a country which, along with Sierra Leone and Guinea, is currently experiencing the largest recorded Ebola outbreak. A nurse (patient 2) who provided hospital bedside care to patient 1 in Texas visited an emergency department (ED) with fever and was diagnosed with laboratory-confirmed Ebola on October 11, and a second nurse (patient 3) who also provided hospital bedside care visited an ED with fever and rash on October 14 and was diagnosed with laboratory-confirmed Ebola on October 15. Patient 3 visited Ohio during October 10-13, traveling by commercial airline between Dallas, Texas, and Cleveland, Ohio. Based on the medical history and clinical and laboratory findings on October 14, the date of illness onset was uncertain; therefore, CDC, in collaboration with state and local partners, included the period October 10-13 as being part of the potentially infectious period, out of an abundance of caution to ensure all potential contacts were monitored. On October 15, the Ohio Department of Health requested CDC assistance to identify and monitor contacts of patient 3, assess the risk for disease transmission, provide infection control recommendations, and assess and guide regional health care system preparedness. The description of this contact investigation and hospital assessment is provided to help other states in planning for similar events.

  15. Polymerase Chain Reaction: An Important Tool for Early Diagnosis of Leptospirosis Cases

    PubMed Central

    Mullan, Summaiya

    2016-01-01

    Introduction Various diagnostic methods like Microscopic Agglutination Test (MAT), IgM ELISA, Isolation of Leptospira from the clinical specimen, Rapid leptocheck tests etc., are available for diagnosis of leptospirosis. Polymerase Chain Reaction (PCR) is used for diagnosis of various diseases of infectious origin including leptospirosis but there is paucity of data about comparison of PCR with other available method of diagnosis of leptospirosis. Aim The aim of the study was to detect the leptospiral DNA by PCR method and to compare the results of PCR with other available diagnostic methods used for diagnosis of suspected leptospirosis cases in acute phase of illness. Materials and Methods A total of 207 blood samples were obtained from suspected patients of leptospirosis admitted in New Civil Hospital, a tertiary care hospital in South Gujarat, during the period of July 2008 to November 2008. These blood samples were subjected to Rapid leptocheck, IgM ELISA, MAT test to detect (IgG or IgM) antibody level, Leptospira culture and PCR. Results In early phase of the disease, Rapid leptocheck test gave 44% detection, but along with PCR seropositivity reached upto 71%. Detection rate by IgM ELISA was 59% which increased to 80% with PCR. By MAT seropositivity was 57% but combined seropositivity of MAT with PCR was 78%. Sensitivity and specificity of PCR as compared to MAT (Gold standard) was 52% and 79% respectively. Leptospira was not growing in culture. Conclusion In present study, PCR picked up to 50% of cases which were negative by other serological tests so these finding suggest that PCR should be used routinely in acute phase of disease. PMID:28208854

  16. The importance of a proper selection area to be biopsied in nodular leukoplakia: a case report.

    PubMed

    Pagin, Otávio; Santos, Paulo Sérgio da Silva; Del Neri, Nathalia Bigelli; Gustavo de Lima, Heliton; Lara, Vanessa Soares

    2014-03-01

    Nodular leukoplakia is a non-homogeneous type of oral leukoplakia presenting a white surface with verrucous, nodular, ulcerated or erythematous features with a greater risk of malignant transformation when compared to the homogeneous type. Common sites of involvement include lip commissures, buccal mucosa and soft palate. It is often associated with epithelial dysplasia or carcinoma and requires detailed microscopic assessment and regular follow-up. The importance of a proper selection of the area to be biopsied and the close teamwork between a dentist and oral pathologist is the basis of providing an accurate final diagnosis.

  17. [Prehospital cardiac resuscitation in Queretaro, Mexico. Report of 3 cases. Importance of an integral emergency medical care system].

    PubMed

    Fraga-Sastrías, Juan Manuel; Aguilera-Campos, Andrea; Barinagarrementería-Aldatz, Fernando; Ortíz-Mondragón, Claudio; Asensio-Lafuente, Enrique

    2014-01-01

    In Mexico, out-of-hospital cardiac arrest is a health problem that represents 33,000 to 150,000 or more deaths per year. The few existent reports show mortality as high as 100% in contrast to some international reports that show higher survival rates. In Queretaro, during the last 5 years there were no successful resuscitation cases. However, in 2012 some patients were reported to have return of spontaneous circulation. We report in this article 3 cases with return of spontaneous circulation and pulse at arrival to the hospital. Two of the patients were discharged alive, one of them with poor cerebral performance category. Community cardiopulmonary resuscitation, early defibrillation and better emergency medical system response times, are related with survival. This poorly explored health problem in Queretaro could be increased with quality and good public education, bystander assisted cardiopulmonary resuscitation, police involvement in cardiopulmonary resuscitation and defibrillation, public access defibrillation programs and measurement of indicators and feedback for better results.

  18. Parallel imports and innovation in an emerging economy: the case of Indian pharmaceuticals.

    PubMed

    Mantovani, Andrea; Naghavi, Alireza

    2012-11-01

    This paper studies the impact of the re-importation of imitated pharmaceuticals as a by-product of an open policy toward parallel import (PI) on process innovation. Foreign investment by a firm to exploit a new unregulated market with weak intellectual property rights can give rise to imitation. These products can potentially re-enter the original country when PI is allowed influencing research and development (R&D) incentives. In an emerging economy with technologically heterogeneous firms, trade costs shift PI-related market share losses from the more to the less R&D efficient firm, inducing the former to strategically increase R&D. PI accompanied by tariffs also induces higher R&D effort by the technologically inferior firm when it results in an expansion of its sales abroad. A tariff on PI is most likely to increase welfare when the technological gap between the two firms at home is sufficiently large. Copyright © 2011 John Wiley & Sons, Ltd.

  19. The importance of family relations for cannabis users: the case of serbian adolescents.

    PubMed

    Terzic Supic, Zorica; Santric Milicevic, Milena; Sbutega, Isidora; Vasic, Vladimir

    2013-01-01

    Adolescence is transitional stage of physical and mental human development occuring between childhood and adult life. Social interactions and environmental factors together are important predictors of adolescent cannabis use. This study aimed to examine the relationship between the social determinants and adolescents behavior with cannabis consumption. A cross sectional study as part of the European School Survey Project on Alcohol and other Drugs was conducted among 6.150 adolescents aged 16 years in three regions of Serbia, and three types of schools (gymnasium, vocational - professional, and vocational - handicraft) during May - June 2008. A multivariate logistic regression analysis was carried out to obtain adjusted odds ratios with 95% confidence intervals in which the dependent variable was cannabis consumption non-user and user. Among 6.7% of adolescents who had tried cannabis at least one in their lives, boys were more involved in cannabis use than girls, especially boys from gymnasium school. Well off family, lower education of mother, worse relations with parents were significantly associated with cannabis use (P < 0.05). Behaviors like skipping from schools, frequent evening outs, and playing on slot machines were also related to cannabis use (P < 0.05). The study confirmed the importance of family relationship development. Drug use preventive programmes should include building interpersonal trust in a family lifecycle and school culture.

  20. Conservation of socioculturally important local crop biodiversity in the Oromia region of Ethiopia: a case study.

    PubMed

    Balemie, Kebu; Singh, Ranjay K

    2012-09-01

    In this study, we surveyed diversity in a range of local crops in the Lume and Gimbichu districts of Ethiopia, together with the knowledge of local people regarding crop uses, socio-economic importance, conservation, management and existing threats. Data were collected using semistructured interviews and participant observation. The study identified 28 farmers' varieties of 12 crop species. Among these, wheat (Triticum turgidum) and tef (Eragrostis tef) have high intra-specific diversity, with 9 and 6 varieties respectively. Self-seed supply or seed saving was the main (80 %) source of seeds for replanting. Agronomic performance (yield and pest resistance), market demand, nutritional and use diversity attributes of the crop varieties were highlighted as important criteria for making decisions regarding planting and maintenance. Over 74 % of the informants grow a combination of "improved" and farmers' varieties. Of the farmers' varieties, the most obvious decline and/or loss was reported for wheat varieties. Introduction of improved wheat varieties, pest infestation, shortage of land, low yield performance and climate variability were identified as the principal factors contributing to this loss or decline. Appropriate interventions for future conservation and sustainable use of farmers' varieties were suggested.

  1. The Importance of Family Relations for Cannabis Users: The Case of Serbian Adolescents

    PubMed Central

    TERZIC SUPIC, Zorica; SANTRIC MILICEVIC, Milena; SBUTEGA, Isidora; VASIC, Vladimir

    2013-01-01

    Background Adolescence is transitional stage of physical and mental human development occuring between childhood and adult life. Social interactions and environmental factors together are important predictors of adolescent cannabis use. This study aimed to examine the relationship between the social determinants and adolescents behavior with cannabis consumption. Methods: A cross sectional study as part of the European School Survey Project on Alcohol and other Drugs was conducted among 6.150 adolescents aged 16 years in three regions of Serbia, and three types of schools (gymnasium, vocational – professional, and vocational – handicraft) during May – June 2008. A multivariate logistic regression analysis was carried out to obtain adjusted odds ratios with 95% confidence intervals in which the dependent variable was cannabis consumption non-user and user. Results: Among 6.7% of adolescents who had tried cannabis at least one in their lives, boys were more involved in cannabis use than girls, especially boys from gymnasium school. Well off family, lower education of mother, worse relations with parents were significantly associated with cannabis use (P < 0.05). Behaviors like skipping from schools, frequent evening outs, and playing on slot machines were also related to cannabis use (P < 0.05). Conclusions: The study confirmed the importance of family relationship development. Drug use preventive programmes should include building interpersonal trust in a family lifecycle and school culture. PMID:23641402

  2. Internal Concentration and Time Are Important Modifiers of Toxicity: The Case of Chlorpyrifos on Caenorhabditis elegans.

    PubMed

    Roh, Ji-Yeon; Lee, Hyun-Jeoung; Kwon, Jung-Hwan

    2016-09-06

    The internal concentration of chemicals in exposed organisms changes over time due to absorption, distribution, metabolism, and excretion processes since chemicals are taken up from the environment. Internal concentration and time are very important modifiers of toxicity when biomarkers are used to evaluate the potential hazards and risks of environmental pollutants. In this study, the responses of molecular biomarkers, and the fate of chemicals in the body, were comprehensively investigated to determine cause-and-effect relationships over time. Chlorpyrifos (CP) was selected as a model chemical, and Caenorhabditis elegans was exposed to CP for 4 h using the passive dosing method. Worms were then monitored in fresh medium during a 48-h recovery regime. The mRNA expression of genes related to CYP metabolism (cyp35a2 and cyp35a3) increased during the constant exposure phase. The body residue of CP decreased once it reached a peak level during the early stage of exposure, indicating that the initial uptake of CP rapidly induced biotransformation with the synthesis of new CYP metabolic proteins. The residual chlorpyrifos-oxon concentration, an acetylcholinesterase (AChE) inhibitor, continuously increased even after the recovery regime started. These delayed toxicokinetics seem to be important for the extension of AChE inhibition for up to 9 h after the start of the recovery regime. Comprehensive investigation into the molecular initiation events and changes in the internal concentrations of chemical species provide insight into response causality within the framework of an adverse outcome pathway.

  3. Conservation of Socioculturally Important Local Crop Biodiversity in the Oromia Region of Ethiopia: A Case Study

    NASA Astrophysics Data System (ADS)

    Balemie, Kebu; Singh, Ranjay K.

    2012-09-01

    In this study, we surveyed diversity in a range of local crops in the Lume and Gimbichu districts of Ethiopia, together with the knowledge of local people regarding crop uses, socio-economic importance, conservation, management and existing threats. Data were collected using semistructured interviews and participant observation. The study identified 28 farmers' varieties of 12 crop species. Among these, wheat ( Triticum turgidum) and tef ( Eragrostis tef) have high intra-specific diversity, with 9 and 6 varieties respectively. Self-seed supply or seed saving was the main (80 %) source of seeds for replanting. Agronomic performance (yield and pest resistance), market demand, nutritional and use diversity attributes of the crop varieties were highlighted as important criteria for making decisions regarding planting and maintenance. Over 74 % of the informants grow a combination of "improved" and farmers' varieties. Of the farmers' varieties, the most obvious decline and/or loss was reported for wheat varieties. Introduction of improved wheat varieties, pest infestation, shortage of land, low yield performance and climate variability were identified as the principal factors contributing to this loss or decline. Appropriate interventions for future conservation and sustainable use of farmers' varieties were suggested.

  4. Risk of MERS importation and onward transmission: a systematic review and analysis of cases reported to WHO.

    PubMed

    Poletto, Chiara; Boëlle, Pierre-Yves; Colizza, Vittoria

    2016-08-25

    The continuing circulation of MERS in the Middle East makes the international dissemination of the disease a permanent threat. To inform risk assessment, we investigated the spatiotemporal pattern of MERS global dissemination and looked for factors explaining the heterogeneity observed in transmission events following importation. We reviewed imported MERS cases worldwide up to July 2015. We modelled importations in time based on air travel combined with incidence in Middle East. We used the detailed history of MERS case management after importation (time to hospitalization and isolation, number of hospitals visited,…) in logistic regression to identify risk factors for secondary transmission. We assessed changes in time to hospitalization and isolation in relation to collective and public health attention to the epidemic, measured by three indicators (Google Trends, ProMED-mail, Disease Outbreak News). Modelled importation events were found to reproduce both the temporal and geographical structure of those observed - the Pearson correlation coefficient between predicted and observed monthly time series was large (r = 0.78, p < 10(-4)). The risk of secondary transmission following importation increased with the time to case isolation or death (OR = 1.7 p = 0.04) and more precisely with the duration of hospitalization (OR = 1.7, p = 0.02). The average daily number of secondary cases was 0.02 [0.0,0.12] in the community and 0.20 [0.03,9.0] in the hospital. Time from hospitalisation to isolation decreased in periods of high public health attention (2.33 ± 0.34 vs. 6.44 ± 0.97 days during baseline attention). Countries at risk of importation should focus their resources on strict infection control measures for the management of potential cases in healthcare settings and on prompt MERS cases identification. Individual and collective awareness are key to substantially improve such preparedness.

  5. The importance of magnetic methods for soil mapping and process modelling. Case study in Ukraine

    NASA Astrophysics Data System (ADS)

    Menshov, Oleksandr; Pereira, Paulo; Kruglov, Oleksandr; Sukhorada, Anatoliy

    2016-04-01

    The correct planning of agriculture areas is fundamental for a sustainable future in Ukraine. After the recent political problems in Ukraine, new challenges emerged regarding sustainability questions. At the same time the soil mapping and modelling are intensively developing all over the world (Pereira et al., 2015; Brevik et al., in press). Magnetic susceptibility (MS) methods are low cost and accurate for the developing maps of agricultural areas, fundamental for Ukrain's economy.This allow to colleact a great amount of soil data, usefull for a better understading of the spatial distribution of soil properties. Recently, this method have been applied in other works in Ukraine and elsewhere (Jordanova et al., 2011; Menshov et al., 2015). The objective of this work is to study the spatial distribution of MS and humus content on the topsoils (0-5 cm) in two different areas. The first is located in Poltava region and the second in Kharkiv region. The results showed that MS depends of soil type, topography and anthropogenic influence. For the interpretation of MS spatial distribution in top soil we consider the frequency and time after the last tillage, tilth depth, fertilizing, and the puddling regarding the vehicle model. On average the soil MS of the top soil of these two cases is about 30-70×10-8 m3/kg. In Poltava region not disturbed soil has on average MS values of 40-50×10-8 m3/kg, for Kharkiv region 50-60×10-8 m3/kg. The tilled soil of Poltava region has on average an MS of 60×10-8 m3/kg, and 70×10-8 m3/kg in Kharkiv region. MS is higher in non-tilled soils than in the tilled ones. The correlation between MS and soil humus content is very high ( up to 0.90) in both cases. Breivik, E., Baumgarten, A., Calzolari, C., Miller, B., Pereira, P., Kabala, C., Jordán, A. Soil mapping, classification, and modelling: history and future directions. Geoderma (in press), doi:10.1016/j.geoderma.2015.05.017 Jordanova D., Jordanova N., Atanasova A., Tsacheva T., Petrov P

  6. The importance of quality of care in perinatal mortality: a case-control study in Chiapas, Mexico.

    PubMed

    Cruz-Anguiano, Veronica; Talavera, Juan O; Vázquez, Laura; Antonio, Abdiel; Castellanos, Antonio; Lezana, Miguel A; Wacher, Niels H

    2004-01-01

    This study was undertaken in order to ascertain the relative importance of different risk factors for perinatal mortality (PM) in a community of Chiapas, Mexico stressing the importance of antenatal and neonatal medical care. Cases were stillbirth and early neonatal death (END). Two children born in the same hospital and/or day as the case were randomly selected as controls, in Tapachula, Chiapas, Mexico. Socioeconomic, cultural, maternal, pregnancy, delivery, product and medical care factors were recorded. Two analyses were performed using multiple logistic regression: one for stillbirths, the other for END. PM rate was 46.7/1000; 142 cases and 284 controls were studied. Fifteen cases were excluded due to congenital malformations; 62 stillbirth and 65 END were analyzed. For stillbirth, pregnancy-delivery and maternal medical care factors resulted in the most strongly associated risk factors for PM (OR=27.5 95% CI 6.4-116.8), and within this index insufficient prenatal care had the strongest impact on PM (%population attributable risk (%PAR)=24%). For END, fetal conditions and the newborn medical care index had the strongest association with PM (OR=9.5 95% CI 1.5-60.3), and within the index inappropriate medical care of the newborn (%PAR=27%) was the most important variable. Our results support the fact that insufficient prenatal care and failure to comply with the standards of care for labor, delivery and for the care of the newborn are strong predictors of PM.

  7. Blastomycosis in India: report of an imported case and current status.

    PubMed

    Randhawa, Harbans S; Chowdhary, Anuradha; Kathuria, Shallu; Roy, Pradip; Misra, Deepti S; Jain, Sarika; Chugh, Tulsi D

    2013-02-01

    We report a case of disseminated blastomycosis in a female resident of Delhi, who acquired the infection during travel to the USA, which was successfully treated with oral itraconazole. In addition, we present a critical literature review, indicating that blastomycosis is endemic in India but its areas of endemicity, prevalence, and the natural habitat of the etiologic agent, remain undetermined. The diagnosis of blastomycosis was made by examination of Gomori's methenamine silver stained sections of tissue obtained from a biopsy of a subcutaneous, abdominal nodular. These studies revealed thick-walled, broad-based budding yeast cells compatible with Blastomyces dermatitidis, and consistent with the isolation of the fungus in cultures inoculated with posterior auricular lymph node aspirate. Microscopically, the isolate had thin, septate hyphae and characteristic spherical to pyriform, smooth-walled microconidia. Its identity was confirmed by conversion to its typical yeast form on pea seed agar at 37°C and by DNA sequencing of ITS and BAD 1 promoter regions.

  8. [Idiopathic mental retardation--importance of clinical diagnostic scores for case selection].

    PubMed

    Caba, Lavinia; Rusu, Cristina; Voloşciuc, M; Butnariu, Lăcrămioara; Braha, Elena; Grămescu, Mihaela; Bujoran, C; Gorduza, E V; Covic, M

    2009-01-01

    We present a retrospective study aimed to identify the correlation between de Vries clinical score and the detection of chromosomal abnormalities in mentally retarded (MR) children. We have used the score to identify patients who should be tested by karyotyping and subsequently MLPA (multiplex ligation dependent probe amplification) for subtelomeric rearrangements. Our group is formed of 36 children with variable MR associated with other anomalies. 18 children had chromosomal defects, whereas 18 had normal karyotypes. In the first group, total scores varied between 3 and 7. Chromosomal anomalies identified were: numerical (4) and structural (14). Chromosomes involved were: 1, 4, 5, 7, 8, 9, 17, X. Deletions were the most common and correlate with a greater score (> or = 4). Common clinical features were: short stature, microcephaly, nasal, ear and hand anomalies. In the second group the most frequent clinical feature was hand anomaly (61.2%) and cases with a high score have to be further tested (e.g. using MLPA) in order to identify minor defects. In our opinion a high score indicates the karyotype and then a MLPA testing. In conclusion, we present a retrospective study that proves the use of de Vries diagnostic score in the identification of chromosomal abnormalities in MR children.

  9. A rare variant of the ulnar artery with important clinical implications: a case report

    PubMed Central

    2012-01-01

    Background Variations in the major arteries of the upper limb are estimated to be present in up to one fifth of people, and may have significant clinical implications. Case presentation During routine cadaveric dissection of a 69-year-old fresh female cadaver, a superficial brachioulnar artery with an aberrant path was found bilaterally. The superficial brachioulnar artery originated at midarm level from the brachial artery, pierced the brachial fascia immediately proximal to the elbow, crossed superficial to the muscles that originated from the medial epicondyle, and ran over the pronator teres muscle in a doubling of the antebrachial fascia. It then dipped into the forearm fascia, in the gap between the flexor carpi radialis and the palmaris longus. Subsequently, it ran deep to the palmaris longus muscle belly, and superficially to the flexor digitorum superficialis muscle, reaching the gap between the latter and the flexor carpi ulnaris muscle, where it assumed is usual position lateral to the ulnar nerve. Conclusion As far as the authors could determine, this variant of the superficial brachioulnar artery has only been described twice before in the literature. The existence of such a variant is of particular clinical significance, as these arteries are more susceptible to trauma, and can be easily confused with superficial veins during medical and surgical procedures, potentially leading to iatrogenic distal limb ischemia. PMID:23194303

  10. A review of risk factors for oral cavity cancer: the importance of a standardized case definition.

    PubMed

    Radoï, Loredana; Luce, Danièle

    2013-04-01

    The aim of this work is to review the literature on risk factors of oral cavity cancer with a special attention to the definition of the cases, in order to highlight special features of these cancers and of their subsites. PubMed database was systematically searched to access relevant articles published between 1980 and 2010. Reference lists of selected papers were examined to identify further articles. One hundred and two studies met the inclusion criteria. Their results were difficult to compare because of the lack of uniformity in defining oral cavity. In addition, few studies examined risk factors other than alcohol and tobacco, and studies differentiating between subsites were rare. Despite these limitations, some characteristics of oral cavity cancers may be emphasized: smoked tobacco seems to be a stronger risk factor for oral cavity cancer than alcohol, and the floor of the mouth seems to be more sensitive to the harmful effects of alcohol and smoked tobacco. Studies limited strictly to oral cavity cancers and distinguishing between subsites are needed to better understand the aetiology of these cancers, and better define risk groups to target prevention efforts and screening.

  11. Importance of defining the best treatment of a genital gunshot wound: A case report.

    PubMed

    García-Perdomo, Herney Andrés

    2014-10-16

    Twenty percent of genital traumas are caused by penetrating injuries; accordingly gunshot and stab wounds have increased in the last couple of years around the globe, even in Colombia. A 67-year-old male patient was admitted to the emergency room because he received multiple gunshot wounds. On physical examination, multiple wounds on his penis with loss of tissue in the foreskin, glans, anterior urethra (distal third) and cavernous corpora were found. The urologist performed a partial penectomy with a penis reconstruction, he debrided the cutaneous flap of the dorsal foreskin and its glans, sutured the distal cavernous corpora and dissected the urethra. Penetrating genital injuries are extremely important due to their impact on the functional, psychological and the aesthetic consequences. It is necessary to define the best possible treatment to minimize the damage.

  12. Alternative population sampling frames produced important differences in estimates of association: a case-control study of vasculitis.

    PubMed

    Macfarlane, Gary J; Jones, Gareth T; Swafe, Leyla; Reid, David M; Basu, Neil

    2013-06-01

    A common population sampling frame in countries with universal health care is health service registers. We have evaluated the use of such a register, in the United Kingdom, against a commercially available database claiming large population coverage, an alternative that offers ease of access and flexibility of use. A case-control study of vasculitis, which recruited cases from secondary care clinics in Scotland, compared two alternative sampling frames for population controls, namely the registers of National Health Service (NHS) primary care practices and a commercially available database. The characteristics of controls recruited from both sources were compared in addition to separate case-control comparison using logistic regression. A total of 166 of 189 cases participated (88% participation rate), while both the commercial database and NHS Central Register (NHSCR) controls achieved a participation rate of 24% among persons assumed to have received the invitation. On several measures, the NHSCR patients reported poorer health than the commercial database controls: low scores on the physical component score of the Short Form 36 (odds ratio [OR]: 2.3; 95% confidence interval [CI]: 1.3-4.1), chronic widespread pain (OR: 2.3; CI: 1.1-4.7), and high levels of fatigue (OR: 2.0; CI: 1.3-3.1). These had an important influence on the estimates of association with case status with one association (pain) showing a strong and significant association using commercial database controls, which was absent with NHSCR controls. There are important differences in self-reported measures of health and quality of life using controls from two alternative population sampling frames. It emphasizes the importance of methodological rigor and prior assessment in choosing sampling frames for case-control studies. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Global importation and population risk factors for measles in New Zealand: a case study for highly immunized populations.

    PubMed

    Hayman, D T S; Marshall, J C; French, N P; Carpenter, T E; Roberts, M G; Kiedrzynski, T

    2017-07-01

    As endemic measles is eliminated through immunization, countries must determine the risk factors for the importation of measles into highly immunized populations to target control measures. Despite eliminating endemic measles, New Zealand suffers from outbreaks after introductions from abroad, enabling us to use it as a model for measles introduction risk. We used a generalized linear model to analyze risk factors for 1137 measles cases from 2007 to June 2014, provide estimates of national immunity levels, and model measles importation risk. People of European ethnicity made up the majority of measles cases. Age is a positive risk factor, particularly 0-2-year-olds and 5-17-year-old Europeans, along with increased wealth. Pacific islanders were also at greater risk, but due to 0-2-year-old cases. Despite recent high measles, mumps, and rubella vaccine immunization coverage, overall population immunity against measles remains ~90% and is lower in people born between 1982 and 2005. Greatest measles importation risk is during December, and countries predicted to be sources have historical connections and highest travel rates (Australia and UK), followed by Asian countries with high travel rates and higher measles incidences. Our results suggest measles importation due to travel is seeding measles outbreaks, and immunization levels are insufficient to continue to prevent outbreaks because of heterogeneous immunity in the population, leaving particular age groups at risk.

  14. Confirmed Zika virus infection in a Belgian traveler returning from Guatemala, and the diagnostic challenges of imported cases into Europe.

    PubMed

    De Smet, Birgit; Van den Bossche, Dorien; van de Werve, Charlotte; Mairesse, Jacques; Schmidt-Chanasit, Jonas; Michiels, Jo; Ariën, Kevin K; Van Esbroeck, Marjan; Cnops, Lieselotte

    2016-07-01

    We report the first laboratory-confirmed Zika virus (ZIKV) infection in a Belgian traveler after a three week holiday in Guatemala, December 2015. This case along with other imported cases into Europe emphases once again the need for accurate diagnostic tools for this rapidly emerging virus. The challenge is to diagnose patients in the acute phase, which appears short, as serological testing is complicated by cross-reactivity, vaccination status and scarce availability of specific ZIKV tests. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Importance of multi-modal approaches to effectively identify cataract cases from electronic health records

    PubMed Central

    Rasmussen, Luke V; Berg, Richard L; Linneman, James G; McCarty, Catherine A; Waudby, Carol; Chen, Lin; Denny, Joshua C; Wilke, Russell A; Pathak, Jyotishman; Carrell, David; Kho, Abel N; Starren, Justin B

    2012-01-01

    Objective There is increasing interest in using electronic health records (EHRs) to identify subjects for genomic association studies, due in part to the availability of large amounts of clinical data and the expected cost efficiencies of subject identification. We describe the construction and validation of an EHR-based algorithm to identify subjects with age-related cataracts. Materials and methods We used a multi-modal strategy consisting of structured database querying, natural language processing on free-text documents, and optical character recognition on scanned clinical images to identify cataract subjects and related cataract attributes. Extensive validation on 3657 subjects compared the multi-modal results to manual chart review. The algorithm was also implemented at participating electronic MEdical Records and GEnomics (eMERGE) institutions. Results An EHR-based cataract phenotyping algorithm was successfully developed and validated, resulting in positive predictive values (PPVs) >95%. The multi-modal approach increased the identification of cataract subject attributes by a factor of three compared to single-mode approaches while maintaining high PPV. Components of the cataract algorithm were successfully deployed at three other institutions with similar accuracy. Discussion A multi-modal strategy incorporating optical character recognition and natural language processing may increase the number of cases identified while maintaining similar PPVs. Such algorithms, however, require that the needed information be embedded within clinical documents. Conclusion We have demonstrated that algorithms to identify and characterize cataracts can be developed utilizing data collected via the EHR. These algorithms provide a high level of accuracy even when implemented across multiple EHRs and institutional boundaries. PMID:22319176

  16. Importance of multi-modal approaches to effectively identify cataract cases from electronic health records.

    PubMed

    Peissig, Peggy L; Rasmussen, Luke V; Berg, Richard L; Linneman, James G; McCarty, Catherine A; Waudby, Carol; Chen, Lin; Denny, Joshua C; Wilke, Russell A; Pathak, Jyotishman; Carrell, David; Kho, Abel N; Starren, Justin B

    2012-01-01

    There is increasing interest in using electronic health records (EHRs) to identify subjects for genomic association studies, due in part to the availability of large amounts of clinical data and the expected cost efficiencies of subject identification. We describe the construction and validation of an EHR-based algorithm to identify subjects with age-related cataracts. We used a multi-modal strategy consisting of structured database querying, natural language processing on free-text documents, and optical character recognition on scanned clinical images to identify cataract subjects and related cataract attributes. Extensive validation on 3657 subjects compared the multi-modal results to manual chart review. The algorithm was also implemented at participating electronic MEdical Records and GEnomics (eMERGE) institutions. An EHR-based cataract phenotyping algorithm was successfully developed and validated, resulting in positive predictive values (PPVs) >95%. The multi-modal approach increased the identification of cataract subject attributes by a factor of three compared to single-mode approaches while maintaining high PPV. Components of the cataract algorithm were successfully deployed at three other institutions with similar accuracy. A multi-modal strategy incorporating optical character recognition and natural language processing may increase the number of cases identified while maintaining similar PPVs. Such algorithms, however, require that the needed information be embedded within clinical documents. We have demonstrated that algorithms to identify and characterize cataracts can be developed utilizing data collected via the EHR. These algorithms provide a high level of accuracy even when implemented across multiple EHRs and institutional boundaries.

  17. The importance of being flexible: the case of basic region leucine zipper transcriptional regulators.

    PubMed

    Miller, Maria

    2009-06-01

    Large volumes of protein sequence and structure data acquired by proteomic studies led to the development of computational bioinformatic techniques that made possible the functional annotation and structural characterization of proteins based on their primary structure. It has become evident from genome-wide analyses that many proteins in eukaryotic cells are either completely disordered or contain long unstructured regions that are crucial for their biological functions. The content of disorder increases with evolution indicating a possibly important role of disorder in the regulation of cellular systems. Transcription factors are no exception and several proteins of this class have recently been characterized as premolten/molten globules. Yet, mammalian cells rely on these proteins to control expression of their 30,000 or so genes. Basic region:leucine zipper (bZIP) DNA-binding proteins constitute a major class of eukaryotic transcriptional regulators. This review discusses how conformational flexibility "built" into the amino acid sequence allows bZIP proteins to interact with a large number of diverse molecular partners and to accomplish their manifold cellular tasks in a strictly regulated and coordinated manner.

  18. The importance of problem formulations in risk assessment: a case study involving dioxin-contaminated soil.

    PubMed

    Dourson, Michael L; Gadagbui, Bernard; Griffin, Susan; Garabrant, David H; Haws, Laurie C; Kirman, Christopher; Tohyama, Chiharu

    2013-07-01

    The need to remediate contaminated soils is typically accomplished by applying standard risk assessment methods followed by risk management to select remedial options. These human health risk assessments (HHRAs) have been largely conducted in a formulaic manner that relies heavily on standard deterministic exposure, toxicity assumptions and fixed mathematical formulas. The HHRA approach, with its traditional formulaic practice, does not take advantage of problem formulation in the same manner as is done in ecological risk assessment, and historically, has generally failed to emphasize incorporation of site-specific information. In response to these challenges, the National Academy of Sciences recently made several recommendations regarding the conduct of HHRAs, one of which was to begin all such assessments with problem formulation. These recommendations have since been extended to dose response assessment. In accordance with these recommendations, a group of experts presented and discussed findings that highlighted the importance and impact of including problem formulation when determining the need for remediation of dioxin contamination in soils, focusing in particular on exposure assessment is described. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. The Importance of Being Flexible: The Case of Basic Region Leucine Zipper Transcriptional Regulators

    PubMed Central

    Miller, Maria

    2009-01-01

    Large volumes of protein sequence and structure data acquired by proteomic studies led to the development of computational bioinformatic techniques that made possible the functional annotation and structural characterization of proteins based on their primary structure. It has become evident from genome-wide analyses that many proteins in eukaryotic cells are either completely disordered or contain long unstructured regions that are crucial for their biological functions. The content of disorder increases with evolution indicating a possibly important role of disorder in the regulation of cellular systems. Transcription factors are no exception and several proteins of this class have recently been characterized as premolten/molten globules. Yet, mammalian cells rely on these proteins to control expression of their 30,000 or so genes. Basic region:leucine zipper (bZIP) DNA-binding proteins constitute a major class of eukaryotic transcriptional regulators. This review discusses how conformational flexibility “built” into the amino acid sequence allows bZIP proteins to interact with a large number of diverse molecular partners and to accomplish their manifold cellular tasks in a strictly regulated and coordinated manner. PMID:19519454

  20. First isolation of dengue 3 in Brazil from an imported case.

    PubMed

    Rocco, I M; Kavakama, B B; Santos, C L

    2001-01-01

    The authors report the isolation of dengue 3 virus for the first time in Brazil. The patient, resident in Limeira-SP, traveled to Nicaragua on May 16th, 1998, where he stayed for two months. Starting on August 14 th he had fever, headache, myalgia, arthralgia, retro-orbital pain and diarrhea. He returned to Brazil on August 16th and was hospitalized in the next day. The patient had full recovery and was discharged on August 20th. The virus was isolated in C6/36 cell culture inoculated with serum collected on the 6th day after the onset of the symptoms. The serotype 3 was identified by indirect immunofluorescence assays performed with type-specific monoclonal antibodies. This serotype was further confirmed by polymerase chain reaction analysis. The introduction of a new dengue serotype in a susceptible population is a real threat for the occurrence of severe forms of the disease. The isolation and identification of dengue virus are important in order to monitoring the serotypes circulating in Brazil and to take the measures necessary to prevent and control an epidemic.

  1. [Imported B3 genotype measles viruses were isolated from measles cases in the Chinese mainland].

    PubMed

    Wang, Shu-Lei; Li, Chong-Shan; Wang, Hui-Ling; Tang, Wei; Song Jin-Hua; Yang, Jin-Hua; Wang, Shi-Wen; Zhang, Yan; Xu, Wen-Bo

    2014-09-01

    We isolated and identified the genotypes and molecular characteristics of the imported B3 measles virus (MeV) in the Chinese mainland. The Vero/SLAM cell line was used to isolate the viruses. Reverse transcription-polymerase chain reaction was undertaken to amplify the 450 nucleotide acids of the 3-terminal of the nucleoprotein gene. A phylogenetic tree was constructed and similarities in homology assessed. Results suggested that the Shanghai isolates MVi/Shanghai. CHN/38. 13/02 [B3] and MVi/Shanghai. CHN/40. 13/02[B3] were clustered within the same genotype group as the World Health Organization (WHO) B3 genotype reference strain. The number of differences in nucleotide acids between the two Shanghai isolates was one. The homology of nucleotide acids between the Shanghai isolates and the WHO B3 genotype reference strain (MVi/Ibadan. NGA/0.97/1/B3) was 98%. Comparative results from the Measles Nucleotide Surveillance system suggested that the sequences of Shanghai isolates and the 2013 vi- ruses from Australia, Japan, Korea, Hong Kong China, Philippines and Iran were identical. This is the first time that the B3 genotype of MeV in the Chinese mainland has been isolated since 1993. These data can be used to create a "baseline" of genetic information for measles viruses in China, and help to trace the transmission of measles viruses in China and the rest of the world.

  2. The importance of drug metabolites synthesis: the case-study of cardiotoxic anticancer drugs.

    PubMed

    Hrynchak, Ivanna; Sousa, Emília; Pinto, Madalena; Costa, Vera Marisa

    2017-05-01

    Anticancer drugs are presently guarantying more survivors as a result of more powerful drugs or combinations of drugs used in therapy. Thus, it has become more crucial to study and overcome the side effects of these therapies. Cardiotoxicity is one of the most relevant side effects on the long-term cancer survivors, because of its high social and economic impact. Drug metabolism can result in active metabolites or toxic metabolites that can lead to important side effects. The metabolites of anticancer drugs are possible culprits of cardiotoxicity; however, the cardiotoxicity of many of the metabolites in several drug classes was not yet suitably studied so far. On the other hand, the use of prodrugs that are bioactivated through metabolism can be a good alternative to obtain more cardio safe drugs. In this review, the methods to obtain and study metabolites are summarized and their application to the study of a group of anticancer drugs with acknowledged cardiotoxicity is highlighted. In this group of drugs, doxorubicin (DOX, 1), mitoxantrone (MTX, 2), cyclophosphamide (CTX, 3) and 5-fluorouracil (5-FU, 4) are included, as well as the tyrosine kinase inhibitors, such as imatinib (5), sunitinib (6) and sorafenib (7). Only with the synthesis and purification of considerable amounts of the metabolites can reliable studies be performed, either in vitro or in vivo that allow accurate conclusions regarding the cardiotoxicity of anticancer drug metabolites and then pharmacological prevention or treatment of the cardiac side effects can be done.

  3. The importance of context in delivering effective EIA: Case studies from East Africa

    SciTech Connect

    Marara, Madeleine; Okello, Nick; Kuhanwa, Zainab; Douven, Wim; Beevers, Lindsay Leentvaar, Jan

    2011-04-15

    This paper reviews and compares the condition of the environmental impact assessment (EIA) system in three countries in the East Africa region: Kenya, Rwanda and Tanzania. The criteria used for the evaluation and the comparison of each system are based on the elements of the legal, administrative and procedural frameworks, as well as the context in which they operate. These criteria are adapted from the evaluation and quality control criteria derived from a number of literature sources. The study reveals that the EIA systems of Kenya and Tanzania are at a similar stage in their development. The two countries, the first to introduce the EIA concept into their jurisdiction in this part of Africa, therefore have more experience than Rwanda in the practice of environmental impact assessment, where the legislation and process requires more time to mature both from the governmental and societal perspective. The analysis of the administrative and procedural frameworks highlights the weakness in the autonomy of the competent authority, in all three countries. Finally a major finding of this study is that the contextual set up i.e. the socio-economic and political situation plays an important role in the performance of an EIA system. The context in developing countries is very different from developed countries where the EIA concept originates. Interpreting EIA conditions in countries like Kenya, Rwanda and Tanzania requires that the analysis for determining the effectiveness of their systems should be undertaken within a relevant framework, taking into account the specific requirements of those countries.

  4. Is importing second-hand products a good thing? The cases of computers and tires in Cambodia

    SciTech Connect

    Chanthy, Lay Nitivattananon, Vilas

    2011-04-15

    Is importing second-hand products (SHPs) good for Cambodia? To answer this question, one must seriously consider environmental and social effects. The main objective of this study is to identify and assess the economic, social, and environmental impacts of imported SHPs to determine whether or not Cambodia benefits. Imported second-hand computers (SHPCs) and second-hand tires (SHTs) were selected as cases for the study. The study used a scaling checklist to identify significant impacts of these two imported items. Significant impacts were ranked and rated into a single value (score) for integration. Integrated impact assessment showed that imported SHPCs create a very small positive impact (+ 0.1 of + 5) and imported SHTs generate a large negative impact (- 2.83 of - 5). These scores are mainly the result of environmental impact, predominantly waste issues. Thus, current imports of SHPCs and SHTs do not really benefit Cambodia, but instead cause serious environmental problems from their waste issues. The import serves as a channel to transfer waste into developing countries.

  5. Assessing reproductive behavior important to fisheries management: a case study with red drum, Sciaenops ocellatus.

    PubMed

    Lowerre-barbieri, Susan K; Burnsed, Sarah L Walters; Bickford, Joel W

    2016-06-01

    Spawning site selection and reproductive timing affect stock productivity and structure in marine fishes but are poorly understood. Traditionally, stock assessments measure reproductive potential as spawning stock biomass or egg production and do not include other aspects of reproductive behavior. Red drum make an excellent case study to assess these other aspects, as (1) they are highly fecund, pelagic spawners, like most exploited marine fishes; (2) their life cycle is delineated between nursery (estuarine) and adult (coastal and offshore) habitat; and (3) they are managed at these two spatial scales. This study was conducted from August 2012 to December 2013 and integrates data from multiple methods and spatial scales. Aerial surveys were used for large-scale monitoring of aggregations off two known estuarine nursery areas, Tampa Bay and Charlotte Harbor, Florida, USA. Capture-based sampling in Tampa Bay coastal (n = 2581) and estuarine waters (n = 158) was used to assess reproductive state and to confirm coastal spawning. To assess spatial dynamics, we acoustically tagged two population components in the Tampa Bay system, subadults from the estuary (n = 20) and adults from the coastal spawning site (n = 60). Behavioral plasticity was seen in subadult recruitment to coastal habitat, with some subadults maturing and recruiting before or during the spawning season and others (14 of 20 acoustically tagged fish) recruiting at the end of the 2012 spawning season. Both adults and recruited subadults (n = 29) were consequently detected in the Charlotte Harbor array, 132 km to the south. Spawning-site fidelity to the Tampa Bay spawning site occurred at both the population and individual scales. Aggregations consistently occurred in Tampa Bay coastal waters during the spawning season, and approximately two-thirds of tagged adults returned in the 2013 spawning season. A similar proportion of subadults returned to the Tampa Bay spawning site, exhibiting natal homing

  6. Assessing reproductive behavior important to fisheries management: a case study with red drum, Sciaenops ocellatus.

    PubMed

    Lowerre-Barbieri, Susan K; Walters Burnsed, Sarah L; Bickford, Joel W

    2016-06-01

    Spawning site selection and reproductive timing affect stock productivity and structure in marine fishes but are poorly understood. Traditionally, stock assessments measure reproductive potential as spawning stock biomass or egg production and do not include other aspects of reproductive behavior. Red drum make an excellent case study to assess these other aspects, as (1) they are highly fecund, pelagic spawners, like most exploited marine fishes; (2) their life cycle is delineated between nursery (estuarine) and adult (coastal and offshore) habitat; and (3) they are managed at these two spatial scales. This study was conducted from August 2012 to December 2013 and integrates data from multiple methods and spatial scales. Aerial surveys were used for large-scale monitoring of aggregations off two known estuarine nursery areas, Tampa Bay and Charlotte Harbor, Florida, USA. Capture-based sampling in Tampa Bay coastal (n = 2581) and estuarine waters (n = 158) was used to assess reproductive state and to confirm coastal spawning. To assess spatial dynamics, we acoustically tagged two population components in the Tampa Bay system, subadults from the estuary (n = 20) and adults from the coastal spawning site (n = 60). Behavioral plasticity was seen in subadult recruitment to coastal habitat, with some subadults maturing and recruiting before or during the spawning season and others (14 of 20 acoustically tagged fish) recruiting at the end of the 2012 spawning season. Both adults and recruited subadults (n = 29) were consequently detected in the Charlotte Harbor array, 132 km to the south. Spawning-site fidelity to the Tampa Bay spawning site occurred at both the population and individual scales. Aggregations consistently occurred in Tampa Bay coastal waters during the spawning season, and approximately two-thirds of tagged adults returned in the 2013 spawning season. A similar proportion of subadults returned to the Tampa Bay spawning site, exhibiting natal

  7. Importance of using regional and national data in comparative bioaccumulation studies: A case study

    SciTech Connect

    Rawa, A.; Peterson, S.C.; Eich, C.

    1995-12-31

    As part of an investigation to determine whether site-related contaminants are bioaccumulating in fish from Puffer Pond (located at the Sudbury US Army Training Annex, Massachusetts), filet and whole body preparations from yellow perch, chain pickerel, and brown bullhead were analyzed for mercury and other contaminants and compared with levels in the same fish species from Ministers Pond, a nearby off-site ``background`` pond. The mean concentration of mercury was higher in pickerel from Puffer Pond (0.61 {micro}g/g versus 0.50 {micro}g/g). Mercury was also found to be higher an average in perch from Puffer Pond (0.38 {micro}g/g versus 0.24 {micro}g/g) suggesting potential site-related contamination. Results were subsequently compared to Massachusetts clean water reference data, to USEPA national background mercury data, and to nationwide USFWS contaminant biomonitoring program mercury data. Average mercury concentrations were 0.47 {micro}g/g, 0.34 {micro}g/g, and 0.11 {micro}g/g, respectively. The variety of fish species, analytical methods, and times and locations of capture make direct comparison uncertain, but the data provide additional perspective. Specifically, Puffer Pond fish, with a mean mercury concentration of 0.36 {micro}g/g, and Ministers Pond fish, with a mean concentration of 0.37 {micro}g/g, exhibit mercury levels within the range of national and regional background mercury levels. Mercury was not found at detectable concentrations in surface water or sediment of either pond. Bioaccumulation of mercury in Puffer Pond and clean water bodies in Massachusetts is likely related to the low-pH of the water and atmospheric deposition of mercury from global and regional sources rather than from site-related sources. This study emphasizes the importance of consulting regional and national data when drawing conclusions from comparative bioaccumulation studies.

  8. An imported case of echinococcosis of the liver in a Korean who traveled to western and central Europe.

    PubMed

    Byun, Sun-Ju; Moon, Kyung Chul; Suh, Kyung-Suk; Han, Joon Koo; Chai, Jong-Yil

    2010-06-01

    Echinococcus granulosus, an intestinal tapeworm of dogs and other canids, infects humans in its larval stage and causes human echinococcosis or hydatid disease. In the Republic of Korea, 31 parasite-proven human echinococcosis cases have been reported, most of which were imported from the Middle East. We recently examined a 61-year-old Korean man who had a large cystic mass in his liver. ELISA was negative for tissue parasitic infections, including echinococcosis, cysticercosis, paragonimiasis, and sparganosis. The patient underwent surgery to remove the cyst, and the resected cyst was processed histopathologically for microscopic examinations. In sectioned cyst tissue, necrotizing protoscolices with disintegrated hooklets of E. granulosus were found. In some areas, only freed, fragmented hooklets were detected. The patient had traveled to western and central Europe in 1996, and had no other history of overseas travel. We report our patient as a hepatic echinococcosis case which was probably imported from Europe.

  9. The first imported case of Rift Valley fever in China reveals a genetic reassortment of different viral lineages.

    PubMed

    Liu, Jingyuan; Sun, Yulan; Shi, Weifeng; Tan, Shuguang; Pan, Yang; Cui, Shujuan; Zhang, Qingchao; Dou, Xiangfeng; Lv, Yanning; Li, Xinyu; Li, Xitai; Chen, Lijuan; Quan, Chuansong; Wang, Qianli; Zhao, Yingze; Lv, Qiang; Hua, Wenhao; Zeng, Hui; Chen, Zhihai; Xiong, Haofeng; Jiang, Chengyu; Pang, Xinghuo; Zhang, Fujie; Liang, Mifang; Wu, Guizhen; Gao, George F; Liu, William J; Li, Ang; Wang, Quanyi

    2017-01-18

    We report the first imported case of Rift Valley fever (RVF) in China. The patient returned from Angola, a non-epidemic country, with an infection of a new reassortant from different lineages of Rift Valley fever viruses (RVFVs). The patient developed multiorgan dysfunction and gradually recovered with continuous renal replacement therapy and a short regimen of methylprednisolone treatment. The disordered cytokines and chemokines in the plasma of the patient revealed hypercytokinemia, but the levels of protective cytokines were low upon admission and fluctuated as the disease improved. Whole-genome sequencing and phylogenetic analysis revealed that the imported strain was a reassortant comprising the L and M genes from lineage E and the S gene from lineage A. This case highlights that RVFV had undergone genetic reassortment, which could potentially alter its biological properties, cause large outbreaks and pose a serious threat to global public health as well as the livestock breeding industry.

  10. The first imported case of Rift Valley fever in China reveals a genetic reassortment of different viral lineages

    PubMed Central

    Liu, Jingyuan; Sun, Yulan; Shi, Weifeng; Tan, Shuguang; Pan, Yang; Cui, Shujuan; Zhang, Qingchao; Dou, Xiangfeng; Lv, Yanning; Li, Xinyu; Li, Xitai; Chen, Lijuan; Quan, Chuansong; Wang, Qianli; Zhao, Yingze; lv, Qiang; Hua, Wenhao; Zeng, Hui; Chen, Zhihai; Xiong, Haofeng; Jiang, Chengyu; Pang, Xinghuo; Zhang, Fujie; Liang, Mifang; Wu, Guizhen; Gao, George F; Liu, William J; Li, Ang; Wang, Quanyi

    2017-01-01

    We report the first imported case of Rift Valley fever (RVF) in China. The patient returned from Angola, a non-epidemic country, with an infection of a new reassortant from different lineages of Rift Valley fever viruses (RVFVs). The patient developed multiorgan dysfunction and gradually recovered with continuous renal replacement therapy and a short regimen of methylprednisolone treatment. The disordered cytokines and chemokines in the plasma of the patient revealed hypercytokinemia, but the levels of protective cytokines were low upon admission and fluctuated as the disease improved. Whole-genome sequencing and phylogenetic analysis revealed that the imported strain was a reassortant comprising the L and M genes from lineage E and the S gene from lineage A. This case highlights that RVFV had undergone genetic reassortment, which could potentially alter its biological properties, cause large outbreaks and pose a serious threat to global public health as well as the livestock breeding industry. PMID:28096531

  11. Importance of HER2 Work-Up and Treatment Even in Patients with Poor Performance Status: A Case Report

    PubMed Central

    Suner, Ali; Balakan, Ozan; Kalender, Mehmet Emin; Ulas, Turgay; Sevinc, Alper; Camci, Celalettin

    2014-01-01

    Gastric cancer is one of most common types of cancers. Metastatic gastric cancer has a poor prognosis and is accepted as incurable at this stage. Treatment of metastatic gastric cancer did not progress substantially until new targeted agents have come out. Recently published ToGA trial showed promising results in HER2 overexpressing metastatic gastric cancer. In this case we present a case with an excellent complete response with anti-HER2 treatment. Most importantly, we wanted to emphasize (1) the importance of early determination of HER2 overexpression, and (2) to draw attention of anti-HER2 agents in the first line treatment even in patients with a poor performance status. PMID:24822142

  12. Importance of Relationship Context in HIV Transmission: Results From a Qualitative Case-Control Study in Rakai, Uganda

    PubMed Central

    Mathur, Sanyukta; Eckel, Elizabeth; Kelly, Laura; Nakyanjo, Neema; Sekamwa, Richard; Namatovu, Josephine; Ddaaki, William; Nakubulwa, Rosette; Namakula, Sylvia; Nalugoda, Fred; Santelli, John S.

    2014-01-01

    We present results from life history interviews with 60 young adults from southern Uganda. Using a novel qualitative case-control design, we compared newly HIV-positive cases with HIV-negative controls matched on age, gender, marital status, and place of residence. Relationship context was the most salient theme differentiating cases from controls. Compared with HIV-negative respondents, recent seroconverters described relationships marked by poorer communication, greater suspicion and mistrust, and larger and more transitory sexual networks. Results highlight the importance of dyadic approaches to HIV and possibly of couple-based interventions. Using HIV-matched pairs allowed additional understanding of the factors influencing transmission. This hybrid methodological approach holds promise for future studies of sexual health. PMID:24524490

  13. [Importance of the case of coronavirus-associated severe acute respiratory syndrome detected in Hungary in 2005].

    PubMed

    Rókusz, László; Jankovics, István; Jankovics, Máté; Sarkadi, Júlia; Visontai, Ildikó

    2013-11-24

    Ten years have elapsed since the severe acute respiratory syndrome outbreak, which resulted in more than 8000 cases worldwide with more than 700 deaths. Recently, a new coronavirus, the Middle East Respiratory Syndrome Coronavirus emerged, causing serious respiratory cases and death. By the end of August 2013, 108 cases including 50 deaths were reported. The authors discuss a coronavirus-associated severe acute respiratory syndrome, which was detected in Hungary in 2005 and highlight its significance in 2013. In 2005 the patient was hospitalized and all relevant clinical and microbiological tests were performed. Based on the IgG antibody positivity of the serum samples, the patient was diagnosed as having severe acute respiratory syndrome coronavirus infection in the past. The time and source of the infection remained unknown. The condition of the patient improved and he was discharged from the hospital. The case raises the possibility of infections in Hungary imported from remote areas of the world and the importance of thorough examination of patients with severe respiratory syndrome with unknown etiology.

  14. A domain-specific system for representing knowledge of both man-made objects and human actions. Evidence from a case with an association of deficits.

    PubMed

    Vannuscorps, Gilles; Pillon, Agnesa

    2011-07-01

    We report the single-case study of a brain-damaged individual, JJG, presenting with a conceptual deficit and whose knowledge of living things, man-made objects, and actions was assessed. The aim was to seek for empirical evidence pertaining to the issue of how conceptual knowledge of objects, both living things and man-made objects, is related to conceptual knowledge of actions at the functional level. We first found that JJG's conceptual knowledge of both man-made objects and actions was similarly impaired while his conceptual knowledge of living things was spared as well as his knowledge of unique entities. We then examined whether this pattern of association of a conceptual deficit for both man-made objects and actions could be accounted for, first, by the "sensory/functional" and, second, the "manipulability" account for category-specific conceptual impairments advocated within the Feature-Based-Organization theory of conceptual knowledge organization, by assessing, first, patient's knowledge of sensory compared to functional features, second, his knowledge of manipulation compared to functional features and, third, his knowledge of manipulable compared to non-manipulable objects and actions. The later assessment also allowed us to evaluate an account for the deficits in terms of failures of simulating the hand movements implied by manipulable objects and manual actions. The findings showed that, contrary to the predictions made by the "sensory/functional", the "manipulability", and the "failure-of-simulating" accounts for category-specific conceptual impairments, the patient's association of deficits for both man-made objects and actions was not associated with a disproportionate impairment of functional compared to sensory knowledge or of manipulation compared to functional knowledge; manipulable items were not more impaired than non-manipulable items either. In the general discussion, we propose to account for the patient's association of deficits by the

  15. The Importance of Audience and Agency for Representation: A Case Study of an Urban Youth Media Community

    PubMed Central

    Charmaraman, Linda

    2010-01-01

    Purpose Urban youths' agency to represent their realities through media has been largely unexplored in the youth development literature. In this qualitative case study of an after-school youth media program in the Bay Area, expressions of youth agency and the role of audiences are explored during the process of producing videos for public consumption. Methodology As participant observer of 14 ethnically diverse youth participants aged between 15 and 18 years over 18 months, I documented (a) the kind of agencies participants engaged in and (b) the impact of live and imagined future audiences on youths' creative processes. Analyses of field notes, semi-structured interviews, and media projects were conducted using thematic analysis to inductively generate emerging categories. Findings Themes included an agentive sense of self-efficacy, commitment, and responsibility, as well as perceived contributions to local audiences and an emerging collective identity. The youth demonstrated their increased sense of a social or civic duty to realistically represent youth of color to familiar and unfamiliar audiences. Implications This case study demonstrated how one youth media organization fostered agency through youth authorship, production, distribution, and local community dialogue. By documenting the impact of audiences from conception to public reception, this study provides valuable insight into the agentive process of publicly “performing” a commitment to complete a social change video project. Contribution This chapter underscores the value of performance within youth development programs and the critical component of audiences as one form of authentic assessment in order to foster individual and collective agency. PMID:20671812

  16. [Determination of blood alcohol level of people who are involved in a judicial event of medical importance (case report)].

    PubMed

    Alkan, N; Demircan, T

    2001-10-01

    In some cases, determination of blood alcohol level is very important. The alcohol level at the time of an event, can affect the court decision and may lead to aggravate the penalty or on the contrary an acquittal. In this article, a criminal action, in one of Turkish High Criminal Court is examined. The case was about the death of a drunk person who had fallen down from the window of his girl friend's house which is on the third floor of an apartment. This person's parent applied to public prosecutor saying that their child did not fall down but was murdered by his girl friend. During this trial, in the victim's autopsy, no alcohol detected in blood in contrast with his girl friend's testimony. Because of this contradiction, a reasonable doubt has emerged that she was the murderer in this suspicious death. However, in the further stages of trial, the reasons of no alcohol detection in the autopsy is investigated. In the basis of this case, the importance and techniques of alcohol detection in blood is discussed with literature.

  17. Financial crisis, virtual carbon in global value chains, and the importance of linkage effects. The Spain-china case.

    PubMed

    López, Luis-Antonio; Arce, Guadalupe; Zafrilla, Jorge

    2014-01-01

    Trade has a disproportionate environmental impact, while the international fragmentation of production promotes different patterns of intermediate inputs and final goods. Therefore, we split up the balance of domestic embodied emissions in trade (BDEET) to assess it. We find that Spain has a significant emissions deficit with China between 2005 and 2011. The Global Financial Crisis of 2008 reduced Spanish imports of pollution-intensive inputs from China and slightly improved the BDEET. China primarily exports indirect virtual carbon, representing 86% of the total, especially from Production of electricity, gas, and water sector. These linkages effects in China indicate that post-Kyoto agreements must focus not only on traded goods but also on the environmental efficiency of all domestic production chains. The methodology proposed allows us to identify the agents responsible for this trade in both Spain and China, namely the sectors importing intermediate inputs (Construction and Transport equipment) and industries and consumers importing final goods (Textiles, Other manufactures, Computers, and Machinery). The relevant sectors uncertainties found when we compare the results for BDEET and emissions embodied in bilateral trade (BEET) lead us to recommend the former methodology to evaluate the implications of environmental and energy policy for different industries and agents.

  18. Importance of Laparoscopic Assessment of the Uterine Adnexa in a Mayer-Rokitansky-Kuster-Hauser Syndrome Type II Case

    PubMed Central

    DRAGUSIN, ROXANA; TUDORACHE, ȘTEFANIA; SURLIN, V.; LICHIARDOPOL, CORINA; ILIESCU, D.G.

    2014-01-01

    In the case reported, diagnosed with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome, the presence of normal ovaries proved to be challenging to confirm due to unusual high positioned (ectopic) ovaries. MRKH syndrome is a rare pathological condition characterized by a spectrum of the Mullerian duct abnormalities resulting in congenital aplasia of the uterus and of the upper part (2/3) of the vagina, developed during embryogenesis. At the same time, the mullerian development is interdependent with the Wolffian (mesonephric) duct and this explains the associated renal abnormalities (MRKH type II). Laparoscopic assessment was of great importance in defining the exact anatomic characteristics of MRKH syndrome. PMID:25729598

  19. Importance of Laparoscopic Assessment of the Uterine Adnexa in a Mayer-Rokitansky-Kuster-Hauser Syndrome Type II Case.

    PubMed

    Dragusin, Roxana; Tudorache, Ștefania; Surlin, V; Lichiardopol, Corina; Iliescu, D G

    2014-01-01

    In the case reported, diagnosed with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome, the presence of normal ovaries proved to be challenging to confirm due to unusual high positioned (ectopic) ovaries. MRKH syndrome is a rare pathological condition characterized by a spectrum of the Mullerian duct abnormalities resulting in congenital aplasia of the uterus and of the upper part (2/3) of the vagina, developed during embryogenesis. At the same time, the mullerian development is interdependent with the Wolffian (mesonephric) duct and this explains the associated renal abnormalities (MRKH type II). Laparoscopic assessment was of great importance in defining the exact anatomic characteristics of MRKH syndrome.

  20. The importance of user centered design methods applied to the design of a new workstation: a case study.

    PubMed

    Duschenes, Ronaldo; Mendes, Andressa; Betiol, Adriana; Barreto, Suzana

    2012-01-01

    This paper presents a case study of the application of user centered design methodologies in the product development for a line of ergonomic office furniture. The study aimed to analyze the experience of using a workstation from the perspective of two groups of users, installers and end users. The observation of users in their natural context of use not only allowed the development team to identify key needs and strategies of the users, transforming them into design solutions, but mainly it warned them of the importance and impact of user involvement in the product development cycle.

  1. Representing Natural-Language Case Report Form Terminology Using Health Level 7 Common Document Architecture, LOINC, and SNOMED-CT: Lessons Learned

    PubMed Central

    Hunscher, Dale; Boyd, Andrew; Green, Lee A.; Clauw, Daniel J.

    2006-01-01

    Clinicians and biomedical research investigators ordinarily use natural language when describing biomedical concepts and constructs, even in the context of highly structured case report forms. We describe work in progress and lessons learned in translating complex natural-language concepts on case report forms into machine-readable format using the HL7 CDA, LOINC, and SNOMED-CT standards. PMID:17238580

  2. Representing natural-language case report form terminology using Health Level 7 Common Document Architecture, LOINC, and SNOMED-CT: lessons learned.

    PubMed

    Hunscher, Dale; Boyd, Andrew; Green, Lee A; Clauw, Daniel J

    2006-01-01

    Clinicians and biomedical research investigators ordinarily use natural language when describing biomedical concepts and constructs, even in the context of highly structured case report forms. We describe work in progress and lessons learned in translating complex natural-language concepts on case report forms into machine-readable format using the HL7 CDA, LOINC, and SNOMED-CT standards.

  3. Paget Schroetter Syndrome: A case study of the chiropractor’s role in recognizing and comanaging an important condition

    PubMed Central

    Rowan, Tracy L.; Kazemi, Mohsen

    2012-01-01

    Objective: To emphasize the importance for health care professionals to be knowledgeable of a relatively rare form of thoracic outlet syndrome, known as Paget Schroetter syndrome. The etiology, key signs and symptoms, and the importance of immediate referral are highlighted and an introduction to manual therapists’ role within a multidisciplinary team is provided. Clinical Features: Healthy athletes aged 15–30 are most commonly affected with 60–80% of patients reporting a history of repetitive or vigorous overhead activity prior to symptom onset. Intervention and Outcome: Manual therapists have a role in recognizing, referring, and providing symptomatic relief with soft tissue therapy, correcting abnormal biomechanics, manipulations, mobilizations, and a rehabilitative program, as seen in this case report. Conclusion: Early recognition and referral of Paget Schroetter syndrome are essential for optimal recovery. Manual therapists may prove to have a role in decreasing the need for surgical decompression and accelerating resumption of regular activities. PMID:23204568

  4. Participatory democracy, representative democracy, and the nature of diffuse and concentrated interests: A case study of public involvement on a national gorest district

    Treesearch

    Christine Overdevest

    2000-01-01

    To evaluate whether public involvement on a national forest district fairly represents the public's values, this article proposes four hypothesis tests. First, it is hypothesized that public-involvement programs operute according to a participatory democracy logic, in which broad cross sections of the public participate in public involvement opportunities. A...

  5. Continuing Professional Education of Insurance and Risk Management Practitioners: A Comparative Case Study of Customer Service Representatives, Insurance Agents and Risk Managers

    ERIC Educational Resources Information Center

    Krauss, George E.

    2009-01-01

    The purpose of this study is to understand how selected insurance practitioners learn and developed in their practices setting. The selected insurance practitioners (collectively customer service representatives, insurance agents, and risk managers) are responsible for the counseling and placement of insurance products and the implementation of…

  6. Continuing Professional Education of Insurance and Risk Management Practitioners: A Comparative Case Study of Customer Service Representatives, Insurance Agents and Risk Managers

    ERIC Educational Resources Information Center

    Krauss, George E.

    2009-01-01

    The purpose of this study is to understand how selected insurance practitioners learn and developed in their practices setting. The selected insurance practitioners (collectively customer service representatives, insurance agents, and risk managers) are responsible for the counseling and placement of insurance products and the implementation of…

  7. An imported case of severe falciparum malaria with prolonged hemolytic anemia clinically mimicking a coinfection with babesiosis.

    PubMed

    Na, Young Ju; Chai, Jong-Yil; Jung, Bong-Kwang; Lee, Hyun Jung; Song, Ji Young; Je, Ji Hye; Seo, Ji Hye; Park, Sung Hun; Choi, Ji Seon; Kim, Min Ja

    2014-12-01

    While imported falciparum malaria has been increasingly reported in recent years in Korea, clinicians have difficulties in making a clinical diagnosis as well as in having accessibility to effective anti-malarial agents. Here we describe an unusual case of imported falciparum malaria with severe hemolytic anemia lasting over 2 weeks, clinically mimicking a coinfection with babesiosis. A 48-year old Korean man was diagnosed with severe falciparum malaria in France after traveling to the Republic of Benin, West Africa. He received a 1-day course of intravenous artesunate and a 7-day course of Malarone (atovaquone/proguanil) with supportive hemodialysis. Coming back to Korea 5 days after discharge, he was readmitted due to recurrent fever, and further treated with Malarone for 3 days. Both the peripheral blood smears and PCR test were positive for Plasmodium falciparum. However, he had prolonged severe hemolytic anemia (Hb 5.6 g/dl). Therefore, 10 days after the hospitalization, Babesia was considered to be potentially coinfected. A 7-day course of Malarone and azithromycin was empirically started. He became afebrile within 3 days of this babesiosis treatment, and hemolytic anemia profiles began to improve at the completion of the treatment. He has remained stable since his discharge. Unexpectedly, the PCR assays failed to detect DNA of Babesia spp. from blood. In addition, during the retrospective review of the case, the artesunate-induced delayed hemolytic anemia was considered as an alternative cause of the unexplained hemolytic anemia.

  8. The Importance of Socio-Economic Versus Environmental Risk Factors for Reported Dengue Cases in Java, Indonesia.

    PubMed

    Wijayanti, Siwi P M; Porphyre, Thibaud; Chase-Topping, Margo; Rainey, Stephanie M; McFarlane, Melanie; Schnettler, Esther; Biek, Roman; Kohl, Alain

    2016-09-01

    Dengue is a major mosquito-borne viral disease and an important public health problem. Identifying which factors are important determinants in the risk of dengue infection is critical in supporting and guiding preventive measures. In South-East Asia, half of all reported fatal infections are recorded in Indonesia, yet little is known about the epidemiology of dengue in this country. Hospital-reported dengue cases in Banyumas regency, Central Java were examined to build Bayesian spatial and spatio-temporal models assessing the influence of climatic, demographic and socio-economic factors on the risk of dengue infection. A socio-economic factor linking employment type and economic status was the most influential on the risk of dengue infection in the Regency. Other factors such as access to healthcare facilities and night-time temperature were also found to be associated with higher risk of reported dengue infection but had limited explanatory power. Our data suggest that dengue infections are triggered by indoor transmission events linked to socio-economic factors (employment type, economic status). Preventive measures in this area should therefore target also specific environments such as schools and work areas to attempt and reduce dengue burden in this community. Although our analysis did not account for factors such as variations in immunity which need further investigation, this study can advise preventive measures in areas with similar patterns of reported dengue cases and environment.

  9. The Importance of Socio-Economic Versus Environmental Risk Factors for Reported Dengue Cases in Java, Indonesia

    PubMed Central

    Chase-Topping, Margo; Rainey, Stephanie M.; McFarlane, Melanie; Schnettler, Esther; Biek, Roman; Kohl, Alain

    2016-01-01

    Background Dengue is a major mosquito-borne viral disease and an important public health problem. Identifying which factors are important determinants in the risk of dengue infection is critical in supporting and guiding preventive measures. In South-East Asia, half of all reported fatal infections are recorded in Indonesia, yet little is known about the epidemiology of dengue in this country. Methodology/Principal findings Hospital-reported dengue cases in Banyumas regency, Central Java were examined to build Bayesian spatial and spatio-temporal models assessing the influence of climatic, demographic and socio-economic factors on the risk of dengue infection. A socio-economic factor linking employment type and economic status was the most influential on the risk of dengue infection in the Regency. Other factors such as access to healthcare facilities and night-time temperature were also found to be associated with higher risk of reported dengue infection but had limited explanatory power. Conclusions/Significance Our data suggest that dengue infections are triggered by indoor transmission events linked to socio-economic factors (employment type, economic status). Preventive measures in this area should therefore target also specific environments such as schools and work areas to attempt and reduce dengue burden in this community. Although our analysis did not account for factors such as variations in immunity which need further investigation, this study can advise preventive measures in areas with similar patterns of reported dengue cases and environment. PMID:27603137

  10. Probabilistic differential diagnosis of Middle East respiratory syndrome (MERS) using the time from immigration to illness onset among imported cases.

    PubMed

    Ejima, Keisuke; Aihara, Kazuyuki; Nishiura, Hiroshi

    2014-04-07

    Middle East respiratory syndrome (MERS) has spread worldwide since 2012. As the clinical symptoms of MERS tend to be non-specific, the incubation period has been shown to complement differential diagnosis, especially to rule out influenza. However, because an infection event is seldom directly observable, the present study aims to construct a diagnostic model that predicts the probability of MERS diagnosis given the time from immigration to illness onset among imported cases which are suspected of MERS. Addressing censoring by considering the transmission dynamics in an exporting country, we demonstrate that the illness onset within 2 days from immigration is suggestive of influenza. Two exceptions to suspect MERS even for those with illness onset within 2 days since immigration are (i) when we observe substantial community transmissions of MERS and (ii) when the cases are at high risk of MERS (e.g. cases with close contact in hospital or household). It is vital to collect the information of the incubation period upon emergence of a novel infectious disease, and moreover, in our model, the fundamental transmission dynamics including the initial growth rate has to be explored to differentiate the disease diagnoses with non-specific symptoms.

  11. Evaluation of rotavirus infection and diarrhea in Iowa commercial pigs based on an epidemiologic study of a population represented by diagnostic laboratory cases.

    PubMed

    Will, L A; Paul, P S; Proescholdt, T A; Aktar, S N; Flaming, K P; Janke, B H; Sacks, J; Lyoo, Y S; Hill, H T; Hoffman, L J

    1994-10-01

    Group A, B, and C rotaviruses were identified in 9% (96/1,048) of pig fecal specimens submitted to the Iowa State University Veterinary Diagnostic Laboratory during 1987 and 1988. Six of the rotaviruses were group B, 5 were group C, and the remaining 89% were group A. Of the rotavirus cases with more than 1 serotype, 5 were multiple group A serotypes, 1 involved a group A and B serotype, and 1 included 2 group C serotypes. A retrospective epidemiologic evaluation of pig diarrhea in herds of origin was done using data obtained from the accession records of the rotavirus and 88 matched nonrotavirus pig diarrhea control cases. Herds from which rotavirus cases were derived experienced lower morbidity, mortality, and case fatality rates than matched control herds. The incidence of diarrhea decreased rapidly among all pigs from birth to 3 weeks of age. The peak incidence for piglet diarrhea occurred in February, and a moderate rise occurred in August-September. Definitive evidence for transmissible gastroenteritis virus was found in 12% of nonrotavirus cases but none of the rotavirus cases in which it was sought. Other pathogenic microorganisms were identified less frequently and inconsistently.

  12. Revisiting the importance of knowledge: from Namibia, a case for promoting knowledge by campaigns to reduce stigma.

    PubMed

    Chung, Adrienne H; Rimal, Rajiv N

    2015-04-01

    Reducing stigma against people living with HIV is key to encouraging HIV testing, which in turn is an important component in the treatment-as-prevention approach. We analyzed nationally representative survey data of participants aged 15 years and older in Namibia (N = 4,300) to determine whether knowledge about HIV and self-efficacy to protect against sexually transmitted HIV would be independently and jointly associated with stigma against people living with HIV, after controlling for demographics. Findings indicated that having less knowledge and feeling less self-efficacy were associated with greater stigma. Our key interaction hypothesis was also supported: stigma among those with lower self-efficacy to reduce risk of sexually transmitted HIV infection was particularly sensitive to the effects of increased knowledge about HIV. Results highlight the importance of enriching knowledge about HIV transmission modes, prevention strategies, and support services among those with low self-efficacy in order to reduce stigma against people living with HIV, and has useful implications for designing anti-stigma campaigns. © 2014 Society for Public Health Education.

  13. Molecular characterization of NRXN1 deletions from 19,263 clinical microarray cases identifies exons important for neurodevelopmental disease expression

    PubMed Central

    Lowther, Chelsea; Speevak, Marsha; Armour, Christine M.; Goh, Elaine S.; Graham, Gail E.; Li, Chumei; Zeesman, Susan; Nowaczyk, Malgorzata J.M.; Schultz, Lee-Anne; Morra, Antonella; Nicolson, Rob; Bikangaga, Peter; Samdup, Dawa; Zaazou, Mostafa; Boyd, Kerry; Jung, Jack H.; Siu, Victoria; Rajguru, Manjulata; Goobie, Sharan; Tarnopolsky, Mark A.; Prasad, Chitra; Dick, Paul T.; Hussain, Asmaa S.; Walinga, Margreet; Reijenga, Renske G.; Gazzellone, Matthew; Lionel, Anath C.; Marshall, Christian R.; Scherer, Stephen W.; Stavropoulos, Dimitri J.; McCready, Elizabeth; Bassett, Anne S.

    2016-01-01

    Purpose The purpose of the current study was to assess the penetrance of NRXN1 deletions. Methods We compared the prevalence and genomic extent of NRXN1 deletions identified among 19,263 clinically referred cases to that of 15,264 controls. The burden of additional clinically relevant CNVs was used as a proxy to estimate the relative penetrance of NRXN1 deletions. Results We identified 41 (0.21%) previously unreported exonic NRXN1 deletions ascertained for developmental delay/intellectual disability, significantly greater than in controls [OR=8.14 (95% CI 2.91–22.72), p< 0.0001)]. Ten (22.7%) of these had a second clinically relevant CNV. Subjects with a deletion near the 3′ end of NRXN1 were significantly more likely to have a second rare CNV than subjects with a 5′ NRXN1 deletion [OR=7.47 (95% CI 2.36–23.61), p=0.0006]. The prevalence of intronic NRXN1 deletions was not statistically different between cases and controls (p=0.618). The majority (63.2%) of intronic NRXN1 deletion cases had a second rare CNV, a two-fold greater prevalence than for exonic NRXN1 deletion cases (p=0.0035). Conclusions The results support the importance of exons near the 5′ end of NRXN1 in the expression of neurodevelopmental disorders. Intronic NRXN1 deletions do not appear to substantially increase the risk for clinical phenotypes. PMID:27195815

  14. OSMOSE experiment representativity studies.

    SciTech Connect

    Aliberti, G.; Klann, R.; Nuclear Engineering Division

    2007-10-10

    leads to a uniform well-behaved system so that the reactor configuration is in the fundamental mode. In fact, an important property of the oscillation experiments performed in the OSMOSE program is that the neutron flux at the sample location has reached the asymptotic fundamental mode of the MINERVE lattice. This property allows the use of simple spatial methods for the analysis (e.g. a lattice code with axial buckling representing the leakage), without loss of accuracy. The computational challenge is then reduced to the need of an appropriate cross-section processing and of accurate resonance shielding algorithms. In the present study, calculations have been performed to investigate the similarity of the flux spectra at the sample position of different OSMOSE configurations with the neutron energy distributions characterizing existing thermal and fast reactors proposed under the advanced reactor programs Gen-IV, GNEP and NGNP.

  15. Two- and Three-Dimensional Numerical Experiments Representing Two Limiting Cases of an In-Line Pair of Finger Seal Components

    NASA Technical Reports Server (NTRS)

    Braun, M. J.; Steinetz, B. M.; Kudriavtsev, V. V.; Proctor, M. P.; Kiraly, L. James (Technical Monitor)

    2002-01-01

    The work presented here concerns the numerical development and simulation of the flow, pressure patterns and motion of a pair of fingers arranged behind each other and axially aligned in-line. The fingers represent the basic elemental component of a Finger Seal (FS) and form a tight seal around the rotor. Yet their flexibility allows compliance with rotor motion and in a passive-adaptive mode complies also with the hydrodynamic forces induced by the flowing fluid. While the paper does not treat the actual staggered configuration of a finger seal, the inline arrangement represents a first step towards that final goal. The numerical 2-D (axial-radial) and 3-D results presented herein were obtained using a commercial package (CFD-ACE+). Both models use an integrated numerical approach, which couples the hydrodynamic fluid model (Navier-Stokes based) to the solid mechanics code that models the compliance of the fingers.

  16. Church representatives' perspectives on masculinities in the context of HIV: the case of the Ecumenical HIV and AIDS Initiative in Africa.

    PubMed

    Lusey, Hendrew G; Christianson, Monica; Sebastian, Miguel San; Edin, Kerstin E

    2016-09-01

    Despite a growing body of literature related to church leaders challenging dominant norms of masculinities that may enable the spread of HIV, research on masculinity issues among African church representatives who are policy makers is scarce. The objectives of this study were to explore the perspectives on masculinities held by church representatives within the Ecumenical HIV and AIDS Initiative in Africa (EHAIA) and to identify strategies they used to transform masculinities in their respective churches. Qualitative interviews were carried out with 14 church representatives belonging to the EHAIA International Reference Group. These interviews were analysed using thematic analysis and four themes were identified: "barriers to challenge masculinities" may contribute to the spread of HIV; "counterproductive conservative church leadership" fails to challenge dominant forms of masculinities; "facilitators to challenge masculinities" perceived as slowly changing men and "an evolving hope for gender equality" would be perceived in certain marital relationships. The latter two were viewed as positive approaches resulting from masculinity workshops and male priests disclosing their HIV-positive status. This research highlights strategies that may help male church-goers challenge masculinities, support gender equality and, improve the lives of men and women in the context of HIV.

  17. A Scientific Approach to Cultural Heritage Preservation: A Case Study of Vandalistic Acts on Important Roman Mosaics

    NASA Astrophysics Data System (ADS)

    Ciliberto, Enrico; Spoto, Giuseppe; Matteini, Mauro; Puglisi, Concetto

    1998-10-01

    As an example of the way in which a scientific study can help the restorer in the restoration of important artistic works, the authors report the case study of vandalistic acts on important Roman mosaics. On the night of September 29, 1995, some unknown vandals poured dark brown paint over several of the most beautiful and important mosaics of the Villa del Casale (Piazza Armerina, Italy). The villa, consisting of an extensive network of rooms, galleries, courtyards, and baths, contains some of the largest and most beautiful mosaics surviving from Roman times. Chemical investigations were performed in order to draw up a rapid restoration plan aimed at identifying the substances used and proposing a correct restoration procedure. A multitechnique, analytical approach was used for these investigations because of the highly complex heterogeneity of the materials studied. The results showed that toluidine red was present in the paint as pigment and that the vehicle was made up of a mixture of alkyd resins, together with styrenated compounds and unsaturated long chain-containing oils. Moreover, besides compounds like calcium carbonate, barium sulfate, and aluminum oxide, silver-containing compounds were present in the paint. All of these observations allowed the authors to propose the removal method to be adopted that achieved the restoration of the mosaics.

  18. Convectively Generated Gravity Waves In The Tropical Stratosphere: Case Studies And Importance For The Circulation Of The Middle Atmosphere

    NASA Technical Reports Server (NTRS)

    Pfister, Leonhard; Chan, Kwoklong R.; Gary, Bruce; Singh, Hanwant B. (Technical Monitor)

    1995-01-01

    The advent of high altitude aircraft measurements in the stratosphere over tropical convective systems has made it possible to observe the mesoscale disturbances in the temperature field that these systems excite. Such measurements show that these disturbances have horizontal scales comparable to those of the underlying anvils (about 50-100 km) with peak to peak theta surface variations of about 300-400 meters. Moreover, correlative wind measurements from the tropical phase of the Stratosphere-Troposphere Exchange Project (STEP) clearly show that these disturbances are gravity waves. We present two case studies of anvil-scale gravity waves over convective systems. Using steady and time-dependent linear models of gravity wave propagation in the stratosphere, we show: (1) that the underlying convective systems are indeed the source of the observed phenomena; and (2) that their generating mechanism can be crudely represented as flow over a time-dependent mountain. We will then discuss the effects gravity waves of the observed amplitudes have on the circulation of the middle atmosphere, particularly the quasi-biennial, and semiannual oscillations.

  19. Bronchoaspiration as a possible cause in a case of tetanus. A reminder on the importance of adulthood immunizations.

    PubMed

    Ostrosky-Zeichner, L; Volkow, P; Ponce de León, S

    1999-01-01

    Although preventable by immunization tetanus still takes a large death toll, mostly in developing countries, where adult population is often unprotected and opportune medical care unavailable. We present a case of tetanus in an elderly patient with bronchoaspiration pneumonia after a near-drowning incident, in which no objective entry site could be suspected with as much temporal relation as the bronchoaspiration incident. Bronchoaspiration of organic matter and feces provides both a source of the causative agent and an adequate polymicrobial environment for the development of the disease. It is under such conditions that we propose this unusual entry site as the cause of tetanus in our patient. Special emphasis is made on the importance of adulthood immunization programs and how incidents like this one should be taken into account in the overall care provided to the elderly population.

  20. [The difficult passage between life and death of advanced patients and their most important needs: three clinical cases].

    PubMed

    Gabanelli, P

    2009-01-01

    In the current study we describe three clinical cases with the aim of reflecting upon an increasingly frequent but still neglected reality in oncological practice; namely, the difficult passage of advanced patients and their most important needs as they progress from a so-called active form of treatment to a more supportive and palliative approach. The attempt to identify strategies that will enable the treatment center to remain impervious and receptive to the patient's suffering, has led us to consider the institutional organism as a field of defense mechanisms and as a thinking tool, of which the psychologist is part but must deal with in order to facilitate the patient's experience during the clinical course.

  1. The important role of food composition in policies and programmes for better public health: A South African case study.

    PubMed

    Schönfeldt, Hettie C; Hall, Nicolette; Pretorius, B

    2018-01-01

    Most governments have committed to the set of Sustainable Development Goals established by the United Nations (UN) to be achieved by 2030. Subsequently the governments have drafted, or are in process of drafting, policies and programmes which aim to answer to these global requests. South Africa provides a unique case study: despite economic growth, undernutrition has not improved when compared to other industrialised nations, while at the same time, diet-related non-communicable diseases and obesity have exponentially increased. Access to healthy food is a constitutional right of all South Africans, and towards increasing food security and improving population health, various policies, programmes and regulations have been developed and implemented by the government to rectify the situation. The paper presents an overview of food composition within these public health policies, programmes and regulations and unpacks the important role of accurate food composition data. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. On the relative importance of magnetospheric and ionospheric processes during substorm onset and expansion: A case study

    NASA Technical Reports Server (NTRS)

    Lopez, Ramon E.

    1992-01-01

    The question of whether substorm onset is triggered in the magnetotail or the ionosphere is presented. The possible influence of the ionosphere in the subsequent development of a substorm is discussed. Theoretical considerations involved are reviewed and a case study to address this question is examined. The evidence indicates that magnetotail processes initiate the sequence of events called a substorm, while the ionosphere appears to play a critical role in the subsequent evolution of the substorm expansion phase. However, the necessary observations, in particular high time resolution coordinated observations in the ionosphere and magnetotail are relatively rare. Continued examination of existing ground and space based data sets, in particular underutilized observations such as the Scatha data, may provide a more solid foundation for clarifying this issue and determining the relative importance of magnetospheric and ionospheric processes during substorms.

  3. On the relative importance of magnetospheric and ionospheric processes during substorm onset and expansion: A case study

    NASA Technical Reports Server (NTRS)

    Lopez, Ramon E.

    1992-01-01

    The question of whether substorm onset is triggered in the magnetotail or the ionosphere is presented. The possible influence of the ionosphere in the subsequent development of a substorm is discussed. Theoretical considerations involved are reviewed and a case study to address this question is examined. The evidence indicates that magnetotail processes initiate the sequence of events called a substorm, while the ionosphere appears to play a critical role in the subsequent evolution of the substorm expansion phase. However, the necessary observations, in particular high time resolution coordinated observations in the ionosphere and magnetotail are relatively rare. Continued examination of existing ground and space based data sets, in particular underutilized observations such as the Scatha data, may provide a more solid foundation for clarifying this issue and determining the relative importance of magnetospheric and ionospheric processes during substorms.

  4. A Domain-Specific System for Representing Knowledge of Both Man-Made Objects and Human Actions. Evidence from a Case with an Association of Deficits

    ERIC Educational Resources Information Center

    Vannuscorps, Gilles; Pillon, Agnesa

    2011-01-01

    We report the single-case study of a brain-damaged individual, JJG, presenting with a conceptual deficit and whose knowledge of living things, man-made objects, and actions was assessed. The aim was to seek for empirical evidence pertaining to the issue of how conceptual knowledge of objects, both living things and man-made objects, is related to…

  5. A Domain-Specific System for Representing Knowledge of Both Man-Made Objects and Human Actions. Evidence from a Case with an Association of Deficits

    ERIC Educational Resources Information Center

    Vannuscorps, Gilles; Pillon, Agnesa

    2011-01-01

    We report the single-case study of a brain-damaged individual, JJG, presenting with a conceptual deficit and whose knowledge of living things, man-made objects, and actions was assessed. The aim was to seek for empirical evidence pertaining to the issue of how conceptual knowledge of objects, both living things and man-made objects, is related to…

  6. THE IMPORTANCE OF INSTRUMENT MAKERS FOR THE DEVELOPMENT OF EXPERIMENTAL PSYCHOLOGY: THE CASE OF ALFRED BINET AT THE SORBONNE LABORATORY.

    PubMed

    Nicolas, Serge

    2016-07-01

    The importance of instrument firms in the development of psychology, and science in general, should not be underestimated since it would not have been possible for various leading psychologists at the turn of the twentieth century to conduct certain experiments without the assistance of instrument makers, as is often the case today. To illustrate the historical perspective introduced here, the example of Alfred Binet is taken, as he is an interesting case of a psychologist working in close collaboration with various French instrument designers of the time. The objective of this article is twofold: (1) to show the considerable activity carried out by early psychologists to finalize new laboratory instruments in order to develop their research projects; (2) to reassess the work of a major figure in French psychology through his activity as a designer of precision instruments. The development of these new instruments would certainly have been difficult without the presence in Paris of numerous precision instrument manufacturers such as Charles Verdin, Otto Lund, Henri Collin, and Lucien Korsten, on whom Binet successively called in order to develop his projects in the field of experimental psychology.

  7. How do agents represent?

    NASA Astrophysics Data System (ADS)

    Ryan, Alex

    Representation is inherent to the concept of an agent, but its importance in complex systems has not yet been widely recognised. In this paper I introduce Peirce's theory of signs, which facilitates a definition of representation in general. In summary, representation means that for some agent, a model is used to stand in for another entity in a way that shapes the behaviour of the agent with respect to that entity. Representation in general is then related to the theories of representation that have developed within different disciplines. I compare theories of representation from metaphysics, military theory and systems theory. Additional complications arise in explaining the special case of mental representations, which is the focus of cognitive science. I consider the dominant theory of cognition — that the brain is a representational device — as well as the sceptical anti-representational response. Finally, I argue that representation distinguishes agents from non-representational objects: agents are objects capable of representation.

  8. Morphologic variations of maxillary molars palatal root and the importance of its knowledge for endodontic practice: a case series.

    PubMed

    Scarparo, Roberta Kochenborger; Pereira, Leticia; Moro, Diana; Grundling, Grasiela; Gomes, Maximiliano; Grecca, Fabiana Soares

    2011-03-01

    The present report describes and discusses root canal variations in the internal morphology of maxillary molars. Dental internal anatomy is directly related to all the technical stages of the endodontic treatment. Even though, in some situations a typical anatomical characteristics can be faced, and the professional should be able to identify them. This clinical report describes five cases with different pulpar and periapical diagnostics where the endodontic treatment was performed, in which during the treatment the unusual occurrence of two or three canals in the palatal root 'or even two distinct palatal roots' of first and second maxillary molars, were described and important details for achieving treatment success were discussed. The knowledge of tooth internal anatomy must be considered during clinical and radiographic examinations. This should be valued not only to find atypical canals but also to enable calcified canals cleaning and shaping, once they are frequently omitted during endodontic therapy. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. The complexity of the root canal system and the importance of identifying its internal anatomy for planning endodontic treatment increase the chances of success.

  9. Epidemiologic investigation of a family cluster of imported ZIKV cases in Guangdong, China: probable human-to-human transmission

    PubMed Central

    Yin, Yingxian; Xu, Yi; Su, Ling; Zhu, Xun; Chen, Minxia; Zhu, Weijin; Xia, Huimin; Huang, Xi; Gong, Sitang

    2016-01-01

    Zika virus (ZIKV) is an emerging mosquito-borne flavivirus that can potentially threaten South China. A Chinese family of four returning from Venezuela to China was found to be positive for ZIKV when the youngest son's fever was first detected at an airport immigration inspection. They were isolated temporarily in a local hospital in Enping city, Guangdong province, where their clinical data were recorded and urine and saliva were collected to isolate ZIKV and to obtain viral sequences. All of them except the mother presented mild symptoms of rash and fever. Envelope gene sequences from the father, daughter and son were completely identical. Phylogenetic analysis demonstrated that this strain is similar to several imported strains reported in recent months, which are all clustered into a group isolated from 2015 ZIKA outbreaks in Brazil. Together with the climatic features in Venezuela, New York and Guangdong in February, it can be concluded that our subjects are imported cases from Venezuela. With the same viral sequence being shared between family members, neither direct human-to-human nor vector transmission can be ruled out in this study, but the former seems more likely. Although our subjects had mild illness, epidemiologists and public health officials should be aware of the risk of further expansion of ZIKV transmission by local competent vectors. PMID:27599469

  10. The importance of microearthquakes in crustal extension of an active rift: A case study from New Zealand

    NASA Astrophysics Data System (ADS)

    Mouslopoulou, Vasiliki; Hristopulos, Dionissios T.; Nicol, Andrew; Walsh, John J.; Bannister, Stephen

    2013-04-01

    The amount of extension accommodated in active rifts by earthquakes that do not rupture the ground surface (e.g., represents up to ~30% of the total contemporary deformation recorded across the north Taupo Rift by GPS (15 ± 5 mm/yr). The bulk of the MES (94%) occurred at depths of 1.5 to 6.5 km and may not be observed in geological datasets (e.g., as displacements of the ground- or near-surface horizons). Small-scale faulting associated with microseismicity may thus record strains not measured by geological datasets and constitute an important component of the ~3-10 mm/yr disparity between geological and GPS rates of extension across the Taupo Rift.

  11. The importance of microearthquakes in crustal extension of an active rift: a case study from New Zealand

    NASA Astrophysics Data System (ADS)

    Mouslopoulou, Vasiliki; Hristopulos, Dionissios; Nicol, Andrew; Walsh, John; Bannister, Stephen

    2013-04-01

    The amount of extension accommodated in active rifts by earthquakes that do not rupture the ground surface (e.g., represents up to ~30% of the total contemporary deformation recorded across the north Taupo Rift by GPS (15±5 mm/yr). The bulk of the MES (94%) occurred at depths of 1.5 to 6.5 km and may not be observed in geological datasets (e.g., as displacements of the ground- or near-surface horizons). Small-scale faulting associated with microseismicity may record strains not measured by geological datasets, and constitute an important component of the ~3-10 mm/yr disparity between geological and GPS rates of extension across the Taupo Rift.

  12. Representativity of TMA studies.

    PubMed

    Sauter, Guido

    2010-01-01

    The smaller the portion of a tumor sample that is analyzed becomes, the higher is the risk of missing important histological or molecular features that might be present only in a subset of tumor cells. Many researchers have, therefore, suggested using larger tissue cores or multiple cores from the same donor tissue to enhance the representativity of TMA studies. However, numerous studies comparing the results of TMA studies with the findings from conventional large sections have shown that all well-established associations between molecular markers and tumor phenotype or patient prognosis can be reproduced with TMAs even if only one single 0.6 mm tissue spot is analyzed. Moreover, the TMA technology has proven to be superior to large section analysis in finding new clinically relevant associations. The high number of samples that are typically included in TMA studies, and the unprecedented degree of standardization during TMA experiments and analysis often give TMA studies an edge over traditional large-section studies.

  13. Does urbanization shape bacterial community composition in urban park soils? A case study in 16 representative Chinese cities based on the pyrosequencing method.

    PubMed

    Xu, Hui-Juan; Li, Shun; Su, Jian-Qiang; Nie, San'an; Gibson, Valerie; Li, Hu; Zhu, Yong-Guan

    2014-01-01

    Although the geographical distribution patterns of microbes have been studied for years, few studies have focused on urban soils. Urbanization may have detrimental effects on the soil ecosystem through pollution discharge and changes in urban climate. It is unclear whether urbanization-related factors have any effect on soil bacterial communities. Therefore we investigated geographical patterns of soil microbial communities in parks in 16 representative Chinese cities. The microbial communities in these 95 soil samples were revealed by 454-pyrosequencing. There were 574,442 effective sequences among the total of 980,019 16S rRNA gene sequences generated, showing the diversity of the microbial communities. Proteobacteria, Actinobacteria, Acidobacteria, Planctomycetes, Chloroflexi and Bacteroidetes were found to be the six dominant phyla in all samples. Canonical correspondence analysis showed that pH, followed by annual average precipitation, annual average temperature, annual average relative humidity and city sunshine hours, Mn and Mg were the factors most highly correlated with the bacterial community variance. Urbanization did have an effect on bacterial community composition of urban park soils but it contributed less to the total variance compared with geographical locations and soil properties, which explained 6.19% and 16.78% of the variance, respectively.

  14. Does fingerprinting truly represent the diversity of wine yeasts? A case study with interdelta genotyping of Saccharomyces cerevisiae strains.

    PubMed

    Pfliegler, W P; Sipiczki, M

    2016-12-01

    Simple and efficient genotyping methods are widely used to assess the diversity of a large number of microbial strains, e.g. wine yeasts isolated from a specific geographical area or a vintage. Such methods are often also the first to be applied, to decrease the number of strains deemed interesting for a more time-consuming physiological characterization. Here, we aimed to use a physiologically characterized strain collection of 69 Saccharomyces cerevisiae strains from Hungarian wine regions to determine whether geographical origin or physiological similarity can be recovered by clustering the strains with one or two simultaneously used variations of interdelta genotyping. Our results indicate that although a detailed clustering with high resolution can be achieved with this method, the clustering of strains is largely contrasting when different primer sets are used and it does not recover geographical or physiological groups. Genotyping is routinely used for assessing the diversity of a large number of isolates/strains of a single species, e.g. a collection of wine yeasts. We tested the efficiency of interdelta genotyping on a collection of Saccharomyces wine yeasts from four wine regions of Hungary that was previously characterized physiologically. Interdelta fingerprinting recovered neither physiological nor geographical similarities, and in addition, the two different primer pairs widely used for this method showed conflicting and barely comparable results. Thus, this method does not necessarily represent the true diversity of a strain collection, but detailed clustering may be achieved by the combined use of primer sets. © 2016 The Society for Applied Microbiology.

  15. Using stories to disseminate research: the attributes of representative stories.

    PubMed

    Steiner, John F

    2007-11-01

    When researchers communicate their findings to patients, clinicians, policy-makers, or media, they may find it helpful to supplement quantitative data with stories about individuals who represent themes in their research. Whether such stories are gathered during the research itself or identified from other sources, researchers must develop strategies for assessing their representativeness. This paper proposes 5 attributes of representative stories: (1) expression of important themes in the research, (2) explicit location in the "distribution" of stories that exemplify the theme, (3) verifiability, (4) acknowledgment of uncertainty, and (5) compelling narration. This paper summarizes research on substance abuse among physicians, and uses these 5 attributes to assess the representativeness of a published case report and a fictional short story about addicted physicians. While neither story is fully representative of the research, the process of evaluating these stories illustrates an approach to identifying representative stories for use in disseminating research.

  16. Using Stories to Disseminate Research: The Attributes of Representative Stories

    PubMed Central

    2007-01-01

    When researchers communicate their findings to patients, clinicians, policy-makers, or media, they may find it helpful to supplement quantitative data with stories about individuals who represent themes in their research. Whether such stories are gathered during the research itself or identified from other sources, researchers must develop strategies for assessing their representativeness. This paper proposes 5 attributes of representative stories: (1) expression of important themes in the research, (2) explicit location in the “distribution” of stories that exemplify the theme, (3) verifiability, (4) acknowledgment of uncertainty, and (5) compelling narration. This paper summarizes research on substance abuse among physicians, and uses these 5 attributes to assess the representativeness of a published case report and a fictional short story about addicted physicians. While neither story is fully representative of the research, the process of evaluating these stories illustrates an approach to identifying representative stories for use in disseminating research. PMID:17763914

  17. Oligodendroglial cell proliferation arising in an ovarian mature cystic teratoma. Clinicopathological, inmunohistochemical, and ultrastructural study of a case that may represent an oligodendroglioma.

    PubMed

    Serrano-Arévalo, Mónica Lizzette; Lino-Silva, Leonardo Saúl; Domínguez Malagón, Hugo Ricardo

    2017-01-01

    Ovarian mature cystic teratoma (OMCT) is an ovarian benign neoplasm with excellent prognosis presenting components of the three germinal layers. However, transformation into a malignant neoplasm is a rare event (so-called somatic transformation). In most of the cases, the malignant component expresses as epidermoid carcinoma, but occasionally central nervous system tumors occur. Some of the previously reported tumors are astrocytoma, glioblastoma, and ependymoma. Somatic transformation of OMCT into an oligodendroglioma is exceptional. We report a 19-year-old female with a left OMCT with an area of oligonedroglial cells proliferation characterized by immunohistochemical studies with positivity for GFAP and S100, with a low Ki67 index (5%). Additionally, electron microscopy revealed oligodendrocytes with parallel bundles of cytoplasmic intermediate filaments, confirming the oligodendroglial nature of the proliferation. The patient was treated only with left oophorectomy, and three and half years after surgery, there is no evidence of disease.

  18. Do HIV Prevalence Trends in ANC Surveillance Represent Trends in the General Population in the ART Era? The Case of Manicaland, East Zimbabwe

    PubMed Central

    Gregson, Simon; Dharmayat, Kanika; Pereboom, Monique; Takaruza, Albert; Mugurungi, Owen; Schur, Nadine; Nyamukapa, Constance A.

    2016-01-01

    Objective National estimates of HIV trends in generalised epidemics rely on HIV prevalence data from antenatal clinic (ANC) surveillance. We investigate whether HIV prevalence trends in ANC data reflect trends in men and women in the general population during the scale-up of anti-retroviral treatment (ART) in Manicaland, Zimbabwe. Methods Trends in HIV prevalence in local ANC attendees and adults aged 15-49yrs in towns, agricultural estates, and villages were compared using five rounds of parallel ANC (N≈1,200) and general-population surveys (N≈10,000) and multi-variable log-linear regression. Changes in the age-pattern of HIV prevalence and the age-distribution of ANC attendees were compared with those in the general population. Age-specific pregnancy prevalence rates were compared by HIV infection and ART status. Results Cumulatively, from 1998-2000 to 2009-2011, HIV prevalence fell by 60.0% (95% CI, 51.1%-67.3%) in ANC surveillance data and by 34.3% (30.8%-37.7%) in the general population. Most of the difference arose following the introduction of ART (2006-2011). The estates and villages reflected this overall pattern but HIV prevalence in the towns was lower at local ANCs than in the general population, largely due to attendance by pregnant women from outlying (lower prevalence) areas. The ageing of people living with HIV in the general population (52.4% aged >35yrs, 2009-2011) was under-represented in the ANC data (12.6%) due to lower fertility in older and HIV-infected women. Conclusion After the introduction of ART in Manicaland, HIV prevalence declined more steeply in ANC surveillance data than in the general population. Models used for HIV estimates must reflect this change in bias. PMID:26372390

  19. Importance of well-designed monitoring programs for the conservation of endangered species: case study of the Snail Kite

    USGS Publications Warehouse

    Martin, J.; Kitchens, W.M.; Hines, J.E.

    2007-01-01

    Monitoring natural populations is often a necessary step to establish the conservation status of species and to help improve management decisions. Nevertheless, many monitoring programs do not effectively address primary sources of variability in monitoring data, which ultimately may limit the utility of monitoring in identifying declines and improving management. To illustrate the importance of taking into account detectability and spatial variation, we used a recently proposed estimator of abundance (superpopulation estimator) to estimate population size of and number of young produced by the Snail Kite (Rostrhamus sociabilis plumbeus) in Florida. During the last decade, primary recovery targets set by the U.S. Fish and Wildlife Service for the Snail Kite that were based on deficient monitoring programs (i.e., uncorrected counts) were close to being met (by simply increasing search effort during count surveys). During that same period, the Snail Kite population declined dramatically (by 55% from 1997 to 2005) and the number of young decreased by 70% between 1992?1998 and 1999?2005. Our results provide a strong practical case in favor of the argument that investing a sufficient amount of time and resources into designing and implementing monitoring programs that carefully address detectability and spatial variation is critical for the conservation of endangered species.

  20. Importance of revealing a rare case of breast cancer in a female to male transsexual after bilateral mastectomy

    PubMed Central

    2012-01-01

    The incidence of breast carcinoma following prophylactic mastectomy is probably less than 2%. We present a 43-year-old female to male transsexual who developed breast cancer 1 year after bilateral nipple- sparing subcutaneous mastectomy as part of female to male gender reassignment surgery. In addition to gender reassignment surgery, total abdominal hysterectomy with bilateral salpingo-oophorectomy (to avoid the patient from entering menopause and to eliminate any subsequent risk of iatrogenic endometrial carcinoma), colpocleisys, metoidioplasty, phalloplasty, urethroplasty together with scrotoplasty/placement of testicular prosthesis and perineoplasty were also performed. Before the sex change surgery, the following diagnostic procedures were performed: breast ultrasound and mammography (which were normal), lung radiography (also normal) together with abdominal ultrasound examination, biochemical analysis of the blood and hormonal status. According to medical literature, in the last 50 years only three papers have been published with four cases of breast cancer in transsexual female to male patients. All hormonal pathways included in this complex hormonal and surgical procedure of transgender surgery have important implications for women undergoing prophylactic mastectomy because of a high risk of possible breast cancer. PMID:23273269

  1. Importance of revealing a rare case of breast cancer in a female to male transsexual after bilateral mastectomy.

    PubMed

    Nikolic, Dejan V; Djordjevic, Miroslav L; Granic, Miroslav; Nikolic, Aleksandra T; Stanimirovic, Violeta V; Zdravkovic, Darko; Jelic, Svetlana

    2012-12-28

    The incidence of breast carcinoma following prophylactic mastectomy is probably less than 2%. We present a 43-year-old female to male transsexual who developed breast cancer 1 year after bilateral nipple- sparing subcutaneous mastectomy as part of female to male gender reassignment surgery. In addition to gender reassignment surgery, total abdominal hysterectomy with bilateral salpingo-oophorectomy (to avoid the patient from entering menopause and to eliminate any subsequent risk of iatrogenic endometrial carcinoma), colpocleisys, metoidioplasty, phalloplasty, urethroplasty together with scrotoplasty/placement of testicular prosthesis and perineoplasty were also performed. Before the sex change surgery, the following diagnostic procedures were performed: breast ultrasound and mammography (which were normal), lung radiography (also normal) together with abdominal ultrasound examination, biochemical analysis of the blood and hormonal status.According to medical literature, in the last 50 years only three papers have been published with four cases of breast cancer in transsexual female to male patients. All hormonal pathways included in this complex hormonal and surgical procedure of transgender surgery have important implications for women undergoing prophylactic mastectomy because of a high risk of possible breast cancer.

  2. [Why is it important to achieve the goals of treatment of hypertension…. About a case that began as ischemic stroke].

    PubMed

    Sauza-Sosa, Julio César; Romero-Figueroa, José Antonio; Sierra-Galán, Lilia Mercedes; Ferez-Santander, Sergio Mario

    2016-01-01

    Systemic arterial hypertension (SAH) is one of the most common conditions seen in primary care of cardiovascular disease and whose consequences; depending on the "target organ" affecting produce ischemic heart disease, cerebral vascular disease or chronic kidney disease. In the pathogenesis of HAS are several physiopathological mechanisms involved; of which currently, to name the most important and frequent play a role in increasing adrenaline levels, the renin-angiotensin-aldosterone system and recently, much the participation of insulin resistance and hyperinsulinemia mentioned. These processes lead to an imbalance between the sympathetic and parasympathetic tone, coupled with hypersensitivity sodium trigger one of the pathophysiologic mechanisms of hypertension. SAH is currently defined as finding numbers of older blood pressure 140/90mm Hg. This is one of the diseases that most affect the world population prevalences found in age and gender groups 45 to 55% in men between 45 and 70 years and 45 to 65% in women of the same age group. In 2013 most recent clinical guidelines for treatment and the recommended goals, which has managed to reduce its complications and mortality were published; among which include vascular diseases such as ischemic heart and brain and kidney. In this paper a case that exemplifies the secondary complications in late diagnosis, damage to "target organ" by long-term exposure and inadequate compliance with therapeutic goals discussed. Copyright © 2015 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  3. Representing Learning With Graphical Models

    NASA Technical Reports Server (NTRS)

    Buntine, Wray L.; Lum, Henry, Jr. (Technical Monitor)

    1994-01-01

    Probabilistic graphical models are being used widely in artificial intelligence, for instance, in diagnosis and expert systems, as a unified qualitative and quantitative framework for representing and reasoning with probabilities and independencies. Their development and use spans several fields including artificial intelligence, decision theory and statistics, and provides an important bridge between these communities. This paper shows by way of example that these models can be extended to machine learning, neural networks and knowledge discovery by representing the notion of a sample on the graphical model. Not only does this allow a flexible variety of learning problems to be represented, it also provides the means for representing the goal of learning and opens the way for the automatic development of learning algorithms from specifications.

  4. Representing Learning With Graphical Models

    NASA Technical Reports Server (NTRS)

    Buntine, Wray L.; Lum, Henry, Jr. (Technical Monitor)

    1994-01-01

    Probabilistic graphical models are being used widely in artificial intelligence, for instance, in diagnosis and expert systems, as a unified qualitative and quantitative framework for representing and reasoning with probabilities and independencies. Their development and use spans several fields including artificial intelligence, decision theory and statistics, and provides an important bridge between these communities. This paper shows by way of example that these models can be extended to machine learning, neural networks and knowledge discovery by representing the notion of a sample on the graphical model. Not only does this allow a flexible variety of learning problems to be represented, it also provides the means for representing the goal of learning and opens the way for the automatic development of learning algorithms from specifications.

  5. On the importance of mesoscale potential vorticity anomalies and topographic forcing during cyclone redevelopment across the Appalachians: A GALE case study

    SciTech Connect

    O'Handley, C.

    1992-01-01

    The evolution of the structure of cyclones and cold fronts over the eastern United States is investigated observationally. Two primary goals of the research are to understand the mechanisms controlling cyclone and frontal evolution across the Appalachian mountains, and to document the presence and importance of mesoscale disturbances during cyclogenesis. First, a climatological survey of seven winter seasons of cyclones and fronts was performed. This study revealed cold fronts are slowed and deformed by the Appalachians, with the cross-frontal pressure and thermal contrasts enhanced considerably across the mountains. In addition, cyclones generally curve northward and dissipate over the mountains while secondary development occurs further south over the lee region. Both upper-level [open quote]forcing[close quote] and low-level thermal structure are important in determining the exact location of redevelopment. Second, a detailed case study was conducted of a cyclone observed during the Genesis of Atlantic Lows Experiment (GALE). The primary cyclone dissipitated over the Northern Appalachians while a secondary lower tropospheric (800-900 mb) cyclone formed over eastern North Carolina. However, strong low-level static stability prevented this disturbance from penetrating to the surface. Instead, cyclogenesis occurred offshore when two mesoscale mid-tropospheric (500 mb) PV maxima, one of which represented an upper level frontal zone, moved over a series of quasi-stationary shallow cloud clusters over the Gulf Stream. Meanwhile, the primary surface cold front was blocked west of the Appalachians, but the mid-level (700-850 mb) front progressed unimpeded across the mountains. Later, a new surface front formed east of the mountains through diabetic processes. These results indicate that future mesoscale models will need to incorporate topography and diabatic processes with increased accuracy.

  6. Representing Substantive Structures.

    ERIC Educational Resources Information Center

    Finley, Fred N.; Stewart, James

    1982-01-01

    Discusses the meaning of Schwab's "substantive structures" of a discipline in terms of science philosophy. Presents three techniques for representing substantive structures and discusses some of their uses in science education research. (SK)

  7. Representing properties locally.

    PubMed

    Solomon, K O; Barsalou, L W

    2001-09-01

    Theories of knowledge such as feature lists, semantic networks, and localist neural nets typically use a single global symbol to represent a property that occurs in multiple concepts. Thus, a global symbol represents mane across HORSE, PONY, and LION. Alternatively, perceptual theories of knowledge, as well as distributed representational systems, assume that properties take different local forms in different concepts. Thus, different local forms of mane exist for HORSE, PONY, and LION, each capturing the specific form that mane takes in its respective concept. Three experiments used the property verification task to assess whether properties are represented globally or locally (e.g., Does a PONY have mane?). If a single global form represents a property, then verifying it in any concept should increase its accessibility and speed its verification later in any other concept. Verifying mane for PONY should benefit as much from having verified mane for LION earlier as from verifying mane for HORSE. If properties are represented locally, however, verifying a property should only benefit from verifying a similar form earlier. Verifying mane for PONY should only benefit from verifying mane for HORSE, not from verifying mane for LION. Findings from three experiments strongly supported local property representation and ruled out the interpretation that object similarity was responsible (e.g., the greater overall similarity between HORSE and PONY than between LION and PONY). The findings further suggest that property representation and verification are complicated phenomena, grounded in sensory-motor simulations.

  8. The Importance of Workforce Training in Community Colleges: A Case Study on the Discourse and Best Practices during Financial Difficulty

    ERIC Educational Resources Information Center

    Davis, Adriene Leanora

    2013-01-01

    Since the 2008-2009 academic year, community colleges in the state of California have faced a budget reduction of 12%. This represents a reduction of $809 million in state appropriations. Despite the reduction in funding, the California Master Plan for Higher Education includes provisions for community colleges to develop quality workforce…

  9. The Importance of Workforce Training in Community Colleges: A Case Study on the Discourse and Best Practices during Financial Difficulty

    ERIC Educational Resources Information Center

    Davis, Adriene Leanora

    2013-01-01

    Since the 2008-2009 academic year, community colleges in the state of California have faced a budget reduction of 12%. This represents a reduction of $809 million in state appropriations. Despite the reduction in funding, the California Master Plan for Higher Education includes provisions for community colleges to develop quality workforce…

  10. Climate and the Timing of Imported Cases as Determinants of the Dengue Outbreak in Guangzhou, 2014: Evidence from a Mathematical Model

    PubMed Central

    Spear, Robert C.; Marshall, John M.; Yang, Zhicong; Gong, Peng

    2016-01-01

    As the world’s fastest spreading vector-borne disease, dengue was estimated to infect more than 390 million people in 2010, a 30-fold increase in the past half century. Although considered to be a non-endemic country, mainland China had 55,114 reported dengue cases from 2005 to 2014, of which 47,056 occurred in 2014. Furthermore, 94% of the indigenous cases in this time period were reported in Guangdong Province, 83% of which were in Guangzhou City. In order to determine the possible determinants of the unprecedented outbreak in 2014, a population-based deterministic model was developed to describe dengue transmission dynamics in Guangzhou. Regional sensitivity analysis (RSA) was adopted to calibrate the model and entomological surveillance data was used to validate the mosquito submodel. Different scenarios were created to investigate the roles of the timing of an imported case, climate, vertical transmission from mosquitoes to their offspring, and intervention. The results suggested that an early imported case was the most important factor in determining the 2014 outbreak characteristics. Precipitation and temperature can also change the transmission dynamics. Extraordinary high precipitation in May and August, 2014 appears to have increased vector abundance. Considering the relatively small number of cases in 2013, the effect of vertical transmission was less important. The earlier and more frequent intervention in 2014 also appeared to be effective. If the intervention in 2014 was the same as that in 2013, the outbreak size may have been over an order of magnitude higher than the observed number of new cases in 2014.The early date of the first imported and locally transmitted case was largely responsible for the outbreak in 2014, but it was influenced by intervention, climate and vertical transmission. Early detection and response to imported cases in the spring and early summer is crucial to avoid large outbreaks in the future. PMID:26863623

  11. O the Importance of Mesoscale Potential Vorticity Anomalies and Topographic Forcing during Cyclone Redevelopment across the Appalachians: a Gale Case Study.

    NASA Astrophysics Data System (ADS)

    O'Handley, Christopher

    The evolution of the structure of cyclones and cold fronts over the eastern United States is investigated observationally. Two primary goals of the research are to understand the mechanisms controlling cyclone and frontal evolution across the Appalachian mountains, and to document the presence and importance of mesoscale disturbances during cyclogenesis. The research was accomplished in two phases. First, a climatological survey of seven winter seasons of cyclones and fronts was performed. This study revealed that cold fronts are slowed and deformed by the Appalachians, with the cross-frontal pressure and thermal contrasts enhanced considerably across the mountains. In addition, cyclones generally curve northward and dissipate over the mountains while secondary development occurs further south over the lee region. Both upper-level "forcing" and low-level thermal structure are important in determining the exact location of redevelopment. Second, a detailed case study was conducted of a cyclone observed during the Genesis of Atlantic Lows Experiment (GALE). The primary cyclone dissipated over the northern Appalachians while a secondary lower tropospheric (800-900 mb) cyclone formed over eastern North Carolina. However, strong low-level static stability prevented this disturbance from penetrating to the surface. Instead, cyclogenesis occurred offshore when two mesoscale mid-tropospheric (500 mb) PV maxima, one of which represented an upper level frontal zone, moved over a series of quasi-stationary shallow cloud clusters over the Gulf Stream. Meanwhile, the primary surface cold front was blocked west of the Appalachians, but the mid-level (700-850 mb) front progressed unimpeded across the mountains. Later, a new surface front formed east of the mountains through diabatic processes. Both surface heating and evaporation played important roles in the frontal redevelopment. These results indicate that future mesoscale models will need to incorporate topography and

  12. A case of autoimmune hypoglycemia outside Japan: Rare, but in the era of expanding drug-list, important to suspect

    PubMed Central

    Gopal, Krishan; Priya, Gagan; Gupta, Nandita; Praveen, E. P.; Khadgawat, Rajesh

    2013-01-01

    We are hereby reporting a case of a 72-year-old Indian man, who, in the absence of a detectable tumor, presented with symptomatic hypoglycemia in the postabsorptive state (3-5 h after meal). His serum levels of insulin and C-peptide were very high. He was not taking any hypoglycemic drug. Hypoglycemic episodes completely subsided after withdrawal of pentoprazole and incorporation of small frequent meals in the dietary plan. Six months after the initial presentation, the subject became free of hypoglycemic episodes. Although insulin autoimmune syndrome (IAS) is the third leading cause of spontaneous hypoglycemia in Japan, it is extremely uncommon in the Western Countries. Till 2009, more than 200 cases from Japan and as many as 58 cases outside Asia have been reported. To the best of our knowledge, this is the first case of IAS reported from India. PMID:24381896

  13. Barite: a case study of import reliance on an essential material for oil and gas exploration and development drilling

    USGS Publications Warehouse

    Bleiwas, Donald I.; Miller, M. Michael

    2015-01-01

    Domestic barite production was about 670,000 metric tons (t) in 2012, equivalent to about 20 percent of the domestic drilling industry’s barite demand. Mine production for the United States in 2012 was about one-third of what was produced in 1980. In 2012, barite imported from China was approximately 2.2 million t and comprised about 77 percent of total barite imports and about 70 percent of the barite used in domestic drilling. Barite from India (14 percent), Morocco (6 percent) and Mexico (2 percent) comprised the bulk of the remaining total import balance; drilling applications consumed nearly all barite imported from these three countries.

  14. META-ANALYSIS OF FACTOR V LEIDEN AND ISCHEMIC STROKE IN YOUNG ADULTS: THE IMPORTANCE OF CASE ASCERTAINMENT

    PubMed Central

    Hamedani, Ali G.; Cole, John W.; Mitchell, Braxton D.; Kittner, Steven J.

    2010-01-01

    The Factor V Leiden mutation is associated with ischemic stroke in children, but not in adults. Whether it is associated with ischemic stroke in young adults, however, is uncertain. To address this issue, we performed a meta-analysis of 18 case-control studies of ischemic stroke in adults ≤ 50 years of age published before June 2009. Across all studies, Factor V Leiden was detected in 154 of 2,045 cases (7.5%) and 217 of 5,307 controls (4.1%), yielding a fixed effect odds ratio of 2.00 (95% CI: 1.59–2.51). However, further analyses revealed substantial heterogeneity among these studies (p=0.005 for Q-test of heterogeneity). Hypothesizing that this heterogeneity could be related to differences among studies in case selection criteria, we stratified the meta-analysis into studies for which case samples were enriched or not enriched to include cases having an increased likelihood of prothrombotic genetic involvement (“selected” ischemic stroke studies, n = 9) and those that recruited cases from consecutive neurology referrals or hospitalizations (“unselected” ischemic stroke studies, n = 8). Among the nine “selected” ischemic stroke studies, Factor V Leiden was more strongly associated with stroke [OR = 2.73 (95% CI: 1.98–3.75)], whereas among the eight “unselected” ischemic stroke studies, the association between Factor V Leiden and stroke was substantially weaker [OR=1.40 (95% CI: 0.998–1.95)]. This difference was found to be statistically significant (p = 0.003 for Woolf’s test for heterogeneity). We conclude that Factor V Leiden is associated with ischemic stroke in young adults, particularly in patient populations where there is an increased clinical suspicion of prothrombotic state. PMID:20616326

  15. Meta-analysis of factor V Leiden and ischemic stroke in young adults: the importance of case ascertainment.

    PubMed

    Hamedani, Ali G; Cole, John W; Mitchell, Braxton D; Kittner, Steven J

    2010-08-01

    The factor V Leiden mutation is associated with ischemic stroke in children but not in adults. Whether it is associated with ischemic stroke in young adults, however, is uncertain. To address this issue, we performed a meta-analysis of 18 case-control studies of ischemic stroke in adults 50 years of age and younger published before June 2009. Across all studies, factor V Leiden was detected in 154 of 2045 cases (7.5%) and 217 of 5307 controls (4.1%), yielding a fixed-effect odds ratio of 2.00 (95% CI, 1.59-2.51). However, further analyses revealed substantial heterogeneity among these studies (P=0.005 for Q-test of heterogeneity). Hypothesizing that this heterogeneity could be related to differences among studies in case selection criteria, we stratified the meta-analysis into studies for which case samples were enriched or not enriched to include cases having an increased likelihood of prothrombotic genetic involvement ("selected" ischemic stroke studies, n=9) and those that recruited cases from consecutive neurology referrals or hospitalizations ("unselected" ischemic stroke studies, n=8). Among the 9 "selected" ischemic stroke studies, factor V Leiden was more strongly associated with stroke (OR, 2.73; 95% CI, 1.98-3.75), whereas among the 8 "unselected" ischemic stroke studies, the association between factor V Leiden and stroke was substantially weaker (OR, 1.40; 95% CI, 0.998-1.95). This difference was found to be statistically significant (P=0.003 for Woolf test for heterogeneity). We conclude that factor V Leiden is associated with ischemic stroke in young adults, particularly in patient populations in which there is an increased clinical suspicion of prothrombotic state.

  16. Photograph-based diagnosis of burns in patients with dark-skin types: the importance of case and assessor characteristics.

    PubMed

    Boissin, C; Laflamme, L; Wallis, L; Fleming, J; Hasselberg, M

    2015-09-01

    This study assessed whether photographs of burns on patients with dark-skin types could be used for accurate diagnosing and if the accuracy was affected by physicians' clinical background or case characteristics. 21 South-African cases (Fitzpatrick grades 4-6) of varying complexity were photographed using a camera phone and uploaded on a web-survey. Respondents were asked to assess wound depth (3 categories) and size (in percentage). A sample of 24 burn surgeons and emergency physicians was recruited in South-Africa, USA and Sweden. Measurements of accuracy (using percentage agreement with bedside diagnosis), inter- (n=24), and intra-rater (n=6) reliability (using percentage agreement and kappa) were computed for all cases aggregated and by case characteristic. Overall diagnostic accuracy was 67.5% and 66.0% for burn size and depth, respectively. It was comparable between burn surgeons and emergency physicians and between countries of practice. However, the standard deviations were smaller, showing higher similarities in diagnoses for burn surgeons and South-African clinicians compared to emergency physicians and clinicians from other countries. Case characteristics (child/adult, simple/complex wound, partial/full thickness) affected the results for burn size but not for depth. Inter- and intra-rater reliability for burn depth was 55% and 77%. Size and depth of burns on patients with dark-skin types could be assessed at least as well using photographs as at bedside with 67.5% and 66.0% average accuracy rates. Case characteristics significantly affected the accuracy for burn size, but medical specialty and country of practice seldom did in a statistically significant manner. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  17. Representing Color Ensembles.

    PubMed

    Chetverikov, Andrey; Campana, Gianluca; Kristjánsson, Árni

    2017-10-01

    Colors are rarely uniform, yet little is known about how people represent color distributions. We introduce a new method for studying color ensembles based on intertrial learning in visual search. Participants looked for an oddly colored diamond among diamonds with colors taken from either uniform or Gaussian color distributions. On test trials, the targets had various distances in feature space from the mean of the preceding distractor color distribution. Targets on test trials therefore served as probes into probabilistic representations of distractor colors. Test-trial response times revealed a striking similarity between the physical distribution of colors and their internal representations. The results demonstrate that the visual system represents color ensembles in a more detailed way than previously thought, coding not only mean and variance but, most surprisingly, the actual shape (uniform or Gaussian) of the distribution of colors in the environment.

  18. [Experience of integrated traditional Chinese and Western medicine in first case of imported Zika virus disease in China].

    PubMed

    Deng, Yichu; Zeng, Liping; Bao, Wen; Xu, Pinghua; Zhong, Gongrong

    2016-02-01

    Zika virus disease is an acute infectious disease caused by Zika virus transmitted through Aedes mosquitoes. To explore the therapeutic effect of integrated traditional Chinese and Western Medicine for Zika virus disease, the treatment process of the first imported case in China was reviewed. The first imported Zika virus disease in China was admitted to Ganxian People's Hospital in Jiangxi Province on February 6th, 2016, and the patient received isolation treatment for 9 days and cured later. The effect of antiviral treatments including Xiyanping injection was evaluated based on clinical diagnosis and treatment process of the patient. A 34-year old male patient was admitted with chief complaint of fever for 9 days, orbital pain and itching rash for 4 days on February 6th, 2016. (1) Epidemiological characteristics: the patient was bitted by mosquitoes during his business trip in Venezuela since January 1st, where Zika virus disease was spreading. On January 20th he had dizziness without fever, and the symptom disappeared after taking medicines without details. Paroxysmal dizziness, chills and mild fever without myalgia was experienced on January 28th. On February 3rd small red rash appeared in the neck, spreading to anterior part of chest, limbs and trunk, and the fever, fatigue, nausea was continued, and a new symptom of paroxysmal pain in back of ears and orbits appeared, during which he had not go to hospital. The symptoms relieved on February 4th. He returned to Ganxian County on February 5th, he had yellow stool 3 times with normal temperature, without abdominal pain, and red rash still appeared in the neck. He went to Ganxian People's Hospital on February 6th, 2016. (2) Clinical manifestation: the vital signs showed a temperature of 36.8?centigrade, a pulse rate of 80 bpm, a respiratory rate of 20 bpm, and a blood pressure of 110/70 mmHg (1 mmHg = 0.133 kPa). It was showed by physical examination that red rash appeared in the neck, and no superficial enlarged

  19. Outbreak of Hepatitis A virus in Italy associated with frozen red currents imported from Poland: A case study

    USDA-ARS?s Scientific Manuscript database

    During 2013 Italy experienced an increase in cases of hepatitis A virus (HAV) infection and the epidemic HAV strain has been characterized as genotype IA. Preliminary epidemiological, microbiological and environmental investigations suggested mixed frozen berries as the possible vehicle of infection...

  20. Perceptions of Child Sexual Abuse in a Hypothetical Cybersexploitation Case: The Importance of Perpetrator Honesty, Outcome Type, and Respondent Gender

    ERIC Educational Resources Information Center

    Davies, Michelle; Rogers, Paul; Hood, Paul A.

    2009-01-01

    This study investigated perceptions of child sexual abuse in a hypothetical cybersexploitation case. Men were predicted to be more negative toward the victim than were women. Victims were predicted to be more negatively judged when they consented to sex than when they did not and when they were lied to than when they were not. Two hundred and…

  1. Perceptions of Child Sexual Abuse in a Hypothetical Cybersexploitation Case: The Importance of Perpetrator Honesty, Outcome Type, and Respondent Gender

    ERIC Educational Resources Information Center

    Davies, Michelle; Rogers, Paul; Hood, Paul A.

    2009-01-01

    This study investigated perceptions of child sexual abuse in a hypothetical cybersexploitation case. Men were predicted to be more negative toward the victim than were women. Victims were predicted to be more negatively judged when they consented to sex than when they did not and when they were lied to than when they were not. Two hundred and…

  2. [The importance of case reports in current pediatric endocrinology and metabolism literature--the analysis of publications indexed in Medline in the years 2004-2009].

    PubMed

    Kuchar, Ernest

    2010-01-01

    Case reports have been used as an educational tool in medicine for a long time, as they are usually the first kind of publications prepared by new authors. In compliance with the rules of the EBM, the evidence-based medicine, a clinical case report (which describes and analyses the manner of diagnosis and treatment) appears at the bottom of the hierarchy of scientific evidences. As a result, medical periodicals limit the publishing of case reports. The aim of the study is to assess how important case reports are in the modern pediatric literature, with special interests in endocrine and metabolic disorders. Searching Medline over the last 5 years (October 2004-October 2009) using key words "case report" was performed. The limitations: "human", age "all children: 0-18 years" and the kind of publication: "case report" were used. For the huge number of publications found, the number and language of the publication was analyzed, and the first 100 free full-text publications in field of endocrine and metabolic disorders in English (from 2007-2009) were rated depending on the kind of case and aim of the publication. A total of 55379 publications classified by Pubmed as case reports were found, including 48805 English, 1592 Spanish, 1538 French, 794 German, 370 Polish, 356 Chinese, 265 Russian and 135 Italian. The published case reports were more often informative than educational in character. The content of the published case reports deals more often with the notification of a new mutation, less frequently presentation of an interesting, rare, unusual case or a new illness or the description of a novel therapy. Less often the published case reports appear to be of educational character or those concerning diagnostic problems or treatment failure. Case reports remain an important contribution to the pediatric literature, mainly fulfilling an essential role in providing information about new medical problems. Medical literature published in Polish is relatively rich in

  3. Investigation of the First Case of Dengue Virus Infection Acquired in Western Australia in Seven Decades: Evidence of Importation of Infected Mosquitoes?

    PubMed Central

    McCarthy, Suzi; Whittle, Amanda; Lyttle, Heather; Harrington, Sue; Nicholson, Jay

    2015-01-01

    In October 2013, a locally-acquired case of dengue virus (DENV) infection was reported in Western Australia (WA) where local dengue transmission has not occurred for over 70 years. Laboratory testing confirmed recent DENV infection and the case demonstrated a clinically compatible illness. The infection was most likely acquired in the Pilbara region in the northwest of WA. Follow up investigations did not detect any other locally-acquired dengue cases or any known dengue vector species in the local region, despite intensive adult and larval mosquito surveillance, both immediately after the case was notified in October 2013 and after the start of the wet season in January 2014. The mechanism of infection with DENV in this case cannot be confirmed. However, it most likely followed a bite from a single infected mosquito vector that was transiently introduced into the Pilbara region but failed to establish a local breeding population. This case highlights the public health importance of maintaining surveillance efforts to ensure that any incursions of dengue vectors into WA are promptly identified and do not become established, particularly given the large numbers of viraemic dengue fever cases imported into WA by travellers returning from dengue-endemic regions. PMID:26406471

  4. LGMD2D syndrome: the importance of clinical and molecular genetics in patient and family management. Case Report.

    PubMed

    Al-Harbi, Khalid M; Abdallah, Atiyeh M

    2016-09-01

    We report the case of a seven-year-old female from a consanguineous Saudi family with autosomal recessive limb girdle muscular dystrophy type 2D (LGMD2D) most likely caused by a rare SGCA mutation. Histopathological and molecular investigations resulted in the discovery of a homozygous mutation (c.226 C>T (p.L76 F)) in exon 3 of SGCA in the patient. The parents and one sibling were heterozygous carriers, but the mutation was not otherwise detected in 80 ethnic controls from the same geographic area. In silico analysis revealed that the mutation resulted in a functional leucine to phenylalanine alteration that was deleterious to the protein structure. This is only the second reported case of the p.L76F mutation in LGMD, and highlights that molecular genetics analysis is essential to deliver the most appropriate management to the patient and offer the family genetic counseling.

  5. Integrating between-session interventions (homework) in therapy: the importance of the therapeutic relationship and cognitive case conceptualization.

    PubMed

    Cronin, Timothy J; Lawrence, Katherine A; Taylor, Kate; Norton, Peter J; Kazantzis, Nikolaos

    2015-05-01

    Between-session interventions, or homework, are crucial to a range of psychological therapies, including cognitive behavior therapy (CBT). Therapeutic interventions often involve experiencing emotions and situations, or examining strongly held views about their problems, that clients can find distressing. Hence, the clinician faces a particular challenge in collaborating with the client to carry out these interventions between sessions. In this article, we convey how this process in CBT requires not only a consideration of the theoretically meaningful determinants of adherence behavior but also a sophisticated cognitive case conceptualization. Using case material, we illustrate the interplay between in-session design, planning, and review of between-session interventions and the conceptualization. We also include a distinction between generic elements of the therapeutic relationship and CBT-specific elements. The case material also attends to the person of the therapist, and his or her own cognitive and emotional reactions occurring throughout the process of discussing between-session interventions. © 2015 Wiley Periodicals, Inc.

  6. First imported Plasmodium ovale malaria in Central America: case report of a Guatemalan soldier and a call to improve its accurate diagnosis.

    PubMed

    Castellanos, María Eugenia; Díaz, Sheilee; Parsons, Emily; Peruski, Leonard F; Enríquez, Fabiola; Ramírez, Juan Luis; Padilla, Norma

    2015-01-01

    The Mesoamerican Ministers of Health have set 2020 as the target for malaria elimination to be achieved in the region. Imported malaria cases are a potential threat to countries attempting elimination or working to prevent resurgence. We report the first imported Plasmodium ovale infection with molecular confirmation in Central America, which occurred in a Guatemalan soldier that had been deployed in Africa. The obstacles for its diagnosis using the standard microscopy technique and the need to improve its detection are discussed.

  7. The Importance of Evolutionary Theory for Developmental Science--And Vice Versa: The Case of Developmental Psychology

    ERIC Educational Resources Information Center

    Greve, Werner

    2012-01-01

    The empirical and conceptual interrelations of phylogeny (evolution) and ontogeny (development) may prove to be more important than previously acknowledged. It is argued that this holds particularly for evolutionary psychology. For instance, an evolutionary point of view will add to the explanation of (the shape of) pre- and post-reductive phases…

  8. The clinical and virological features of the first imported case causing MERS-CoV outbreak in South Korea, 2015.

    PubMed

    Lee, Ji Yeon; Kim, You-Jin; Chung, Eun Hee; Kim, Dae-Won; Jeong, Ina; Kim, Yeonjae; Yun, Mi-Ran; Kim, Sung Soon; Kim, Gayeon; Joh, Joon-Sung

    2017-07-14

    In 2015, the largest outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outside the Middle East occurred in South Korea. We summarized the epidemiological, clinical, and laboratory findings of the first Korean case of MERS-CoV and analyzed whole-genome sequences of MERS-CoV derived from the patient. A 68-year-old man developed fever and myalgia 7 days after returning to Korea, following a 10-day trip to the Middle East. Before diagnosis, he visited 4 hospitals, potentially resulting in secondary transmission to 28 patients. On admission to the National Medical Center (day 9, post-onset of clinical illness), he presented with drowsiness, hypoxia, and multiple patchy infiltrations on the chest radiograph. He was intubated (day 12) because of progressive acute respiratory distress syndrome (ARDS) and INF-α2a and ribavirin treatment was commenced. The treatment course was prolonged by superimposed ventilator associated pneumonia. MERS-CoV PCR results converted to negative from day 47 and the patient was discharged (day 137), following rehabilitation therapy. The complete genome sequence obtained from a sputum sample (taken on day 11) showed the highest sequence similarity (99.59%) with the virus from an outbreak in Riyadh, Saudi Arabia, in February 2015. The first case of MERS-CoV infection had high transmissibility and was associated with a severe clinical course. The patient made a successful recovery after early treatment with antiviral agents and adequate supportive care. This first case in South Korea became a super-spreader because of improper infection control measures, rather than variations of the virus.

  9. [Importance of the nerve biopsy for the diagnosis of atypical forms of chronic inflammatory demyelinating polyradiculoneuritis: 8 cases].

    PubMed

    Vallat, Jean-Michel; Tabaraud, François; Magy, Laurent; Couratier, Philippe

    2003-01-01

    The objective of the study was to define how could be helpful a nerve biopsy for identification of atypical cases of chronic inflammatory demyelinating polyneuropathy (CIDP). An ad hoc committee in 1991 defined the clinical, electrophysiological and pathological criteria for diagnosis of CIDP. In common with other authors, we regard the rather specific electrophysiological criteria as being too restrictive, and we think that a significant number of patients may therefore not benefit from effective treatment or be excluded from therapeutic trials. The Inflammatory Neuropathy Cause and Treatment (INCAT) group (2001) has proposed new electrophysiological criteria of CIDP, which are more sensitive and do not loose any specificity. Over a period of three years (January 1999 to December 2001), we classified 44 patients into two categories: those presenting the strict criteria of the ad hoc committee and those who we regarded as cases of CIDP who did not meet these strict criteria. All these patients benefited from one or more clinical and electrophysiological examinations; extensive biological workup and genetic study when appropriate excluded other causes of neuropathy. Nerve biopsies were taken from all patients and samples were included in paraffin and epon for systematic light and electron microscopic examination. Out of 44 patients, 24 fulfilled the INCAT electrophysiological criteria with only 12 of these cases fulfilling the criteria of the ad hoc committee. Eight patients did not fulfill any of the widely accepted electrophysiological criteria of CIDP. However, study of nerve biopsies of these eight patients revealed histological features characteristic of CIDP according to histological criteria (AAN-1991). Among these patients, six have been treated and five responded favorably to conventional treatments for CIDP. Without information from the nerve biopsy, these patients would not have been treated effectively because their electrophysiological profile was

  10. Pregnancy in dialysis-dependent women--the importance of frequent dialysis and collaborative care: a case report.

    PubMed

    Pipili, Chrisoula; Grapsa, Eirini; Koutsobasili, Alexandra; Sorvinou, Patra; Poirazlar, Engin; Kiosses, Dimitrios; Xatzigeorgiou, Georgia

    2011-07-01

    An increasing number of successful pregnancies have been reported among women on chronic hemodialysis. Even with reduced fertility and high risk of complications, women of childbearing age receiving hemodialysis, should not be discouraged from pregnancy. Practitioners should be familiar with the effects of renal disease on pregnancy, consult patients about the possibility of pregnancy and its hazards and provide, if necessary, prompt surveillance and treatment. This paper describes the case of an unplanned but successful pregnancy of a woman receiving hemodialysis, emphasizing pregnancy management, mother's response evaluation, and infant growth.

  11. Importance of cone beam computed tomography for diagnosis of calcifying cystic odontogenic tumour associated to odontoma. Report of a case.

    PubMed

    Marques, Yonara-Maria-Freire-Soares; Botelho, Tessa-de Lucena; Xavier, Flávia-Caló-de Aquino; Rangel, Andrea-Leão; Rege, Inara-Carneiro-Costa; Mantesso, Andrea

    2010-05-01

    The calcifying cystic odontogenic tumour (CCOT) is a rare benign cystic neoplasm not infrequently associated with odontoma. This report documents a case of CCOT associated with compound odontoma arising in the anterior maxilla in a 25-year-old woman. Conventional radiographs showed a large calcified mass with poorly visualized radiolucent margins. The extent and condition of the internal structure of the CCOT associated with odontoma was able to be determined based on radiographic findings from cone beam computed tomography. This advanced image technique proved to be extremely useful in the radiographic assessment of this particular neoplasm of the jawbones.

  12. Multi-organ injuries due to a lightning strike: a case report highlighting the importance of a multi-disciplinary approach.

    PubMed

    Tadler, Marlene; Rüegg, Eva; Niquille, Marc; Gencer, Baris; Gautschi, Oliver P; Pittet-Cuénod, Brigitte; Modarressi, Ali

    2017-01-01

    The interdisciplinary management of patients with multiple organ injuries after lightning strike is of paramount importance. Cutaneous burns can be associated to other organ injuries requiring emergency and life-support treatment. We report the case of a lightning strike victim who presented with burns as well as cardiologic and neurologic complications.

  13. Multi-organ injuries due to a lightning strike: a case report highlighting the importance of a multi-disciplinary approach

    PubMed Central

    Tadler, Marlene; Rüegg, Eva; Niquille, Marc; Gencer, Baris; Gautschi, Oliver P.; Pittet-Cuénod, Brigitte; Modarressi, Ali

    2017-01-01

    Abstract The interdisciplinary management of patients with multiple organ injuries after lightning strike is of paramount importance. Cutaneous burns can be associated to other organ injuries requiring emergency and life-support treatment. We report the case of a lightning strike victim who presented with burns as well as cardiologic and neurologic complications. PMID:28164145

  14. The Importance of Diabetes Mellitus in the Global Epidemic of Cardiovascular Disease: The Case of the State of Qatar

    PubMed Central

    Mushlin, Alvin I.; Christos, Paul J.; Abu-Raddad, Laith; Chemaitelly, Hiam; Deleu, Dirk; Gehani, Abdul Razak

    2012-01-01

    As a manifestation of the epidemiologic transition being experienced throughout the developing world, the prevalence of diabetes mellitus (DM) is increasing. However, whether an individual's risk of cardiovascular diseases as a consequence of DM is also higher in these countries is unknown. We conducted a case-control study at the medical center in the state of Qatar comparing the prevalence of DM in 512 patients who were admitted with acute myocardial infarctions (MI) and 262 cases of cerebrovascular accidents (CVA) to 382 hospital and outpatient controls to calculate the odds ratios (OR) associated with DM for MI and CVA. The OR for MI was estimated to be 4.01 compared to 2.92 for other countries in the Middle East and 1.75 for North America. The OR was even higher for Qatari natives. Understanding the reasons for this increase, including genetic differences, lifestyle, and medical management issues, is critical for the design and prioritization of effective interventions. PMID:23303985

  15. Rabies virus dissemination in neural tissues of autopsy cases due to rabies imported into Japan from the Philippines: immunohistochemistry.

    PubMed

    Tobiume, Minoru; Sato, Yuko; Katano, Harutaka; Nakajima, Noriko; Tanaka, Keiko; Noguchi, Akira; Inoue, Satoshi; Hasegawa, Hideki; Iwasa, Yoko; Tanaka, Junichi; Hayashi, Hiroyuki; Yoshida, Sachiko; Kurane, Ichiro; Sata, Tetsutaro

    2009-08-01

    Two Japanese men, 65 and 69 years old, developed rabies in Japan around 2-3 months after dog-bite exposure in the Philippines. Laboratory diagnosis of rabies was made following the detection of rabies virus genome on reverse transcription-polymerase chain reaction from saliva, and on immunohistochemistry of a nuchal skin punch biopsy in one case. The patients died 9 and 19 days after clinical onset. At autopsy, no macroscopic changes in the CNS were observed. Histopathology indicated that eosinophilic and cytoplasmic inclusion bodies, Negri bodies, were seen in neuronal cells of the CNS. Inflammatory cell reactions were scarce, and no apoptosis in the CNS was detected. Immunohistochemistry demonstrated that rabies virus nucleoprotein (N) and phosphoprotein (P) were disseminated to all neural tissues and cells in the body with a similar pattern in both cases. Interestingly, there were no differences of localization between N and P antigen in the brain, but the N antigen was located at the peripheral nerve sheaths and the P antigen was localized in axons. These data indicate that rabies virus dissemination in all neural tissues causes disease development and death. Immunohistochemistry for rabies is a powerful tool to understand the pathogenesis of rabies.

  16. Are ecologically important tree species the most useful? A case study from indigenous people in the Bolivian Amazon

    PubMed Central

    Guèze, Maximilien; Luz, Ana Catarina; Paneque-Gálvez, Jaime; Macía, Manuel J.; Orta-Martínez, Martí; Pino, Joan; Reyes-García, Victoria

    2015-01-01

    Researchers have argued that indigenous peoples preferably use the most apparent plant species, particularly for medicinal uses. However, the association between the ecological importance of a species and its usefulness remains unclear. In this paper we quantify such association for six use categories (firewood, construction, materials, food, medicines and other uses). We collected data on the uses of 58 tree species, as reported by 93 informants in 22 villages in the Tsimane’ territory (Bolivian Amazon). We calculated the ecological importance of the same species by deriving their importance value index (IVI) in 48 0.1-ha old-growth forest plots. Matching both data sets, we found a positive relation between the IVI of a species and its overall use value (UV) as well as with its UV for construction and materials. We found a negative relation between IVI and UV for species that were reportedly used for medicine and food uses, and no clear pattern for the other categories. We hypothesize that species used for construction or crafting purposes because of their physical properties are more easily substitutable than species used for medicinal or edible purposes because of their chemical properties. PMID:26097243

  17. Health problems associated with international travel: a case of cutaneous myiasis in China due to Cordylobia anthropophaga imported from Uganda.

    PubMed

    Ruan, Wei; Feng, Yan; Zhang, Lingling; Sun, Jimin; Yao, Linong

    2014-12-01

    More affordable international travel, global trade and commerce, and the exporting of labor have all contributed to international population mobility. Furthermore, population migration leads to the incidence or recurrence of once-controlled diseases. Evidence shows that the popularity of travel can impact health through imported infections and illness. Imported cutaneous myiasis, a type of skin lesion, has attracted the attention of the current authors. This condition often occurs among travelers and it has been reported in several non-endemic countries. However, diagnosis of myiasis and identification of the larvae are difficult. Advances in molecular detection techniques could provide a new way to identify larvae. This study used sequencing of the 28S rRNA gene and morphology to identify the larva infesting the upper arm of a Chinese woman returning from Uganda. The larva was identified as Cordylobia anthropophaga (C. anthropophaga) and the sequences were submitted to GenBank (accession number: KM506761). As foreign interaction increases, imported health problems may become more common in China. Knowledge about various pathogens needs to be increased and molecular methods need to be used to accurately identify those pathogens.

  18. Are ecologically important tree species the most useful? A case study from indigenous people in the Bolivian Amazon.

    PubMed

    Guèze, Maximilien; Luz, Ana Catarina; Paneque-Gálvez, Jaime; Macía, Manuel J; Orta-Martínez, Martí; Pino, Joan; Reyes-García, Victoria

    2014-03-01

    Researchers have argued that indigenous peoples preferably use the most apparent plant species, particularly for medicinal uses. However, the association between the ecological importance of a species and its usefulness remains unclear. In this paper we quantify such association for six use categories (firewood, construction, materials, food, medicines and other uses). We collected data on the uses of 58 tree species, as reported by 93 informants in 22 villages in the Tsimane' territory (Bolivian Amazon). We calculated the ecological importance of the same species by deriving their importance value index (IVI) in 48 0.1-ha old-growth forest plots. Matching both data sets, we found a positive relation between the IVI of a species and its overall use value (UV) as well as with its UV for construction and materials. We found a negative relation between IVI and UV for species that were reportedly used for medicine and food uses, and no clear pattern for the other categories. We hypothesize that species used for construction or crafting purposes because of their physical properties are more easily substitutable than species used for medicinal or edible purposes because of their chemical properties.

  19. A stab wound to the axilla illustrating the importance of brachial plexus anatomy in an emergency context: a case report.

    PubMed

    Casal, Diogo; Cunha, Teresa; Pais, Diogo; Iria, Inês; Angélica-Almeida, Maria; Millan, Gerardo; Videira-Castro, José; Goyri-O'Neill, João

    2017-01-04

    Although open injuries involving the brachial plexus are relatively uncommon, they can lead to permanent disability and even be life threatening if accompanied by vascular damage. We present a case report of a brachial plexus injury in which the urgency of the situation precluded the use of any ancillary diagnostic examinations and forced a rapid clinical assessment. We report a case of a Portuguese man who had a stabbing injury at the base of his left axilla. On observation in our emergency room an acute venous type of bleeding was present at the wound site and, as a result of refractory hypotension after initial management with fluids administered intravenously, he was immediately carried to our operating room. During the course of transportation, we observed that he presented hypoesthesia of the medial aspect of his arm and forearm, as well as of the ulnar side of his hand and of the palmar aspect of the last three digits and of the dorsal aspect of the last two digits. Moreover, he was not able to actively flex the joints of his middle, ring, and small fingers or to adduct or abduct all fingers. Exclusively relying on our anatomical knowledge of the axillary region, the site of the stabbing wound, and the physical neurologic examination, we were able to unequivocally pinpoint the place of the injury between the anterior division of the lower trunk of his brachial plexus and the proximal portion of the following nerves: ulnar, medial cutaneous of his arm and forearm, and the medial aspect of his median nerve. Surgery revealed a longitudinal laceration of the posterior aspect of his axillary vein, and confirmed a complete section of his ulnar nerve, his medial brachial and antebrachial cutaneous nerves, and an incomplete section of the ulnar aspect of his median nerve. All structures were repaired microsurgically. Three years after the surgery he showed a good functional outcome. We believe that this case report illustrates the relevance of a sound anatomical

  20. Blog-based applications and health information: two case studies that illustrate important questions for Consumer Health Informatics (CHI) research.

    PubMed

    Adams, Samantha A

    2010-06-01

    Weblogs (blogs), together with podcasts and wikis are part of the larger body of next-generation communication applications dubbed "web 2.0." Within the specific area of health care, little attention has been devoted to understanding what applications are available to the lay public and how these are being used. In this study, a literature review on blogs and blogging practices was conducted, followed by case study analyses of two separate sites that use blogging tools to help patients and other lay web end-users record health-related experiences. This paper explores the diverse purposes for which blogging applications can be (or are being) used in relation to health and introduces the idea of "health goal-oriented" blogging. The discussion focuses on relevant informatics questions that arise with respect to the use of blogs and makes suggestions for subsequent research. Copyright 2008 Elsevier Ireland Ltd. All rights reserved.

  1. Perceptions of child sexual abuse in a hypothetical cybersexploitation case: the importance of perpetrator honesty, outcome type, and respondent gender.

    PubMed

    Davies, Michelle; Rogers, Paul; Hood, Paul A

    2009-01-01

    This study investigated perceptions of child sexual abuse in a hypothetical cybersexploitation case. Men were predicted to be more negative toward the victim than were women. Victims were predicted to be more negatively judged when they consented to sex than when they did not and when they were lied to than when they were not. Two hundred and seventy-six respondents read a sexual abuse depiction in which the perpetrator's disclosure about his age (being honest from the outset, lying, or refusing to disclose when questioned) and the final outcome of the meeting (consensual verses nonconsensual sexual intercourse) were varied between subjects. Respondents then completed a 17-item attribution scale. ANOVAs revealed broad support for the predictions. Results have implications for education about cybercrime.

  2. Outbreak of hepatitis A in the USA associated with frozen pomegranate arils imported from Turkey: an epidemiological case study.

    PubMed

    Collier, Melissa G; Khudyakov, Yury E; Selvage, David; Adams-Cameron, Meg; Epson, Erin; Cronquist, Alicia; Jervis, Rachel H; Lamba, Katherine; Kimura, Akiko C; Sowadsky, Rick; Hassan, Rashida; Park, Sarah Y; Garza, Eric; Elliott, Aleisha J; Rotstein, David S; Beal, Jennifer; Kuntz, Thomas; Lance, Susan E; Dreisch, Rebecca; Wise, Matthew E; Nelson, Noele P; Suryaprasad, Anil; Drobeniuc, Jan; Holmberg, Scott D; Xu, Fujie

    2014-10-01

    In May, 2013, an outbreak of symptomatic hepatitis A virus infections occurred in the USA. Federal, state, and local public health officials investigated the cause of the outbreak and instituted actions to control its spread. We investigated the source of the outbreak and assessed the public health measures used. We interviewed patients, obtained their shopping information, and did genetic analysis of hepatitis A virus recovered from patients' serum and stool samples. We tested products for the virus and traced supply chains. Of 165 patients identified from ten states, 69 (42%) were admitted to hospital, two developed fulminant hepatitis, and one needed a liver transplant; none died. Illness onset occurred from March 31 to Aug 12, 2013. The median age of patients was 47 years (IQR 35-58) and 91 (55%) were women. 153 patients (93%) reported consuming product B from retailer A. 40 patients (24%) had product B in their freezers, and 113 (68%) bought it according to data from retailer A. Hepatitis A virus genotype IB, uncommon in the Americas, was recovered from specimens from 117 people with hepatitis A virus illness. Pomegranate arils that were imported from Turkey--where genotype IB is common--were identified in product B. No hepatitis A virus was detected in product B. Imported frozen pomegranate arils were identified as the vehicle early in the investigation by combining epidemiology--with data from several sources--genetic analysis of patient samples, and product tracing. Product B was removed from store shelves, the public were warned not to eat product B, product recalls took place, and postexposure prophylaxis with both hepatitis A virus vaccine and immunoglobulin was provided. Our findings show that modern public health actions can help rapidly detect and control hepatitis A virus illness caused by imported food. Our findings show that postexposure prophylaxis can successfully prevent hepatitis A illness when a specific product is identified. Imported food

  3. Materials Data Infrastructure: A Case Study of the Citrination Platform to Examine Data Import, Storage, and Access

    NASA Astrophysics Data System (ADS)

    O'Mara, Jordan; Meredig, Bryce; Michel, Kyle

    2016-08-01

    Considerations are presented around the design of a materials data infrastructure including import of structured and unstructured data, storage of that data for archival and retrieval, and access to that data through programmatic and graphical interfaces. In particular, the choices around technologies used in such an infrastructure, the benefits and drawbacks of those technologies, and their impact on the experience of users of that system are presented. The Citrination platform is used as an example of a materials data infrastructure and the choices made around architecture are discussed.

  4. Important Factors in the Cognitive Development of Children with Hearing Impairment: Case Studies of Candidates for Cochlear Implants

    PubMed Central

    Nasralla, Heloisa Romeiro; Goffi Gomez, Maria Valéria Schimidt; Magalhaes, Ana Tereza; Bento, Ricardo Ferreira

    2014-01-01

    Introduction The factors that affect the development of children with and without hearing disabilities are similar, provided their innate communication abilities are taken into account. Parents need to mourn the loss of the expected normally hearing child, and it is important that parents create bonds of affection with their child. Objective To conduct a postevaluation of the development and cognition of 20 candidates for cochlear implants between 1 and 13 years of age and to observe important factors in their development. Methods The following instruments were used in accordance with their individual merits: interviews with parents; the Vineland Social Maturity Scale; the Columbia Maturity Scale; free drawings; Bender and Pre-Bender testing; and pedagogical tests. Results The results are described. Conclusion Parental acceptance of a child's deafness proved to be the starting point for the child's verbal or gestural communication development, as well as for cognitive, motor, and emotional development. If the association between deafness and fine motor skills (with or without multiple disabilities) undermines the development of a child's speech, it does not greatly affect communication when the child interacts with his or her peers and receives maternal stimulation. Overprotection and poor sociability make children less independent, impairs their development, and causes low self-esteem. Further observational studies are warranted to determine how cochlear implants contribute to patient recovery. PMID:25992122

  5. Important factors in the cognitive development of children with hearing impairment: case studies of candidates for cochlear implants.

    PubMed

    Nasralla, Heloisa Romeiro; Goffi Gomez, Maria Valéria Schimidt; Magalhaes, Ana Tereza; Bento, Ricardo Ferreira

    2014-10-01

    Introduction The factors that affect the development of children with and without hearing disabilities are similar, provided their innate communication abilities are taken into account. Parents need to mourn the loss of the expected normally hearing child, and it is important that parents create bonds of affection with their child. Objective To conduct a postevaluation of the development and cognition of 20 candidates for cochlear implants between 1 and 13 years of age and to observe important factors in their development. Methods The following instruments were used in accordance with their individual merits: interviews with parents; the Vineland Social Maturity Scale; the Columbia Maturity Scale; free drawings; Bender and Pre-Bender testing; and pedagogical tests. Results The results are described. Conclusion Parental acceptance of a child's deafness proved to be the starting point for the child's verbal or gestural communication development, as well as for cognitive, motor, and emotional development. If the association between deafness and fine motor skills (with or without multiple disabilities) undermines the development of a child's speech, it does not greatly affect communication when the child interacts with his or her peers and receives maternal stimulation. Overprotection and poor sociability make children less independent, impairs their development, and causes low self-esteem. Further observational studies are warranted to determine how cochlear implants contribute to patient recovery.

  6. The importance of cultural factors in the distribution of medicinal plant knowledge: a case study in four Basque regions.

    PubMed

    Menendez-Baceta, Gorka; Aceituno-Mata, Laura; Reyes-García, Victoria; Tardío, Javier; Salpeteur, Matthieu; Pardo-de-Santayana, Manuel

    2015-02-23

    Previous research suggests that the use of medicinal plants by a given group is mainly driven by biological variables such as the chemical composition or the ecological distribution of plants. However, other studies highlight the importance of cultural aspects such as the curative meaning given to a plant, beliefs, religion or the historical context. Such aspects could play an important role in the use, diffusion or even in the effectiveness of a plant remedy. Fieldwork consisted of 233 orally consented semi-structured interviews with 178 informants about medicinal uses of plants. Interviews were conducted in four historically and geographycally delimited regions of Alava and Biscay with similar environmental conditions but different sociolinguistic backgrounds: two regions were Basque- and two Spanish-speaking. Data were structured in use-reports. A Between Class Analysis was conducted to assess the intercultural and intracultural variability of medicinal plants knowledge. The results show the existence of four clearly different medicinal ethnofloras. While the four ethnofloras share remedies widely distributed through the territory, each of them also includes remedies that are only shared among closely related communities. The ecological availability and chemical composition of the plants may explain why there are widely used plant remedies. On the contrary, the distribution of the locally shared remedies matches up with the cultural heterogeneity of the territory, so cultural factors, such as, language, social networks or the meaning response of the plants seem to explain the use of many traditional plant remedies. In Addition, we also found that Basque speaking territories show higher knowledge levels than Spanish speaking territories. In this sense, the development and reinforcement of Basque identity by Basque nationalism seems to have contributed to maintain the traditional knowledge in the Basque speaking regions. Despite the fact that pharmacological

  7. The Importance of Choice and Definition for the Measurement of Child Poverty-the case of Vietnam.

    PubMed

    Roelen, Keetie; Gassmann, Franziska; de Neubourg, Chris

    2009-09-01

    Increased attention to childrens' special position within poverty measurement resulted in the development of various child poverty approaches in the last decade. Analysis shows that their development processes involve a similar set of steps and decisions, predominantly taken in the same sequence. However, it also becomes apparent that many of these decisions are made implicitly rather than explicitly, resulting in unclear and non-transparent underlying constructs. Consequently, child poverty approaches often lack a solid and robust foundation and are misinterpreted and misunderstood when used for analytical and policy purposes. This paper distills a generic construction process from the analysis of existing child poverty approaches, presenting a tool for clear and transparent development of such approaches. It is then applied to the case of Vietnam, using household survey data, to illustrate its practical use and develop a Vietnam-specific child poverty approach. Findings suggest that 37% of all children are poor, whilst observing a large rural-urban divide but no significant differences between boys and girls.

  8. The importance of addressing social determinants of health at the local level: the case for social capital.

    PubMed

    Hunter, Bradley D; Neiger, Brad; West, Joshua

    2011-09-01

    Social determinants are gaining momentum in public health practice. Many proposed solutions for tackling social determinants are outside the scope of local public health professionals. This article reviews the literature to find possible moderating variables which may buffer the effects of the social determinants of health at the local level, and allow social determinants to be addressed within the purview of local health departments. The systematic approach employed for this article entailed searches of electronic academic databases (PubMed, EBSCO and Medline) and additional searches using Internet search engines and relevant websites for articles published between 1,975 and May 2010. The search revealed 2,554 articles, and 36 were determined appropriate for inclusion. The purpose of the search was to identify published articles relating to social determinants of health, social capital and effective approaches for addressing both at the level of the local health department. The search was then expanded to include unpublished material, to include the perspectives of local health departments. This process resulted in the inclusion of content from five sources. In this article, the case is made for focusing on social capital interventions to mitigate health problems associated with social determinants. Examples of successful interventions are provided to aid public health professionals in developing locale-specific solutions for addressing social determinants. © 2011 Blackwell Publishing Ltd.

  9. Imported case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection from Oman to Thailand, June 2015

    PubMed Central

    Plipat, Tanarak; Buathong, Rome; Wacharapluesadee, Supaporn; Siriarayapon, Potjaman; Pittayawonganon, Chakrarat; Sangsajja, Chariya; Kaewpom, Thongchai; Petcharat, Sininat; Ponpinit, Teerada; Jumpasri, Jaruphan; Joyjinda, Yutthana; Rodpan, Apaporn; Ghai, Siriporn; Jittmittraphap, Akanitt; Khongwichit, Sarawut; Smith, Duncan R; Corman, Victor M; Drosten, Christian; Hemachudha, Thiravat

    2017-01-01

    Thailand reported the first Middle East respiratory syndrome (MERS) case on 18 June 2015 (day 4) in an Omani patient with heart condition who was diagnosed with pneumonia on hospital admission on 15 June 2015 (day 1). Two false negative RT-PCR on upper respiratory tract samples on days 2 and 3 led to a 48-hour diagnosis delay and a decision to transfer the patient out of the negative pressure unit (NPU). Subsequent examination of sputum later on day 3 confirmed MERS coronavirus (MERS-CoV) infection. The patient was immediately moved back into the NPU and then transferred to Bamrasnaradura Infectious Disease Institute. Over 170 contacts were traced; 48 were quarantined and 122 self-monitored for symptoms. High-risk close contacts exhibiting no symptoms, and whose laboratory testing on the 12th day after exposure was negative, were released on the 14th day. The Omani Ministry of Health (MOH) was immediately notified using the International Health Regulation (IHR) mechanism. Outbreak investigation was conducted in Oman, and was both published on the World Health Organization (WHO) intranet and shared with Thailand’s IHR focal point. The key to successful infection control, with no secondary transmission, were the collaborative efforts among hospitals, laboratories and MOHs of both countries. PMID:28840828

  10. Characterization of the metacaspase 1 gene in Plasmodium vivax field isolates from southern Iran and Italian imported cases.

    PubMed

    Rezanezhad, H; Menegon, M; Sarkari, B; Hatam, G R; Severini, C

    2011-07-01

    Plasmodium vivax is still the more prevalent human Plasmodium outside Africa and despite this fact, there is still a deep lack of knowledge on its biology. Metacaspases are cysteine proteases related to metazoan caspases, involved in programmed cell death. Here, we have characterized the P. vivax metacaspase 1 gene in a total of 63 vivax isolates, 32 isolates collected in southern Iran and 31 Italian imported isolates originating from 12 different endemic countries. We have firstly identified DNA size polymorphism in P. vivax metacaspase 1 gene. A total of four different allelic sizes were found, resulting from the insertion of 1 to 4 tandem repeat units located within the intronic region of the P. vivax metacaspase 1. Similarly, we also have identified four distinct allelic types by using vivax merozoite surface protein-1 size polymorphism analysis.

  11. The importance of fidelity in peer-based programs: the case of the Wellness Recovery Action Plan.

    PubMed

    Federici, Matthew R

    2013-12-01

    This article reflects on the importance of fidelity in the delivery of the peer-based Wellness Recovery Action Plan. The purpose of this account is to describe efforts being made to preserve the evidenced-based practice of the Wellness Recovery Action Plan in ways that sustain the core value of self-determination, maintain fidelity to its copyrighted curriculum, and support its positive impact for all people. The writing is based on personal knowledge and research literature related to the Wellness Recovery Action Plan. The implementation and training of facilitators committed to the value of self-determination is critical to the fidelity of the evidence-based, peer-delivered Wellness Recovery Action Plan. Value-based training and WRAP standards are essential to ensure that WRAP continues to contribute substantially to transformative change. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  12. pfk13-Independent Treatment Failure in Four Imported Cases of Plasmodium falciparum Malaria Treated with Artemether-Lumefantrine in the United Kingdom.

    PubMed

    Sutherland, Colin J; Lansdell, Paul; Sanders, Mandy; Muwanguzi, Julian; van Schalkwyk, Donelly A; Kaur, Harparkash; Nolder, Debbie; Tucker, Julie; Bennett, Hayley M; Otto, Thomas D; Berriman, Matthew; Patel, Trupti A; Lynn, Roderick; Gkrania-Klotsas, Effrossyni; Chiodini, Peter L

    2017-03-01

    We present case histories of four patients treated with artemether-lumefantrine for falciparum malaria in UK hospitals in 2015 to 2016. Each subsequently presented with recurrent symptoms and Plasmodium falciparum parasitemia within 6 weeks of treatment with no intervening travel to countries where malaria is endemic. Parasite isolates, all of African origin, harbored variants at some candidate resistance loci. No evidence of pfk13-mediated artemisinin resistance was found. Vigilance for signs of unsatisfactory antimalarial efficacy among imported cases of malaria is recommended. Copyright © 2017 Sutherland et al.

  13. pfk13-Independent Treatment Failure in Four Imported Cases of Plasmodium falciparum Malaria Treated with Artemether-Lumefantrine in the United Kingdom

    PubMed Central

    Lansdell, Paul; Sanders, Mandy; Muwanguzi, Julian; van Schalkwyk, Donelly A.; Kaur, Harparkash; Tucker, Julie; Bennett, Hayley M.; Otto, Thomas D.; Berriman, Matthew; Patel, Trupti A.; Lynn, Roderick; Gkrania-Klotsas, Effrossyni; Chiodini, Peter L.

    2017-01-01

    ABSTRACT We present case histories of four patients treated with artemether-lumefantrine for falciparum malaria in UK hospitals in 2015 to 2016. Each subsequently presented with recurrent symptoms and Plasmodium falciparum parasitemia within 6 weeks of treatment with no intervening travel to countries where malaria is endemic. Parasite isolates, all of African origin, harbored variants at some candidate resistance loci. No evidence of pfk13-mediated artemisinin resistance was found. Vigilance for signs of unsatisfactory antimalarial efficacy among imported cases of malaria is recommended. PMID:28137810

  14. Importance of speech production for phonological awareness and word decoding: the case of children with cerebral palsy.

    PubMed

    Peeters, Marieke; Verhoeven, Ludo; de Moor, Jan; van Balkom, Hans

    2009-01-01

    The goal of this longitudinal study was to investigate the precursors of early reading development in 52 children with cerebral palsy at kindergarten level in comparison to 65 children without disabilities. Word Decoding was measured to investigate early reading skills, while Phonological Awareness, Phonological Short-term Memory (STM), Speech Perception, Speech Production and Nonverbal Reasoning were considered reading precursors. Children with cerebral palsy lag behind on all reading precursors at the beginning of the second year of kindergarten. For the children without disabilities, early reading skills in Grade 1 were best predicted by Phonological Awareness and Phonological STM while Speech Production was the most important predictor of early reading success for the children with cerebral palsy, followed by Phonological Awareness and Speech Perception. Furthermore, for children with cerebral palsy, Speech Production appears to dominate reading development, as Speech Production measured at the beginning of the second year of kindergarten was strongly predictive of all other reading precursors measured at the end of the second year of kindergarten. The results of this study reveal that children with cerebral palsy with additional speech impairments are at risk for limited literacy development. Clinical implications are discussed.

  15. Is flow cytometry crossmatch analysis using sera with different dilutions important for pretransplant analysis? A case report.

    PubMed

    Sağıroğlu, T; Tozkır, H; Kılıçarslan-Ayna, T; Yağcı, M A; Sezer, A; Carin, M

    2012-01-01

    The most effective form of treatment for chronic renal failure is kidney transplantation from a cadaver or a living donor. For a kidney transplant to be successful, tissue compatibility and a lack of donor-specific anti-human leukocyte antigen (HLA) antibodies in the circulation of the patient are vital, in addition to ABO blood group compatibility. The presence of anti-HLA antibodies is assayed before transplantation using various methods, but because organ rejections have been observed in previous studies, different techniques are required to detect anti-HLA antibodies. Today, flow cytometry crossmatching is one of the most important and effective techniques in testing for donor-specific anti-HLA antibodies (DSAs). If weakly positive serum is assayed after serial dilution, it can yield high positivity. Herein, we describe the differences between the results for diluted and undiluted weakly positive sera studied using the flow cytometry crossmatch (FCXM) technique. In a recent study, the sera of weakly FCXM-positive patients were diluted 1/50, and the FCXM test was repeated. The use of diluted serum eliminated the effect of the prozone so that the DSAs could be detected.

  16. [Reality and importance of transfusion-transmitted malaria in a stable endemic context: Cotonou case in Benin].

    PubMed

    Anani, L Y; Bigot, A; Latoundji, S; Ahlonsou, F; de Souza, J; Akplogan, S; Lawson, J; Py, J Y; Zohoun, I

    2014-03-01

    Malaria endemic status of our countries supports avoiding malaria screening for the blood qualification. But this attitude makes young children, pregnant women and people without semi-immunity incur a high risk of malaria. The goal of the survey was to value the reality and the importance of transfusion-transmitted malaria and to assess its determining factors. The study included 141 packed-red-cells units transfused to 77 hospitalized recipients, not suffering from malaria and not having been transfused the last two weeks. Every packed-red-cells assigned to a patient was tested for malaria before use. Thick and thin blood film were performed 96hours after transfusion. A clinical follow-up was undertaken as well as in the hospital and at home after release. In all, 13.47% of the transfused packed-red-cells were positive for the thick blood film. Plasmodium research in patients was negative 96hours after transfusion, even in the 19 patients who had received parasitized blood units! The home follow-up had permitted to note that 15.78% of blood recipients had developed clinical malaria. Parasitic density ≥240 parasites/mm(3) seems to be a determining factor. Transfusion-transmitted malaria is a reality we ought to consider. Introduction of malaria screening in donated blood qualification testings simultaneously with a framing of the blood donors appear the lasting solution to hope in the future to limit the waited excessive blood evictions.

  17. The Importance of Accurate Dating and Multiproxy Analyses in Paleoenvironmental Reconstructions: A Case Study from Cocha Cashu, Peru

    NASA Astrophysics Data System (ADS)

    Salenbien, W.; Jackson, L. J.; Baker, P. A.; Rigsby, C. A.; Wheatley, A.; Fritz, S. C.

    2016-12-01

    Using a multiproxy approach and LA-ICP-MS dating of detrital zircons, we propose a revised age and depositional setting for the well-known Cocha Cashu outcrop situated along the Manu River, approximately 2 kilometers downstream from the Cocha Cashu Biological Station, located in Manu National Park, southeastern Peruvian Amazonia. This outcrop stretches for 650 meters alongside the river with an average height of 10 meters. The depositional setting is reconstructed by the combined use of detailed sedimentological logging and analyses as well as geochemical analyses of podogenic carbonate (δ13C, δ18O) and the soil organic fraction (δ15N, δ13C, %S, %C, %N), which shows fluctuations in the source of organic material. We use palynological analyses to further improve the paleoenvironmental reconstruction by studying a series of samples evenly spaced throughout the whole outcrop. Radiometric dating on detrital zircon crystals in the coarse sedimentary fractions by LA-ICP-MS in conjunction with palynological data provide a much younger age for this outcrop than previously reported in the literature ( 0.1 Ma vs. 9 Ma). These dates are some of the youngest detrital zircons to be dated using LA-ICP-MS. The updated age, alongside with the sedimentological analyses, palynological and geochemical evidence, can be best explained by a fully continental, fluvial setting, with the outcrop having been deposited as a repeated series of crevasse splays, suggesting that the Amazonian forelands experienced a similar sedimentary regime during Middle to Late Quaternary. This has major implications for a series of paleogeographic reconstructions that utilized previous interpretations of the Cocha Cashu Outcrop for Miocene marine incursions and questions the validity of certain proxy types that have been frequently used in other studies, such as trace fossil assemblages and application of sedimentary statistics. Overall, this case study shows that in order to accurately reconstruct the

  18. Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya

    PubMed Central

    2010-01-01

    Abstract Background The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. Methods The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. Results The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a “resource team”, supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation

  19. Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya.

    PubMed

    Abuya, Timothy; Amin, Abdinasir; Molyneux, Sassy; Akhwale, Willis; Marsh, Vicki; Gilson, Lucy

    2010-07-02

    The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a "resource team", supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation difficulties. For effective scaling up of PMR

  20. Risk analysis of quarantine station performance: a case study of the importation of equine infectious anemia virus-infected horses into California.

    PubMed

    Carpenter, T E; McBride, M D; Hird, D W

    1998-01-01

    We examined the risk of importing and mistakenly releasing equine infectious anemia virus (EIAV)-infected horses into California. A computer simulation model was constructed to evaluate current and alternative quarantine station procedures; 150,000 iterations were performed to simulate 15 different scenarios of 10,000 horses imported into the state over a 14-year period. Simulation results showed that under current conditions of low EIAV prevalence in exporting countries, increasing the quarantine period would not decrease the number of EIAV-infected horses mistakenly released from quarantine. In a worst case scenario of high EIAV prevalence in exporting countries, the model predicted 10 EIAV-infected horses would be imported, of these 1 or none would escape detection and would be released mistakenly if quarantine duration were 3 or 14 days, respectively. This model may be applied to other quarantine station situations for evaluating the importation risk for EIAV and other diseases.

  1. LiPD and CSciBox: A Case Study in Why Data Standards are Important for Paleoscience

    NASA Astrophysics Data System (ADS)

    Weiss, I.; Bradley, E.; McKay, N.; Emile-Geay, J.; de Vesine, L. R.; Anderson, K. A.; White, J. W. C.; Marchitto, T. M., Jr.

    2016-12-01

    CSciBox [1] is an integrated software system that helps geoscientists build and evaluate age models. Its user chooses from a number of built-in analysis tools, composing them into an analysis workflow and applying it to paleoclimate proxy datasets. CSciBox employs modern database technology to store both the data and the analysis results in an easily accessible and searchable form, and offers the user access to the computational toolbox, the data, and the results via a graphical user interface and a sophisticated plotter. Standards are a staple of modern life, and underlie any form of automation. Without data standards, it is difficult, if not impossible, to construct effective computer tools for paleoscience analysis. The LiPD (Linked Paleo Data) framework [2] enables the storage of both data and metadata in systematic, meaningful, machine-readable ways. LiPD has been a primary enabler of CSciBox's goals of usability, interoperability, and reproducibility. Building LiPD capabilities into CSciBox's importer, for instance, eliminated the need to ask the user about file formats, variable names, relationships between columns in the input file, etc. Building LiPD capabilities into the exporter facilitated the storage of complete details about the input data-provenance, preprocessing steps, etc.-as well as full descriptions of any analyses that were performed using the CSciBox tool, along with citations to appropriate references. This comprehensive collection of data and metadata, which is all linked together in a semantically meaningful, machine-readable way, not only completely documents the analyses and makes them reproducible. It also enables interoperability with any other software system that employs the LiPD standard. [1] www.cs.colorado.edu/ lizb/cscience.html[2] McKay & Emile-Geay, Climate of the Past 12:1093 (2016)

  2. Delayed removal of a primary incisor embedded in the upper lip after dental trauma: a case report about the importance of soft tissue examination.

    PubMed

    Cubukcu, Cigdem Elbek; Aydin, Ufuk; Ozbek, Serhat; Kahveci, Ramazan

    2011-08-01

    This article describes a child patient who initially had inadequate treatment and suffered concomitant soft tissue trauma involving complete displacement of a primary central incisor into the lip tissue. The primary tooth was subsequently removed by surgery under general anesthesia. Despite the delay in diagnosis, there was an excellent outcome following removal of the embedded tooth. This paper again emphasizes the importance of an accurate history, physical, and radiographic evaluation of these patients in the acute phase. The importance of soft tissue inspection even in cases that are presented late for dental trauma management is also highlighted. This case shows that educated emergency room staff preferably including an oral and maxillofacial surgeon is required for a proper emergency management in orofacial traumas. © 2011 John Wiley & Sons A/S.

  3. The importance of using dynamical a-priori profiles for infrared O3 retrievals : the case of IASI.

    NASA Astrophysics Data System (ADS)

    Peiro, H.; Emili, E.; Le Flochmoen, E.; Barret, B.; Cariolle, D.

    2016-12-01

    MOCAGE+MLS PR than CLIM PR. We found biases of 6% instead of 33% in SH showing that the a priori plays an important role within O3 infrared-retrievals. Improvements of IASI retrievals have been obtained in the free troposphere and low stratosphere, inserting dynamical a priori profiles from a CTM in SOFRID. Possible advancements would be to insert dynamical COV in SOFRID.

  4. [Imported histoplasmosis].

    PubMed

    Stete, Katarina; Kern, Winfried V; Rieg, Siegbert; Serr, Annerose; Maurer, Christian; Tintelnot, Kathrin; Wagner, Dirk

    2015-06-01

    Infections with Histoplasma capsulatum are rare in Germany, and mostly imported from endemic areas. Infections can present as localized or disseminated diseases in immunocompromised as well as immunocompetent hosts. A travel history may be a major clue for diagnosing histoplasmosis. Diagnostic tools include histology, cultural and molecular detection as well as serology. Here we present four cases of patients diagnosed and treated in Freiburg between 2004 and 2013 that demonstrate the broad range of clinical manifestations of histoplasmosis: an immunocompetent patient with chronic basal meningitis; a patient with HIV infection and fatal disseminated disease; a patient with pulmonary and cutaneous disease and mediastinal and cervical lymphadenopathy; and an immunosuppressed patient with disseminated involvement of lung, bone marrow and adrenal glands.

  5. Use of cell-free circulating schistosome DNA in serum, urine, semen, and saliva to monitor a case of refractory imported schistosomiasis hematobia.

    PubMed

    Kato-Hayashi, Naoko; Yasuda, Mitsuko; Yuasa, Jozi; Isaka, Shigeo; Haruki, Kosuke; Ohmae, Hiroshi; Osada, Yoshio; Kanazawa, Tamotsu; Chigusa, Yuichi

    2013-10-01

    This case of imported refractory schistosomiasis has highlighted the usefulness of cell-free parasite DNA as a diagnostic marker to assess active schistosome infection. In contrast to the rapid disappearance of ova in urine, parasite DNA remained persistent in several other specimen types even after the fourth treatment with praziquantel. This result was consistent with the presence of morphologically intact ova in bladder biopsy samples and with the corresponding symptoms.

  6. Two clinical cases of renal syndrome caused by Dobrava/Saaremaa hantaviruses imported to the Netherlands from Poland and Belarus, 2012–2014

    PubMed Central

    GeurtsvanKessel, Corine H.; Goeijenbier, Marco; Verner-Carlsson, Jenny; Litjens, Eline; Bos, Willem-Jan; Pas, Suzan D.; Medonça Melo, Mariana; Koopmans, Marion; Lundkvist, Åke; Reusken, Chantal B. E. M.

    2016-01-01

    We report the rare event of two imported cases in the Netherlands presenting with renal syndrome caused by Dobrava (DOBV)/Saaremaa (SAAV) hantaviruses. DOBV/SAAV hantaviruses are not circulating in the Netherlands and their clinical manifestation is typically more severe than that of the endemic Puumala virus (PUUV). This report aims to increase awareness among healthcare professionals and diagnostic laboratories to consider different hantaviruses as a cause of renal failure. PMID:26818411

  7. Disseminated Penicillium marneffei infection as an imported disease in HIV-1 infected patients. Description of two cases and a review of the literature.

    PubMed

    Kok, I; Veenstra, J; Rietra, P J; Dirks-Go, S; Blaauwgeers, J L; Weigel, H M

    1994-01-01

    Two cases of disseminated Penicillium marneffei infection, as an imported disease, in HIV-1-infected patients with a severe immunodeficiency are reported. These patients had a history of travel in Southeast Asia where P. marneffei is endemic. Fever, cough, malaise, hepatosplenomegaly, anaemia, skin lesions and mucosal ulcers are the main clinical characteristics. Differentiation from histoplasmosis and leishmaniasis might be difficult. Treatment with amphotericin B was successful. Anti-fungal maintenance therapy is most likely indicated.

  8. Use of Cell-Free Circulating Schistosome DNA in Serum, Urine, Semen, and Saliva To Monitor a Case of Refractory Imported Schistosomiasis Hematobia

    PubMed Central

    Yasuda, Mitsuko; Yuasa, Jozi; Isaka, Shigeo; Haruki, Kosuke; Ohmae, Hiroshi; Osada, Yoshio; Kanazawa, Tamotsu; Chigusa, Yuichi

    2013-01-01

    This case of imported refractory schistosomiasis has highlighted the usefulness of cell-free parasite DNA as a diagnostic marker to assess active schistosome infection. In contrast to the rapid disappearance of ova in urine, parasite DNA remained persistent in several other specimen types even after the fourth treatment with praziquantel. This result was consistent with the presence of morphologically intact ova in bladder biopsy samples and with the corresponding symptoms. PMID:23884992

  9. Patient-, health worker-, and health facility-level determinants of correct malaria case management at publicly funded health facilities in Malawi: results from a nationally representative health facility survey

    PubMed Central

    2014-01-01

    Background Prompt and effective case management is needed to reduce malaria morbidity and mortality. However, malaria diagnosis and treatment is a multistep process that remains problematic in many settings, resulting in missed opportunities for effective treatment as well as overtreatment of patients without malaria. Methods Prior to the widespread roll-out of malaria rapid diagnostic tests (RDTs) in late 2011, a national, cross-sectional, complex-sample, health facility survey was conducted in Malawi to assess patient-, health worker-, and health facility-level factors associated with malaria case management quality using multivariate Poisson regression models. Results Among the 2,019 patients surveyed, 34% had confirmed malaria defined as presence of fever and parasitaemia on a reference blood smear. Sixty-seven per cent of patients with confirmed malaria were correctly prescribed the first-line anti-malarial, with most cases of incorrect treatment due to missed diagnosis; 31% of patients without confirmed malaria were overtreated with an anti-malarial. More than one-quarter of patients were not assessed for fever or history of fever by health workers. The most important determinants of correct malaria case management were patient-level clinical symptoms, such as spontaneous complaint of fever to health workers, which increased both correct treatment and overtreatment by 72 and 210%, respectively (p < 0.0001). Complaint of cough was associated with a 27% decreased likelihood of correct malaria treatment (p = 0.001). Lower-level cadres of health workers were more likely to prescribe anti-malarials for patients, increasing the likelihood of both correct treatment and overtreatment, but no other health worker or health facility-level factors were significantly associated with case management quality. Conclusions Introduction of RDTs holds potential to improve malaria case management in Malawi, but health workers must systematically assess all patients for

  10. The importance of a urine sample in persons intoxicated with flunitrazepam--legal issues in a forensic psychiatric case study of a serial murderer.

    PubMed

    Dåderman, Anna Maria; Strindlund, Hans; Wiklund, Nils; Fredriksen, Svend-Otto; Lidberg, Lars

    2003-10-14

    The sedative-hypnotic benzodiazepine flunitrazepam (FZ) is abused worldwide. The purpose of our study was to investigate violence and anterograde amnesia following intoxication with FZ, and how this was legally evaluated in forensic psychiatric investigations with the objective of drawing some conclusions about the importance of urine sample in a case of a suspected intoxication with FZ. The case was a 23-year-old male university student who, intoxicated with FZ (and possibly with other substances such as diazepam, amphetamines or cannabis), first stabbed an acquaintance and, 2 years later, two friends to death. The police investigation files, including video-typed interviews, the forensic psychiatric files, and also results from the forensic autopsy of the victims, were compared with the information obtained from the case. Only partial recovery from anterograde amnesia was shown during a period of several months. Some important new information is contained in this case report: a forensic analysis of blood sample instead of a urine sample, might lead to confusion during police investigation and forensic psychiatric assessment (FPA) of an FZ abuser, and in consequence wrong legal decisions. FZ, alone or combined with other substances, induces severe violence and is followed by anterograde amnesia. All cases of bizarre, unexpected aggression followed by anterograde amnesia should be assessed for abuse of FZ. A urine sample is needed in case of suspected FZ intoxication. The police need to be more aware of these issues, and they must recognise that they play a crucial role in an assessment procedure. Declaring FZ an illegal drug is strongly recommended.

  11. Clinical and radiological features of imported chikungunya fever in Japan: a study of six cases at the National Center for Global Health and Medicine.

    PubMed

    Mizuno, Yasutaka; Kato, Yasuyuki; Takeshita, Nozomi; Ujiie, Mugen; Kobayashi, Taiichiro; Kanagawa, Shuzo; Kudo, Koichiro; Lim, Chang-Kweng; Takasaki, Tomohiko

    2011-06-01

    Chikungunya fever (CHIKF) is currently distributed in Africa and in South and Southeast Asia; outbreaks have occurred periodically in the region over the past 50 years. After a large outbreak had occurred in countries in the western Indian Ocean region in 2005, several countries reported cases of CHIKF from travelers who had visited affected areas. In Japan, there have been only 15 cases of CHIKF patients so far, according to the National Institute of Infectious Diseases. Therefore, to evaluate the clinical and radiological features associated with the disease, we describe 6 imported cases of CHIKF. All of the patients had had prolonged arthralgia on admission to our hospital, and diagnosis was confirmed with specific antibodies by using an IgM-capture enzyme-linked immunoassay and a plaque reduction neutralizing antibody assay. Magnetic resonance imaging (MRI) of one patient revealed erosive arthritis and tenosynovitis during the convalescence stage. Clinicians should be aware of the late consequences of infection by the chikungunya virus (CHIKV) and recognize the possible association of subacute and chronic arthritis features. In addition, competent vectors of CHIKV, Aedes aegypti, can now be found in many temperate areas of the eastern and western hemispheres, including Japan. This fact raises concern that the virus could be introduced and become established in these areas. This necessitates an increased awareness of the disease, because imported cases are likely to contribute to the spread of CHIKV infection wherever the competent mosquito vectors are distributed.

  12. Early Estimation of the Reproduction Number in the Presence of Imported Cases: Pandemic Influenza H1N1-2009 in New Zealand

    PubMed Central

    Roberts, Michael George; Nishiura, Hiroshi

    2011-01-01

    We analyse data from the early epidemic of H1N1-2009 in New Zealand, and estimate the reproduction number . We employ a renewal process which accounts for imported cases, illustrate some technical pitfalls, and propose a novel estimation method to address these pitfalls. Explicitly accounting for the infection-age distribution of imported cases and for the delay in transmission dynamics due to international travel, was estimated to be (95% confidence interval: ). Hence we show that a previous study, which did not account for these factors, overestimated . Our approach also permitted us to examine the infection-age at which secondary transmission occurs as a function of calendar time, demonstrating the downward bias during the beginning of the epidemic. These technical issues may compromise the usefulness of a well-known estimator of - the inverse of the moment-generating function of the generation time given the intrinsic growth rate. Explicit modelling of the infection-age distribution among imported cases and the examination of the time dependency of the generation time play key roles in avoiding a biased estimate of , especially when one only has data covering a short time interval during the early growth phase of the epidemic. PMID:21637342

  13. Comments from Pacific representatives.

    PubMed

    1997-01-01

    Reports from Fiji, Nauru, the Northern Mariana Islands, the Solomon Islands, and Vanuatu were given in statements to the Senior Officials segment of the 53rd session of the Commission. In Fiji, based on 1996 census results, urbanization has increased from 30% of the total population to 46%. Squatter settlements have become an issue in urban areas, as have waste disposal and management problems. Another problem is the age distribution of the population; one-fourth of the population of Fiji are between the ages of 15 and 24. Of the 13,000 who come out of school annually, 4000 find paid work. 75% of the unemployed are young people. Migration from rural to urban areas adds to the number of youth seeking employment. The head of the Nauru delegation stated that population issues are important in Nauru, despite its small population size, because 60% of the population in Nauru are under age 25, and the annual population growth rate is 4%. The head of the delegation from the Northern Mariana Islands, the Honorable Manuel Tenario, said that regional and subregional cooperation is the key to successful sustainable growth in view of the global implications of trade, transportation, communications, population movements, and technology. The Honorable David Sitai, head of the delegation from the Solomon Islands, noted that the population there would reach 750,000 in less than 2 decades at the current annual population growth rate of 3.5%. The formal sector employment growth of 2.5% per annum has not kept pace with the labor force growth of approximately 4% per annum within the formal sector. According to the Honorable Willie Jimmy, head of the delegation from Vanuatu, sustainable development has been his country's goal despite rapid urbanization, rapid population growth, and slow economic growth.

  14. Two different scenarios of squamous cell carcinoma within advanced Basal cell carcinomas: cases illustrating the importance of serial biopsy during vismodegib usage.

    PubMed

    Zhu, Gefei A; Sundram, Uma; Chang, Anne Lynn S

    2014-09-01

    Vismodegib is a Hedgehog signaling pathway inhibitor recently approved by the US Food and Drug Administration for advanced basal cell carcinoma. We present 2 cases of clinically significant squamous cell carcinoma within the tumor bed of locally advanced basal cell carcinoma found during vismodegib treatment. The first case is that of a patient with locally advanced basal cell carcinoma responsive to vismodegib but with an enlarging papule within the tumor bed. On biopsy, this papule was an invasive acantholytic squamous cell carcinoma. The second case is that of a patient with Gorlin syndrome with a locally advanced basal cell carcinoma that was stable while the patient was receiving therapy with vismodegib for 2.5 years but subsequently increased in size. Biopsy specimens from this tumor showed invasive squamous cell carcinoma, spindle cell subtype. In both cases, the squamous cell carcinomas were surgically resected. These cases highlight the importance of repeated biopsy in locally advanced basal cell carcinomas in 2 clinical situations: (1) when an area within the tumor responds differentially to vismodegib, and (2) when a tumor stops being suppressed by vismodegib. Timely diagnosis of non-basal cell histologic characteristics is critical to institution of effective therapy.

  15. Cardiovascular and psychiatric morbidity in obstructive sleep apnea (OSA) with insomnia (sleep apnea plus) versus obstructive sleep apnea without insomnia: a case-control study from a Nationally Representative US sample.

    PubMed

    Gupta, Madhulika A; Knapp, Katie

    2014-01-01

    To evaluate cardiovascular and psychiatric morbidity in patient visits with obstructive sleep apnea (OSA) with insomnia (OSA+Insomnia) versus OSA without insomnia (OSA-Insomnia) in a nationally representative US sample. A retrospective case-control study of epidemiologic databases (National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey) representing an estimated ± standard error (SE) 62,253,910 ± 5,274,747 (unweighted count=7234) patient visits with diagnosis of OSA from 1995-2010, was conducted. An estimated 3,994,104 ± 791,386 (unweighted count=658) were classified as OSA+Insomnia and an estimated 58,259,806 ± 4,849,800 (unweighted count=6576) as OSA-Insomnia. Logistic regression analysis was carried out using OSA+Insomnia versus OSA-Insomnia as the dependent variable, and age (>50 years versus ≤ 50 years), sex, race ('White' versus 'non-White'), essential hypertension, heart failure, ischemic heart disease, cardiac dysrhythmia, cerebrovascular disease, diabetes, obesity, hyperlipidemia, depressive, anxiety, and adjustment disorders (includes PTSD), hypersomnia and all medications used as independent variables. All comorbidities were physician diagnosed using the ICD9-CM. Among patient visits with OSA, an estimated 6.4%± 0.9% also had insomnia. Logistic regression analysis revealed that the OSA+Insomnia group was significantly more likely to have essential hypertension (all ICD9-CM codes 401) (OR=1.83, 95% CI 1.27-2.65) and provisionally more likely to have cerebrovascular disease (ICD9-CM codes 430-438) (OR=6.58, 95% CI 1.66-26.08). The significant OR for cerebrovascular disease was considered provisional because the unweighted count was <30. In a nationally representative sample, OSA+Insomnia was associated significantly more frequently with essential hypertension than OSA-Insomnia, a finding that has not been previously reported. In contrast to studies that have considered patient self-reports of psychological

  16. Representing actions through their sound.

    PubMed

    Aglioti, Salvatore M; Pazzaglia, Mariella

    2010-10-01

    Since the discovery of 'mirror neurons' in the monkey premotor and parietal cortex, an increasing body of evidence in animals and humans alike has supported the notion of the inextricable link between action execution and action perception. Although research originally focused on the relationship between performed and viewed actions, more recent studies highlight the importance of representing the actions of others through audition. In the first part of this article, we discuss animal studies, which provide direct evidence that action is inherently linked to multi-sensory cues, as well as the studies carried out on healthy subjects by using state-of-the-art cognitive neuroscience techniques such as functional magnetic resonance imaging (fMRI), event-related potentials (ERP), magnetoencephalography (MEG), and transcranial magnetic stimulation (TMS). In the second section, we review the lesion analysis studies in brain-damaged patients demonstrating the link between 'resonant' fronto-parieto-temporal networks and the ability to represent an action by hearing its sound. Moreover, we examine the evidence in favour of somatotopy as a possible representational rule underlying the auditory mapping of actions and consider the links between language and audio-motor action mapping. We conclude with a discussion of some outstanding questions for future research on the link between actions and the sounds they produce.

  17. The importance (or lack thereof) of niche divergence to the maintenance of a northern species complex: the case of the long-toed salamander (Ambystoma macrodactylum Baird).

    PubMed

    Lee-Yaw, J A; Irwin, D E

    2015-04-01

    The relative importance of ecological vs. non-ecological factors for the origin and maintenance of species is an open question in evolutionary biology. Young lineages--such as the distinct genetic groups that make up the ranges of many northern species--represent an opportunity to study the importance of ecological divergence during the early stages of diversification. Yet, few studies have examined the extent of niche divergence between lineages in previously glaciated regions and the role of ecology in maintaining the contact zones between them. In this study, we used tests of niche overlap in combination with ecological niche models to explore the extent of niche divergence between lineages of the long-toed salamander (Ambystoma macrodactylum Baird) species complex and to determine whether contact zones correspond to (divergent) niche limits. We found limited evidence for niche divergence between the different long-toed salamander lineages, substantial overlap in the predicted distribution of suitable climatic space for all lineages and range limits that are independent of niche limits. These results raise questions as to the importance of ecological divergence to the development of this widespread species complex and highlight the potential for non-ecological factors to play a more important role in the maintenance of northern taxa. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary Biology.

  18. A measles outbreak in Catania, Sicily: the importance of high vaccination coverage and early notification of cases for health and economic reasons.

    PubMed

    Celesia, Benedetto Maurizio; Fontana, Rossella; Pinzone, Marilia Rita; Cuccia, Mario; Bellissimo, Francesco; Rapisarda, Liliana; Rinnone, Sebastiano; Rapisarda, Venerando; Pavone, Piero; Cacopardo, Bruno; Nunnari, Giuseppe

    2014-09-01

    Measles is a paediatric exanthematous disease. Even though vaccination has dramatically reduced measles morbidity and mortality, outbreaks still occur due to insufficient vaccination coverage and importation of the virus from endemic regions. Although child vaccination coverage in Italy has been broadened (from 74% in 2000 to 90.1% in 2011), outbreaks are still observed at a regional level. We describe epidemiological and clinical characteristics of cases reported from January 2009 to May 2010 to the Epidemiology Service of the Provincial Health Authority of Catania. We obtained demographic data and vaccination status from the database of the Epidemiology Service and clinical features and laboratory data from medical records. In all, 522 cases were notified: 286 males (54%), median age 12 years (interquartile range (IQR) 4-18); 401 cases (77%) were notified by the hospital, and 121 (23%) by general practitioners. Only one patient had been previously vaccinated. 52 cases were hospitalized, median age 18 years (IQR 17-23). We observed hypertransaminasaemia in 20 patients (38%), thrombocytopenia in 22 patients (42%) and a creatine phosphokinase increase in 16 (30%). Complications (pneumonia, haemorrhagic cystitis, acute hepatitis) occurred in 10 patients (19%), all older than 18. Recent outbreaks show that immunization practices are still insufficient. Most cases were recorded in adolescents and young adults; even if the vaccine has limited virus circulation in childhood, it did not prevent the infection of other age groups. The number of notifications also suggests that the phenomenon is underestimated. In order to monitor the disease we need early notification of cases and increased vaccination coverage.

  19. Imported viral haemorrhagic fever with a potential for person-to-person transmission: review and recommendations for initial management of a suspected case in Belgium.

    PubMed

    Colebunders, R; Van Esbroeck, M; Moreau, M; Borchert, M

    2002-01-01

    Viral haemorrhagic fevers are caused by a wide range of viruses. There are 4 types of viruses well known to spread from person to person and able to cause nosocomial outbreaks with a high case fatality rate: an arenavirus (Lassa fever and more exceptionally the Junin and Machupo virus), a bunyavirus (Crimean-Congo haemorrhagic fever) and the Filoviridae (Ebola and Marburg viruses). So far there have been only a limited number of imported cases of viral haemorrhagic fever in industrialized countries. In recent years an increasing number of outbreaks of filovirus infections have occurred in Africa and in 2000 5 cases of Lassa fever were brought from Sierra Leone to Europe. Therefore European physicians should consider the possibility of a viral haemorrhagic fever in an acutely ill patient just returning from Africa or South-America with fever for which there is no obvious cause. Such patients should be questioned for risk factors for viral haemorrhagic fever. Using universal precautions for handling blood and body fluids and barrier nursing techniques there is little risk that if a patient with viral haemorrhagic fever arrives in Belgium there will be secondary cases.

  20. Assessing the scale-specific importance of niches and other spatial processes on beta diversity: a case study from a temperate forest.

    PubMed

    Laliberté, Etienne; Paquette, Alain; Legendre, Pierre; Bouchard, André

    2009-03-01

    Niche processes and other spatial processes, such as dispersal, may simultaneously control beta diversity, yet their relative importance may shift across spatial and temporal scales. Although disentangling the relative importance of these processes has been a continuing methodological challenge, recent developments in multi-scale spatial and temporal modeling can now help ecologists estimate their scale-specific contributions. Here we present a statistical approach to (1) detect the presence of a space-time interaction on community composition and (2) estimate the scale-specific importance of environmental and spatial factors on beta diversity. To illustrate the applicability of this approach, we use a case study from a temperate forest understory where tree seedling abundances were monitored during a 9-year period at 40 permanent plots. We found no significant space-time interaction on tree seedling composition, which means that the spatial abundance patterns did not vary over the study period. However, for a given year the relative importance of niche processes and other spatial processes was found to be scale-specific. Tree seedling abundances were primarily controlled by a broad-scale environmental gradient, but within the confines of this gradient the finer scale patchiness was largely due to other spatial processes. This case study illustrates that these two sets of processes are not mutually exclusive and can affect abundance patterns in a scale-dependent manner. More importantly, the use of our methodology for future empirical studies should help in the merging of niche and neutral perspectives on beta diversity, an obvious next step for community ecology.

  1. A case of ruptured descending thoracic aortic aneurysm into the right pleural cavity: importance of preoperative drainage of the right pleural cavity.

    PubMed

    Akiyama, K; Takazawa, A; Hirota, J; Yamagishi, H; Akazawa, T

    1998-12-01

    We present an unusual case of a ruptured descending thoracic aortic aneurysm into the right pleural cavity of a patient with pectus carinatum. The presence of pectus carinatum played an important role in the development of the aneurysm at the atypical site and the rupture into the right pleural cavity. A small amount of right pleural bleeding on admission can increase and develop to massive hemothorax until emergency operation. Massive bleeding in the right pleural cavity where the dependent lung is located causes atelectasis and increased shunt fraction under one lung ventilation. Therefore, continuous drainage of the right pleural cavity is essential to prevent serious hypoxia during graft replacement in a case of ruptured descending thoracic aneurysm into the right hemithorax.

  2. Prescription opioid abuse based on representative postmortem toxicology.

    PubMed

    Häkkinen, Margareeta; Vuori, Erkki; Ojanperä, Ilkka

    2014-12-01

    Opioids are important medications for pain and opioid maintenance treatment. Increasing use and abuse of prescription opioids has, however, caused worldwide concern. Our aim was to estimate the ratio between prescription opioid abuse and total use, based on representative postmortem toxicology. Our material included all the medico-legally examined deaths in Finland during 2010-2011 involving positive findings involving buprenorphine, codeine, fentanyl, methadone, oxycodone, or tramadol. We studied drug abuse by age group, with "abuse" meaning licit opioids used illicitly as narcotics. Drug-abuse history, drug injecting, or laboratory findings of illicit drugs defined an abuser case. We then compared abuser cases and other opioid-related cases between the opioids with the number of fatal poisonings, accidents, suicides, alcohol findings, concomitant opioid use, and median postmortem blood opioid concentrations. Opioid findings numbered 2499 in 2088 cases. Drug abuse involved 545 opioid-positive cases, which in Finland represented 0.5% of those deceased. The proportion of abuser cases among all opioid-related cases for buprenorphine was 85.5%, for methadone 82.4%, for tramadol 29.4%, for codeine 16.3%, for fentanyl 14.5%, and for oxycodone 6.9%. Abuse in age-groups >60 was rare. Concomitant other opioid findings were more frequent in abuser- than in other cases for codeine, oxycodone, and tramadol, whereas alcohol findings were more frequent in buprenorphine, codeine, and fentanyl abuse. Buprenorphine and methadone were most often related to drug abuse. Every other opioid studied involved some abuse, and especially tramadol. Abuse and fatal poisonings were concentrated in men aged 20-49.

  3. Clinical Aspects of Dermatitis Associated with Dirofilaria repens in Pets: A Review of 100 Canine and 31 Feline Cases (1990-2010) and a Report of a New Clinic Case Imported from Italy to Dubai.

    PubMed

    Tarello, Walter

    2011-01-01

    Cutaneous dirofilariasis is a parasitic disease caused by the mosquito-borne filarial nematodes Dirofilaria (Nochtiella) repens, living in the subcutaneous tissue of dogs, cats, wild carnivores, and humans. Cases have been recently reported also from Germany, Czech Republic, Hungary, Ukraine, Russia, Austria, Switzerland, France, The Netherlands, and the Middle East. D. repens is not widely known to cause chronic pruritic dermatitis in animals. Dermatological signs observed in 100 canine clinic cases were pruritus (100%), erythema (79%), papulae (62%), focal or multifocal alopecia (55%), hyperkeratosis (18%), crusting (14%), nodules (12%), acantosis (5%), and eczema (3%). Signs other than dermatological were conjunctivitis (46%), anorexia (35%), vomiting (26%), fever (25%), lethargy (20%), and lymph-adenomegaly (10%). A case imported from Italy to Dubai is described. The opportunistic role of D. repens might explain the presence of asymptomatic carriers, the concurrent observation of nondermatological signs, and the development of dermatitis in a subgroup of parasitized dogs.

  4. Clinical Aspects of Dermatitis Associated with Dirofilaria repens in Pets: A Review of 100 Canine and 31 Feline Cases (1990–2010) and a Report of a New Clinic Case Imported from Italy to Dubai

    PubMed Central

    Tarello, Walter

    2011-01-01

    Cutaneous dirofilariasis is a parasitic disease caused by the mosquito-borne filarial nematodes Dirofilaria (Nochtiella) repens, living in the subcutaneous tissue of dogs, cats, wild carnivores, and humans. Cases have been recently reported also from Germany, Czech Republic, Hungary, Ukraine, Russia, Austria, Switzerland, France, The Netherlands, and the Middle East. D. repens is not widely known to cause chronic pruritic dermatitis in animals. Dermatological signs observed in 100 canine clinic cases were pruritus (100%), erythema (79%), papulae (62%), focal or multifocal alopecia (55%), hyperkeratosis (18%), crusting (14%), nodules (12%), acantosis (5%), and eczema (3%). Signs other than dermatological were conjunctivitis (46%), anorexia (35%), vomiting (26%), fever (25%), lethargy (20%), and lymph-adenomegaly (10%). A case imported from Italy to Dubai is described. The opportunistic role of D. repens might explain the presence of asymptomatic carriers, the concurrent observation of nondermatological signs, and the development of dermatitis in a subgroup of parasitized dogs. PMID:22203888

  5. The role of transnational mobility in the local spread of mosquito-borne disease: Measuring the determinants of spatial-temporal lags of imported dengue cases initiating indigenous epidemics in Taiwan

    NASA Astrophysics Data System (ADS)

    Wen, Tzai-Hung

    2014-05-01

    Dengue fever is one of the world's most widely spread mosquito-borne diseases. International travelers who acquire dengue infection are important routes for virus transmission from one country to another one. Previous studies have shown that imported dengue cases are able to initiate indigenous epidemics when appropriate weather conditions are present. However, the spatial-temporal associations between imported cases and indigenous epidemics in areas with different social-economic conditions are still unclear. This study investigated determinants of spatial-temporal lags of imported dengue cases who initiated indigenous epidemics from 2003 to 2012 in Taiwan. The quantile regression is used to explore the associations between spatial-temporal lags of imported cases and social-economic indicators with geographic heterogeneity. Our results indicated that imported cases in April and May have statistically significant contribution to initiate indigenous epidemics. Areas with high population density and low average income have significant risk of being imported virus from other areas. However, the areas with imported cases are not significant transmission risk. The results imply that imported cases reported in early summer may be an early-warning indicator of indigenous epidemics. Local demographic and economic conditions, rather than imported cases, may determine the areas with the risk of indigenous epidemics.

  6. The Evolving Role of Union Learning Representatives

    ERIC Educational Resources Information Center

    Moore, Sian; Ross, Cilla

    2008-01-01

    This article suggests that the union learning representative (ULR) is increasingly situated at the heart of trade union activity. The paper draws upon recent research based on interviews with national trade union officers and case studies of union learning activity to explore the competing demands being made upon ULRs and the implications for…

  7. Origin and Possible Genetic Recombination of the Middle East Respiratory Syndrome Coronavirus from the First Imported Case in China: Phylogenetics and Coalescence Analysis.

    PubMed

    Wang, Yanqun; Liu, Di; Shi, Weifeng; Lu, Roujian; Wang, Wenling; Zhao, Yanjie; Deng, Yao; Zhou, Weimin; Ren, Hongguang; Wu, Jun; Wang, Yu; Wu, Guizhen; Gao, George F; Tan, Wenjie

    2015-09-08

    The Middle East respiratory syndrome coronavirus (MERS-CoV) causes a severe acute respiratory tract infection with a high fatality rate in humans. Coronaviruses are capable of infecting multiple species and can evolve rapidly through recombination events. Here, we report the complete genomic sequence analysis of a MERS-CoV strain imported to China from South Korea. The imported virus, provisionally named ChinaGD01, belongs to group 3 in clade B in the whole-genome phylogenetic tree and also has a similar tree topology structure in the open reading frame 1a and -b (ORF1ab) gene segment but clusters with group 5 of clade B in the tree constructed using the S gene. Genetic recombination analysis and lineage-specific single-nucleotide polymorphism (SNP) comparison suggest that the imported virus is a recombinant comprising group 3 and group 5 elements. The time-resolved phylogenetic estimation indicates that the recombination event likely occurred in the second half of 2014. Genetic recombination events between group 3 and group 5 of clade B may have implications for the transmissibility of the virus. The recent outbreak of MERS-CoV in South Korea has attracted global media attention due to the speed of spread and onward transmission. Here, we present the complete genome of the first imported MERS-CoV case in China and demonstrate genetic recombination events between group 3 and group 5 of clade B that may have implications for the transmissibility of MERS-CoV. Copyright © 2015 Wang et al.

  8. 24th WRSM panel discussion: {open_quotes}The role of research in nuclear regulation: The case of qualified importers{close_quotes}

    SciTech Connect

    Alonso, A.

    1997-01-01

    Scientific knowledge and technological maturity are needed to establish regulatory requirements, what also needs talent and skills. Scientists are rarely interested in regulation and regulators not always are closely connected to scientific research. This has created gaps in regulations, mainly within qualified importers. A qualified importer, in the sense of this presentation, is a country who has acquired nuclear power plants from more technologically advanced exporters but with an increasing participation of its own industry and institutions in the design, construction, component manufacture and assembly of such nuclear power plants and is fully responsible for the operation of the nuclear units and the corresponding fuel cycle. These countries have also a long standing and independent nuclear regulatory organization and the corresponding technical body. Spain is a qualified importer. In the case of Spain, it originally adopted the codes and regulations of the UE which it was a member of, as well as the codes and standards of the country from which their reactors were produced. Since Spain added KWU plants they even went to German regulations. Plant operation rested with Spain. As problems began to appear in operating plants, local research projects were funded to study the problems, aimed at immediate solutions, but also providing training for local personnel in addition to information of use for regulators. Spain has participated in many joint research projects, which have trained people, and given confidence to Spaniards involved in science and regulations. Qualified importers, like Spain, participate in research, even though it may not translate itself into regulation. Such participation will always serve to give self-confidence and independence to regulators and licensees, to better understand the adopted regulations of the most advanced countries and to solve specific problems.

  9. Representing Tactical Land Navigation Expertise

    DTIC Science & Technology

    2000-09-01

    they adjust and recalibrate tools dynamically; and (4) they visualize spatial information. Finally, a multi - agent system computationally represents the route planning portion of the performance model.

  10. Importance of Cross-redistribution in Scattering Polarization of Spectral Lines: The Cases of 3P‑3S Triplets of Mg i and Ca i

    NASA Astrophysics Data System (ADS)

    Sampoorna, M.; Nagendra, K. N.

    2017-04-01

    Scattering on a multi-level atomic system has dominant contributions from resonance and Raman scattering. While initial and final levels are the same for resonance scattering, they are different for Raman scattering. The frequency redistribution for resonance scattering is described by the usual partial frequency redistribution functions of Hummer, while that for Raman scattering is described by cross-redistribution (XRD) function. In the present paper, we investigate the importance of XRD on linear polarization profiles of 3P‑3S triplets of Mg i and Ca i formed in an isothermal one-dimensional atmosphere. We show that XRD produces significant effects on the linear polarization profiles when the wavelength separations between the line components of the multiplet are small, like in the cases of Mg i b and Ca i triplets.

  11. Important considerations for feasibility studies in physical activity research involving persons with multiple sclerosis: a scoping systematic review and case study.

    PubMed

    Learmonth, Yvonne C; Motl, Robert W

    2018-01-01

    Much research has been undertaken to establish the important benefits of physical activity in persons with multiple sclerosis (MS). There is disagreement regarding the strength of this research, perhaps because the majority of studies on physical activity and its benefits have not undergone initial and systematic feasibility testing. We aim to address the feasibility processes that have been examined within the context of physical activity interventions in MS. A systematic scoping review was conducted based on a literature search of five databases to identify feasibility processes described in preliminary studies of physical activity in MS. We read and extracted methodology from each study based on the following feasibility metrics: process (e.g. recruitment), resource (e.g. monetary costs), management (e.g. personnel time requirements) and scientific outcomes (e.g. clinical/participant reported outcome measures). We illustrate the use of the four feasibility metrics within a randomised controlled trial of a home-based exercise intervention in persons with MS. Twenty-five studies were identified. Resource feasibility (e.g. time and resources) and scientific outcomes feasibility (e.g. clinical outcomes) methodologies were applied and described in many studies; however, these metrics have not been systematically addressed. Metrics related to process feasibility (e.g. recruitment) and management feasibility (e.g. human and data management) are not well described within the literature. Our case study successfully enabled us to address the four feasibility metrics, and we provide new information on management feasibility (i.e. estimate data completeness and estimate data entry) and scientific outcomes feasibility (i.e. determining data collection materials appropriateness). Our review highlights the existing research and provides a case study which assesses important metrics of study feasibility. This review serves as a clarion call for feasibility trials that will

  12. Persistence of intrasellar trigeminal artery and simultaneous pituitary adenoma: description of two cases and their importance for the differential diagnosis of sellar lesions.

    PubMed

    Machado, Marcio Carlos; Kodaira, Sergio; Musolino, Nina Rosa Castro

    2014-08-01

    Persistent trigeminal artery (PTA) is the most frequent embryonic communication between the carotid and vertebrobasilar systems. However, hormonal changes or the association of PTA with other sellar lesions, such as pituitary adenomas, are extremely rare. The aim of the present study was to report two patients with intrasellar PTA and simultaneous pituitary adenoma in order to emphasize the importance of differential diagnoses for sellar lesions. Case 1. A female patient, 41 years old, was admitted with a history of chronic headache (> 20 years). Pituitary magnetic resonance imaging (MRI) showed a rounded lesion in the left portion of the pituitary gland suggestive of adenoma (most likely clinically non-functioning adenoma). In addition to this lesion, the MRI demonstrated ecstasy of the right internal carotid artery and imaging suggestive of an intrasellar artery that was subsequently confirmed by an angio-MRI of the cerebral vessels as PTA. Case 2. A female patient, 42 years old, was admitted with a history of amenorrhea and galactorrhea in 1994. Laboratorial investigation revealed hyperprolactinemia. Pituitary MRI showed a small hyposignal area in the anterior portion of pituitary gland suggestive of a microadenoma initiated by a dopaminergic agonist. Upon follow-up, aside from the first lesion, the MRI showed a well delineated rounded lesion inside the pituitary gland, similar to a vessel. Angio-MRI confirmed a left primitive PTA. Failure to recognize these anomalous vessels within the sella might lead to serious complications during transsphenoidal surgery. Therefore, although their occurrence is uncommon, a working knowledge of vascular lesions in the sella turcica or pituitary gland is important for the differential diagnosis of pituitary lesions, especially pituitary adenomas.

  13. A Case of Intractable Left Forearm Congenital Arteriovenous Fistula Ending with Amputation: Importance of New Medical Information Obtained via the Internet.

    PubMed

    Liu, Jiajia; Shimada, Yasuyuki

    2014-01-01

    The aim of the present study was to consider the importance of medical information obtained via the Internet for difficult cases in hospitals, especially in those located in rural areas. We report here a case of congenital arteriovenous fistula (AVF) in the upper extremities. A 30-year-old lady was transported to our hospital by ambulance due to massive bleeding in her left hand. She was seen by our current cardiovascular surgery team for the first time, although she had been diagnosed with congenital AVF of the left arm 9 years previously. Because it was asymptomatic, she was followed up by observation. During 5 years of observation, symptoms such as cyanosis, pain, and refractory ulcers gradually developed. When she was 26 years old, she was referred to a university hospital in Akita, but surgery had already been judged to be impossible. When she was 30 years old, traumatic bleeding in her left hand and hemorrhagic shock led her to be taken to our hospital by ambulance. Using the Internet, we found an institution that had treated a large number of cases of AVF. After controlling the bleeding, we referred her to that institution. However, she could not be treated without an above-elbow amputation. Congenital AVF in the upper extremities is a rare vascular anomaly and has been generally accepted to be an extremely difficult disease to treat. Treatment should be started as early as possible before the presence of any symptoms. When a specialist is not available near the hospital, precise information must be found using the Internet and the patient should be referred without any delay.

  14. A Case of Intractable Left Forearm Congenital Arteriovenous Fistula Ending with Amputation: Importance of New Medical Information Obtained via the Internet

    PubMed Central

    Liu, Jiajia; Shimada, Yasuyuki

    2014-01-01

    Objective: The aim of the present study was to consider the importance of medical information obtained via the Internet for difficult cases in hospitals, especially in those located in rural areas. We report here a case of congenital arteriovenous fistula (AVF) in the upper extremities. Patient: A 30-year-old lady was transported to our hospital by ambulance due to massive bleeding in her left hand. She was seen by our current cardiovascular surgery team for the first time, although she had been diagnosed with congenital AVF of the left arm 9 years previously. Because it was asymptomatic, she was followed up by observation. During 5 years of observation, symptoms such as cyanosis, pain, and refractory ulcers gradually developed. When she was 26 years old, she was referred to a university hospital in Akita, but surgery had already been judged to be impossible. When she was 30 years old, traumatic bleeding in her left hand and hemorrhagic shock led her to be taken to our hospital by ambulance. Using the Internet, we found an institution that had treated a large number of cases of AVF. After controlling the bleeding, we referred her to that institution. However, she could not be treated without an above-elbow amputation. Conclusion: Congenital AVF in the upper extremities is a rare vascular anomaly and has been generally accepted to be an extremely difficult disease to treat. Treatment should be started as early as possible before the presence of any symptoms. When a specialist is not available near the hospital, precise information must be found using the Internet and the patient should be referred without any delay. PMID:25650050

  15. Important Risk Factors of Mortality Among Children Aged 1-59 Months in Rural Areas of Shahroud, Iran: A Community-based Nested Case-Control Study

    PubMed Central

    Chaman, Reza; Alami, Ali; Emamian, Mohammad Hassan; Naieni, Kourosh Holakouie; Mirmohammadkhani, Majid; Ahmadnezhad, Elham; Entezarmahdi, Rasool; Shati, Mohsen; Shariati, Mohammad

    2012-01-01

    Background: The aim of the study was to evaluate potential risk factors of children mortality between 1-59 months of age. Methods: This nested case-control study was conducted among children born from June 1999 to March 2009 in rural areas of Shahroud, located in the central region of Iran using health care visit reports and follow-up data available in household health records. Results: Mortality was significantly associated with breastfeeding duration (OR: 0.87, 95% CI: 0.81-0.93), total health care visits (OR: 0.90, 95% CI: 0.83-0.98) and low birth weight (LBW) (OR: 7.38, 95% CI: 1.37-39.67). Conclusion: In our study, a longer breastfeeding period and more frequent health care visits were two important protective factors, while LBW was an important risk factor for 1-59 month child mortality. It seems, that complex and multiple factors may be involved in mortality of under 5-year-old children, so combined efforts would be necessary to improve child health indicators. PMID:23272287

  16. The importance of hard core repulsion in models of activity coefficients in aqueous electrolyte solutions: Illustration in the case of hydration theory

    SciTech Connect

    Wolery, T.J.; Jackson, K.J.

    1992-07-01

    Activity coefficients in aqueous electrolyte solutions are primarily affected by two kinds of phenomena. The standard Debye-Huckel equation represents only one of these, the long range electrical interactions. Of nearly equal importance is hard core (HC) repulsion, which is not electrical in nature. To a first-order approximation, HC repulsive effects are independent of the ionic strength, depending instead on the sum of the solute molalities ({Sigma}m). Adding a term for HC repulsion to the standard Debye-Huckel model produces what we call a hybrid two-term model In a previous work (Wolery and Jackson 1990) we proposed a new method for making hydration corrections to the standard Debye-Huckel model. In the present work, we examine the effect of extending this model to include hard core repulsion. Although the activity coefficients of 1:1 electrolytes can be fit quite well by the model without a HC term the inclusion of such a term is critical to success in fitting the data for 2:1 and other higher-order electrolytes.

  17. The importance of hard core repulsion in models of activity coefficients in aqueous electrolyte solutions: Illustration in the case of hydration theory

    SciTech Connect

    Wolery, T.J.; Jackson, K.J.

    1992-07-01

    Activity coefficients in aqueous electrolyte solutions are primarily affected by two kinds of phenomena. The standard Debye-Huckel equation represents only one of these, the long range electrical interactions. Of nearly equal importance is hard core (HC) repulsion, which is not electrical in nature. To a first-order approximation, HC repulsive effects are independent of the ionic strength, depending instead on the sum of the solute molalities ([Sigma]m). Adding a term for HC repulsion to the standard Debye-Huckel model produces what we call a hybrid two-term model In a previous work (Wolery and Jackson 1990) we proposed a new method for making hydration corrections to the standard Debye-Huckel model. In the present work, we examine the effect of extending this model to include hard core repulsion. Although the activity coefficients of 1:1 electrolytes can be fit quite well by the model without a HC term the inclusion of such a term is critical to success in fitting the data for 2:1 and other higher-order electrolytes.

  18. Identifying Representative Textbooks in U. S. History.

    ERIC Educational Resources Information Center

    Woodward, Arthur

    1982-01-01

    The selection of textbooks used in content analysis to determine values taught to students is important. Only widely used texts must be analyzed. The samples of U.S. history texts used by Fitzgerald (1979) and Barth and Shermis (1980) in their studies were not representative of textbooks used in schools. (RM)

  19. Comparison of Zika virus (ZIKV) RNA detection in plasma, whole blood and urine - Case series of travel-associated ZIKV infection imported to Italy, 2016.

    PubMed

    Rossini, Giada; Gaibani, Paolo; Vocale, Caterina; Cagarelli, Roberto; Landini, Maria Paola

    2017-09-01

    The capability to detect ZIKV RNA is of crucial importance for cases confirmation. However, due to the short-lived viremia, the detection of ZIKV RNA in plasma/serum is challenging for samples collected more than one week after onset of clinical illness. We compared the window time and detection rate of ZIKV RNA in different specimen types (plasma, whole blood and urine) collected simultaneously at several times post-symptom onset. We examined the presence of ZIKV RNA in matched specimens of whole blood, plasma and urine collected in the same date (3-28 days after symptom onset) from 10 ZIKV infected patients. ZIKV RNA was found in plasma as late as 10 days after symptoms onset and tested positive in all 5 (100%) and in 2 of 6 (33,3%) plasma samples collected 1-5 and 6-10 days after symptoms onset, respectively. ZIKV RNA was positive in urine through the 21st day after symptom onset; the detection rate of ZIKV RNA in urine samples was 100% (11/11) for samples collected 1-10 days from symptoms onset, decreasing at later times of sampling. The detection rate of ZIKV RNA in whole blood was comparable to that in urine samples but extended the window of detection of ZIKV RNA up to 26 days after symptom onset. Our results highlight the usefulness of simultaneously testing multiple specimen types in order to extend the rate and the time frame of ZIKV RNA detection, increasing the possibility of cases confirmation through direct diagnosis in convalescence-phase of infection, supplementing serological data which are often difficult to interpret. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  20. [Malaria importation into Germany in 1989/90].

    PubMed

    Zastrow, K D; Dieckmann, S; Schöneberg, I

    1993-11-01

    Malaria was in 1989/90 the most important imported disease in Germany. Most of all cases were imported by German tourists (about 75%). Africa was the most prominently represented geographic region (about 75%). Kenia and Ghana represented there the biggest share. About 33% of all patients had not done a sufficient prophylaxis against malaria. An adequate prophylaxis against malaria taking into consideration the recommendations for medicaments for different geographical areas is imperative before the number of importations of malaria into Germany can be reduced.

  1. Imported malaria.

    PubMed

    Schultz, M G

    1974-01-01

    There have been 4 waves of imported malaria in the USA. They occurred during the colonization of the country and during the Second World War, the UN Police Action in Korea, and the Viet-Nam conflict. The first 3 episodes are briefly described and the data on imported malaria from Viet-Nam are discussed in detail.Endemic malaria is resurgent in many tropical countries and international travel is also on the rise. This increases the likelihood of malaria being imported from an endemic area and introduced into a receptive area. The best defence for countries threatened by imported malaria is a vigorous surveillance programme. The principles of surveillance are discussed and an example of their application is provided by a description of the methods used to conduct surveillance of malaria in the USA.

  2. Non-fatal gunshot wounds in the context of intimate partner violence. The importance of a multidisciplinary approach: a case report.

    PubMed

    Puentes, Katerina; Ribeiro, Cristina; Jardim, Patrícia; Santos, Agostinho; Magalhães, Teresa

    2011-07-01

    According to Portuguese law, if a case of intimate partner violence is noticed or suspected by a professional working in public services, reporting it to the police, medico-legal services or directly to the public prosecutor is mandatory. However, in most cases, reporting does not take place, despite its vital importance in triggering the multidisciplinary intervention that will ensure the correct and timely diagnosis and protection of the victim. In the present case, the victim, a 37 year-old woman, was sexually and physically abused by her husband in their home, and was physically abused again at the victim's mother's house. The victim mentioned that her husband struck her in the head with a hammer and shot a handgun while in her mother's house. However, she denied having a gunshot wound. The couple's daughter was also slapped in the face by her father. The police took the victim to the emergency room of a central hospital to receive medical attention, while the medical examiner on duty was called to the same emergency room to perform a medico-legal evaluation in the context of the intimate partner violence reported to the police. Medico-legal assessment revealed scalp injuries that had not been detected during the first inspection by the emergency room attending physicians who had performed a neurological examination, which revealed no neurological dysfunction. A cranial computed tomography with three-dimensional reconstitution and virtual dissection, requested by the medical examiner, revealed two projectiles trapped in between the inner and the outer table of the cranium, with linear fractures only in the inner table and no brain injuries. Gynecological examination with the collection of biological evidence, also performed by the medical examiner, made it possible to identify a male DNA profile matching her husband's. The victim was subjected to neurosurgery and a follow-up, and was released one month after the traumatic event. A forensic psychological

  3. [Sensitivity of four representative angular cephalometric measures].

    PubMed

    Xü, T; Ahn, J; Baumrind, S

    2000-05-01

    Examined the sensitivity of four representative cephalometric angles to the detection of different vectors of craniofacial growth. Landmark coordinate data from a stratified random sample of 48 adolescent subjects were used to calculate conventional values for changes between the pretreatment and end-of-treatment lateral cephalograms. By modifying the end-of-treatment coordinate values appropriately, the angular changes could be recalculated reflecting three hypothetical situations: Case 1. What if there were no downward landmark displacement between timepoints? Case 2. What if there were no forward landmark displacement between timepoints? Case 3. What if there were no Nasion change? These questions were asked for four representative cephalometric angles: SNA, ANB, NAPg and UI-SN. For Case 1, the associations (r) between the baseline and the modified measure for the three angles were very highly significant (P < 0.001) with r2 values no lower than 0.94! For Case 2, however, the associations were much weaker and no r value reached significance. These angular measurements are less sensitive for measuring downward landmark displacement than they are for measuring forward landmark displacement.

  4. Seclusions and Restraints: Selected Cases of Death and Abuse at Public and Private Schools and Treatment Centers. Testimony Before the Committee on Education and Labor, House of Representatives. GAO-09-719T

    ERIC Educational Resources Information Center

    Kutz, Gregory D.

    2009-01-01

    The Government Accountability Office (GAO) recently testified before the Committee on Education and Labor, House of Representatives, regarding allegations of death and abuse at residential programs for troubled teens. The document presents the statement of Gregory D. Kutz, Managing Director, Forensic Audits and Special Investigations. Recent…

  5. Clinical spectrum and survival analysis of 145 cases of HIV-negative Castleman’s disease: renal function is an important prognostic factor

    PubMed Central

    Zhang, Lu; Li, Zhiyuan; Cao, Xinxin; Feng, Jun; Zhong, Dingrong; Wang, Shujie; Zhou, Daobin; Li, Jian

    2016-01-01

    Castleman’s disease (CD) is a rare lymphoproliferative disorder with clinical features and prognostic factors that are incompletely characterized. This retrospective single-center study reviewed the largest HIV-negative CD patient cohort (n = 145) to date. By clinical classification, we identified 69 patients (47.6%) as unicentric CD (UCD) and 76 patients (52.4%) as multicentric CD (MCD). Pathological classification identified 74 patients (51.0%) with the hyaline-vascular variant, 51 patients (35.2%) with the plasma-cell variant, and 20 patients (13.8%) with a mixed variant. After a median follow-up duration of 58 months (range, 1–180 months), the 1-year and 5-year survival rates were 95.1% and 91.0%, respectively. UCD patients exhibited significantly better survival (1-year and 5-year survival rates of 98.5% and 97.1%, respectively) compared with MCD patients (1-year and 5-year survival rates of 92.1% and 85.5%, respectively; p = 0.005). By univariate and multivariate Cox regression analyses, the estimated glomerular filtration rate < 60 ml/min (with the MDRD equation; hazard ratio = 4.60; 95% confidence interval, 1.50–14.12; p = 0.008) was clinically significant and represented an independent predictor for death in MCD patients. In summary, this large-scale study suggests that UCD patients enjoy better survival than MCD patients and that renal function is an important prognostic factor for MCD patients. PMID:27029894

  6. [Imported viral hepatitis in the Czech Republic].

    PubMed

    Dlhý, J; Benes, C

    2007-04-01

    Through the analysis of notified viral hepatitis, trends in the occurrence of imported cases in the Czech Republic have been specified, the aim of which was to draw attention to the epidemiologically important aspects of travelling abroad. In the software environment of Epi Info version 6.04d, nationwide databases of communicable diseases over the period of 1993-2005 were analysed. The period was defined with respect to the availability of necessary data in the Epidat information system for communicable disease reporting in the Czech Republic. During the years 1993-2005, 12,091 cases of communicable diseases were imported into the Czech Republic of which viral hepatitis accounted for 5.7 % (685). The rates by diagnosis were as follows: viral hepatitis A 61 %, acute viral hepatitis B 15 %, chronic viral hepatitis C 11 %, viral hepatitis E 5 %, acute viral hepatitis C 3 %, chronic viral hepatitis B 3 % and other cases of viral hepatitis 2 %. The rates by the "imported by" variable: Czech tourists 47.2 %, foreigners 32.8 %, Czech business travellers 20.0 %. The diseases were most commonly imported from the following countries: Ukraine 13 %, Slovakia 8 %, Southern Europe 6 %, Egypt 6 % and Russia 5 %. In the Czech Republic, communicable diseases are reported using the Epidat system. The Epidat database analysis focused on reported cases of imported viral hepatitis represents an important starting point for assessing health risks associated with travelling abroad.

  7. Characterization of anti-MERS-CoV antibodies against various recombinant structural antigens of MERS-CoV in an imported case in China

    PubMed Central

    Wang, Wenling; Wang, Huijuan; Deng, Yao; Song, Tie; Lan, Jiaming; Wu, Guizhen; Ke, Changwen; Tan, Wenjie

    2016-01-01

    The first imported case of Middle East respiratory syndrome (MERS) in China recently occurred, allowing for the characterization of antibody titers in a series of the patient's sera using the following methods based on recombinant viral structural antigens: inactivated MERS coronavirus (MERS-CoV) enzyme-linked immunosorbent assay (ELISA), recombinant MERS-CoV spike (S, or fragments of S) ELISA, nucleoprotein (NP) ELISA and MERS S pseudovirus particle-based neutralization test (ppNT). A longitudinal profile of the infection showed that seroconversion detected by ELISAs based on the recombinant extracellular domain, S, S1 and receptor-binding domain (RBD) antigens occurred as early as neutralizing antibodies were detected by the ppNT and earlier than antibodies were detected by the inactivated MERS-CoV and N-terminal domain (NTD) ELISAs. Antibodies detected by the NP ELISA occurred last. Strong correlations were found between the S1, RBD and NP ELISAs and the inactivated MERS-CoV ELISA. The S and RBD ELISAs were highly correlated with the commercial S1 ELISA. The S ELISA strongly correlated with the ppNT, although the MERS-CoV, S1, NTD and RBD ELISAs were also significantly correlated with the ppNT (P<0.001). PMID:27826140

  8. The importance of genetic counseling and genetic screening: a case report of a 16-year-old boy with resistant hypertension and severe hypokalemia.

    PubMed

    Kuang, Ze-Min; Wang, Ying; Wang, Jia-Jie; Liu, Jing-Hua; Zeng, Rong; Zhou, Qi; Yu, Zhen-Qiu; Jiang, Long

    2017-03-01

    Liddle's syndrome, an autosomal dominant form of monogenic hypertension, is characterized by salt-sensitive hypertension with early penetrance, hypokalemia, metabolic alkalosis, suppression of plasma rennin activity and aldosterone secretion, and a clear-cut response to epithelial sodium channel blockers but not spironolactone therapy. Here, we describe the case of a 16-year-old boy patient with resistant hypertension (maintain 170-180/100-110 mm Hg after administration four kinds of antiypertensive drugs) and severe hypokalemia. After a series of checks, we exclude primary aldosteronism and renal artery stenosis and other diseases. Finally, the Liddle syndrome was diagnosed because of the DNA sequencing found that the proband's mother and himself had mutations P616L (c.1847 C>T) in the SCNN1B gene. Liddle syndrome should be considered as a cause of hypertension in children or adolescents particularly with suppressed renin activity. Early diagnosis and appropriately tailored treatment avoid complications of long-term unrecognized or inappropriately managed hypertension. Genetic testing has made it possible to make accurate diagnoses and develop tailored therapies for mutation carriers. The role of genetic testing and genetic counseling in establishing the early diagnosis of Liddle's syndrome is important. Copyright © 2017 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  9. Characterization of anti-MERS-CoV antibodies against various recombinant structural antigens of MERS-CoV in an imported case in China.

    PubMed

    Wang, Wenling; Wang, Huijuan; Deng, Yao; Song, Tie; Lan, Jiaming; Wu, Guizhen; Ke, Changwen; Tan, Wenjie

    2016-11-09

    The first imported case of Middle East respiratory syndrome (MERS) in China recently occurred, allowing for the characterization of antibody titers in a series of the patient's sera using the following methods based on recombinant viral structural antigens: inactivated MERS coronavirus (MERS-CoV) enzyme-linked immunosorbent assay (ELISA), recombinant MERS-CoV spike (S, or fragments of S) ELISA, nucleoprotein (NP) ELISA and MERS S pseudovirus particle-based neutralization test (ppNT). A longitudinal profile of the infection showed that seroconversion detected by ELISAs based on the recombinant extracellular domain, S, S1 and receptor-binding domain (RBD) antigens occurred as early as neutralizing antibodies were detected by the ppNT and earlier than antibodies were detected by the inactivated MERS-CoV and N-terminal domain (NTD) ELISAs. Antibodies detected by the NP ELISA occurred last. Strong correlations were found between the S1, RBD and NP ELISAs and the inactivated MERS-CoV ELISA. The S and RBD ELISAs were highly correlated with the commercial S1 ELISA. The S ELISA strongly correlated with the ppNT, although the MERS-CoV, S1, NTD and RBD ELISAs were also significantly correlated with the ppNT (P<0.001).

  10. Forensically Important Blow Flies Chrysomya pinguis, C. villeneuvi, and Lucilia porphyrina (Diptera: Calliphoridae) in a Case of Human Remains in Thailand

    PubMed Central

    Monum, Tawatchai; Sukontason, Kabkaew L.; Sribanditmongkol, Pongruk; Sukontason, Kom; Samerjai, Chutharat; Limsopatham, Kwankamol; Suwannayod, Suttida; Klong-klaew, Tunwadee; Wannasan, Anchalee

    2017-01-01

    This is the first study to report Chrysomya pinguis (Walker) and Lucilia porphyrina (Walker) (Diptera: Calliphoridae) as forensically important blow fly species from human cadavers in Thailand, in addition to Chrysomya villeneuvi (Patton) already known in Thailand. In 2016, a fully decomposed body of an unknown adult male was discovered in a high mountainous forest during winter in Chiang Mai province. The remains were infested heavily with thousands of blow fly larvae feeding simultaneously on them. Morphological identification of adults reared from the larvae, and molecular analysis based on sequencing of 1,247 bp partial mitochondrial cytochrome c oxidase subunit 1 gene (CO1) of the larvae and puparia, confirmed the above mentioned 3 species. The approving forensic fly evidence by molecular approach was described for the first time in Thailand. Moreover, neighbor-joining phylogenetic analysis of the CO1 was performed to compare the relatedness of the species, thereby affirming the accuracy of identification. As species of entomofauna varies among cases in different geographic and climatic circumstances, C. pinguis and L. porphyrina were added to the list of Thai forensic entomology caseworks, including colonizers of human remains in open, high mountainous areas during winter. Further research should focus on these 3 species, for which no developmental data are currently available. PMID:28285509

  11. Forensically Important Blow Flies Chrysomya pinguis, C. villeneuvi, and Lucilia porphyrina (Diptera: Calliphoridae) in a Case of Human Remains in Thailand.

    PubMed

    Monum, Tawatchai; Sukontason, Kabkaew L; Sribanditmongkol, Pongruk; Sukontason, Kom; Samerjai, Chutharat; Limsopatham, Kwankamol; Suwannayod, Suttida; Klong-Klaew, Tunwadee; Wannasan, Anchalee

    2017-02-01

    This is the first study to report Chrysomya pinguis (Walker) and Lucilia porphyrina (Walker) (Diptera: Calliphoridae) as forensically important blow fly species from human cadavers in Thailand, in addition to Chrysomya villeneuvi (Patton) already known in Thailand. In 2016, a fully decomposed body of an unknown adult male was discovered in a high mountainous forest during winter in Chiang Mai province. The remains were infested heavily with thousands of blow fly larvae feeding simultaneously on them. Morphological identification of adults reared from the larvae, and molecular analysis based on sequencing of 1,247 bp partial mitochondrial cytochrome c oxidase subunit 1 gene (CO1) of the larvae and puparia, confirmed the above mentioned 3 species. The approving forensic fly evidence by molecular approach was described for the first time in Thailand. Moreover, neighbor-joining phylogenetic analysis of the CO1 was performed to compare the relatedness of the species, thereby affirming the accuracy of identification. As species of entomofauna varies among cases in different geographic and climatic circumstances, C. pinguis and L. porphyrina were added to the list of Thai forensic entomology caseworks, including colonizers of human remains in open, high mountainous areas during winter. Further research should focus on these 3 species, for which no developmental data are currently available.

  12. Do regional climate models represent regional climate?

    NASA Astrophysics Data System (ADS)

    Maraun, Douglas; Widmann, Martin

    2014-05-01

    When using climate change scenarios - either from global climate models or further downscaled - to assess localised real world impacts, one has to ensure that the local simulation indeed correctly represents the real world local climate. Representativeness has so far mainly been discussed as a scale issue: simulated meteorological variables in general represent grid box averages, whereas real weather is often expressed by means of point values. As a result, in particular simulated extreme values are not directly comparable with observed local extreme values. Here we argue that the issue of representativeness is more general. To illustrate this point, assume the following situations: first, the (GCM or RCM) simulated large scale weather, e.g., the mid-latitude storm track, might be systematically distorted compared to observed weather. If such a distortion at the synoptic scale is strong, the simulated local climate might be completely different from the observed. Second, the orography even of high resolution RCMs is only a coarse model of true orography. In particular in mountain ranges the simulated mesoscale flow might therefore considerably deviate from the observed flow, leading to systematically displaced local weather. In both cases, the simulated local climate does not represent observed local climate. Thus, representativeness also encompasses representing a particular location. We propose to measure this aspect of representativeness for RCMs driven with perfect boundary conditions as the correlation between observations and simulations at the inter-annual scale. In doing so, random variability generated by the RCMs is largely averaged out. As an example, we assess how well KNMIs RACMO2 RCM at 25km horizontal resolution represents winter precipitation in the gridded E-OBS data set over the European domain. At a chosen grid box, RCM precipitation might not be representative of observed precipitation, in particular in the rain shadow of major moutain ranges

  13. Imported submicroscopic malaria in Madrid

    PubMed Central

    2012-01-01

    Background Submicroscopic malaria (SMM) can be defined as low-density infections of Plasmodium that are unlikely to be detected by conventional microscopy. Such submicroscopic infections only occasionally cause acute disease, but they are capable of infecting mosquitoes and contributing to transmission. This entity is frequent in endemic countries; however, little is known about imported SMM. The goals of this study were two-fold: a) to know the frequency of imported SMM, and b) to describe epidemiological, laboratorial and clinical features of imported SMM. Methods A retrospective study based on review of medical records was performed. The study population consisted of patients older than 15 years attended at the Tropical Medicine Unit of Hospital Carlos III, between January 1, 2002 and December 31, 2007. Routinely detection techniques for Plasmodium included Field staining and microscopic examination through thick and thin blood smear. A semi-nested multiplex malaria PCR was used to diagnose or to confirm cases with low parasitaemia. Results SMM was diagnosed in 104 cases, representing 35.5% of all malaria cases. Mean age (IC95%) was 40.38 years (37.41-43.34), and sex distribution was similar. Most cases were in immigrants, but some cases were found in travellers. Equatorial Guinea was the main country where infection was acquired (81.7%). Symptoms were present only in 28.8% of all SMM cases, mainly asthenia (73.3% of symptomatic patients), fever (60%) and arthromialgias (53.3%). The associated laboratory abnormalities were anaemia (27.9%), leukopaenia (15.4%) and thrombopaenia (15.4%). Co-morbidity was described in 75 cases (72.1%). Conclusions Results from this study suggest that imported SMM should be considered in some patients attended at Tropical Medicine Units. Although it is usually asymptomatic, it may be responsible of fever, or laboratory abnormalities in patients coming from endemic areas. The possibility of transmission in SMM has been previously

  14. Imported submicroscopic malaria in Madrid.

    PubMed

    Ramírez-Olivencia, Germán; Rubio, José Miguel; Rivas, Pablo; Subirats, Mercedes; Herrero, María Dolores; Lago, Mar; Puente, Sabino

    2012-09-12

    Submicroscopic malaria (SMM) can be defined as low-density infections of Plasmodium that are unlikely to be detected by conventional microscopy. Such submicroscopic infections only occasionally cause acute disease, but they are capable of infecting mosquitoes and contributing to transmission. This entity is frequent in endemic countries; however, little is known about imported SMM.The goals of this study were two-fold: a) to know the frequency of imported SMM, and b) to describe epidemiological, laboratorial and clinical features of imported SMM. A retrospective study based on review of medical records was performed. The study population consisted of patients older than 15 years attended at the Tropical Medicine Unit of Hospital Carlos III, between January 1, 2002 and December 31, 2007. Routinely detection techniques for Plasmodium included Field staining and microscopic examination through thick and thin blood smear. A semi-nested multiplex malaria PCR was used to diagnose or to confirm cases with low parasitaemia. SMM was diagnosed in 104 cases, representing 35.5% of all malaria cases. Mean age (IC95%) was 40.38 years (37.41-43.34), and sex distribution was similar. Most cases were in immigrants, but some cases were found in travellers. Equatorial Guinea was the main country where infection was acquired (81.7%). Symptoms were present only in 28.8% of all SMM cases, mainly asthenia (73.3% of symptomatic patients), fever (60%) and arthromialgias (53.3%). The associated laboratory abnormalities were anaemia (27.9%), leukopaenia (15.4%) and thrombopaenia (15.4%). Co-morbidity was described in 75 cases (72.1%). Results from this study suggest that imported SMM should be considered in some patients attended at Tropical Medicine Units. Although it is usually asymptomatic, it may be responsible of fever, or laboratory abnormalities in patients coming from endemic areas. The possibility of transmission in SMM has been previously described in endemic zones, and presence of

  15. Elastofibromatous changes in tissues from spinal biopsies. A degenerative process afflicting a small but important subset of patients operated for spinal canal compression: report of 18 cases.

    PubMed

    Daum, Ondrej; Ferda, Jiri; Curik, Romuald; Choc, Milan; Mukensnabl, Petr; Michal, Michal

    2010-12-01

    Elastofibroma is a tumorlike lesion occurring usually in the subscapular region of elderly females. In this study, 18 cases of elastofibromatous tissue retrieved from the spinal canal were analyzed to elucidate its frequency and possible clinical associations. The patients included 8 men and 10 women with a mean age of 63.4 years (range, 40-84 years). The elastic nature of the material was confirmed by Weigert's elastic stain and immunohistochemically. Elastofibroma was diagnosed in 6 patients, and elastofibroma-like tissue was found in 11 samples. The finding of elastofibromatous tissue was associated with clinical diagnosis of juxtaarticular cysts (3 cases), thickening of ligamentum flavum (4 cases), extradural expansion (2 cases), metastatic involvement of the dorsal spine (3 cases), and a vertebral fracture (1 case). Two cases were located above the transpedicular fixation. Elastofibromatous tissue may be found in approximately 2.6% of all spinal biopsies and it may take part in compression of spinal cord and nerve roots.

  16. Representing and acquiring geographic knowledge

    SciTech Connect

    Davis, E.

    1986-01-01

    Intended for researchers and students in AI, cognitive psychology, and computational geometry, this work presents an original theory of how knowledge of a large-scale neighborhood can be represented symbolically in a computer program, accessed for use, and increased by experience. The discussion analyzes related work in the field, presents an actual computer implementation, and suggests areas for further research.

  17. Representing and acquiring geographic knowledge

    SciTech Connect

    Davis, E.

    1986-01-01

    This book presents a theory of how knowledge of a large-scale neighborhood can be represented symbolically in a computer program, accessed for use, and increased by experience. The discussion analyzes related work in the field, presents an actual computer implementation, and suggests areas for further research.