To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Dengue virus type 3 genotype III (DENV-3/III) is widely distributed in most dengue-endemic regions. It emerged in Malaysia in 2008 and autochthonously spread in the midst of endemic DENV-3/I circulation. The spread, however, was limited and the virus did not cause any major outbreak. Spatiotemporal distribution study of DENV-3 over the period between 2005 and 2011 revealed that dengue cases involving DENV-3/III occurred mostly in areas without pre-existing circulating DENV-3. Neutralisation assays performed using sera of patients with the respective infection showed that the DENV-3/III viruses can be effectively neutralised by sera of patients with DENV-3 infection (50% foci reduction neutralisation titres (FRNT50) > 1300). Sera of patients with DENV-1 infection (FRNT50 ⩾ 190), but not sera of patients with DENV-2 infection (FRNT50 ⩽ 50), were also able to neutralise the virus. These findings highlight the possibility that the pre-existing homotypic DENV-3 and the cross-reacting heterotypic DENV-1 antibody responses could play a role in mitigating a major outbreak involving DENV-3/III in the Klang Valley, Malaysia.
The aim of this study is to establish clinical evidence regarding the use of magnetic resonance imaging (MRI) in target volume definition for radiotherapy treatment planning of brain tumours.
Primary studies were systematically retrieved from six electronic databases and other sources. Studies included were only those that quantitatively compared computed tomography (CT) and MRI in target volume definition for radiotherapy of brain tumours. Study characteristics and quality were assessed and the data were extracted from eligible studies. Effect estimates for each study was computed as mean percentage difference based on individual patient data where available. The included studies were then combined in meta-analysis using Review Manager (RevMan) software version 5.0.
Five studies with a total number of 72 patients were included in this review. The quality of the studies was rated strong. The percentages mean differences of the studies were 7·47, 11·36, 30·70, 41·69 and −24·6% using CT as the baseline. The result of statistical analysis showed small-to-moderate heterogeneity; τ2=36·8; χ2=6·23; df=4 (p=0·18); I2=36%. The overall effect estimate was −1·85 [95% confidence interval (CI); −7·24, 10·94], Z=0·40 (p=0·069>0·5).
Brain tumour volumes measured using MRI-based method for radiotherapy treatment planning were larger compared with CT defined volumes but the difference lacks statistical significance.
Tuberculosis (TB) is a chronic debilitating disease of man and animals caused by members of the genus Mycobacterium. TB is a major health problem with 8-9 million new cases a year in the world and 3 million deaths (WHO, 2002), and the majority of these are in developing nations. Infection due to due to M. bovis was once a major problem in developed countries but following eradication programmes, the incidence reduced to the extent that some areas are now free of the disease (Caffery, 1994). However, the infection continues in developing countries due to lack of rigorous control measures. In Nigeria there have been limited studies to determine the prevalence/relationship between bovine and human TB especially with the eating culture of ‘fura da nono’ i.e. unpasteurized milk. Abuja is the new capital of Nigeria with the population of 4 million continues to increase due to the influx of people from all states of the federation. The number of people diagnosed with TB is also on the increase. The semi forest vegetation of the Federal Capital Territory (FCT) also encourages migration of Fulani nomads in search of green area for their animals. The objective of this study was to determine the prevalence of bovine and human TB in the capital as well as to establish whether there is a link between animal and human TB.
The emerging restive youth culture in Nigeria has been a critical subject in Nigerian writing recently, with Obafemi's Dark Times Are Over? one of the pioneering plays. The play opens with a series of activities by university student associations, ranging from ‘Kegite’ (palm-wine club), to ‘Yepa’ (a religious cult group) and ‘Aristo Girls’ (campus ‘sex workers'). The groups, under the guise of freedom of association, constitute themselves into different forms of lethal nuisance on campus and, in the fight for supremacy, violence ensues. The emergence of ‘Man O’ War’ – a voluntary informal para-military group – provides hope for the restitution of the campus from the stranglehold of terror. The return of the campus to a conducive environment for learning is, however, short-lived. Obafemi berates the decay in the education and legal systems, two arms of national development. The young generation constitute the main focus of the play, which laments their vulnerability to the vices pervading tertiary institutions in Nigeria. Instead of being the fulcrum of the development of young people into industrious and patriotic citizens, he argues that the institutions have turned into breeding grounds of decadence and corruption – portrayed in the play as an extension of national life. The anti-social behaviour is attributed to maladministration and a debased judicial system. The play is a warning of the danger posed by unruly youths in a country overtaken by a youth explosion.
The desperate need for political reform is viewed via historical antecedents in Running Dreams. The playwright decries the deep involvement of superpowers in steering the political affairs of African and other so-called Third World nations through their conglomerates. This, in his view, has allowed for mediocrity in the political system whereby unpatriotic citizens with international connections, or identified as instruments to fulfil foreign economic agendas, are sponsored.
The plot revolves around Yohanna, a former diplomat and economic guru, who is caught in a conflict between the capitalists’ insatiable quest for wealth and the urgent need for national rejuvenation. A dream trope employed by the playwright gives him recourse to history and a mediation between the past and the present to navigate the future. Nationalists from various African countries constitute the realm of Yohanna's dream. Their persistence in the dream enlivens the patriotic demand for self-appraisal and rejuvenation to initiate national reforms.
Parasitic infections are among the leading global public health problems with very high economic and mortality burdens. Unfortunately, the available treatment drugs are beset with side effects and continuous parasite drug resistance is being reported. However, new findings reveal more promising compounds especially of plant origin. Among the promising leads are the pentacyclic triterpenes (PTs) made up of the oleanane, ursane, taraxastane, lupane and hopane types. This paper reviews the literature published from 1985 to date on the in vitro and in vivo anti-parasitic potency of this class of phytochemicals. Of the 191 natural and synthetic PT reported, 85 have shown high anti-parasitic activity against various species belonging to the genera of Plasmodium, Leishmania, Trypanosoma, as well as various genera of Nematoda. Moreover, structural modification especially at carbon 3 (C3) and C27 of the parent backbone of PT has led to improved anti-parasitic activity in some cases and loss of activity in others. The potential of this group of compounds as future alternatives in the treatment of parasitic diseases is discussed. It is hoped that the information presented herein will contribute to the full exploration of this promising group of compounds as possible drugs for parasitic diseases.
The issues of ethnicity and democratization and the prospects for development in postcolonial Africa have long preoccupied scholars. When most African countries gained independence from the colonialists in the 1960s, the ruling elites who inherited state power insisted that Africa could not afford the luxury of democracy because of its potential for exacerbating ethnic pluralism and political conflict, which would be detrimental to the more pertinent projects of development and integration/nation building. The ideology of development and national integration in postcolonial Africa thus became the justification for one-party rule, autocracy, and military dictatorship.
The present investigation aims to enhance the mechanical properties and shape memory characteristics of Cu–Ni–Al shape memory alloys (SMAs) by alloying additional elements. These additions were found to control the phase morphology and grain size, along with the formation of different volume fractions, sizes, and distributions of precipitates. The features of the precipitates were mainly dependent on the type of alloying element. It was found that a Co (1.14 wt%) alloy gave the best overall improvement in terms of the transformation temperatures, ductility, and shape memory recovery. These improvements were mainly due to the exceptionally high presence of the γ2 phase in the microstructures of the modified alloy. The results of the current investigation were analyzed and compared to those of previous studies related to Cu–Al–Ni SMAs.
Communicative Development Inventories (CDIs, parent-completed language development checklists) are a helpful tool to assess language in children who are unused to interaction with unfamiliar adults. Generally, CDIs are completed in written form, but in developing country settings parents may have insufficient literacy to complete them alone. We designed CDIs to assess language development in children aged 0;8 to 2;4 in two languages used in Coastal communities in Kenya. Measures of vocabulary, gestures, and grammatical constructions were developed using both interviews with parents from varying backgrounds, and vocabulary as well as grammatical constructions from recordings of children's spontaneous speech. The CDIs were then administered in interview format to over 300 families. Reliability and validity ranged from acceptable to excellent, supporting the use of CDIs when direct language testing is impractical, even when children have multiple caregivers and where respondents have low literacy levels.
This paper attempts to examine the paradigm shift in ASEAN from a state-based to a people-based organization. We argue that by adopting a people-based organization, ASEAN now enters an era of Neo-Communitarianism replacing the Old Communitarianism of the old generation of ASEAN. By using communitarian perspectives, we look at the continuities and changes in ASEAN with regard to how it deals with issues involving their members. Three important issues namely the debates on intervention principle; the adoption of the three pillars of the ASEAN Community; and the inclusion of human rights are seen as the signposts where ASEAN departs from their Old to a Neo-Communitarianism. Although there have been a lot of challenges to the realization of the people-based organization, we see that the dynamics of debates and the active participation of the community in the debates show good prospects for the new paradigm to realize. In this paper, we use debate on the formation of ASEAN Intergovernmental Commission on Human Rights (ICHR), to show the involvements of people in setting the agendas for the future ASEAN.
Completion of treatment is key to tuberculosis control. Using national surveillance data we assessed factors associated with tuberculosis patients being lost to follow-up before completing treatment (‘lost’). Patients reported in England, Wales and Northern Ireland between 2001 and 2007 who were lost 12 months after beginning treatment were compared to those who completed, or were still on treatment, using univariable and multivariable logistic regression. Of 41 120 patients, men [adjusted odds ratio (aOR) 1·29; 95% confidence interval (CI) 1·23–1·35], 15- to 44-year-olds (P<0·001), and patients with pulmonary sputum smear-positive disease (aOR 1·25, 95% CI 1·12–1·45) were at higher risk of being lost. Those recently arrived in the UK were also at increased risk, particularly those of the White ethnic group (aOR 6·39, 95% CI 4·46–9·14). Finally, lost patients had a higher risk of drug resistance (aOR 1·41, 95% CI 1·17–1·69). Patients at risk of being lost require enhanced case management and novel case retention methods are needed to prevent this group contributing towards onward transmission.
This study used linked national tuberculosis (TB) and HIV surveillance data to investigate recent trends and factors associated with HIV co-infection (TB-HIV) in healthcare workers (HCWs) with TB in England and Wales. Methods applied were the χ2 trend test and logistic regression. Overall 14% (231/1627) of HCWs with TB were co-infected with HIV, increasing from 8% in 1999 to 14% in 2005 (P<0·001). Most (78%) HCWs were non-UK born and 74% of these developed TB ⩾2 years post-entry. Being born in Sub-Saharan Africa was an independent predictor for TB-HIV, especially for female HCWs (odds ratio 66·5, 95% confidence interval 16·3–271·1), who also had a lower median CD4 count than other co-infected women (106/mm3, interquartile range 40–200, P<0·01). Voluntary HIV testing of new HCWs should be encouraged as an opportunity for early diagnosis. Post-entry, a high index of clinical suspicion for TB in those most at risk remains important.
The quality of infant-mother attachment has been linked to competence in different domains of child development. Research indicates that early intervention can enhance the quality of infant-mother attachment, though its efficacy in a group format has yet to be evaluated. The current study is aimed at examining the usefulness of a group intervention in enhancing infant-mother attachment. An intervention aimed at addressing aspects such as maternal responsivity, sensitivity and childrearing behaviour was developed by the researchers and experienced psychologists. The intervention spanned a period of 14 months starting from the third quarter of pregnancy. The intervention was evaluated among 24 mothers from the Basque region of Spain. The sample consisted of children of both genders in a similar proportion: 45.8% were boys and 54.2% were girls. The children in this sample were full-term born and did not present symptoms of any serious pre- or postnatal complications. The intervention had a statistically non-significant medium effect. Infants whose mothers had received the intervention showed higher rates of secure attachment compared to children from the control group, as assessed by the Strange Situation observation procedure. A potentially significant confounding variable, maternal attachment, was balanced across the intervention and comparison groups. We can tentatively point out that a group intervention may enhance the quality of infant-mother attachment. Nevertheless, because the study design was not randomized, the results of this study remain preliminary and need replication in a full randomized controlled trial designed study.
We report a rare case of cervical necrotising fasciitis arising from poorly managed acute tonsillitis.
A 23-year-old woman presented with a two-week history of fever and an eight-day history of painful neck swelling. Nine days before presentation, she had received digital manipulation of her throat by a neighbour, which had worsened her throat pain. There was associated progressive generalised neck swelling, odynophagia, dysphagia and dyspnoea. An X-ray of the neck soft tissue showed multiple gas collections.
Cervical necrotising fasciitis is rare and usually odontogenic in origin. It is associated with a high mortality rate. Our patient responded to aggressive daily bedside wound debridements and dressings, appropriate intravenous antibiotics and high-protein nutritional support. In this way, exploration under general anaesthesia was avoided, in a developing country with limited facilities.
This study investigates the association between socio-economic deprivation and tuberculosis (TB) treatment delays in England, 2000–2005. Patients reported to the Enhanced TB Surveillance system were assigned a deprivation score based on residential postcode, and categorized into deprivation quartiles. Data were analysed using Cox regression. The median interval from symptom onset to treatment initiation was 67 days (inter-quartile range 30–131). The effect of deprivation on this interval was modified by ethnic group and place of birth/time since entry into the United Kingdom. Longer intervals were experienced by the most deprived black Africans, Indians/Pakistanis/Bangladeshis and recent entrants to the United Kingdom, compared to the least deprived. In contrast, among white and UK-born patients, longer intervals were experienced by the least deprived. In conclusion, the effect of deprivation on TB treatment delays varies in different population groups. Efforts are needed to reduce delays including improving awareness of TB and increasing the index of clinical suspicion.
Differentiation of bloodstream-form trypanosomes into procyclics in tsetse flies (Diptera: Glossinidae) is a crucial step in the establishment of midgut infections. A number of factors have been implicated in the transformation process, including enzymes and lectins or lectin-like molecules. Recently, Glossina proteolytic lectin (Gpl) gene, which encodes a protein with both lectin and trypsin activities has been shown to stimulate transformation of bloodstream-form trypanosomes into procyclics in vitro. Using RT-PCR, we show that the induction of Gpl gene expression by blood meal occurs only in Glossina fuscipes fuscipes Newstead, Glossina austeni Newstead, Glossina pallidipes Austen, and not in the Anopheles gambiae Giles sensu stricto, Phlebotomus duboscqi Neveu-Lemaire, Rhipicephalus appendiculatus Neumann and Stomoxys calcitrans (Linnaeus). The expression means of Gpl mRNA in G. f. fuscipes following a blood meal were significant (P < 0.05) with low expression in teneral flies and reaching a maximum between 48 and 72 h (P < 0.05), suggesting time-dependent regulation of the transcription. The expression of the Gpl gene was significantly lower (P < 0.05) in G. f. fuscipes fed on blood meal infected with Trypanosoma brucei brucei as compared with G. f. fuscipes fed on uninfected blood meal. This suggests some form of interaction of T. b. brucei or the parasite products with Gpl within the tsetse midgut leading to down-regulation of the Gpl gene. Additionally, refractory G. f. fuscipes expressed higher (P < 0.05) transcript abundance than the susceptible G. pallidipes.
The re-emergence of tuberculosis (TB) has been observed in both developing and developed countries in recent years. Tuberculosis, a major public health and zoonotic problem, is responsible for 2 to 3 million human deaths annually (WHO 2003) and also causes great economic loss in the animal industry. Tuberculosis has been declared a global emergency by WHO in 1993; the first to be declared as such. Nigeria with a population of over 120 million people and cattle population of about 19.8 million has been ranked 4th among the world’s 22 countries with a high TB burden. The objective of this study was to determine the prevalence of bovine tuberculosis among Fulani cattle, which are the main source of milk and milk products to the public. The culture of consuming raw milk as a local delicacy known as ‘fura da nono’ among Nigerians especially in the study area informed this study.