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Xpert MTB/RIF (Xpert) is the preferred first-line test for all persons with tuberculosis (TB) symptoms in South Africa in line with a diagnostic algorithm. This study evaluates pre- and post-implementation trends in diagnostic practices for drug-sensitive, pulmonary TB in adults in an operational setting, following the introduction of the Xpert-based algorithm. We retrospectively analysed data from the national TB database for Greater Tzaneen sub-district, Limpopo Province. Trends in a number of cases, diagnosis and outcome and characteristics associated with death are reported. A total of 8407 cases were treated from 2008 until 2015, with annual cases registered decreasing by 31·7% over that time period (from 1251 to 855 per year). After implementation of Xpert, 69·9% of cases were diagnosed by Xpert, 29·4% clinically, 0·6% by smear microscopy and 0·1% by culture. Cases with a recorded microbiological test increased from 76·2% to 96·4%. Cases started on treatment without confirmation, but with a negative microbiological test increased from 7·1% to 25·7%. Case fatality decreased from 15·0% to 9·8%, remaining consistently higher in empirically treated groups, regardless of HIV status. Implementation of the algorithm coincided with a reduced number of TB cases treated and improved coverage of microbiological testing; however, a substantial proportion of cases continued to start treatment empirically.
Dementia is a neurodegenerative disorder with global impact, with the largest proportion of cases occurring in low- and middle-income countries. It is estimated that there are 46.8 million cases globally with approximately 10 million new cases each year or a new case occurring every 3 sec (Prince et al., 2015). For comparison there are 36.7 million HIV cases with an estimated 2 million new cases each year (WHO, 2017). The rise in dementia prevalence is largely due to population ageing, with the oldest being at highest risk. To date there are no diseases modifying medications for Alzheimer's disease or the other causes of dementia. Academics and research groups are increasingly focused on prevention or delay of dementia (Brayne and Miller, 2017) and a number of organizations now prioritize dementia, indicating a strong and coherent international effort to address this problem. Examples include the World Health Organisation (WHO), which has established a Global Dementia Observatory; the World Dementia Council; the Organisation for Economic Co-operation and Development (OECD); the U.S. National Alzheimer's Project Act (NAPA); and the Global Council on Brain Health.
Mitochondrial dysfunction and resulting changes in adiposity have been observed in the offspring of animals fed a high fat (HF) diet. As iron is an important component of the mitochondria, we have studied the offspring of female rats fed complete (Con) or iron-deficient (FeD) rations for the duration of gestation to test for similar effects. The FeD offspring were ~12% smaller at weaning and remained so because of a persistent reduction in lean tissue mass. The offspring were fed a complete (stock) diet until 52 weeks of age after which some animals from each litter were fed a HF diet for a further 12 weeks. The HF diet increased body fat when compared with animals fed the stock diet, however, prenatal iron deficiency did not change the ratio of fat:lean in either the stock or HF diet groups. The HF diet caused triglyceride to accumulate in the liver, however, there was no effect of prenatal iron deficiency. The activity of the mitochondrial electron transport complexes was similar in all groups including those challenged with a HF diet. HF feeding increased the number of copies of mitochondrial DNA and the prevalence of the D-loop mutation, however, neither parameter was affected by prenatal iron deficiency. This study shows that the effects of prenatal iron deficiency differ from other models in that there is no persistent effect on hepatic mitochondria in aged animals exposed to an increased metabolic load.
HR 6469 consists of an evolved G5 star and a close pair of fainter stars, probably both on the main sequence. The period of the close pair is just over two days, and shallow eclipses have been detected (Boyd et al. 1985), although no analysis of the light curve has been published. The wide system has a period of about 5.5 years, and has been resolved by speckle interferometry (McAlister et al. 1983). The G5 star and the primary of the close pair are detectable in the spectrum, with the latter showing modest rotational broadening. Spectral types and rotational velocities for the evolved star and the brighter component of the close pair have been published by Strassmeier & Fekel (1990).
Using semi-empirical isochrones, we find the age of the Taurus star-forming region to be 3-4 Myr. Comparing the disc fraction in Taurus to young massive clusters suggests discs survive longer in this low density environment. We also present a method of photometrically de-reddening young stars using iZJH data.
Depressive symptoms are prominent psychopathological features of Huntington's disease (HD), making a negative impact on social functioning and well-being.
We compared the frequencies of a history of depression, previous suicide attempts and current subthreshold depression between 61 early-stage HD participants and 40 matched controls. The HD group was then split based on the overall HD group's median Hospital Anxiety and Depression Scale-depression score into a group of 30 non-depressed participants (mean 0.8, s.d. = 0.7) and a group of 31 participants with subthreshold depressive symptoms (mean 7.3, s.d. = 3.5) to explore the neuroanatomy underlying subthreshold depressive symptoms in HD using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI).
Frequencies of history of depression, previous suicide attempts or current subthreshold depressive symptoms were higher in HD than in controls. The severity of current depressive symptoms was also higher in HD, but not associated with the severity of HD motor signs or disease burden. Compared with the non-depressed HD group DTI revealed lower fractional anisotropy (FA) values in the frontal cortex, anterior cingulate cortex, insula and cerebellum of the HD group with subthreshold depressive symptoms. In contrast, VBM measures were similar in both HD groups. A history of depression, the severity of HD motor signs or disease burden did not correlate with FA values of these regions.
Current subthreshold depressive symptoms in early HD are associated with microstructural changes – without concomitant brain volume loss – in brain regions known to be involved in major depressive disorder, but not those typically associated with HD pathology.
The ultraviolet (UV) color-color relation of early-type galaxies (ETGs) in the nearby universe (0.05 < z < 0.12) is re-examined with the latest GALEX GR6 and SDSS DR7 data. By drawing the FUV – NUV (as a measure of UV temperature) versus FUV – r (as a measure of UV amplitude) color-color diagram for the morphologically-cleaned, spectroscopically-cleaned sample of ~3700 quiescent ETGs, we find that the “old and dead“ ETGs consist of a well-defined sequence in UV colors, the “UV red sequence”, so that the stronger UV excess galaxies should have a harder UV spectral shape systematically. However, the observed UV spectral slope is too steep to be reproduced by the canonical models in which the UV flux is mainly controlled by age or metallicity parameters. The observed data support the helium enhancement scenario in which the UV spectral shape of UV upturn (FUV – NUV < 0.9; FUV – r ~ 6) galaxies may be governed by the minority population of helium-enhanced horizontal-branch (HB) stars.
A 2,3-dibutoxy-1,4-phenylenevinylene comonomer was incorporated into a distyrylbenzene derivative 11. Novel 1,2-disubstituted-3,6-dibromobenzene comonomers 15 and 18 were prepared by directed metallation. Copolymerization of 11with a 9,9-dioctylfluorene-2,7-diboronate ester 1 yielded a green fluorescent polymer while copolymerization of 15 and 18 with the 9,9-dihexylfluorene-2,7-diboronate 22 afforded promising blue fluorescent polymers 23 and 24 respectively.
The utilization of recently discovered aluminum-oxygen-carbon backbone polymers in the preparation of various phases of A12O3 is presented. The structure of the polymers has been examined by ss 27AI NMR, TGA, MS, SEM, XRD, and EDAX. The solid pyrolysis products of these polymers have been characterized by ss 27AI NMR, XRD, SEM, and EDAX. The volatile products of pyrolysis have been studied by trapping, TGA and MS.
Liquid helium was shock-compressed in Hugoniot equation-of-state measurements at pressures of 1.2 and 16 GPa (12 and 160 kbar) using a two-stage light-gas gun . Specimens were initially at a temperature of 4.3 K and a molar volume of 32 cm3/mole. Specimen holders were a refinement of the cryogenic targets used for liquid H2 and D2 experiments . The data are in good agreement with the published theoretical prediction of Young, et al. The high shock temperatures test the repulsive pair potential to an interatomic spacing approaching 1 Å, which is comparable to a solid volume at a temperature of 0 K of about 0.5 cm3/mole.
A new diamine monomer, N,N'-bis(4-aminophenyl)-2,5-(diisopropoxycarbony)benzene-l,4-dicarboxamide was synthesized. Using the diamine, several alternating copolyimide precursors were successfully synthesized by its condensation polymerization with dianhydrides. The structure and properties (mechanical properties and thermal expansivity) of alternating copolyimides imidized thermally were characterized, and compared with those of the corresponding randomcopolyimides prepared from the copoly(amic acid)s. The alternating copolyimides exhibited relatively higher chain order and in-plane orientation in films than the random copolyimides. The higher chain order and in-plane orientation led to the higher tensile modulus and lower thermal expansivity in the alternating copolyimides. Such effect of comonomer sequence was found to be highly pronounced in copolyimides consisting of comonomers which have a large difference in the chain rigidity. It was demonstrated in this study that the formation of alternating copolyimides is a suitable route to improve the performance of properties.
Statistical mechanical studies predict that a chemically reactive system containing species composed of C, H, N, O atoms can exhibit a phase separation into a N2-rich and a N2-poor phase. The present work is concerned with the effect of the fluid phase separation upon addition of F atoms to the system. Our study shows that F atoms mainly appear as a constituent of HF in a N2-poor fluid phase up to a certain pressure beyond which they occur as CF4 in a N2-rich phase and that the phase separation may be abrupt in a thermodynamic sense. The pressure at the phase boundary can occur at about 30 GPa at 3000 K and about 10 GPa to 20 GPa at 1000 K. Some of these ranges may be accessible by present-day experimental high-pressure techniques. We discuss implications of this study to detonation physics.
Nasal swabs were taken from 492 babies born consecutively to residents of two South Wales towns soon after their discharge from maternity hospitals. Staphylococcus aureus was isolated from 352 babies (72%) and in 79 (22%) of these it was resistant to at least one antibiotic. By the time these babies were a year old the prevalence of both sensitive and resistant strains had fallen, so that only 12% still carried nasal staphylococci, but 64% of these organisms were then resistant to penicillin. Administration of penicillin to the baby seemed to be a more important factor in selecting resistant organisms than other antibiotics given to the baby, any antibiotic treatment to other members of the household, or discharge from hospital.
Plants of two rye genotypes, one highly inbred, the other not, were grown with varying amounts of available mineral phosphate. In two experiments, one using culture solutions, the other a field experiment, the results show an effect of phosphate treatments on mean chiasma frequency at first metaphase in meiocytes. Plants given increased amounts of phosphate showed an increase in chiasma frequency. A similar effect of phosphate on chromosome size and mass at mitotic metaphase in meristems is known and there may be a direct link between chromosome size and chiasma frequency.
The usual systems of assay using techniques of chromosome substitution demonstrated in Drosophila and wheat are not applicable to barley (Hordeum vulgare). Chromosomal material for assay may, however, be substituted from one variety into another by using translocations to mark and restrict crossing over in the chromosomes to be transferred. This paper describes the isolation and assay of lines derived in this way.
Seven substitution lines derived from the donor variety Maris Badger and the recipient variety Mars have been scored for quantitative characters in two field trials.
The results indicate that variation in flowering time and other associated characters is largely determined by genes on chromosome 2 and that chromosome 4 is involved in the control of plant height.
The feasibility of the technique as a method of assaying the contributions of chromosomes to qualitative characters by substitution in a diploid is discussed.