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Kinetoplastid parasites are responsible for serious diseases in humans and livestock such as Chagas disease and sleeping sickness (caused by Trypanosoma cruzi and Trypanosoma brucei, respectively), and the different forms of cutaneous, mucocutaneous and visceral leishmaniasis (produced by Leishmania spp). The limited number of antiparasitic drugs available together with the emergence of resistance underscores the need for new therapeutic agents with novel mechanisms of action. The use of agents binding to surface glycans has been recently suggested as a new approach to antitrypanosomal design and a series of peptidic and non-peptidic carbohydrate-binding agents have been identified as antiparasitics showing efficacy in animal models of sleeping sickness. Here we provide an overview of the nature of surface glycans in three kinetoplastid parasites, T. cruzi, T. brucei and Leishmania. Their role in virulence and host cell invasion is highlighted with the aim of identifying specific glycan–lectin interactions and carbohydrate functions that may be the target of novel carbohydrate-binding agents with therapeutic applications.
While echocardiographic parameters are used to quantify ventricular function in infants with single ventricle physiology, there are few data comparing these to invasive measurements. This study correlates echocardiographic measures of diastolic function with ventricular end-diastolic pressure in infants with single ventricle physiology prior to superior cavopulmonary anastomosis.
Data from 173 patients enrolled in the Pediatric Heart Network Infant Single Ventricle enalapril trial were analysed. Those with mixed ventricular types (n = 17) and one outlier (end-diastolic pressure = 32 mmHg) were excluded from the analysis, leaving a total sample size of 155 patients. Echocardiographic measurements were correlated to end-diastolic pressure using Spearman’s test.
Median age at echocardiogram was 4.6 (range 2.5–7.4) months. Median ventricular end-diastolic pressure was 7 (range 3–19) mmHg. Median time difference between the echocardiogram and catheterisation was 0 days (range −35 to 59 days). Examining the entire cohort of 155 patients, no echocardiographic diastolic function variable correlated with ventricular end-diastolic pressure. When the analysis was limited to the 86 patients who had similar sedation for both studies, the systolic:diastolic duration ratio had a significant but weak negative correlation with end-diastolic pressure (r = −0.3, p = 0.004). The remaining echocardiographic variables did not correlate with ventricular end-diastolic pressure.
In this cohort of infants with single ventricle physiology prior to superior cavopulmonary anastomosis, most conventional echocardiographic measures of diastolic function did not correlate with ventricular end-diastolic pressure at cardiac catheterisation. These limitations should be factored into the interpretation of quantitative echo data in this patient population.
The Rio Grande Cone is a major fanlike depositional feature in the continental slope of the Pelotas Basin, Southern Brazil. Two representative sediment cores collected in the Cone area were retrieved using a piston core device. In this work, the organic matter (OM) in the sediments was characterized for a continental vs. marine origin using chemical proxies to help constrain the origin of gas in hydrates. The main contribution of OM was from marine organic carbon based on the stable carbon isotope (δ13C-org) and total organic carbon/total nitrogen ratio (TOC:TN) analyses. In addition, the 14C data showed important information about the origin of the OM and we suggest some factors that could modify the original organic matter and therefore mask the “real” 14C ages: (1) biological activity that could modify the carbon isotopic composition of bulk terrestrial organic matter values, (2) the existence of younger sediments from mass wasting deposits unconformably overlying older sediments, and (3) the deep-sediment-sourced methane contribution due to the input of “old” (>50 ka) organic compounds from migrating fluids.
The first period of agrarian reforms with clear state control over the land (African socialisms) took place between 1945 and 1980, but then a second period started in which market agrarian reforms have prevailed. This work synthesizes agrarian structural reform policies (property systems and land tenure) between 1980 and 2016 in African countries, especially those that had or have bureaucratic bourgeoisie governments (one-party and/or African socialist). The two periods are complementary, rather then being opposed to each other, as state agrarian reforms smoothed the path to market agrarian reforms. Although there is not yet sufficient empirical research on the results of the agrarian reforms implemented during this period, our hypothesis is that they are helping to: increase the unequal structure of property; develop tenure systems and non-capitalist contractual labour relations in new ways, both non-associative (the grabbing of vast tracts of land) and associative (renewed control of customary lands by traditional authorities); and force peasant expropriation and the subsequent increase in the number of landless non-proletarianized peasants. Therefore, the problem of poor agrarian structures in Africa is still unresolved.
Formally established in the fall of 1947, the Laboratory of Archaeology at the University of Georgia is an archaeological research and collection repository. It is considered one of the premier institutions for curation of archaeological collections from the American Southeast. For over 70 years, the Laboratory has served as a repository for objects and associated records generated from archaeological projects and research undertaken by faculty, students, CRM professionals, and state and federal agencies. The Laboratory curates over 20,000 cubic feet of artifacts as well as paper and digital archives. In addition, the Laboratory houses the Georgia Archaeological Site File and manages data from more than 59,000 archaeological sites, including over 11,500 archaeological reports. In this paper, we explore implementation procedures for bringing legacy collections up to modern curation standards. We also outline how we migrate the data on paper records into the digital realm, articulating them within a comprehensive framework.
In coastal and island archaeology, carbonate mollusk shells are often among the most abundant materials available for radiocarbon (14C) dating. The marsh periwinkle (Littorina irrorata) is one of these such species, ubiquitously found along the Atlantic and Gulf coasts of the United States in both modern and archaeological contexts. This paper presents a novel approach to dating estuarine mollusks where rather than attempting to characterize the size and variability of reservoir effects to “correct” shell carbonate dates, we describe a compound-specific approach that isolates conchiolin, the organic matter bound with the shell matrix of the L. irrorata. Conchiolin typically constitutes <5% of shell weight. In L. irrorata, it is derived from the snail’s terrestrial diet and is thus not strongly influenced by marine, hardwater, or other carbon reservoir effects. We compare the carbon isotopes (δ13C and Δ14C) of L. irrorata shell carbonate, conchiolin, and bulk soft tissue from six modern, live-collected specimens from Apalachicola Bay, Florida, with samples that represent possible sources of carbon within their environment including surface sediments, marsh plant tissues, and dissolved inorganic carbon (DIC) in water. Ultimately, this paper demonstrates that samples obtained from wet chemical oxidation of L. irrorata conchiolin produces accurate 14C dates.
We report four cases of Taenia saginata taeniasis in different urban communities of Aragua state, Venezuela. After subsequent treatment with praziquantel and a saline purge, adult tapeworms were collected from all four patients and demonstrated to be T. saginata by morphological and molecular characterization. The finding of T. saginata in four distinct and separate urban municipalities of the Aragua state indicates the pertinence of rigorous meat inspection, and the importance of establishing parasite prevalence in human and bovine Venezuelan populations.
In this study, for the first time, chemically modified carbon nanotubes (CNTs) were used as a conductive additive in the cathode composite for lithium–sulfur batteries. Oxidation of pure CNTs has been carried out using modified Hummers’ method, and to partially remove oxygen groups from the CNT surface and increase their electronic conductivity, oxidized CNTs have been hydrothermally treated. The cathode slurry was mixed in water with a water-soluble LA133 binder. Despite the decrease in electronic conductivity of CNTs after chemical treatment, the presence of structural defects and oxygen groups provides uniform distribution of modified CNTs in the sulfur-based composite, which results in more than twice higher electrode specific capacity compared with the electrodes comprising pure CNTs. Using chemically modified CNTs as a conductive additive is proposed as an effective way for the preparation of nontoxic and cost-effective water-based cathode slurries in lithium–sulfur batteries.
Computer-assisted navigation (CAN) improves the accuracy of spinal instrumentation in vertebral fractures and degenerative spine disease; however, it is not widely adopted because of lack of training, high capital costs, workflow hindrances, and accuracy concerns. We characterize shifts in the use of spinal CAN over time and across disciplines in a single-payer health system, and assess the impact of intra-operative CAN on trainee proficiency across Canada.
A prospectively maintained Ontario database of patients undergoing spinal instrumentation from 2005 to 2014 was reviewed retrospectively. Data were collected on treated pathology, spine region, surgical approach, institution type, and surgeon specialty. Trainee proficiency with CAN was assessed using an electronic questionnaire distributed across 15 Canadian orthopedic surgical and neurosurgical programs.
In our provincial cohort, 16.8% of instrumented fusions were CAN-guided. Navigation was used more frequently in academic institutions (15.9% vs. 12.3%, p<0.001) and by neurosurgeons than orthopedic surgeons (21.0% vs. 12.4%, p<0.001). Of residents and fellows 34.1% were fully comfortable using spinal CAN, greater for neurosurgical than orthopedic surgical trainees (48.1% vs. 11.8%, p=0.008). The use of CAN increased self-reported proficiency in thoracic instrumentation for all trainees by 11.0% (p=0.036), and in atlantoaxial instrumentation for orthopedic trainees by 18.0% (p=0.014).
Spinal CAN is used most frequently by neurosurgeons and in academic centers. Most spine surgical trainees are not fully comfortable with the use of CAN, but report an increase in technical comfort with CAN guidance particularly for thoracic instrumentation. Increased education in spinal CAN for trainees, particularly at the fellowship stage and, specifically, for orthopedic surgery, may improve adoption.
The period between 1499 and 1516 witnessed an important revival of the doctrines of Ramón Lull at Paris, one that was to have important consequences for the history of European thought in the sixteenth and seventeenth centuries. This revival was primarily the work of three men, Jacques Lefèvre d'Étaples, his pupil and friend Charles de Bovelles, and the Catalan theologian Bernardo de Lavinheta. Each man cultivated a different aspect of Lull's thought in his work. Lefèvre appreciated the mystical side of Lull, Bovelles his metaphysics and rational theology, and de Lavinheta his encyclopedism. Through the writings of each Lullism traveled the road from mysticism to metaphysics and encyclopedism and thus handed on to later generations an important foundation upon which to build.
Motivated by subsurface carbon sequestration, an experimental investigation of dissolution-driven Rayleigh–Darcy convection using two miscible fluids in a Hele-Shaw cell is conducted. A thin horizontal layer of circular impermeable discs is inserted to create an environment with heterogeneous and anisotropic permeability. The Sherwood number that measures the convective mass transfer rate between two fluids at the interface is linked to different parameters of the disc layer, including the disc size, spacing, layer permeability and its relative height with respect to the fluid interface. It is surprising that the convective mass transfer rate in our configuration is dominated by the disc spacing, but almost independent of either the disc size or the mean permeability of the layer. To explain this dependence, the convective mass transfer rate is decomposed into the number, velocity and density contrast of fingers travelling through the disc layer. Both the number and density contrast of fingers show dependences on the disc layer permeability, even though the product of them, the mass transfer rate, does not. In addition, the density contrast also shows a non-monotonic dependence on the disc spacing. The transition point is at a spacing that is close to the finger width. Based on this observation, a simple model based on mixing and scale competition is proposed, and it shows an excellent agreement with the experimental results.
PUFA might modulate inflammatory responses involved in the development of severe dengue. We aimed to examine whether serum PUFA concentrations in patients diagnosed with dengue fever (DF) were related to the risk of progression to dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS). A secondary aim was to assess correlations between fatty acids (FA) and inflammatory biomarkers in patients with DF. We conducted a prospective case–control study nested within a cohort of patients who were diagnosed with DF and followed during the acute episode. We compared the distribution of individual FA (% of total FA) at onset of fever between 109 cases who progressed to DHF/DSS and 235 DF non-progressing controls using unconditional logistic regression. We estimated correlations between baseline FA and cytokine concentrations and compared FA concentrations between the acute episode and >1 year post-convalescence in a subgroup. DHA was positively related to progression to DHF/DSS (multivariable adjusted OR (AOR) for DHA in quintile 5 v. 1=5·34, 95 % CI 2·03, 14·1; Ptrend=0·007). Dihomo-γ-linolenic acid (DGLA) was inversely associated with progression (AOR for quintile 5 v. 1=0·30, 95 % CI 0·13, 0·69; Ptrend=0·007). Pentadecanoic acid concentrations were inversely related to DHF/DSS. Correlations of PUFA with cytokines at baseline were low. PUFA were lower during the acute episode than in a disease-free period. In conclusion, serum DHA in patients with DF predicts higher odds of progression to DHF/DSS whereas DGLA and pentadecanoic acid predict lower odds.
In this overview we discuss the palliative psychiatric care of older people towards the end of life. We briefly consider ethics, dementia care, delirium, depression, anxiety, grief and physician-assisted suicide. We also discuss hope, dignity, spirituality and existentialism. We hope that this article will encourage clinicians to reflect on the effects of terminal illnesses on the mental health of dying people and the current provision of palliative psychiatric care.
•Appreciate that patient-centred care builds on providing individualised care for the dying person to meet their needs and wishes
•Understand the collaborative role of psychiatry in assessing the aetiology and appropriate response to patients presenting with problems of loss, grief, anxiety, depression, hopelessness, suicidal ideation, personality change and confusion
•Recognise that maintaining hope and living with hope is a way for terminally ill patients to endure and cope with their suffering
Current policy emphasises the importance of ‘living well’ with dementia, but there has been no comprehensive synthesis of the factors related to quality of life (QoL), subjective well-being or life satisfaction in people with dementia. We examined the available evidence in a systematic review and meta-analysis. We searched electronic databases until 7 January 2016 for observational studies investigating factors associated with QoL, well-being and life satisfaction in people with dementia. Articles had to provide quantitative data and include ⩾75% people with dementia of any type or severity. We included 198 QoL studies taken from 272 articles in the meta-analysis. The analysis focused on 43 factors with sufficient data, relating to 37639 people with dementia. Generally, these factors were significantly associated with QoL, but effect sizes were often small (0.1–0.29) or negligible (<0.09). Factors reflecting relationships, social engagement and functional ability were associated with better QoL. Factors indicative of poorer physical and mental health (including depression and other neuropsychiatric symptoms) and poorer carer well-being were associated with poorer QoL. Longitudinal evidence about predictors of QoL was limited. There was a considerable between-study heterogeneity. The pattern of numerous predominantly small associations with QoL suggests a need to reconsider approaches to understanding and assessing living well with dementia.