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Avian malaria is a mosquito-borne disease caused by Plasmodium spp. protozoa. Although these parasites have been extensively studied in North America and Eurasia, knowledge on the diversity of Plasmodium, its vectors and avian hosts in Africa is scarce. In this study, we report on natural malarial infections in free-ranging sparrows (Passer domesticus) sampled at Giza Governorate, Egypt. Parasites were morphologically characterized as Plasmodium cathemerium based on the examination of thin blood smears from the avian host. Sequencing a fragment of the mitochondrial cytochrome b gene showed that the parasite corresponded to lineage PADOM02. Phylogenetic analysis showed that this parasite is closely related to the lineages SERAU01 and PADOM09, both of which are attributed to P. cathemerium. Experimental infection of Culex pipiens complex was successful, with ookinetes first detected at 1-day post infection (dpi), oocysts at 4 dpi and sporozoites at 6 dpi. The massive infection of the salivary glands by sporozoites corroborates that Cx. pipiens complex is a competent vector of PADOM02. Our findings confirm that Plasmodium lineage PADOM02 infects sparrows in urban areas along the Nile River, Egypt, and corroborate that Cx. pipiens complex is a highly competent vector for these parasites. Furthermore, our results demonstrate that this lineage corresponds to the morphospecies P. cathemerium and not P. relictum as previously believed.
To investigate a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak event involving multiple healthcare facilities in Riyadh, Saudi Arabia; to characterize transmission; and to explore infection control implications.
Cases presented in 4 healthcare facilities in Riyadh, Saudi Arabia: a tertiary-care hospital, a specialty pulmonary hospital, an outpatient clinic, and an outpatient dialysis unit.
Contact tracing and testing were performed following reports of cases at 2 hospitals. Laboratory results were confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) and/or genome sequencing. We assessed exposures and determined seropositivity among available healthcare personnel (HCP) cases and HCP contacts of cases.
In total, 48 cases were identified, involving patients, HCP, and family members across 2 hospitals, an outpatient clinic, and a dialysis clinic. At each hospital, transmission was linked to a unique index case. Moreover, 4 cases were associated with superspreading events (any interaction where a case patient transmitted to ≥5 subsequent case patients). All 4 of these patients were severely ill, were initially not recognized as MERS-CoV cases, and subsequently died. Genomic sequences clustered separately, suggesting 2 distinct outbreaks. Overall, 4 (24%) of 17 HCP cases and 3 (3%) of 114 HCP contacts of cases were seropositive.
We describe 2 distinct healthcare-associated outbreaks, each initiated by a unique index case and characterized by multiple superspreading events. Delays in recognition and in subsequent implementation of control measures contributed to secondary transmission. Prompt contact tracing, repeated testing, HCP furloughing, and implementation of recommended transmission-based precautions for suspected cases ultimately halted transmission.
Public health authorities recommend all fertile women to increase their folate intake to 400 µg/d by eating folate-rich foods or by taking a folic acid supplement to protect against neural tube defects. In a previous study it was shown that folate-rich foods improved folate blood status as effectively as folic acid supplementation. The aim of the present study was to investigate, using NMR metabolomics, the effects of an intervention with a synthetic folic acid supplement v. native food folate on the profile of plasma metabolites. Healthy women with normal folate status received, in parallel, 500 µg/d synthetic folic acid from a supplement (n 18), 250 µg/d folate from intervention foods (n 19), or no additional folate (0 µg/d) through a portion of apple juice (n 20). The metabolic profile of plasma was measured using 1H-NMR in fasted blood drawn at baseline and after 12 weeks of intervention. Metabolic differences between the groups at baseline and after intervention were assessed using a univariate statistical approach (P ≤ 0·001, Bonferroni-adjusted significance level). At baseline, the groups showed no significant differences in measured metabolite concentrations. After intervention, eight metabolites, of which six (glycine, choline, betaine, formate, histidine and threonine) are related to one-carbon metabolism, were identified as discriminative metabolites. The present study suggests that different folate forms (synthetic v. natural) may affect related one-carbon metabolites differently.
The Middle East respiratory syndrome coronavirus (MERS-CoV) is a life-threatening respiratory disease with a high case fatality rate; however, its risk factors remain unclear. We aimed to explore the influence of demographic factors, clinical manifestations and underlying comorbidities on mortality in MERS-CoV patients. Retrospective chart reviews were performed to identify all laboratory-confirmed cases of MERS-COV infection in Saudi Arabia that were reported to the Ministry of Health of Saudi Arabia between 23 April 2014 and 7 June 2016. Statistical analyses were conducted to assess the effect of sex, age, clinical presentation and comorbidities on mortality from MERS-CoV. A total of 281 confirmed MERS-CoV cases were identified: 167 (59.4%) patients were male and 55 (20%) died. Mortality predominantly occurred among Saudi nationals and older patients and was significantly associated with respiratory failure and shortness of breath. Of the 281 confirmed cases, 160 (56.9%) involved comorbidities, wherein diabetes mellitus, hypertension, ischemic heart disease, congestive heart failure, end-stage renal disease and chronic kidney disease were significantly associated with mortality from MERS-CoV and two or three comorbidities significantly affected the fatality rates from MERS-CoV. The findings of this study show that old age and the existence of underlying comorbidities significantly increase mortality from MERS-CoV.
Nitric oxide (NO) plays various roles in insect immunity: as a cytotoxic component and as a signalling molecule; and immune-reactive lysozymes (IrLys) provide a first line of humoral immune functions against invading bacteria. Although there is considerable literature on eicosanoid and biogenic monoamine actions on insect immunity, there is no information on the role(s) of these chemicals in inducing NO and IrLys. We addressed this gap by challenging third instar Sarcophaga (Liopygia) argyrostoma (Robineau-Desvoidy) with the Gram-positive bacterium Micrococcus luteus. Here, we report that bacterial challenge induces elevation of NO and IrLys concentrations in haemocytes and in the fat body. The plasma pool content is comparatively low. Eicosanoid biosynthesis inhibitors (EBIs) lead to suppression of both NO and IrLys levels. Control larvae have low constitutive levels of NO and lysozyme concentrations. Octopamine (OA) elicits elevation of NO and IrLys concentrations. A similar effect is obtained by 5-hydroxytryptamine (5-HT) for NO. These data indicate immune-mediating roles of eicosanoids, OA and 5-HT in NO and IrLys activities.
This work aims to develop simple and cost-effective methods in reduction of Cr(VI) from water to less toxic and easy separated Cr(III) using Titanium dioxide (TiO2).
TiO2 nanoparticles are prepared by a sol-gel method using titanium tetra-chloride and characterized using X-Ray Diffraction (XRD), Scanning electron microscope (SEM), Energy dispersive X-ray Fluorescence spectrometer (EDX) and UV-visible spectroscopy. XRD shows Anatase structure of TiO2 after annealing at 600°C for four hours. The particles size is estimated to be 70 nm using SEM.UV-Visible spectroscopy indicated that TiO2 nanoparticles played important role in decreasing the concentration of Cr (VI) in water samples for different pH range of 1 to 4. The decrease in Cr(VI) concentration after the treatment is ascribed to the reduction caused by the photocatalyst effect that resulted from the presence of TiO2 nanoparticle in water samples under direct exposure to direct sunlight.
Top-down biomedical interventions to control schistosomiasis in sub-Saharan Africa have had limited success, primarily because they fail to engage with the social, political, economic and ecological contexts in which they are delivered. Despite the call to foster community engagement and to adapt interventions to local circumstances, programmes have rarely embraced such an approach. This article outlines a community co-designed process, based upon Human-Centered Design, to demonstrate how this approach works in practice. It is based on initial work undertaken by social science researchers, public health practitioners and community members from the Zanzibar Islands, Tanzania, between November 2011 and December 2013. During the process, 32 community members participated in a qualitative and quantitative data-driven workshop where they interpreted data on local infections from S. haematobium and co-designed interventions with the assistance of a facilitator trained in the social sciences. These interventions included the implementation of novel school-based education and training, the identification of relevant safe play activities and events at local schools, the installation of community-designed urinals for boys and girls and the installation of community-designed laundry-washing platforms to reduce exposure to cercariae-contaminated fresh water. It is suggested that the a community co-designed process, drawing from Human-Centered Design principles and techniques, enables the development of more sustainable and effective interventions for the control of schistosomiasis.
Religious laws do not usually forbid the use of psychotropic medication, but many do forbid the consumption of animal-based derivatives of bovine and/or porcine origin (e.g. gelatin and stearic acid) such as are found in many medications. Demonstrating awareness of this, combined with a genuine concern about how it affects the patient, may strengthen the doctor—patient relationship and avoid non-adherence. In this article, we outline dietary requirements of key religions and belief systems that may have a bearing when prescribing medication containing animal-based ingredients. We identify common psychotropics that contain animal-based derivatives and suggest alternative prescribing options and approaches to dealing with sensitive ethical issues.
In the Kingdom of Saudi Arabia (KSA), Old World cutaneous leishmaniasis (CL) is mainly caused by Leishmania major and Leishmania tropica parasites. Diagnosis of CL is predominately made by clinicians, who at times fail to detect the disease and are unable to identify parasite species. Here, we report the development of a chemiluminescent enzyme-linked immunosorbent assay (CL-ELISA) to measure the levels of anti-α-galactosyl antibodies in human sera. Using this assay, we have found that individuals infected with either Leishmania spp. had significantly elevated levels (up to 9-fold higher) of anti-α-Gal IgG compared to healthy control individuals. The assay sensitivity was 96% for L. major (95% CI; 94–98%) and 91% for L. tropica (95% CI; 86–98%) infections and therefore equivalent to restriction fragment length polymorphism-polymerase chain reaction analysis of parasite ITS1 gene. In addition, the assay had higher sensitivity than microscopy analysis, which only detected 68 and 45% of the L. major and L. tropica infections, respectively. Interestingly, up to 2 years following confirmed CL cure individuals had 28-fold higher levels of anti-α-Gal IgG compared to healthy volunteers. Monitoring levels of anti-α-Gal antibodies can be exploited as both a diagnostic tool and as a biomarker of cure of Old World CL in disease elimination settings.
We review clinical, neuroimaging, and genetic information on six individuals with isolated sulfite oxidase deficiency (ISOD).
All patients were examined, and clinical records, biochemistry, neuroimaging, and sulfite oxidase gene (SUOX) sequencing were reviewed.
Data was available on six individuals from four nuclear families affected by ISOD. Each individual began to seize within the first week of life. neurologic development was arrested at brainstem reflexes, and severe microcephaly developed rapidly. neuroimaging within days of birth revealed hypoplasia of the cerebellum and corpus callosum and damage to the supratentorial brain looking like severe hypoxic-ischemic injury that evolved into cystic hemispheric white matter changes. Affected individuals all had elevated urinary S-sulfocysteine and normal urinary xanthine and hypoxanthine levels diagnostic of ISOD. Genetic studies confirmed SUOX mutations in four patients.
ISOD impairs systemic sulfite metabolism, and yet this genetic disease affects only the brain with damage that is commonly confused with the clinical and radiologic features of severe hypoxic-ischemic encephalopathy.
This study aimed at exploring the experiences of primary health-care providers of their encounters with patients with type 2 diabetes, and their preferences and suggestions for future improvement of diabetes care.
Barriers to good diabetes care could be related to problems from health-care providers’ side, patients’ side or the health-care system of the country. Treatment of patients with type 2 diabetes has become a huge challenge in Oman, where the prevalence has increased to high levels.
Semi-structured interviews were conducted with 26 health-care professionals, 19 doctors and seven nurses, who worked in primary health care in Oman. Qualitative content analysis was applied.
Organizational barriers and barriers related to patients and health-care providers were identified. These included workload and lack of teamwork approach. Poor patients’ management adherence and influence of culture on their attitudes towards illness were identified. From the providers’ side, language barriers, providers’ frustration and aggressive attitudes towards the patients were reflected. Decreasing the workload, availability of competent teams with diabetes specialist nurses and continuity of care were suggested. Furthermore, changing professional behaviours towards a more patient-centred approach and need for health education to the patients, especially on self-management, were addressed. Appropriate training for health-care providers in communication skills with emphasis on self-care education and individualization of care according to each patient's needs are important for improvement of diabetes care in Oman.
This article reviews the literature of multimedia glosses in computer assisted language learning (CALL) and their effects on L2 vocabulary acquisition during the past seventeen years. Several studies have touched on this area to examine the potential of multimedia in a CALL environment in aiding L2 vocabulary acquisition. In this review, the researchers investigate the studies that deal with different modes of multimedia annotations in a CALL environment. This article reviews the empirical studies of multimedia glosses in reading as well as in listening comprehension activities and discusses the factors under which these studies have been conducted and their impact on L2 vocabulary acquisition. The study aims to understand how multimedia glosses have been used in the past to support second language vocabulary acquisition and also to explore any evidence regarding how multimedia glosses in a CALL environment can enhance the acquisition of L2 vocabulary. Only empirical studies (18 studies published in international refereed journals and conference) have been reviewed exclusively. The article discusses the findings of the reviewed studies and recommends future research.
Triassic lungfish (Dipnoi) have been extensively documented from the Gondwanan continental and marine shelf deposits of Africa and Madagascar (Teixeira, 1949; Lehman et al., 1959; Beltan, 1968; Martin, 1979, 1981; Kemp 1996), Australia (Kemp, 1993, 1994, 1997a, 1998), India (Jain et al, 1964; Jain, 1968), and Antarctica (Dziewa, 1980). Numerous records also exist from Laurasian landmasses including Europe (Agassiz, 1838; Schultze, 1981), North America (Case, 1921) and central and eastern Asia (Liu and Yeh, 1957; Vorobyeva, 1967; Martin and Ingavat, 1982). By comparison, nothing is known of contemporary lungfish fossils from the Middle East. Thus, the recent recovery of a single tooth plate representing a new geographic occurrence of the genus Ceratodus Agassiz, 1838 from paralic marine deposits of the Jilh Formation, a latest Anisian to lower Carnian unit that crops out along the eastern margin of the Proterozoic Arabian Shield in central Saudi Arabia (Fig. 1), is significant because it provides the stratigraphically oldest record of dipnoans from the Arabian Peninsula.
Road traffic crashes (RTCs) are common in Qatar, and are now considered the third leading cause of mortality. In this study, the safety devices used by the Qatari public at the time of RTCs were assessed and the association between seatbelt use by vehicle occupants involved in RTCs and severe injury/death in the prehospital setting was determined.
This study was a retrospective case-control investigation. A Hamad Medical Corporation Emergency Medical Services (EMS) database of RTCs occurring from January 2006 to April 2007 was utilized for this study, providing a total of 5,267 patient records (83.5 % male, 16.5% female, median age = 28 years). Patient demographics, crash characteristics, prehospital assessments, and interventions were identified, and use of safety devices was determined. Univariate analysis including chi-square, Student's t-test, and analysis of variance (ANOVA) was performed as appropriate. “Case” patients are defined as those who had specific, critical prehospital assessments, or who received advanced cardio-respiratory life support measures in the field. Logistic regression modeling was used to predict the probability of a case being unbelted, controlling for confounders.
Seatbelt use in Qatar was low: 33.9% of males and 32.6% of females wore seatbelts at the time of the RTC. Victims involved in a vehicle rollover crash were less likely to be belted than were those involved in a non-rollover incident (26.2% belted vs. 37.8%; OR = 0.59; 95%CI = 0.50–0.68). Case patients—those with defined critical assessment findings or resuscitation in the field—and control patients were similar in age (30 years vs. 28 years median). Case patients were disproportionately male (89.1% vs. 83.2%; OR = 1.65; 95%CI = 1.01–2.83) and were more likely to be victims of a vehicle rollover crash (44.7% vs. 23.8%; OR = 2.57; 95%CI = 1.84–3.59). Seatbelt use was significantly lower among cases than controls: 19.7% of cases were reported to have worn seatbelts compared to 34.2% of controls (OR = 0.47; 95%CI = 0.31–0.69). This relationship also persisted (OR = 0.51; 95%CI = 0.33–0.76) after controlling for confounders.
Seatbelt use in Qatar is low. Seatbelts are protective: in the pre-hospital setting unbelted vehicle occupants involved in RTCs were nearly twice as likely to suffer severe injury or death compared to belted patients. Prehospital morbidity and mortality appears to be reduced significantly by the consistent use of seatbelts by the motoring population in Qatar.
Thin films of Zn
CdxO with x = 0, 0.1, 0.2, 0.3, 0.4 and 0.5
at.% were deposited by electron-beam evaporation technique. It has
been found that, for as-deposited films, both the transmittance and
electrical resistivity decreased with increasing the Cd content. To improve
the optical and electrical properties of these films, the effect of
annealing temperature and time were taken into consideration for Zn
CdxO film with x = 0.2. It was found that, the optical
transmittance and the electrical conductivity were improved significantly
with increasing the time of annealing. At fixed temperature of 300 °C,
the transmittance increased with increasing the time of annealing and
reached its maximum values of 81% in the visible region and 94% in the
NIR region at annealing time of 120 min. The low electrical resistivity of
3.6 × 10−3 Ω cm was achieved at the same conditions. Other
parameters named free carrier concentrations, refractive index, extinction
coefficient, plasma frequency, and relaxation time were studied as a
function of annealing temperature and time for 20% Cd content.
The effect of both annealing and In content on the properties
of ZnO films prepared by electron beam evaporation were investigated. The
evaporation was carried out at room temperature from bulk samples prepared
by sintering technique. X-ray diffraction showed that the structure of
ZnO-In2O3 films depends on both the In content and annealing
temperature. Amorphous, highly transparent and relatively low resistive
films which can be suitable for the usage as transparent electrode of
organic light-emitting diode were obtained upon annealing at 300
Partially crystalline, highly transparent and highly resistive films which
can be used in piezoelectric applications were obtained upon annealing at 500
C. For each composition the refractive index has no monotonic variation upon increasing annealing temperature.