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Although the impact of diarrhoeal disease on paediatric health in Nigeria has decreased in recent years, it remains an important cause of morbidity and mortality in children under 5 years. Rotavirus is recognised as an important aetiological agent, but information on the contribution of intestinal protozoa to watery diarrhoea in this age group in Nigeria is scarce. In this cross-sectional study, faecal samples from children admitted to healthcare centres in Abakaliki, Nigeria with acute watery diarrhoea (N = 199) and faecal samples from age-matched controls (N = 37) were examined for Cryptosporidium and Giardia using immunofluorescent antibody testing and molecular methods. Cryptosporidium was identified in 13 case samples (6.5%) and no control samples. For three samples, molecular characterisation indicated C. hominis, GP60 subtypes IaA30R3, IaA14R3 and IdA11. Giardia was not detected in any samples. This contrast in prevalence between the two intestinal protozoa may reflect their variable epidemiologies and probably differing routes of infection. Given that these two parasitic infections are often bracketed together, it is key to realise that they not only have differing clinical spectra but also that the importance of each parasite is not the same in different age groups and/or settings.
There is much epidemiological evidence suggesting a reduced risk of development of type 2 diabetes (T2D) in habitual coffee drinkers, however to date there have been few longer-term interventions, directly examining the effects of coffee intake on glucose and lipid metabolism. Previous studies may be confounded by inter-individual variation in caffeine metabolism. Specifically, the rs762551 SNP in the CYP1A2 gene has been demonstrated to influence caffeine metabolism, with carriers of the C allele considered to be of a ‘slow’ metaboliser phenotype. This study investigated the effects of regular coffee intake on markers of glucose and lipid metabolism in coffee-naïve individuals, with novel analysis by rs762551 genotype. Participants were randomised to either a coffee group (n 19) who consumed four cups/d instant coffee for 12 weeks or a control group (n 8) who remained coffee/caffeine free. Venous blood samples were taken pre- and post-intervention. Primary analysis revealed no significant differences between groups. Analysis of the coffee group by genotype revealed several differences. Before coffee intake, the AC genotype (‘slow’ caffeine metabolisers, n 9) displayed higher baseline glucose and NEFA than the AA genotype (‘fast’ caffeine metabolisers, n 10, P<0·05). Post-intervention, reduced postprandial glycaemia and reduced NEFA suppression were observed in the AC genotype, with the opposite result observed in the AA genotype (P<0·05). These observed differences between genotypes warrant further investigation and indicate there may be no one-size-fits-all recommendation with regard to coffee drinking and T2D risk.
The correlation between ATP concentration and bacterial burden in the patient care environment was assessed. These findings suggest that a correlation exists between ATP concentration and bacterial burden, and they generally support ATP technology manufacturer-recommended cutoff values. Despite relatively modest discriminative ability, this technology may serve as a useful proxy for cleanliness.
VLBI observations at 2.3 GHz of SN1987A on 28 February 1987 yielded no fringes, implying, for an optically thin shell, a lower bound on the (outer) diameter of 1.9 mas. From the comparison of the VLBI and optical results, we infer that the radiosphere of SN1987A was either about equal to, or larger than, the photosphere of the supernova five days after the explosion.
Sediments from the Antarctic continental margin may provide detailed palaeoenvironmental records for Antarctic shelf waters during the late Quaternary. Here we present results from a palaeoenvironmental study of two sediment cores recovered from the continental shelf off Mac. Robertson Land, East Antarctica. These gravity cores were collected approximately 90 km apart from locations on the inner and outer shelf. Both cores are apparently undisturbed sequences of diatom ooze mixed with fine, quartz-rich sand. Core stratigraphies have been established from radiocarbon analyses of bulk organic carbon. Down-core geochemical determinations include the lithogenic components AÍ and Fe, biogenic components opal and organic carbon, and palaco-redox proxies Mn, Mo and U. We use the geochemical data to infer past variations in the deposition of biogenic and lithogenic materials, and the radiocarbon dates to estimate average sediment accumulation rates. The Holocene record of the outer-shelf core suggests three episodes of enhanced diatom export production at about 1.8, 3.8 and 5.5 ka BP, as well as less pronounced bloom episodes which occurred over a shorter period. Average sediment accumulation rates at this location range from 13.7 cm ka−1 in the late Pleistocene early Holocene to 82 cm ka−1 in the late Holocene, and suggest that the inferred episodes of enhanced biogenic production lasted 100-1000 years. in contrast, data for the inner-shelf core suggest that there has been a roughly constant proportion of biogenic and lithogenic material accumulating during the middle to late Holocene, with a greater proportion of biogenic material relative to the outer shelf. Notably, there is an approximately 7-fold increase in average sediment accumulation rate (from 24.5 to 179 cm ka−1) at this inner-shelf location between the middle and late Holocene, with roughly comparable increases in the mass accumulation rates of both biogenic and lithogenic material. This may represent changes in sediment transport processes, or reflect real increases in pelagic sedimentation in this region during the Holocene. Our results suggest quite different sedimentation regimes in these two shelf locations during the middle to late Holocene.
The Mesaoria (Mesarya) Basin exemplifies multi-stage basin development within a regional setting of diachronous continental collision. The Plio-Pleistocene represented a period of major sediment accumulation between two topographic highs, the Kyrenia Range in the north and the Troodos Massif in the south. During Pliocene time, open-marine marls and chalks of the Nicosia (Lefkoşa) Formation accumulated in a shelf setting. The Early Pleistocene period was characterized by a relative fall in sea level and a change to shallower-water bioclastic deposition of the Athalassa (Gürpınar) Formation. The northern margin of the basin was approximately delineated by the E–W neotectonic Ovgos (Dar Dere) fault zone. A carbonate ramp system formed directly to the south of this structural feature. During Early Pleistocene time, the basin evolved from an open-marine shelf to semi-enclosed lagoons with deltaic deposits, and finally to a non-marine aeolian setting, flanked by the rising Kyrenia Range to the north. Synthesis of geological evidence from the Mesaoria (Mesarya) Basin as a whole, including outcrop and borehole evidence from the south, adjacent to the Troodos Massif, indicates that the Pliocene – Early Pleistocene represented a relatively quiescent period. This intervened between Late Miocene – earliest Pleistocene southward thrusting–folding of the Kyrenia Range and Pleistocene intense surface uplift of both the Kyrenia Range and the Troodos Massif. The basin development reflects flexurally controlled collapse during Late Miocene – earliest Pliocene time related to southward thrusting, followed by strike-slip during westward tectonic escape of Anatolia, and finally regional uplift controlled by under-thrusting of continental crust from the south, as collision progressed.
Universal screening for postpartum depression is recommended in many countries. Knowledge of whether the disclosure of depressive symptoms in the postpartum period differs across cultures could improve detection and provide new insights into the pathogenesis. Moreover, it is a necessary step to evaluate the universal use of screening instruments in research and clinical practice. In the current study we sought to assess whether the Edinburgh Postnatal Depression Scale (EPDS), the most widely used screening tool for postpartum depression, measures the same underlying construct across cultural groups in a large international dataset.
Ordinal regression and measurement invariance were used to explore the association between culture, operationalized as education, ethnicity/race and continent, and endorsement of depressive symptoms using the EPDS on 8209 new mothers from Europe and the USA.
Education, but not ethnicity/race, influenced the reporting of postpartum depression [difference between robust comparative fit indexes (∆*CFI) < 0.01]. The structure of EPDS responses significantly differed between Europe and the USA (∆*CFI > 0.01), but not between European countries (∆*CFI < 0.01).
Investigators and clinicians should be aware of the potential differences in expression of phenotype of postpartum depression that women of different educational backgrounds may manifest. The increasing cultural heterogeneity of societies together with the tendency towards globalization requires a culturally sensitive approach to patients, research and policies, that takes into account, beyond rhetoric, the context of a person's experiences and the context in which the research is conducted.
Radiocarbon, δ13C and major-element data were used to construct a geochemical framework for interpretation of the hydrological flow system in the lower San Pedro basin, southeastern Arizona, USA. The 14C and major-element data show a regional confined aquifer that extends throughout most of the basin. Groundwater ages, after correcting for chemistry, are greater than 10 ka bp. The groundwater ages do not increase in a downvalley direction, the assumed direction of groundwater movement in most intermontane basins in the region, but along general flow paths normal to the mountains toward the center of the basin. Recharge to the confined aquifer originates from infiltration of precipitation and runoff near the alluvium-mountain contact along the Galiuro Mountains and is discharged by evapotranspiration along the center of the basin. The hydrogeological concept of the 14C model is supported by the water chemistry and by the mass transfer defined by the chemical model. Weathering of primary silicate minerals in the confined aquifer does not occur downvalley, but only along the direction of flow. Hydraulic conductivities calculated for the aquifer from 14C velocities are about an order of magnitude slower than those determined through hydrological methods. The lower hydraulic-conductivity values are attributed to a thick confining layer overlying the discharge area along the San Pedro River.
Many adults with autism spectrum disorder (ASD) remain undiagnosed. Specialist assessment clinics enable the detection of these cases, but such services are often overstretched. It has been proposed that unnecessary referrals to these services could be reduced by prioritizing individuals who score highly on the Autism-Spectrum Quotient (AQ), a self-report questionnaire measure of autistic traits. However, the ability of the AQ to predict who will go on to receive a diagnosis of ASD in adults is unclear.
We studied 476 adults, seen consecutively at a national ASD diagnostic referral service for suspected ASD. We tested AQ scores as predictors of ASD diagnosis made by expert clinicians according to International Classification of Diseases (ICD)-10 criteria, informed by the Autism Diagnostic Observation Schedule-Generic (ADOS-G) and Autism Diagnostic Interview-Revised (ADI-R) assessments.
Of the participants, 73% received a clinical diagnosis of ASD. Self-report AQ scores did not significantly predict receipt of a diagnosis. While AQ scores provided high sensitivity of 0.77 [95% confidence interval (CI) 0.72–0.82] and positive predictive value of 0.76 (95% CI 0.70–0.80), the specificity of 0.29 (95% CI 0.20–0.38) and negative predictive value of 0.36 (95% CI 0.22–0.40) were low. Thus, 64% of those who scored below the AQ cut-off were ‘false negatives’ who did in fact have ASD. Co-morbidity data revealed that generalized anxiety disorder may ‘mimic’ ASD and inflate AQ scores, leading to false positives.
The AQ's utility for screening referrals was limited in this sample. Recommendations supporting the AQ's role in the assessment of adult ASD, e.g. UK NICE guidelines, may need to be reconsidered.
Blazar OJ 287 is one of the best observed extragalactic objects. It's historical light curve goes back to 1890′s. Based on the historical behaviour Sillanpää et al. (1988) showed that OJ 287 displays large periodic outbursts, with a period of 11.7 years. We have monitored OJ 287 intensively for two years, during the OJ-94 project. This project was created for monitoring OJ 287 during its predicted new outburst in 1994. In the data archive we have over 7000 observations on OJ 287, in the radio, infrared and optical bands. This data archive contains the best ever obtained light curves for any extragalactic object. The optical light curve shows continuous variability down to time scales of tens of minutes. The variability observed in OJ 287 can be broken down to (at least) four different categories:
The objective of this study was to assess the use of statistical algorithms in identifying significant clusters of Salmonella spp. across different sectors of the food chain within an integrated surveillance programme. Three years of weekly Salmonella serotype data from farm animals, meat, and humans were used to create baseline models (first two years) and identify weeks with counts higher than expected using surveillance algorithms in the third (test) year. During the test year, an expert working group identified events of interest reviewing descriptive analyses of same data. The algorithms did not identify Salmonella events presenting as gradual increases or seasonal patterns as identified by the working group. However, the algorithms did identify clusters for further investigation, suggesting they could be a valuable complementary tool within an integrated surveillance system.
Previous studies regarding the acute effects of coffee on glycaemic control have used a single large dose of coffee, typically containing the caffeine equivalent of 2–4 servings of coffee. This study investigates whether the acute effects of coffee are dose-dependent, starting with a single serving. A total of ten healthy overweight males participated in a two-part randomised double-blind cross-over study. In the first part, they ingested 2, 4 or 8 g instant decaffeinated coffee (DC) dissolved in 400 ml water with caffeine added in proportion to the DC (total 100, 200 or 400 mg caffeine) or control (400 ml water) all with 50 g glucose. In the second part, they ingested the same amounts of DC (2, 4, 8 g) or control, but with a standard 100 mg caffeine added to each. Capillary blood samples were taken every 15 min for 2 h after each drink and glucose and insulin levels were measured. Repeated measures ANOVA on glucose results found an effect when caffeine was varied in line with DC (P=0·008). Post hoc analysis revealed that both 2 and 4 g DC with varied caffeine content increased the glycaemic response v. control. There was no effect of escalating doses of DC when caffeine remained constant at 100 mg. These results demonstrate that one standard serving of coffee (2 g) is sufficient to affect glucose metabolism. Furthermore, the amount of caffeine found in one serving (100 mg) is sufficient to mask any potential beneficial effects of increasing other components. No dose-dependent effect was found.
A primary otological presentation of granulomatosis with polyangiitis is rare. We present four cases of granulomatosis with polyangiitis with different otological manifestations.
A literature review of granulomatosis with polyangiitis cases presenting to otolaryngologists was undertaken. A case series review of four patients presenting within a 12-month period was also performed. One patient had serous otitis media which worsened after myringotomy. Two patients presented with acute ear infection and facial palsy and one with acute mastoiditis. All were positive for antineutrophilic cytoplasmic antibody, and three had positive findings upon histological analysis.
When acute supposed ear infections fail to respond to treatment (antibiotics or surgery), rarer causes of the symptoms should be considered. By reporting this case series, we aim to improve the early diagnosis of granulomatosis with polyangiitis to enable timely treatment and prevent systemic involvement.