Intravenous (IV) artesunate is the treatment of choice for severe malaria. In Europe, however, no GMP-manufactured product is available and treatment data in European travellers are scarce. Fortunately, artesunate became available in the Netherlands and Belgium through a named patient programme. This is the largest case series of artesunate treated patients with severe malaria in Europe.
Methods
Hospitalized patients treated with IV artesunate between November 2007 and December 2010 in the Netherlands and Belgium were retrospectively evaluated. Patient characteristics, treatment and clinical outcome were recorded on a standardized form and mortality, parasite clearance times and the occurrence of adverse events were evaluated.
Results
Of the 68 treated patients, including 55 with severe malaria, two patients died (2/55 = 3.6%). The mean time to 50% parasite clearance (PCT50), 90% and 99% were 4.4 hours (3.9 - 5.2), 14.8 hours (13.0 - 17.2), and 29.5 hours (25.9 - 34.4) respectively. Artesunate was well tolerated. However, an unusual form of haemolytic anaemia was observed in seven patients. The relationship with artesunate remains uncertain.
Conclusions
Data from the named patient programme demonstrate that IV artesunate is effective and well-tolerated in European travellers lacking immunity. However, increased attention needs to be paid to the possible development of haemolytic anaemia 2-3 weeks after start of treatment. Treatment of IV artesunate should be limited to the period that IV treatment is required and should be followed by a full oral course of an appropriate anti-malarial drug. 相似文献
The oviduct (or fallopian tube) serves as an environment for gamete transport, fertilization and preimplantation embryo development in mammals. Although there has been increasing evidence linking infertility with disrupted oviduct function, the specific roles that the oviduct plays in both normal and impaired reproductive processes remain unclear. The mouse is an important mammalian model to study human reproduction. However, most of the current analyses of the mouse oviduct rely on static histology or 2D visualization, and are unable to provide dynamic and volumetric characterization of this organ. The lack of imaging access prevents longitudinal live analysis of the oviduct and its associated reproductive events, limiting the understanding of mechanistic aspects of fertilization and preimplantation pregnancy. To address this limitation, we report a 3D imaging approach that enables prolonged functional assessment of the mouse oviduct in vivo. By combining optical coherence tomography with a dorsal imaging window, this method allows for extended volumetric visualization of the oviduct dynamics, which was previously not achievable. The approach is used for quantitative analysis of oviduct contraction, spatiotemporal characterization of cilia beat frequency and longitudinal imaging. This new approach is a useful in vivo imaging platform for a variety of live studies in mammalian reproduction. 相似文献
Optical coherence tomography through an implanted dorsal imaging window allows for prolonged in vivo structural and functional assessment of the mouse oviduct (Fallopian tube), including threedimensional structural imaging, quantitative measurements of the smooth muscle contraction, and mapping of cilia beat frequency. This method brings new opportunities for live studies and longitudinal analyses of mouse reproductive events in the native context. Further details can be found in the article by Shang Wang et al. ( e201700316 ).
Comparative analyses have sought to explain variation in human marriage patterns, often using predictions derived from sexual selection theory. However, most previous studies have not controlled for non-independence of populations due to shared ancestry. Here we leverage a phylogenetic supertree of human populations that includes all 186 populations in the Standard Cross-Cultural Sample (SCCS), a globally representative and widely-used sample of human populations. This represents the most comprehensive human phylogeny to date, and allows us not only to control for non-independence, but also to quantify the role of population history in explaining behavioral variation, in addition to current socio-ecological conditions. We use multiple imputation to overcome missing data problems and build a comprehensive Bayesian phylogenetic model of marriage patterns with two correlated response variables and eleven minimally collinear predictors capturing various socio-ecological conditions. We show that ignoring phylogeny could lead to both false positives and false negatives, and that the phylogeny explained about twice as much variance as all the predictors combined. Pathogen stress and assault frequency emerged as the predictors most strongly associated with polygyny, which had been considered evidence for female choice of good genes and male intra-sexual competition or male coercion, respectively. Mixed support was found for a polygyny threshold based on variance in male wealth, which is discussed in light of recent theory. Barring caveats, these findings refine our understanding of the evolution of human marriage systems, and highlight the value of combining population history and current socio-ecology in explaining human behavioral variation. Future studies using the SCCS should do so using the present supertree. 相似文献
The present study examined the relation between ethnic identity and indicators of positive youth development (PYD) in a sample of low-income, urban Black and Latino male youth (N = 254; 66% Black, mean age = 14). Using structural equation modeling, a two-factor model of PYD and ethnic identity was found to provide the best fit to the data with a significant, positive relation between the two factors. At age 14, PYD was positively related to concurrent involvement in prosocial activities, and negatively related to criminal and externalizing behaviors; ethnic identity was related to lower levels of internalizing symptoms. The PYD factor was also related to higher prosocial activity involvement and lower criminal offending at age 15. The findings suggest that male Black and Latino teens living in urban poverty have intrapersonal competencies that promote healthy outcomes and that integration of culturally-relevant factors can enhance our understanding of positive youth development. 相似文献
The effects of varying interrepetition rest and eccentric velocity on power output (PO) and the number of repetitions performed during a bench press set were examined in 24 college-aged resistance trained men. On 6 separate occasions, subjects performed a set of bench press at 80% 1 repetition maximum until volitional fatigue. For each of the 6 repetition tempo trials, the bench press set was paced by metronome to a unique repetition tempo involving a combination of the following: interrepetition rest of 0 or 4 seconds; eccentric velocity of 1 or 4 seconds and bottom rest of 0 or 3 seconds. The velocity of concentric contraction was maximal during all 6 tempo trials. During each trial, video data were captured to determine PO variables and number of successful repetitions completed at each tempo. One-way repeated measures analysis of variance showed tempos with a fast eccentric phase (1 second), and no bottom rest produced significantly greater (p ≤ 0.05) PO and repetitions than tempos involving slower eccentric velocity (4 seconds) or greater bottom rest (4 seconds). This combination of greater repetitions and PO resulted in a greater volume of work. Varying interrepetition rest (1 or 4 seconds) did not significantly affect PO or repetitions. The results of this study support the use of fast eccentric speed and no bottom rest during acute performance testing to maximize PO and number of repetitions during a set of bench press. 相似文献
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