The Incidence of Human Cysticercosis in a Rural Community of Eastern Zambia

A community-based longitudinal study was performed in the Eastern Province of Zambia, in which repeated serological samplings were done to determine the incidence of human cysticercosis. Three sampling rounds were carried out at six months intervals. A total of 867 participants presented for all three samplings. All samples were tested for the presence of cysticercus antigens using a monoclonal antibody-based enzyme-linked immunosorbent assay (sero-Ag-ELISA), while a randomly selected sub-sample of 161 samples from each sampling round was tested for specific antibodies using a commercial enzyme-linked immunoelectrotransfer blot (EITB) assay. Stool samples (n = 226) were also collected during the final round of sampling for taeniosis diagnosis by coprology and coproantigen ELISA. Cysticercosis seroprevalence varied from 12.2% to 14.5% (sero-Ag) and from 33.5% to 38.5% (sero-Ab) during the study period. A taeniosis prevalence of 11.9% was determined. Incidence rates of 6300 (sero-Ag, per 100000 persons-year) and 23600 (sero-Ab, per 100000 persons-year) were determined. Seroreversion rates of 44% for sero-Ag and 38.7% for sero-Ab were recorded over the whole period. In conclusion, this study has shown the dynamic nature of T. solium infections; many of the people at risk become (re)infected due to the high environmental contamination, with a high number turning seronegative within a year after infection. An important number of infections probably never fully establish, leading to transient antibody responses and short-term antigen presence.     

Copeptin as a Marker for Severity and Prognosis of Aneurysmal Subarachnoid Hemorrhage

Background

Grading of patients with aneurysmal subarachnoid hemorrhage (aSAH) is often confounded by seizure, hydrocephalus or sedation and the prediction of prognosis remains difficult. Recently, copeptin has been identified as a serum marker for outcomes in acute ischemic stroke and intracerebral hemorrhage (ICH). We investigated whether copeptin might serve as a marker for severity and prognosis in aSAH.

Methods

Eighteen consecutive patients with aSAH had plasma copeptin levels measured with a validated chemiluminescence sandwich immunoassay. The primary endpoint was the association of copeptin levels at admission with the World Federation of Neurological Surgeons (WFNS) grade score after resuscitation. Levels of copeptin were compared across clinical and radiological scores as well as between patients with ICH, intraventricular hemorrhage, hydrocephalus, vasospasm and ischemia.

Results

Copeptin levels were significantly associated with the severity of aSAH measured by WFNS grade (P = 0.006), the amount of subarachnoid blood (P = 0.03) and the occurrence of ICH (P = 0.02). There was also a trend between copeptin levels and functional clinical outcome at 6-months (P = 0.054). No other clinical outcomes showed any statistically significant association.

Conclusions

Copeptin may indicate clinical severity of the initial bleeding and may therefore help in guiding treatment decisions in the setting of aSAH. These initial results show that copeptin might also have prognostic value for clinical outcome in aSAH.     

Six-Minute Walk Test: Reference Values and Prediction Equation in Healthy Boys Aged 5 to12 Years

OBJECTIVE

This study aimed to (1) generate normative data in healthy boys aged 5–12 years for the six-minute walk test (6MWT), an outcome measure currently used in clinical trials in Duchenne muscular dystrophy (DMD), (2) to describe the relation with anthropometric variables and myometry, and (3) to compare our data with published equations.

METHODS

The 6MWT was conducted in 442 boys according to a standardized protocol, as currently used in clinical trials in DMD. Maximal voluntary isometric contractions for knee flexion and extension were recorded with a hand-held myometer.

RESULTS

The 6MWD increased significantly with age, from 478.0±44.1 m at age 5, to 650.0±76.8 m at age 12, with the steepest increase between 5 and 8 years. Age- and height related percentile curves of the 6MWD were developed. Correlations with anthropometric variables were fair to good (age r = 0.60, height r = 0.57, weight r = 0.44). Myometric variables (knee flexors and extensors) showed correlations of 0.46 and 0.50 respectively. When dividing into two age categories (5–8 years, 9–12 years), these magnitudes of correlations only applied to the younger age group. Additionally, predicted values were calculated according to available reference equations (Geiger and Ben Saad), indicating an overestimation by those equations. Finally, the Geiger equation was refitted to our population.

CONCLUSION

The percentile curves according to age and height provide a useful tool in the assessment of ambulatory capacity in boys aged 5 to 12 years. Significant correlations with anthropometric variables and myometry were only found in the 5–8 years age group. The Geiger prediction equation, currently used to assess ambulatory capacity in DMD was refitted to obtain a more accurate prediction model based on a large sample with a homogenous distribution across the age categories 5 to 12 years and applying the methodology as currently used in clinical trials in DMD.     

The Contribution of Emotional Partners to Sexual Risk Taking and Violence among Female Sex Workers in Mombasa,Kenya: A Cohort Study

Objectives

To assess sexual risk-taking of female sex workers (FSWs) with emotional partners (boyfriends and husbands), compared to regular and casual clients. Experiences of violence and the degree of relationship control that FSWs have with emotional partners are also described.

Design

Cohort study with quarterly follow-up visit over 12-months.

Methods

Four hundred HIV-uninfected FSWs older than 16 years were recruited from their homes and guesthouses in Mombasa, Kenya. A structured questionnaire assessed participant characteristics and study outcomes at each visit, and women received risk-reduction counselling, male and female condoms, and HIV testing.

Results

Four or more unprotected sex acts in the past week were reported by 21.3% of women during sex with emotional partners, compared to 5.8% with regular and 4.8% with casual clients (P<0.001). Total number of unprotected sex acts per week was 5–6-fold higher with emotional partners (603 acts with 259 partners) than with regular or casual clients (125 acts with 456, and 98 acts with 632 clients, respectively; P<0.001). Mostly, perceptions of “trust” underscored unprotected sex with emotional partners. Low control over these relationships, common to many women (36.9%), was linked with higher partner numbers, inconsistent condom use, and being physically forced to have sex by their emotional partners. Half experienced sexual or physical violence in the past year, similarly associated with partner numbers and inconsistent condom use.

Conclusions

High-risk sexual behaviour, low control and frequent violence in relationships with emotional partners heighten FSWs'' vulnerability and high HIV risk, requiring targeted interventions that also encompass emotional partners.     

Prevalence and correlates of poor sleep quality and daytime sleepiness in Belgian truck drivers

Sleepiness and sleep complaints are common among professional drivers. Sleepiness is a considerable problem not only because it affects the drivers' well-being, but also because of the consequences for performance and safety. Assessment of the (self-reported) prevalence and research into the risk factors are thus an important health issue and are also indispensable to prevent productivity loss and work-related accidents and injuries. Therefore, the aim of this study was to describe sleeping, driving, and health characteristics of Belgian truck drivers and to determine occupational and individual factors associated with poor sleep quality and daytime sleepiness. Cross-sectional data were collected using a self-administered questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Berlin Questionnaire (BQ). The mean (SD) age of the 476 studied truck drivers was 42.7 (10.2) yrs and the mean (SD) body mass index was 27.3 (5.1) kg/m(2). Approximately 47% declared that they drove >50 h/wk and found their work schedule unrealistic. The mean (SD) PSQI score was 4.45 (2.7); poor quality of sleep (PSQI >5) was found in 27.2%. The mean (SD) ESS score was 6.79 (4.17); 18% had a score >10. The BQ indicated that 21.5% had a higher risk on obstructive sleep apnea. In multiple logistic regression analysis, low educational level (odds ratio [OR] 1.86), current smoking (OR 1.75), unrealistic work schedule (OR 1.75), and risk for obstructive sleep apnea (OR 2.97) were found to be independent correlates of daytime sleepiness. Poor sleep quality was significantly associated with poor self-perceived health (OR 1.95), unrealistic work schedule (OR 2.85), low job satisfaction (OR 1.91), and less driving experience (OR 1.73). These results show that poor sleep quality and daytime sleepiness were prevalent in Belgian truck drivers. Taking into account that several significant correlates with respect to these sleep problems were identified both at the individual and the occupational level, comprehensive countermeasures to improve working conditions and organization are needed, as well as health promotion interventions, to ensure the safety and well-being of truck drivers.     

Recognition of cellular implants by the brain's innate immune system

Currently, much attention is given to the development of cellular therapies for treatment of central nervous system (CNS) injuries. Diverse cell implantation strategies, either to directly replace damaged neural tissue or to create a neuroregenerative environment, are proposed to restore impaired brain function. However, because of the complexity of the CNS, it is now becoming clear that the contribution of cell implantation into the brain will mainly act in a supportive manner. In addition, given the time dependence of neural development during embryonic and post-natal life, cellular implants, either self or non-self, will most likely have to interact for a sustained period of time with both healthy and injured neural tissue. The latter also implies potential recognition of cellular implants by the innate immune system of the brain. In this review, we will emphasize on preclinical observations in rodents, regarding the recognition and immunogenicity of autologous, allogeneic and xenogeneic cellular implants in the CNS of immune-competent hosts. Taken together, we here suggest that a profound study of the interaction between cellular grafts and the brain's innate immune system will be inevitable before clinical cell transplantation in the CNS can be performed successfully.     

UV-inducible DNA exchange in hyperthermophilic archaea mediated by type IV pili

Archaea, like bacteria and eukaryotes, contain proteins involved in various mechanisms of DNA repair, highlighting the importance of these processes for all forms of life. Species of the order Sulfolobales of hyperthermophilic crenarchaeota are equipped with a strongly UV-inducible type IV pilus system that promotes cellular aggregation. Here we demonstrate by fluorescence in situ hybridization that cellular aggregates are formed based on a species-specific recognition process and that UV-induced cellular aggregation mediates chromosomal marker exchange with high frequency. Recombination rates exceeded those of uninduced cultures by up to three orders of magnitude. Knockout strains of Sulfolobus acidocaldarius incapable of pilus production could not self-aggregate, but were partners in mating experiments with wild-type strains indicating that one cellular partner can mediate the DNA transfer. Since pilus knockout strains showed decreased survival upon UV treatment, we conclude that the UV-inducible DNA transfer process and subsequent homologous recombination represents an important mechanism to maintain chromosome integrity in Sulfolobus. It might also contribute substantially to the frequent chromosomal DNA exchange and horizontal gene transfer in these archaea in their natural habitat.     

Polarization of PIN3-dependent auxin transport for hypocotyl gravitropic response in Arabidopsis thaliana

Gravitropism aligns plant growth with gravity. It involves gravity perception and the asymmetric distribution of the phytohormone auxin. Here we provide insights into the mechanism for hypocotyl gravitropic growth. We show that the Arabidopsis thaliana PIN3 auxin transporter is required for the asymmetric auxin distribution for the gravitropic response. Gravistimulation polarizes PIN3 to the bottom side of hypocotyl endodermal cells, which correlates with an increased auxin response at the lower hypocotyl side. Both PIN3 polarization and hypocotyl bending require the activity of the trafficking regulator GNOM and the protein kinase PINOID. Our data suggest that gravity-induced PIN3 polarization diverts the auxin flow to mediate the asymmetric distribution of auxin for gravitropic shoot bending.