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Female genital schistosomiasis (FGS) is a chronic disease manifestation of the waterborne parasitic infection Schistosoma haematobium that affects up to 56 million women and girls, predominantly in sub-Saharan Africa. Starting from early childhood, this stigmatizing gynaecological condition is caused by the presence of Schistosoma eggs and associated toxins within the genital tract. Schistosoma haematobium typically causes debilitating urogenital symptoms, mostly as a consequence of inflammation, which includes bleeding, discharge and lower abdominal pelvic pain. Chronic complications of FGS include adverse sexual and reproductive health and rights outcomes such as infertility, ectopic pregnancy and miscarriage. FGS is associated with prevalent human immunodeficiency virus and may increase the susceptibility of women to high-risk human papillomavirus infection. Across SSA, and even in clinics outside endemic areas, the lack of awareness and available resources among both healthcare professionals and the public means FGS is underreported, misdiagnosed and inadequately treated. Several studies have highlighted research needs and priorities in FGS, including better training, accessible and accurate diagnostic tools, and treatment guidelines. On 6 September, 2024, LifeArc, the Global Schistosomiasis Alliance and partners from the BILGENSA Research Network (Genital Bilharzia in Southern Africa) convened a consultative, collaborative and translational workshop: ‘Female Genital Schistosomiasis: Translational Challenges and Opportunities’. Its ambition was to identify practical solutions that could address these research needs and drive appropriate actions towards progress in tackling FGS. Here, we present the outcomes of that workshop – a series of discrete translational actions to better galvanize the community and research funders.
In 2010, USAID catalyzed the formation of One Health University Networks as part of a holistic response designed to promote the One Health approach for addressing complex health challenges. This globally connected One Health University network now includes the African One Health University Network (AFROHUN) and the Southeast Asia University Network (SEAOHUN) and has representation from over 120 universities in 17 countries across Africa and Southeast Asia. Over more than 15 years of USAID investment, these networks have trained more than 85,000 students, in-service professionals and faculty around the world in One Health principles and collaborative problem solving, grounded in One Health core competencies. These One Health practitioners have gone on to contribute to improved global health security in their communities and countries. The evolution and maturation of these networks is a testament to a strong vision and dedication to the task by leadership and donors. As the global academic community continues to refine and adapt training methodologies for ‘future ready’ individuals, resources and examples from One Health University Networks stand as a legacy to build upon.
The gut microbiome is impacted by certain types of dietary fibre. However, the type, duration and dose needed to elicit gut microbial changes and whether these changes also influence microbial metabolites remain unclear. This study investigated the effects of supplementing healthy participants with two types of non-digestible carbohydrates (resistant starch (RS) and polydextrose (PD)) on the stool microbiota and microbial metabolite concentrations in plasma, stool and urine, as secondary outcomes in the Dietary Intervention Stem Cells and Colorectal Cancer (DISC) Study. The DISC study was a double-blind, randomised controlled trial that supplemented healthy participants with RS and/or PD or placebo for 50 d in a 2 × 2 factorial design. DNA was extracted from stool samples collected pre- and post-intervention, and V4 16S rRNA gene sequencing was used to profile the gut microbiota. Metabolite concentrations were measured in stool, plasma and urine by high-performance liquid chromatography. A total of fifty-eight participants with paired samples available were included. After 50 d, no effects of RS or PD were detected on composition of the gut microbiota diversity (alpha- and beta-diversity), on genus relative abundance or on metabolite concentrations. However, Drichlet’s multinomial mixture clustering-based approach suggests that some participants changed microbial enterotype post-intervention. The gut microbiota and fecal, plasma and urinary microbial metabolites were stable in response to a 50-d fibre intervention in middle-aged adults. Larger and longer studies, including those which explore the effects of specific fibre sub-types, may be required to determine the relationships between fibre intake, the gut microbiome and host health.
Chater & Loewenstein argue for a shift in focus from individual- to structural-level approaches to societal ills. This is valid and important but overlooks the barriers inherent in the current US partisan context. Psychology can be applied to help people of mixed allyship join together, to effectively and quickly force institutions and corporations to accept structural change.
Shuffle Along, or, The Making of the Musical Sensation of 1921 and All That Followed, directed and written by George C. Wolfe, opened to great acclaim in the spring of 2016. The $12 million show closed at a loss after just 100 performances – 404 fewer than the Shuffle Along of 1921, which was one of the few shows of the decade to run more than 500 performances. What led to the abbreviated, disappointing run of Shuffle Along, or, The Making of…? Its veteran, controversial producer, Scott Rudin, blamed it on the upcoming maternity leave of six-time Tony Award winner Audra McDonald, who played the star role of Lottie Gee. Rudin brought a suit against insurer Lloyd's of London for refusing to pay on two policies worth $14.1 million, a Non-Appearance policy and an Abandonment policy entitling producers to compensation if a performance had to be cancelled due to the ‘Death, Accident, or Illness’ of McDonald. Lloyd's of London claimed that pregnancy is not a death, accident or illness and that the show did not need to close when it was playing at 101.25 per cent capacity during its final week. Shuffle Along, or, The Making of… boasted many stars, including Tony Award winners Brian Stokes Mitchell and Billy Porter, although it did not win any of the ten Tony Awards for which it was nominated. The litigious Rudin had failed in his bid to reclassify the show as a revival so it would not have to battle Lin-Manuel Miranda's smash hit Hamilton, winner of eleven of its record-breaking sixteen Tony nominations. After four years of court battles, Rudin and Lloyd's of London finally agreed to drop the insurance case in October 2020.
There is much to unpack in this story of lawsuits, a dash of pregnancy-shaming, and duelling musicals deeply rooted in American history and commitments to performers of colour. This chapter will focus on how the ‘failure’ of Shuffle Along, or, The Making of… reveals the challenges of restaging and remembering modernist Black performance on contemporary stages.
The question of whether witnessing slaughter of conspecifics is distressing was investigated in sheep. Previously catheterized sheep were allowed to see the stunning and sticking (exsanguination) of other sheep. Heart rate was monitored and serial blood samples were taken to assess stress responses. Although the measurable parameter levels were generally high due to human contact and handling, there were no specific increases in response to witnessing stunning and slaughter. This work failed to produce any evidence to suggest that sheep are distressed by witnessing the slaughter act.
We performed an epidemiological investigation and genome sequencing of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to define the source and scope of an outbreak in a cluster of hospitalized patients. Lack of appropriate respiratory hygiene led to SARS-CoV-2 transmission to patients and healthcare workers during a single hemodialysis session, highlighting the importance of infection prevention precautions.
Complete thrombosis of a pulmonary artery interposition graft in an adolescent with complex repaired CHD was treated successfully with a combination of a novel mechanical thrombectomy system, stent implantation, and thrombolysis. This thrombectomy system used a flexible catheter with a built-in mechanism to attenuate blood loss, while providing effective recanalisation of a foreign graft.
High-energy and high-intensity lasers are essential for pushing the boundaries of science. Their development has allowed leaps forward in basic research areas, including laser–plasma interaction, high-energy density science, metrology, biology and medical technology. The Helmholtz International Beamline for Extreme Fields user consortium contributes and operates two high-peak-power optical lasers using the high energy density instrument at the European X-ray free electron laser (EuXFEL) facility. These lasers will be used to generate transient extreme states of density and temperature to be probed by the X-ray beam. This paper introduces the ReLaX laser, a short-pulse high-intensity Ti:Sa laser system, and discusses its characteristics as available for user experiments. It will also present the first experimental commissioning results validating its successful integration into the EuXFEL infrastructure and viability as a relativistic-intensity laser driver.
Populations of rigid ryegrass (Lolium rigidum Gaudin) from southern Australia have evolved resistance to the thiocarbamate herbicide prosulfocarb. The inheritance of prosulfocarb resistance was explored by crossing resistant (R) and susceptible (S) individuals. In all families within each cross, except 16.2, the response of the F1 was intermediate between the parents, suggesting that resistance is inherited as a single, partially dominant trait. For 16.2, the response of the F1 was more similar to the S parent, suggesting resistance may be a recessive trait in this population. Segregation at the discriminating dose of 1,200 g ai ha−1 prosulfocarb in population 375-14 fit the ratio (15:1) consistent with two independent dominant alleles; in population 198-15, it fit a ratio (13:3) for two independent alleles, one dominant and one recessive; and in population EP162, it fit a ratio (9:7) for two additive dominant alleles. In contrast, segregation of population 16.2 fit a ratio (7:9) consistent with two independent recessive alleles contributing to prosulfocarb resistance. Four different patterns of resistance to prosulfocarb were identified in different R populations, with inheritance as a dominant allele, dominant and recessive, additive dominant and as an independent recessive allele. This suggests there are several different mechanisms of prosulfocarb resistance present in L. rigidum.
Three resistant (R) rigid ryegrass (Lolium rigidum Gaudin) populations from southern Australia (EP162, 375-14, and 198-15) with cross-resistance to thiocarbamate, chloroacetamide, and sulfonylisoxazoline herbicides displayed reduced sensitivity to the isoxazolidinone herbicides bixlozone and clomazone. Each of these R populations was exposed to two cycles of recurrent selection (RS) in which plants were treated with the field rate of bixlozone, survivors were bulk crossed, and seed was collected. After the first cycle of recurrent selection (RS1), the LD50 to bixlozone in population 198-15 increased to 17.5-fold compared with the S population and increased further to 26.9-fold after a second cycle of recurrent selection (RS2). The recurrent selection process also increased the level of resistance to bixlozone in populations EP162 and 375-14 (7.8- to 18.4-fold) compared with the S population. Phorate antagonized bixlozone and clomazone in SLR4 (34.6- and 28.1-fold increase in LD50) and both herbicides in populations EP162 (36.5- to 46.6-fold), 375-14 (71.4- to 73.9-fold), and 198-15 (86.4- to 91.5-fold) compared with the absence of phorate. The increase in LD50 of all L. rigidum RS populations when treated with phorate suggests a lack of herbicide activation is not the likely resistance mechanism to these herbicides. This research highlights the elevated risk of thiocarbamate-resistant L. rigidum populations to rapidly evolve resistance to the isoxazolidinone herbicides bixlozone and clomazone.
Interactions between polyphenols and non-digestible carbohydrates (NDC) can impact on polyphenolic metabolites bioavailability, including phenolic acids. The BLEND2 trial (NCT03840746) aims to study longer-term interactions of a flavonoid-rich food with/without NDC on microbiota metabolites and cardiometabolic markers. Trial feasibility using a bespoke food was tested.
Material and Methods
The soup was developed locally containing cherry tomatoes, tomato puree, red onion, fresh lovage, with/without the NDC inulin (10g), but improved and processed with Campden BRI, Chipping Campden, UK. The final product (~400g/ tin) was evaluated with VAS scales (0–10) for appearance, smell, taste and overall palatability, and flavonoid content evaluated using liquid chromatography-mass spectrometry. The 3-arm parallel randomised blinded design (control soup, soup + inulin, habitual diet control) recruited self-reported healthy participants (BMI > 25, 40–70y) with urine, blood, faecal samples collected at baseline, 3-week, 6-weeks.
Results
Both soups scored similarly (n = 8 testers) for visual appeal (with inulin 5.1 ± 2.1; without 4.5 ± 2.0); smell (with 5.9 ± 1.7; without 5.4 ± 0.8); taste (with 6.6 ± 2.0; without 5.5 ± 2.3), aftertaste (with 6.3 ± 2.9; without 5.4 ± 2.3) and overall palatability (with 7.0 ± 1.9; without 6.1 ± 2.1).
The soups (A&B), 1 tin/day, provide 68.5 ± 10.9 mg total flavonoids (soup A n = 3, quercetin equivalents) and 74.0 ± 16.1 mg (soup B, n = 3): quercetin (A 1.2 ± 0.1 mg; B 1.3 ± 0.6 mg), quercetin-4-glucoside (A 3.9 ± 1.0 mg; B 4.1 ± 1.9 mg), quercetin-3-rutinoside (A 23.0 ± 3.2 mg; B 20.5 ± 1.0 mg), quercetin 3,4-diglucosides (A 40.5 ± 6.9 mg; B 48.2 ± 14.9 mg).
Following notes of interest (n = 415), n = 111 attended screening, n = 34 did not proceed (medications, opt-out; 31%). Participants (n = 77) are mostly British (79%), median age 56y (IQR 49-62) with a median BMI of 31 (IQR 28-35). Dropout was low (12%) and early in the study (personal issues, n = 2; gastrointestinal issues, n = 2; failure to comply with protocol, n = 2; acid reflux symptoms, n = 1; dislike of test food, n = 1). Adverse events included acid reflux/heartburn (n = 4), gastrointestinal distress (n = 3) accounting for 3 drop-outs.
To date, urine, blood and faecal samples (study day or day + 1) were collected at all timepoints, for all participants. Participation (soup arms) has not led to body weight or blood lipids changes compared to control group.
Discussion
The protocol for this 6-week trial has proved feasible with lower dropout than expected. Soup flavonoid content representing ~16% of average European flavonoid intakes, with inulin (10g) half the UK daily fibre intake. The soup was well accepted with few reports of adverse issues. Recruitment in this population is challenging, due to high levels of medication and ill health.
Cardiac catheterisations for CHD produce anxiety for patients and families. Current strategies to mitigate anxiety and explain complex anatomy include pre-procedure meetings and educational tools (cardiac diagrams, echocardiograms, imaging, and angiography). More recently, three-dimensionally printed patient-specific models can be added to the armamentarium. The purpose of this study was to evaluate the efficacy of pre-procedure meetings and of different educational tools to reduce patient and parent anxiety before a catheterisation.
Methods:
Prospective study of patients ≥18 and parents of patients <18 scheduled for clinically indicated catheterisations. Patients completed online surveys before and after meeting with the interventional cardiologist, who was blinded to study participation. Both the pre- and post-meeting surveys measured anxiety using the State-Trait Anxiety Inventory. In addition, the post-meeting survey evaluated the subjective value (from 1 to 4) of individual educational tools: physician discussion, cardiac diagrams, echocardiograms, prior imaging, angiograms and three-dimensionally printed cardiac models. Data were compared using paired t-tests.
Results:
Twenty-three patients consented to participate, 16 had complete data for evaluation. Mean State-Trait Anxiety Inventory scores were abnormally elevated at baseline and decreased into the normal range after the pre-procedure meeting (39.8 versus 31, p = 0.008). Physician discussion, angiograms, and three-dimensional models were reported to be most effective at increasing understanding and reducing anxiety.
Conclusion:
In this pilot study, we have found that pre-catheterisation meetings produce a measurable decrease in patient and family anxiety before a procedure. Discussions of the procedure, angiograms, and three-dimensionally printed cardiac models were the most effective educational tools.
Organophosphate insecticides, which have the capacity to inhibit specific herbicide-degrading (cytochrome P450) enzymes, have been used to explore metabolic herbicide-resistance mechanisms in weeds. This study investigates the response of seven field-selected rigid ryegrass (Lolium rigidum Gaudin) populations to herbicides from three different sites of action in the presence or absence of the P450 inhibitor phorate. Phorate antagonized the thiocarbamate herbicides triallate and prosulfocarb (8-fold increase in LD50) in multiple resistant L. rigidum populations with resistance to three different site-of-action herbicides. In contrast, phorate synergized trifluralin and propyzamide in some populations, reducing the LD50 by 50%. Conversely, treatment with phorate had no significant effect on the LD50 for S-metolachlor or pyroxasulfone (inhibitors of very-long-chain fatty-acid synthesis). Phorate has diverse effects that are herbicide and population dependant in field-selected L. rigidum, suggesting P450 involvement in the metabolism of trifluralin and failure to activate thiocarbamate herbicides in these populations. This research highlights the need for implementation of diverse approaches other than herbicide alone as part of a long-term integrated strategy to reduce the likelihood of metabolism-based resistance to PPI herbicides in L. rigidum.
Non-naturalist normative realists face an epistemological objection: They must explain how their preferred route of justification ensures a non-accidental connection between justified moral beliefs and the normative truths. One strategy for meeting this challenge begins by pointing out that we are semantically or conceptually competent in our use of the normative terms, and then argues that this competence guarantees the non-accidental truth of some of our first-order normative beliefs. In this paper, I argue against this strategy by illustrating that this competence based strategy undermines the non-naturalist's ability to capture the robustly normative content of our moral beliefs.
Most previous discussions of Ezra Pound, gender and sexuality have focused on Pound’s poetic depictions of women and his relationships with women artists, patrons and muses. The fascinating biographical stories include such figures as the poet H. D., perhaps Pound’s first love; the pianist and patron Margaret Cravens, who took her life after playing a song Pound and Walter Rummel wrote for her; Pound’s wife, Dorothy (Shakespear) Pound; and his long-time mistress, Olga Rudge, a concert violinist. When critics focus on sexuality and Pound, the result tends to be ‘paranoid’ rather than ‘reparative’ readings, to use Eve Sedgwick’s famous formulation.
Two field experiments were conducted during 2018 at Paskeville and Arthurton, South Australia, to identify effective herbicide options for the control of thiocarbamate-resistant rigid ryegrass in wheat. Dose–response experiments confirmed resistance in both field populations (T1 and A18) of rigid ryegrass to triallate, prosulfocarb, trifluralin, and pyroxasulfone. T1 and A18 were 17.9- and 20-fold more resistant to triallate than susceptible SLR4. The level of resistance detected in T1 to prosulfocarb (5.9-fold) and pyroxasulfone (4-fold) was lower compared to A18, which displayed 12.1- and 7.8-fold resistance to both herbicides, respectively. Despite resistance, the mixture of two different preplant-incorporated (PPI) site-of-action herbicides improved rigid ryegrass control and wheat yield compared to a single PPI herbicide only. Prosulfocarb + triallate and prosulfocarb + S-metolachlor + triallate did not reduce rigid ryegrass seed set when compared to prosulfocarb applied alone at the higher rate (2,400 g ai ha–1). Pyroxasulfone + triallate PPI followed by glyphosate (1,880 g ai ha-1) as a weed seed set control treatment reduced rigid ryegrass seed production by 93% and 95% at both sites, respectively. These herbicides also significantly improved grain yield of wheat at Paskeville (22%) and Arthurton (38%) compared to the untreated.
Patients’ experience of the quality of care received throughout their continuum of care can be used to direct quality improvement efforts in areas where they are most needed. This study aims to establish validity and reliability of the Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ) – a tool that collects patients’ experience that quantifies aspect of care used to make judgments about quality from the perspective of the Alberta Quality Matrix for Health (AQMH).
Background
The AQMH is a framework that can be used to assess and compare the quality of care in different healthcare settings. The AQMH provides a common language, understanding, and approach to assessing quality. The HAPSQ is one tool that is able to assess quality of care according to five of six AQMH’s dimensions.
Methods
This was a prospective methodologic study. Between March and October 2015, a convenience sample of patients presenting with chronic full-thickness rotator cuff tears was recruited prospectively from the University of Calgary Sport Medicine Centre in Calgary, Alberta, Canada. Reliability of the HAPSQ was assessed using test–retest reliability [interclass correlation coefficient (ICC)>0.70]. Validity was assessed through content validity (patient interviews, floor and ceiling effects), criterion validity (percent agreement >70%), and construct validity (hypothesis testing).
Findings
Reliability testing was completed on 70 patients; validity testing occurred on 96 patients. The mean duration of symptoms was three years (SD: 5.0, range: 0.1–29). Only out-of-pocket utilization possessed an ICC<0.70. Patients reported that items were relevant and appropriate to measuring quality of care. No floor or ceiling effects were present. Criterion validity was reached for all items assessed. A priori hypotheses were confirmed. The HAPSQ represents an inexpensive, reliable, and valid approach toward collecting clinical information across a patient’s continuum of care.
Five populations of rigid ryegrass (Lolium rigidum Gaudin) from fields across cropping regions in southern Australia were suspected of having resistance to thiocarbamates, chloroacetamides, and sulfonylisoxazoline herbicides. Resistant (R) populations 375-14, 198-15, 16.2, EP162, RAC1, and A18 and two susceptible (S) populations (SLR4 and VLR1) were included in a dose–response study. All suspected R populations expressed resistance to one or all herbicides (thiocarbamates, chloroacetamides, and pyroxasulfone). Population 198-15 exhibited the highest LD50 to triallate (44.7-fold), prosulfocarb (45.7-fold), S-metolachlor (31.5-fold), and metazachlor (27.2-fold) compared with the S populations. Populations 198-15 and 375-14 were also resistant to pyroxasulfone (13.5- and 14.9-fold) compared with the S populations, as was population EP162. This study documents the first case of field-evolved resistance to thiocarbamate, chloroacetamide, and sulfonylisoxazoline herbicides in L. rigidum.
Recent infection testing algorithms (RITA) for HIV combine serological assays with epidemiological data to determine likely recent infections, indicators of ongoing transmission. In 2016, we integrated RITA into national HIV surveillance in Ireland to better inform HIV prevention interventions. We determined the avidity index (AI) of new HIV diagnoses and linked the results with data captured in the national infectious disease reporting system. RITA classified a diagnosis as recent based on an AI < 1.5, unless epidemiological criteria (CD4 count <200 cells/mm3; viral load <400 copies/ml; the presence of AIDS-defining illness; prior antiretroviral therapy use) indicated a potential false-recent result. Of 508 diagnoses in 2016, we linked 448 (88.1%) to an avidity test result. RITA classified 12.5% of diagnoses as recent, with the highest proportion (26.3%) amongst people who inject drugs. On multivariable logistic regression recent infection was more likely with a concurrent sexually transmitted infection (aOR 2.59; 95% CI 1.04–6.45). Data were incomplete for at least one RITA criterion in 48% of cases. The study demonstrated the feasibility of integrating RITA into routine surveillance and showed some ongoing HIV transmission. To improve the interpretation of RITA, further efforts are required to improve completeness of the required epidemiological data.