The use of VTE prophylaxis in relation to patient risk profiling(TUNE-IN) Wave 2 Study

KMBackground: The TUNE-IN (The Use of VTE prophylaxis in relatioN to patiEnt risk profiling) study evaluated venous thromboembolism (VTE) risk assessment and prophylaxis in private medical and surgical inpatients in Gauteng Province, South Africa. The study concluded that of the 608 patients enrolled, 54.1% were clinically evaluated to be at risk for VTE. A VTE risk assessment model (RAM), the Caprini score, increased the rate to 74.6%. Objectives: TUNE-IN Wave 2, an extension of TUNE-IN, was conducted on a national level including the public sector, focusing on surgical inpatients. Methods. The study was a national, prospective, non-interventional, multisite, epidemiological disease registry enrolling 453 surgical inpatients. The perceived clinical VTE risk, VTE risk score on Caprini RAM, VTE prophylaxis and clinical details were documented during a baseline visit. A bleeding risk score was provided. Results: Of the cohort, 269 patients (59.4%) were assessed to be at risk for VTE before applying the RAM. All patients (100%), however, were at risk on the RAM score. Early mobilisation and assessment of the VTE risk as low were the most frequent reasons for non-prescription of prophylaxis. Only 15 patients in the private and 2 in the public sector were assessed as having a bleeding risk. Chemoprophylaxis differed between the healthcare sectors, with low-molecular-weight heparin predominating in the private sector and unfractionated heparin being prescribed only in the public sector. Conclusion: VTE risk assessment and prophylaxis need to improve in both the public and the private sectors. A formal RAM will improve identification of patients at risk of VTE

Shallow rainwater lenses in deltaic areas with saline seepage

In deltaic areas with saline seepage, freshwater availability is often limited to shallow rainwater lenses lying on top of saline groundwater. Here we describe the characteristics and spatial variability of such lenses in areas with saline seepage and the mechanisms that control their occurrence and size. Our findings are based on different types of field measurements and detailed numerical groundwater models applied in the south-western delta of the Netherlands. By combining the applied techniques we could extrapolate measurements at point scale (groundwater sampling, temperature and electrical soil conductivity (TEC)-probe measurements, electrical cone penetration tests (ECPT)) to field scale (continuous vertical electrical soundings (CVES), electromagnetic survey with EM31), and even to regional scale using helicopter-borne electromagnetic measurements (HEM). The measurements show a gradual mixing zone between infiltrating fresh rainwater and upward flowing saline groundwater. The mixing zone is best characterized by the depth of the centre of the mixing zone <i>D</i><sub>mix</sub>, where the salinity is half that of seepage water, and the bottom of the mixing zone <i>B</i><sub>mix</sub>, with a salinity equal to that of the seepage water (Cl-conc. 10 to 16 g l<sup>−1</sup>). <i>D</i><sub>mix</sub> is found at very shallow depth in the confining top layer, on average at 1.7 m below ground level (b.g.l.), while <i>B</i><sub>mix</sub> lies about 2.5 m b.g.l. The model results show that the constantly alternating upward and downward flow at low velocities in the confining layer is the main mechanism of mixing between rainwater and saline seepage and determines the position and extent of the mixing zone (<i>D</i><sub>mix</sub> and <i>B</i><sub>mix</sub>). Recharge, seepage flux, and drainage depth are the controlling factors

FTIR, dissolution and anti-viral activity of nevirapine co-crystals

The study uses Fourier Transform Infrared (FTIR) spectroscopy to identify five Nevirapine (NV) co-crystals, determines the dissolution profile of the co-crystals and the antiviral activity comparative to pure NV. Hot stage microscopy measured the purity and integrity of each co-crystal. FTIR analysis was used to identify the co-crystals to make recommendations regarding the future use of the technique to identify the NV co-crystals. Dissolution studies of the NV co-crystals prepared with maleic acid, salicylic acid and glutaric acid (NVMLE, NVSLI and NVGLT, respectively) were completed using the rotating basket method. Assays were conducted using High Performance Liquid Chromatography and compared to pure NV and the five NV: co-former mixtures. The antiviral activity was tested to determine whether the co-crystals had an improved activity against HIV-1 compared to pure NV. All co-crystals, except NVTTA (a NV co-crystal prepared with rac-tartaric acid), were pure and maintained their integrity for approximately one year. NVGLT, NVMLE and NVTTA, 1:1 molar ratio co-crystals were identified by FTIR. The C=O stretching frequency of the carboxylic acid groups of NV and GLT were observed at 1638.15 cm-1 and 1719.23 cm-1 in the NVGLT co-crystal which corresponded with spectra of NVMLE and NVTTA. In NVMLE the C=O stretching frequency of the C=O of NV and MLE were observed at 1640.58 cm-1 and 1694.10 cm-1 and in NVTTA it was at 1637.25 cm-1 and 1708.50 cm-1, suggesting the presence of both parent molecules in the new phase for NVGLT, NVMLE and NVTTA. Dissolution studies suggested that NVGLT was the only co-crystal that yielded better results than both NV and its physical mixture. The antiviral activity of the NVSC (an NV co-crystal prepared with saccharin) and NVSLI cocrystals in DMSO was significantly different to pure NV, demonstrating an improvement in anti-viral activity

Lizard epidermal gland secretions II : chemical characterization of the generation gland secretion of the sungazer, Cordylus giganteus

The original publication is available at http://pubs.acs.org/doi/full/10.1021/np1008366In lizards, the epidermal glands of the femoral and precloacal regions are involved in the production of semiochemicals. In addition to its femoral glands, the giant girdled lizard, or sungazer, Cordylus giganteus, which is endemic to South Africa, has generation glands as an additional potential source of semiochemicals. These epidermal glands are described as glandular scales that overlay the femoral glands and are included in the normal epidermal profile located in the femoral (thigh) and anterior antebrachial (fore-leg) regions of the male sungazer. GC-MS analysis of the generation gland secretions and the trimethylsilyl derivatives of some of the steroidal constituents was employed to identify 59 constituents, including alkenes, carboxylic acids, alcohols, ketones, aldehydes, esters, amides, nitriles, and steroids. The quantitative differences of the volatile constituents of the fore- and hind-leg generation glands were compared between individuals. This is the first report on the chemical composition of generation glandular material of lizards. © 2011 The American Chemical Society and American Society of Pharmacognosy.Post-prin

Effect of human rotavirus vaccine on severe diarrhea in African infants.

BACKGROUND: Rotavirus is the most common cause of severe gastroenteritis among young children worldwide. Data are needed to assess the efficacy of the rotavirus vaccine in African children. METHODS: We conducted a randomized, placebo-controlled, multicenter trial in South Africa (3166 infants; 64.1% of the total) and Malawi (1773 infants; 35.9% of the total) to evaluate the efficacy of a live, oral rotavirus vaccine in preventing severe rotavirus gastroenteritis. Healthy infants were randomly assigned in a 1:1:1 ratio to receive two doses of vaccine (in addition to one dose of placebo) or three doses of vaccine--the pooled vaccine group--or three doses of placebo at 6, 10, and 14 weeks of age. Episodes of gastroenteritis caused by wild-type rotavirus during the first year of life were assessed through active follow-up surveillance and were graded with the use of the Vesikari scale. RESULTS: A total of 4939 infants were enrolled and randomly assigned to one of the three groups; 1647 infants received two doses of the vaccine, 1651 infants received three doses of the vaccine, and 1641 received placebo. Of the 4417 infants included in the per-protocol efficacy analysis, severe rotavirus gastroenteritis occurred in 4.9% of the infants in the placebo group and in 1.9% of those in the pooled vaccine group (vaccine efficacy, 61.2%; 95% confidence interval, 44.0 to 73.2). Vaccine efficacy was lower in Malawi than in South Africa (49.4% vs. 76.9%); however, the number of episodes of severe rotavirus gastroenteritis that were prevented was greater in Malawi than in South Africa (6.7 vs. 4.2 cases prevented per 100 infants vaccinated per year). Efficacy against all-cause severe gastroenteritis was 30.2%. At least one serious adverse event was reported in 9.7% of the infants in the pooled vaccine group and in 11.5% of the infants in the placebo group. CONCLUSIONS: Human rotavirus vaccine significantly reduced the incidence of severe rotavirus gastroenteritis among African infants during the first year of life. (ClinicalTrials.gov number, NCT00241644.

Response to recharge variation of thin rainwater lenses and their mixing zone with underlying saline groundwater

In coastal zones with saline groundwater, fresh groundwater lenses may form due to infiltration of rain water. The thickness of both the lens and the mixing zone, determines fresh water availability for plant growth. Due to recharge variation, the thickness of the lens and the mixing zone are not constant, which may adversely affect agricultural and natural vegetation if saline water reaches the root zone during the growing season. In this paper, we study the response of thin lenses and their mixing zone to variation of recharge. The recharge is varied using sinusoids with a range of amplitudes and frequencies. We vary lens characteristics by varying the Rayleigh number and Mass flux ratio of saline and fresh water, as these dominantly influence the thickness of thin lenses and their mixing zone. Numerical results show a linear relation between the normalised lens volume and the main lens and recharge characteristics, enabling an empirical approximation of the variation of lens thickness. Increase of the recharge amplitude causes increase and the increase of recharge frequency causes a decrease in the variation of lens thickness. The average lens thickness is not significantly influenced by these variations in recharge, contrary to the mixing zone thickness. The mixing zone thickness is compared to that of a Fickian mixing regime. A simple relation between the travelled distance of the centre of the mixing zone position due to variations in recharge and the mixing zone thickness is shown to be valid for both a sinusoidal recharge variation and actual records of daily recharge data. Starting from a step response function, convolution can be used to determine the effect of variable recharge in time. For a sinusoidal curve, we can determine delay of lens movement compared to the recharge curve as well as the lens amplitude, derived from the convolution integral. Together the proposed equations provide us with a first order approximation of lens characteristics using basic lens and recharge parameters without the use of numerical models. This enables the assessment of the vulnerability of any thin fresh water lens on saline, upward seeping groundwater to salinity stress in the root zone

Effect of human rotavirus vaccine on severe diarrhea in African infants

BACKGROUND: Rotavirus is the most common cause of severe gastroenteritis among young children worldwide. Data are needed to assess the efficacy of the rotavirus vaccine in African children. METHODS: We conducted a randomized, placebo-controlled, multicenter trial in South Africa (3166 infants; 64.1% of the total) and Malawi (1773 infants; 35.9% of the total) to evaluate the efficacy of a live, oral rotavirus vaccine in preventing severe rotavirus gastroenteritis. Healthy infants were randomly assigned in a 1:1:1 ratio to receive two doses of vaccine (in addition to one dose of placebo) or three doses of vaccine — the pooled vaccine group — or three doses of placebo at 6, 10, and 14 weeks of age. Episodes of gastroenteritis caused by wild-type rotavirus during the first year of life were assessed through active follow-up surveillance and were graded with the use of the Vesikari scale. RESULTS: A total of 4939 infants were enrolled and randomly assigned to one of the three groups; 1647 infants received two doses of the vaccine, 1651 infants received three doses of the vaccine, and 1641 received placebo. Of the 4417 infants included in the per-protocol efficacy analysis, severe rotavirus gastroenteritis occurred in 4.9% of the infants in the placebo group and in 1.9% of those in the pooled vaccine group (vaccine efficacy, 61.2%; 95% confidence interval, 44.0 to 73.2). Vaccine efficacy was lower in Malawi than in South Africa (49.4% vs. 76.9%); however, the number of episodes of severe rotavirus gastroenteritis that were prevented was greater in Malawi than in South Africa (6.7 vs. 4.2 cases prevented per 100 infants vaccinated per year). Efficacy against all-cause severe gastroenteritis was 30.2%. At least one serious adverse event was reported in 9.7% of the infants in the pooled vaccine group and in 11.5% of the infants in the placebo group. CONCLUSIONS: Human rotavirus vaccine significantly reduced the incidence of severe rotavirus gastroenteritis among African infants during the first year of life. (ClinicalTrials.gov number, NCT00241644.

Project management practices in engineering university

The article presents the analysis of usage of project management methodology in Tomsk Polytechnic University, in particular the experience with the course Project management which started 15 years ago. The article presents the discussion around advantages of project management methodology for engineering education and administration of the university in general and the problems impeding extensive implementation of this methodology in teaching, research and management in the university

Recent African derivation of Chrysomya putoria from C. chloropyga and mitochondrial DNA paraphyly of cytochrome oxidase subunit one in blowflies of forensic importance

Chrysomya chloropyga (Wiedemann) and C. putoria (Wiedemann) (Diptera: Calliphoridae) are closely related Afrotropical blowflies that breed in carrion and latrines, reaching high density in association with humans and spreading to other continents. In some cases of human death, Chyrsomya specimens provide forensic clues. Because the immature stages of such flies are often difficult to identify taxonomically, it is useful to develop DNA-based tests for specimen identification. Therefore we attempted to distinguish between C. chloropyga and C. putoria using mitochondrial DNA (mtDNA) sequence data from a 593-bp region of the gene for cytochrome oxidase subunit one (COI). Twelve specimens from each species yielded a total of five haplotypes, none being unique to C. putoria. Therefore it was not possible to distinguish between the two species using this locus. Maximum parsimony analysis indicated paraphyletic C. chloropyga mtDNA with C. putoria nested therein. Based on these and previously published data, we infer that C. putoria diverged very recently from C. chloropyga