The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015.

Since the year 2000, a concerted campaign against malaria has led to unprecedented levels of intervention coverage across sub-Saharan Africa. Understanding the effect of this control effort is vital to inform future control planning. However, the effect of malaria interventions across the varied epidemiological settings of Africa remains poorly understood owing to the absence of reliable surveillance data and the simplistic approaches underlying current disease estimates. Here we link a large database of malaria field surveys with detailed reconstructions of changing intervention coverage to directly evaluate trends from 2000 to 2015, and quantify the attributable effect of malaria disease control efforts. We found that Plasmodium falciparum infection prevalence in endemic Africa halved and the incidence of clinical disease fell by 40% between 2000 and 2015. We estimate that interventions have averted 663 (542-753 credible interval) million clinical cases since 2000. Insecticide-treated nets, the most widespread intervention, were by far the largest contributor (68% of cases averted). Although still below target levels, current malaria interventions have substantially reduced malaria disease incidence across the continent. Increasing access to these interventions, and maintaining their effectiveness in the face of insecticide and drug resistance, should form a cornerstone of post-2015 control strategies.

Kaposi's sarcoma and its management by radiotherapy.

Thirteen patients with Kaposi's sarcoma were treated by radiotherapy between 1975 and 1984. Five patients were kidney transplant recipients receiving immunosuppressive drugs, while eight patients had spontaneous Kaposi's sarcoma. Eleven patients were followed up for periods from two to 63 months (mean, 27 months). All patients had complete response throughout the period of follow-up except one patient who developed recurrence one year after completion of radiotherapy. There was no difference in the response between transplant recipients and patients with spontaneous disease. This response was also unrelated to the dose or type of radiation used. Radiotherapy has been found effective in the local control of Kaposi's sarcoma with complete relief of symptoms and minimal morbidity.

Methods for estimating the case fatality ratio for a novel, emerging infectious disease.

During the course of an epidemic of a potentially fatal disease, it is important that the case fatality ratio be well estimated. The authors propose a novel method for doing so based on the Kaplan-Meier survival procedure, jointly considering two outcomes (death and recovery), and evaluate its performance by using data from the 2003 epidemic of severe acute respiratory syndrome in Hong Kong, People's Republic of China. They compare this estimate obtained at various points in the epidemic with the case fatality ratio eventually observed; with two commonly quoted, naïve estimates derived from cumulative incidence and mortality statistics at single time points; and with estimates in which a parametric mixture model is used. They demonstrate the importance of patient characteristics regarding outcome by analyzing subgroups defined by age at admission to the hospital.

Racism and humiliation in the African-American community.

This paper examines the relationship between the humiliation dynamic and individual, institutional, and cultural racism. It concludes with suggestions for reducing humiliations based on racism.

Laboratory evaluation of adhesively crimped surgical ball hooks.

The aim of this study was to examine the effect of the addition of sandblasting and/or dental adhesive on the stability of the crimpable hook when positioned and crimped onto surgical arch wires. Ninety crimpable ball hooks were divided into six test groups: crimp only; apply Panavia 21 and crimp; apply C & B Metabond and crimp; sandblast and crimp; sandblast, apply Panavia 21, and crimp; and sandblast, apply C & B Metabond, and crimp. Each hook was treated according to the criteria of the relevant test group and then crimped to the arch wire. The force required to dislodge each hook from the arch wire was measured. The results demonstrated that sandblasting caused a significant increase in the force required to dislodge the crimped hook. The addition of either Panavia 21 or C & B Metabond adhesives also resulted in a significant increase in the required dislodging force. The force required to dislodge the hook was increased by a factor of 10 where sandblasting and Panavia 21 were applied. The same increase was observed where C & B Metabond was applied, without sandblasting. However, it was concluded that the use of Panavia 21, together with an intraoral sandblasting machine, would be more appropriate in the clinical setting, primarily due to the ease of use associated with Panavia 21.

Evaluation of chromatin integrity in human sperm using acridine orange staining with different fixatives and after cryopreservation.

Staining of cells with acridine orange (AO) has been widely accepted as a predictor of DNA damage in many cell types. Because of variability of protocols used in previous studies, the AO staining technique has not been widely accepted as a screening test to predict DNA damage in human sperm. In order to further validate the use of AO staining, sperm were evaluated using numerous variations in the staining protocol. This study also elucidated the effects of cryopreservation on sperm DNA. Sperm fixation in Carnoy's solution showed significantly (P < 0.05) more DNA damage (29.9 +/- 4.5%) than 2% glutaraldehyde (14.4 +/- 2.1%), 4% paraformaldehyde (5.5 +/- 1.7%), no fixation (15.8 +/- 4.3%) but did not differ from Diff Quik solution (19.2 +/- 5.8%). No difference was observed for sperm DNA damage assessment using a 0.2 m (15.5 +/- 3.2%) or 0.3 m (14.9 +/- 3.3%) concentration of Na(2)HPO(4).7H(2)O in the AO staining solution. Frozen-thawed semen samples showed increased damage to sperm DNA under both Carnoy's (fresh: 10.9 +/- 1.3%; frozen: 30.8 +/- 2.9%; P < 0.05) and Diff Quik fixation (fresh: 6.2 +/- 0.8; frozen: 17.1 +/- 2.5%P < 0.05). Present data also showed that spermatozoa from some individuals are more prone to DNA damage after freezing and thawing procedures than others. In conclusion, Carnoy's fixative provides a better predictive value for DNA damage to sperm using AO staining. Additionally, cryopreservation increased damage to the sperm DNA.