Knowledge, Attitudes and Practices among Women of Reproductive Age on Human Papillomavirus Infection, Cervical Cancer and Vaccination in Otukpo, Nigeria.

Background: Knowledge, attitudes and practices (KAP) of human papilloma virus (HPV) is a necessary measure in curtailing delayed diagnosis and poor control practices. The objective of this study was to assess the knowledge, attitudes and practices vis-à-vis HPV infection, cervical cancer and vaccination among women. Methods: This cross-sectional study was conducted at 15 selected health-care facilities in Otukpo metropolis and it involved 168 pregnant women. The data were collected using structured questionnaire, and analysed for descriptive and analytical statistics using Epi Data Version 3.1 and SPSS statistical package Version 21. Results: Most of the respondents (75.0%) have heard of human papilloma virus and their information source were mostly the health-care providers. In total, 132(78.6%) agreed to take the vaccine if offered for free but 152(90.5%) stated that it is imperative to seek the opinion of health providers before vaccine uptake. However, only 27(16.1%) have undergone recommended checkup for human papilloma virus/cervical cancer and 23(13.7%) have taken at least a vaccine dose. Some respondents 66(39.3%) had good knowledge while 95(56.6%) demonstrated positive attitude. However, most respondents 161(95.8%) demonstrated poor practices. Conclusions: There is enormous need to improve HPV sensitization especially in women due to cervical cancer associated risks. Healthcare personnel are therefore encouraged to create more awareness on HPV infection and screening of cervical cancer (CC) via counseling sessions and communications tool like the new media. KAP approach is a critical tool towards successful CC screening and HPV control.

Pharmacognostic profiles, evaluation of analgesic, anti-inflammatory and anticonvulsant activities of Newbouldia laevis (P. Beauv.) Seem. ex Bureau leaf and root extracts in Wistar rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Newbouldia laevis is a popular medicinal plant whose leaves and roots are used in Nigeria as ethnomedicinal prescriptions for pain, inflammation, convulsion, and epilepsy. These claims have not been scientifically verified prior to this study. AIM OF THE STUDY: To determine pharmacognostic profiles of the leaves and roots and evaluate the analgesic, anti-inflammatory, and anticonvulsant activities of methanol leaf and root extracts in Wistar rats. MATERIAL AND METHODS: The pharmacognostic profiles of the leaves and roots were determined using standard procedures to serve as fingerprints for the plant. The methanol leaf and root extracts of Newbouldia laevis were tested for acute toxicity using the OECD's up and down method at the maximum dose of 2000 mg/kg (orally) in Wistar rats. Analgesic studies were carried out in acetic acid-induced writhing in rats and tail immersion. The anti-inflammatory activity of the extracts was evaluated using carrageenan-induced rat paw-oedema and formalin-induced inflammation in rats' mode. The anticonvulsant activity was determined using strychnine-induced, pentylenetetrazol-induced, and maximal electroshock-induced rat convulsion models. For each of these studies, the extracts doses of 100, 200 and 400 mg/kg were administered to the rats following the oral route. RESULTS: The pharmacognostic profiles showed that the leaves possessed deep-sunken paracytic stomata (5-8-16 mm2; adaxial, 8-11-24 mm2; abaxial epidermis), vein islets (2-4-10 mm2; adaxial), vein terminations (10-14-18 mm2; adaxial), palisade ratio (8.3-12.5-16.4 mm2; adaxial, 2.5-6.8-12.2 mm2; adaxial), covering unicellular trichome (8-14; adaxial), spheroidal calcium oxalate crystals (3-5 µm), and oval-shaped striated starch grain with no hilum (0.5-4.3 µm). The transverse section of the leaf showed the presence of spongy and palisade parenchyma as well as a closed vascular bundle. The root powder showed the presence of brachy sclereid, fibers without lumen, and lignin. All physicochemical parameters fall within the acceptable limits, phytochemical contents showed mainly glycosides, alkaloids, and steroids while acute oral toxicity (LD50) of the parts for 14 days did not produce any toxicity signs or mortality in the rats. The extracts produced dose-dependent (100-400 mg/kg) analgesic involving opioid receptors, anti-inflammatory, and anticonvulsant activities in the rats which were significant (p ≤ 0.05) when compared to the standard drugs. The leaf extract possessed the most potent analgesic and anti-inflammatory effects in the rats, while the most anticonvulsant effects were observed in rats treated with the leaf extract. Both extracts showed elevated levels of protection against strychnine-induced, pentylenetetrazol-induced, and maximal electroshock-induced seizure in rats. CONCLUSION: Our study revealed some pharmacognostic profiles of Newbouldia laevis leaves and roots that are vital for its identification from closely related species often used for adulteration in traditional medicine. The study further showed that the leaf and root extracts of the plant possessed dose-dependent analgesics, anti-inflammatory and anti-convulsant activities in rats, thus, justifying its use for the treatment of these diseases in Nigerian traditional medicine. There is a need to further study its mechanisms of action towards drug discovery.

Endotracheal tube biofilm in critically ill patients during the COVID-19 pandemic : description of an underestimated microbiological compartment.

Biofilm (BF) growth is believed to play a major role in the development of ventilator-associated pneumonia (VAP) in the intensive care unit. Despite concerted efforts to understand the potential implication of endotracheal tube (ETT)-BF dispersal, clinically relevant data are lacking to better characterize the impact of its mesostructure and microbiological singularity on the occurrence of VAP. We conducted a multicenter, retrospective observational study during the third wave of the COVID-19 pandemic, between March and May 2021. In total, 64 ETTs collected from 61 patients were included in the present BIOPAVIR study. Confocal microscopy acquisitions revealed two main morphological aspects of ETT-deposited BF: (1) a thin, continuous ribbon-shaped aspect, less likely monobacterial and predominantly associated with Enterobacter spp., Streptococcus pneumoniae or Viridans streptococci, and (2) a thicker, discontinuous, mushroom-shaped appearance, more likely characterized by the association of bacterial and fungal species in respiratory samples. The microbiological characterization of ETT-deposited BF found higher acquired resistance in more than 80% of analyzed BF phenotypes, compared to other colonization sites from the patient's environment. These findings reveal BF as a singular microbiological compartment, and are of added clinical value, with a view to future ETT-deposited BF-based antimicrobial stewardship in critically ill patients. Trial registration NCT04926493. Retrospectively registered 15 June 2021.

Increased Incidence of Ventilator-Acquired Pneumonia in Coronavirus Disease 2019 Patients: A Multicentric Cohort Study.

OBJECTIVES: Little is known about the epidemiology of ventilator-acquired pneumonia among coronavirus disease 2019 patients such as incidence or etiological agents. Some studies suggest a higher risk of ventilator-associated pneumonia in this specific population. DESIGN: Cohort exposed/nonexposed study among the REA-REZO surveillance network. SETTING: Multicentric; ICUs in France. PATIENTS: The coronavirus disease 2019 patients at admission were matched on the age, sex, center of inclusion, presence of antimicrobial therapy at admission, patient provenance, time from ICU admission to mechanical ventilation, and Simplified Acute Physiology Score II at admission to the patients included between 2016 and 2019 within the same surveillance network (1:1). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The overall incidence of ventilator-associated pneumonia, the cumulative incidence, and hazard rate of the first and the second ventilator-associated pneumonia were estimated. In addition, the ventilator-associated pneumonia microbiological ecology and specific resistant pattern in coronavirus disease 2019 exposed and nonexposed patients were compared. Medication data were not collected. A total of 1,879 patients were included in each group. The overall incidence of ventilator-associated pneumonia was higher among coronavirus disease 2019 exposed patients (25.5; 95% CI [23.7-27.45] vs 15.4; 95% CI [13.7-17.3] ventilator-associated pneumonia per 1,000 ventilation days). The cumulative incidence was higher for the first and the second ventilator-associated pneumonia among the coronavirus disease 2019 exposed patients (respective Gray test p < 0.0001 and 0.0167). The microbiological ecology and resistance were comparable between groups with a predominance of Enterobacterales and nonfermenting Gram-negative bacteria. The documented resistance pattern was similar between groups, except for a lower rate of methicillin-resistant Staphylococcus aureus in the coronavirus disease 2019 exposed patient (6% vs 23%; p = 0.013). CONCLUSIONS: There was a higher incidence of ventilator-associated pneumonia occurring among coronavirus disease 2019 patient compared with the general ICU population, with a similar microbiological ecology and resistance pattern.

[The desire and the experience of participation among children and adolescents in inpatient mental healthcare]. / Wunsch und Erleben von Partizipation für Kinder und Jugendliche in der stationären Psychiatrie.

The desire and the experience of participation among children and adolescents in inpatient mental healthcare Abstract. Objective: Children have the right to participate in decisions that affect them. However, the stages and domains of participation relevant within inpatient child and adolescent psychiatry have rarely been empirically investigated. The present study closes this research gap. Method: A prospective, multicenter, questionnaire-based survey was conducted. The questionnaire comprised 100 items, summarized in 16 scales, to assess the desire and the experience of participation. The data were quantitively evaluated. Results: 81 children and adolescents from 5 psychiatric hospitals took part in the study. Overall, they wished more participation than experienced. The higher the level of participation, the greater the difference was between wish and reality. The desire for participation is particularly high for decisions regarding communication with family and friends. The largest difference between desire and experience related to respectful and trusting interaction with patients, and for female patients, this difference was even higher. Conclusion: Participation means more than informed consent. There is still potential for expanding participation in child and adolescent psychiatry, especially at higher levels of participation and concerning decisions about communication with family and friends. A respectful and trusting interaction with patients, regardless of age, sex, or illness, is fundamental.

Potential impacts of climate change on geographical distribution of three primary vectors of African Trypanosomiasis in Tanzania's Maasai Steppe: G. m. morsitans, G. pallidipes and G. swynnertoni.

In the Maasai Steppe, public health and economy are threatened by African Trypanosomiasis, a debilitating and fatal disease to livestock (African Animal Trypanosomiasis -AAT) and humans (Human African Trypanosomiasis-HAT), if not treated. The tsetse fly is the primary vector for both HAT and AAT and climate is an important predictor of their occurrence and the parasites they carry. While understanding tsetse fly distribution is essential for informing vector and disease control strategies, existing distribution maps are old and were based on coarse spatial resolution data, consequently, inaccurately representing vector and disease dynamics necessary to design and implement fit-for-purpose mitigation strategies. Also, the assertion that climate change is altering tsetse fly distribution in Tanzania lacks empirical evidence. Despite tsetse flies posing public health risks and economic hardship, no study has modelled their distributions at a scale needed for local planning. This study used MaxEnt species distribution modelling (SDM) and ecological niche modeling tools to predict potential distribution of three tsetse fly species in Tanzania's Maasai Steppe from current climate information, and project their distributions to midcentury climatic conditions under representative concentration pathways (RCP) 4.5 scenarios. Current climate results predicted that G. m. morsitans, G. pallidipes and G swynnertoni cover 19,225 km2, 7,113 km2 and 32,335 km2 and future prediction indicated that by the year 2050, the habitable area may decrease by up to 23.13%, 12.9% and 22.8% of current habitable area, respectively. This information can serve as a useful predictor of potential HAT and AAT hotspots and inform surveillance strategies. Distribution maps generated by this study can be useful in guiding tsetse fly control managers, and health, livestock and wildlife officers when setting surveys and surveillance programs. The maps can also inform protected area managers of potential encroachment into the protected areas (PAs) due to shrinkage of tsetse fly habitats outside PAs.

Systematic Analysis of Readability of Patient Information on Internet Pages from Departments for Trauma Surgery of German University Hospitals. / Systematische Analyse der Lesbarkeit von Patienteninformationstexten auf Internetseiten von Abteilungen für Unfallchirurgie deutscher Universitätskliniken.

INTRODUCTION: The need-based information transfer in education as well as for the recruitment of patients becomes more and more relevant. Here, the internet has emerged as an increasingly important factor in recent years and therefore information pages on hospital homepages can be very helpful. However, it is known that basic text comprehension skills are lacking among large populations. METHOD: The aim of the present study was to evaluate the readability of the patient information available on the websites of trauma departments of German university hospitals. For this purpose, a search for information material on 10 different diagnoses was carried out. Out of 360 texts possible, 185 were found and assigned to 2 superordinate thematic areas (emergency vs. elective operations), subjected to a systematic text analysis via software "Text-Lab" and rated using 5 known readability indices (Amstad, G-SMOG, LIX, HIX, WSTF). RESULTS: The indices used for both thematic complexes consistently showed poor readability, so that the texts only seem sufficiently comprehensible to readers with higher education. (Amstad: 21.4 ± 20.8; G-SMOG: 11.6 ± 2.0; WSTF 13.3 ± 2.1; LIX: 60.9 ± 7.6; HIX: 4.1 ± 3.2). CONCLUSION: For the medical information provided by university hospitals, there is a clear need for improvement in order to make the adequate acquisition of knowledge accessible to a broader spectrum of patients.

Estimation of COVID-19 risk-stratified epidemiological parameters and policy implications for Los Angeles County through an integrated risk and stochastic epidemiological model

SummaryO_ST_ABSBackgroundC_ST_ABSHealth disparities have emerged with the COVID-19 epidemic because the risk of exposure to infection and the prevalence of risk factors for severe outcomes given infection vary within and between populations. However, estimated epidemic quantities such as rates of severe illness and death, the case fatality rate (CFR), and infection fatality rate (IFR), are often expressed in terms of aggregated population-level estimates due to the lack of epidemiological data at the refined subpopulation level. For public health policy makers to better address the pandemic, stratified estimates are necessary to investigate the potential outcomes of policy scenarios targeting specific subpopulations. MethodsWe develop a framework for using available data on the prevalence of COVID-19 risk factors (age, comorbidities, BMI, smoking status) in subpopulations, and epidemic dynamics at the population level and stratified by age, to estimate subpopulation-stratified probabilities of severe illness and the CFR (as deaths over observed infections) and IFR (as deaths over estimated total infections) across risk profiles representing all combinations of risk factors including age, comorbidities, obesity class, and smoking status. A dynamic epidemic model is integrated with a relative risk model to produce time-varying subpopulation-stratified estimates. The integrated model is used to analyze dynamic outcomes and parameters by population and subpopulation, and to simulate alternate policy scenarios that protect specific at-risk subpopulations or modify the population-wide transmission rate. The model is calibrated to data from the Los Angeles County population during the period March 1 - October 15 2020. FindingsWe estimate a rate of 0.23 (95% CI: 0.13,0.33) of infections observed before April 15, which increased over the epidemic course to 0.41 (0.11,0.69). Overall population-average IFR(t) estimates for LAC peaked at 0.77% (0.38%,1.15%) on May 15 and decreased to 0.55% (0.24%,0.90%) by October 15. The population-average IFR(t) stratified by age group varied extensively across subprofiles representing each combination of the additional risk factors considered (comorbidities, BMI, smoking). We found median IFRs ranging from 0.009%-0.04% in the youngest age group (0-19), from 0.1%-1.8% for those aged 20-44, 0.36%-4.3% for those aged 45-64, and 1.02%-5.42% for those aged 65+. In the group aged 65+ for which the rate of unobserved infections is likely much lower, we find median CFRs in the range 4.4%-23.45%. The initial societal lockdown period avoided overwhelming healthcare capacity and greatly reduced the observed death count. In comparative scenario analysis, alternative policies in which the population-wide transmission rate is reduced to a moderate and sustainable level of non-pharmaceutical interventions (NPIs) would not have been sufficient to avoid overwhelming healthcare capacity, and additionally would have exceeded the observed death count. Combining the moderate NPI policy with stringent protection of the at-risk subpopulation of individuals 65+ would have resulted in a death count similar to observed levels, but hospital counts would have approached capacity limits. InterpretationThe risk of severe illness and death of COVID-19 varies tremendously across subpopulations and over time, suggesting that it is inappropriate to summarize epidemiological parameters for the entire population and epidemic time period. This includes variation not only across age groups, but also within age categories combined with other risk factors analyzed in this study (comorbidities, obesity status, smoking). In the policy analysis accounting for differences in IFR across risk groups in comparing the control of infections and protection of higher risk groups, we find that the strict initial lockdown period in LAC was effective because it both reduced overall transmission and protected individuals at greater risk, resulting in preventing both healthcare overload and deaths. While similar numbers of deaths as observed in LAC could have been achieved with a more moderate NPI policy combined with greater protection of individuals 65+, this would have come at the expense of overwhelming the healthcare system. In anticipation of a continued rise in cases in LAC this winter, policy makers need to consider the trade offs of various policy options on the numbers of the overall population that may become infected, severely ill, and that die when considering policies targeted at subpopulations at greatest risk of transmitting infection and at greatest risk for developing severe outcomes.

[Patient Participation in Child and Adolescent Psychiatry - A Scoping Review]. / Partizipation von Patienten im Kontext der stationären Kinder- und Jugendpsychiatrie ­ ein Scoping Review.

Patient Participation in Child and Adolescent Psychiatry - A Scoping Review The present study deals with the concept of participation in inpatient child- and adolescent mental health care. Aim is to analyse theoretical constructs in the light of a literature review on participation as an important method to implement patient autonomy in the specific context. The potential for conflict of patient autonomy as a greater principle and the absence of literature reviews on the topic make this study essential. The method is a scoping-review. 978 texts from three central databases have been screened for title and abstract, 27 have been included. The results show arguments, barriers and methods of participation. Most of the arguments are utilitarian: positive effects on patients, therapists and the hospital. On the other hand, there are multiple barriers of implementation: willingness of physicians, reticence of patients and systemic barriers. Structures of cooperation, key figures and interactive information brochures have already been used as methods of participation. In conclusion, a contextual concept of participation is proposed: Shared Care Planning. It is meant to be independent from the capacity to give informed consent and underlines the importance of day-to-day issues. It calls for the consideration of the mentioned barriers and a high flexibility of participation methods.

What are the characteristics that lead physicians to perceive an ICU stay as non-beneficial for the patient?

PURPOSE: We sought to describe the characteristics that lead physicians to perceive a stay in the intensive care unit (ICU) as being non-beneficial for the patient. MATERIALS AND METHODS: In the first step, we used a multidisciplinary focus group to define the characteristics that lead physicians to consider a stay in the ICU as non-beneficial for the patient. In the second step, we assessed the proportion of admissions that would be perceived by the ICU physicians as non-beneficial for the patient according to our focus group's definition, in a large population of ICU admissions in 4 French ICUs over a period of 4 months. RESULTS: Among 1075 patients admitted to participating ICUs during the study period, 155 stays were considered non-beneficial for the patient, yielding a frequency of 14.4% [95% confidence interval (CI) 8.9, 19.9]. Average age of these patients was 72 ±12.8 years. Mortality was 43.2% in-ICU [95%CI 35.4, 51.0], 55% [95%CI 47.2, 62.8] in-hospital. The criteria retained by the focus group to define a non-beneficial ICU stay were: patient refusal of ICU care (23.2% [95%CI 16.5, 29.8]), and referring physician's desire not to have the patient admitted (11.6% [95%CI 6.6, 16.6]). The characteristics that led physicians to perceive the stay as non-beneficial were: patient's age (36.8% [95%CI 29.2, 44.4]), unlikelihood of recovering autonomy (61.9% [95%CI 54.3, 69.6]), prior poor quality of life (60% [95%CI 52.3, 67.7]), terminal status of chronic disease (56.1% [95%CI 48.3, 63.9]), and all therapeutic options have been exhausted (35.5% [95%CI 27.9, 43.0]). Factors that explained admission to the ICU of patients whose stay was subsequently judged to be non-beneficial included: lack of knowledge of patient's wishes (52% [95%CI 44.1, 59.9]); decisional incapacity (sedation) (69.7% [95%CI 62.5, 76.9]); inability to contact family (34% [95%CI 26.5, 41.5]); pressure to admit (from family or other physicians) (50.3% [95%CI 42.4, 58.2]). CONCLUSIONS: Non-beneficial ICU stays are frequent. ICU admissions need to be anticipated, so that patients who would yield greater benefit from other care pathways can be correctly oriented in a timely manner.

Nitrogen fertilizer is a key factor affecting the soil chemical and microbial communities in a Mollisol.

Microbial communities drive geochemical cycles in soils. Relatively few studies have assessed the long-term impacts of different types of soil amendments under field conditions in long-term experiments. The response of soil microbial organisms in a Mollisol cultivated with maize for 35 years was examined. Treatments involved the use of N, P, and K fertilizers and two doses of straw residue in isolation or combined. Real-time PCR and Illumina MiSeq sequencing methods were used to characterize the microbial community. The results showed that addition of nitrogen fertilizers decreased soil pH, but this was mitigated when a high dose of straw was also incorporated. Long-term application of inorganic fertilizers was able to alter the abundance of functional soil microbial population. Application of inorganic N fertilizer resulted in distinctive changes on N-cycle microorganisms. Phosphate-solubilizing functional genes abundance was lower in plots with no phosphate fertilizer. Sequencing analysis showed that the presence or absence of N in the fertilizer mix is a key factor affecting bacterial community diversity of agricultural soil, and pH, total organic C, and total N show a high correlation with bacterial community composition. Nitrogen addition increased the N concentration in the soil, which could cause changes in the soil pH and change the soil bacterial community. Our findings proved that interaction of N fertilizer with other fertilizers can affect microbial communities.

Immune Reconstitution Inflammatory Syndrome in Patients with AIDS and Disseminated Coccidioidomycosis: A Case Series and Review of the Literature.

Coccidioidomycosis causes substantial morbidity and mortality in endemic areas, and dissemination is frequent in patients with impaired cellular immunity such as AIDS. Immune reconstitution inflammatory syndrome (IRIS) is paradoxical clinical worsening after initiation of antiretroviral therapy (ART) in a patient with HIV and a simultaneous opportunistic infection (OI). Immune reconstitution inflammatory syndrome has been well described for a host of mycobacterial, viral, and fungal OIs and malignancies such as Kaposi sarcoma. To date, only 3 cases of IRIS due to coccidioidomycosis have been reported in the literature. At our institution, we report 4 cases of IRIS in HIV-infected patients with disseminated coccidioidomycosis. Unfortunately, all 4 patients died of worsening coccidioidal infection after initiating ART. The optimal timing of ART in patients with AIDS and coccidioidomycosis remains to be elucidated.

Sertraline demonstrates fungicidal activity in vitro for Coccidioides immitis.

Coccidioidomycosis causes substantial morbidity in endemic areas. Disseminated coccidioidomycosis is an AIDS defining condition and treatment often requires lifelong antifungal therapy. Sertraline, a widely used serotonin-reuptake inhibitor anti-depressant, has demonstrated activity against Candida and Cryptococcus sp. both in vitro and in vivo. To evaluate if sertraline has activity against Coccidioides, the minimal inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) of sertraline for four clinical isolates of C. immitis were determined. Sertraline was observed to have an MIC range of 4-8 µg/ml and MFC also of 4-8 µg/ml for Coccidioides. These MIC and MFC results for C. immitis are similar to those reported for Cryptococcus sp. suggesting sertraline may potentially have utility for the treatment of coccidioidomycosis.

Examining professionals' perspectives on sexuality for service users of a forensic psychiatry unit.

Very little is known about the sexual activities of psychiatric patients during their stay in hospital and beyond. In this article, we have explored how mental health professionals working within a forensic psychiatric unit construct the issue of patient sexuality in order to ascertain the range of sexual possibilities open to patients. Drawing on interviews with twenty four participants--psychiatrists and clinical psychologists (clinical staff), we examined how participants made sense of patient sexuality and their clinical judgments in relation to them. Using a thematic analysis, we were able to identify a number of relevant themes emerging, including a) what the limits of acceptable sexual behaviour were judged to be, b) discrimination against transgender and same sex relationships, c) vulnerability among female patients and therapeutic efficacy, and d) an abject fear of patient pregnancy. Furthermore, a general concern throughout was the putative professional conflict between the clinical and ward staff. Further discussion regarding the potential for clearer policy on patient sexuality and further training for professionals is developed in the final section.

The influence of situational variables on ball possession in the English Premier League.

Abstract The aims of this study were twofold: (1) to examine the influence of situational variables on ball possession in elite soccer and (2) to quantify the variables that discriminate between high or low percentage ball possession teams (HPBPT and LPBPT) across different playing positions. Match performance data were collected from English Premier League matches using a multiple-camera system. Data were examined using linear regression, a 2 × 5 factorial analysis of variance and discriminant analysis. Playing against weak opposition was associated with an increase (P < 0.01) in time spent in possession while playing away decreased (P < 0.01) the time spent in possession by ~3%. Possession was increased (P < 0.01) when losing than winning or drawing. Finally, the better the ranking of a team, the higher (P < 0.01) the time spent in possession. The playing position effect was significant for all variables (P < 0.05); however, there were only interactions with team ball possession in some cases. The discriminant analysis identified functions for all five playing positions (P < 0.01). The variables that discriminated performance between HPBPT and LPBPT were different for various playing positions, although the number of successful passes was the most common discriminating variable. The results demonstrate that HPBPT and LPBPT developed different possession strategies during matches and that selected variables such as successful passes were identified to explain these data trends across various playing positions. Combinations of variables could be used to develop a probabilistic model for predicting time spent in possession by teams.

Incidence of Kaposi's sarcoma and associated mortality in Fresno, California, 1998 to 2012.

OBJECTIVE: The incidence of Kaposi's sarcoma (KS) decreased dramatically after the introduction of highly active antiretroviral therapy (HAART). This study determined the ongoing incidence of and mortality from KS in HIV-infected adults from 1998-2012 in Fresno County, California. The role of virologic control and immune reconstitution was assessed. METHODS: Incident cases were identified from the state Electronic HIV/AIDS Reporting System (EHARS), the California Cancer Registry, and hospital records of the county HIV treatment center. RESULTS: From 1998-2012, the average incidence of KS was 0.51 cases per 100,000 person-years. Of the 66 cases of KS there were 20 deaths, with 85% of the mortality occurring in the first 12 months. Among patients on HAART achieving HIV RNA <400 copies/uL, but with a <50 cell/uL increase in CD4 count there was no improvement in mortality. CONCLUSIONS: The incidence of KS remains stable since 1998 with a 12-month mortality of 30%.

In silico analysis of tkt1 from avian pathogenic Escherichia coli and its virulence evaluation in chickens.

Extraintestinal pathogenic Escherichia coli (ExPEC) contain tktA and tktB which code for transketolases involved in the pentose phosphate pathway. Recent studies demonstrated that a third gene coding for transketolase 1 (tkt1) was located in a pathogenicity island of avian and human ExPEC belonging to phylogenetic group B2. In the present study, in silico analysis of tkt1 revealed 68% and 69% identity with tktA and tktB, respectively, of ExPEC and 68% identity with tktA and tktB of E. coli MG1655. The translated tkt1 shared 69% and 68% identity with TktA and TktB proteins, respectively, of ExPEC and E. coli MG1655. Phylogenetically, it is shown that the three genes (tktA, tktB and tkt1) cluster in three different clades. Further analysis suggests that tkt1 has been acquired though horizontal gene transfer from plant-associated bacteria within the family Enterobacteriaceae. Virulence studies were performed in order to evaluate whether tkt1 played a role in avian pathogenic E. coli CH2 virulence in chickens. The evaluation revealed that mutant virulence was slightly lower based on LD50 when compared to the wild type during infection of chickens, but there were no significant differences when the two strains were compared based on the number of deaths and lesion scores.