Understanding the role of community resilience in addressing the Ebola virus disease epidemic in Liberia: a qualitative study (community resilience in Liberia).

Background: There is an increasing recognition that community resilience plays a significant role in addressing health shocks like the Ebola virus disease (EVD) epidemic. However, the factors that constitute community resilience, and how these operate dynamically with other health system factors are less understood. Objective: This paper seeks to understand key factors that constitute community resilience and their role in responding to the EVD outbreak in Liberia. Methods: Key informant interviews were conducted between November 2017 and April 2018 with community representatives in Bomi, Margibi and Montserrado counties, and other national stakeholders involved in the EVD response in Liberia from 2014 to 2016. A national stakeholder meeting was conducted to verify and interpret information emerging from the interviews. Results: Factors that were critical for addressing the EVD epidemic in Liberia were identified as: strong leadership, tight bonds and sense of kinship at the community level; trusted communication channels; and trust among various health system stakeholders. These factors facilitated collective actions within communities and helped to direct response initiatives from other levels of the health system to the community. Foreign assistance was seen as crucial for recovery and revitalization of affected communities. However, such aid is often not targeted at addressing critical challenges in a sustainable way, especially when the assistance is highly restricted to specific activities, and those activities are determined without consultation with local actors and community groups. Conclusion: Efforts to systematically build responsible leadership and social capital at community level, including those that strengthen bonds in communities and trust across key actors in the health system, are needed to address health shocks like EVD outbreaks. Without building such capabilities in community resilience, it will be difficult to reap the expected gains from investments focusing on building physical capital and technical capabilities in health services and emergency preparedness.

Substrate-Borne Marking in the Parasitoid Wasp Urolepis rufipes (Hymenoptera: Pteromalidae).

Many animals use pheromone marking as a way to identify their territory or other resources. Among insects, substrate-borne marking is frequently reported for females, which in many species make marks containing oviposition-deterring pheromone, which other females avoid. However, there are fewer reports of substrate-borne marking for males. Here, marking in males of the parasitoid wasp Urolepis rufipes (Ashmead) is described. The conditions under which males mark and whether males and females respond to the males' marks were examined using behavioral observations. Males marked by dragging the tips of their abdomens across a substrate. They marked much more after mating and after consuming honey. They also marked more when with a female, irrespective of copulation, although not when with a male. Females spent more time on or near marked substrates, and males also responded to their own marks. Although males aggressively and successfully defended areas that they had marked against other males, males did not respond to another male's marks in the conspecific's absence. In contrast to males, females did not mark, either on the surface of hosts or on other surfaces, and males showed no detectable response to surfaces which females had recently occupied.

Anterior cruciate ligament injuries in patients with open physes.

From July 1988 to August 1989, six children with open physes and injuries to the anterior cruciate ligament were treated operatively. All injuries involved twisting episodes during sports activities. All six patients had meniscal abnormalities, and, additionally, one patient sustained a Grade III medical ligament tear and had a lateral patellar dislocation. Operative reconstruction used hamstring tendons and place a groove over the front of the tibia and a groove over the top of the femur without violation of the growth plates. The anterior cruciate ligament was primarily repaired (three patients) at the time of reconstruction, if possible. At 3 months, one patient underwent arthroscopic resection of adhesions for arthrofibrosis. There were no other complications. Five patients were evaluated with clinical examination, radiographs, magnetic resonance imaging, and functional testing at an average followup of 33.2 months (range, 25 to 38). Four of the five had returned to their preinjury level of sports participation. Manual maximum KT-1000 arthrometer side-to-side differences averaged 3.6 +/- 1.9 mm. The average Lysholm knee score was 95.2 +/- 2.5; the average Hospital for Special Surgery knee score was 96.6 +/- 2.3. There were no growth plate injuries. Despite the overall clinical stability, magnetic resonance image scans of the five patients consistently demonstrated areas of increased signal in the anterior cruciate ligament grafts.

Stumbling corrective responses in healthy human subjects to rapid reversal of treadmill direction.

The kinematics of stumbling and recovery induced by a rapidly reversing treadmill is described for eight healthy adults. Stability was achieved in approximately 400 ms following treadmill reversal (initiated at heel-strike) and the ensuing stumble. It appeared to be accomplished primarily by rapid flexion of the thigh and knee of the stance limb, which prevented damage to the knee joint and lowered the trunk, and by extension of the contralateral joints (swing limb), which contacted the ground presumably to deliver an impulsive thrust to counter the backward lean of the trunk. The movements of the ankle also contributed to the recovery from the stumble, but its movements were markedly more variable among the subjects than those of the thigh and knee. The observed kinematics to some extent resembled a crossed-extension reflex, which may have been triggered by muscle, joint, cutaneous or vestibular afferents. These data should provide a baseline by which to compare groups in which recovery from stumbling is known to be deficient (e.g., the elderly).

Specialty care for patients with epilepsy must become standard of care. Promotion of Specialty Care for Epilepsy Group.

Epilepsy is a complex, common disorder with severe consequences for patients. The authors believe that a significant percentage of patients are receiving suboptimal care. The national standard of care needs to be upgraded to include the notion that patients with less than total seizure control or those suffering from any medication side-effects should be given the opportunity to receive specialty care by physicians with specific expertise in the field of epilepsy.

Epidemiologic observations on infection with Rochalimaea species among cats living in Baltimore, Md.

Cats from several sources in Baltimore, Md, were tested for seropositivity to Rochalimaea henselae and R quintana. Co-infection with Toxoplasma gondii or feline immunodeficiency virus was assessed as a risk factor for infection with Rochalimaea spp. Of 592 cats tested, 87 (14.7%) were seropositive for one or both Rochalimaea spp, although titers to R henselae were significantly higher than those to R quintana. Prevalence of seropositivity increased significantly with cat age and weight and was associated with seropositivity to T gondii but was not associated with gender. Prevalence of seropositivity was similar (12.5 to 14.4%) among groups of cats with some history of human contact but was higher among feral cats (44.4%). Whether cats are reservoirs or mechanical vectors of Rochalimaea spp that can cause diseases in people is still uncertain, but these findings indicated widespread infection of cats and suggested possible modes of transmission for Rochalimaea spp among cats.

The automation of routine calculations and graphing for alkaline filter elution analysis on a computer-controlled liquid scintillation analyzer.

The data calculations and graphing functions for the widely used alkaline filter elution technique have been completely automated. This saves considerable time and increases both efficiency and accuracy by eliminating human error. The automation was accomplished utilizing Lotus 1-2-3 and Lotus Graphwriter II on a Packard Tri-Carb 1900CA liquid scintillation analyzer containing a built-in pico-XTE computer. A batch file is used to control the overall execution of the process. It copies the data stored by the 1900CA into the Lotus subdirectory and invokes Lotus 1-2-3. A Lotus macro automatically imports the data file, performs the calculations, and prints the results. Graphwriter II is then invoked by the batch file and the charts are composed and graphed. Finally, the instrument operating software for the 1900CA is reentered and sample analysis can be resumed for any unanalyzed samples.

Insulin-like growth factor II binding to cultured human chondrosarcoma cells.

Cultured cells originally derived from a human chondrosarcoma (A1684) were used to investigate somatomedin binding in terms of kinetics and specificity. In this study, the rat somatomedin, multiplication-stimulation activity (MSA) was utilized. While the human chondrosarcoma cells did not exhibit a mitogenic response to MSA, the rate of transport of glucose and amino acids was significantly increased. In competitive binding experiments a specific insulin-insensitive MSA receptor was identified which showed half maximal displacement of tracer at a concentration of 250 ng/ml of MSA using whole cells. This receptor had an affinity constant of 4.8 X 10(7) M-1. Kinetic analysis of MSA binding to membrane preparations and to Triton X-100 solubilized membranes revealed an increase in the binding affinity to 1.28 X 10(8) M-1 and 2.8 X 10(8) M-1, respectively. Of particular significance is the observation that these cells have especially high levels of MSA receptors. Determination of binding capacity revealed that these cells contain approximately 1.9 X 10(6) MSA receptors per cell and therefore are an excellent model system for the characterization and purification of somatomedin receptors. Affinity labeling of the MSA receptor using the chemical crosslinking reagent, disuccinimidyl suberate, confirmed that this receptor was of the type II class of somatomedin receptors and exhibited a molecular weight of 218,000 under nonreducing conditions.

Developmental impact on trans-acting dosage effects in maize aneuploids.

The reduction in vigor or viability caused by aneuploidy may be the result of trans-acting dosage effects that reduce gene expression. To investigate the molecular and developmental parameters of aneuploid syndromes, the expression of sucrose synthase1 (sus1) and shrunken1 (sh1) was studied in 2-week-old plants. Expression of sus1 and sh1 was first investigated in euploids, where it was found that both transcripts varied in a diurnal fashion. Chromosome arm number can be varied in a series from one to three doses in maize. In the 14 aneuploid dosage series examined, most caused changes in sus1 and sh1 RNA levels that were both gene and tissue specific. Results were compared to previous data from embryo and endosperm tissue. More dosage effects were detected and the magnitude of RNA level modulation was greater in 2-week-old plant tissue. These findings suggest that the molecular consequences of aneuploidy might become more severe as development progresses.

Late G1 amino acid restriction point in human dermal fibroblasts.

Human dermal fibroblasts arrested in G0 by maintenance in medium supplemented with 0.1% serum were not restimulated to divide when fresh medium containing 10% dialyzed serum but lacking group B amino acids (cystine, isoleucine, lysine, phenylalanine and tyrosine) was added. Unlike rodent cells, the addition of fresh serum-supplemented medium lacking only isoleucine did not cause a growth arrest. The amino acid sensitive growth arrest in human fibroblasts was dependent both on presynchronization in G0 as well as a prestarvation for amino acids prior to stimulation with high serum. When cells were restimulated in the absence of amino acids, they arrested predominantly in G1, although a small percentage of cells entered early S phase. When medium containing a complete complement of amino acids was then added, cells initiated DNA synthesis following a minimum lag of 2-3 hr. Growth arrested cells initiated DNA synthesis even when complete unsupplemented medium was added, although the addition of high concentrations of insulin or 10% serum increased the rate of entry.

Characterization of the rebinding of 125I-epidermal growth factor released from BALB/c-3T3 cells following accumulation in the presence of chloroquine.

Lysosomotropic amines, such as chloroquine and methylamine, increase the intracellular accumulation of 125I-EGF by inhibiting lysosomal degradation. It has been shown previously that BALB/c-3T3 cells, prelabeled at 4 degrees C with 125I-EGF for 3 h and subsequently chased at 37 degrees C in the presence of chloroquine, internalized the surface bound 125I-EGF which was subsequently released into the extracellular medium in a high molecular weight form which co-migrated with native 125I-EGF. The secreted 125I-EGF rebound to the cells from which it was released more efficiently than does peptide in the extracellular media. We now show that when the BALB/c-3T3 cells were prelabeled at 37 degrees C for 2 h in the presence of chloroquine, the internalized 125I-EGF released into the medium was in a high molecular weight form which co-migrated with native 125I-EGF and did not rebind anymore efficiently than did peptide in the extracellular media. This lack of rebinding was not due to an alteration in the 125I-EGF molecule since it was still capable of rebinding to naive A431 cells, nor was it due to the exhaustion of EGF receptors on the BALB/c-3T3 cells. The inhibition of rebinding was observed only when the cells were treated with EGF in the presence of chloroquine, and was not due to a general down-regulation of membrane receptors. The differences between the rebinding of 125I-EGF at 4 degrees C and 37 degrees C suggest that EGF may be processed via different pathways in the cell.

Orbital histiocytic lymphoma arising from the ethmoid sinus.

Histiocytic lymphoma has been reported previously as an orbital manifestation of systemic malignancy. We report herein a 49-year-old white male with orbital involvement from a sclerosing lesion in the ethmoid sinus that initially caused a biopsy-proven orbital inflammatory mass. This report of an orbito-sinus histiocytic lymphoma underscores the need to re-biopsy symptomatic orbital inflammatory lesions that continue to enlarge.