Impact of on-site testing for maternal syphilis on treatment delays, treatment rates, and perinatal mortality in rural South Africa: a randomised controlled trial

Background: Syphilis remains a significant cause of preventable perinatal death in developing countries with many women remaining untested and thus untreated. Syphilis testing in the clinic (on-site testing) may be a useful strategy to overcome this. We studied the impact of on-site syphilis testing on treatment delays and rates, and perinatal mortality. Methods: We conducted a cluster randomised controlled trial among seven pairs of primary healthcare clinics in rural South Africa, comparing on-site testing complemented by laboratory confirmation versus laboratory testing alone. Intervention clinics used the on-site test conducted by primary care nurses, with results and treatment available within an hour. Control clinics sent blood samples to the provincial laboratory, with results returned 2 weeks later. Results: Of 7134 women seeking antenatal care with available test results, 793 (11.1%) tested positive for syphilis. Women at intervention clinics completed treatment 16 days sooner on average (95% confidence interval: 11 to 21), though there was no significant difference in the proportion receiving adequate treatment at intervention (64%) and control (69%) clinics. There was also no significant difference in the proportion experiencing perinatal loss (3.3% v 5.1%; adjusted risk difference: -0.9%; 95% Cl -4.4 to 2.7). Conclusions: Despite reducing treatment delays, the addition of on-site syphilis testing to existing laboratory testing services did not lead to higher treatment rates or reduce perinatal mortality. However on-site testing for syphilis may remain an important option for improving antenatal care in settings where laboratory facilities are not available.

How to be a chaste species pluralist-realist: the origins of species modes and the synapomorphic species concept

The biological species (biospecies) concept applies only to sexually reproducing species, which means that until sexual reproduction evolved, there were no biospecies. On the universal tree of life, biospecies concepts therefore apply only to a relatively small number of clades, notably plants and animals. I argue that it is useful to treat the various ways of being a species (species modes) as traits of clades. By extension from biospecies to the other concepts intended to capture the natural realities of what keeps taxa distinct, we can treat other modes as traits also, and so come to understand that the plurality of species concepts reflects the biological realities of monophyletic groups. We should expect that specialists in different organisms will tend to favour those concepts that best represent the intrinsic mechanisms that keep taxa distinct in their clades. I will address the question whether modes of reproduction such as asexual and sexual reproduction are natural classes, given that they are paraphyletic in most clades.

Effects of age and alcohol exposure during early life on pyramidal cell numbers in the CA1-CA3 region of the rat hippocampus

We have previously shown that exposing rats to a relatively high dose of ethanol during early postnatal life can result in an alteration in spatial learning ability. The hippocampal formation is known to be involved in the control of this ability. The purpose of the present study was to determine whether exposure of rats to ethanol during early postnatal life had either immediate or delayed effects on the numbers of pyramidal cells in the CA1-CA3 subregion of the hippocampus. Wistar rats were exposed to a relatively high daily dose of ethanol at postnatal day 10-15 by placing them for 3 h/day in a chamber containing ethanol vapor. Groups of ethanol-treated (ET), separation control (SC), and mother-reared control (MRC) rats were anesthetized and killed at 16 and 30 days of age by perfusion with phosphate-buffered 2.5% glutaraldehyde. The Cavalieri principle was used to determine the volumes of the CA1 and CA2+CA3 regions. The physical disector method was used to estimate the numerical density of neurons in each of the subdivisions. The total number of pyramidal cells was calculated by multiplying the appropriate estimates of the numerical density by the volume. There were significant age-related reductions in the total numbers of pyramidal cells at 16-30 days of age irrespective of the groups examined. Ethanol treated rats were found to have slightly but significantly fewer pyramidal cell neurons than either the MRC or SC groups. These observations indicate that pyramidal cells in the hippocampus may be vulnerable to a relatively high dose of ethanol exposure during this short period of early postnatal life. (C) 2003 Wiley-Liss, Inc.

The impact of life stage and societal culture on subordinate influence ethics: A study of Brazil, China, Germany, and the US

In this paper, we investigate the effects of societal values and life stage on subordinate influence ethics. Based on the evolving crossvergence theory of macro-level predictors of values evolution, we demonstrate the applicability of crossvergence theory in the micro-level context. Furthermore, our study provides the first empirical multi-level analysis of influence ethics utilizing a multi pie-country sample. Thus, we illustrate how the breath of crossvergence can be expanded to provide a multi-level theoretical foundation of values and behavior evolution across cultures. Specifically, we integrate micro-level life stage theory and macro-level societal culture theory to concurrently assess the contributions of each theory in explaining subordinate influence ethics across the diverse societies of Brazil. China, Germany and the U.S. Consistent with previous research, we found significant societal differences in influence ethics. However, we also found that life stage theory played a significant role in understanding influence ethics. Thus, our findings expand the crossvergence perspective on societal change, indicating that key micro-level predictors (e.g., life stage) should be included in cross-cultural research. (C) 2009 Elsevier Inc. All rights reserved.

Shelter association between the hermit crab Sympagurus dimorphus and the zoanthid Epizoanthus paguricola in the southwestern Atlantic Ocean

Schejter, L. and Mantelatto, F.L. 2011. Shelter association between the hermit crab Sympagurus dimorphus and the zoanthid Epizoanthus paguricola in the southwestern Atlantic Ocean. -Acta Zoologica (Stockholm) 92: 141-149. The available literature on zoanthid-hermit crab associations deals only with records of this phenomenon, providing no detailed information. We describe, for the first time, the shell-like colonies of Epizoanthus paguricola associated with the hermit crab Sympagurus dimorphus from benthic samples taken in the Argentine Sea, between 85 and 131 m depth, and provide information about morphometric relationships between the hermits and the zoanthids. In total, 260 specimens (137 males and 123 females) of S. dimorphus were collected, 240 (92.3%) of which were living in symbiosis with E. paguricola. The remaining 20 (7.7%) were living inside gastropod shells. As the initial structure of the pseudoshell, 12 different gastropod species were found (all were almost totally covered with colonies of E. paguricola). The hermit crab lives in the spiral cavity inside the soft colony, which seemed to be slightly different depending on the initial gastropod. Aperture pseudoshell morphology did not seem to be related to the sex of the hermit crab host, although males showed larger apertures for a given colony size. This fact is probably related to a larger size of male`s cheliped (sexual dimorphic character) used like a gastropod operculum and that may serve as a template for the growing of the aperture pseudoshell edge. The number of epizoanthid polyps per colony increased in relation to the weight of the colony and to the size of the hermit crab. A process of selection of the initial shell was evident, because species of Naticidae were not the most common gastropods in this benthic community, but were those most used by hermit crabs (> 60%). The puzzling association between hermit crab, shell and zoanthid presumably occurs during the hermit juvenile phase, when the crab occupies a small shell, and a zoanthid larva settles on it. Given the close relationship between S. dimorphus and E. paguricola found in this region, we support the idea that due to the low availability of adequate gastropod shells for hermit life cycle, this association allows the establishment and the continuity of the hermit crab population in the studied area.

Implications of current ecological thinking for biodiversity conservation: A review of the salient issues

Given escalating concern worldwide about the loss of biodiversity, and given biodiversity's centrality to quality of life, it is imperative that current ecological knowledge fully informs societal decision making. Over the past two decades, ecological science has undergone many significant shifts in emphasis and perspective, which have important implications for how we manage ecosystems and species. In particular, a shift has occurred from the equilibrium paradigm to one that recognizes the dynamic, non-equilibrium nature of ecosystems. Revised thinking about the spatial and temporal dynamics of ecological systems has important implications for management. Thus, it is of growing concern to ecologists and others that these recent developments have not been translated into information useful to managers and policy makers. Many conservation policies and plans are still based on equilibrium assumptions. A fundamental difficulty with integrating current ecological thinking into biodiversity policy and management planning is that field observations have yet to provide compelling evidence for many of the relationships suggested by non-equilibrium ecology. Yet despite this scientific uncertainty, management and policy decisions must still be made. This paper was motivated by the need for considered scientific debate on the significance of current ideas in theoretical ecology for biodiversity conservation. This paper aims to provide a platform for such discussion by presenting a critical synthesis of recent ecological literature that (1) identifies core issues in ecological theory, and (2) explores the implications of current ecological thinking for biodiversity conservation.

On Reciprocal Illumination and Consilience in Biogeography

Biogeography deals with the combined analysis of the spatial and temporal components of the evolutionary process. To this purpose, biogeographical analysis should consider two extra steps: a reciprocal illumination step, and a consilience step. Even if the traditional challenges of biogeography were successfully handled, the obtained hypothesis is not necessarily meaningful in biogeographical terms--it needs continuous test in the light of external hypotheses. For this reason, a concept analogous to Hennig`s reciprocal illumination is valuable, as well as a sort of biogeographical consilience in Whewell`s sense. Firstly, through the search for different classes of evidence, information useful to improve the hypothesis can be accessed via reciprocal illumination. Following, a more general hypothesis would arise through a consilience process, when the hypothesis explains phenomena not contemplated during its construction, as the distribution of other taxa or the existence (or absence) of fossils. This procedure aims to evaluate the robustness of biogeographical hypotheses as scientific theories. Such theories are reliable descriptions of how life changes its form both in space and time, putting historical biogeography close to Croizat`s statement of evolution as a three dimensional phenomenon.

Dental caries in cerebral palsied individuals and their caregivers` quality of life

To study the correlation between caries experience in individuals with cerebral palsy (CP) and the quality of life of their primary caregivers. Sixty-five non-institutionalized individuals, presenting CP, aged 2-21 years old, were evaluated for caries experience. Their respective caregivers aged 20-74 years old answered the Short Form 36 (SF-36) health survey and Independence Measure for Children. Fifty-eight non-disabled individuals (ND group), aged 2-21 years old, and their respective caregivers, aged 25-56 years old, were submitted to the same evaluation process as the CP group. Primary caregivers of CP individuals exhibited significantly lower scores than the ND group in all subscales of the SF-36 health survey questionnaire: physical functioning, physical role, bodily pain, general health, vitality, social functioning, emotional role and mental health. The CP group presented significantly higher values for the Decayed, Missed and Filled (DMF-T) index than the ND group and a significant negative correlation was obtained between the SF-36 and DMF-T index. The results suggest that caregivers of CP individuals exhibited worse quality of life than those of the non-disabled. A negative correlation exists between caries experience of CP individuals and their caregivers` quality of life.

Formation Of The Maritime Labor Force In Brazil: Culture And Daily Life, Tradition And Resistance (1808-1850).

Formation Of The Maritime Labor Force In Brazil: Culture And Daily Life, Tradition And Resistance (1808-1850). Since the 16(th) Century, Brazil has played a major role in the rise of a new economical and social order, in which ships represented a space of struggle and contradictions among rulers, captains and sailors. This article will study the proletarization process that transformed Indians, small farmers, free and slave black people in maritime labor force in Brazil during the first half of 19(th) century.

Sleep Quality and Quality of Life in Patients with Hypertrophic Cardiomyopathy

Objectives: To evaluate clinical predictors of poor sleep quality and quality of life (QOL) in patients with hypertrophic cardiomyopathy (HCM). Methods: Consecutive stable patients with HCM were evaluated for the risk of obstructive sleep apnea (OSA) by the Berlin Questionnaire, daytime sleepiness by the Epworth Sleepiness Scale, sleep quality by the Pittsburgh Sleep Questionnaire Index and QOL by the Minnesota Living with Heart Failure Questionnaire. Asymptomatic subjects without HCM were used as controls. Results: We studied 84 patients with HCM and 42 controls who were similar with regard to gender (49 vs. 50% males), age [52 (38-62) vs. 47 (33-58) years] and body mass index (27 +/- 4 vs. 27 +/- 5). HCM diagnosis, high risk for OSA and female gender were independently associated with poor sleep quality in the entire population. Among patients with HCM, poor QOL was independently associated with poor sleep quality, New York Heart Association functional class and diuretic therapy. Conclusion: Poor sleep quality is very common in patients with HCM and may have a negative impact on the QOL, which in turn is an important marker of prognosis in patients with cardiomyopathies. Copyright (C) 2010 S. Karger AG, Basel

Molecular analysis of CYP21A2 can optimize the follow-up of positive results in newborn screening for congenital adrenal hyperplasia

Neonatal screening for congenital adrenal hyperplasia (CAH) is useful in diagnosing salt wasting form (SW). However, there are difficulties in interpreting positive results in asymptomatic newborns. The main objective is to analyze genotyping as a confirmatory test in children with neonatal positive results. Patients comprised 23 CAH children and 19 asymptomatic infants with persistently elevated 17-hydroxyprogesterone (17OHP) levels. CYP21A2 gene was sequenced and genotypes were grouped according to the enzymatic activity of the less severe allele: A1 null, A2 < 2%, B 3-7%, C > 20%. Twenty-one children with neonatal symptoms and/or 17OHP levels > 80 ng/ml carried A genotypes, except two virilized girls (17OHP < 50 ng/ml) without CAH genotypes. Patients carrying SW genotypes (A1, A2) and low serum sodium levels presented with neonatal 17OHP > 200 ng/ml. Three asymptomatic boys carried simple virilizing genotypes (A2 and B): in two, the symptoms began at 18 months; another two asymptomatic boys had nonclassical genotypes (C). The remaining 14 patients did not present CAH genotypes, and their 17OHP levels were normalized by 14 months of age. Molecular analysis is useful as a confirmatory test of CAH, mainly in boys. It can predict clinical course, identify false-positives and help distinguish between clinical forms of CAH.