Who fails to complete tuberculosis treatment? Temporal trends and risk factors for treatment interruption in a community-based directly observed therapy programme in a rural district of South Africa

SETTING: Hlabisa Tuberculosis Programme, Hlabisa, South Africa. OBJECTIVE: To determine trends in and risk factors for interruption of tuberculosis treatment. METHODS: Data were extracted from the control programme database starting in 1991. Temporal trends in treatment interruption are described; independent risk factors for treatment interruption were determined with a multiple logistic regression model, and Kaplan-Meier survival curves for treatment interruption were constructed for patients treated in 1994-1995. RESULTS: Overall 629 of 3610 surviving patients (17%) failed to complete treatment; this proportion increased from 11% (n = 79) in 1991/1992 to 22% (n = 201) in 1996. Independent risk factors for treatment interruption were diagnosis between 1994-1996 compared with 1991-1393 (odds ratio [OR] 1.9, 95% confidence interval [CT] 1.6-2.4); human immunodeficiency virus (HIV) positivity compared with HIV negativity (OR 1.8, 95% CI 1.4-2.4); supervised by village clinic compared with community health worker (OR 1.9, 95% CI 1.4-2.6); and male versus female sex (OR 1.3, 95% CI 1.1-1.6). Few patients interrupted treatment during the first 2 weeks, and the treatment interruption rate thereafter was constant at 1% per 14 days. CONCLUSIONS: Frequency of treatment interruption from this programme has increased recently. The strongest risk factor was year of diagnosis, perhaps reflecting the impact of an increased caseload on programme performance. Ensuring adherence to therapy in communities with a high level of migration remains a challenge even within community-based directly observed therapy programmes.

The last glacial cycle from the humid tropics of northeastern Australia: comparison of a terrestrial and a marine record

A detailed pollen record from the Ocean Drilling Program Site 820 core, located on the upper part of the continental slope off the coast of northeast Queensland, was constructed to compare with the existing pollen record from Lynch's Crater on the adjacent Atherton Tableland and allow the production of a regional picture of vegetation and environmental change through the last glacial cycle. Some broad similarities in patterns of vegetation change are revealed, despite the differences between sites and their pollen catchments, which can be related largely to global climate and sea-level changes. The original estimated time scale of the Lynch's Crater record is largely confirmed from comparison with the more thoroughly dated ODP record. Conversely, the Lynch's Crater pollen record has assisted in dating problematic parts of the ODP record. In contrast to Lynch's Crater, which reveals a sharp and sustained reduction in drier araucarian forest around 38,000 yrs BP, considered to have been the result of burning by Aboriginal people, the ODP record indicates, most likely, a stepwise reduction, dating from 140,000 yrs BP or beyond. The earliest reduction shows lack of a clear connection between Araucaria decline and increased burning and suggests that people may not have been involved at this stage. However, a further decline in araucarian forest, possibly around 45,000 yrs BP, which has a more substantial environmental impact and is not related to a time of major climate change, is likely, at least partially, the result of human burning. The suggestion, from the ODP core oxygen isotope record, of a regional sea-surface temperature increase of around 4 degrees C between about 400,000 and 250,000 yrs BP, may have had some influence on the overall decline in Araucaria and its replacement by sclerophyll vegetation. (C) 2000 Elsevier Science B.V. All rights reserved.

Malevolence, stigma, and social distance: Maximizing intergroup differences in HIV/AIDS discourse

This study examined the intergroup language used by young heterosexual Australians in conversations about HIV/AIDS and safe sex. Sixty male and 72 female heterosexuals participated in four-person facilitated conversations (same-sex or mixed-sex) about HIV/AIDS and safe sex, which were recorded and transcribed. We focused on extracts concerning strangers or malevolent individuals who appear to be group members, along with extracts involving foreign national groups. Discourse analysis showed that groups at lower levels of social distance were constructed mainly in terms of individual responsibility. At moderate social distance, stereotypes were more negative, but sub-typing was common, whereas at the highest levels, people were constructed entirely in intergroup terms. The findings of this study suggest that HN prevention programs should make reference to all salient outgroups, so as to neutralize communicative strategies that strengthen intergroup boundaries as a means of reducing perceived personal threat of HIV infection.

Contemporary strategies for rural community development in Australia: a governmentality perspective

Contemporary strategies for rural development in Australia are based upon notions of self-help and bottom-up, community-based initiatives which are said to 'empower' the individual from the imposing structures of government intervention. While such strategies are not entirely new to Australia, they have, it seems, been inadequately theorised to date and are generally regarded, in rather functionalist terms, as indicative of attempts to cut back on public expenditure. Harnessing itself to the 'governmentality' perspective, this paper explores government and 'expert' discourses of rural community development in Queensland and suggests, instead, that these strategies are indicative of an advanced liberal form of rule which seeks to 'govern through community'. With this in mind, three basic research questions are identified as worthy of further exploration; how are the notions of self-governing individuals and communities constructed in political discourse; what political rationalities are used to justify current levels of(non) intervention and finally; what are the discourses, forms and outcomes of empowerment at the local level? The paper concludes by arguing that while the empowering effects of self-help are frequently cited as its greatest virtue, it is not so much control as the added burden of responsibility that is being devolved to local people. Given the emphasis of the governmentality perspective on strategies for 'governing at a distance', however, these conclusions can hardly be unexpected. (C) 2000 Elsevier Science Ltd, All rights reserved.

Effect of density on spatial distribution, pit formation and pit diameter of Myrmeleon acer Walker, (Neuroptera : Myrmeleontidae): patterns and processes

The effect of increasing population density on the formation of pits, their size and spatial distribution, and on levels of mortality was examined in the antlion Myrmeleon acer Walker. Antlions were kept at densities ranging from 0.4 to 12.8 individuals per 100 cm(2). The distribution of pits was regular or uniform across all densities, but antlions constructed proportionally fewer and smaller pits as density increased. Mortality through cannibalism was very low and only occurred at densities greater than five individuals per 100 cm(2). Antlions in artificially crowded situations frequently relocated their pits and when more space became available, individuals became more dispersed with time. Redistribution of this species results from active avoidance of other antlions and sand throwing associated with pit construction and maintenance, rather than any attempt to optimise prey capture per se.

U-q[(sl(2)over-cap vertical bar 1)] vertex operators, screen currents, and correlation functions at an arbitrary level

Bosonized q-vertex operators related to the four-dimensional evaluation modules of the quantum affine superalgebra U-q[sl((2) over cap\1)] are constructed for arbitrary level k=alpha, where alpha not equal 0,-1 is a complex parameter appearing in the four-dimensional evaluation representations. They are intertwiners among the level-alpha highest weight Fock-Wakimoto modules. Screen currents which commute with the action of U-q[sl((2) over cap/1)] up to total differences are presented. Integral formulas for N-point functions of type I and type II q-vertex operators are proposed. (C) 2000 American Institute of Physics. [S0022-2488(00)00608-3].

Papillomavirus virus-like particles for the delivery of multiple cytotoxic T cell epitopes

Chimeric papillomavirus (PV) virus-like particles (VLPs) based on the bovine papillomavirus type 1 (BPV-1) L1 protein were constructed by replacing the 23-carboxyl-terminal amino acids of the BPV1 major protein L1 with an artificial polytope minigene, containing known CTL epitopes of human PV16 E7 protein, HIV IIIB gp120 P18, Nef, and reverse transcriptase (RT) proteins, and an HPV16 E7 linear B epitope. The CTL epitopes were restricted by three different MHC class 1 alleles (H-2(b), H-2(d), HLA-A*0201). The chimeric L1 protein assembled into VLPs when expressed in SF-9 cells by recombinant baculovirus. After immunization of mice with polytope VLPs in the absence of adjuvant, serum antibodies were detected which reacted with both polytope VLPs and wild-type BPV1L1 VLPs, in addition to the HPV16E7 linear B cell epitope. CTL precursors specific for the HPV16 E7, HIV P18, and RT CTL epitopes were also detected in the spleen of immunized mice. Polytope VLPs can thus deliver multiple B and T epitopes as immunogens to the MHC class I and class II pathways, extending the utility of VLPs as self-adjuvanting immunogen delivery systems. (C) 2000 Academic Press.

Experimental study of phase equilibria in the PbO-MgO-SiO2 system

Equilibrium phase relations in the PbO-Al2O3-SiO2 system have been investigated experimentally by means of high-temperature equilibration, quenching, and electron probe X-ray microanalysis (EPMA). The system has 21 primary phase fields including three monoxides (PbO, Al2O3, and SiO2), seven binary compounds (Al6Si2O13, PbAl2O4, PbAl12O19, Pb2Al2O5, PbSiO3, Pb2SiO4, and Pb4SiO6), and eleven ternary compounds (PbAl2Si2O8, Pb3Al10SiO20, Pb4Al2Si2O11, Pb4Al4SiO12, Pb4Al4Si3O16, Pb4Al4Si5O20, Pb5Al2Si10O28, Pb6Al2Si6O21, Pb8Al2Si4O19, Pb12Al2Si17O49, and Pb12Al2Si20O55). Three new ternary compounds, Pb4Al4SiO12, Pb4Al4Si5O20, and Pb12Al2Si17O49, were observed and characterized by EPMA. No extensive solid solution in any of the compounds was found in the present study. The liquidus isotherms were experimentally determined in most of the primary phase fields in the temperature range from 923 to 1873 K, and the ternary phase diagram of the PbO-Al2O3-SiO2 System has been constructed.

Modelling solute transport in structured soils: Performance evaluation of the ADR and TRM models

The movement of chemicals through the soil to the groundwater or discharged to surface waters represents a degradation of these resources. In many cases, serious human and stock health implications are associated with this form of pollution. The chemicals of interest include nutrients, pesticides, salts, and industrial wastes. Recent studies have shown that current models and methods do not adequately describe the leaching of nutrients through soil, often underestimating the risk of groundwater contamination by surface-applied chemicals, and overestimating the concentration of resident solutes. This inaccuracy results primarily from ignoring soil structure and nonequilibrium between soil constituents, water, and solutes. A multiple sample percolation system (MSPS), consisting of 25 individual collection wells, was constructed to study the effects of localized soil heterogeneities on the transport of nutrients (NO3-, Cl-, PO43-) in the vadose zone of an agricultural soil predominantly dominated by clay. Very significant variations in drainage patterns across a small spatial scale were observed tone-way ANOVA, p < 0.001) indicating considerable heterogeneity in water flow patterns and nutrient leaching. Using data collected from the multiple sample percolation experiments, this paper compares the performance of two mathematical models for predicting solute transport, the advective-dispersion model with a reaction term (ADR), and a two-region preferential flow model (TRM) suitable for modelling nonequilibrium transport. These results have implications for modelling solute transport and predicting nutrient loading on a larger scale. (C) 2001 Elsevier Science Ltd. All rights reserved.

Functional significance of the beta-hairpin in the insecticidal neurotoxin omega-atracotoxin-Hv1a

omega -Atracotoxin-Hv1a is an insect-specific neurotoxin whose phylogenetic specificity derives from its ability to antagonize insect, but not vertebrate, voltage-gated calcium channels. In order to help understand its mechanism of action and to enhance its utility as a lead compound for insecticide development, we used a combination of protein engineering and site-directed mutagenesis to probe the toxin for key functional regions. First, we constructed a Hairpinless mutant in which the C-terminal beta -hairpin, which is highly conserved in this family of neurotoxins, was excised without affecting the fold of the residual disulfide-rich core of the toxin. The Hairpinless mutant was devoid of insecticidal activity, indicating the functional importance of the hairpin. We subsequently developed a highly efficient system for production of recombinant toxin and then probed the hairpin for key functional residues using alanine-scanning mutagenesis followed by a second round of mutagenesis based on initial hits from the alanine scan. This revealed that two spatially proximal residues, Asn(27) and Arg(35), form a contiguous molecular surface that is essential for toxin activity. We propose that this surface of the beta -hairpin is a key site for interaction of the toxin with insect calcium channels.

A time-harmonic inverse methodology for the design of RF coils in MRI

An inverse methodology is described to assist in the design of radio-frequency (RF) coils for magnetic resonance imaging (MRI) applications. The time-harmonic electromagnetic Green's functions are used to calculate current on the coil and shield cylinders that will generate a specified internal magnetic field. Stream function techniques and the method of moments are then used to implement this theoretical current density into an RF coil. A novel asymmetric coil operating for a 4.5 T MRI machine was designed and constructed using this methodology and the results are presented.

In vivo protein cyclization promoted by a circularly permuted Synechocystis sp PCC6803 DnaB mini-intein

A synthetic Synechocystis sp. PCC6803 DnaB split mini-intein gene was constructed for the in vivo cyclization of recombinant proteins expressed in Escherichia coli. The system was used to cyclize the NH2-terminal domain of E. coli DnaB, the structure of which had been determined previously by NMR spectroscopy. Cyclization was found to proceed efficiently, with little accumulation of precursor, and the product was purified in high yield. The solution structure of cyclic DnaB-N is not significantly different from that of linear DnaB-N and it unfolds reversibly at temperatures similar to14 degreesC higher. Improved hydrogen bonding was observed in the first and last helices, and the length of the last helix was increased, while the 9-amino acid linker used to join the NH2 and COOH termini was found to be highly mobile. The measured thermodynamic stabilization of the structure (DeltaDeltaG approximate to 2 kcal/mol) agrees well with the value estimated from the reduced conformational entropy in the unfolded form. Simple polymer theory can be used to predict likely free energy changes resulting from protein cyclization and how the stabilization depends on the size of the protein and the length of the linker used to connect the termini.

Algebraic Bethe ansatz for integrable one-dimensional extended Hubbard models with open boundary conditions

Nine classes of integrable open boundary conditions, further extending the one-dimensional U-q (gl (212)) extended Hubbard model, have been constructed previously by means of the boundary Z(2)-graded quantum inverse scattering method. The boundary systems are now solved by using the algebraic Bethe ansatz method, and the Bethe ansatz equations are obtained for all nine cases.

Neuroarchitecture of the color and polarization vision system of the stomatopod haptosquilla

The apposition compound eyes of stomatopod crustaceans contain a morphologically distinct eye region specialized for color and polarization vision, called the mid-band. In two stomatopod superfamilies, the mid-band is constructed from six rows of enlarged ommatidia containing multiple photoreceptor classes for spectral and polarization vision. The aim of this study was to begin to analyze the underlying neuroarchitecture, the design of which might reveal clues how the visual system interprets and communicates to deeper levels of the brain the multiple channels of information supplied by the retina. Reduced silver methods were used to investigate the axon pathways from different retinal regions to the lamina ganglionaris and from there to the medulla externa, the medulla interna, and the medulla terminalis. A swollen band of neuropil-here termed the accessory lobe-projects across the equator of. the lamina ganglionaris, the medulla externa, and the medulla interna and represents, structurally, the retina's mid-band. Serial semithin and ultrathin resin sections were used to reconstruct the projection of photoreceptor axons from the retina to the lamina ganglionaris. The eight axons originating from one ommatidium project to the same lamina cartridge. Seven short visual fibers end at two distinct levels in each lamina cartridge, thus geometrically separating the two channels of polarization and spectral information. The eighth visual fiber runs axially through the cartridge and terminates in the medulla externa. We conclude that spatial, color, and polarization information is divided into three parallel data streams from the retina to the central nervous system. (C) 2003 Wiley-Liss, Inc.

Image calibration to like-values in mapping shallow water quality from multitemporal data

The applicability of image calibration to like-values in mapping water quality parameters from multitemporal images is explored, Six sets of water samples were collected at satellite overpasses over Moreton Bay, Brisbane, Australia. Analysis of these samples reveals that waters in this shallow bay are mostly TSS-dominated, even though they are occasionally dominated by chlorophyll as well. Three of the images were calibrated to a reference image based on invariant targets. Predictive models constructed from the reference image were applied to estimating total suspended sediment (TSS) and Secchi depth from another image at a discrepancy of around 35 percent. Application of the predictive model for TSS concentration to another image acquired at a time of different water types resulted in a discrepancy of 152 percent. Therefore, image calibration to like-values could be used to reliably map certain water quality parameters from multitemporal TM images so long as the water type under study remains unchanged. This method is limited in that the mapped results could be rather inaccurate if the water type under study has changed considerably. Thus, the approach needs to be refined in shallow water from multitemporal satellite imagery.