Detection of four Plasmodium species in blood from humans by 18S rRNA gene subunit-based and specific real-time PCR assays

Résumé : Un nombre croissant de cas de malaria chez les voyageurs et migrants a été rapporté. Bien que l'analyse microscopique des frottis sanguins reste traditionnellement l'outil diagnostic de référence, sa fiabilité dépend considérablement de l'expertise de l'examinateur, pouvant elle-même faire défaut sous nos latitudes. Une PCR multiplex en temps réel a donc été développée en vue d'une standardisation du diagnostic. Un ensemble d'amorces génériques ciblant une région hautement conservée du gène d'ARN ribosomial 18S du genre Plasmodium a tout d'abord été conçu, dont le polymorphisme du produit d'amplification semblait suffisant pour créer quatre sondes spécifiques à l'espèce P. falciparum, P. malariae, P. vivax et P. ovale. Ces sondes utilisées en PCR en temps réel se sont révélées capables de détecter une seule copie de plasmide de P. falciparum, P. malariae, P. vivax et P. ovale spécifiquement. La même sensibilité a été obtenue avec une sonde de screening pouvant détecter les quatre espèces. Quatre-vingt-dix-sept échantillons de sang ont ensuite été testés, dont on a comparé la microscopie et la PCR en temps réel pour 66 (60 patients) d'entre eux. Ces deux méthodes ont montré une concordance globale de 86% pour la détection de plasmodia. Les résultats discordants ont été réévalués grâce à des données cliniques, une deuxième expertise microscopique et moléculaire (laboratoire de Genève et de l'Institut Suisse Tropical de Bâle), ainsi qu'à l'aide du séquençage. Cette nouvelle analyse s'est prononcé en faveur de la méthode moléculaire pour tous les neuf résultats discordants. Sur les 31 résultats positifs par les deux méthodes, la même réévaluation a pu donner raison 8 fois sur 9 à la PCR en temps réel sur le plan de l'identification de l'espèce plasmodiale. Les 31 autres échantillons ont été analysés pour le suivi de sept patients sous traitement antimalarique. Il a été observé une baisse rapide du nombre de parasites mesurée par la PCR en temps réel chez six des sept patients, baisse correspondant à la parasitémie déterminée microscopiquement. Ceci suggère ainsi le rôle potentiel de la PCR en temps réel dans le suivi thérapeutique des patients traités par antipaludéens. Abstract : There have been reports of increasing numbers of cases of malaria among migrants and travelers. Although microscopic examination of blood smears remains the "gold standard" in diagnosis, this method suffers from insufficient sensitivity and requires considerable expertise. To improve diagnosis, a multiplex real-time PCR was developed. One set of generic primers targeting a highly conserved region of the 18S rRNA gene of the genus Plasmodium was designed; the primer set was polymorphic enough internally to design four species-specific probes for P. falciparum, P. vivax, P. malarie, and P. ovale. Real-time PCR with species-specific probes detected one plasmid copy of P. falciparum, P. vivax, P. malariae, and P. ovale specifically. The same sensitivity was achieved for all species with real-time PCR with the 18S screening probe. Ninety-seven blood samples were investigated. For 66 of them (60 patients), microscopy and real-time PCR results were compared and had a crude agreement of 86% for the detection of plasmodia. Discordant results were reevaluated with clinical, molecular, and sequencing data to resolve them. All nine discordances between 18S screening PCR and microscopy were resolved in favor of the molecular method, as were eight of nine discordances at the species level for the species-specific PCR among the 31 samples positive by both methods. The other 31 blood samples were tested to monitor the antimalaria treatment in seven patients. The number of parasites measured by real-time PCR fell rapidly for six out of seven patients in parallel to parasitemia determined microscopically. This suggests a role of quantitative PCR for the monitoring of patients receiving antimalaria therapy.

Iowa Finance Authority Performance Report, FY 2004

Agency Performance Report

Iowa Department of Revenue and Finance Performance Report, FY 2004

Agency Performance Report

Iowa Department of Revenue and Finance Performance Report, FY 2005

Agency Performance Report

Experiències amb interacció de cos sencer generades en temps real amb entorns d’aigua virtual

L’objectiu d’aquest projecte ha estat la realització de dues aplicacions independents entre elles la interacció de les quals és a temps real i a cos sencer. En una aplicació l’usuari se li dona la possibilitat de, mitjançant el seu propi cos, transformar gotes que cauen en forma de plujavirtual en diferents flocs de neu. En la segona aplicació l’usuari pot generar onades en una superfície “aquosa”.Les dues aplicacions s’han creat amb la finalitat que puguin ser instal·lades i exposades en el centre de visitants de l’Expo2008 a Saragossa. Aquest fet ha estat fonamental per la tria de la temàtica de les aplicacions.Per assolir aquest objectiu, des del punt de vista del projectista, diferents estudis s’han hagut de portar terme. S’han realitzat estudis per tal de saber el funcionament del sistema de càmeres i del seu calibratge i de com es capta la informació referent a l’usuari. Aquestes parts són fonamentals per tal de poder gestionar bé la interacció i, sense les quals, no seria possible eldesenvolupament de les experiències. Un altre tipus d’estudi és el de la interacció, que és el que condueix l’eix principal del projecte, i el de la generació d’efectes visuals gràfics.

SIIMTA, Sistema Integrat d’Interacció de cos sencer generada en temps real i MusicoTeràpia per a persones amb discapacitats com l’Autisme

L’objectiu d’aquest Projecte Final de Carrera és el poder desenvolupar una nova eina de treball, segons el paradigme de l’interacció a cos sencer, per als terapeutes de la Fundació Tekhnikós, per a poder afavorir nous processos d’expressió, comunicació i interactivitat entre elpacient i el terapeuta en les sessions de Musicoteràpia.El Projecte tracta d’un sistema d’interacció a cos sencer per a pacients amb diferentspatologies o síndromes de conducta. Mitjançant un sistema de captura que treballa en el camp dels infrarojos, el pacient és capaç d’interactuar amb els elements de l’aplicació a través de lagesticulació. El moviment d’aquestes partícules (vegis el Glossari de termes en l’Annexe)generarà diferents sons segons posició i direcció en l’espai de la pantalla motivant al pacient a explorar el comportament el sistema de diferents maneres. Aquests estímuls sonors estan basatsen l’experiència prèvia de la Fundació amb les seves sessions de Musitoràpia, basades enl’observació de les reaccions del pacient davant estímuls sonors. Aquesta eina permetràexperimentat tot un món nou d’estímuls per al pacient, tant sonors, com visuals gràcies a la possibilitat de configuració de molts dels paràmetres del sistema. Gràcies al sistema de visió artifical s’aconsegueix una interacció màquina / pacient a cos sencer no intrusiu, molt interessant tenint en compte que l’aplicació està destinada a un gran espectre de patologies o síndromes. A més tenint en compte la tipologia general del pacient s’haoptat per una estètica molt minimalista, evitant qualsevol referència icònica per tal de no sobre estimular al pacient abans de que pugui interactuar amb el sistema.

Early detection of microcirculatory perfusion changes with a high resolution, real time laser Doppler imaging camera--frostbite case study.

A 41-year-old male presented with severe frostbite that was monitored clinically and with a new laser Doppler imaging (LDI) camera that records arbitrary microcirculatory perfusion units (1-256 arbitrary perfusion units (APU's)). LDI monitoring detected perfusion differences in hand and foot not seen visually. On day 4-5 after injury, LDI showed that while fingers did not experience any significant perfusion change (average of 31±25 APUs on day 5), the patient's left big toe did (from 17±29 APUs day 4 to 103±55 APUs day 5). These changes in regional perfusion were not detectable by visual examination. On day 53 postinjury, all fingers with reduced perfusion by LDI were amputated, while the toe could be salvaged. This case clearly demonstrates that insufficient microcirculatory perfusion can be identified using LDI in ways which visual examination alone does not permit, allowing prognosis of clinical outcomes. Such information may also be used to develop improved treatment approaches.

Breathhold three-dimensional coronary magnetic resonance angiography using real-time navigator technology.

The acquisition duration of most three-dimensional (3D) coronary magnetic resonance angiography (MRA) techniques is considerably prolonged, thereby precluding breathholding as a mechanism to suppress respiratory motion artifacts. Splitting the acquired 3D volume into multiple subvolumes or slabs serves to shorten individual breathhold duration. Still, problems associated with misregistration due to inconsistent depths of expiration and diaphragmatic drift during sustained respiration remain to be resolved. We propose the combination of an ultrafast 3D coronary MRA imaging sequence with prospective real-time navigator technology, which allows correction of the measured volume position. 3D volume splitting using prospective real-time navigator technology, was successfully applied for 3D coronary MRA in five healthy individuals. An ultrafast 3D interleaved hybrid gradient-echoplanar imaging sequence, including T2Prep for contrast enhancement, was used with the navigator localized at the basal anterior wall of the left ventricle. A 9-cm-thick volume, with in-plane spatial resolution of 1.1 x 2.2 mm, was acquired during five breathholds of 15-sec duration each. Consistently, no evidence of misregistration was observed in the images. Extensive contiguous segments of the left anterior descending coronary artery (48 +/- 18 mm) and the right coronary artery (75 +/- 5 mm) could be visualized. This technique has the potential for screening for anomalous coronary arteries, making it well suited as part of a larger clinical MR examination. In addition, this technique may also be applied as a scout scan, which allows an accurate definition of imaging planes for subsequent high-resolution coronary MRA.

2001 Annual Report of the Iowa Railway Finance Authority

Railway finance report for the Iowa Department of Transportation.

2005 Annual Report of the Iowa Railway Finance Authority

Annual report for Iowa Railway Finance Authority. Annual Report produced by Iowa Department of Transportation.

Uniform Manual Real Property Acquisition and Relocation Assistance Section II - Chapter 111 Uniform Rules and Procedures April, 2006

The purpose of this chapter is to implement Iowa Code chapter 316 and sections 6B.42, 6B.45, 6B.54 and 6B.55, as required by the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, Pub. L. 91-646, as amended by the Uniform Relocation Act Amendments of 1987, Title IV, Pub. L. No. 100-17 , Sec. 104, Pub. L. 105-117, and federal regulations adopted pursuant thereto.

Nonsurgical options for treatment of diabetic macular edema

In the new book series 'ESASO Course Series', the essentials of the courses of the European School for Advanced Studies in Ophthalmology (ESASO) are made available to interested ophthalmologists, optometrists, technicians and residents all over the world. In this volume, the seminars on surgical retina presented by renowned experts during ESASO's activities are collected. Many specialists have contributed their knowledge to make this volume a device to give practical support. The topics range from prevention to state-of-the-art diagnostic techniques and the latest surgical treatment options for many eye conditions such as diabetic retinopathy and rhegmatogenous retinal detachment. This publication provides the ophthalmologist with the main aspects of surgical retina in a simple and practical update.

Iowa Water Pollution Control Works and Drinking Water Facilities Financing Programs, (Joint Programs of the Iowa Finance Authority and the Iowa Department of Natural Resources), Independent Auditor's Reports, Financial Statements and Supplementary Information, Schedule of Findings, June 30, 2005

State Audit Reports

Institutions, Public Debt and Foreign Finance

We study the role of domestic financial institutions in sustaining capital flows to the private and public sector of a country whose government can default on its debt. As in recent public debt crises, in our model public defaults weaken banks' balance sheets, disrupting domestic financial markets. This effect leads to a novel complementarity between private capital inflows and public borrowing, where the former sustain the latter by boosting the government's cost of default. Our key message is that, by shaping the direction of private capital flows, financial institutions determine whether financial integration improves or reduces government discipline. We explore the implications of this complementarity for financial liberalization and debt-financed bailouts of banks. We present some evidence consistent with complementarity.

Adjustment to Target Capital, Finance, and Growth

Does financial development result in capital being reallocated more rapidly to industries where it is most productive? We argue that if this was the case, financially developed countries should see faster growth in industries with investment opportunities due to global demand and productivity shifts. Testing this cross-industry cross-country growth implication requires proxies for (latent) global industry investment opportunities. We show that tests relying only on data from specific (benchmark) countries may yield spurious evidence for or against the hypothesis. We therefore develop an alternative approach that combines benchmark-country proxies with a proxy that does not reflect opportunities specific to a country or level of financial development. Our empirical results yield clear support for the capital reallocation hypothesis.