Correct diagnosis of childhood pneumonia in public facilities in Tanzania: a randomised comparison of diagnostic methods.

Objective: This study compares two methods for clinical diagnosis of childhood pneumonia that aim to estimate rates of underdiagnosis and overdiagnosis of childhood pneumonia by examining the sensitivity of Integrated Management of Childhood Diseases implementation in routine care against lung ultrasound (LUS) diagnosis.

Setting: We conducted observations in 83 public health facilities (dispensaries, health centres and district hospitals) in Pwani, Dodoma and Tabora, Tanzania between October and December 2017.

Methods: We used a novel method to estimate rates of underdiagnosis and overdiagnosis of childhood pneumonia by comparing directly observed public provider diagnoses to the results of diagnoses made by trained clinicians using Mindray DP-10 ultrasound machines.

Improving measles vaccine uptake rates in Nigeria: An RCT evaluating the impact of incentive sizes and reminder calls on vaccine uptake.

Objective: To assess the impact of increasing incentive size and reminder calls on the measles vaccine uptake rate.

Design: Randomized controlled trial, randomized at individual level, stratified by clinic.

Setting: Nigeria.

The Impact of SMS-Based Interventions on VMMC Uptake in Lusaka Province, Zambia: A Randomized Controlled Trial.

Introduction: Zambia has high HIV prevalence and low voluntary medical male circumcision (VMMC) rates, heightening the need for effective VMMC demand generation strategies for HIV prevention.

Methods: A 3-arm randomized controlled trial measured the impact of 2 short message service (SMS) campaigns on self-reported and verified VMMC uptake over 6 months in Lusaka Province. The study enrolled 2312 uncircumcised males aged 15-30 previously subscribed on Zambia U-Report, an existing SMS platform providing confidential, free counseling services relevant to HIV and other sexually transmitted infections.

Community point distribution of insecticide-treated bed nets and community health worker hang-up visits in rural Zambia: a decision-focused evaluation.

Background: In 2013, the Zambian Ministry of Health through its National Malaria Control Programme distributed over two million insecticide-treated bed nets (ITNs) in four provinces using a door-to-door distribution strategy, and more than 6 million ITNs were allocated to be distributed in 2014. This study was commissioned to measure attendance rates at a community point distribution and to examine the impact of follow-up community health worker (CHW) hang-up visits on short and medium-term ITN retention and usage with a view of informing optimal ITN distribution strategy in Zambia.

Methods: Households received ITNs at community point distributions conducted in three rural communities in Rufunsa District, Zambia.

A Cluster Randomised Trial on the Impact of Integrating Early Infant HIV Diagnosis with the Expanded Programme on Immunization on Immunization and HIV Testing Rates in Rural Health Facilities in Southern Zambia.

Background: We assessed the integration of early infant HIV diagnosis with the expanded programme for immunization in a rural Zambian setting with the aim of determining whether infant and postpartum maternal HIV testing rates would increase without harming immunization uptake.

Methods: In an unblinded, location stratified, cluster randomised controlled trial, 60 facilities in Zambia's Southern Province were equally allocated to a control group, Simple Intervention group that received a sensitization meeting and the resupply of HIV testing commodities in the event of a stock-out, and a Comprehensive Intervention group that received the Simple Intervention as well as on-site operational support to facilitate the integration of HIV testing services with EPI.

Findings: The average change in number of first dose diphtheria, pertussis, and tetanus vaccine (DPT1) provided per month, per facility was approximately 0.

Essay: a lesson in living.

This 2013 Consortium of Universities for Global Health essay examines the ethical dilemmas encountered by a public health worker engaged in HIV/AIDS prevention and health promotion in a rural Tanzanian community. Is the professional objective of improving the health and well-being of the population so simple?

TNFα modulates protein degradation pathways in rheumatoid arthritis synovial fibroblasts.

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory and destructive disease of the joint. The synovial lining consists of two main types of cells: synovial fibroblasts and macrophages. The macrophage-derived cytokine TNFα stimulates RA synovial fibroblasts to proliferate and produce growth factors, chemokines, proteinases and adhesion molecules, making them key players in the RA disease process.

Staff solutions for noise reduction in the workplace.

Setting: A comprehensive noise-reduction project was initiated in response to low patient-satisfaction scores on an inpatient neuroscience unit at St Luke's Hospital and Health Network. The effects of noise on the health of patients and staff provided additional rationale for the project.

Methods: The performance-improvement model of Plan, Do, Check, Act, along with a literature review, was used to identify the negative effects of noise on patients and staff.

Inhibition of protein geranylgeranylation induces apoptosis in synovial fibroblasts.

Statins, competitive inhibitors of hydroxymethylglutaryl-CoA reductase, have recently been shown to have a therapeutic effect in rheumatoid arthritis (RA). In RA, synovial fibroblasts in the synovial lining, are believed to be particularly important in the pathogenesis of disease because they recruit leukocytes into the synovium and secrete angiogenesis-promoting molecules and proteases that degrade extracellular matrix. In this study, we show a marked reduction in RA synovial fibroblast survival through the induction of apoptosis when the cells were cultured with statins.

Somatic mutations in the mitochondria of rheumatoid arthritis synoviocytes.

Somatic mutations have a role in the pathogenesis of a number of diseases, particularly cancers. Here we present data supporting a role of mitochondrial somatic mutations in an autoimmune disease, rheumatoid arthritis (RA). RA is a complex, multifactorial disease with a number of predisposition traits, including major histocompatibility complex (MHC) type and early bacterial infection in the joint.

p53 tumor suppressor gene mutations in fibroblast-like synoviocytes from erosion synovium and non-erosion synovium in rheumatoid arthritis.

Abnormalities in the p53 tumor suppressor gene have been detected in rheumatoid arthritis (RA) and could contribute to the pathogenesis of chronic disease. To determine whether synoviocytes from invasive synovium in RA have an increased number of mutations compared with non-erosion synoviocytes, p53 cDNA subclones from fibroblast-like synoviocytes (FLS) derived from erosion and non-erosion sites of the same synovium were examined in patients requiring total joint replacement. Ten erosion FLS lines and nine non-erosion FLS lines were established from nine patients with RA.

Mutant p53 in bone marrow stromal cells increases VEGF expression and supports leukemia cell growth.

Objective: Genetic alterations, including p53 mutations, have been identified in the stroma of solid tumors and are thought be involved in the induction of tumor growth and metastasis. We tested the hypothesis that somatic molecular alterations in bone marrow stromal cells provide a favorable growth environment for leukemic cells.

Materials And Methods: We established an in vitro model consisting of stroma expressing mutant p53 (Cys135Ser) to study its ability to support growth of cells from a pre-B acute lymphoblastic leukemia (ALL) cell line.