Methods for identifying Neisseria meningitidis carriers: a multi-center study in the African meningitis belt.

Objective: Detection of meningococcal carriers is key to understanding the epidemiology of Neisseria meningitidis, yet no gold standard has been established. Here, we directly compare two methods for collecting pharyngeal swabs to identify meningococcal carriers.

Methods: We conducted cross-sectional surveys of schoolchildren at multiple sites in Africa to compare swabbing the posterior pharynx behind the uvula (U) to swabbing the posterior pharynx behind the uvula plus one tonsil (T).

Variable duration of decaffeinated green tea extract ingestion on exercise metabolism.

Purpose: The aim of this study was to investigate if the duration of decaffeinated green tea extract (dGTE) ingestion plays a role in augmenting fat oxidation rates during moderate-intensity exercise.

Methods: In a crossover, placebo-controlled design, 19 healthy males (mean ± SD; age = 21 ± 2 yr, weight = 75.0 ± 7.

Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring.

Objective: Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it feasible for application on a larger scale such as in routine civil registration and vital statistics (CRVS) systems.

Local illness concepts and their relevance for the prevention and control of malaria during pregnancy in Ghana, Kenya and Malawi: findings from a comparative qualitative study.

Background: In sub-Saharan Africa, the burden of morbidity and mortality linked to malaria during pregnancy (MiP) is significant and compounded by its unclear symptoms and links with other health problems during pregnancy. Mindful of the biomedical and social complexity of MiP, this article explores and compares local understandings of MiP and their links with other pregnancy-related health problems.

Methods: A comparative qualitative study was undertaken at four sites in three countries: Ghana, Malawi and Kenya.

'They treat you like you are not a human being': maltreatment during labour and delivery in rural northern Ghana.

Objective: to explore community and health-care provider attitudes towards maltreatment during delivery in rural northern Ghana, and compare findings against The White Ribbon Alliance's seven fundamental rights of childbearing women.

Design: a cross-sectional qualitative study using in-depth interviews and focus groups.

Setting: the Kassena-Nankana District of rural northern Ghana between July and October 2010.

Knowledge, attitudes, and practices related to meningitis in northern Ghana.

Meningitis has a significant impact in the Sahel, but the mechanisms for transmission and factors determining a person's vulnerability are not well understood. Our survey examined the knowledge, attitudes, and practices of people in a meningitis-endemic area in the Upper East region of northern Ghana to identify social, economic, and behavioral factors that may contribute to disease transmission and possible interventions that might improve health outcomes. Key results suggest potential interventions in response to the risk posed by migration, especially seasonal migration, a lack of knowledge about early symptoms causing delayed treatment, and a need for further education about the protective benefits of vaccination.

Sam68 modulates the promoter specificity of NF-κB and mediates expression of CD25 in activated T cells.

CD25, the alpha chain of the interleukin-2 receptor, is expressed in activated T cells and has a significant role in autoimmune disease and tumorigenesis; however, the mechanisms regulating transcription of CD25 remain elusive. Here we identify the Src-associated substrate during mitosis of 68 kDa (Sam68) as a novel non-Rel component in the nuclear factor-kappaB (NF-κB) complex that confers CD25 transcription. Our results demonstrate that Sam68 has an essential role in the induction and maintenance of CD25 in T cells.

Multiple populations of artemisinin-resistant Plasmodium falciparum in Cambodia.

We describe an analysis of genome variation in 825 P. falciparum samples from Asia and Africa that identifies an unusual pattern of parasite population structure at the epicenter of artemisinin resistance in western Cambodia. Within this relatively small geographic area, we have discovered several distinct but apparently sympatric parasite subpopulations with extremely high levels of genetic differentiation.

Lack of antigenic diversification of major outer membrane proteins during clonal waves of Neisseria meningitidis serogroup A colonization and disease.

In particular in the 'meningitis belt' of sub-Saharan Africa, epidemic meningococcal meningitis is a severe public health problem. In the past decades, serogroup A lineages have been the dominant etiologic agents, but also other serogroups have caused outbreaks. A comprehensive vaccine based on subcapsular outer membrane proteins (OMPs) is not available.

The metabolic and performance effects of caffeine compared to coffee during endurance exercise.

There is consistent evidence supporting the ergogenic effects of caffeine for endurance based exercise. However, whether caffeine ingested through coffee has the same effects is still subject to debate. The primary aim of the study was to investigate the performance enhancing effects of caffeine and coffee using a time trial performance test, while also investigating the metabolic effects of caffeine and coffee.

Preliminary evaluation of an MRI-based technique for displaying and quantifying bony deformities in cam-type femoroacetabular impingement.

Purpose: Characterizing aspheric deformities of the femoral head-neck junction in cam-type femoroacetabular impingement (FAI) requires representing the location, size, or extent of the bony lesion. The objectives of this work are to (1) assess the feasibility of creating 3D models of cam deformities from MRI sets, (2) present a standardized 2D visualization of the lesion, and (3) present and evaluate the potential utility of summary metrics in distinguishing between FAI patients and control subjects.

Methods: Using MRIs from five subjects with diagnosed cam-type FAI and four healthy subjects, we developed a technique based on subtracting an estimated normal surface from each subject's actual bone surface in order to generate a subject-specific 2D "diagnosis graph" that characterized the femoral deformity.

Why are babies dying in the first month after birth? A 7-year study of neonatal mortality in northern Ghana.

Objectives: To determine the neonatal mortality rate in the Kassena-Nankana District (KND) of northern Ghana, and to identify the leading causes and timing of neonatal deaths.

Methods: The KND falls within the Navrongo Health Research Centre's Health and Demographic Surveillance System (HDSS), which uses trained field workers to gather and update health and demographic information from community members every four months. We utilized HDSS data from 2003-2009 to examine patterns of neonatal mortality.

The effect of green tea extract on fat oxidation at rest and during exercise: evidence of efficacy and proposed mechanisms.

Green tea is made from the leaves of the Camellia sinensis L plant, which is rich in polyphenol catechins and caffeine. There is increasing interest in the potential role of green tea extract (GTE) in fat metabolism and its influence on health and exercise performance. A number of studies have observed positive effects of GTE on fat metabolism at rest and during exercise, following both shorter and longer term intake.

"It's up to the woman's people": how social factors influence facility-based delivery in Rural Northern Ghana.

To explore the impact of social factors on place of delivery in northern Ghana. We conducted 72 in-depth interviews and 18 focus group discussions in the Upper East Region of northern Ghana among women with newborns, grandmothers, household heads, compound heads, community leaders, traditional birth attendants, traditional healers, and formally trained healthcare providers. We audiotaped, transcribed, and analyzed interactions using NVivo 9.

Infant illness spanning the antenatal to early neonatal continuum in rural northern Ghana: local perceptions, beliefs and practices.

Objective: To explore community understanding of perinatal illness in northern Ghana.

Study Design: A cross-sectional descriptive study design.

Result: 253 community members participated in in-depth interviews and focus group discussions, including women with newborn infants, grandmothers and health care providers.

Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi.

Background: Antenatal care (ANC) is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended number of ANC visits. Drawing on qualitative data, this article comparatively explores the factors that influence ANC attendance across four sub-Saharan African sites in three countries (Ghana, Kenya and Malawi) with varying levels of ANC attendance.

3D ultrasound-CT registration in orthopaedic trauma using GMM registration with optimized particle simulation-based data reduction.

Accurate real-time registration of intra-operative ultrasound (US) to computed tomography (CT) remains a challenging problem. In orthopedic applications, a recent promising approach proposed the use of Gaussian mixture modeling for bone surface registration. Though relatively successful, the method relied on naive and error prone subsampling of the surfaces registered to reduce computational cost and also heavily relied on heuristically-set parameters for bone surface generation.

No effect of 1 or 7 d of green tea extract ingestion on fat oxidation during exercise.

Purpose: The aim of this study was to investigate the effects of 1 and 7 d of green tea extract (GTE) ingestion on whole body fat oxidation during moderate-intensity exercise.

Methods: Thirty-one men completed two exercise trials (60-min cycle, 50% Wmax). After the baseline trial (day 0), subjects were randomly assigned to one of three conditions involving a week supplementation of the following: 1) 7 d of placebo, 2) 6 d of placebo followed by 1 d of GTE (GTE1), and 3) 7 d of GTE ingestion (GTE7).

Rapid cytological analysis of endobronchial ultrasound-guided aspirates in sarcoidosis.

Rapid on-site evaluation (ROSE) of endobronchial ultrasound-guided transbronchial needle aspirates (EBUS-TBNA) has not been compared to final detailed cytological analysis in patients with suspected sarcoidosis. To assess the diagnostic accuracy of EBUS-TBNA with ROSE in patients with suspected sarcoidosis, a prospective two-centre study performed EBUS-TBNA with ROSE of cellular material followed by transbronchial lung biopsy (TBLB) and endobronchial biopsy (EBB). The diagnostic accuracy of EBUS-TBNA with ROSE was compared to the final cytological assessment and to TBLB and EBB.

Metabolic response to green tea extract during rest and moderate-intensity exercise.

Background: Green tea catechins have been hypothesized to increase energy expenditure and fat oxidation by inhibiting catechol-O-methyltransferase (COMT) and thus promoting more sustained adrenergic stimulation. Metabolomics may help to clarify the mechanisms underlying their putative physiological effects.

Objective: The study investigated the effects of 7-day ingestion of green tea extract (GTE) on the plasma metabolite profile at rest and during exercise.

Strengthening standardised interpretation of verbal autopsy data: the new InterVA-4 tool.

Background: Verbal autopsy (VA) is the only available approach for determining the cause of many deaths, where routine certification is not in place. Therefore, it is important to use standards and methods for VA that maximise efficiency, consistency and comparability. The World Health Organization (WHO) has led the development of the 2012 WHO VA instrument as a new standard, intended both as a research tool and for routine registration of deaths.

The Role of Weather in Meningitis Outbreaks in Navrongo, Ghana: A Generalized Additive Modeling Approach.

Bacterial (meningococcal) meningitis is a devastating infectious disease with outbreaks occurring annually during the dry season in locations within the 'Meningitis Belt', a region in sub-Saharan Africa stretching from Ethiopia to Senegal. Meningococcal meningitis occurs from December to May in the Sahel with large epidemics every 5-10 years and attack rates of up to 1000 infections per 100,000 people. High temperatures coupled with low humidity may favor the conversion of carriage to disease as the meningococcal bacteria in the nose and throat are better able to cross the mucosal membranes into the blood stream.

Profile of the Navrongo Health and Demographic Surveillance System.

Located in the Kassena-Nankana districts of northern Ghana, the Navrongo health and demographic surveillance system (NHDSS) was established in 1992 by the Navrongo health research centre (NHRC). The NHRC is one of three research centres of the Ghana health service. The activities and potential of the NHDSS for collaborative research are described.

Infant nutrition in the first seven days of life in rural northern Ghana.

Background: Good nutrition is essential for increasing survival rates of infants. This study explored infant feeding practices in a resource-poor setting and assessed implications for future interventions focused on improving newborn health.

Methods: The study took place in the Kassena-Nankana District of the Upper East Region of northern Ghana.

A molecular perspective of water at metal interfaces.

Water/solid interfaces are relevant to a broad range of physicochemical phenomena and technological processes such as corrosion, lubrication, heterogeneous catalysis and electrochemistry. Although many fields have contributed to rapid progress in the fundamental knowledge of water at interfaces, detailed molecular-level understanding of water/solid interfaces comes mainly from studies on flat metal substrates. These studies have recently shown that a remarkably rich variety of structures form at the interface between water and even seemingly simple flat surfaces.