bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of awareness, attitude, and utilization of Complementary and Alternative Medicine among patients visiting urban and rural health centers
Authors: Asheeka Zainab Arif  , Balaji Ramraj  , Swapna Kiran  , Balasandhiya Prabakar
Published: March 2021

Worldwide there is a recent increase in the usage of Complementary and Alternative Medicine (CAM), which has been defined as a group of diverse medical and healthcare systems, practices and products that are presently not considered to be a part of conventional medicine. The objectives were to assess and to compare the awareness, perspective, and utilization of CAM among urban and rural patients. A cross-sectional study was conducted among 200 out-patients attending the urban and rural health centers with a standardized questionnaire. MS Excel and Epi Info were used for data entry and analysis. The awareness of CAM was 71% of urban patients and 63% of rural patients. Despite the awareness of CAM, the urban patient either liked CAM (32%) or apathetic towards CAM (32%) and rural patients mostly apathetic towards CAM (47%). Both areas of patients (41%) used CAM, of which 36% were urban patients and 46% were rural patients. There is a higher proportion of aware patients in rural areas (73%) used CAM when compared to the usage of CAM by aware patients in the urban area (51%). Despite the usage of CAM, both areas of patients preferred Allopathy. In summary, this study demonstrated that most patients are aware of CAM, but patients were mostly apathetic towards CAM. Around half of the patients utilized alternative medicine.
Wearable EMG Sensor for Gait Rehabilitation using IoT
Authors: Bethanney Janney J  , Sindu Divakaran  , Kezia George  , Chandana H  , Caroline Chriselda L
Published: March 2021

Interventions for movement dysfunction, including radiography and rhythmic planning, have demonstrated a significant increase in gait mechanics. While the optimum criteria for gait training are still to be determined, previous research shown that the training duration facilitates neural restructuring, thereby promoting the design of wearable technology for gait recovery. This work provides evidence of the advanced tool used to acquire muscle activity. Muscle activity is recorded and analyzed on Node micro controller unit, then sent to remote service using internet of things concepts, where message queuing telemetry transport protocol is used in the cloud based telemetry of the received signals and is given to the thing speak. The live recordings, along with the frequency variation of the gait in moving and stable condition, are also obtained on the central monitor using the MATLAB. By creating a device that can be used at home, patients would be able to practice and sustain longer recovery services on a regular basis, thus encouraging neural reorganization. This can also help us to monitor patient treatment progress even if the physiotherapist is not able to come and recorded data can be sent directly to them.
Anti-diabetic activity of rhizome extracts of Imperata cylindrical against alloxan-induced Diabetes Mellitus in rats
Authors: Ranjana Kohli  , Madan L Kaushik  , Jai Parkash Kadian  , Bhupendra Chauhan
Published: March 2021

The anti-diabetic effect of ethanolic and aqueous extracts of Imperata cylindrical  rhizomes was investigated in alloxan-induced diabeties in rats. Diabetes was induced by a single 150 mg/kg intraperitoneal dose of alloxan. Rats were divided into five groups with six rats in each group i.e. the normal control group, diabetic control group, standard group (glibenclamide, 10mg/kg, p.o.), Test-I group (200 mg/kg ethanolic extract) and Test-II group (200 mg/kg aqueous extract). The above concerned groups were inoculated on 21st day. On the last day of the experiment, fasted rats were killed by cervical dislocation. The body weight was measured at the initial day and final day. The blood samples were collected for estimation of glucose. The loss of body weight in control group, but recovery was observed in drug treated group. The serum glucose level was significant increased in diabetic rats. However, significant improvement was observed in treated group. The biochemical parameters such as HDL and proteins level were decreased in the control group but maintained in drug treated group. LDL, cholesterol, triglyceride creatinine and urea were significant increase in control group however, reduced level in drug treated group. The present study concluded that ethanolic and aqueous extracts of I. cylindrical  rhizome showed an appreciable effect in reducing the hyperglycemia and the complications associated with diabetes. However, aqueous extract is found more significant in decreasing blood glucose level in comparison to the ethanolic extract. The study results justify the traditional use of the plant as anti-diabetic.
Standardisation of Holarrhena floribunda (G. Don) Durand & Schinz: pharmacognostic evaluation and HPLC profiling of some of its steroidal alkaloids as chemical markers
Authors: Amponsah Kingsley I  , Ampofo Kwesi E  , Oppong Bekoe S  , Harley Kingsley B  , Armah Ackah F  , Adjei S  , Baah Kwesi M
Published: March 2021

The World Health Organization has encouraged the development of medicinal plant monographs in various countries. The present study therefore aimed at developing pharmacognostic standards for the quality evaluation of Holarrhena floribunda (G. Don) Durand & Schinz, used as anti-infective in folklore medicine. The macromorphological and micromorphological features, physicochemical, phytochemical and thin layer chromatograms of the leaves and stem bark were evaluated using standard methods. An HPLC method was also developed and validated to profile some steroidal alkaloids of the stem bark. The plant has simple, glaborous leaves, broadly lanceolate to ovate in shape and opposite in arrangement. The leaves were hypostomatic with paracytic and anomocytic stomata on the abaxial surface. The flat stem bark is light brown on the inner surface. Three alkaloids were profiled as chemical markers for the quality control of the stem bark of H. floribunda, to aid its correct identification for research and industry.
Biochemical study of Cancer Antigen CEA and CA 19-9 as prognostic markers in colorectal cancer (CRC)
Authors: Ananthi N  , Padmini Habbu
Published: March 2021

Colorectal cancer is one of the most common types of cancer in the world. Several factors have been shown to put individuals at risk to CRC and these include age, the presence of polyps, inflammatory bowel disease, lifestyle, genetic background and family medical history. In the present study, we were related to the cancer antigen CEA and CA19-9 as prognostic markers in colorectal cancer. This may be helping us to detect colorectal cancer in an early stage. In this study, we have included 60 patients diagnosed with colorectal cancer. These patients were categorized as 10 patients between stage I-IV with disease dissemination and recurrence; 50 patients in between stage I- IV without dissemination and recurrence; 60 healthy controls. The cancer antigen CEA and Ca 19-9 were analyzed as prognostic markers in colorectal cancer. The statistical analysis was done by using SPSS software and expressed in terms of mean ± standard deviation. The p values (p˂0.005) were considered as statistically significant value. Person correlation between the cancer antigen CEA and CA-19-9 were analyzed. The cancer antigen CEA and Ca19-9 level were significantly increased in colorectal cancer patients as compared to the healthy controls group (p˂0.005). The significant Person correlation was observed in between CEA and CA19-9. The level of CEA and CA19-9 were significantly prognostic indicator in colorectal cancer. CEA and CA19-9 can be used as a diagnostic and prognostic marker for the screening of both colon and rectum cancer.
The AXL-PYK2-PKCα axis as a nexus of stemness circuits in TNBC
Authors: Khera Lohit , Vinik Yaron , Maina Flavio , Lev Sima
Published: March 2021

Cancer stem cells (CSCs) are implicated in tumor initiation, metastasis and drug resistance, and considered as attractive targets for cancer therapy. Here we identified a clinically relevant signaling nexus mediated by AXL receptor, PYK2 and PKCα and show its impact on stemness in TNBC. AXL, PYK2, and PKCα expression correlates with stemness signature in basal-like breast cancer patients, and their depletion in multiple mesenchymal TNBC cell lines markedly reduced the number of mammosphere-forming cells and cells harboring CSCs characteristic markers. Knockdown of PYK2 reduced the levels of AXL, PKCα, FRA1, and PYK2 proteins, and similar trend was obtained upon PKCα depletion. PYK2 depletion decreased AXL transcription through feedback loops mediated by FRA1 and TAZ, whereas PKCα inhibition induced redistribution of AXL to endosomal/lysosomal compartment and enhanced its degradation. PYK2 and PKCα cooperate at a convergence point of multiple stemness-inducing pathways to regulate AXL levels and concomitantly the levels/activation of STAT3, TAZ, FRA1, and SMAD3 as well as the pluripotent transcription factors Nanog and Oct4. Induction of stemness in TNBC sensitized cells to PYK2 and PKCα inhibition suggesting that targeting the AXL-PYK2-PKCα circuit could be an efficient strategy to eliminate CSCs in TNBC.
Conto Escolar, de M.R. James
Authors: De Araújo Santos Cílio Lindemberg
Published: March 2021

Publicado em 1911 em Ghost Stories of an Antiquary Part 2: More Ghost Stories, de M.R. James, o conto A School Story ecoa o fascínio de James por antiguidades em fusão ao que o autor posiciona como sendo a força sobrenatural que age e/ou interfere na vida dos personagens. No conto, um professor de Latim, de nome Sampson, possui uma moeda bizantina pela qual seus alunos tomam interesse. No entanto, ele se preocupa após ler sentenças que os seus alunos dizem não ter escrito. Em seguida, a partir da visita de uma estranha figura, avistada por dois de seus alunos, o professor desaparece misteriosamente, e, cerca de trinta anos mais tarde, sua moeda dourada é encontrada junto a dois corpos num poço entre quatro árvores...
Práticas tradutórias como práticas de si
Authors: Mendes Gambassi Giulia , Lima Érica
Published: March 2021

O objetivo deste artigo é fazer algumas reflexões sobre a tradução como um estado permanente em que se encontra o migrante, que vive entre-línguas e entre-culturas. Aborda-se, para tanto, as práticas tradutórias como práticas do sujeito se inscrever em uma outra língua-cultura que não a materna. Nosso corpus se volta para os dizeres de sujeitos que passaram por situação de migração forçada e a análise que empreendemos é fundamentada principalmente na condição do migrante como sujeito traduzido, como propõe Cronin (2006) e no conceito de hos(ti)pitalidade, desenvolvido por Derrida (2000).
Ossos e pelo, de Pilar Quintana
Authors: Cuartas Villalobos Ángela María
Published: March 2021

Versão em português brasileiro do conto “Huesos y pelo”, da reconhecida escritora colombiana Pilar Quintana. Originalmente publicada no Chile, com o título “Animales no domesticables”, trata-se de uma narração, em primeira pessoa, da experiência de uma mulher viajante na selva da região do Oceano Pacífico, uma das regiões mais agrestes, negligenciadas e desconhecidas da geografia colombiana. A personagem chega ao local para conhecer uma onça da qual tinha notícia, e que estava sendo “domesticada” dentro de uma jaula no meio de uma reserva. Com o tempo, ela resolve ficar para trabalhar junto com outro voluntário. O conto narra como eles acabam sendo “tomados”, ou tendo sua própria natureza revelada, pela força incontestável do ambiente selvagem, alheio Ã s considerações humanas.

O trabalho inclui também uma análise dos procedimentos de tradução, com especial atenção para os desafios próprios do trabalho com duas línguas muito semelhantes, o tratamento das palavras homófonas e as possibilidades da tradução cultural.
Uiraúna Gûyrauna
Authors: Borges Igor Alexandre Barcelos Graciano
Published: March 2021

Poema de minha autoria.
Explicação
Authors: Campos da Cunha Moura Dayane
Published: March 2021

Trata-se de um conto sobre a dor da perda e a tentativa de se reencontrar.
Audiodescrição no futebol
Authors: Sena da Silva Marcos Alexandre , Alves Leão Bruna
Published: March 2021

o presente trabalho aborda dois momentos de uma mesma partida (Vitória x Ceará, válida pela 6ª rodada do Campeonato Brasileiro da Série A 2018), a partir de dois vieses diferentes: a locução radiofônica e a locução televisiva, contemplando as duas transmissões apresentadas. O objetivo é, desta maneira, identificar as lacunas (das locuções aqui destacadas) que a locução audiodescritiva possa preencher, a fim de discutir a falta de acessibilidade nas transmissões esportivas nacionais. Com base nas análises efetuadas, é possível afirmar que as locuções radiofônica e televisiva podem, sim, ser um recurso para as pessoas com deficiência visual (PcDVs), porém, não em sua totalidade. Para estas, mas não de forma exclusiva, há a opção da locução audiodescritiva, apoiada em detalhes realmente voltados ao seu público-alvo.
RESTITUTION RIGHTS AS A CONSTRUCTION OF JUSTICE REFERRING TO THE LAW ON PROTECTION OF WITNESSES AND VICTIMS
Authors: Bawono Bambang Tri
Published: March 2021

This study aims to determine the effectiveness of restitution rights regulations for witnesses and victims based on Law No. 31 of 2014 concerning Amendments to Law No. 13 of 2006 concerning Protection of Witnesses and Victims. The provision of restitution which is the right of victims is often neglected, so that victims in their capacity as the aggrieved party do not get the rights that should be as stipulated in legislation. Based on this, this research emphasizes more on the factors that cause the ineffectiveness of regulations regarding restitution rights, as well as how efforts should be made so that victims can get restitution rights in accordance with the value of justice. The research method used in this research isresearch method library with a normative juridical approach that emphasizes secondary data in the form of primary legal materials, secondary legal materials, and tertiary legal materials. The results of the research state that the factors that cause the ineffectiveness of restitution rights are the victim's ignorance of the existence of the right to retribution and the procedure for filing it, the perpetrators of criminal acts are generally incapacitated, and there is no good faith for the perpetrators of crimes who generally have adequate financial capacity. Efforts that must be made so that victims get the right to restitution is to replace the application of the service model for victims of criminal acts that should position the victim as a subject who needs extra services, as stated in Law No. 21 of 2007 concerning the Eradication of the Crime of Trafficking in Persons. In addition, the current effort is to make the replacement of the right to restitution as an additional punishment which automatically becomes part of the judge's decision to be implemented immediately.
A bi-level optimization model for grouping constrained storage location assignment problems
Authors: Xie Jing , Mei Yi , Ernst Andreas T , Li Xiaodong , Song Andy
Published: March 2021

In this paper, a novel bi-level grouping optimization (BIGO) model is proposed for solving the storage location assignment problem with grouping constraint (SLAP-GC). A major challenge in this problem is the grouping constraint which restricts the number of groups each product can have and the locations of items in the same group. In SLAP-GC, the problem consists of two subproblems, one is how to group the items, and the other one is how to assign the groups to locations. It is an arduous task to solve the two subproblems simultaneously. To overcome this difficulty, we propose a BIGO. BIGO optimizes item grouping in the upper level, and uses the lower-level optimization to evaluate each item grouping. Sophisticated fitness evaluation and search operators are designed for both upper and lower level optimization so that the feasibility of solutions can be guaranteed, and the search can focus on promising areas in the search space. Based on the BIGO model, a multistart random search method and a tabu search algorithm are proposed. The experimental results on the real-world dataset validate the efficacy of the BIGO model and the advantage of the tabu search method over the random search method.

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An investigation of ensemble combination schemes for genetic programming based hyper-heuristic approaches to dynamic job shop scheduling
Authors: Park John , Mei Yi , Nguyen Su , Chen Gang , Zhang Mengjie
Published: March 2021

Genetic programming based hyper-heuristic (GP-HH) approaches that evolve ensembles of dispatching rules have been effectively applied to dynamic job shop scheduling (JSS) problems. Ensemble GP-HH approaches have been shown to be more robust than existing GP-HH approaches that evolve single dispatching rules for dynamic JSS problems. For ensemble learning in classification, the design of how the members of the ensembles interact with each other, e.g., through various combination schemes, is important for developing effective ensembles for specific problems. In this paper, we investigate and carry out systematic analysis for four popular combination schemes. They are majority voting, which has been applied to dynamic JSS, followed by linear combination, weighted majority voting and weighted linear combination, which have not been applied to dynamic JSS. In addition, we propose several mea-sures for analysing the decision making process in the ensembles evolved by GP. The results show that linear combination is generally better for the dynamic JSS problem than the other combination schemes investigated. In addition, the different combination schemes result in significantly different interactions between the members of the ensembles. Finally, the analysis based on the measures shows that the behaviours of the evolved ensembles are significantly affected by the combination schemes. Weighted majority voting has bias towards single members of the ensembles.

© This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Pengembangan Media Crossword Puzzle Berbasis HOTS pada Pembelajaran Tematik
Authors: Kusuma Elisabet Dyah
Published: March 2021

Pengembangan media Crossword puzzle berbasis hots pada pembelajaran tematik bertujuan utuk meningkatkan keterampilan berpikir kritis pada siswa sekolah dasar, agar terjadi peningkatan keterampilan berpikir kritis siswa dan peningkatan hasil belajar siswa di SD Negeri Gadingan 02 Kecamatan Mojolaban Kabupaten Sukoharjo. Inovasi ini dikembangkan dengan menerapkan metode penelitian dan pengembangan. Hasil yang diperoleh menunjukan persentase hasil belajar siswa yang mengalami peningkatan, dari sebelum penggunaan media Crossword puzzle berbasis hots diperoleh rata- rata 50,02%, kemudian mengalami peningkatan saat ujicoba 1 menjadi 56,18% dan semakin meningkat pada uji coba 2 menjadi 78,75%. Kesimpulan yang diperoleh atas pencapaian peningkatan yang terjadi dikarenakan penggunaan media Crossword puzzle berbasis HOTS, dimana keaktifan siswa dalam menggunakan media Crossword puzzle berbasis HOTS merupakan tahapan dalam peningkatan keterampilan berpikir kritis pembelajaran tematik.
Penggunaan Sim-Rosi Berbasis PjBL dan Steam untuk Meningkatkan Keterampilan Abad 21 Bagi Peserta Didik Sekolah Dasar
Authors: Burhanudin AH
Published: March 2021

Guru sebagai ujung tombak pendidikan yang berhubungan langsung dengan peserta didik diharapkan mampu memberikan muatan positif dalam menumbuhkan karakteristik pembelajaran abad 21, berupa: critical thinking, problem solving, collaboration, dan communication (4C). Tujuan kegiatan tersebut adalah agar dapat membekali dan menumbuhkan kreativitas, produktivitas, dan mempersiapkan peserta didik menghadapi kemajuan abad 21. Berdasar observasi awal diketahui bahwa pembelajaran yang memicu tumbuhnya karakteristik abad 21 (4C) pada peserta didik kelas 3 Sekolah Dasar Negeri Langenharjo 2 dalam proses pembelajaran sangat rendah. Simple Rocket Design (SIM-ROSI) merupakan rancangan yang dikembangkan sebagai sebuah solusi untuk memperbaiki kualitas belajar peserta didik. Dikembangkan dengan model penelitian pengembangan 4D menurut Thiagarajan. Ditunjang dengan pelaksanaan pembelajaran berbasis Project Based Learning (PjBl) dan Sains, Technologi, Enginering, Art, and Math (STEAM). Indikator keberhasilan pengembangan berdasar observasi terhadap aktivitas 4C peserta didik dalam pembelajaran. Data yang terkumpul dianalisis menggunakan analisis deskriptif dan uji statistik menggunakan paired sample t-test. Hasil analisis menunjukkan simpulan bahwa SIM-ROSI berbasis PjBL dan STEAM sangat efektif digunakan untuk meningkatkan aktivitas 4C peserta didik di dalam pada pembelajaran tematik di sekolah dasar.
Penggunaan Powtakon Kardus Sebagai Upaya Meningkatkan Hasil Belajar Peserta Didik SDN 2 Kembang
Authors: Zuliyanti Nurma
Published: March 2021

These classroom action research aims: To improve student learning outcomes using Powtakon kardus media. The research setting was grade V students of SDN 2 Kembang Jepara for the 2019/2020 academic year. This study consisted of 2 cycles in one basic competency. The research begins with compiling a lesson plan, making observation sheets and other research instruments. During the learning process, observations were made on the performance of the teacher as a researcher, and an assessment was made of students through test sheets. Other findings during the learning process were discussed between the researcher and the observer, equipped with data from observations made by reflection at each meeting. The results of research in cycle 1 and cycle 2 showed an increase in student learning outcomes. The student learning outcomes are in cycle 1 an average of 66.33 with learning completeness 40%, in cycle 2 an average of 81.27 with learning completeness 86.67%. Based on the results of the study, it can be concluded that the learning process using powtakon kardus media can improve student learning outcomes in Class V SDN 2 Kembang Jepara for the 2019/2020 academic year.
Measles outbreak in Switzerland - an update relevant for the European football championship (EURO 2008)
Authors: Richard J L , Masserey-Spicher V , Santibanez S , Mankertz A
Published: March 2021

Since November 2006, Switzerland has been experiencing the largest measles outbreak registered in the country since the introduction of mandatory notification for this disease in 1999. The first eight months of this outbreak have already been described in this journal [1]. From November 2006 to 13 February 2008, 1,405 measles cases were reported by physicians or laboratories in Switzerland (1,106 of them in 2007). Of these, 976 cases (69%) occurred in the cantons of Lucerne (29% of the total), Basel-Land (16%), Zurich (11%) Bern (7%), and Aargau (7%). The incidence for the whole country and all ages, calculated for this 15-month period, was 19 cases per 100,000 inhabitants (15 cases per 100,000 for the year 2007). For children under the age of 16 years living in the canton of Lucerne, it was 500 per 100,000.
An outbreak of measles including nosocomial transmission in Apulia, south-east Italy, January-March 2008 - a preliminary report
Authors: Caputi G , Tafuri S , Chironna M , Martinelli D , Sallustio A , Falco A , Germinario C  A , Prato R , Quarto M
Published: March 2021

Between 7 January and 16 March 2008, 16 cases of measles were reported in the region of Apulia in south-eastern Italy (about four millions inhabitants). This outbreak is currently ongoing: we present here a preliminary report.
Rabies – a recurrent danger to European countries from dogs introduced from endemic countries
Authors: Steffens I , Ekdahl K
Published: March 2021

Although vaccine-preventable, rabies remains a worldwide-occurring disease of major public health concern. Globally, rabies is responsible for about 55,000 human deaths per year, mainly in Asia and Africa, and 30-50% of the cases are in children, most often following an infection transmitted through the bite of a rabid dog.
Prevalence of hepatitis C and hepatitis B infection in the HIV-infected population of France, 2004
Authors: Larsen C , Pialoux G , Salmon D , Antona D , Le Strat Y , Piroth L , Pol S , Rosenthal E , Neau D , Semaille C , Delarocque Astagneau E
Published: March 2021

Our objective was to estimate the prevalence of HCV and HBV co-infection among HIV-infected adults in France and describe the epidemiological characteristics of co-infected patients and their clinical management. A one-day national cross-sectional survey was conducted in 2004. A random and proportional probability sample design was used, based on the number of AIDS cases reported since 1999 by hospital wards. Weighted estimations were computed. HIV-infected adults (out/in-patients) were included after consent. Data were collected on demographic criteria, HIV, HCV and HBV infections, as well as on antiviral therapies. Overall, 1849 HIV-infected patients were included. The prevalence of anti-HCV or HCV RNA positivity (HCV co-infection) was 24.3% [95% confidence interval (CI): 21.3-27.6] and varied from 3.1% in men who had sex with men to 92.8% in injecting drug users (IDUs). The prevalence of positive HCV RNA was 17.0% [95% CI:14.7-19.4]. The prevalence of HBs antigen (Ag) or HBV DNA positivity was 7.0% [95% CI: 5.9-8.1] and varied with the continent of birth from 2.1% in Northern Africa to 10.8% in sub-Saharan Africa. The prevalence of HIV-HCV-HBV co-infection was 1.6% [95% CI: 1.0-2.4], mostly IDUs (83.3%). A severe liver disease (cirrhosis or hepatocellular carcinoma) was diagnosed in 24.7% of the positive HCV RNA patients.This study confirmed the burden of HCV infection in French HIV-infected patients and described for the first time in France the epidemiological characteristics of HIV-HBV co-infection. Furthermore, it stresses the severity of liver disease related to HCV in HIV-infected population.
Imported falciparum malaria in Europe: 2007 data from TropNetEurop
Authors: Jelinek T
Published: March 2021

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Surveillance of air-travel-related tuberculosis incidents, England and Wales: 2007-2008
Authors: Abubakar I , Welfare R , Moore J , Watson J  M
Published: March 2021

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European network cooperation to identify hotel as source for pneumonia caused by Legionella pneumophila serogroup 2
Authors: Lück PC , Hahn F , Senger M , Boers SA , Brandsema P
Published: March 2021

Here we describe a case of hotel-associated legionellosis in an immuno-competent man caused byLegionella pneumophila serogroup 2, sequence type (ST) 39 that was identified through European cooperation.
Outbreak of lymphogranuloma venereum among men who have sex with men in Barcelona 2007/08 – an opportunity to debate sexual health at the EuroGames 2008
Authors: Vall Mayans M , Caballero E , Garcia de Olalla P , Armengol P , Codina MG , Barberà MJ , Sanz B , Andreu A , Caylà J
Published: March 2021

Lymphogranuloma venereum (LGV) is a systemic sexually transmitted infection (STI) caused by Chlamydia trachomatis (L serovars L1, L2 or L3). Since 2003, several outbreaks of rectal LGV affecting men who have sex with men (MSM) have occurred in western Europe [1]. The first case in Spain was confirmed in Barcelona in 2005 [2], but no further cases have been detected in this city since until September 2007. We briefly summarise the characteristics of the LGV cases diagnosed at the outpatient STI clinic in Barcelona between September 2007 and April 2008.
Onychomadesis outbreak in Valencia, Spain, June 2008
Authors: Salazar A , Febrer I , Guiral S , Gobernado M , Pujol C , Roig J
Published: March 2021

Onychomadesis describes complete nail shedding from the proximal portion. It is consecutive to a nail matrix arrest and can affect both fingernails and toenails. It is a rare disorder in children. Except for serious generalised diseases or inherited forms, most cases are considered to be idiopathic. Nail matrix arrest has been associated with a variety of drug exposures and systemic illnesses, including infections, and may result in a variety of changes, including transverse ridging (Beau's lines) and nail shedding (onychomadesis).
Large ongoing Q fever outbreak in the south of The Netherlands, 2008
Authors: Schimmer B , Morroy G , Dijkstra F , Schneeberger P M , Weers-Pothoff G , Timen A , Wijkmans C , van der Hoek W
Published: March 2021

Q fever is a worldwide zoonosis caused by the bacterium Coxiella burnetii which is common in a wide range of wild and domestic animals. Cattle and small ruminants, in particular sheep and goats, have been associated with large human outbreaks. Humans become infected primarily by inhaling aerosols that are contaminated by C. burnetii. Most infections remain asymptomatic but in about 40% lead to a febrile disease, pneumonia and/or hepatitis. Chronic infections, mainly endocarditis, are observed in 3 to 5% of cases, with an increased risk for pregnant women and persons with heart valve disorders or impaired immunity. Q fever in pregnancy, whether symptomatic or asymptomatic, may also result in adverse pregnancy outcomes [1]. Q fever in humans is a notifiable disease in The Netherlands. The notification criteria for a confirmed case of acute Q fever are clinical symptoms consistent with Q fever and a positive serology defined by immunofluoresence assay (IFA) test or a C. burnetii complement fixation test [2]. Also clinical patients diagnosed by PCR are considered as confirmed cases. Between 1997 and 2006, Q fever was notified rarely with an average of 11 (range 5-16) cases annually [3]. In 2007, we reported in this journal the first community outbreak of Q fever in the south of The Netherlands [4].
Extensively drug-resistant tuberculosis – first report of a case in Austria, May 2008
Authors: Indra A , Rowhani M , Rumetshofer R , Robl B , Konrad M , Meidlinger L , Allerberger F
Published: March 2021

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Preparedness activities ahead of the Beijing 2008 Olympic Games - enhancing EU epidemic intelligence
Authors: Payne L , Arias P , Kreidl P , Ciotti M , Coulombier D
Published: March 2021

This Friday, 8 August 2008 will see the official opening of the Beijing 2008 Olympic Games. In the following weeks (8-24 August) an estimated 10,500 athletes from 205 participating countries will compete in the Olympics, followed by the Paralympics (6-17 September). Sporting events will be held in Olympic venues hosted mainly in Beijing city, Tianjin, Hong Kong, Shanghai, Shenyang, Qinhuangdao and Qingdao (See Figure). An estimated 2.4 million spectators are anticipated to join in the celebration of the Olympics alone, with over 20,000 accredited media present [1] and 450,000 foreigners expected [2].
Four years of surveillance of recent HIV infections at country level, France, mid 2003 – 2006: Experience and perspectives
Authors: Semaille C , Cazein F , Pillonel J , Lot F , Le Vu S , Pinget R , Desenclos J  C , Barin F
Published: March 2021

New systems of surveillance to better monitor the dynamics of HIV are needed. A national surveillance of new HIV diagnoses which included the collection of dried serum spots (DSS) to identify recent infections (<6 months) using an EIA-RI assay was implemented in 2003 in France. The collection of DSS is based on the voluntary participation by both patients and microbiologists. Multivariate analysis was used to identify factors associated with recent infection (RI). Between July 2003 and December 2006, 14,155 cases newly diagnosed for HIV were reported. A minority of patients refused the collection of DSS (3.3%) and the rate of participation of laboratories was 80%. The test was performed for 10,855 newly diagnosed HIV cases, the overall proportion of RI was 23.1% (95% CI, 22.3%-23.9%). The proportion of RI was higher among men who have sex with men (MSM) (42.8%) than among heterosexuals (16.3%). Among heterosexuals, it varied by current nationality: 27% among French versus 8.4% among Africans. The risk of RI was greater for MSM (aOR=1.8), those of French nationality (aOR=3.9), those with high-economic status (aOR=1.2), those tested after a risk exposure (aOR=1.4), those tested for HIV three or more times during their lifetime (aOR=2.5). The risk of RI decreased with age. A nation-wide implementation of RI monitoring is feasible. The information on RI is very useful for renewing prevention messages, particularly among population in which HIV transmission is on going, such as MSM.
Public health implications of influenza B outbreaks in closed settings in the United Kingdom in the 2007/08 influenza season
Authors: Mook P , Ellis J , Watson J  M , Thompson CI , Zambon M , McMenamin J , Smyth B , Thomas DRh , Pebody R  G
Published: March 2021

Several influenza B outbreaks occurred in closed settings late in the 2007/08 influenza season (October to mid-May) in the United Kingdom (UK), with implications for public health management. Influenza B viruses usually circulate late in the season and cause a milder disease than influenza A viruses [1]. Epidemics of influenza B usually occur every two to three years with the burden of disease falling predominantly on school-aged children [2].
Recent trends in antimicrobial resistance among Streptococcus pneumoniae and Staphylococcus aureus isolates: the French experience
Authors: Anonymous Collective
Published: March 2021

In France, the overall proportion of penicillin-non-susceptible Streptococcus pneumoniae has decreased from 53% in 2002 to 38% in 2006, and the proportion of methicillin-resistant Staphylococcus aureus from 33% in 2001 to 26% in 2007. Although the rates remain very high compared to northern European countries, these trends suggest that the prevention efforts implemented since 2000 through two national programmes (the national plan for preserving the efficacy of antibiotics and the national infection control programme) and updated recommendations for pneumococcal vaccination are successful.
Experiences in prevention and control of antibiotic resistance in Slovenia
Authors: Čižman M
Published: March 2021

During 1991-1999 a significant increase of consumption of macrolides and fluoroquinolones was observed in Slovenia, and this was associated with significant increase of resistance of Streptococcus pneumoniae and Streptococcus pyogenes to macrolides and Escherichia coli to fluoroquinolones, respectively. Between 1999 and 2007 the prevalence of S. pneumoniae resistant to erythromycin increased from 3.7% to 16.8% even though the use of macrolides in the same period decreased from 3.81 to 2.43 defined daily doses (DDD) per 1,000 inhabitants and per day. The co-resistance and the spread of resistant clones were the reason for constant increase in macrolide resistance. Slovenia is one of the few European countries with decreasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in hospital care during the last years. As a result of control measures introduced in 1999, the MRSA prevalence rates decreased from 21.4% in 2000 to 8.3% in 2007.
Surveillance of listeriosis in Navarre, Spain, 1995-2005 – epidemiological patterns and characterisation of clinical and food isolates
Authors: Garrido V , Torroba L , García-Jalón I , Vitas A I
Published: March 2021

We monitored the incidence of human listeriosis in Navarre, a region in north of Spain between 1995 and 2005, and carried out the characterisation of Listeria monocytogenes isolates obtained from clinical samples and ready-to-eat products (sliced cooked meat, smoked salmon and liver pate). The active surveillance requesting hospitals to notify all listeriosis cases (n=40) yielded higher incidence rates (average annual rate 0.65/100,000 inhabitants, range 0.18-1.18/100,000 inhabitants) than expected. Pregnant women were the largest group affected (n=13, 32.5% of the cases), with a peak in incidence during the last three years of the study period. From the 40 human cases we obtained 33 Listeria isolates. Serological and molecular characterisation by PFGE identified 20 different pulsotypes, which on three occasions enabled us to link sporadic cases into clusters. Although we could not identify the incriminated food product we found two clinical pulsotypes among smoked salmon and cooked meat isolates. Surveillance of listeriosis in Spain should be improved and coordinated with other European Union Member States in order to better estimate the burden of disease and to prevent foodborne outbreaks.
European cluster of imported falciparum malaria from Gambia
Authors: Jelinek T , Schade Larsen C , Siikamäki H , Myrvang B , Chiodini P , Gascón J , Visser L , Kapaun A , Just-Nübling G
Published: March 2021

A cluster of 56 patients returning from Gambia with falciparum malaria has been noted in several countries of the European Union since September this year. TropNetEurop, the European Network on Imported Infectious Disease Surveillance, collected and reported the cases. Lack of awareness and, consequently, of prophylactic measures against malaria were apparent in the majority of patients.
Botulism in injecting drug users, Dublin, Ireland, November-December 2008
Authors: Barry J , Ward M , Cotter S , MacDiarmada J , Hannan M , Sweeney B , Grant K A , McKeown P
Published: March 2021

In November and December 2008, six cases of suspect wound botulism were reported in heroin injecting drug users, all residents in Dublin, Ireland. Patients were aged between 23-42 years of age; four cases were male; one patient died shortly after admission. The patients presented to four different hospitals across the city. Botulism in injecting drug users in Ireland was last reported in 2002.
Risk factors for sporadic Campylobacter infection: an all-Ireland case-control study
Authors: Danis K , Di Renzi M , O’Neill W , Smyth B , McKeown P , Foley B , Tohani V , Devine M
Published: March 2021

We report the findings of the first case-control study conducted in both the Republic of Ireland and Northern Ireland to determine risk factors for sporadic Campylobacter infections. A total of 197 cases and 296 case-nominated controls matched for age, were included. Based on Population Attributable Fraction (PAF), the most important risk factors were consuming chicken [adjusted matched (am) OR 6.8; 95%CI 2.1-21.9], consuming lettuce (amOR 3.3; 95%CI 1.5-7.1) and eating in takeaways (amOR=3.1; 95%CI 1.4-6.6). Contact with sheep (amOR=11; 95%CI 1.6-78), peptic ulcer (amOR=19; 95%CI 3.8-93.7), hiatus hernia (amOR=20.3; 95%CI 2.3-183.3), lower bowel problems (amOR=4.5; 95%CI 1.2-16.8) were also independently associated with infection. Mains water supply showed protective effect (amOR=0.2; 95 CI 0.1-0.9). The findings highlight the continued need for consumer food safety education and further control measures throughout the food chain on the island of Ireland.
Nosocomial measles cluster in Denmark following an imported case, December 2008-January 2009
Authors: Groth C , Böttiger B  E , Plesner A , Christiansen A  H , Glismann S , Hogh B
Published: March 2021

A cluster of six confirmed cases with identical measles virus genotype was reported in Denmark between December 2008 and January 2009. Transmission occurred among unvaccinated children aged 15-23 months admitted to the same hospital as a 36-month-old unvaccinated girl diagnosed with measles following travel. The findings highlight the importance of vaccination before travelling and adherence to the routine vaccination schedule.
Prevalence of human cytomegalovirus congenital infection in Portuguese newborns
Authors: Paixão P , Almeida S , Gouveia P , Vilarinho L , Vaz Osório R
Published: March 2021

Human cytomegalovirus (HCMV) is considered the most frequent cause of congenital infection, occurring in 0.2 to 2.2% of all live births. Since this is a wide range of prevalences observed in different studies, it would be desirable to investigate the prevalence of this infection at national level. The aim of this study was the evaluation of the national prevalence of HCMV congenital infection. We analysed a total of 3,600 Guthrie cards collected from Portuguese newborns during a period of 14 months (August 2003 to September 2004). The cards covered all regions of Portugal and were proportional to the number of births in each region. A heat DNA extraction method was used, followed by DNA amplification by nested PCR. Sensitivity and specificity of this method were evaluated as 93% and 100%, respectively, using 28 cards from HCMV-positive and 280 cards from HCMV-negative children. The national prevalence of congenital HCMV was determined as 1.05% (95% confidence interval: 0.748-1.446). This is the first study of the prevalence of HCMV congenital infection at national level in Portugal. It suggests that Portugal may have one of the highest prevalences of congenital HCMV infection in Europe.
VACSATC (Vaccine safety: attitudes, training and communication): Why such a project?
Authors: Alvarez-Pasquín M J , Heijbel H , Yarwood J , Van Damme P , VACSATC partners
Published: March 2021

The Vaccine safety: attitudes, training and communication (VACSATC) project was established in 2006 to study perceptions of immunisation and vaccine safety, to improve training of healthcare professionals on vaccine safety and to improve the availability of information on vaccine safety on the internet that adheres to good information practices. The three year project is funded by the European Commission's Directorate General for Health and Consumers and by the partners. The project complements the activities of the Vaccine Safety Net project and the Vaccine European New Integrated Collaboration Effort (VENICE) project.
Universal varicella vaccination in the Sicilian paediatric population: rapid uptake of the vaccination programme and morbidity trends over five years
Authors: Giammanco G , Ciriminna S , Barberi I , Titone L , Lo Giudice M , Biasio L R
Published: March 2021

Following the licensure of the Oka/Merck varicella vaccine in Italy in January 2003, the Sicilian health authorities launched a universal vaccination programme in all nine Local Health Units. A two-cohort vaccination strategy was adopted to minimise the shift of the mean age of varicella occurrence to older age groups, with the goal of vaccinating with one dose at least 80% of children in their second year of life and 50% of susceptible adolescents in their 12th year of life. Two studies were implemented in parallel to closely monitor vaccination coverage as well as varicella incidence. Overall, the programme achieved its target, with 87.5% vaccine coverage for the birth cohort 2005 and 90.2% for adolescents born in 1995 and 1996. Varicella surveillance data obtained from a total of 28,188 children (0-14 years-old) monitored by family paediatricians showed a decline in incidence rates from 95.7 (95% confidence interval (CI): 72.2-126.8) for 1,000 person-years (PY) in 2004 to 9.0 (95% CI: 6.4-12.6) for 1,000 PY in 2007. In Europe, the only similar experience is the routine childhood varicella vaccination programme in Germany that started in 2004 with a single dose at the age of 11-14 months. The two-cohort universal vaccination programme implemented in Sicily, as well as the network for the surveillance study, can offer a model to other European countries that are considering introducing universal childhood varicella vaccination.
Sporadic cases of chikungunya, Réunion Island, August 2009
Authors: D’Ortenzio E , Grandadam M , Balleydier E , Dehecq J S , Jaffar-Bandjee M C , Michault A , Andriamandimby S F , Reynes J M , Filleul L
Published: March 2021

On 28 August 2009, French authorities reported five cases of chikungunya fever on Réunion Island: three confirmed, one probable, and one suspected case under investigation. All three confirmed patients presented with an acute febrile syndrome, arthralgia, myalgia and cutaneaous rash. All live in the same area on the western side of the island.
Detection of influenza A(H1N1)v virus by real-time RT-PCR
Authors: Panning M , Eickmann M , Landt O , Monazahian M , Ölschläger S , Baumgarte S , Reischl U , Wenzel J J , Niller H H , Günther S , Hollmann B , Huzly D , Drexler J F , Helmer A , Becker S , Matz B , Eis-Hübinger A M , Drosten C
Published: March 2021

Influenza A(H1N1)v virus was first identified in April 2009. A novel real-time RT-PCR for influenza A(H1N1)v virus was set up ad hoc and validated following industry-standard criteria. The lower limit of detection of the assay was 384 copies of viral RNA per ml of viral transport medium (95% confidence interval: 273-876 RNA copies/ml). Specificity was 100% as assessed on a panel of reference samples including seasonal human influenza A virus H1N1 and H3N2, highly pathogenic avian influenza A virus H5N1 and porcine influenza A virus H1N1, H1N2 and H3N2 samples. The real-time RT-PCR assay for the influenza A matrix gene recommended in 2007 by the World Health Organization was modified to work under the same reaction conditions as the influenza A(H1N1)v virus-specific test. Both assays were equally sensitive. Clinical applicability of both assays was demonstrated by screening of almost 2,000 suspected influenza (H1N1)v specimens, which included samples from the first cases of pandemic H1N1 influenza imported to Germany. Measuring influenza A(H1N1)v virus concentrations in 144 laboratory-confirmed samples yielded a median of 4.6 log RNA copies/ml. The new methodology proved its principle and might assist public health laboratories in the upcoming influenza pandemic.
Does viral interference affect spread of influenza?
Authors: Linde A , Rotzén-Östlund M , Zweygberg-Wirgart B , Rubinova S , Brytting M
Published: March 2021

This short communication hypothesises that rhinovirus epidemics occurring after start of school may interfere with the spread of influenza during the period when warm and humid climate decreases the influenza spread by aerosol. Limited laboratory data supporting this hypothesis are included in the article, but the report is written mainly to stimulate interest and research concerning the possibility that viral interaction may affect influenza epidemiology.
Trichinellosis acquired in Nunavut, Canada in September 2009: meat from grizzly bear suspected
Authors: Houzé S , Ancelle T , Matra R , Boceno C , Carlier Y , Gajadhar A  A , Dupouy-Camet J
Published: March 2021

Five cases of trichinellosis with onset of symptoms in September 2009, were reported in France, and were probably linked to the consumption of meat from a grizzly bear in Cambridge Bay in Nunavut, Canada. Travellers should be aware of the risks of eating raw or rare meat products in arctic regions, particularly game meat such as bear or walrus meat.
Behaviours regarding preventive measures against pandemic H1N1 influenza among Italian healthcare workers, October 2009
Authors: La Torre G , Di Thiene D , Cadeddu C , Ricciardi W , Boccia A
Published: March 2021

A survey on attitudes and behaviours towards preventive measures against pandemic H1N1 influenza 2009 was carried out during the month of October 2009 in Italy through an online questionnaire adapted to the Italian situation from a similar survey of the Harvard School of Public Health in the United States (US). Results show that the intention to get vaccinated against pandemic H1N1 influenza 2009 is generally low and that there are differences in attitudes and behaviours towards preventive measures against pandemic H1N1 influenza 2009 between physicians and nurses, especially concerning vaccination. Differences relate also to sex, region of residence and marital status.
Prolonged shedding of influenza A(H1N1)v virus: two case reports from France 2009
Authors: Fleury H , Burrel S , Balick Weber C , Hadrien R , Blanco P , Cazanave C , Dupon M
Published: March 2021

We observed a prolonged shedding of virus 14 and 28 days after symptom onset in two patients with pandemic H1N1 influenza, who did not have immunodepression and were treated with neuraminidase inhibitor. This prolonged shedding was not associated with the emergence of resistance mutation H275Y in the viral neuraminidase gene.