bluuebunny/crossref_metadata_2025 huggingface dataset:
Les « mobilités inversées » comme clé de lecture de la dépendance dans les territoires de montagne
Authors: Cholat Florent
Published: September 2018

La ville et les territoires modernes se sont structurés par et pour les mobilités. L’étalement des activités induites par la vitesse croissante des modes de transport a permis d’étirer les espaces des territoires (Zahavi, 1974). Les conséquences sont une distance croissante entre lieu d’habitation, de consommation, de travail, de socialisation et de loisir qui amène elle-même à une forte dépendance aux mobilités motorisées et à l’automobile (Kaufman, Guidez, 1998). Les modes actifs ne sont plus suffisants et les offres de mobilités se multiplient. Cependant, les individus ne sont pas tous égaux au regard des mobilités. La mobilité dépend des aptitudes psychologiques, cognitives et culturelles à se mouvoir. Chaque individu présente un potentiel de mobilité propre que Vincent Kaufmann (2002) propose d’appeler « motilité ». Les jeunes enfants et les aînés les plus âgés ont en commun d’avoir une motilité plus faible que la moyenne de la population. Les premiers parce qu’ils sont en apprentissage de la marche, des transports et qu’ils ne peuvent donc pas bénéficier de l’autonomie nécessaire pour se déplacer seuls. Les seconds parce qu’avec le vieillissement vient un affaiblissement des fonctions physiques et cognitives qui limite les capacités à se mouvoir de manière autonome et les capacités à se saisir des différents modes de transport, notamment l’automobile. Dès lors, pour effectuer les tâches de la vie quotidienne, pour se socialiser ou encore pour consommer, les individus dépendants doivent soit être accompagnés dans leurs mobilités soit à l’inverse il faut que les biens, les services ou encore les personnes viennent à eux. Dans le premier cas, l’accompagnement d’une tierce personne pour les déplacements répond aux mêmes critères de « motilité » puisque le déplacement prendra en compte les aptitudes psychologiques, cognitives et culturelles à se mouvoir de ce « couple de mobilité » que représentent la personne dépendante et son accompagnateur. Dans le deuxième cas, l’appareillage théorique de la « motilité » (Kaufmann, 2002) n’est pas suffisant pour saisir la complexité d’une mobilité que nous appellerons « mobilités inversées » (Cholat, 2013) et qui, si elle intègre la notion de la motilité des aidants, traite également des questions de mobilités logistiques induites par la personne en perte d’autonomie. Cet article propose de détailler cette notion de mobilités inversées à l’aune d’un territoire contraint, la montagne, et d’une population, les personnes âgées dépendantes, notion particulièrement pertinente pour la comprendre. Nous évoquerons alors les impacts sociaux, économiques et environnementaux positifs et négatifs de ces mobilités sur les territoires et nous vous inviterons à généraliser et à réfléchir la place de ces mouvements que nous générons dans notre quotidien et dans des contextes urbains comme ruraux.
Le management de l’action complexe : contrôler ou explorer ?
Authors: Lorino Philippe
Published: September 2018

Deux paradigmes organisationnels ont émergé historiquement et sont concurrents : l’organisation conçue comme processeur d’information, vision cohérente avec l’identification du management comme fonction de contrôle, et l’organisation conçue comme système d’action collective, vision cohérente avec l’identification du management comme fonction de support méthodologique aux enquêtes menées réflexivement par les équipes opérationnelles elles-mêmes sur leur propre activité. Le concept de représentation rationnelle, représentation de l’action (taylorisme) ou représentation de la pensée sur l’action (cognitivisme, Herbert Simon), est au cœur du premier paradigme. Au cœur du second se trouve le concept d’enquête, issu de la philosophie pragmatiste et développé dans le monde des affaires par le mouvement du management de la Qualité. Pour prendre en compte la complexité et la variabilité de l’action située, le concept d’enquête met l’accent sur deux règles méthodologiques : toute amélioration organisationnelle est expérimentale et il n’y a pas de substitut abstrait à l’expérience directe de l’activité.
L’assurance qualité, révélateur d’universités entrepreneuriales à la française
Authors: Pierronnet Romain
Published: September 2018

Les universités constituent des organisations complexes, ne serait-ce que parce qu’elles associent de nombreuses parties prenantes, auxquelles sont en outre adossées des instances collégiales où se nouent des enjeux de pouvoir. Ainsi, la compréhension des mécanismes de production des décisions au sein des organisations universitaires a constitué une question récurrente depuis plusieurs décennies. En France, la loi LRU (2007) ayant eu pour objectif de développer l’autonomie de gestion des universités, elles ont dû se réorganiser en conséquence, rebattant ainsi la répartition des pouvoirs et processus au sein des organisations pour les rendre plus entrepreneuriales. Pour en rendre compte, nous discutons de manière exploratoire du déploiement des pratiques d’assurance qualité au sein d’une université, ce qui nous amènera à proposer de mobiliser cette clef de lecture comme un révélateur éloquent des transformations des universités françaises.
Artisans entrepreneurs de territoire et agir entrepreneurial cas d’une pme familiale
Authors: Billet Jeanine
Published: September 2018

Dans cet article, l’auteure recherche comment des artisans-entrepreneurs de PME Familiale de terroir agissent et élaborent leur stratégie, à partir de l’analyse de situations entrepreneuriales (Schmitt, 2015), en s’appuyant sur les expériences et les vécus de ces derniers. Ce travail de recherche porte sur l’identification de Savoir-Agir entrepreneuriaux, à partir des interactions entre l’entrepreneur, son territoire et les opportunités saisies et développées, par ce dernier (Avenier MJ et Schmitt C, 2009). L’auteure s’interroge sur : « Comment des artisans-entrepreneurs de PME Familiale ont-ils construit une Stratégie de Différenciation Singulière ( SDS ), en s’appuyant sur leur territoire ? » Cette recherche est réalisée à partir d’une étude longitudinale, sur un cas de PME Familiale artisanale, de 3 e  génération, à visée exploratoire. Les résultats de cette recherche mettent en exergue un Savoir Innover Singulier ( SIS ), identifié à partir de l’Agir Entrepreneurial ( AE ) se déclinant en 3 « Sous-Agir » : l’Agir Stratégique [Valeurs Intrinsèques d’Artisans-Entrepreneurs], l’Agir Sociétal [Valeurs Idiosyncratiques du Territoire] et l’Agir Social [Valeurs Typiques de la PMEF].
Sur la voie d’un enseignement et d’un apprentissage autres : de l’intérêt des études globales
Authors: Saliba-Chalhoub Nicole , Schmitt Christophe
Published: September 2018

L’article s’intéresse au nouveau modèle académique des études globales et les présente comme un nouveau défi à relever par le secteur de l’Enseignement Supérieur, notamment à l’ère de la nécessité pour les universités de former des étudiants dont la posture au monde puisse être celle du citoyen systémicien et des chercheurs dont la qualité de la recherche réussisse, sinon à englober toutes les autres, du moins à aller à leur rencontre, pour donner à la recherche plus de complexité, d’ouverture interdisciplinaire et une meilleure actionnabilité sociétale. L’article illustre, enfin, l’application de ce nouveau modèle académique à un dispositif de l’Université de Lorraine, le PeeL (Pôle entrepreneuriat étudiant de Lorraine), ainsi qu’auprès des enseignants-chercheurs qui y sont liés et des parties prenantes de l’écosystème y afférent.
L’« autoexotisme » des poètes provinciaux : une ruse dix-neuviémiste ? Le cas des Amours jaunes de Tristan Corbière
Authors: Gosetti Valentina , Viselli Antonio
Published: September 2018

La notion d’« autoexotisme » est le plus souvent synonyme, dans les études littéraires et musicales, de pratique automutilatrice, dénotant l’acceptation passive d’une subjugation culturelle et la perpétuation des constructions hégémoniques de la culture dominante. En réévaluant la valeur « ex-centrique », « ex-centriste » et « dé-centralisante » des Amours jaunes (1873) de Tristan Corbière (1845-1875), cet essai entend souligner au contraire la réappropriation par la culture dite dominée d’un exotisme revalorisé en mode de création. En se fondant sur de récents débats dans le domaine des études postcoloniales et de la World Literature , cette nouvelle réflexion sur l’« autoexotisme » tente de dépasser les frontières et la logique de l’État-nation (Paris vs. Province) afin de réexaminer la contribution littéraire des poètes provinciaux français au xix e  siècle.
“Good” Biases: Does Doxastic Irrationality Benefit Individuals and Groups?
Authors: Polonioli Andrea , Stammers Sophie , Bortolotti Lisa
Published: September 2018

On s’interroge sur le fait de savoir si les stratégies de raisonnement conduisant à l’irrationalité doxastique et qui profitent aux agents individuels profitent aussi aux groupes d’agents. Nous considérons plus particulièrement le biais d’excès de confiance, le biais intergroupe et le biais d’optimisme. Dans les trois cas, ces biais sont réputés contribuer au bien-être ou au fonctionnement adéquat de l’agent, à la réalisation des buts qu’il poursuit et à la qualité de ses interactions interpersonnelles. Mais les effets de ces biais sur le groupe social ou sur la société dans son ensemble demeurent obscurs. Cette question du bénéfice social des biais est souvent négligée parce que l’individualisme méthodologique domine dans ce champ de recherche. Nous espérons que notre analyse pourra faire apparaître la dimension sociale de la cognition et contribuer à une meilleure compréhension de la manière dont l’irrationalité doxastique peut être profitable.
COMPLICAÇÕES DO USO DO ITRACONAZOL – REVISÃO
Authors: Pimentel Samantha Pinheiro , Dos Santos Maressa Holanda , Rodrigues Cabral Leonardo Alves , Correia costa Paula Priscila
Published: September 2018

O uso de medicamentos antifúngicos devem ser eficazes e seguros, isso se faz importante para a cura adequada do paciente, e para evitar o desenvolvimento de resistência do patógeno. Dentre as classes de fármacos, o Itraconazol destaca-se por ser um dos primeiros antifúngicos utilizados, além de apresentar efeito fungicida eficaz em micoses superficiais e sistêmicas. Poucos relatos existem sobre efeitos colaterais em pequenos animais, havendo mais informações em estudos humanos. Foram observados que efeitos colaterais se manifestam quando a dose de itraconazol é excessiva, podendo desencadear problemas hepatotóxicos principalmente. Este trabalho tem como objetivo desenvolver uma breve revisão de literatura sobre o fármaco Itraconazol e suas prováveis complicações de uso.
ANÁLISE BROMATOLÓGICA DE FILÉ DE PACU (Piaractus mesopotamicus), PIRAPITINGA (Piaractus brachypomum) E TAMBAQUI (Colossoma macropomum)
Authors: Botelho Hortência Aparecida , Costa Adriano Carvalho , Freitas Rilke Tadeu Fonseca de , Fernandes Érica Machado
Published: September 2018

O trabalho foi realizado com objetivo de comparar os teores de matéria seca, matéria mineral, extrato etéreo e proteína bruta presente no filé de pacu, pirapitinga e tambaqui. Foram utilizados 10 peixes da espécie pacu, 10 pirapitinga e 10 tambaqui criados em sistema de recirculação no Setor de Piscicultura da Universidade Federal de Lavras. Após 465 dias de cultivo, os animais foram abatidos, o filé retirado, pesado, liofilizado e então submetido à análise bromatológica. Para a análise dos dados foi realizado o teste Scott Knott para verificar a diferença entre as espécies. Também foi realizado as correlações das variáveis bromatológica e peso corporal.  Observou-se que para o teor de matéria seca houve diferença significativa entre as espécies sendo que para o tambaqui a média de matéria seca foi superior ás espécies pacu e pirapitinga. Não houve diferença significativa entre as espécies para a matéria mineral. Para o teor de extrato etéreo houve diferença significativa entre as espécies. O tambaqui apresentou maior teor de extrato etéreo, e a pirapitinga o menor. O teor de proteína bruta na matéria seca e na matéria natural diferiram significativamente entre as espécies, sendo que a espécie tambaqui apresentou menor teor de proteína bruta no filé. No entanto, as espécies pacu e pirapitinga apresentaram maior teor e não diferiram. Na análise de correlação a matéria seca apresentou forte correlação com o extrato étereo indicando que peixes com maior teor de matéria seca apresenta maior teor de gordura em sua carne.
HEMOGRAMA E BIOQUÍMICA SÉRICA DE JUMENTOS DA REGIÃO NORTE E NOROESTE DO CEARÁ – BRASIL
Authors: Ribeiro Rodrigo Martins , Duarte Patricia De Castro , Viana Vivian Aguiar , Araújo Magda Lima chagas , Pedroza Heloisa De paula , Ribeiro Debora Da silva freitas
Published: September 2018

Os índices hematimétricos e bioquímicos séricos são exames complementares frequentemente necessários na clínica médica de equídeos, muitas vezes são utilizados valores de referência de equinos para a interpretação de exames de asininos, sendo necessário uma fonte maior de referências para os asininos. Objetivo: Avaliar os valores hematológicos e bioquímicos séricos dos jumentos da região norte e noroeste do estado do Ceará. Foram realizados exames de hemograma e bioquímica sérica de 45 jumentos apreendidos pelo Detran na região norte e noroeste do estado Ceará localizados na fazenda do Detran na cidade de Santa Quitéria - CE. A estatística foi realizada através da avaliação das médias e seus respectivos desvios padrões. Os valores observados foram, hematócrito 35% (±3,84), proteína total 7,32 g/dL (±0,81), fibrinogênio 104 mg/dL (±100), hemoglobina 11,96 g/dL (±1,28), hemácias 7,25 x106 /mm3 (± 0,80 x106), volume corpuscular média 48,58 U3 (±0,83), concentração de hemoglobina corpuscular média 33,92 g/dL (± 1,05), leucócitos totais 9,611 x103/mm3 (±3,2 x103), bastonetes 0%, neutrófilos 49,2% (±5,71%), eosinófilos 8,26% (3,64%), basófilos 0%, linfócitos 35,93% (±5,85%), monócitos 6,44% (±3,33%) e plaquetas 342.888,89 103/mm3 (± 45.232,84). As médias com seus respectivos desvios padrões do perfil bioquímico foram uréia 30,44 mg/dL (±10,66), creatinina. 1,31 mg/dL (±0,28), alanino aminotransferase 20,18 U/L (±10,23), aspartato aminotransferase 276,37 U/L (±118,79), fosfatase alcalina 268,93 U/L (±65,30) e glicose. 89 mg/dL (±12,95). Conclusão: Na avaliação individual entre os animais não foi observado alterações no eritrograma e no leucograma, e o valores estão próximos dos valores observados por outros autores em trabalhos com asininos.
RARA APRESENTAÇÃO MACROSCOPICA DE EFUSÃO PLEURAL LINFOCITICA MALIGNA EM GATO
Authors: Marcelino Sostenes Apolo , Serakides Rogeria , Santos Daniel Oliveira , Ocarino Natalia M
Published: September 2018

O presente relato descreve os achados patológicos relacionados à uma rara apresentação macroscópica de efusão pleural linfocítica maligna em um gato. Macroscopicamente, observou-se  efusão pleural branco-amarelada repleta de coágulos brancacentos de células neoplásicas e uma massa tumoral macia e esbranquiçada no mediastino, linfonodos mediastinais e saco pericárdico. As características citológicas do líquido pleural demonstraram um grande número de linfócitos malignos que caracterizam a efusão pleural linfocítica maligna. Histologicamente, a massa tumoral era composta de células redondas com citoplasma eosinofílico e homogêneo variando de escasso a moderado. Os achados macro, micro e citológicos confirmam o diagnóstico de efusão pleural linfocítica maligna devido ao linfoma.
MELANOMA NA MUCOSA VULVAR EM CADELA: RELATO DE CASO
Authors: Mezaroba Maurício Eduardo , Figueiró Giuliano Moraes , Veiga Angela Medeiros
Published: September 2018

O melanoma, um tumor invasivo de melanócitos e altamente metastático, possui como áreas de comum ocorrência a pele, a cavidade oral e estruturas oculares, sendo responsável por 10-15% das neoplasias cutâneas de caninos. O Laboratório de Análises Clínicas Veterinárias (LaClin) da Universidade Federal de Santa Catarina (UFSC) diagnosticou um caso de melanoma em local de ocorrência incomum (mucosa vulvar) em uma cadela errante, por meio de avaliação citológica de um imprint do local. Diante disso, objetivou-se relatar o caso para que sirva como modelo de diagnóstico diferencial de neoplasias mais comuns na genitália de cadelas, como o tumor venéreo transmissível canino.
A Competency-Based Curriculum for Critical Care Nurse Practitioners’ Transition to Practice
Authors: Kopf R. Scott , Watts Penni I. , Meyer Eileen S. , Moss Jacqueline A.
Published: September 2018

Background

Nearly one-third of new-graduate nurse practitioners report undergoing no formal orientation process, and postcertification orientation processes vary. A validated curriculum would address the need for structured training to enhance new graduates’ practice transition.

Methods

A competency-based practice transition curriculum for intensive care unit nurse practitioners was created using a literature review and expert panels. Competencies were established that were based on clinical categories essential to nurse practitioner practice in the intensive care unit and adapted from existing Accreditation Council for Graduate Medical Education training, aligned with the precertification nursing curriculum. Participants recruited from academic and clinical backgrounds were asked to rank curriculum items using a 4-point Likert scale. Competencies were refined on the basis of participants’ survey feedback.

Results

A total of 31 participants from academic medical centers and schools of nursing throughout the United States responded to the request for competency validation; 29% of participants provided qualitative data. All 9 competency topics received a mean rating greater than 3.5 and were deemed valid. Using the combined quantitative and qualitative data, a final set of competencies for nurse practitioners in the intensive care unit was developed.

Conclusions

The curriculum developed and validated in this study can become the basis for practice transition for novice nurse practitioners. The curriculum is adaptable and can be used for surgical and medical intensive care units. As refined, the competencies provide a validated foundation for training of new-graduate nurse practitioners in the intensive care unit.
Cerebral Autoregulation in Neonates With and Without Congenital Heart Disease
Authors: Tran Nhu N. , Kumar S. Ram , Hodge Felicia S. , Macey Paul M.
Published: September 2018

Background

Congenital heart disease (CHD) is a leading birth defect in the United States, affecting about 40 000 neonates each year. Despite efforts to prevent developmental delays, many children with CHD have neurological deficits that last into adulthood, influencing employability, self-care, and quality of life.

Objective

To determine if neonates with CHD have impaired cerebral autoregulation and poorer neurodevelopmental outcomes compared with healthy controls.

Methods

A total of 44 full-term neonates, 28 with CHD and 16 without, were enrolled in the study. Inclusion criteria included confirmed diagnosis of CHD, stable hemodynamic status, and being no more than 12 days old. Exclusion criteria included intraventricular hemorrhage and intubation. Cerebral autoregulation was determined by measuring regional cerebral oxygenation during a postural change. The Einstein Neonatal Neurobehavioral Assessment Scale was used to measure overall neurodevelopmental outcomes (motor, visual, and auditory functions).

Results

Of the 28 neonates with CHD, 8 had single-ventricle physiology. A χ2 analysis indicated no significant difference in impaired cerebral autoregulation between neonates with CHD and controls (P = .38). Neonates with CHD had lower regional cerebral oxygenation than did neonates without CHD (P < .001). Regression analyses with adjustments for cerebral autoregulation indicated that neonates with CHD had poorer total neurodevelopmental outcomes scores (β = 9.3; P = .02) and motor scores (β = 7.6; P = .04).

Conclusion

Preoperative neonates with CHD have poorer developmental outcomes and more hypoxemia than do controls.
EFFECT OF PERMETHRIN-TREATED BED NETS ON THE SPATIAL DISTRIBUTION OF MALARIA VECTORS IN WESTERN KENYA
Authors: GIMNIG JOHN E. , KOLCZAK MARGARETTE S. , HIGHTOWER ALLEN W. , VULULE JOHN M. , SCHOUTE ERIK , KAMAU LUNA , PHILLIPS-HOWARD PENELOPE A. , TER KUILE FEIKO O. , NAHLEN BERNARD L. , HAWLEY WILLIAM A.
Published: September 2018

The effect of insecticide (permethrin)-treated bed nets (ITNs) on the spatial distribution of malaria vectors in neighboring villages lacking ITNs was studied during a randomized controlled trial of ITNs in western Kenya. There was a trend of decreased abundance of Anopheles gambiae with decreasing distance from intervention villages both before (P = 0.027) and after (P = 0.002) introduction of ITNs, but this trend was significantly stronger after ITNs were introduced (P = 0.05). For An. funestus, no pre-intervention trend was observed (P = 0.373), but after the intervention, a trend of decreased abundance with closer proximity to intervention compounds developed (P = 0.027). Reduction in mosquito populations in villages lacking ITNs was most apparent in compounds located within 600 meters of intervention villages. Sporozoite infection rates decreased in control areas following the introduction of ITNs (P < 0.001 for both species), but no spatial association was detected between sporozoite rates and distance to nearest intervention village. We conclude that high coverage of ITNs is associated with a community-wide suppression of mosquito populations that is detectable in neighboring villages lacking ITNs, thereby affording individuals residing in these villages some protection against malaria.
ANALYSIS OF THE PRESENCE OF TRYPANOSOMA CRUZI IN THE HEART TISSUE OF THREE PATIENTS WITH CHRONIC CHAGAS’ HEART DISEASE
Authors: ELIAS FERNANDO E. , VIGLIANO CARLOS A. , LAGUENS RUBÉN P. , LEVIN MARIANO J. , BEREK CLAUDIA
Published: September 2018

It is still unclear to what extent myocarditis-associated, chronic Chagas’ heart disease is due to persisting Trypanosoma cruzi. In the present study, we have analyzed tissue samples from the hearts of three patients with this disease. In situ hybridization provided little evidence for the presence of intact T. cruzi, even at sites of strong inflammation. Nevertheless, micromanipulation techniques detected remnants of both T. cruzi kinetoplast DNA and nuclear DNA. Trypanosoma cruzi DNA was also detected in single macrophages dissected directly from frozen heart tissue sections. Thus, this analysis demonstrates that T. cruzi kinetoplast DNA and nuclear DNA are widely dispersed in the heart tissue, although in low amounts. Since we rarely detected intact T. cruzi parasites during the chronic phase of Chagas’ heart disease, we can exclude heart tissue as a major parasite reservoir.
THE ASSOCIATION OF HEALTH-CARE USE AND HEPATITIS C VIRUS INFECTION IN A RANDOM SAMPLE OF URBAN SLUM COMMUNITY RESIDENTS IN SOUTHERN INDIA
Authors: MARX MELISSA A. , MURUGAVEL K. G. , SIVARAM SUDHA , BALAKRISHNAN P. , STEINHOFF MARK , ANAND S. , THOMAS DAVID L. , SOLOMON SUNITI , CELENTANO DAVID D.
Published: September 2018

To determine whether health-care use was associated with prevalent hepatitis C virus (HCV) infection in Chennai, India, 1,947 adults from 30 slum communities were randomly selected to be interviewed about parenteral and sexual risks for HCV infection and to provide biological specimens for HCV and sexually transmitted infection (STI) testing. Prevalent HCV infection was detected in 2.4% of non-injection drug using (IDU) participants. Controlling for other associated factors, and excluding IDU, men who used informal health-care providers were five times as likely to be HCV infected as those who did not use informal providers (Adjusted Odds Ratio, AOR = 5.83; 95% confidence interval [CI]: 1.57, 21.6), a finding not detected in women. More research is needed to determine the extent to which HCV infection is associated with reuse of contaminated injection equipment in health-care settings in developing countries.
EOSINOPHILIC MENINGITIS CAUSED BY ANGIOSTRONGYLUS CANTONENSIS ASSOCIATED WITH EATING RAW SNAILS: CORRELATION OF BRAIN MAGNETICRESONANCE IMAGING SCANS WITH CLINICAL FINDINGS
Authors: TSAI HUNG-CHIN , LIU YUNG-CHING , KUNIN CALVIN M. , LAI PING-HONG , LEE SUSAN SHIN-JUNG , CHEN YAO-SHEN , WANN SHUE-REN , LIN WEI-RU , HUANG CHUN-KAI , GER LUO-PING , LIN HSI-HSUN , YEN MUH-YONG
Published: September 2018

Angiostrongylus cantonensis is the most common cause of eosinophilic meningitis worldwide. Human infection occurs after ingestion of the worms in raw snails or fish that serve as intermediate hosts. Two outbreaks of central nervous system infection with A. cantonensis occurred in Kaoshiung, Taiwan, during 1998 and 1999 among Thai laborers who ate raw snails. A detailed clinical studies of 17 of these patients was conducted, including study of 13 patients who underwent magnetic resonance imaging (MRI) scans of the brain. The MRI scans revealed high signal intensities over the globus pallidus and cerebral peduncle on TI-weighted imaging, leptomeningeal enhancement, ventriculomegaly, and punctate areas of abnormal enhancement within the cerebral and cerebellar hemisphere on gadolinium-enhancing T1 imaging, and a hyperintense signal on T2-weighted images. There was a significant correlation between severity of headache, cerebrospinal fluid (CSF) pleocytosis, and CSF and blood eosinophilia with MRI signal intensity in T1-weighted imaging (P < 0.05). Eosinophilic meningitis produced by A. cantonensis needs to added to the list of causes of hyperintense basal ganglia lesions found on T1-weighted MRI scans in tropical countries.
ENHANCEMENT OF DISEASE AND PATHOLOGY BY SYNERGY OF TRICHURIS SUIS AND CAMPYLOBACTER JEJUNI IN THE COLON OF IMMUNOLOGICALLY NAIVE SWINE
Authors: MANSFIELD LINDA S. , GAUTHIER DAVID T. , ABNER SHEILA R. , JONES KATHRYN M. , WILDER STACEY R. , URBAN JOSEPH F.
Published: September 2018

Campylobacter jejuni, a leading cause of bacterial gastroenteritis, has different age distribution and disease expression in developing and developed countries, which may be due to the endemnicity of infection and the age of acquisition of immunity. Differences in disease expression are not solely dependent on the C. jejuni strain or virulence attributes. Another modulating factor in developing countries may be endemic nematode infections such as Trichuris, which drive type 2 cytokine responses and down-regulate type 1 immune responses. In this study, three-day-old germ-free pigs given dual infections with Trichuris suis and C. jejuni had more frequent, more severe diarrhea and severe pathology than pigs given no pathogens, only T. suis, or only C. jejuni. These pigs had significant hemorrhage and inflammatory cell infiltrates in the proximal colon where adult worms were found, and abscessed lymphoglandular complexes in the distal colon with intracellular C. jejuni. Pigs given only C. jejuni had mild clinical signs and pathology, and bacteria in feces or extracellular sites. Pigs given T. suis or no pathogens had no disease and minimal pathology. Thus, these agents synergized to produce significant disease and pathology, which was site specific.
CASE REPORT: SEVERE JUVENILE TYPE PARACOCCIDIOIDOMYCOSIS WITH HEPATITIS C
Authors: PELLEGRINO ANTONELLA , DE CAPRILES CLAUDIA HARTUNG , MAGALDI SYLVIA , DE OCA ISRAEL MONTES , RUIZ MARÌA ELENA , PÉREZ CELINA , MATA-ESSAYAG SOFÍA
Published: September 2018

We present the case of a 34-year-old man with previous history of hepatitis C and severe juvenile type of paracoccidioidomycosis characterized by involvement of the reticuloendothelial system, eosinophilia, lung compromise (pleural effusion), retinal hemorrhage, and blood culture positive to Paracoccidioides brasiliensis. The immune evaluation showed four precipitation lines to P. brasiliensis by the double immunodiffusion test. Treatment with amphotericin B and itraconazol resulted in resolution of the disease.
SHORT REPORT: ANALYSIS OF ANTI-MALARIA IMMUNE RESPONSE DURING HUMAN IMMUNODEFICIENCY VIRUS INFECTION IN ADULTS IN KINSHASA, DEMOCRATIC REPUBLIC OF THE CONGO
Authors: KASHAMUKA M. , NZILA N. , MUSSEY L. , LUBAKI N. , QUINN T. C. , BOLLINGER R. , KUMAR N.
Published: September 2018

Co-infection of human immunodeficiency virus and malaria is not uncommon in people living in sub-Saharan Africa. Since HIV infection results in immune deficiency, it may alter the ability of HIV patients to mount proper immune responses against malaria parasites. We measured specific malaria antibodies in 47 specimens from 25 couples from Kinshasa, Democratic Republic of the Congo (DRC), according to their HIV status, and investigated probable interaction between malaria and HIV infection. Plasma samples were analyzed for HIV markers (western blot and viral load) and malaria parasite-specific antibody (antibody titer, pattern of antigen recognized by western blotting, and parasite neutralizing antibodies assayed by growth inhibition). No correlation was identified between measured HIV infection status and malaria-specific parameters.
RECOVERY OF CHLOROQUINE SENSITIVITY AND LOW PREVALENCE OF THE PLASMODIUM FALCIPARUM CHLOROQUINE RESISTANCE TRANSPORTER GENE MUTATION K76T FOLLOWING THE DISCONTINUANCE OF CHLOROQUINE USE IN MALAWI
Authors: MITA TOSHIHIRO , KANEKO AKIRA , LUM J. KOJI , BWIJO BWIJO , TAKECHI MIHO , ZUNGU INNOCENT L. , TSUKAHARA TAKAHIRO , TANABE KAZUYUKI , KOBAYAKAWA TAKATOSHI , BJÖRKMAN ANDERS
Published: September 2018

In 1993, Malawi stopped treating patients with chloroquine for Plasmodium falciparum malaria because of a high treatment failure rate (58%). In 1998, the in vitro resistance rate to chloroquine was 3% in the Salima District of Malawi; in 2000, the in vivo resistance rate was 9%. We assayed two genetic mutations implicated in chloroquine resistance (N86Y in the P. falciparum multiple drug resistance gene 1 and K76T in the P. falciparum chloroquine resistance transporter gene) in 82 P. falciparum isolates collected during studies in 1998 and 2000. The prevalence of N86Y remained similar to that in neighboring African countries that continued to use chloroquine. In contrast, the prevalence of K76T was substantially lower than in neighboring countries, decreasing significantly from 17% in 1998 to 2% in 2000 (P < 0.02). However, neither mutation was significantly associated with in vivo or in vitro resistance (P > 0.29). Withdrawal of the use of chloroquine appears to have resulted in the recovery of chloroquine efficacy and a reduction in the prevalence of K76T. However, other polymorphisms are also expected to contribute to resistance.
EX VIVO INTERFERON-GAMMA IMMUNE RESPONSE TO THROMBOSPONDIN-RELATED ADHESIVE PROTEIN IN COASTAL KENYANS: LONGEVITY AND RISK OF PLASMODIUM FALCIPARUM INFECTION
Authors: FLANAGAN KATIE L. , MWANGI TABITHA , PLEBANSKI MAGDALENA , ODHIAMBO KENNEDY , ROSS AMANDA , SHEU ERIC , KORTOK MOSES , LOWE BRETT , MARSH KEVIN , HILL ADRIAN V. S.
Published: September 2018

Thrombospondin-related adhesive protein (TRAP) of Plasmodium falciparum is currently being tested in human vaccine studies. However, its natural reactivity in the field remains poorly characterized. More than 40% of 217 Kenyan donors responded in an ex vivo interferon-γ (IFN-γ) enzyme-linked immunospot (ELISPOT) assay to at least one of 14 20mer peptides spanning 42% of the antigen. Reactivity was comparable from early childhood (>1 year of age) to old age, and the maximal precursor frequency of TRAP-specific cells to all 14 peptides was 1 in 4,000. Prospective follow-up for one year indicated that these low-level ex vivo responses to TRAP did not protect against the subsequent development of malaria. Retesting of selected donors after one year showed a complete change in the reactivity pattern, suggesting that malaria-specific ex vivo IFN-γ ELISPOT assay responses are short lived in naturally exposed donors, even to conserved epitopes. This study provides important information regarding natural reactivity to a key malaria antigen.
DIAGNOSTIC AND PRESCRIBING PRACTICES IN PERIPHERAL HEALTH FACILITIES IN RURAL WESTERN KENYA
Authors: PHILLIPS-HOWARD PENELOPE A. , WANNEMUEHLER KATHLEEN A. , TER KUILE FEIKO O. , HAWLEY WILLIAM A. , KOLCZAK MARGARETTE S. , ODHACHA AMOS , VULULE JOHN M. , NAHLEN BERNARD L.
Published: September 2018

Health facility ledgers of 11 rural health facilities in western Kenya were reviewed to evaluate diagnostic and prescribing practices. Clinics lacked laboratory facilities. Of 14,267 sick child visits (SCVs), 76% were diagnosed with malaria and/or upper respiratory infections. Other diagnoses were recorded in less than 5% of SCVs. Although two-thirds of malaria cases were diagnosed with co-infections, less than 3% were concomitantly diagnosed with anemia. Chloroquine and penicillin constituted 94% of prescriptions. Half of children given a sole diagnosis of measles or pneumonia were prescribed chloroquine, and 22% of children with a sole diagnosis of malaria were given penicillin. Antimalarials other than chloroquine were rarely prescribed. Only 12% of children diagnosed with anemia were prescribed iron supplementation, while 53% received folic acid. This study highlights limited diagnostic and prescribing practices and a lack of adherence to national treatment guidelines in rural western Kenya.
EFFECTS OF PERMETHRIN-TREATED BED NETS ON IMMUNITY TO MALARIA IN WESTERN KENYA I. ANTIBODY RESPONSES IN PREGNANT WOMEN AND CORD BLOOD IN AN AREA OF INTENSE MALARIA TRANSMISSION
Authors: KARIUKI SIMON K. , TER KUILE FEIKO O. , WANNEMUEHLER KATHLEEN , TERLOUW DIANNE J. , KOLCZAK MARGARETTE S. , HAWLEY WILLIAM A. , PHILLIPS-HOWARD PENELOPE A. , ORAGO ALLOYS S. S. , NAHLEN BERNARD L. , LAL ALTAF A. , SHI YA PING
Published: September 2018

As part of a community-based group-randomized trial on the impact of permethrin-treated bed nets (ITNs) on malaria in pregnancy in a holoendemic area of western Kenya, we assessed their effects on antibody responses to Plasmodium falciparum pre-erythrocytic antigens (recombinant circumsporozoite protein [CSP] and peptides complimentary to the repeat region of the liver stage antigen-1 [LSA-1]) and blood stage antigen (recombinant C-terminal domain of the merozoite surface protein-1 [MSP-119 kD]) in paired maternal/cord plasma samples obtained from 296 deliveries (157 from ITN villages and 139 control villages). Levels of total IgG and IgG subclasses 1–3 to LSA-1 and total IgG and IgG3 to MSP-1 were lower, whereas those of total IgG to CSP were significantly higher in women from ITN villages than those from control villages. In cord plasma, levels of total IgG and IgG2 to LSA-1 and IgG3 to MSP-1 were lower in ITN villages than in control villages, but antibody responses to CSP were similar. Our results suggest that the use of ITNs decreases antibody responses to LSA-1 and MSP-1 antigens in pregnant women with associated reductions in levels of the same antibodies in cord blood. In contrast, ITN use was found to be associated with increased antibody responses to CSP in pregnant women, but had no effect on antibody levels to CSP in cord blood.
PLACENTAL AND ORAL DELIVERY OF SCHISTOSOMA MANSONI ANTIGEN FROM INFECTED MOTHERS TO THEIR NEWBORNS AND CHILDREN
Authors: ATTALLAH ABDELFATTAH M. , GHANEM GAMAL E. , ISMAIL HISHAM , EL WASEEF AHMED M.
Published: September 2018

A 63-kD Schistosoma mansoni antigen was detected in 149 (86%) of 174 umbilical cord blood sera from infected women at delivery. Specific IgG antibodies to this antigen were also detected in 80% of cord blood sera. The 63-kD antigen showed the same molecular mass by Western blotting when isolated from cord blood, maternal blood, breast milk, and urine from women infected with S. mansoni. This antigen was detected in the urine of 25 infants born to infected mothers and followed for 18–24 months after delivery. It was also detected in some infants up to 21 days after parturition and then disappeared at 28 days, demonstrating the influence of breast-feeding on persistence of antigen in infants born to infected women. Thus, exposure to Schistosoma antigens and maternal antibodies to this organism may influence the developing immune responses to natural infection or vaccination of children born in endemic areas.
ANTIMICROBIAL RESISTANCE OF BACTERIAL PATHOGENS ASSOCIATED WITH DIARRHEAL PATIENTS IN INDONESIA
Authors: TJANIADI PERISKA , LESMANA MURAD , SUBEKTI DECY , MACHPUD NUNUNG , KOMALARINI SHINTA , SANTOSO WASIS , SIMANJUNTAK CYRUS H. , PUNJABI NARAIN , CAMPBELL JAMES R. , ALEXANDER WILLIAM K. , BEECHAM H. JAMES , CORWIN ANDREW L. , OYOFO BUHARI A.
Published: September 2018

The antimicrobial susceptibility patterns for 2,812 bacterial pathogens isolated from diarrheal patients admitted to hospitals in several provinces in the cities of Jakarta, Padang, Medan, Denpasar, Pontianak, Makassar, and Batam, Indonesia were analyzed from 1995 to 2001 to determine their changing trends in response to eight antibiotics: ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, tetracycline, cephalothin, ceftriaxone, norfloxacin, and ciprofloxacin. Vibrio cholerae O1 (37.1%) was the pathogen most frequently detected, followed by Shigella spp. (27.3%), Salmonella spp. (17.7%), V. parahaemolyticus (7.3%), Salmonella typhi (3.9%), Campylobacter jejuni (3.6%), V. cholerae non-O1 (2.4%), and Salmonella paratyphi A (0.7%). Of the 767 Shigella spp. isolated, 82.8% were S. flexneri, 15.0% were S. sonnei, and 2.2% were S. dysenteriae (2.2%). The re-emergence of Shigella dysenteriae was noted in 1998, after an absence of 15 years. Shigella spp. were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline. Salmonella typhi and Salmonella paratyphi A were susceptible to all antibiotics tested, while Salmonella spp. showed various resistance patterns according to species grouping. A small number of V. cholerae O1 were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline; however, they were still sensitive to ceftriaxon, norfloxacin, and ciprofloxacin. Similar results were shown for V. cholerae non-O1. Campylobacter jejuni showed an increased frequency of resistance to ceftriaxone, norfloxacin, and ciprofloxacin, but was susceptible to erythromycin. This study shows that except for C. jejuni and V. parahaemolyticus, which appeared to be resistant to ciprofloxacin, the majority of the enteric pathogens tested were still susceptible to fluoroquinolones.
SEROPREVALENCE OF TRYPANOSOMA CRUZI INFECTION AMONG SCHOOL-AGE CHILDREN IN THE ENDEMIC AREA OF GUATEMALA
Authors: RIZZO NIDIA R. , ARANA BYRON A. , DIAZ ANAITE , CORDON-ROSALES CELIA , KLEIN ROBERT E. , POWELL MALCOLM R.
Published: September 2018

In support of the National Program for Chagas Disease Control, we conducted a cross-sectional study to estimate the seroprevalence rate of Trypanosoma cruzi infection across the five Departments (Chiquimula, Jalapa, Zacapa, Jutiapa, and Santa Rosa) that are believed to comprise the entire principal endemic area in Guatemala. Also, so that the results could be used to identify areas of active transmission, we conducted the survey in school-aged children. We used an experimental enzyme-linked immunosorbent assay with blood samples obtained by finger prick to estimate the seroprevalence of T. cruzi. This assay has been previously tested and showed good sensitivity and specificity. Overall, the seropositivity rate for T. cruzi infection was 5.28% (235 of 4,450). Of 173 communities evaluated, 35 (20.23%) had a seropositive rate ranging from 10% to 45%. A number of parameters, including but not limited to living conditions, were examined for possible association with seropositivity. While there are several associations, the strongest association with seropositivity is living in a house with a thatch roof. The survey results will permit the Ministry of Health to stratify T. cruzi-endemic communities, enabling local health authorities to efficiently focus on vector control operations.
SHORT REPORT: VARIATION IN MITOCHONDRIAL 12S AND 16S RIBOSOMAL DNA SEQUENCES IN NATURAL POPULATIONS OF TRIATOMA INFESTANS (HEMIPTERA: REDUVIIDAE)
Authors: GARCÍA BEATRIZ A. , MANFREDI CANDELA , FICHERA LAURA , SEGURA ELSA L.
Published: September 2018

Mitochondrial DNA sequences of the 12S and 16S ribosomal RNA genes were analyzed in five natural populations of the Chagas’ disease vector Triatoma infestans from Argentina. DNA sequence comparisons of 878 basepairs (12S plus 16S) revealed 13 haplotypes. A total of 10 private haplotypes were found in four of the populations analyzed, suggesting low current levels of genetic exchange. The levels of genetic differentiation between the population of Chancaní (Córdoba) and other two of the populations analyzed indicated significant deviation from a pattern of unrestricted gene flow. The haplotypic diversity and the private haplotypes found in the geographically closest localities of Chancaní and El Jardín (La Rioja) suggest that the reduction in the population size by insecticide treatment did not avoid the recovery of the populations apparently from survivors of the same area.
CRYPTOSPORIDIUM PARVUM IN CHILDREN WITH DIARRHEA IN MULAGO HOSPITAL, KAMPALA, UGANDA
Authors: TUMWINE JAMES K. , KEKITIINWA ADDY , NABUKEERA NICOLETTE , AKIYOSHI DONNA E. , RICH STEPHEN M. , WIDMER GIOVANNI , FENG XIAOCHUAN , TZIPORI SAUL
Published: September 2018

A cross-sectional case-control study (ratio = 3:1) was conducted over a 15-month period to determine the prevalence and consequences of cryptosporidiosis in hospitalized diarrheic children (0–5 years old) at Mulago Hospital in Kampala, Uganda. Cryptosporidium parvum was detected and genotyped among 2,446 children of whom 1,779 (72.7%) had diarrhea, and 667 (27.3%) were age- and sex-matched controls. Of the 1,779 children with diarrhea, 532 (29.9%) had persistent (> 14 days) diarrhea and 1,247 (70.1%) had acute diarrhea. Overall, 444 (25.0%) of the 1,779 children with diarrhea had C. parvum, compared with only 57 (8.5%) of the 667 children without diarrhea (χ2 = 80.2, P ≤ 0.0001). Within this group of infected children, 72.8% were infected with genotype 1, 18.4% with genotype 2, and 4.1% with a mixture of both genotypes, and 4.1% isolates were either unclassified or C. meleagridis. The prevalence was highest during the rainy months of April to June. Of the 532 children with persistent diarrhea, 166 (31.2%) had C. parvum compared with 278 (22.3%) of the 1,247 children with acute diarrhea (χ2 = 15.8, P ≤ 0.0001). There was a significant association between C. parvum and malnutrition including stunting, being underweight, and wasting. Unfavorable outcome (death or failure to resolve within 14 days) occurred in 139 (72.8%) of the 191 children with C. parvum, and in only 65.1% of the 545 without (odds ratio = 1.117, 95% confidence interval = 1.005–1.243, P = 0.05), Of the 191 children with C. parvum, 24 (12.6%) died, compared with 34 (6.2%) of the 545 without C. parvum (P = 0.005). Mortality rates were higher among children with severe dehydration and persistent diarrhea, and in stunted or underweight children infected with C. parvum. Among Ugandan children, cryptosporidiosis, which remains untreatable, is frequently associated with diarrhea and other serious and unfavorable consequences.
SPATIAL AND TEMPORAL HETEROGENEITY OF ANOPHELES MOSQUITOES AND PLASMODIUM FALCIPARUM TRANSMISSION ALONG THE KENYAN COAST
Authors: MBOGO CHARLES M. , MWANGANGI JOSEPH M. , NZOVU JOSEPH , GU WEIDONG , YAN GUIYAN , GUNTER JAMES T. , SWALM CHRIS , KEATING JOSEPH , REGENS JAMES L. , SHILILU JOSEPHAT I. , GITHURE JOHN I. , BEIER JOHN C.
Published: September 2018

The seasonal dynamics and spatial distributions of Anopheles mosquitoes and Plasmodium falciparum parasites were studied for one year at 30 villages in Malindi, Kilifi, and Kwale Districts along the coast of Kenya. Anopheline mosquitoes were sampled inside houses at each site once every two months and malaria parasite prevalence in local school children was determined at the end of the entomologic survey. A total of 5,476 Anopheles gambiae s.l. and 3,461 An. funestus were collected. Species in the An. gambiae complex, identified by a polymerase chain reaction, included 81.9% An. gambiae s.s., 12.8% An. arabiensis, and 5.3% An. merus. Anopheles gambiae s.s. contributed most to the transmission of P. falciparum along the coast as a whole, while An. funestus accounted for more than 50% of all transmission in Kwale District. Large spatial heterogeneity of transmission intensity (< 1 up to 120 infective bites per person per year) resulted in correspondingly large and significantly related variations in parasite prevalence (range = 38–83%). Thirty-two percent of the sites (7 of 22 sites) with malaria prevalences ranging from 38% to 70% had annual entomologic inoculation rates (EIR) less than five infective bites per person per year. Anopheles gambiae s.l. and An. funestus densities in Kwale were not significantly influenced by rainfall. However, both were positively correlated with rainfall one and three months previously in Malindi and Kilifi Districts, respectively. These unexpected variations in the relationship between mosquito populations and rainfall suggest environmental heterogeneity in the predominant aquatic habitats in each district. One important conclusion is that the highly non-linear relationship between EIRs and prevalence indicates that the consistent pattern of high prevalence might be governed by substantial variation in transmission intensity measured by entomologic surveys. The field-based estimate of entomologic parameters on a district level does not provide a sensitive indicator of transmission intensity in this study.
AGE-DEPENDENT IMPAIRMENT OF IgG RESPONSES TO GLYCOSYLPHOSPHATIDYLINOSITOL WITH EQUAL EXPOSURE TO PLASMODIUM FALCIPARUM AMONG JAVANESE MIGRANTS TO PAPUA, INDONESIA
Authors: KEENIHAN SARAH N. HUDSON , RATIWAYANTO SUTANTI , SOEBIANTO SARASWATI , KRISIN  , MARWOTO HARIJANI , KRISHNEGOWDA GOWDAHALLI , GOWDA D. CHANNE , BANGS MICHAEL J. , FRYAUFF DAVID J. , RICHIE THOMAS L. , KUMAR SANJAI , BAIRD J. KEVIN
Published: September 2018

Immune responses directed at glycosylphosphatidylinositol (GPI) anchors of Plasmodium falciparum may offer protection against symptomatic malaria. To independently explore the effect of age on generation of the anti-GPI IgG response, we measured serum anti-GPI IgGs in a longitudinal cohort of migrant Javanese children (6–12 years old) and adults (≥20 years old) with equivalent numbers of exposures to P. falciparum in Papua, Indonesia. While the peak response in adults was achieved after a single infection, comparable responses in children required ≥3–4 infections. Significantly fewer children (16%) than adults (41%) showed a high (optical density > 0.44) anti-GPI IgG response (odds ratio [OR] = 3.8, 95% confidence interval [CI] = 2.3–6.3, P < 0.0001), and adults were more likely to show a persistently high response (OR = 5.5, 95% CI = 1.0–56.8, P = 0.03). However, the minority of children showing a strong response were significantly less likely to experience symptoms with subsequent parasitemia compared with those with a weak response (OR = 4.0, 95% CI = 1.1–13.8, P = 0.02). This effect was not seen among high- and low-responding adults (OR = 1.2, 95% CI = 0.5–2.8, P = 0.60). Host age, independent of cumulative exposure, apparently represents a key determinant of the quantitative and qualitative nature of the IgG response to P. falciparum GPI.