bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti-Pfs25 Human Plasma Reduces Transmission of Plasmodium falciparum Isolates That Have Diverse Genetic Backgrounds
Authors: Da Dari F. , Dixit Saurabh , Sattabonkot Jetsumon , Mu Jianbing , Abate Luc , Ramineni Bhanumati , Ouedraogo Jean Bosco , MacDonald Nicholas J. , Fay Michael P. , Su Xin-zhuan , Cohuet Anna , Wu Yimin 
Published: March 2013

ABSTRACT

Pfs25 is a leading candidate for a malaria transmission-blocking vaccine whose potential has been demonstrated in a phase 1 trial with recombinant Pfs25 formulated with Montanide ISA51. Because of limited sequence polymorphism, the anti-Pfs25 antibodies induced by this vaccine are likely to have transmission-blocking or -reducing activity against most, if not all, field isolates. To test this hypothesis, we evaluated transmission-blocking activities by membrane feeding assay of anti-Pfs25 plasma from the Pfs25/ISA51 phase 1 trial against
Plasmodium falciparum
parasites from patients in two different geographical regions of the world, Thailand and Burkina Faso. In parallel, parasite isolates from these patients were sequenced for the Pfs25 gene and genotyped for seven microsatellites. The results indicate that despite different genetic backgrounds among parasite isolates, the Pfs25 sequences are highly conserved, with a single nonsynonymous nucleotide polymorphism detected in 1 of 41 patients in Thailand and Burkina Faso. The anti-Pfs25 immune plasma had significantly higher transmission-reducing activity against parasite isolates from the two geographical regions than the nonimmune controls (
P
< 0.0001).
CD40 Induces Anti-Toxoplasma gondii Activity in Nonhematopoietic Cells Dependent on Autophagy Proteins
Authors: Van Grol Jennifer , Muniz-Feliciano Luis , Portillo Jose-Andres C. , Bonilha Vera L. , Subauste Carlos S. 
Published: March 2013

ABSTRACTToxoplasma gondiiinfects both hematopoietic and nonhematopoietic cells and can cause cerebral and ocular toxoplasmosis, as a result of either congenital or postnatally acquired infections. Host protection likely acts at both cellular levels to control the parasite. CD40 is a key factor for protection against cerebral and ocular toxoplasmosis. We determined if CD40 induces anti-T. gondiiactivity at the level of nonhematopoietic cells. Engagement of CD40 on various endothelial cells including human microvascular brain endothelial cells, human umbilical vein endothelial cells, and a mouse endothelial cell line as well as human and mouse retinal pigment epithelial cells resulted in killing ofT. gondii. CD40 stimulation increased expression of the autophagy proteins Beclin 1 and LC3 II, enhanced autophagy flux, and led to recruitment of LC3 around the parasite. The late endosomal/lysosomal marker LAMP-1 accumulated around the parasite in CD40-stimulated cells. This was accompanied by killing ofT. gondiidependent on lysosomal enzymes. Accumulation of LAMP-1 and killing ofT. gondiiwere dependent on the autophagy proteins Beclin 1 and Atg7. Together, these studies revealed that CD40 induces toxoplasmacidal activity in various nonhematopoietic cells dependent on proteins of the autophagy machinery.
Exacerbated Type II Interferon Response Drives Hypervirulence and Toxic Shock by an Emergent Epidemic Strain of Streptococcus suis
Authors: Lachance Claude , Gottschalk Marcelo , Gerber Pehuén P. , Lemire Paul , Xu Jianguo , Segura Mariela 
Published: March 2013

ABSTRACTStreptococcus suis, a major porcine pathogen, can be transmitted to humans and cause severe symptoms. A large human outbreak associated with an unusual streptococcal toxic shock-like syndrome (STSLS) was described in China. Albeit an early burst of proinflammatory cytokines following ChineseS. suisinfection was suggested to be responsible for STSLS case severity, the mechanisms involved are still poorly understood. Using a mouse model, the host response toS. suisinfection with a North American intermediately pathogenic strain, a European highly pathogenic strain, and the Chinese epidemic strain was investigated by a whole-genome microarray approach. Proinflammatory genes were expressed at higher levels in mice infected with the Chinese strain than those infected with the European strain. The Chinese strain induced a fast and strong gamma interferon (IFN-γ) response by natural killer (NK) cells. In fact, IFN-γ-knockout mice infected with the Chinese strain showed significantly better survival than wild-type mice. Conversely, infection with the less virulent North American strain resulted in an IFN-β-subjugated, low inflammatory response that might be beneficial for the host to clear the infection. Overall, our data suggest that a highly virulent epidemic strain has evolved to massively activate IFN-γ production, mainly by NK cells, leading to a rapid and lethal STSLS.
An Analysis of the Emergency Ambulance Workload in the British Eastern Sovereign Base Area of Cyprus May 1995 to April 1998
Authors: Leach Jonathan , Menzies Angus 
Published: March 2013

ObjectiveTo assess emergency ambulance workload in terms of patients treated, casemix and whether or not a member of the British Forces Community, between May 1995 and April 1998 within the British Eastern Sovereign Base area in Cyprus.MethodsRetrospective analysis of all incidents attended within the study period.ResultsA total of 452 patients were treated of which 47% were members of the British Forces Community in Cyprus. 14 Deaths were attended of which 9 were due to road traffic accidents. Of all incidents attended 45% were following a road traffic accident and over three quarters of all patients treated had suffered trauma to some degree.ConclusionThe British military ambulance and supporting medical services located in the Eastern Sovereign Base Area in Cyprus provide a service to the British Forces Community, but the majority of patients treated are primarily the local Greek Cypriots with a sizeable minority of visiting tourists. Comment is made on the high incidence of morbidity and mortality from road traffic accidents within Cyprus as a whole.
Behind Armour Blunt Trauma - an emerging problem
Authors: Cannon L 
Published: March 2013

Behind Armour Blunt Trauma (BABT) is the non-penetrating injury resulting from the rapid deformation of armours covering the body. The deformation of the surface of an armour in contact with the body wall arises from the impact of a bullet or other projectile on its front face. The deformation is part of the retardation and energy absorbing process that captures the projectile. In extreme circumstances, the BABT may result in death, even though the projectile has not perforated the armour. An escalation of the available energy of bullets and the desire of armour designers to minimise the weight and bulk of personal armour systems will increase the risk of BABT in military and security forces personnel.In order to develop materials that can be interposed between the armour and the body wall to attenuate the transfer of energy into the body, it is essential that the mechanism of BABT is known. There is a great deal of activity within UK and NATO to unravel the interactions; the mechanism is likely to be a combination of stress (pressure) waves generated by the rapid initial motion of the rear of the armour, and shear deformation to viscera produced by gross deflection of the body wall.Physical and computer model systems are under development to characterise the biophysical processes and provide performance targets for materials to be placed between armours and the body wall in order to attenuate the injuries (trauma attenuating backings - TABs).The patho-physiological consequences of BABT are being clarified by research, but the injuries will have some of the features of blunt chest trauma observed in road traffic accidents and other forms of civilian blunt impact injury. The injuries also have characteristics of primary blast injury. An overview diagnosis and treatment is described.
Early Increases In Blood Lactate Following Injury
Authors: Coats TJ , Smith JE , Lockey D , Russell M 
Published: March 2013

Current pre-hospital trauma triage systems are based mainly on physiological parameters, but in compensated shock injury severity may not be immediately obvious, as the physiological parameters remain normal for some time. Serum lactate, measured in hospital, is known to be a predictor of injury severity and outcome. The technology for easy field lactate measurement has recently become available. We found that capillary lactate is elevated in trauma patients in the early phase of the response to injury. There is a moderate correlation (R2 = 0.44) between early lactate levels and injury severity, in patients who might otherwise be difficult to triage.Our aims were:(a) To determine if lactate levels are elevated in the pre-hospital phase of trauma, and to establish whether there is a correlation between pre-hospital lactate and injury severity.(b) To determine if there is a relationship between pre-hospital lactate and injury severity in patients with normal blood pressure and Glasgow Coma Score of greater than 12 (“difficult to triage” group).MethodsProspective analysis of pre-hospital capillary lactate levels and Injury Severity Score (ISS) in 23 trauma patients attended by the London Helicopter Emergency Medical Service.ResultsCapillary lactate is elevated in trauma patients in the early phase of the response to injury. There is a moderate correlation (R2 = 0.44) between early lactate levels and injury severity, in patients who might otherwise be difficult to triage.ConclusionsLactate is elevated in the earliest prehospital phase of injury following trauma. The potential contribution of this biochemical para-meter to field triage requires further evaluation.
Degenerative Disease In Lumbar Spine Of Military Parachuting Instructors
Authors: Bar-Dayan Yosefa , Weisbort Moshe , Bar-Dayan Yaron , Velan Gad J , Ravid Mordchai , Hendel David , Shemer Joshua 
Published: March 2013

Parachuting, be it static line or skydiving, places enormous stresses on the human spine. It is, therefore, important to determine the prevalence and severity of degenerative changes in the lumbar spine of subjects who practice this sport activity.Seventy four parachuting instructors, mean age 33 years and with an average of 410 static line and skydiving jumps, were included in the study. Past radiographs were examined and compared to current anterolateral and lateral views of the lumbar spine, in order to determine the prevalence of degenerative changes and document possible progression.Doubtful radiographic changes in the lumbar spine were identified in 47.4 percent of the parachuting instructors, mild degeneration in 9.6 percent, moderate degenerative disease in 10.9 percent and severe radiographic changes in 5.5 percent. Schmorll nodes were found in 8.1 percent of the subjects. Traction spurs - osteophytes were identified in 6.8 percent. The degenerative changes correlated with age and the number of jumps. Spondylolysis of L5-S1 and L3- L4 segments were observed in 12.2 and 1.4 percent respectively. Progressive spondylolisthesis was found in 2 subjects.No correlation was found between the severity of radiographic changes and either the prevalence and the severity of low back pain.The present findings provide a rational for considering repeated sheer stress as an etiology of degenerative changes in the spinal cord, and as a possible contributing factor to the pathogenesis of spondylolysis.Further study has to be done comparing parachuting instructors to a nonparachuting group, or equivalent physically active individuals, in order to assess the effect of sport-background on the development of degenerative changes.
The Thomas Splint – A Necessary Tool In The Management Of Battlefield Injuries
Authors: Rowlands TK , Clasper J 
Published: March 2013

The Thomas splint was developed for the stabilisation of femoral fractures at the end of the nineteenth century, and since the First World War has been extensively used by the British Army. It has been shown to improve the outcome after ballistic fractures of the femur, but recently there have been moves to abandon this device in favour of more modern splints such as the Sager splint©. This is predominately due to the ease of use and smaller size of newer devices, which makes them more suitable for the pre-hospital environment.However, we present our experience of managing both ballistic and closed femoral injuries using Thomas splints during the recent Gulf Conflict. It is our belief that the Thomas splint is an essential tool in the management of military femoral injuries at role three facilities and must be retained.
Mission Creep: An Analysis Of Accident And Emergency Room Activity In A Military Facility In Bosnia-Herzegovina
Authors: Kenward G , Jain TNM , Nicholson K 
Published: March 2013

ObjectiveTo evaluate accident and emergency (A&E) room activity at a Role 3 Multinational Integrated Medical Unit (R3 MIMU) facility in Bosnia- Herzegovina.MethodsRetrospective analysis of all patients attending the A&E room from 1st October 1999 – 30th September 2002.Results1864 casualties are included in the analysis. 52.1% of casualties were Bosnian, 43.8% were military. Mean age of casualties was 35.5 years (SD 18.3), range 1 – 88 years. Traumatic injury was the leading cause of presentation (58.1%). Following treatment 66.7% of all cases were discharged or returned to unit, with 19.8% admitted to a ward area. During the 3 year period there was a 5 fold increase in the number of Bosnian nationals treated, this included 80 children (<13 years).ConclusionThere has been a dramatic increase in A&E use during the period evaluated, particularly by the local population. The increasing number of locals treated, both adult and child, has the potential to undermine the R3 MIMU mission and increase dependency within the Bosnian population. A balance is needed to ensure the staff and functions of a hospital are maintained whilst preserving the capability to deal with an influx of military casualties.
A Study Into Commanders’ Understanding Of, And Attitudes To, Stress And Stress-Related Problems
Authors: Cawkill P 
Published: March 2013

ObjectivesTo undertake a tri-Service questionnaire survey to examine the commanders’ understanding of, and attitudes to, stress and stress-related problems.MethodsA questionnaire was designed to elicit information on: Personal experience of stress and stress-related problems; Stress education; Pre-deployments briefings; and Post-incident stress debriefing. A total of 9,020 questionnaires were distributed between the three Services based on their proportional manning contribution to the Armed Forces as a whole. The population sampled ranged in rank from Corporal/Leading Rate up to, and including, Colonel/Captain RN/Group Captain (ranks below Leading Rate/Corporal were excluded because of their lack of command experience). The overall response rate was 55.8%. The study was carried out between September and December 2001 (i.e. pre-OP TELIC).ResultsChronic work-based stressors were seen as most stressful when compared with family and health stressors. Most respondents accepted that stress and stress-related problems exist, but were reluctant to disclose their own stressrelated problems or seek help for fear that it might be detrimental both personally and professionally. There was found to be little support from peers or commanders. Little stress training was provided during recruit training, there were gaps in pre-deployment briefings and little in the way of post-deployment stress support.ConclusionsSome of the more negative findings could have implications in terms of seeking help for stress-related problems at an early stage, which is counterproductive to the military’s genuine attempts to foster the psychological welfare of its employees. Some concerns could be alleviated by better and more timely stress education, preferably early on in a commander’s career, so that positive attitudes to stress and stressrelated problems can be formed and any negative attitudes changed, thereby bringing about a change in organisational culture in relation to stress. Some of the study’s concerns were addressed by the Operational Health Strategic Surveillance Committee which advised on operational health aspects of OP TELIC.
Reducing Medical Downgrading In A High Readiness Royal Marine Unit
Authors: Hayton J 
Published: March 2013

ObjectiveThis 3 year retrospective observational study aims to determine the diagnoses causing medical downgrading in a high readiness Royal Marine Commando unit, and to direct future investment to reduce numbers downgraded.MethodsMedical and administrative records were used to ascertain diagnoses, aetiology, time downgraded, and whether men returned to full duties.Results4.4% of unit strength was lost through medical downgrading. 43% was due to soft tissue lower limb injuries, of which 41% was due to anterior knee pain syndrome. Low back pain accounts for 24% of the total. Median length of downgrading episodes was 3 months (range 1-40 months). Low back pain and lower limb soft tissue related episodes were longer (median 9 months p= 0.001, and 10 months p=0.003 respectively). Fractures (median 2 months p < 0.001) and general surgical problems (median 2 months p=0.013) were shorter than the overall mean. Orthopaedic conditions related to overuse had longer periods of downgrading (median 6 months) compared to trauma (median 3 months p = 0.01). 9.3% of completed episodes of downgrading resulted in a medical discharge and 1.9% in a permanently reduced medical category.ConclusionsConditions that respond rapidly to secondary care interventions have shorter episodes of downgrading compared to overuse conditions. Therefore, prevention and improved rehabilitation facilities are likely to be more effective than further secondary care investment in reducing medical downgrading. More timely use of permanent medical downgrading and medical discharge could reduce temporary downgrading by 20%.
The Role Of The Physician In Modern Military Operations: 12 Months Experience In Southern Iraq
Authors: Grainge C , Heber M 
Published: March 2013

ObjectivesTo examine the profile of medical morbidity and the role of the physician in modern conflict.MethodsRetrospective survey of admission records at a British Military Field Hospital on operational duty in Southern Iraq.Results62.5% of 4870 admissions to the Field Hospital in Shaibah during the first 12 months of military operations in Iraq were under the care of physicians. Of these 1531 (31.4%) were due to diarrhoea and vomiting (D&V) and 764 (15.7%) due to heat illness. The incidence of heat illness rose with ambient temperature, but soldiers were more likely to be admitted with heat illness shortly after arrival in theatre than when fully acclimatised. There was also a steady flow of admissions with a broad spectrum of medical pathology requiring the clinical skills of a general physician.ConclusionsA general physician is a necessary part of the clinical team in modern conflict. The incidence of D&V and of heat illness on military operations remains high. Planners for any operation in tropical climates should take this into consideration and put preventative measures into place early.
Incidence Of SLAP Lesions In A Military Population
Authors: Kampa RJ , Clasper J 
Published: March 2013

ObjectivesSLAP (superior labrum anterior and posterior) lesions are a recognised cause of shoulder pain and instability. They can occur following a direct blow, biceps traction and compression injuries, and are commonly seen in overhead athletes. Military personnel are physically active and often subjected to trauma. We assessed the incidence of SLAP lesions within a military population presenting with shoulder symptoms.MethodsA retrospective review, of all shoulder arthroscopies performed by a single surgeon between June 2003 and December 2004 at a district general hospital serving both a military and civilian population, was undertaken. The presentation and incidence of SLAP lesions were recorded for both military and civilian patients.ResultsOne hundred and seventy eight arthroscopies were performed on 70 (39.3%) military and 108 (60.7%) civilian patients. The average age was 42.3 (range 17-75), 50 females and 128 males were included. Indications for arthroscopy included pain (75.3%), instability (15.7%), pain and instability (7.9%), or “other symptoms” (1.1%). 39 SLAP lesions (22%) were found and grouped according to the Snyder classification – 20.5% type 1, 69.3% type 2, 5.1% type 3, 5.1% type 4. Patients with a history of trauma or symptoms of instability were more likely to have a SLAP lesion (p<0.0001). The incidence of SLAP lesions in the military patients was 38.6% compared to 11.1% in civilian patients (p<0.0001). After allowing for the increased incidence of trauma and instability in the military, SLAP lesions were still more common in the military patients (p<0.001).ConclusionsThere is a higher than average incidence of SLAP lesions in military patients compared to civilian patients. They tend to present with a history of trauma, as well as symptoms of pain and instability. Given the high incidence in military personnel, this diagnosis should be considered in military patients presenting with shoulder symptoms, and there should be a low threshold for shoulder arthroscopy.
The House Advancement Anoplasty for Treatment of Anal Disorders.
Authors: Owen Harriet A. , Edwards David P. , Khosraviani Kourosh , Phillips Robin K.S. 
Published: March 2013

ObjectivesAnal advancement flaps treat a variety of anal disorders. In recent years the “House” advancement flap has been used with good success, the term referring to the shape of the flap used. It is simple with few shortcomings. We reviewed a single centre’s experience of this procedure.MethodsAll patients who underwent a house advancement flap between 1996 and 2001 were identified. The case notes were examined and data collected on indication for surgery, complications, follow-up and outcome.ResultsThirteen consecutive patients were identified, mean age of 44 years. Indications for surgery were chronic anal fissure, fistulous disease and post surgical deformity or stenosis of the anal canal. Median follow-up was 37 months (25-84). In 9 patients the flaps healed within 4 weeks. In the remaining 4 patients the flaps healed by secondary intention over a median of 14 weeks (8-20). Postoperative complications occurred in 5 patients (3 donor site separation and 2 flap retraction). Two patients developed recurrence of their original disorder. Eleven patients have relief of pre-operative symptoms with fully healed flaps.ConclusionThis procedure is simple, easy to construct and robust. It can be performed for a variety of anal disorders with satisfactory results and few complications and should be in every Coloproctologist’s armamentarium.