Search

This article examines the durability of racial science in the field of anatomy at one of South Africa's oldest universities and its resonance with race essentialist research in other national and transnational contexts. We present a critical assessment of more than 70 published and unpublished papers in anatomy through the lens of the "politics of knowledge"; in this perspective, scientific knowledge is viewed as socially constructed, value-laden, and acting in the service of power. The study finds that racial science thinking in medical science research persists after apartheid, that "race" is a poor proxy for explaining complex patterns of disease, and that by medicalizing health maladies scientists fail to account for their links to racialized inequalities in the broader society. Research on the workings of racial science in the health sciences suggests promising new lines of inquiry into the study of "racial projects" in comparative and international education.

Background: The use of human bodies for anatomy education and research forms an integral part of the training of health professionals around the world. However, the ethical acquisition of human remains for this purpose has been a challenge in many countries, particularly for those on the African continent. South African institutions have however, been able to progressively transition to a more ethical approach to human body acquisition. The aim of the current study was to investigate the provenance of human bodies and the number used in South African health sciences institutions during the period 2017-2021., Methods: an online self-administered anonymised questionnaire was circulated to all health sciences institutions in South Africa. Questions were focused on establishing the provenance and the associated number of bodies and body donor programmes., Results: responses were received from thirteen of the fourteen South African institutions. All thirteen institutions use human bodies for teaching and research, with the majority of the institutions being reliant on bequests (77%) and family donations (62%), and less on unclaimed remains (46%). Most institutions have established body donor programmes. Four institutions were negatively affected by the effects of the pandemic. Memorial services, which continued during the pandemic, were conducted by eight of the thirteen institutions., Conclusion: South Africa is leading the transition to the ethical acquisition of human remains on the African continent. It is hoped that South African institutions will soon transform to the exclusive sourcing of bodies through willed donation and provide guidance and support for the other countries on the continent., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier GmbH.)

This paper traces the history of Man's Anatomy , one of the most influential anatomy textbooks produced on the African continent. Authored by the two renowned South African educators Phillip Vallentine Tobias and Maurice Arnold, the first volume of this book was published in 1963. Both an anatomy textbook and a dissection manual Man's Anatomy included an in-depth exposition of structures of the human body, presented in an innovative and engaging way. In 1999, in line with the developments in medical and anatomy education as well as broader societal changes, the book was significantly condensed, and its name changed to Practical Anatomy . The second edition of Practical Anatomy was published in 2020 and is currently still in use at many South African universities., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Tuberculosis (TB) incidence in South Africa is among the highest globally. Initial loss to follow-up (ILFU), defined as not starting on TB treatment within 28 days of testing positive, is undermining control efforts. We assessed the feasibility, acceptability, and potential of a mHealth application to reduce ILFU. Methods: An mHealth application was developed to capture patients TB investigation data, provide results and monitor treatment initiation. This was implemented in two primary health clinics (PHC) in inner-city Johannesburg. Feasibility was assessed by comparing documentation of personal details, specimen results for same individuals during implementation period (paper register and Mhealth application). Effectiveness was assessed by comparing proportion of patients with results within 48 hours, and proportion started on treatment within 28 days of testing TB positive during pre- implementation (paper register) and implementation (mHealth application) periods. In-depth interviews with patients and providers were conducted to assess acceptability of application. Results: Pre-implementation, 457 patients were recorded in paper registers [195 (42.7%) male, median age 34 years (interquartile range IQR (28–40), 45 (10.5%) sputum Xpert positive]. During implementation, 319 patients were recorded in paper register and the mHealth application [131 (41.1%) male, median age 32 years (IQR 27–38), 33 (10.3%) sputum Xpert positive]. The proportion with complete personal details: [mHealth 95.0% versus paper register 94.0%, (p = 0.54)] and proportion with documented results: [mHealth 97.4% versus paper register 97.8%, (p = 0.79)] were not different in the two methods. The proportion of results available within 48 hours: [mHealth 96.8% versus paper register 68.6%), (p <0.001)], and the proportion on treatment within 28 days [mHealth 28/33 (84.8%) versus paper register 30/44 (68.2%), (p = 0.08)] increased during implementation but was not statistically significant. In-depth interviews showed that providers easily integrated the mHealth application into routine TB investigation and patients positively received the delivery of results via text message. Time from sputum collection to TB treatment initiation decreased from 4 days (pre-implementation) to 3 days but was not statistically significant. Conclusions: We demonstrated that implementation of the mHealth application was feasible, acceptable to health care providers and patients, and has potential to reduce the time to TB treatment initiation and ILFU in PHC settings. [ABSTRACT FROM AUTHOR]

At Stellenbosch University, South Africa, basic histology is taught to a combination class of almost 400 first-year medical, physiotherapy, and dietetic students. Many students often find the amount of work in basic histology lectures overwhelming and consequently loose interest. The aim was to determine if a draw-along mapping activity would focus students during large class lectures. After each lecture on three basic histology tissues, a guided draw-along mapping session covering the work from the lecture was introduced in the form of a click-advance PowerPoint presentation which was used to demonstrate the unfolding of an "ideal" map. The lecturer simultaneously drew a similar map using an overhead projector allowing the students to draw their own maps on blank sheets of paper along with the lecturer. Students remained attentive during the activity and many participated in answering informal questions posed by the lecturer as the map-making session progressed. After the last session, students completed an anonymous, voluntary questionnaire (response rate of 78%). The majority of students found the draw-along maps useful (94%) and believed that its use should be continued in the future (93%). A significant increase (P < 0.001) was found in the test results of student cohorts who were given the current intervention compared to cohorts from previous years who were given mind maps as handouts only or had no intervention. The use of the draw-along mapping sessions were successful in focusing students during large class lectures while also providing them with a useful tool for their studies.

This paper provides a critical review of Mcebisi Ndletyana's book The Anatomy of the ANC in Power: Insights from Port Elizabeth, 1990–2019 which was published in 2020 by the Human Sciences Research Council. The review ranges from a discussion of the methodology and concept to a discussion of the major themes. With respect to the concept and methodology, it is argued that a study pithed on an aspect of the polity at a subnational level contributes significantly to the advancement of knowledge in the discipline of politics about the nature of particularly the party system in South Africa. The first of the major themes the review focuses on is the impact of the legacy of the various liberation traditions on the ANC and the implications this had on the emerging political culture of the party in the democratic period. The paper argues that Ndletyana's account demonstrates that some of the bad character traits of the ANC labelled by its leaders as 'new tendencies' were in fact evident right at the formative stage of the party. The second theme adopted here is party-state relations and decay in which the reviewer concurs with the author's central argument that factions had a negative bearing on governance and negatively affected the electoral prospects of the ANC. [ABSTRACT FROM AUTHOR]

Background: Large numbers of young people die yearly due to homicide, but little is known about homicide during adolescence. Research primarily focuses on youth violence among young men and masks important gender-related factors inherent in the adolescent age group. Although young women are less likely to be victims of homicide, violence against women is an important form of violence experienced during adolescence. In this paper, we describe the prevalence of and gender difference in adolescent homicide in South Africa in 2009. Methods: We conducted a retrospective national mortuary-based study to identify all child homicides (boys and girls < 18 years) in 2009 in a proportionate sample of mortuaries. Victim, perpetrator and crime data were collected in three phases: cases were identified from the mortuary register, the autopsy report and from police interviews. In this paper we focus on the adolescent group, aged 10 to 17 years. Findings: We identified 674 (95% CI: 520–823) adolescent homicides for 2009, with more male (520) than female (154) homicides. This gender disparity increased as children aged, with the male homicide rate 27.9/100 000 population (95% CI: 20.3–35.5), nearly 5 times the female rate (4.5:1) of 6.5/ 100 000 population (95% CI: 4.7–8.2) in older adolescents (15–17 year old). Adolescent males were significantly more likely (61.2%) to die in a public space compared to female adolescents (39.3%) but more adolescent females (48.4%) died at home compared to adolescent males (32.9%). Adolescent females (42.1%) were mainly killed by a family member or intimate partner while adolescent males were predominantly (58%) killed by an acquaintance. Conclusion: We found a distinct gender pattern for adolescent homicide in South Africa. This pattern appears to be driven by gender norms that support violence. South Africa requires an investment in developing evidence informed interventions to reduce violence. [ABSTRACT FROM AUTHOR]

Background: Reflecting on teaching is commonly cited as a fundamental practice for personal and professional development. Educational research into the scholarship of teaching and learning anatomy includes engaging in discipline specific literature on teaching, reflecting on individual teaching methods and communicating these findings to peers. The aim of this paper was to formally assess the opinions of senior anatomy instructors regarding the state of anatomical knowledge at their respective institutions., Materials and Methods: An open-ended questionnaire was devised consisting of eight direct questions seeking opinions on anatomy teaching, knowledge, potential educational developments and general thoughts on the teaching of anatomy to medical students. These were distributed to senior Anatomy Faculty (identified by the author by their affiliation with the Anatomical Society of Southern Africa) based at the eight national medical schools within the country., Results and Conclusions: A number of key themes emerged. Most senior faculty felt that the standard of medical education at their respective institutions was "good." However, emphasis was also placed on the "quality of teaching" incorporating clinical scenarios. There were also indications that staff are split into those that are keen to do research and those that are happy to provide teaching to medical students as their primary function. Several challenges such as time constraints within the curricula, lack of cadavers to reinforce knowledge and lack of appropriately qualified staff were highlighted. Recommendations included fostering partnerships with both clinicians and medical scientists into the anatomy curriculum thus improving teaching and research.

Introduction: In many sub-Saharan African countries, confronting the dual epidemic of HIV and NCDs is a public health priority especially in high HIV burden countries such as South Africa. Evidence shows that poor health as a consequence of NCDs and HIV among the workforce increases absenteeism and leads to decrease in productivity. However, the prevalence of these co-occurring chronic conditions and associated factors is unknown in the educator workforce. Improved understanding has implications for their management and wellbeing of educators. This paper reports the prevalence of selected NCDs and associated factors among HIV positive educators in South Africa using the 2015/6 survey of Educators in Public Schools in South Africa. Methods: This was a second-generation surveillance undertaken among educators in selected public schools in all nine provinces in South Africa. A multi-stage stratified cluster design with probability proportional to size sampling was used to draw a random sample of schools. Factors associated with presence of NCDs were determined using a multivariate backward stepwise logistic regression analysis. Results: A total of 1 365 schools were sampled within which 21 495 (85.5%) educators were interviewed. Out of 2691, HIV Positive educators that responded to the questions on NCDs, 36.9% reported having NCDs. The most commonly reported NCDs were high blood pressure (17.4%), and stomach ulcers (13.5%). The increased odds of reporting the presence of NCDs was significantly associated with being female than male [aOR = 1.5: 95% CI (1.1–1.9), p<0.002], age 45 to 54 years [aOR = 1.8: 95% CI (1.4–2.2), p = p<0.001], and age 55 years and older than those 18 to 24 years [aOR = 2.7: 95% CI (1.8–3.9), p<0.001). The decreased odds of reporting the presence of NCDs was significantly associated with not being absent from school for health reasons [aOR = 0.7: 95% CI (0.6–0.9), p = 0.003]. Conclusion: NCDs care and active screening should be an integral part of HIV programmes including interventions such as prevention, treatment, care and support amongst public school educators in SA. The education department will need to invest in health promotion intervention programmes to prevent and mitigate the negative impact of NCDs and HIV on the sector. [ABSTRACT FROM AUTHOR]

Copyright of Enfermería Global is the property of Servicio de Publicaciones de la Universidad de Murcia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of this article is to present the unique challenges faced by postgraduate students, which require specific practices to ensure study completion. Narrative inquiry was used as a methodological framework to uncover current realities within postgraduate studies and practices for previously disadvantaged students in South Africa. Arguments were tabled based on first-hand experiences among the two postgraduate students and their supervisor. The two postgraduate students narrated personalised learning in this article at different levels of study. The research project resulted in the designing of personalised learning strategies, using the open educational practice (PLUOEP) model, where each student discussed open educational resources (OERs). This model enabled both students to take control of their learning by setting their own goals, making choices about their learning activities, and reflecting on their progress. In this study, the level of autonomy and agency allowed students to develop a positive mindset and belief in their ability to succeed. This article discusses how students' individual beliefs and expectations about themselves influenced their behaviour and ultimately led to the realisation of concrete beliefs and expectations. The lessons from this study described how learning was owned by two postgraduate students who tailored their learning to their individual needs and interests. The study found that there is a lack of knowledge and understanding of OER. The study proposes training and workshops for postgraduate students. Students confirmed the sense of ownership and empowerment in their studies and practices. The study recommends adopting OER in the transformation of postgraduate studies and practices as having a "potential" to decolonise teaching and learning. [ABSTRACT FROM AUTHOR]

Gorgonopsians are among the most recognizable groups of synapsids from the Permian period and have an extensive but mostly cranial fossil record. By contrast, relatively little is known about their postcranial anatomy. Here, we describe a nearly complete, semi-articulated skeleton of a gorgonopsian (identified as Gorgonops torvus) from the late Permian Endothiodon Assemblage Zone of the South African Karoo Basin and discuss its paleobiological implications. Known gorgonopsian postcrania indicate morphological conservatism in the group, but the skeletal anatomy of Gorgonops does differ from that of other gorgonopsians in some respects, such as in the triangular radiale and short terminal phalanges in the manus, and a weakly developed distinction between pubis and ischium in ventral aspect of the pelvic girdle. Similarities between the specimen described herein and a historically problematic specimen originally referred to "Scymnognathus cf. whaitsi" confirm referral of the latter specimen to Gorgonops. Since descriptions of gorgonopsian postcrania are rare, new interpretations of the lifestyle and ecology of Gorgonopsia can be drawn from our contribution. We conclude that gorgonopsians were likely ambush predators, able to chase their prey over short distances and pin them down with strong forelimbs before using their canines for the kill. This is evidenced by their different fore- and hindlimb morphology; the former stouter and more robust in comparison to the longer, more gracile, back legs. Furthermore, the completeness of the study specimen facilitates calculation of an estimated body mass of approximately 98 kg, similar to that of a modern lioness. [ABSTRACT FROM AUTHOR]

The Burgersdorp Formation of South Africa is a richly fossiliferous rock sequence at the top of the Permian-Triassic Beaufort Group and is known for its abundance of Early-Middle Triassic vertebrate remains, particularly cynodonts. Fossils from the Burgersdorp Formation are referred biostratigraphically to the Cynognathus Assemblage Zone (CAZ), which is further divided into three subzones: Langbergia-Garjainia, Trirachodon-Kannemeyeria, and Cricodon-Ufudocyclops. Each subzone is characterised by the presence of a distinct species of trirachodontid, a group of gomphodont cynodonts found relatively abundantly throughout the CAZ, with the lower two subzones characterised by the medium-sized trirachodontids Langbergia and Trirachodon. The uppermost part of the formation, the Cricodon-Ufudocyclops subzone, yields trirachodontids of larger size. The majority of these trirachodontid specimens have previously been referred to Cricodon metabolus, a taxon also known from the Manda Beds of Tanzania and the Ntawere Formation of Zambia. Here we identify one of the specimens (BP/1/5538) previously referred to Cricodon as a new taxon, Guttigomphus avilionis. Guttigomphus can be distinguished from other gomphodont cynodonts by features of the upper postcanine teeth, such as an asymmetric crown in occlusal view (crown narrower along the lingual margin than the labial). Our phylogenetic analysis recovers Guttigomphus as a basal member of Trirachodontidae, outside of the clade including Cricodon, Langbergia and Trirachodon. [ABSTRACT FROM AUTHOR]

Summary: The tribe Diosmeae (Rutaceae) encompasses circa 278 species classified in 11 genera: ten of them are shrubs endemic to the Cape Floristic Region (South Africa), while the only arborescent genus (two species) extends from South Africa to Tanzania. We examined the wood structure of 21 species representing nine genera of Diosmeae and analysed it with respect to their life form and climatic niches. Studied taxa share a suite of traits typical for the whole family: radial vessel multiples, simple perforation plates, minute alternate intervessel pits, distinctly bordered vessel-ray pits, non-septate libriform fibres, and — except for Empleurum — marginal axial parenchyma. However, unlike most Rutaceae, they also occasionally feature vessel-ray pits with reduced borders. Most of the studied species are very similar to each other in their wood structure and habit. The two exceptions are Calodendrum capense (the only canopy tree under study) and Empleurum unicapsulare (a large riparian shrub). The first differs from other species in having wider vessels, longer libriform fibres, prismatic crystals in ray cells and winged-aliform axial parenchyma (which may be plesiomorphic for the tribe); the latter is distinctive because it lacks growth rings and banded axial parenchyma. Analysing anatomy–climate relationship, we found that wood anatomy among shrubby Diosmeae relates to their size and environmental factors, rather than taxonomy. Particularly, the vessel grouping weakly increases with stricter water limitation along the gradient from a semi-arid winter-dry climate to a Mediterranean winter-wet climate. [ABSTRACT FROM AUTHOR]

Abstract: Specimen Stw 53 was recovered in 1976 from Member 5 of the Sterkfontein Formation. Since its incomplete initial description and comparison, the partial cranium has figured prominently in discussions about the systematics of early Homo. Despite publication of a preliminary reconstruction in 1985, Stw 53 has yet to be compared comprehensively to other Plio-Pleistocene fossils or assessed systematically. In this paper, we report on a new reconstruction of this specimen and provide a detailed description and comparison of its morphology. Our reconstruction differs in important respects from the earlier one, especially in terms of neurocranial length, breadth, and height. However, given that Stw 53 exhibits extensive damage, these dimensions are most likely prone to much error in reconstruction. In areas of well-preserved bone, Stw 53 shares many cranial features with Homo habilis, and we propose retaining it within this species. We also consider the affinities of dental remains from Sterkfontein Member 5, along with those from Swartkrans and Drimolen previously assigned to Homo. We find evidence for sympatry of H. habilis and Australopithecus robustus and possibly Plio-Pleistocene Homo sapiens sensu lato in Sterkfontein Member 5. At Swartkrans and Drimolen, we find evidence of H. habilis. We also compare the morphologies of Stw 53 and SK 847 and find compelling evidence to assign the latter specimen to H. habilis, as has been proposed. [Copyright &y& Elsevier]

The cynodont fauna of the Trirachodon-Kannemeyeria Subzone of the Middle Triassic Cynognathus Assemblage Zone (AZ) is almost exclusively represented by taxa belonging to the clade Eucynodontia. However, there is one basal (non-eucynodont) cynodont known to have survived into this assemblage: the enigmatic Bolotridon frerensis. BSPG 1934-VIII-7 represents by far the most extensive specimen of B. frerensis, consisting of a partial skull with occluded lower jaw. The specimen was initially described by Broili & Schröder (1934), but their description was limited to surface details of the skull and the dental morphology. Here, by using a computed tomographic (CT) reconstruction, we redescribe this specimen, providing novel information on its palatal and internal anatomy. New endocranial characters recognized for this taxon include ridges in the nasal cavity indicating the presence of cartilaginous respiratory turbinals. New data obtained from the CT scan were incorporated into the most recently published data matrix of early non-mammalian cynodonts to test the previously unstable phylogenetic position of Bolotridon. Our phylogenetic analyses recovered Bolotridon as the sister-taxon of Eucynodontia, a more crownward position than previously hypothesized. [ABSTRACT FROM AUTHOR]

The early-branching crocodylomorph species Notochampsa istedana is known from a single South African specimen collected more than 100 years ago. This species is potentially important for understanding early crocodylomorph evolution, but it is of uncertain taxonomic status and its stratigraphic position is poorly constrained. Here we reinvestigate the anatomy, taxonomy, systematics and biostratigraphy of the holotype specimen, SAM-PK-4013. SAM-PK-4013 has a unique suite of features that distinguish it from the closely related taxa Orthosuchus and Protosuchus. These features include the length and shape of the dentary symphysis, the number and shape of dentary teeth, and the number of dorsal ribs with expanded intercostal ridges. Notochampsa is therefore a valid taxon, and our phylogenetic analysis recovers it as sister to Orthosuchus, in a monophyletic Notochampsidae. Notochampsa and Orthosuchus share a ventrally expanded squamosal flange and expanded intercostal ridges on the dorsal ribs. Notochampsidae is in turn sister to Protosuchidae, forming the monophyletic group Notochampsoidea. Fieldwork and stratigraphic revisions show definitively that SAM-PK-4013 is from the Clarens Formation, approximately ∼65 m above the Elliot contact, ageing Notochampsa to the Pliensbachian stage, a period of vertebrate body fossil scarcity. Thus, Notochampsa istedana is the youngest known occurrence of a crocodylomorph (and vertebrate body fossil) from the Karoo Basin of South Africa. [ABSTRACT FROM AUTHOR]

The Karoo Basin of South Africa has the best global record of Lopingian (Late Permian) non-mammaliaform cynodonts, currently represented by five species. We describe Vetusodon elikhulu gen. et sp. nov. , documented by four specimens from the Daptocephalus Assemblage Zone. With a basal skull length of ~18 cm, it is the largest Lopingian cynodont and is also larger than Induan representatives of the group. Vetusodon elikhulu has a cranial morphology that departs notably from that previously documented for Permo-Triassic cynodonts. It features a short and extremely wide snout, resembling that of the contemporaneous therocephalian Moschorhinus , and has large incisors and canines that contrast with the small unicusped postcanines, suggesting a more important role of the anterior dentition for feeding. The dentary is extremely long and robust, with the posterior margin located closer to the craniomandibular joint than in other Lopingian and Induan cynodonts (e.g. Thrinaxodon). The secondary palate morphology of V. elikhulu is unique, being short and incomplete and with the posterior portion of the maxilla partly covering the vomer. A phylogenetic analysis suggests that V. elikhulu is the sister taxon of Eucynodontia and thus the most derived of the Lopingian to Induan cynodonts yet discovered. [ABSTRACT FROM AUTHOR]

Commercial captive breeding and trade in body parts of threatened wild carnivores is an issue of significant concern to conservation scientists and policy-makers. Following a 2016 decision by Parties to the Convention on International Trade in Endangered Species of Wild Fauna and Flora, South Africa must establish an annual export quota for lion skeletons from captive sources, such that threats to wild lions are mitigated. As input to the quota-setting process, South Africa’s Scientific Authority initiated interdisciplinary collaborative research on the captive lion industry and its potential links to wild lion conservation. A National Captive Lion Survey was conducted as one of the inputs to this research; the survey was launched in August 2017 and completed in May 2018. The structured semi-quantitative questionnaire elicited 117 usable responses, representing a substantial proportion of the industry. The survey results clearly illustrate the impact of a USA suspension on trophy imports from captive-bred South African lions, which affected 82% of respondents and economically destabilised the industry. Respondents are adapting in various ways, with many euthanizing lions and becoming increasingly reliant on income from skeleton export sales. With rising consumer demand for lion body parts, notably skulls, the export quota presents a further challenge to the industry, regulators and conservationists alike, with 52% of respondents indicating they would adapt by seeking ‘alternative markets’ for lion bones if the export quota allocation restricted their business. Recognizing that trade policy toward large carnivores represents a ‘wicked problem’, we anticipate that these results will inform future deliberations, which must nonetheless also be informed by challenging inclusive engagements with all relevant stakeholders. [ABSTRACT FROM AUTHOR]

Background: HIV self-testing (HIVST) may increase HIV testing uptake, facilitating earlier treatment for key populations like MSM who experience barriers accessing clinic-based HIV testing. HIVST usability among African MSM has not been explored. Methods: We assessed usability of oral fluid (OF) and fingerstick (FS; blood) HIVST kits during three phases among MSM with differing degrees of HIVST familiarity in Mpumalanga, South Africa. In 2015, 24 HIVST-naïve MSM conducted counselor-observed OF and FS HIVST after brief demonstration. In 2016 and 2017, 45 and 64 MSM with experience using HIVST in a pilot study chose one HIVST to conduct with a counselor-observer present. In addition to written, the latter group had access to video instructions. We assessed frequency of user errors and reported test use ease, changes in error frequency by phase, and covariates associated with correct usage using log-Poisson and Gaussian generalized estimating equations. Results: Among OF users (n = 57), 15–30% committed errors in each phase; however, observers consistently rated participants as able to test alone. Among FS users (n = 100), observers noted frequent errors, most commonly related to blood collection and delivery. We found suggestive evidence (not reaching statistical significance) that user errors decreased, with 37.5%, to 28.1%, and 18.2% committing errors in phases I, II, and III, respectively (p-value:0.08), however observer concerns remained constant. Ease and confidence using HIVST increased with HIV testing experience. Participants using three HIVST were more likely (RR:1.92, 95% CI:1.32, 2.80) to report ease compared to those without prior HIVST experience. Never testers (RR:0.66, 95% CI:0.44–0.99) reported less ease performing HIVST compared to participants testing in the past six months. Conclusions: MSM were able to perform the OF test. Fingerstick test performance was less consistent; however preference for fingerstick was strong and performance may improve with exposure and instructional resources. Continued efforts to provide accessible instructions are paramount. [ABSTRACT FROM AUTHOR]

A new species of hermit crab, Pagurus fraserorum n. sp. (family Paguridae) is described from rocky subtidal reefs off KwaZulu-Natal, South Africa, and illustrated using both conventional drawings and colour photographs, and via three-dimensional (3D) X-ray micro-computed tomography (μCT). Because of the limitation μCT has in detecting very fine and soft structures, a novel approach of manually drawing setation and spinulation onto the two-dimensional images of the 3D visualizations was used to illustrate the pereopods. In addition, an interactive figure and rotation movie clips in the supplement section complement the species description, and the 3D raw data of the 3D type data are downloadable from the Gigascience Database repository. The new species is the sixth species of Pagurus Fabricius, 1775 reported from South Africa and is closely allied to the Indo-Pacific P. boriaustraliensis Morgen, 1990 and P. pitagsaleei McLaughlin, 2002, from which it differs by its shorter ocular peduncles, by the armature of the carpus of the right cheliped, and also in colouration. This study presents the first description of a hermit crab in which a majority of taxonomic details are illustrated through 3D volume-rendered illustrations. In addition, colour photographs and COI molecular barcodes are provided, and the latter compared to COI sequences of specimens from Western Australia previously identified as P. boriaustraliensis and of specimens of P. pitagsaleei from Taiwan, as well as to three additional South African members of the genus. The South African taxon was confirmed to be genetically distinct from all species tested. [ABSTRACT FROM AUTHOR]

Background: Urine microscopy is the standard diagnostic method for urogenital S. haematobium infection. However, this may lead to under-diagnosis of urogenital schistosomiasis, as the disease may present itself with genital symptoms in the absence of ova in the urine. Currently there is no single reliable and affordable diagnostic method to diagnose the full spectrum of urogenital S. haematobium infection. In this study we explore the classic indicators in the diagnosis of urogenital S. haematobium infection, with focus on young women. Methods: In a cross-sectional study of 1237 sexually active young women in rural South Africa, we assessed four diagnostic indicators of urogenital S. haematobium infection: microscopy of urine, polymerase chain reaction (PCR) of cervicovaginal lavage (CVL), urogenital symptoms, and sandy patches detected clinically in combination with computerised image analysis of photocolposcopic images. We estimated the accuracy of these diagnostic indicators through the following analyses: 1) cross tabulation (assumed empirical gold standard) of the tests against the combined findings of sandy patches and/or computerized image analysis and 2) a latent class model of the four indicators without assuming any gold standard. Results: The empirical approach showed that urine microscopy had a sensitivity of 34.7% and specificity of 75.2% while the latent class analysis approach (LCA) suggested a sensitivity of 81.0% and specificity of 85.6%. The empirical approach and LCA showed that Schistosoma PCR in CVL had low sensitivity (14.1% and 52.4%, respectively) and high specificity (93.0% and 98.0, respectively). Using LCA, the presence of sandy patches showed a sensitivity of 81.6 and specificity of 42.4%. The empirical approach and LCA showed that urogenital symptoms had a high sensitivity (89.4% and 100.0%, respectively), whereas specificity was low (10.6% and 12.3%, respectively). Conclusion: All the diagnostic indicators used in the study had limited accuracy. Using urine microscopy or Schistosoma PCR in CVL would only confirm a fraction of the sandy patches found by colposcopic examination. [ABSTRACT FROM AUTHOR]

Background: In South Africa, roughly half of the drug-resistant TB cases diagnosed are reported to have been started on treatment. We determined the proportion of persons diagnosed with rifampicin resistant (RR-) TB who initiated treatment in Johannesburg after the introduction of decentralized RR-TB care in 2011. Methods: We retrospectively matched adult patients diagnosed with laboratory-confirmed RR-TB in Johannesburg from 07/2011-06/2012 with records of patients initiating RR-TB treatment at one of the city’s four public sector treatment sites (one centralized, three decentralized). Patients were followed from date of diagnosis until the earliest of RR-TB treatment initiation, death, or 6 months’ follow-up. We report diagnostic methods and outcomes, proportions initiating treatment, and median time from diagnosis to treatment initiation. Results: 594 patients were enrolled (median age 34 (IQR 29–42), 287 (48.3%) female). Diagnosis was by GenoType MTBDRplus (Hain-Life-Science) line probe assay (LPA) (281, 47.3%), Xpert MTB/RIF (Cepheid) (258, 43.4%), or phenotypic drug susceptibility testing (DST) (30, 5.1%) with 25 (4.2%) missing a diagnosis method. 320 patients (53.8%) had multi-drug resistant TB, 158 (26.6%) rifampicin resistant TB by Xpert MTB/RIF, 102 (17.2%) rifampicin mono-resistance, and 14 (2.4%) extensively drug-resistant TB. 256/594 (43.0%) patients initiated treatment, representing 70.7% of those who were referred for treatment (362/594). 338/594 patients (57.0%) did not initiate treatment, including 104 (17.5%) who died before treatment was started. The median time from sputum collection to treatment initiation was 33 days (IQR 12–52). Conclusion: Despite decentralized RR-TB treatment, fewer than half the patients diagnosed in Johannesburg initiated appropriate treatment. Offering treatment at decentralized sites alone is not sufficient; improvements in linking patients diagnosed with RR-TB to effective treatment is essential. [ABSTRACT FROM AUTHOR]

Introduction: Streptococcus pneumoniae is a leading cause of severe bacterial infections globally. A full understanding of the impact of pneumococcal conjugate vaccine (PCV) on pneumococcal disease burden, following its introduction in 2009 in South Africa, can support national policy on PCV use and assist with policy decisions elsewhere. Methods: We developed a model to estimate the national burden of severe pneumococcal disease, i.e. disease requiring hospitalisation, pre- (2005–2008) and post-PCV introduction (2012–2013) in children aged 0–59 months in South Africa. We estimated case numbers for invasive pneumococcal disease using data from the national laboratory-based surveillance, adjusted for specimen-taking practices. We estimated non-bacteraemic pneumococcal pneumonia case numbers using vaccine probe study data. To estimate pneumococcal deaths, we applied observed case fatality ratios to estimated case numbers. Estimates were stratified by HIV status to account for the impact of PCV and HIV-related interventions. We assessed how different assumptions affected estimates using a sensitivity analysis. Bootstrapping created confidence intervals. Results: In the pre-vaccine era, a total of approximately 107,600 (95% confidence interval [CI] 83,000–140,000) cases of severe hospitalised pneumococcal disease were estimated to have occurred annually. Following PCV introduction and the improvement in HIV interventions, 41,800 (95% CI 28,000–50,000) severe pneumococcal disease cases were estimated in 2012–2013, a rate reduction of 1,277 cases per 100,000 child-years. Approximately 5000 (95% CI 3000–6000) pneumococcal-related annual deaths were estimated in the pre-vaccine period and 1,900 (95% CI 1000–2500) in 2012–2013, a mortality rate difference of 61 per 100,000 child-years. Conclusions: While a large number of hospitalisations and deaths due to pneumococcal disease still occur among children 0–59 months in South Africa, we found a large reduction in this estimate that is temporally associated with PCV introduction. In HIV-infected individuals the scale-up of other interventions, such as improvements in HIV care, may have also contributed to the declines in pneumococcal burden. [ABSTRACT FROM AUTHOR]

Here we present a new species of placoderm fish, Africanaspis edmountaini sp. nov., and redescribe Africanaspis doryssa on the basis of new material collected from the type locality of Africanaspis. The new material includes the first head shields of Africanaspis doryssa in addition to soft anatomy for both taxa. Hitherto Africanaspis was entirely described from trunk armour and no record of body and fin outlines had been recorded. In addition the first record of embryonic and juvenile specimens of Africanaspis doryssa is presented and provides a growth series from presumed hatchlings to presumed adults. The presence of a greater number of juveniles compared to adults indicates that the Waterloo Farm fossil site in South Africa represents the first nursery site of arthrodire placoderms known from a cold water environment. The preservation of an ontogenetic series demonstrates that variation within the earlier known sample, initially considered to have resulted from ontogenetic change, instead indicates the presence of a second, less common species Africanaspis edmountaini sp. nov. There is some faunal overlap between the Waterloo Farm fossil site and faunas described from Strud in Belgium and Red Hill, Pennsylvania, in north America, supporting the concept of a more cosmopolitan vertebrate fauna in the Famennian than earlier in the Devonian. [ABSTRACT FROM AUTHOR]

Background: We assessed the diagnostic accuracy of Determine TB-LAM (LF-LAM) to screen for tuberculosis among ambulatory adults established in HIV care in South Africa. Methods: A systematic sample of adults attending for HIV care, regardless of symptomatology, were enrolled in the XPHACTOR study, which tested a novel algorithm for prioritising investigation with Xpert MTB/RIF. In this substudy, restricted to participants with enrolment CD4<200x106/l, urine was stored at enrolment for later testing with LF-LAM. Sputum was sent for immediate Xpert MTB/RIF if any of: current cough, fever ≥3 weeks, body mass index (BMI)<18.5kg/m2, CD4<100x106/l (or <200x106/l if pre-ART), weight loss ≥10% or strong clinical suspicion were present; otherwise, sputum was stored for Xpert testing at study completion. Participants were reviewed monthly, with reinvestigation if indicated, to 3 months, when sputum and blood were taken for mycobacterial culture. We defined tuberculosis as “confirmed” if Xpert, line probe assay or culture for M. tuberculosis within six months of enrolment were positive, and “clinical” if tuberculosis treatment started without microbiological confirmation. Results: Amongst 424 participants, 61% were female and 57% were taking ART (median duration 22 months); median age, CD4 and BMI were 39 years, 111x106/l, and 23 kg/m2. 56/424 (13%) participants had tuberculosis (40 confirmed, 16 clinical). 24/424 (5.7%) vs. 8/424 (1.9%) were LAM-positive using grade 1 vs. grade 2 cut-off. Using grade 1 cut-off, sensitivity for confirmed TB (all clinical TB excluded) was 12.5% (95% CI 4.2%, 26.8%) and in CD4<100x106/l vs. CD4 ≥100x106/l was 16.7% (95% CI 4.7%, 37.4%) vs. 6.3% (95% CI 0.2%, 30.2%). Specificity was >95% irrespective of diagnostic reference standard, CD4 stratum, or whether grade 1 or grade 2 cut-off was used. Conclusion: Sensitivity of LF-LAM is too low to recommend as part of intensified case finding in ambulatory patients established in HIV care. [ABSTRACT FROM AUTHOR]

Background: The BD-FACSPresto™ CD4 is a new, point-of-care (POC) instrument utilising finger-stick capillary blood sampling. This study evaluated its performance against predicate CD4 testing in South Africa. Methods: Phase-I testing: HIV+ patient samples (n = 214) were analysed on the Presto™ under ideal laboratory conditions using venous blood. During Phase-II, 135 patients were capillary-bled for CD4 testing on FACSPresto™, performed according to manufacturer instruction. Comparative statistical analyses against predicate PLG/CD4 method and industry standards were done using GraphPad Prism 6. It included Bland-Altman with 95% limits of agreement (LOA) and percentage similarity with coefficient of variation (%CV) analyses for absolute CD4 count (cells/μl) and CD4 percentage of lymphocytes (CD4%). Results: In Phase-I, 179/217 samples yielded reportable results with Presto™ using venous blood filled cartridges. Compared to predicate, a mean bias of 40.4±45.8 (LOA of -49.2 to 130.2) and %similarity (%CV) of 106.1%±7.75 (7.3%) was noted for CD4 absolute counts. In Phase-2 field study, 118/135 capillary-bled Presto™ samples resulted CD4 parameters. Compared to predicate, a mean bias of 50.2±92.8 (LOA of -131.7 to 232) with %similarity (%CV) 105%±10.8 (10.3%), and 2.87±2.7 (LOA of -8.2 to 2.5) with similarity of 94.7±6.5% (6.83%) noted for absolute CD4 and CD4% respectively. No significant clinical differences were indicated for either parameter using two sampling methods. Conclusion: The Presto™ produced remarkable precision to predicate methods, irrespective of venous or capillary blood sampling. A consistent, clinically insignificant over-estimation (5–7%) of counts against PLG/CD4 and equivalency to FACSCount™ was noted. Further field studies are awaited to confirm longer-term use. [ABSTRACT FROM AUTHOR]

Background: High rates of patient attrition from care between HIV testing and antiretroviral therapy (ART) initiation have been documented in sub-Saharan Africa, contributing to persistently low CD4 cell counts at treatment initiation. One reason for this is that starting ART in many countries is a lengthy and burdensome process, imposing long waits and multiple clinic visits on patients. We estimated the effect on uptake of ART and viral suppression of an accelerated initiation algorithm that allowed treatment-eligible patients to be dispensed their first supply of antiretroviral medications on the day of their first HIV-related clinic visit.Methods and Findings: RapIT (Rapid Initiation of Treatment) was an unblinded randomized controlled trial of single-visit ART initiation in two public sector clinics in South Africa, a primary health clinic (PHC) and a hospital-based HIV clinic. Adult (≥18 y old), non-pregnant patients receiving a positive HIV test or first treatment-eligible CD4 count were randomized to standard or rapid initiation. Patients in the rapid-initiation arm of the study ("rapid arm") received a point-of-care (POC) CD4 count if needed; those who were ART-eligible received a POC tuberculosis (TB) test if symptomatic, POC blood tests, physical exam, education, counseling, and antiretroviral (ARV) dispensing. Patients in the standard-initiation arm of the study ("standard arm") followed standard clinic procedures (three to five additional clinic visits over 2-4 wk prior to ARV dispensing). Follow up was by record review only. The primary outcome was viral suppression, defined as initiated, retained in care, and suppressed (≤400 copies/ml) within 10 mo of study enrollment. Secondary outcomes included initiation of ART ≤90 d of study enrollment, retention in care, time to ART initiation, patient-level predictors of primary outcomes, prevalence of TB symptoms, and the feasibility and acceptability of the intervention. A survival analysis was conducted comparing attrition from care after ART initiation between the groups among those who initiated within 90 d. Three hundred and seventy-seven patients were enrolled in the study between May 8, 2013 and August 29, 2014 (median CD4 count 210 cells/mm3). In the rapid arm, 119/187 patients (64%) initiated treatment and were virally suppressed at 10 mo, compared to 96/190 (51%) in the standard arm (relative risk [RR] 1.26 [1.05-1.50]). In the rapid arm 182/187 (97%) initiated ART ≤90 d, compared to 136/190 (72%) in the standard arm (RR 1.36, 95% confidence interval [CI], 1.24-1.49). Among 318 patients who did initiate ART within 90 d, the hazard of attrition within the first 10 mo did not differ between the treatment arms (hazard ratio [HR] 1.06; 95% CI 0.61-1.84). The study was limited by the small number of sites and small sample size, and the generalizability of the results to other settings and to non-research conditions is uncertain.Conclusions: Offering single-visit ART initiation to adult patients in South Africa increased uptake of ART by 36% and viral suppression by 26%. This intervention should be considered for adoption in the public sector in Africa.Trial Registration: ClinicalTrials.gov NCT01710397, and South African National Clinical Trials Register DOH-27-0213-4177. [ABSTRACT FROM AUTHOR]

Data on neonatal group B streptococcal (GBS) invasive disease burden are needed to refine prevention policies. Differences in surveillance methods and investigating for cases can lead to varying disease burden estimates. We compared the findings of laboratory-based passive surveillance for GBS disease across South Africa, and for one of the provinces compared this to a real-time, systematic, clinical surveillance in a population-defined region in Johannesburg, Soweto. Passive surveillance identified a total of 799 early-onset disease (EOD, <7 days age) and 818 LOD (late onset disease, 7–89 days age) cases nationwide. The passive surveillance provincial incidence varied for EOD (range 0.00 to 1.23/1000 live births), and was 0.03 to 1.04/1000 live births for LOD. The passive surveillance rates for Soweto, were not significantly different compared to those from the systematic surveillance (EOD 1.23 [95%CI 1.06–1.43] vs. 1.50 [95%CI 1.30–1.71], respectively, rate ratio 0.82 [95%CI 0.67–1.01]; LOD 1.04 [95% CI 0.90–1.23] vs. 1.22 [95%CI 1.05–1.42], rate ratio 0.85 [95% CI 0.68–1.07]). A review of the few cases missed in the passive system in Soweto, suggested that missing key identifiers, such as date of birth, resulted in their omission during the electronic data extraction process. Our analysis suggests that passive surveillance provides a modestly lower estimate of invasive GBS rates compared to real time sentinel-site systematic surveillance, however, this is unlikely to be the reason for the provincial variability in incidence of invasive GBS disease in South Africa. This, possibly reflects that invasive GBS disease goes undiagnosed due to issues related to access to healthcare, poor laboratory capacity and varying diagnostic procedures or empiric antibiotic treatment of neonates with suspected sepsis in the absence of attempting to making a microbiological diagnosis. An efficacious GBS vaccine for pregnant women, when available, could be used as a probe to better quantify the burden of invasive GBS disease in low-middle resourced settings such as ours. From our study passive systems are important to monitor trends over time as long as they are interpreted with caution; active systems give better detailed information and will have greater representivity when expanded to other surveillance sites. [ABSTRACT FROM AUTHOR]

Edentulism can negatively affect both masticatory performance and dietary intake by altering the patterns of biomechanical stress and strain, which in turn modifies the morphology of the different regions of the mandible. The morphological changes in the mandible caused by these stressors are unknown when comparing mandibles across varying dentition states. This study investigated differences in the morphology of human mandibles across various states of the dentition. In total, 498 mandibles of individuals between 20 and 80 yr of age at death were sourced from the Raymond A. Dart Collection of Human Skeletons. These included fully dentate ( n = 95), partially edentulous ( n = 333), and fully edentulous ( n = 70) mandibles. Twelve linear anthropometric measurements of the mandible were derived from digitized landmarks located on its external surface. Data analysis included geometric morphometrics and multivariate analyses. Compared with dentate and partially edentulous mandibles, fully edentulous mandibles showed a shorter alveolar height (−0.4 mm), a shorter mandibular body length (−4 mm), a larger gonial angle (+4°), a more obtuse mental angle (+4.7°), a broader bicondylar width (+3.8 mm), and a taller ramus height (+1.6 mm). Thus, edentulous states are associated with an altered mandibular morphology, which may result from a reduction in jaw function. [ABSTRACT FROM AUTHOR]

Hahnia larseni n. sp. is described, based on both sexes, from Western Cape, South Africa. Sibling species Hahnia clathrata Simon, 1898, known from females only, is redescribed. [ABSTRACT FROM AUTHOR]

The anatomy of the palatoquadrate ossifications of the Lower Triassic archosauromorph Proterosuchus fergusi from South Africa is described. It consists of two ossifications, the epipterygoid and the quadrate, which were joined by cartilage in life. The margins of the cartilage are clearly indicated by ridges and grooves on the dorsal surface of the pterygoid. The epipterygoid ossification consists of two structures: the anteroposteriorly expanded basal portion and, dorsally from it, an extending, slender, ascending process. From the anterior margin of the basal portion of the epipterygoid, a plate-like structure, herein called the lamina epipterygoidea anteromedialis, extends anteromedially to form the anterolateral wall of the cavum epiptericum. Comparisons with the similarly constructed embryonal and adult epipterygoid components of Sphenodon punctatus show that the anteromedial lamina of the epipterygoid of P. fergusi is an additional component of the epipterygoid of this species and that this lamina is absent in the former species. However, a structure in a topologically similar position to the anteromedial lamina of the epipterygoid of P. fergusi is present in the palatoquadrate of Alligator mississippiensis. In the latter species, the structure is called the lamina palatoquadrati anterior; it ossifies in membrane and forms the dorsolateral cover of the huge trigeminal ganglion. It is hypothesized here that the anteromedial lamina of the epipterygoid of P. fergusi and the anterior lamina of the palatoquadrate of A. mississippiensis are most probably homologous structures and are present in both the basal and one of the crown taxa of the archosauromorph clade, respectively. [ABSTRACT FROM AUTHOR]

The genus Killickia is described to accommodate the South African endemic species formerly placed in Micromeria sect. Hesperothymus. Morphological data, as well as results from unpublished phylogenetic studies support its separation from the genera Micromeria and Clinopodium. A new species Killickia lutea Bräuchler is described and three new combinations are made. Killickia is characterised as comprising solitary- or few-flowered cymes, a campanulate to subcampanulate (obconical) calyx with similar teeth, a corolla tube with two pubescent ridges and nutlets with scattered minute hairs. A thickened marginal vein in the leaves as typical for Micromeria is absent. As currently understood all species are restricted to the Drakensberg mountains and KwaZulu-Natal Midlands in eastern South Africa. A key to the species, brief notes on anatomy and ecology are provided. © 2008 The Linnean Society of London, Botanical Journal of the Linnean Society, 2008, 157, 575–586. [ABSTRACT FROM AUTHOR]

In biology education, the study of structure has traditionally involved the use of dissection. Animal‐rights campaigners have caused biology educators and learners to question the necessity of dissections. This study reviews the research evidence for the efficacy of alternatives to dissection and then turns to research evidence on attitudes to dissection. It suggests that the place, practice, and purpose of dissection in biology education can act as an indicator of the state of society in which those practices are embedded. The current situation in South Africa is reviewed to illustrate how social factors outside the laboratory influence pedagogic practice. [ABSTRACT FROM AUTHOR]

Focuses on a study which analyzed the stomach contents and diet composition of Cordylidae in South Africa. Information on Cordylidae; Methodology; Results of the study.