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Abstract The impact of different types of reactive case detection and/or treatment strategies for malaria elimination depends on high coverage and participants’ adherence. However, strategies to optimise adherence are limited, particularly for people with asymptomatic or no infections. As part of a cluster-randomized trial to evaluate the effect of reactive treatment in The Gambia, all residents in the compound of a diagnosed clinical malaria patient received dihydro-artemisinin–piperaquine (DP). Using a mixed method approach, we assessed which factors contribute to adherence among the contacts of malaria cases that showed no symptoms. Adherence was defined as the proportion of compound members that (1) returned all medicine bags empty and (2) self-reported (3-day) treatment completion. Among the 273 individuals from 14 compounds who received DP, 227 (83.1%) were available for and willing to participate in the survey; 85.3% (233/273) returned empty medicine bags and 91.6% (208/227) self-reported treatment completion. Although clinical malaria was not considered a major health problem, reported adherence was high. The drivers of adherence were the strong sense of responsibility towards protecting the individual, compound and the village. Adherence can be optimised through a transdisciplinary implementation research process of engaging communities to bridge the gap between research goals and social realities.

Cold-stressed leaves possess an elevated risk of photodamage due to an inefficient photosynthetic apparatus during winter conditions. Recovery of cold-stressed coffee seedlings treated with different concentrations of nitrogen applied as foliar urea sprays [control (0), 5, 10, 20, and 40 mM], was investigated under optimum growth chamber conditions (25/20°C) for three months. Concentrations of nitrogen and photosynthetic pigments in the leaves increased with increasing concentration of the foliar sprays up to 20 mM. This was accompanied with a recovery of the photosynthetic apparatus and increased net carbon assimilation rate. In addition, 10 and 20 mM-treated plants also had the highest maximal efficiency of PSII compared to their lower or higher nitrogen concentration treated counterparts. Conversely, these plants contained lower concentrations of 5-caffeoylquinic acid, mangiferin, trigonelline, and caffeine than control plants. We concluded therefore that foliar sprays of the appropriate nitrogen concentration were adequate for recuperating the photosynthetic apparatus and improved the photosynthetic performance of the cold-stressed coffee seedlings.

Spider silk is well known for its high toughness. Here, a comprehensive study of the simultaneous effect of strain rate and humidity on toughness is reported, revealing that toughness is highest under mildly humid conditions and at high strain rates, similar conditions to those in nature.

Abstract Patients with pleuroparenchymal fibroelastosis (PPFE) have severe breathlessness even with mild hypoxaemia. In patients with PPFE, accessory respiratory muscles, such as the sternocleidomastoid muscles, are used to maintain ventilation. An intense 18F‐fluorodeoxyglucose uptake in accessory respiratory muscles using positron emission tomography/computed tomography reflects the strong respiratory effort of patients with PPFE.

In light of the issue related to consensus about the definition of dispositions and the larger issue pertaining to the absence of a model to predict the growth of pre-service teachers in their knowledge, skills, and dispositions that Teacher Performance Expectations (TPEs) specify, the purpose of this study is two-fold. First, the authors aim at testing the hypothesis that teacher candidates who faced challenges in student teaching had lower self-rating scores of teacher dispositions, or lower degrees of alignment between disposition and standards, than their counterparts who did not face challenges in student teaching. Second, this study aims at developing an explanatory model to predict teacher candidates' effectiveness in student teaching based on their assessed disposition. The disposition survey in this study directly reflected the dispositional requirements of California's TPEs. To the degree that one's student teaching mimics one's later professional classroom instruction, it would be useful to have a model to predict teacher candidates' success or challenges in student teaching. The teacher education community in particular would be better able to develop programs that would prepare competent and caring classroom teachers. Such a predictive model would also provide teacher candidates with a template for a periodical check on whether or not and how they have aligned their dispositions to standards. (Contains 3 tables and 1 figure.)

Integrating farmyard manure (FYM) and legume intercropping improves soil chemical and microbial properties, thereby increasing forage productivity and nutritional value. The purpose of this study was to evaluate how fertilizer treatments affected the chemical composition, in vitro gas production and organic matter digestibility (IVOMD), and volatile fatty acid production (VFA) of Napier and desho grasses in the upper Blue Nile basin of Ethiopia. Apart from ether extract content, the chemical composition of the fertilizer treatments in the Aba Gerima watershed did not differ significantly, whereas significant differences were observed in acid detergent fiber and crude protein contents at the Guder watershed. In both watersheds, Napier grass had significantly higher crude protein levels than desho grass. In Aba Gerima, ash content was significantly higher in 2018 than in 2019, but not in Guder. For Napier and desho grasses, there were an increment in IVOMD (6.7 vs 4.7%), metabolizable energy (5.5 vs 4.5%), and VFA production (23.1 vs 3.0%) in the Desmodium intortum plus FYM treatment than in the control in Aba Gerima. In Guder, however, IVOMD (13.7 vs 4.6%), metabolizable energy (13.3 vs 3.3%), and VFA production (11.2 vs 5.6%) increased in the same treatment for Napier and desho grasses than in the control. This study suggests that the Desmodium intortum plus FYM improves the nutritional value, IVOMD, and VFA production of Napier and desho grasses in dryland areas of the upper Blue Nile basin, facilitating their growth as alternative livestock feed for better production in these areas.

BackgroundThe detailed electrophysiological characteristics of atrial fibrillation (AF) initiating non-pulmonary vein (PV) triggers excluding origins from the superior vena cava (SVC) and left atrial posterior wall (LAPW) (Non-PV-SVC-LAPW triggers) remain unclear. This study aimed to clarify the detailed electrophysiological characteristics of non-PV-SVC-LAPW triggers.MethodsAmong 446 AF ablation procedures at 2 institutions, patients with reproducible AF initiating non-PV-SVC-LAPW triggers were retrospectively enrolled. The trigger origin was mapped using the self-reference mapping technique. The following electrophysiological parameters were evaluated: the voltage during sinus rhythm and at the onset of AF at the earliest activation site, coupling interval of the trigger between the prior sinus rhythm and AF trigger, and voltage change ratio defined as the trigger voltage at the onset of AF divided by the sinus voltage.ResultsDetailed electrophysiological data were obtained at 28 triggers in 21 patients. The median trigger voltage at the onset of AF was 0.16mV and median trigger coupling interval 182msec. Normal sinus voltages (≧0.5mV) were observed at 16 triggers and low voltages (ConclusionsThe trigger voltage at the onset of AF was low, regardless of whether the sinus voltage of the trigger was preserved or low.

Spider silk is a protein-based material whose toughness suggests possible novel applications. A particularly fascinating example of silk toughness is provided by Darwin's bark spider (Caerostris darwini) found in Madagascar. This spider produces extraordinarily tough silk, with an average toughness of 350 MJ m−1 and over 50% extensibility, and can build river-bridging webs with a size of 2.8 m2. Recent studies have suggested that specific spidroins expressed in C. darwini are responsible for the mechanical properties of its silk. Therefore, a more comprehensive investigation of spidroin sequences, silk thread protein contents and phylogenetic conservation among closely related species is required. Here, we conducted genomic, transcriptomic and proteomic analyses of C. darwini and its close relative Caerostris extrusa. A variety of spidroins and low-molecular-weight proteins were found in the dragline silk of these species; all of the genes encoding these proteins were conserved in both genomes, but their genes were more expressed in C. darwini. The potential to produce very tough silk is common in the genus Caerostris, and our results may suggest the existence of plasticity allowing silk mechanical properties to be changed by optimizing related gene expression in response to the environment.

Background Heart failure (HF) is a known risk factor for ischemic stroke, but data regarding ischemic stroke during hospitalization for acute decompensated HF (ADHF) are limited. Methods and Results We analyzed the data from a multicenter registry (Kyoto Congestive Heart Failure [KCHF] Registry) that enrolled 4056 consecutive patients with ADHF in Japan (mean age, 78 years; men, 2238 patients [55%]; acute coronary syndrome [ACS], 239 patients [5.9%]). We investigated the incidence and predictors of ischemic stroke during hospitalization for ADHF. During the hospitalization, 63 patients (1.6%) developed ischemic stroke. The median interval from admission to the onset of ischemic stroke was 7 [interquartile range: 2–14] days, and the most common underlying cause was cardioembolism (64%). Men (OR, 1.87; 95%CI, 1.11–3.24), ACS (OR, 2.31; 95%CI, 1.01–4.93), absence of prior HF hospitalization (OR, 2.21; 95%CI, 1.24–4.21), and high B‐type natriuretic peptide (BNP)/N‐terminal proBNP (NT‐proBNP) levels (above the median) at admission (OR, 3.15; 95%CI, 1.84–5.60) were independently associated with ischemic stroke. In patients without ACS, the independent risk factors for ischemic stroke were fully consistent with those in the main analysis. Higher quartiles of BNP/NT‐proBNP levels were significantly associated with higher incidence of ischemic stroke (P for trend,

BackgroundTelemedicine has been increasingly used in many health care fields, including home care, where patients receive medical care at home. Owing to the current COVID-19 crisis, the value of telemedicine via videoconferencing is more recognized, particularly in allowing immobile patients to continue receiving care. However, the efficacy of telemedicine in home care settings in Japan remains to be fully appraised. ObjectiveThis study aims to identify the use and impact of telemedicine in a singular home care delivery setting in Japan. MethodsA retrospective observational study was conducted using patient and other administrative records from a home care clinic. We considered patients who were involved in videoconferencing with home care physicians and telepresenters serving patients during 2018 and 2019. We extracted sociodemographic data of the patients and details of the videoconferencing and descriptively illustrated some specific cases. ResultsIn a home care clinic in Japan, videoconferencing was conducted in 17 cases (involving 14 patients) over a 2-year period. Of all the cases, 12% (2/17) required emergency transfers and were hospitalized. A total of 88% (15/17) of cases remained; 71% (12/17) of cases were found to need extra medication or to go to a medical facility for consultation, whereas 18% (3/17) of cases were found not to be in need of urgent attention and were asked to rest. Problematic symptoms subsequently improved in 82% (14/17) of cases, and only 6% (1/17) of cases were later hospitalized. ConclusionsTelemedicine was deemed effective for assessing patients’ conditions in the home care setting in situations where home visits by a physician cannot be carried out. Our findings indicate that consultations via videoconferencing are safe and effective, suggesting more active use of videoconferencing in other clinical contexts.