Antiplasmodial ealapasamines A-C,'mixed' naphthylisoquinoline dimers from the Central African liana Ancistrocladus ealaensis

Three unusual heterodimeric naphthylisoquinoline alkaloids, named ealapasamines A-C (1-3), were isolated from the leaves of the tropical plant Ancistrocladus ealaensis J. Léonard. These 'mixed', constitutionally unsymmetric dimers are the first stereochemically fully assigned cross-coupling products of a 5,8'- and a 7,8'-coupled naphthylisoquinoline linked via C-6' in both naphthalene portions. So far, only two other West and Central Ancistrocladus species were known to produce dimers with a central 6,6″-axis, yet, in contrast to the ealapasamines, usually consisting of two 5,8'-coupled monomers, like e.g., in michellamine B. The new dimers 1-3 contain six elements of chirality, four stereogenic centers and the two outer axes, while the central biaryl axis is configurationally unstable. The elucidation of the complete stereostructures of the ealapasamines was achieved by the interplay of spectroscopic methods including HRESIMS, 1D and 2D NMR (in particular ROESY measurements), in combination with chemical (oxidative degradation) and chiroptical (electronic circular dichroism) investigations. The ealapasamines A-C display high antiplasmodial activities with excellent half-maximum inhibition concentration values in the low nanomolar range.

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Prevention of mother-to-child transmission of HIV Option B+ cascade in rural Tanzania: the one stop clinic model

Strategies to improve the uptake of Prevention of Mother-To-Child Transmission of HIV (PMTCT) are needed. We integrated HIV and maternal, newborn and child health services in a One Stop Clinic to improve the PMTCT cascade in a rural Tanzanian setting.; The One Stop Clinic of Ifakara offers integral care to HIV-infected pregnant women and their families at one single place and time. All pregnant women and HIV-exposed infants attended during the first year of Option B+ implementation (04/2014-03/2015) were included. PMTCT was assessed at the antenatal clinic (ANC), HIV care and labour ward, and compared with the pre-B+ period. We also characterised HIV-infected pregnant women and evaluated the MTCT rate.; 1,579 women attended the ANC. Seven (0.4%) were known to be HIV-infected. Of the remainder, 98.5% (1,548/1,572) were offered an HIV test, 94% (1,456/1,548) accepted and 38 (2.6%) tested HIV-positive. 51 were re-screened for HIV during late pregnancy and one had seroconverted. The HIV prevalence at the ANC was 3.1% (46/1,463). Of the 39 newly diagnosed women, 35 (90%) were linked to care. HIV test was offered to >98% of ANC clients during both the pre- and post-B+ periods. During the post-B+ period, test acceptance (94% versus 90.5%, p<0.0001) and linkage to care (90% versus 26%, p<0.0001) increased. Ten additional women diagnosed outside the ANC were linked to care. 82% (37/45) of these newly-enrolled women started antiretroviral treatment (ART). After a median time of 17 months, 27% (12/45) were lost to follow-up. 79 women under HIV care became pregnant and all received ART. After a median follow-up time of 19 months, 6% (5/79) had been lost. 5,727 women delivered at the hospital, 20% (1,155/5,727) had unknown HIV serostatus. Of these, 30% (345/1,155) were tested for HIV, and 18/345 (5.2%) were HIV-positive. Compared to the pre-B+ period more women were tested during labour (30% versus 2.4%, p<0.0001). During the study, the MTCT rate was 2.2%.; The implementation of Option B+ through an integrated service delivery model resulted in universal HIV testing in the ANC, high rates of linkage to care, and MTCT below the elimination threshold. However, HIV testing in late pregnancy and labour, and retention during early ART need to be improved.

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Bayesian spatio-temporal modeling of mortality in relation to malaria incidence in Western Kenya

The effect of malaria exposure on mortality using health facility incidence data as a measure of transmission has not been well investigated. Health and demographic surveillance systems (HDSS) routinely capture data on mortality, interventions and other household related indicators, offering a unique platform for estimating and monitoring the incidence-mortality relationship in space and time.; Mortality data from the HDSS located in Western Kenya collected from 2007 to 2012 and linked to health facility incidence data were analysed using Bayesian spatio-temporal survival models to investigate the relation between mortality (all-cause/malaria-specific) and malaria incidence across all age groups. The analysis adjusted for insecticide-treated net (ITN) ownership, socio-economic status (SES), distance to health facilities and altitude. The estimates obtained were used to quantify excess mortality due to malaria exposure.; Our models identified a strong positive relationship between slide positivity rate (SPR) and all-cause mortality in young children 1-4 years (HR = 4.29; 95% CI: 2.78-13.29) and all ages combined (HR = 1.55; 1.04-2.80). SPR had a strong positive association with malaria-specific mortality in young children (HR = 9.48; 5.11-37.94), however, in older children (5-14 years), it was associated with a reduction in malaria specific mortality (HR = 0.02; 0.003-0.33).; SPR as a measure of transmission captures well the association between malaria transmission intensity and all-cause/malaria mortality. This offers a quick and efficient way to monitor malaria burden. Excess mortality estimates indicate that small changes in malaria incidence substantially reduce overall and malaria specific mortality.

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Urbanization is a main driver for the larval ecology of Aedes mosquitoes in arbovirus-endemic settings in south-eastern Côte d'Ivoire

Failure in detecting naturally occurring breeding sites of Aedes mosquitoes can bias the conclusions drawn from field studies, and hence, negatively affect intervention outcomes. We characterized the habitats of immature Aedes mosquitoes and explored species dynamics along a rural-to-urban gradient in a West Africa setting where yellow fever and dengue co-exist.; Between January 2013 and October 2014, we collected immature Aedes mosquitoes in water containers in rural, suburban, and urban areas of south-eastern Côte d'Ivoire, using standardized sampling procedures. Immature mosquitoes were reared in the laboratory and adult specimens identified at species level.; We collected 6,159, 14,347, and 22,974 Aedes mosquitoes belonging to 17, 8, and 3 different species in rural, suburban, and urban environments, respectively. Ae. aegypti was the predominant species throughout, with a particularly high abundance in urban areas (99.37%). Eleven Aedes larval species not previously sampled in similar settings of Côte d'Ivoire were identified: Ae. albopictus, Ae. angustus, Ae. apicoargenteus, Ae. argenteopunctatus, Ae. haworthi, Ae. lilii, Ae. longipalpis, Ae. opok, Ae. palpalis, Ae. stokesi, and Ae. unilineatus. Aedes breeding site positivity was associated with study area, container type, shade, detritus, water turbidity, geographic location, season, and the presence of predators. We found proportionally more positive breeding sites in urban (2,136/3,374, 63.3%), compared to suburban (1,428/3,069, 46.5%) and rural areas (738/2,423, 30.5%). In the urban setting, the predominant breeding sites were industrial containers (e.g., tires and discarded containers). In suburban areas, containers made of traditional materials (e.g., clay pots) were most frequently encountered. In rural areas, natural containers (e.g., tree holes and bamboos) were common and represented 22.1% (163/738) of all Aedes-positive containers, hosting 18.7% of Aedes fauna. The predatory mosquito species Culex tigripes was commonly sampled, while Toxorhynchites and Eretmapodites were mostly collected in rural areas.; In Côte d'Ivoire, urbanization is associated with high abundance of Aedes larvae and a predominance of artificial containers as breeding sites, mostly colonized by Ae. aegypti in urban areas. Natural containers are still common in rural areas harboring several Aedes species and, therefore, limiting the impact of systematic removal of discarded containers on the control of arbovirus diseases.

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Forensic 3D documentation of bodies: Simple and fast procedure for combining CT scanning with external photogrammetry data

Publication date: Available online 6 December 2017
Source:Journal of Forensic Radiology and Imaging
Author(s): Chiara Villa, Mitchell J. Flies, Christina Jacobsen
This study presents a procedure for combining 3D models obtained from CT scanning (internal and external data) and photogrammetry (external data). 3D data were acquired at different times, without the support of reference points. The procedure has been tested on 30 injured areas caused by different wounding mechanisms. The alignment of the different 3D models was in most of the cases very precisely (mean distance around 1mm, SD around or lower than 2mm). Ad hoc procedures should be followed in case of injuries on the head, joints and back.



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