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Background After decades of progress towards malaria elimination, Plasmodium vivax is now the predominant source of infection and the major obstacle towards elimination in the Asia-Pacific region. In the Philippines, the situation is slightly different with P. falciparum still accounting for the largest burden. However, there has been a steady increase in the total number of reported P. vivax cases in the main transmission hotspot of Palawan, as well as two years of consecutive outbreaks of P. vivax in the near-elimination setting of Sultan Kudarat. Here, we describe the protocol for a new study in Sultan Kudarat that aims to identify whether an underlying, hidden, burden of P. vivax contributes to the ongoing risk of outbreaks. Methods A challenge for surveillance of P. vivax is the presence of an additional hidden liver-stage, where parasites (hypnozoites) lie dormant for weeks to months before causing a relapse of infection. Hypnozoites cannot be detected with commercial diagnostic tests. We have designed novel serological exposure markers of recent P. vivax infection, which indirectly inform on hypnozoite carriage. In this study we will conduct a prospective 18-month survey in health facilities within Kalamansig, Sultan Kudarat, and compare epidemiology and serological data with that in archival samples from Palawan. We will enroll both care-seeking individuals and their companions, and utilise remote geolocation to uncover spatial trends. Discussion This study will generate important data for the malaria control program in the Philippines whilst also demonstrating utility of P. vivax serological exposure markers in near-elimination settings. We will utilise this data to build a decision-making framework to support novel, evidence-based elimination strategies relevant for the Philippines and the wider Asia-Pacific region.

Nowadays, the gold standard for the surgical treatment of abdominal wall defects is the use of a mesh. There is an extensive variety of meshes, self-adhesive ones being among the most novel technologies. The literature on the self-adhesive mesh Adhesix ® ( Cousin Biotech Laboratory, 59117 Wervicq South, France ) in medial incisional ventral hernia is scarce. We performed a retrospective descriptive study with prospective data collection from 125 patients who underwent prosthetic repair of medial incisional ventral hernia—M1–M5 classification according to European Hernia Society (EHS)—with self-adhesive mesh Adhesix ® between 2013 and 2021. Follow-up was performed 1 month and yearly after the surgery. Postoperative complications and hernia recurrences were recorded. Epidemiological results were average BMI 30.5 kg/m 2 (SD 5), highlighting that overweight (41.6%) and obesity type 1 (25.6%) were the most represented groups. 34 patients (27.2%) had already undergone a previous abdominal wall surgery. The epigastric–umbilical (M2–M3 EHS classification, 22.4%) and umbilical (M3 EHS classification, 20%) hernias were the predominant groups. The elective surgery technique was Rives or Rives–Stoppa with an associated supraaponeurotic mesh if the closure of the anterior aponeurosis of the rectus sheath was not surgically closed (13 patients). The most frequent postoperative complication was seroma (26.4%). The recurrence rate was 7.2%. The average follow-up length was 2.6 years (SD 1.6 years). According to the results of this study and the literature available, we consider that the self-adhesive mesh Adhesix ® is an appropriate alternative mesh option for the repair of medial incisional ventral hernias.

Background/Objectives: The literature reports high complication rates in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who undergo balloon pulmonary angioplasty (BPA), especially in patients with poor pulmonary hemodynamics. Here, we describe the complications of BPA based on the new definitions. Methods: All patients with CTEPH who completed BPA treatment before 15 September 2023 were selected from the CTEPH database. Peri-procedural complications were collected and classified according to the 2023 consensus paper on BPA treatment. Complications were analyzed in subgroups of patients with pulmonary vascular resistance (PVR), ≤ or >6.6 WU, and mean pulmonary artery pressure (mPAP), ≤ or >45 mmHg, at first BPA. Results: In this analysis, 87 patients (63% women; mean age 61.1 ± 14.0 years; 62% on dual PH targeted medical therapy) underwent 426 (mean 4.9 ± 1.6 per patient) BPAs. Only non-severe complications occurred in 14% of BPA treatments and in 47% of the patients; 31% patients had a thoracic complication. The thoracic complications were mild (71%) or moderate (29%). Patients with a PVR > 6.6 WU (n = 8) underwent more BPA treatments (6.6 ± 1.5 versus 4.6 ± 1.5, p = 0.002), had more complications (88% versus 41% of patients, p = 0.020), and had more thoracic complications (17% vs. 7% of BPAs, p = 0.013) than patients with PVR ≤ 6.6 WU. Patients with mPAP > 45 mmHg (n = 13) also had more BPA treatments (6.5 ± 1.7 versus 4.6 ± 1.4, p < 0.001), more complications (77% versus 44% of patients, p = 0.027) and more thoracic complications (14% versus 8% of BPAs, p = 0.039) than patients with mPAP ≤ 45 mmHg. Conclusions: Complications occurred in 14% of BPAs and were mostly mild. Patients with severe pulmonary hemodynamics suffered more (thoracic) complications.

This work shows improvements made in mixing operations at water treatment plants, as a result of the hydrodynamic analysis of the mixing processes carried out by the use of a Finite Element Model. The code, developed in the Civil Engineering Department of the University of La Coruña, Spain, solves the Navier-Stokes equations that rule viscous incompressible flow by using a Streamline Upwind/Petrov-Galerkin (SUPG) stabilization technique. The incorporation of the SUPG formulation leads to obtaining stable solutions for Reynolds numbers of a moderate order in connection with meshes that are not very refined. Some water treatment units present significant deficiencies in their design. The numerical evaluation of the flow avoids the high expenses of the trial-and-error processes involved in installing and removing the mixing mechanisms and those derived from the need to halt the water treatment processes. As a result, an optimum design of the treatment plant is obtained at a low cost.

A study was conducted in Muntinlupa City a fast expanding city in southern Metro Manila to understand the implications of different ecological, biological, and social determinants affecting vector pupal indices and dengue transmission risk in the area. Selected barangays (administrative `villages') were categorized as either high or low dengue incidence areas based on the reported dengue incidence of the area at the time of study. These communities were further classified into either high or low human population density areas (HPD and LPD clusters) to determine the influence of socio-economic factors on vector density and disease risk. Study findings found HPD and LPD clusters with low dengue incidence were generally more knowledgeable about dengue and have more access to sources of information about the disease and prevention. However, communities' knowledge on dengue does not necessarily translate to reduction of vector density in their areas as indicated by statistical test performed in the study. Statistical analyses also revealed that some of government interventions and community/household-based prevention practices were shown effective for dengue control to reduce infection risk, but require more frequent monitoring to maintain sustainable control of the vector population. Moreover, the percentage of green areas in the surveyed clusters has an effect on the vector density of the study. An overall analysis using chi-square showed that there is a correlation between pupal density and human population density and number of dengue cases.

A numerical model for the two dimensional ShallowWater Equations is described and tested. The Finite Volume Method is applied, upwinding the flux and geometric source terms, but not the friction term. The performance of the model in different situations is shown, including the advance of a shock over an horizontal dry bed and the simulation of an hydraulic jump. The results confirm the good behaviour of the model.

Traditionally, patient travel history has been used to distinguish imported from autochthonous malaria cases, but the dormant liver stages of Plasmodium vivax confound this approach. Molecular tools offer an alternative method to identify, and map imported cases. Using machine learning approaches incorporating hierarchical fixation index and decision tree analyses applied to 799  P. vivax genomes from 21 countries, we identified 33-SNP, 50-SNP and 55-SNP barcodes (GEO33, GEO50 and GEO55), with high capacity to predict the infection’s country of origin. The Matthews correlation coefficient (MCC) for an existing, commonly applied 38-SNP barcode (BR38) exceeded 0.80 in 62% countries. The GEO panels outperformed BR38, with median MCCs > 0.80 in 90% countries at GEO33, and 95% at GEO50 and GEO55. An online, open-access, likelihood-based classifier framework was established to support data analysis (vivaxGEN-geo). The SNP selection and classifier methods can be readily amended for other use cases to support malaria control programs. An online, amendable classifier for detecting malaria parasite country of origin from genomic data is developed using a machine learning approach.

In order to know the adaptive changes of small intestine regions (duodenum, and proximal, medial and distal jejunumileum) due to the reproductive stage (virgin, pregnancy and lactation), the weight, mucosal proportion, mucosal DNA and protein contents and protein/DNA ratio in female Wistar rats were measured. Pregnancy induces hypertrophy of the proximal half of the small intestine (duodenum and proximal jejunum-ileum), whereas lactation induces hyperplasia in all small intestinal regions and also hypertrophy but only in the duodenum.

Suitabe for those who study pragmatics, discourse analysis, second language acquisition, sociolinguistics, corpus linguistics, and language variation, this title examines pragmatic variation focusing on methods utilized to collect and analyze data in a variety of first (L1) and second (L2) language contexts.

Rubredoxin from the hyperthermophile Pyrococcus furiosus is the most thermostable protein characterized to date with an estimated global unfolding rate of 10-6s-1at 100 degrees C. In marked contrast to these slow global dynamics, hydrogen exchange experiments here demonstrate that conformational opening for solvent access occurs in the ≈ millisecond time frame or faster at 28 degrees C for all amide positions. Under these conditions all backbone amides with exchange protection factors between 104and 106, for which EX2exchange kinetics were directly verified, have exchange activation energy values within 2-3 kcal/mol of that observed for unstructured peptides. The conformational flexibility of this protein is thus sufficient for water and base catalyst access to the exchanging amide with quite limited structural disruption. The common hypothesis that enhanced conformational rigidity in the folded native state underlies the increased thermal stability of hyperthermophile proteins is not supported by these data.