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The increasing prevalence of resistance to antimalarial drugs reduces options for malaria prophylaxis. Atovaquone/proguanil (Malarone; GlaxoSmithKline) has been >95% effective in preventing Plasmodium falciparum malaria in lifelong residents of areas of holoendemicity, but data from persons without clinical immunity or who are at risk for Plasmodium vivax malaria have not been described. We conducted a randomized, double-blinded study involving 297 people from areas of nonendemicity in Indonesia who migrated to Papua (where malaria is endemic) ⩽26 months before the study period. Subjects received prophylaxis with 1 Malarone tablet (250 mg of atovaquone and 100 mg of proguanil hydrochloride; n = 148) or placebo (n = 149) per day for 20 weeks. Hematologic and clinical chemistry values did not change significantly. The protective efficacy of atovaquone/proguanil was 84% (95% confidence interval [CI], 44%–95%) for P. vivax malaria, 96% (95% CI, 72%–99%) for P. falciparum malaria, and 93% (95% CI, 77%–98%) overall. Atovaquone/proguanil was well tolerated, safe, and effective for the prevention of drug-resistant P. vivax and P. falciparum malaria in individuals without prior malaria exposure who migrated to Papua, Indonesia.

Malaria causes illness or death in unprotected travelers. Primaquine prevents malaria by attacking liver-stage parasites, a property distinguishing it from most chemoprophylactics and obviating 4-week postexposure dosing. A daily adult regimen of 30 mg primaquine prevented malaria caused by Plasmodium falciparum and P. vivax for 20 weeks in 95 of 97 glucose-6-phosphate dehydrogenase (G6PD)-normal Javanese transmigrants in Papua, Indonesia. In comparison, 37 of 149 subjects taking placebo in a parallel trial became parasitemic. The protective efficacy of primaquine against malaria was 93% (95% confidence interval [CI] 71%-98%); against P. falciparum it was 88% (95% CI 48%-97%), and >92% for P. vivax (95% CI >37%-99%). Primaquine was as well tolerated as placebo. Mild methemoglobinemia (mean of 3.4%) returned to normal within 2 weeks. Blood chemistry and hematological parameters revealed no evidence of toxicity. Good safety, tolerance, and efficacy, along with key advantages in dosing requirements, make primaquine an excellent drug for preventing malaria in nonpregnant, G6PD-normal travelers.

Helping millennials follow Jesus Christ as His disciples remains a significant challenge to most Christian churches. Some literature indicates that most people who finish well in their Christian life relate this to their experiences of being cared for and mentored. However, there is little literature to prove whether Christian mentoring can directly influence the commitment of Canadian-born Chinese Christian (CBCC) millennials to lifelong discipleship with Christ. To address this issue, this study will explore how Christian mentoring influences CBCC millennials’ commitment in following Christ. This research begins by building on the theological and theoretical foundations of Christian mentoring. Secondly, personal interviews with twelve CBCC millennials were conducted to elicit their experiences and perspectives toward mentorship in a Canadian Chinese Immigrant Church (CCIC) context, located in Calgary, Alberta, Canada through semi-structured and open-ended questions as a narrative inquiry approach of qualitative research. The interview data was then transcribed and analyzed to understand how mentoring influences CBCC millennials’ commitment to following Jesus. The research data demonstrates that one’s commitment to following Jesus can be influenced by mentoring experiences that consists of the following crucial and integral essentials: (1) relational dynamics, (2) role modelling, (3) an intergenerational community, and (4) an intentional process.

Thirty-eight of 295 subjects participating in a randomized, double-blind, placebo-controlled trial of the efficacy of daily administration of atovaquone/proguanil for malaria prevention developed malaria at some time during the 20-week prophylaxis period. These subjects (3 atovaquone/proguanil recipients and 35 placebo recipients) were treated with 4 tablets of atovaquone/proguanil per day for 3 days. Atovaquone/proguanil provided safe, well-tolerated, and effective therapy for uncomplicated malaria in nonimmune Indonesians.

•Intention to get the COVID-19 vaccine can be predicted with Protection Motivation Theory constructs.•Greater conspiracy beliefs are associated with lower COVID-19 vaccination intention.•Unvaccinated individuals tend to have greater conspiracy beliefs than vaccinated individuals. While COVID-19 vaccine uptake has been encouraging overall, some individuals are either hesitant towards, or refuse, the vaccine. Protection Motivation Theory (PMT) has been applied to influenza vaccine acceptance, but there is a lack of research applying PMT to COVID-19 vaccine acceptance. Additionally, prior research has suggested that coronavirus conspiracy beliefs and demographic factors may play a role in attitudes towards the vaccine. This study aimed to predict COVID-19 vaccination intention using PMT, coronavirus conspiracy beliefs, and demographic factors. Furthermore, vaccinated and unvaccinated individuals were compared in relation to their coronavirus conspiracy beliefs. An online survey was administered to 382 (278 vaccinated, and 104 unvaccinated) individuals in the United Kingdom (77 males, 301 females, one non-binary/third gender, and three unstated). Respondents’ mean age was 43.78 (SD = 12.58). A hierarchical multiple linear regression was performed in three stages. Initially, four PMT constructs - severity, susceptibility, maladaptive response costs, and self-efficacy - emerged as significant predictors of COVID-19 vaccination intention. The final model accounted for 75% of the variance and retained two significant predictors from PMT - maladaptive response rewards and self-efficacy - alongside coronavirus conspiracy beliefs and age. An independent t-test established that unvaccinated individuals held greater coronavirus conspiracy beliefs than vaccinated ones. Interventions and campaigns addressing COVID-19 vaccine acceptance should employ strategies increasing individuals’ perceived severity of COVID-19, perceived susceptibility, and perceived ability to get vaccinated, while decreasing perceived rewards of not getting vaccinated. Additionally, coronavirus conspiracy beliefs should be addressed, as these appear to play a role for some vaccine-hesitant individuals.

Smart cities have been a global concern in recent years, involving comprehensive scientific research. To obtain a structural overview and assist researchers in making insights into the characteristics of smart cities research, bibliometric analysis was carried out in this paper. With the application of the bibliometric analysis software VOSviewer and CiteSpace, 4409 smart cities were identified by the core collection of the Web of Science in publications between 1998 and 2019 and used in the analysis of this paper. Concretely, this research visually demonstrates a comprehensive overview of the field relating to smart cities in terms of the production of regular publications, main domain of smart cities researchers, most influential countries (institutions, sources and authors), and interesting research directions in the smart city researches. We also present the research collaboration among countries (regions), organizations and authors based on a series of cooperation analyses. The bibliometric analysis of the existing work provided a valuable and seminal reference for researchers and practitioners in smart cities-related research communities.

We aimed to assess whether interferon-γ release assays (IGRAs) can predict the development of active tuberculosis and whether the predictive ability of these tests is better than that of the tuberculin skin test (TST). Longitudinal studies of the predictive value for active tuberculosis of in-house or commercial IGRAs were identified through searches of PubMed, Embase, Biosis, and Web of Science and complementary manual searches up to June 30, 2011. Eligible studies included adults or children, with or without HIV, who were free of active tuberculosis at study baseline. We summarised incidence rates in forest plots and pooled data with random-effects models when appropriate. We calculated incidence rate ratios (IRR) for rates of disease progression in IGRA-positive versus IGRA-negative individuals. 15 studies had a combined sample size of 26 680 participants. Incidence of tuberculosis during a median follow-up of 4 years (IQR 2–6), even in IGRA-positive individuals, was 4–48 cases per 1000 person-years. Seven studies with no possibility of incorporation bias and reporting baseline stratification on the basis of IGRA results showed a moderate association between positive results and subsequent tuberculosis (pooled unadjusted IRR 2·10, 95% CI 1·42–3·08). Compared with test-negative results, IGRA-positive and TST-positive results were much the same with regard to the risk of tuberculosis (pooled IRR in the five studies that used both was 2·11 [95% CI 1·29–3·46] for IGRA vs 1·60 [0·94–2·72] for TST at the 10 mm cutoff). However, the proportion of IGRA-positive individuals in seven of 11 studies that assessed both IGRAs and TST was generally lower than TST-positive individuals. Neither IGRAs nor the TST have high accuracy for the prediction of active tuberculosis, although use of IGRAs in some populations might reduce the number of people considered for preventive treatment. Until more predictive biomarkers are identified, existing tests for latent tuberculosis infection should be chosen on the basis of relative specificity in different populations, logistics, cost, and patients' preferences rather than on predictive ability alone. Special Programme for Research and Training in Tropical Diseases (WHO), Wellcome Trust, Canadian Institutes of Health Research, UK Medical Research Council, and the European and Developing Countries Clinical Trials Partnership.

Several commercial Zika virus (ZIKV) serology assays have been developed since the recognition of ZIKV outbreaks as a Public Health Emergency of International Concern in 2016. However, test interpretation for ZIKV serology can be challenging due to antibody cross-reactivity with other flaviviruses like dengue virus (DENV). Therefore, we sought to evaluate the performance of eight commercially available ZIKV IgM and IgG assays across three testing platforms, namely, immunochromatographic tests (ICT), ELISAs and immunofluorescence tests (IIFT). The test panel comprised of 278 samples, including acute and convalescent sera or plasma from ZIKV-confirmed, DENV-confirmed, non-ZIKV and non-DENV patients, and residual sera from healthy blood donors. The ZIKV IgM and IgG serology assays yielded higher test sensitivities of 23.5% - 97.1% among ZIKV convalescent samples as compared to 5.6% - 27.8% among ZIKV acute samples; the test specificities were 63.3% - 100% among acute and convalescent DENV, non-DENV samples. Among the ELISAs and IIFTs, the Diapro ZIKV IgM ELISA demonstrated high test sensitivity (96%) and specificity (80%) when tested on early convalescent samples, while the Euroimmun ZIKV IgG ELISA yielded the highest test specificity of 97% - 100% on samples from non-ZIKV patients and healthy blood donors. For rapid ICTs, the LumiQuick IgM rapid ICT yielded low test sensitivity, suggesting its limited utility. We showed that commercial ZIKV IgM and IgG serology assays have differing test performances, with some having moderate to high test sensitivities and specificities when used in a dengue endemic setting, although there were limitations in IgG serology.