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Background: A recent clinical trial of seasonal RTS,S/AS01E (RTS,S) vaccination showed that vaccination was non-inferior to seasonal malaria chemoprevention (SMC) in preventing clinical malaria. The combination of these two interventions provided significant additional protection against clinical and severe malaria outcomes. Impact projections of this novel approach to RTS,S vaccination in seasonal transmission settings for longer time frames and across a range of epidemiological settings are needed to inform policy recommendations. Methods: We used a mathematical model of malaria transmission to assess the potential impact of an age-based or seasonally targeted RTS,S vaccination schedule in seasonal transmission settings in both the absence and presence of SMC. Estimates of cases and deaths averted in a population of 100,000 children aged 0-5 years were calculated over a 15-year time horizon for a range of levels of Plasmodium falciparum parasite prevalence in 2–10-year-olds and over two West African seasonality archetypes. Findings: Seasonally targeting RTS,S resulted in greater absolute reductions in malaria cases and deaths compared to an age-based strategy, averting between 32%-100% more clinical cases dependent on seasonality and transmission intensity. We predict that adding seasonally targeted RTS,S to SMC would reduce clinical incidence by up to an additional 36%-56% in children under five compared with SMC alone. Transmission season duration was a key determinant of intervention impact, with the advantage of adding RTS,S to SMC predicted to be smaller with shorter transmission seasons. Interpretation: RTS,S vaccination in seasonal settings could be a valuable additional tool to existing interventions, with seasonal delivery maximising impact relative to an age-based approach. Decisions surrounding deployment strategies of RTS,S in such settings will need to consider the local and regional variations in seasonality, current levels of other interventions and potential achievable RTS,S coverage. Funding: UK Medical Research Council, UK Foreign Commonwealth & Development Office, The Wellcome Trust and The Royal society.

The COVID-19 pandemic is likely to severely interrupt health systems in Sub-Saharan Africa (SSA) over the coming weeks and months. Approximately 90% of malaria deaths occur in this region of the world, with an estimated 380,000 deaths from malaria in 2018. Much of the gain made in malaria control over the last decade has been due to the distribution of long-lasting insecticide treated nets (LLINs). Many SSA countries planned to distribute these in 2020. We used COVID-19 and malaria transmission models to understand the likely impact that disruption to these distributions, alongside other core health services, could have on the malaria burden. Results indicate that if all malaria-control activities are highly disrupted then the malaria burden in 2020 could more than double that in the previous year, resulting in large malaria epidemics across the region. These will depend on the course of the COVID-19 epidemic and how it interrupts local health system. Our results also demonstrate that it is essential to prioritise the LLIN distributions either before or as soon as possible into local COVID-19 epidemics to mitigate this risk. Additional planning to ensure other malaria prevention activities are continued where possible, alongside planning to ensure basic access to antimalarial treatment, will further minimise the risk of substantial additional malaria mortality.

Sulfadoxine-pyrimethamine with amodiaquine (SP-AQ) is a highly efficacious regimen for intermittent preventive treatment to prevent malaria in children (IPTc), but the amodiaquine component is not always well tolerated. We determined the association between amodiaquine dosage by body weight and mild adverse events (AEs) and investigated whether alternative age-based regimens could improve dosing accuracy and tolerability, using data from two trials of IPTc in Senegal, one in which AQ dose was determined by age and the other in which it was determined by weight category. Both dosage strategies resulted in some children receiving AQ doses above the recommended therapeutic range. The odds of vomiting increased with increasing amodiaquine dosage. In one study, incidence of fever also increased with increasing dosage. Anthropometric data from 1,956 children were used to predict the dosing accuracy of existing and optimal alternative regimens. Logistic regression models describing the probability of AEs by dosage were used to predict the potential reductions in mild AEs for each regimen. Simple amendments to current AQ dosing schedules based on the child's age could substantially increase dosing accuracy and thus improve the tolerability of IPTc using SP-amodiaquine in situations where weighing the child is impractical.

Genome-wide microRNA (miRNA) expression profiling of salivary gland pleomorphic adenomas revealed a distinct expression signature consisting largely of upregulated miRNAs compared with matched normal tissue. Microarray data were confirmed by quantitative real time RT-PCR (q-RTPCR). Five miRNA genes upregulated in the tumours were found in close proximity to fragile sites and/or cancer associated genomic regions. Interestingly, q-RTPCR revealed an increase in the expression of components of the miRNA processing machinery (Dicer, Drosha, DGCR8 and p68) in tumours suggesting that the deregulation of miRNA expression may result from increased miRNA biogenesis. Target gene prediction analysis of the altered miRNAs indicated that genes in a number of signalling pathways important in tumourigenesis including WNT, MAPK and JAK-STAT were overrepresented. Significantly, the oncogene PLAG1 was overexpressed in our cohort and may be potentially regulated by these miRNAs. This is the first study to examine changes in the miRNA milieu in pleomorphic adenoma, the most common salivary gland tumour. This study has demonstrated an upregulation of both miRNAs genes and an upregulation of the miRNA processing machinery. These changes may be potential underlying mechanisms for the development of these benign tumours. © 2009 UICC.

The results of multivariate statistical tests indicate that depression specifically affects performance on speed tests in counterdistinction to power tests.

Mannanase is a mannan degrading enzyme which is produced by microorganisms, including bacteria. This enzyme can be used in many industrial processes as well as for improving the quality of animal feeds. The aim of the present study was toscreen and characterize the mannanase-producing bacteria. Two genera of bacteria were isolated from Thai soil samples,fermented coconut, and fertilizer. Screening was carried out on agar plates containing mannan stained with iodine solution.The bacteria were identified by partial 16S rRNA gene sequence, biochemical test and morphology, respectively. The mannanase activity was determined by zymogram and DNS method. Two strains of bacteria with mannanase activity were identified as Bacillus and Chryseobacterium. This is the first report of mannanase-producing Chryseobacterium.