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Abstract We aimed to assess the association of SAF with cardiovascular mortality in the general population and the possible association between SAF with other disease-specific mortality rates. We evaluated 77,143 participants without known diabetes or cardiovascular disease. The cause of death was ascertained by the municipality database. The associations between SAF and all-cause mortality, cardiovascular mortality and cancer mortality were assessed with Cox proportional hazard analysis.After a median follow-up of 115 months, 1447 participants were deceased (1.9%). SAF and age-adjusted SAF-z score were higher in all mortality groups. Cox regression analysis revealed that the highest quartile of SAF was associated with increased odds of cardiovascular mortality, (HR) 12.6 (7.3–21.7) and after adjusting for age (HR 1.8 (1.0–3.2)). Significance was lost after additional adjustments for sex, smoking status, and BMI (HR 1.4 (0.8–2.5). For cancer-related mortality the highest quartile of SAF was associated with higher probability of mortality in all models (unadjusted HR 8.6 (6.6–11.3), adjusted for age HR 2.1 (1.6–2.8)), adjusted for age, sex, smoking status, and BMI HR 1.7 (1.3–2.4)). SAF is associated with all-cause mortality as well as cardiovascular and cancer-related mortality in the general population.

Background: Many retirees in South Africa face the challenge of either outliving their retirement savings or living below their means. Studies suggest a ‘safe’ withdrawal rate of between 4% and 5%, which is below the average fund size-weighted drawdown rate of approximately 6.66%. Aim: To provide a scientific basis for the success rate of a ‘hybrid’ retirement strategy, whereby a retiree invests a proportion of their savings in a life annuity and the remaining proportion in a living annuity, to increase the success rate for South African retirees. Setting: Historical asset class returns (equities, bonds and inflation) for South Africa were sourced for the period 1900–2020. Method: Bootstrap sampling of historical asset returns was employed to simulate 10 000 random scenarios to investigate the success rate of various compositions of the ‘hybrid’ retirement strategy. Results: The success rate of all ‘hybrid’ portfolio compositions is significantly greater than the success rate of a pure living annuity when the withdrawal rate is less than 8%. Conclusion: In a South African context, a ‘hybrid’ retirement portfolio increases the probability of success for retirees withdrawing less than 8% from their portfolio – which constitutes approximately 50% of the current annuatised population – and may increase the inheritance of a retiree’s heir. Contribution: Where other studies have focussed solely on the success rate of a living annuity, we have shown that a ‘hybrid’ retirement strategy increases a South African retiree’s likelihood of retiring successfully when the withdrawal rate is less than 8%, which is approximately 50% of the annuatised population.

Consumption of low levels of egg already can evoke harmful physiological responses in humans in those allergic to eggs. By detection of egg in food products, using Egg ELISA kits to determine its unintended presence, food producers can respond to avoid potential safety or quality risks of their products. Selection of an ELISA kit fit for the issue at hand is challenging due to, amongst others, lack of information on assay performances with specified matrices. In this study, performances of seven commercial egg ELISA kits are compared for nine different relevant matrices: cookie, chocolate, pasta, dressing, stock cube, wine, vegetable drink and milk, ice cream and meat/meat replacers. The presence of egg was unified for all ELISA kits to mg total egg protein kg−1 food product. In every matrix, kit performances for recovery, intra- and interassay were compared, and also processing is accounted for by determination of egg in incurred samples. All seven kits were able to detect egg qualitatively at the VITAL3 ED01 level of 0.2 mg total egg protein and the corresponding relevant portion size for each matrix. For quantitative results, each ELISA kit showed an increase in detected egg concentration with increased egg levels and performed within the set criteria for recovery for the cookie, chocolate, stock cube and wine. For pasta, vegetable drink and milk, ice cream, and salad dressing, recovery of egg was within the set criteria for at least 4 ELISA kits. Most challenging matrices were meat/meat replacers, showing high matrix effects which could not be explained by the possible egg presence in the cognate blank. Only one ELISA kit was able to recover egg within the set criteria for the meat/meat replacer matrix. Results enable food industry to choose for ELISA kits suitable for egg detection in the matrix of interest.

Abstract Increased skin autofluorescence (SAF) predicts the development of diabetes-related complications and cardiovascular disease. We assessed the performance of a simple model which includes SAF to identify individuals at high risk for undiagnosed and incident type 2 diabetes, in 58,377 participants in the Lifelines Cohort Study without known diabetes. Newly-diagnosed diabetes was defined as fasting blood glucose ≥ 7.0 mmol/l and/or HbA1c ≥ 6.5% (≥ 48 mmol/mol) or self-reported diabetes at follow-up. We constructed predictive models based on age, body mass index (BMI), SAF, and parental history of diabetes, and compared to results with the concise FINDRISC model. At 2nd visit to Lifelines, 1113 (1.9%) participants were identified with undiagnosed diabetes and 1033 (1.8%) participants developed diabetes during follow-up. A model comprising age, BMI and SAF yielded an AUC of 0.783 and was non-inferior to the concise FINDRISC model, which had an AUC of 0.797 to predict new diabetes. At a score of 5.8, sensitivity was 78% and specificity of 66%. Model 2 which also incorporated parental diabetes history, had an AUC of 0.792, and a sensitivity of 74% and specificity of 70% at a score of 6.5. Net reclassification index (NRI) did not improve significantly (NRI 1.43% (− 0.50–3.37 p = 0.15). The combination of an easy to perform SAF measurement with age and BMI is a good alternative screening tool suitable for medical and non-medical settings. Parental history of diabetes did not significantly improve model performance in this homogeneous cohort.

IntroductionPulmonary arterial hypertension (PAH) and interstitial lung disease (ILD) are the leading causes of death in systemic sclerosis (SSc). Until now, no prospective biomarker to predict new onset of SSc-ILD or SSc-PAH in patients with SSc has reached clinical application. In homeostasis, the receptor for advanced glycation end products (RAGE) is expressed in lung tissue and involved in cell-matrix adhesion, proliferation and migration of alveolar epithelial cells, and remodeling of the pulmonary vasculature. Several studies have shown that sRAGE levels in serum and pulmonary tissue vary according to the type of lung-related complication. Therefore, we investigated levels of soluble RAGE (sRAGE) and its ligand high mobility group box 1 (HMGB1) in SSc and their abilities to predict SSc-related pulmonary complications.MethodsOne hundred eighty-eight SSc patients were followed retrospectively for the development of ILD, PAH, and mortality for 8 years. Levels of sRAGE and HMGB1 were measured in serum by ELISA. Kaplan-Meier survival curves were performed to predict lung events and mortality and event rates were compared with a log-rank test. Multiple linear regression analysis was performed to examine the association between sRAGE and important clinical determinants.ResultsAt baseline, levels of sRAGE were significantly higher in SSc-PAH-patients (median 4099.0 pg/ml [936.3-6365.3], p = 0.011) and lower in SSc-ILD-patients (735.0 pg/ml [IQR 525.5-1988.5], p = 0.001) compared to SSc patients without pulmonary involvement (1444.5 pg/ml [966.8-2276.0]). Levels of HMGB1 were not different between groups. After adjusting for age, gender, ILD, chronic obstructive pulmonary disease, anti-centromere antibodies, the presence of puffy fingers or sclerodactyly, use of immunosuppression, antifibrotic therapy, or glucocorticoids, and use of vasodilators, higher sRAGE levels remained independently associated with PAH. After a median follow-up of 50 months (25-81) of patients without pulmonary involvement, baseline sRAGE levels in the highest quartile were predictive of development of PAH (log-rank p = 0.01) and of PAH-related mortality (p = 0.001).ConclusionsHigh systemic sRAGE at baseline might be used as a prospective biomarker for patients with SSc at high risk to develop new onset of PAH. Moreover, high sRAGE levels could predict lower survival rates due to PAH in patients with SSc.

Brucellosis remains one of the most significant zoonotic diseases globally, responsible for both considerable human morbidity and economic losses due to its impacts on livestock productivity. Despite this, there remain significant evidence gaps in many low- and middle-income countries, including those of sub-Saharan Africa. Here we report the first molecular characterisation of Brucella sp. from Ethiopia. Fifteen Brucella sp. isolates from an outbreak in cattle from a herd in central Ethiopia were identified as Brucella abortus, using bacterial culture and molecular methods. Sequencing of the Ethiopian B. abortus isolates allowed their phylogenetic comparison with 411 B. abortus strains of diverse geographical origins, using whole genome single nucleotide polymorphisms (wgSNP). The Ethiopian isolates belonged to an early-branching lineage (Lineage A) previously only represented by data from two strains, both of sub-Saharan African origin (Kenya and Mozambique). A second B. abortus lineage (Lineage B), also comprised solely of strains originating from sub-Saharan Africa, was identified. The majority of strains belonged to one of two lineages of strains originating from a much broader geographical range. Further analyses based on multi-locus sequence typing (MLST) and multi-locus variable-number tandem repeat analysis (MLVA) expanded the number of B. abortus strains available for comparison with the Ethiopian isolates and were consistent with the findings from wgSNP analysis. MLST profiles of the Ethiopian isolates expanded the sequence type (ST) diversity of the early branching lineage of B. abortus, equivalent to wgSNP Lineage A. A more diverse cluster of STs, equivalent to wgSNP Lineage B, was comprised solely of strains originating from sub-Saharan Africa. Similarly, analysis of B. abortus MLVA profiles (n = 1891) confirmed that the Ethiopian isolates formed a unique cluster, similar to only two existing strains, and distinct from the majority of other strains of sub-Saharan African origin. These findings expand the known diversity of an under-represented lineage of B. abortus and suggest a potential evolutionary origin for the species in East Africa. In addition to providing information concerning Brucella species extant within Ethiopia this work serves as the basis for further studies on the global population structure and evolutionary history of a major zoonotic pathogen.

Abstract The relationship between intake of saturated fats and subclinical atherosclerosis, as well as the possible influence of genetic variants, is poorly understood and investigated. We aimed to investigate this relationship, with a hypothesis that it would be positive, and to explore whether genetics may modulate it, using data from a European cohort including 3,407 participants aged 54–79 at high risk of cardiovascular disease. Subclinical atherosclerosis was assessed by carotid intima-media thickness (C-IMT), measured at baseline and after 30 months. Logistic regression (OR; 95% CI) was employed to assess the association between high intake of food rich in saturated fat (vs. low) and: (1) the mean and the maximum values of C-IMT in the whole carotid artery (C-IMTmean, C-IMTmax), in the bifurcation (Bif-), the common (CC-) and internal (ICA-) carotid arteries at baseline (binary, cut-point ≥ 75th), and (2) C-IMT progression (binary, cut-point > zero). For the genetic-diet interaction analyses, we considered 100,350 genetic variants. We defined interaction as departure from additivity of effects. After age- and sex-adjustment, high intake of saturated fat was associated with increased C-IMTmean (OR:1.27;1.06–1.47), CC-IMTmean (OR:1.22;1.04–1.44) and ICA-IMTmean (OR:1.26;1.07–1.48). However, in multivariate analysis results were no longer significant. No clear associations were observed between high intake of saturated fat and risk of atherosclerotic progression. There was no evidence of interactions between high intake of saturated fat and any of the genetic variants considered, after multiple testing corrections. High intake of saturated fats was not independently associated with subclinical atherosclerosis. Moreover, we did not identify any significant genetic-dietary fat interactions in relation to risk of subclinical atherosclerosis.

Abstract Background Skin autofluorescence (SAF) is a non-invasive marker of tissue accumulation of advanced glycation endproducts (AGE). Recently, we demonstrated in the general population that elevated SAF levels predict the development of type 2 diabetes (T2D), cardiovascular disease (CVD) and mortality. We evaluated whether elevated SAF may predict the development of CVD and mortality in individuals with T2D. Methods We included 2349 people with T2D, available baseline SAF measurements (measured with the AGE reader) and follow-up data from the Lifelines Cohort Study. Of them, 2071 had no clinical CVD at baseline. 60% were already diagnosed with diabetes (median duration 5, IQR 2–9 years), while 40% were detected during the baseline examination by elevated fasting blood glucose ≥7.0 mmol/l) and/or HbA1c ≥6.5% (48 mmol/mol). Results Mean (±SD) age was 57 ± 12 yrs., BMI 30.2 ± 5.4 kg/m2. 11% of participants with known T2D were treated with diet, the others used oral glucose-lowering medication, with or without insulin; 6% was using insulin alone. Participants with known T2D had higher SAF than those with newly-detected T2D (SAF Z-score 0.56 ± 0.99 vs 0.34 ± 0.89 AU, p

Abstract Understanding why individuals with severe mental illness (Schizophrenia, Bipolar Disorder and Major Depressive Disorder) have increased risk of cardiometabolic disease (including obesity, type 2 diabetes and cardiovascular disease), and identifying those at highest risk of cardiometabolic disease are important priority areas for researchers. For individuals with European ancestry we explored whether genetic variation could identify sub-groups with different metabolic profiles. Loci associated with schizophrenia, bipolar disorder and major depressive disorder from previous genome-wide association studies and loci that were also implicated in cardiometabolic processes and diseases were selected. In the IMPROVE study (a high cardiovascular risk sample) and UK Biobank (general population sample) multidimensional scaling was applied to genetic variants implicated in both psychiatric and cardiometabolic disorders. Visual inspection of the resulting plots used to identify distinct clusters. Differences between these clusters were assessed using chi-squared and Kruskall-Wallis tests. In IMPROVE, genetic loci associated with both schizophrenia and cardiometabolic disease (but not bipolar disorder or major depressive disorder) identified three groups of individuals with distinct metabolic profiles. This grouping was replicated within UK Biobank, with somewhat less distinction between metabolic profiles. This work focused on individuals of European ancestry and is unlikely to apply to more genetically diverse populations. Overall, this study provides proof of concept that common biology underlying mental and physical illness may help to stratify subsets of individuals with different cardiometabolic profiles.

Viruses often encode proteins that mimic host proteins in order to facilitate infection. Little work has been done to understand the potential mimicry of the SARS-CoV-2, SARS-CoV, and MERS-CoV spike proteins, particularly the receptor-binding motifs, which could be important in determining tropism and druggability of the virus. Peptide and epitope motifs have been detected on coronavirus spike proteins using sequence homology approaches; however, comparing the three-dimensional shape of the protein has been shown as more informative in predicting mimicry than sequence-based comparisons. Here, we use structural bioinformatics software to characterize potential mimicry of the three coronavirus spike protein receptor-binding motifs. We utilize sequence-independent alignment tools to compare structurally known protein models with the receptor-binding motifs and verify potential mimicked interactions with protein docking simulations. Both human and non-human proteins were returned for all three receptor-binding motifs. For example, all three were similar to several proteins containing EGF-like domains: some of which are endogenous to humans, such as thrombomodulin, and others exogenous, such as Plasmodium falciparum MSP-1. Similarity to human proteins may reveal which pathways the spike protein is co-opting, while analogous non-human proteins may indicate shared host interaction partners and overlapping antibody cross-reactivity. These findings can help guide experimental efforts to further understand potential interactions between human and coronavirus proteins.

Abstract Background Advanced glycation end products (AGEs) are associated with aging, diabetes mellitus (DM), and other chronic diseases. Recently, the accumulation of AGEs can be evaluated by skin autofluorescence (SAF). However, the relationship between SAF levels and exercise capacity in patients with cardiovascular disease (CVD) remains unclear. This study aimed to investigate the association between the tissue accumulation of AGEs and clinical characteristics, including exercise capacity, in patients with CVD. Methods We enrolled 319 consecutive CVD patients aged ≥40 years who underwent early phase II cardiac rehabilitation (CR) at our university hospital between November 2015 and September 2017. Patient background, clinical data, and the accumulation of AGEs assessed by SAF were recorded at the beginning of CR. Characteristics were compared between two patient groups divided according to the median SAF level (High SAF and Low SAF). Results The High SAF group was significantly older and exhibited a higher prevalence of DM than the Low SAF group. The sex ratio did not differ between the two groups. AGE levels showed significant negative correlations with peak oxygen uptake and ventilator efficiency (both P

Objectives Living donor kidney transplantation is currently the preferred treatment for patients with end-stage renal disease. The psychosocial evaluation of kidney donor candidates relies mostly on the clinical viewpoint of transplant professionals because evidence-based guidelines for psychosocial donor eligibility are currently lacking. However, the accuracy of these clinical risk judgements and the potential added value of a systematic self-reported screening procedure are as yet unknown. The current study examined the effectiveness of the psychosocial evaluation by transplant professionals and the potential value of donor self-report measures in optimising the donor evaluation. Based on the stress-vulnerability model, the predictive value of predonation, intradonation and postdonation factors to impaired longer term health-related quality of life (HRQoL) of kidney donors was studied.Design An observational prospective multicentre study.Setting Seven Dutch transplantation centres.Participants 588 potential donors participated, of whom 361 donated. Complete prospective data of 230 donors were available. Also, 1048 risk estimation questionnaires were completed by healthcare professionals.Methods Transplant professionals (nephrologists, coordinating nurses, social workers and psychologists) filled in risk estimation questionnaires on kidney donor candidates. Furthermore, 230 kidney donors completed questionnaires (eg, on HRQoL) before and 6 and 12 months after donation.Primary and secondary outcome measures HRQoL, demographic and preoperative, intraoperative and postoperative health characteristics, perceived support, donor cognitions, recipient functioning and professionals risk estimation questionnaires.Results On top of other predictors, such as the transplant professionals’ risk assessments, donor self-report measures significantly predicted impaired longer term HRQoL after donation, particularly by poorer predonation physical (17%–28% explained variance) and psychological functioning (23%).Conclusions The current study endorses the effectiveness of the psychosocial donor evaluation by professionals and the additional value of donor self-report measures in optimising the psychosocial evaluation. Consequently, systematic screening of donors based on the most prominent risk factors provide ground for tailored interventions for donors at risk.

Raynaud’s Phenomenon (RP) leading to repetitive ischemia and reperfusion (IR) stress, is the first recognizable sign of systemic sclerosis (SSc) leading to increased oxidative stress. High-mobility group box-1 (HMGB1) is a nuclear factor released by apoptotic and necrotic cells after oxidative stress. Since HMGB1 can signal through the receptor for advanced glycation end products (RAGE), we investigated whether an RP attack promotes the release of HMGB1, leading to fibroblast activation and the upregulation of interferon (IFN)-inducible genes. A cold challenge was performed to simulate an RP attack in patients with SSc, primary RP (PRP), and healthy controls. We measured levels of HMGB1 and IFN gamma-induced Protein 10 (IP-10) at different time points in the serum. Digital perfusion was assessed by photoplethysmography. In vitro, HMGB1 or transforming growth factor (TGF-β1) (as control) was used to stimulate healthy human dermal fibroblasts. Inflammatory, profibrotic, and IFN-inducible genes, were measured by RT-qPCR. In an independent cohort, sera were obtained from 20 patients with SSc and 20 age- and sex-matched healthy controls to determine HMGB1 and IP-10 levels. We found that HMGB1 levels increased significantly 30 min after the cold challenge in SSc compared to healthy controls. In vitro stimulation with HMGB1 resulted in increased mRNA expression of IP-10, and interleukin-6 (IL-6) while TGF-β1 stimulation promoted IL-6 and Connective Tissue Growth Factor (CTGF). In serum, both HMGB1 and IP-10 levels were significantly higher in patients with SSc compared to healthy controls. We show that cold challenge leads to the release of HMGB1 in SSc patients. HMGB1 induces IP-10 expression in dermal fibroblasts partly through the soluble RAGE (sRAGE) axis suggesting a link between RP attacks, the release of HMGB1 and IFN-induced proteins as a putative early pathogenetic mechanism in SSc.

Mycobacterium bovis (M. bovis) is a causative agent of bovine tuberculosis, a significant source of morbidity and mortality in the global cattle industry. The Randomised Badger Culling Trial was a field experiment carried out between 1998 and 2005 in the South West of England. As part of this trial, M. bovis isolates were collected from contemporaneous and overlapping populations of badgers and cattle within ten defined trial areas. We combined whole genome sequences from 1,442 isolates with location and cattle movement data, identifying transmission clusters and inferred rates and routes of transmission of M. bovis. Most trial areas contained a single transmission cluster that had been established shortly before sampling, often contemporaneous with the expansion of bovine tuberculosis in the 1980s. The estimated rate of transmission from badger to cattle was approximately two times higher than from cattle to badger, and the rate of within-species transmission considerably exceeded these for both species. We identified long distance transmission events linked to cattle movement, recurrence of herd breakdown by infection within the same transmission clusters and superspreader events driven by cattle but not badgers. Overall, our data suggests that the transmission clusters in different parts of South West England that are still evident today were established by long-distance seeding events involving cattle movement, not by recrudescence from a long-established wildlife reservoir. Clusters are maintained primarily by within-species transmission, with less frequent spill-over both from badger to cattle and cattle to badger.

Table grape browning is a complex physiological disorder that occurs during cold storage. There is a need to investigate novel and innovative ways to manage the problem that hampers the progressive and sustainable growth of table grape industries. Given the complex nature of the browning phenomenon, techniques such as near-infrared (NIR) spectroscopy can be utilized for the non-destructive classification of different browning phenotypes. In this study, NIR coupled with partial least squares discriminant analysis (PLS-DA) and artificial neural networks (ANN) were used to classify bunches as either clear or as having chocolate browning and friction browning based on the spectra obtained from intact ‘Regal Seedless’ table grape bunches that were cold-stored over different periods. Friction browning appears as circular spots close to the pedicel area that are formed when table grape berries move against each other, and chocolate browning appears as discoloration, which originates mostly from the stylar-end of the berry, although the whole berry may appear brown in severe instances. The evaluation of the models constructed using PLS-DA was done using the classification error rate (CER), specificity, and sensitivity and for the models constructed using ANN, the kappa score was used. The CER for chocolate browning (25%) was better than that of friction browning (46%) for weeks 3 and 4 for both class 0 (absence of browning) and class 1 (presence of browning). Both the specificity and sensitivity of class 0 and class 1 for friction browning were not as good as that of chocolate browning. With ANN, the kappa score was tested to classify table grape bunches as clear or having chocolate browning or friction browning and showed that chocolate browning could be classified with a strong agreement during weeks 3 and 4 and weeks 5 and 6 and that friction browning could be classified with a moderate agreement during weeks 3 and 4. These results open up new possibilities for the development of quality checks of packed table grape bunches before export. This has a significant impact on the table grape industry for it will now be possible to evaluate bunches non-destructively during packaging to determine the possibility of these browning types being present when reaching the export market.

Background: Pneumococcal conjugate vaccines have reduced the incidence of invasive pneumococcal disease, caused by vaccine serotypes, but non-vaccine-serotypes remain a concern. We used whole genome sequencing to study pneumococcal serotype, antibiotic resistance and invasiveness, in the context of genetic background. Methods: Our dataset of 13,454 genomes, combined with four published genomic datasets, represented Africa (40%), Asia (25%), Europe (19%), North America (12%), and South America (5%). These 20,027 pneumococcal genomes were clustered into lineages using PopPUNK, and named Global Pneumococcal Sequence Clusters (GPSCs). From our dataset, we additionally derived serotype and sequence type, and predicted antibiotic sensitivity. We then measured invasiveness using odds ratios that relating prevalence in invasive pneumococcal disease to carriage. Findings: The combined collections (n = 20,027) were clustered into 621 GPSCs. Thirty-five GPSCs observed in our dataset were represented by >100 isolates, and subsequently classed as dominant-GPSCs. In 22/35 (63%) of dominant-GPSCs both non-vaccine serotypes and vaccine serotypes were observed in the years up until, and including, the first year of pneumococcal conjugate vaccine introduction.Penicillin and multidrug resistance were higher (p

Fourier-transform near infrared (FT-NIR) reflection spectra of intact berries of the grape variety Thompson seedless were used to predict total soluble solids (TSS) content. From an initial dataset, 12 subsets were considered by applying variable selection to extract the reflectance values at wavenumbers most correlated to the chemometrically measured TSS content. The datasets were processed by both multiple linear regression (MLR) and partial least squares (PLS) methods towards predicting the TSS content from the reflection values of each spectrum. Prediction accuracy was measured in terms of both the coefficient of determination R2 and the root mean squared error (RMSE). It was found that variable selection improved the prediction accuracy with both processing methods; values of R2 of up to 0.972 and 0.926 and RMSE of up to 0.306 and 0.472 were reported with MLR and PLS, respectively. The combination of variable selection and MLR displayed (a) higher accuracy when the spectra dataset variation was limited, (b) lower accuracy with datasets of large variation such as those with spectra from a variety of maturity stages, and (c) failed with more complex spectra sets such as those from different harvest years. The combination of variable selection and PLS has demonstrated reliable prediction results with various degrees of dataset complexity.

Reason: The article, Mlenga, D.H., Jordaan, A.J. Mandebvu, B., 2019, ‘Monitoring droughts in Eswatini: A spatiotemporal variability analysis using the Standard Precipitation Index’, Jàmbá: Journal of Disaster Risk Studies 11(1), a725. https://doi.org/10.4102/jamba.v11i1.725, published on 03 October 2019 in Jàmbá - Journal of Disaster Risk Studies has been retracted by agreement between the authors (Daniel H. Mlenga, Andries J. Jordaan and Brian Mandebvu), the Publisher (AOSIS) and the journal’s Editor-in-Chief, Prof. Dewald van Niekerk, because of duplicate publication. The second article was published on 24 October 2019 in the Jàmbá: Journal of Disaster Risk Studies (https://doi.org/10.4102/jamba.v11i1.712). We apologise for any inconvenience to the authors and readers of Jàmbá - Journal of Disaster Risk Studies.

In the last decade, Eswatini has been affected by moderate to severe droughts, leading to huge impacts on the economic, environmental and societal sectors. The frequency and magnitude of drought have also increased, emphasising on the importance of drought monitoring. In view of the impacts of drought, it is of critical importance to monitor drought in near real-time and provide early warning information to stakeholders. The challenge however is the fragmentation of climatic data collection, the lack of agreed indicators and the poor coordination amongst institutions resulting in drought management being reactive, or ‘crisis management’ approach. A paradigm shift to a more risk reduction approach is therefore required to enable cost-effective and timely response to drought disasters. The capacity to monitor and predict the drought attributes (onset, frequency, duration and severity) is fundamental for spatiotemporal (drought) monitoring. Based on a review of country and regional networks, this research developed an integrated drought monitoring and early warning framework for Eswatini. The framework incorporated an early warning response trigger threshold derived from an integration of the standardised precipitation index and normalised difference vegetation index. The adoption of the framework allows for early warning and early action to mitigate the consequences of drought disasters. Drought preparedness and risk mitigation will help lower the eventual drought relief costs, protect food security and reduce the humanitarian impact on the population.

Aims: Non-invasively assessed skin autofluorescence (SAF) measures advanced glycation endproducts (AGEs) in the dermis. SAF correlates with dermal AGEs in Caucasians and Asians, but studies in dark-skinned subjects are lacking. In this pilot we aimed to assess whether SAF signal is representative of intrinsic fluorescence (IF) and AGE accumulation in dark skin. Methods: Skin biopsies were obtained in 12 dark-skinned subjects (6 healthy subjects, median age 22 years; 6 diabetes mellitus (DM) subjects, 65 years). SAF was measured with the AGE Reader, IF using confocal microscopy, and AGE distribution with specific antibodies. CML and MG-H1 were quantified with UPLC-MS/MS and pentosidine with HPLC and fluorescent detection. Results: SAF correlated with IF from the dermis (405nm, r = 0.58, p < 0.05), but not with CML (r = 0.54, p = 0.07). CML correlated with IF from the dermis (405nm, r = 0.90, p < 0.01). UV reflectance and the coefficient of variation of SAF were negatively correlated (r = -0.80, p < 0.01). CML and MG-H1 were predominantly present around blood vessels, in collagen and fibroblasts in the dermis. Conclusion: This proof of concept study is the first to compare non-invasive SAF with AGE levels measured in skin biopsies in dark-skinned subjects. SAF did not correlate with individual AGEs from biopsies, but was associated with IF. However, the intra-individual variance was high, limiting its application in dark-skinned subjects on an individual basis.

ABSTRACT Streptococcus pneumoniae (pneumococcus) is a major human pathogen producing structurally diverse capsular polysaccharides. Widespread use of highly successful pneumococcal conjugate vaccines (PCVs) targeting pneumococcal capsules has greatly reduced infections by the vaccine types but increased infections by nonvaccine serotypes. Herein, we report a new and the 100th capsule type, named serotype 10D, by determining its unique chemical structure and biosynthetic roles of all capsule synthesis locus (cps) genes. The name 10D reflects its serologic cross-reaction with serotype 10A and appearance of cross-opsonic antibodies in response to immunization with 10A polysaccharide in a 23-valent pneumococcal vaccine. Genetic analysis showed that 10D cps has three large regions syntenic to and highly homologous with cps loci from serotype 6C, serotype 39, and an oral streptococcus strain (S. mitis SK145). The 10D cps region syntenic to SK145 is about 6 kb and has a short gene fragment of wciNα at the 5′ end. The presence of this nonfunctional wciNα fragment provides compelling evidence for a recent interspecies genetic transfer from oral streptococcus to pneumococcus. Since oral streptococci have a large repertoire of cps loci, widespread PCV usage could facilitate the appearance of novel serotypes through interspecies recombination. IMPORTANCE The polysaccharide capsule is essential for the pathogenicity of pneumococcus, which is responsible for millions of deaths worldwide each year. Currently available pneumococcal vaccines are designed to elicit antibodies to the capsule polysaccharides of the pneumococcal isolates commonly causing diseases, and the antibodies provide protection only against the pneumococcus expressing the vaccine-targeted capsules. Since pneumococci can produce different capsule polysaccharides and therefore reduce vaccine effectiveness, it is important to track the appearance of novel pneumococcal capsule types and how these new capsules are created. Herein, we describe a new and the 100th pneumococcal capsule type with unique chemical and serological properties. The capsule type was named 10D for its serologic similarity to 10A. Genetic studies provide strong evidence that pneumococcus created 10D capsule polysaccharide by capturing a large genetic fragment from an oral streptococcus. Such interspecies genetic exchanges could greatly increase diversity of pneumococcal capsules and complicate serotype shifts.

Carotid intima-media thickness (cIMT) and plaque are associated with subclinical atherosclerosis and coronary heart disease (CHD). Here, the authors identify and prioritize genetic loci for cIMT and plaque by GWAS and colocalization approaches and further demonstrate genetic correlation with CHD and stroke.

Eswatini, as the rest of southern Africa, is being frequented by drought over the last decade, and modelling experts are predicting that drought years will become more and severe. The expected increase in extreme climatic events makes the use of drought indices essential for drought monitoring and early warning. To enable Eswatini to better prepare, analyse and respond to drought, this study analysed the use of Normalised Difference Vegetation Index (NDVI) and Standard Precipitation Index (SPI) for near-real-time drought monitoring through the development of a model for drought severity. Meteorological stations across all agro-ecological zones with data for the period 1986–2017 were selected for analysis. The SPI computation was achieved through DrinC software. Primary NDVI data sources were CHIRPS gridded rainfall dataset and the MODIS NDVI CMG data. Results of the 3-month SPI indicated that moderate droughts were experienced in 1990/1991, 2005/2006, 2011/2012, 2012/2013 and 2015/2016. The Highveld and Middleveld had the lowest drought occurrence percentage of 3.3%, whereas the likelihood of having a moderate, severe and extreme drought was higher in the Lowveld. The study determined a positive correlation between the SPI and the NDVI at 3-month time scale, and a value of Y (drought severity) greater than 0.54 indicated a significant dry spell and could be used as a drought trigger threshold for early warning. The combined use of NDVI and SPI was deemed capable of providing a near-real-time indicator for drought conditions allowing planners to provide timely information for drought preparedness, mitigation and response planning, thereby helping to lower the eventual drought relief costs, protect food security and reduce the humanitarian impact on the population.

The determination of internal maturity parameters of table grape is usually done destructively using manual methods that are time-consuming. The possibility was investigated to determine whether key fruit attributes, namely, total soluble solids (TSS); titratable acidity (TA), TSS/TA, pH, and BrimA (TSS – k x TA) could be determined on intact table grape bunches using Fourier transform near-infrared (FT-NIR) spectroscopy and a contactless measurement mode. Partial Least Squares (PLS) regression models were developed for the maturity and sensory quality parameters using grapes obtained from two consecutive harvest seasons. Statistical indicators used to evaluate the models were the number of latent variables (LVs) used to build the model, the prediction correlation coefficient (R2p) and root mean square error of prediction (RMSEP). For the respective parameters TSS, TA, TSS/TA, pH, and BrimA, the LVs were 21, 23, 5, 7, and 24, the R2p = 0.71, 0.33, 0.57, 0.28, and 0.77, and the RMSEP = 1.52, 1.09, 7.83, 0.14, and 1.80. TSS performed best when moving smoothing windows (MSW) + multiplicative scatter correction (MSC) was used as spectral pre-processing technique, TA with standard normal variate (SNV), TSS/TA with Savitzky-Golay first derivative (SG1d), pH with SG1d, and BrimA with MSC. This study provides the first steps towards a completely nondestructive and contactless determination of internal maturity parameters of intact table grape bunches.

The spatiotemporal analysis of drought is of great importance to Eswatini as the country has been facing recurring droughts with negative impacts on agriculture, the environment and the economy. In 2016, the country experienced the most severe drought in over 35 years, resulting in food shortages, drying up of rivers as well as livestock deaths. The frequent occurrence of extreme drought events makes the use of drought indices essential for drought monitoring, early warning and planning. The aim of this study was to assess the applicability of the Standard Precipitation Index (SPI) for near real-time and retrospective drought monitoring in Eswatini. The 3-, 6- and 12-month SPI were computed to analyse the severity and onset of meteorological drought between 1986 and 2017. The results indicated that the climate of Eswatini exhibits geospatial and temporal variability. Droughts intensified in terms of frequency, severity and geospatial coverage, with the worst drought years being 1985–1986, 2005–2006 and 2015–2016 agricultural seasons. Moderate droughts were the most prevalent, while the frequency of severe and very severe droughts was low. Most parts of the country were vulnerable to mild and moderate agricultural droughts. Spatial analysis showed that the most severe and extreme droughts were mostly experienced in the Lowveld and Middleveld agro-ecological zones. The 3-, 6- and 12-month SPI computations conducted in January detected the onset of early season drought, thereby affirming the applicability of the index for monitoring near real-time and retrospective droughts in Eswatini. Drought monitoring using the SPI provides information for early warning, particularly in drought-prone areas, by depicting a drought before the effects are felt.

Data presented in this article are related to the research article entitled “A priori-defined Mediterranean-like dietary pattern predicts cardiovascular events better in north Europe than in Mediterranean countries” [Veglia et al., 2018]. Data contain information about the incidence of cardiovascular events in a high-risk European population (IMPROVE study) [Baldassarre et al., 2010, 2012, 2013]. Combined vascular events, as well as cardio- and cerebro-vascular events were stratified according to a priori-defined simple Mediterranean Diet (MD) score, based on just seven nutritional items (minimal adherence was 0 and maximal adherence was 7).

Abstract Raynaud's phenomenon (RP) is often the first sign of systemic sclerosis (SSc). Molecular mechanisms involved are incompletely understood, but reactive oxygen, nitrogen, and sulfur species are thought to play an important role in the pathogenesis of SSc. Free thiol groups play a protective role against oxidative stress and may represent an attractive therapeutic target. We aimed to investigate the effects of hypothermia‐induced vasoconstriction on the responsiveness of redox‐related markers. Thirty participants (n = 10/group [SSc, primary Raynaud's phenomenon (PRP), healthy controls (HC)]) were included in this study. Fingertip photoelectric plethysmography was performed during a standardized cooling and recovery experiment. Venous blood was collected at four predetermined time points. Free thiols, NO‐derived species (nitros(yl)ated species, nitrite, nitrate), sulfate and endothelin‐1 were measured. Lower baseline concentrations of free thiols were observed in PRP and SSc patients (HC: 5.87 [5.41–5.99] μmol/g; PRP: 5.17 [4.74–5.61]; SSc 5.28 [4.75–5.80], P = 0.04). Redox‐related markers remained unchanged during cooling. However, an unexpected increase in systemic free thiol concentrations was observed in all groups during the recovery phase. The response of this marker differed between groups, with a higher increase found in SSc patients (HC Δ = 1.30 [1.48–1.17]; PRP Δ = 1.04 [1.06–1.03]; SSc Δ = 1.72 [1.13–1.49], P = 0.04). NO‐derived species, sulfate and endothelin‐1 levels remained unchanged throughout the recovery phase. This exploratory study sheds light on the rapid responsiveness of systemic free thiol concentrations following reperfusion, which may reflect overall redox balance. The robust response to reperfusion in SSc patients suggests that reductive systems involved in this response are functionally intact in these patients.

Understanding the structure of a bacterial population is essential in order to understand bacterial evolution. Estimating the core genome (those genes common to all, or nearly all, strains of a species) is a key component of such analyses. The size and composition of the core genome varies by dataset, but we hypothesized that the variation between different collections of the same bacterial species would be minimal. To investigate this, we analyzed the genome sequences of 3,118 pneumococci recovered from healthy individuals in Reykjavik (Iceland), Southampton (United Kingdom), Boston (United States), and Maela (Thailand). The analyses revealed a “supercore” genome (genes shared by all 3,118 pneumococci) of 558 genes, although an additional 354 core genes were shared by pneumococci from Reykjavik, Southampton, and Boston. Overall, the size and composition of the core and pan-genomes among pneumococci recovered in Reykjavik, Southampton, and Boston were similar. Maela pneumococci were distinctly different in that they had a smaller core genome and larger pan-genome. The pan-genome of Maela pneumococci contained several >25 Kb sequence regions (flanked by pneumococcal genes) that were homologous to genomic regions found in other bacterial species. Overall, our work revealed that some subsets of the global pneumococcal population are highly heterogeneous, and our hypothesis was rejected. This is an important finding in terms of understanding genetic variation among pneumococci and is also an essential point of consideration before generalizing the findings from a single dataset to the wider pneumococcal population.

BACKGROUND:Bovine tuberculosis (bTB) caused by Mycobacterium bovis is a re-emerging problem in both livestock and humans. The association of some M. bovis strains with hyper-virulence, MDR-TB and disseminated disease makes it imperative to understand the biology of the pathogen. METHODS:Mycobacterium bovis (15) among 1755 M. tuberculosis complex (MTBC) isolated between 2012 and 2014 were characterized and analyzed for associated patient demography and other risk factors. Five of the M. bovis isolates were whole-genome sequenced and comparatively analyzed against a global collection of published M. bovis genomes. RESULTS:Mycobacterium bovis was isolated from 3/560(0.5%) females and 12/1195(1.0%) males with pulmonary TB. The average age of M. bovis infected cases was 46.8 years (7-72years). TB patients from the Northern region of Ghana (1.9%;4/212) had a higher rate of infection with M. bovis (OR = 2.7,p = 0.0968) compared to those from the Greater Accra region (0.7%;11/1543). Among TB patients with available HIV status, the odds of isolating M. bovis from HIV patients (2/119) was 3.3 higher relative to non-HIV patients (4/774). Direct contact with livestock or their unpasteurized products was significantly associated with bTB (p

The impact of cholesteryl ester transfer protein (CETP) on atherosclerosis is highly debated. This study aimed to investigate the associations between plasma CETP or CETP genotypes and carotid intima-media thickness (cIMT) and the influence of high-density lipoprotein cholesterol (HDL-C) on these associations. Plasma CETP and HDL-C concentrations were measured in 552 subjects free of any pharmacological treatment from the IMPROVE cohort, which includes 3711 European subjects at high cardiovascular risk. CETP single-nucleotide polymorphisms (SNPs) and cIMT measures (cIMTmax; cIMTmean–max of bifurcations, common and internal carotids; plaque-free common carotid [PF CC]-IMTmean) were available for the full cohort. In drug-free subjects, plasma CETP correlated with HDL-C levels (r = 0.19, p < 0.0001), but not with cIMT variables. When stratified according to HDL-C quartiles, CETP positively correlated with cIMTmax and cIMTmean–max, but not with PF CC-IMTmean, in the top HDL-C quartile only. Positive associations between the CETP concentration and cIMTmax or cIMTmean–max were found in the top HDL-C quartile, whereas HDL-C levels were negatively correlated with cIMTmax and cIMTmean–max when the CETP concentration was below the median (HDL-C × CETP interaction, p = 0.001 and p = 0.003 for cIMTmax and cIMTmean–max, respectively). In the full cohort, three CETP SNPs (rs34760410, rs12920974, rs12708968) were positively associated with cIMTmax. rs12444708 exhibited a significant interaction with HDL-C levels in the prediction of cIMTmax. In conclusion, a significant interplay was found between plasma CETP and/or CETP genotype and HDL-C in the prediction of carotid plaque thickness, as indexed by cIMTmax. This suggests that the association of HDL-C with carotid atherosclerosis is CETP-dependent.

Competition among bacterial members of the same ecological niche is mediated by bacteriocins: antimicrobial peptides produced by bacterial species to kill other bacteria. Bacteriocins are also promising candidates for novel antimicrobials. Streptococcus pneumoniae (the “pneumococcus”) is a leading cause of morbidity and mortality worldwide and a frequent colonizer of the human nasopharynx. Here, 14 newly discovered bacteriocin gene clusters were identified among >6,200 pneumococcal genomes. The molecular epidemiology of the bacteriocin clusters was investigated using a large global and historical pneumococcal dataset dating from 1916. These analyses revealed extraordinary bacteriocin diversity among pneumococci and the majority of bacteriocin clusters were also found in other streptococcal species. Genomic hotspots for the integration of different bacteriocin gene clusters were discovered. Experimentally, bacteriocin genes were transcriptionally active when the pneumococcus was under stress and when two strains were co-cultured in broth. These findings reveal much more diversity among bacterial defense mechanisms than previously appreciated, which fundamentally broaden our understanding of bacteriocins relative to intraspecies and interspecies nasopharyngeal competition and bacterial population structure.

Verilog-A is the de facto standard language that the semiconductor industry uses to define compact models. Unfortunately, it is easy to write models poorly in Verilog-A, and this can lead to unphysical model behavior, poor convergence, and difficulty in understanding and maintaining model codes. This paper details best practices for writing compact models in Verilog-A, to try to help raise the quality of compact modeling throughout the industry.

Even though the significance of indigenous knowledge in agriculture is internationally recognised, the role thereof in disaster risk reduction in South Africa is not well documented. This article determined the influence of indigenous knowledge in drought risk reduction in O.R. Tambo district of the Eastern Cape province (South Africa). Primary data were collected from 87 communal farmers through purposive sampling using a structured questionnaire. Focus group discussions were also held with the target group (farmers and extension officers) to gain more information and clarification on indigenous knowledge. The finding indicated that the majority of respondents (64.4%) relied on indigenous knowledge in their farming practice and drought risk reduction. Two-thirds (66.7%) of the respondents revealed that indigenous knowledge contributed to the resilience of farmers towards drought. The respondents unanimously agreed that indigenous knowledge is losing its significance in farming and drought risk reduction, because the younger generation did not value it anymore. Lack of documentation and deterioration of its application by the younger generation were found to be the main challenge for most respondents. The study concluded that indigenous knowledge was still an integral part of agricultural practices, applied drought risk reduction strategies and contributed to resilience against disasters. Based on the findings, the study recommends that indigenous knowledge be compiled, documented and published so that all farmers can learn of effective farming practices, passed on from generation to generation. Community holders of such information are encouraged to make younger generations aware of the benefits of indigenous knowledge to promote its usage.

Recent advances in highly multiplexed immunoassays have allowed systematic large-scale measurement of hundreds of plasma proteins in large cohort studies. In combination with genotyping, such studies offer the prospect to 1) identify mechanisms involved with regulation of protein expression in plasma, and 2) determine whether the plasma proteins are likely to be causally implicated in disease. We report here the results of genome-wide association (GWA) studies of 83 proteins considered relevant to cardiovascular disease (CVD), measured in 3,394 individuals with multiple CVD risk factors. We identified 79 genome-wide significant (p

PURPOSE:Advanced glycation endproducts (AGEs) and their precursors α-dicarbonyls are implicated in the progression of diabetic retinopathy. The purpose of this study was to assess AGEs and α-dicarbonyls in the vitreous of patients with type 2 diabetes mellitus (T2DM) with early stages or absence of diabetic retinopathy. METHODS:We examined vitreous samples obtained during vitrectomy from 31 T2DM patients presenting themselves with rhegmatogenous retinal detachment and compared these to 62 non-diabetic rhegmatogenous retinal detachment patients, matched on age, estimated glomerular filtration rate, smoking, intra-ocular lens implantation, and proliferative vitreoretinopathy. AGEs (pentosidine, Nε-(carboxymethyl)lysine, Nε-(carboxyethyl)lysine, and 5-hydro-5-methylimidazolone) and α-dicarbonyls (3-deoxyglucosone, methylglyoxal, and glyoxal) were measured by ultra performance liquid chromatography or high performance liquid chromatography. Skin autofluorescence was measured by the AGE Reader. RESULTS:Mean age was 64 ± 7.6 years for T2DM patients and 63 ± 8.1 years for controls. For T2DM patients, median diabetes duration was 2.2 (0.3-7.4) years. Non-proliferative diabetic retinopathy was present in 1 patient and classified as absent or background retinopathy in 30 patients. Vitreous levels of pentosidine (2.20 vs. 1.59 μmol/mol lysine, p = 0.012) and 3-deoxyglucosone (809 vs. 615 nmol/L, p = 0.001) were significantly elevated in T2DM patients compared to controls. Other AGEs and α-dicarbonyls in the vitreous were not significantly different. There was a trend for increased skin autofluorescence in T2DM patients as compared to controls (p = 0.07). CONCLUSIONS:Pentosidine and 3-deoxyglucosone concentrations were increased in the vitreous of rhegmatogenous retinal detachment patients with a relatively short duration of diabetes compared to non-diabetic rhegmatogenous retinal detachment patients.

The aim of this article was to assess and identify social vulnerability of communal farmers to drought in the O.R. Tambo district in the Eastern Cape province of South Africa using a survey data and social vulnerability index (SoVI). Eleven social vulnerability indicators were identified using Bogardi, Birkman and Cardona conceptual framework. The result found that an SoVI estimated for O.R. Tambo district was very high with a Likert scale of 5 for cultural values and practices, security or safety, social networks, social dependence, preparedness strategies and psychological stress attributed for the high value of social vulnerability to drought. Indigenous knowledge and education had an SoVI value of 2, which was of low vulnerability, contributing positively to resilience to drought. The study also found that government involvement in drought risk reduction is limited; as a result, the study recommends that a national, provincial and district municipalities policy on drought risk reduction and mitigation should be developed.

The primary aim of this experiment was to evaluate the intestinal barrier permeability in vivo in rainbow trout (Oncorhynchus mykiss) fed increasing levels of soyabean meal (SBM). The relationship between SBM-induced enteritis (SBMIE) and the permeability markers was also investigated. Our results showed that the mean score of morphological parameters was significantly higher as a result of 37·5 % SBM inclusion in the diet, while the scores of fish fed 25 % SBM or lower were not different from those of the fish meal-fed controls (P

Advanced glycation end products (AGEs) have been implicated in multiple organ failure, predominantly via their cellular receptor (RAGE) in preclinical studies. Little is known about the time course and prognostic relevance of AGEs in critically ill human patients, including those with severe sepsis.1) To explore the reliability of Skin Autofluorescence (AF) as an index of tissue AGEs in ICU patients, 2) to compare its levels to healthy controls, 3) to describe the time course of AGEs and influencing factors during ICU admission, and 4) to explore their association with disease severity, outcome, and markers of oxidative stress and inflammation.Skin AF, serum N"-(carboxyethyl)lysine (CEL), N"-(carboxymethyl)lysine (CML), and soluble RAGE (sRAGE) were serially measured for a maximum of 7 days in critically ill ICU patients with multiple organ failure and compared to age-matched healthy controls. Correlations with (changes in) clinical parameters of disease severity, LDL dienes, and CRP were studied and survival analysis for in-hospital mortality was performed.Forty-five ICU patients (age: 59±15 years; 60% male), and 37 healthy controls (59±14; 68%) were included. Skin AF measurements in ICU patients were reproducible (CV right-left arm: 13%, day-to-day: 10%), with confounding effects of skin reflectance and plasma bilirubin levels. Skin AF was higher in ICU patients vs healthy controls (2.7±0.7 vs 1.8±0.3 au; p

The study assessed the knowledge, attitudes and practices of cholera prevention and preparedness in Ga-Mampuru village (Limpopo, South Africa). Interviewers collected data using a two-pronged method, namely a household questionnaire (open- and closed-ended questions) to assess knowledge and attitudes about cholera and observations to assess practices in the prevention and management of the disease. Additionally, interviewers took pictures with the respondents’ permission. Ninety-six respondents were interviewed. Most respondents (86%) indicated they knew how cholera was contracted with 84% indicating contaminated water as a source. Ninety percent of the respondents indicated they knew how to prevent contracting cholera. All respondents generally knew that cholera could be treated with medicine received at a health-care facility or worker. Fewer respondents (58%) had specific knowledge such as the use of rehydration solutions. The respondents’ high level of prevention practices could be biased. Interviewers observed that many practices were not adhered to, like not washing hands, not using toilet paper and throwing waste in respondents’ yards. Therefore, the community of Ga-Mampuru had not reached a stage of adequate cholera prevention and preparedness in spite of the fact that they were aware of cholera risks and risk-reduction measures.

Legislation that governs the health and safety of communities near major-hazard installations in South Africa is largely based on existing legislation that had been developed in the United Kingdom and other European Union countries. The latter was developed as a consequence of several major human-induced technological disasters in Europe. The history of the evolution of health-and-safety legislation for the protection of vulnerable communities in European Union (EU) countries, France, Malaysia and the USA is explored through a literature survey. A concise comparison is drawn between EU countries, the USA and South Africa to obtain an exploratory view of whether current South-African legislation represents an optimum model for the protection of the health-and-safety of workers and communities near major-hazard installations. The authors come to the conclusion that South-African legislation needs revision as was done in the UK in 2011. Specific areas in the legislation that need revision are an overlap between occupational health and safety and environmental legislation, appropriate land-use planning for the protection of communities near major-hazard installations, the inclusion of vulnerability studies and the refinement of appropriate decision-making instruments such as risk assessment. This article is the first in a series that forms part of a broader study aimed at the development of an optimised model for the regulatory management of human-induced health and safety risks associated with hazardous installations in South Africa.

Background: The prevalence of HIV in specific areas of South Africa and its impact on haematological parameters are largely unknown.Objectives: To (1) describe the prevalence of HIV, (2) stage HIV based on CD4 counts, and (3) determine haematological parameters amongst participants in Mangaung, Free State Province.Method: Blood specimens were obtained from 419 participants in formal and informal settlements in Mangaung. Participants were 25–64 years of age; 23.4% were male. Males and females were a mean of 45.1 and 44.3 years of age, respectively. Screening for HIV status was performed. Positive results were confirmed by a second test. Full blood counts were performed on all participants, and CD4 counts only on HIV-positive serum.Results: The overall prevalence of HIV was 40.8%. The highest prevalence occurred in the 31–40 years age group, with 38.4% of females and 39.5% of males being infected. More than 33% of HIV-uninfected participants were 51–60 years of age. No significant change in CD4 count with age was observed, probably because 19.1% of the 225 respondents who reported using medication were receiving antiretroviral (ARV) treatment. Haematological results showed that HIV-infected participants had significantly reduced values for haemoglobin, leukocytes, neutrophils and lymphocytes, compared to HIV-uninfected participants. The mean corpuscular volume (MCV) was significantly higher in HIV-infected participants.Conclusions: A high prevalence of HIV-infection was found. Anaemia and significantly reduced white blood cell counts were observed in the HIV-infected group. No significant change in CD4 counts with age was observed and could possibly be attributed to ARV therapy.

Background: Chronic lifestyle diseases share similar modifiable risk factors, including hypertension, tobacco smoking, diabetes, obesity, hyperlipidaemia and physical inactivity. Metabolic syndrome refers to the cluster of risk factors that increases the risk for developing type 2 diabetes mellitus (DM) and cardiovascular disease.Objectives: The study aimed to assess health status and identify distinct risk-factor profiles for both chronic lifestyle diseases and metabolic syndrome in rural and urban communities in central South Africa.Methods: The investigation formed part of the Assuring Health for All in the Free State (AHA-FS) study. During interviews by trained researchers, household socio-demographic and health information, diet, risk factors (i.e. history of hypertension and/or diabetes) and habits (e.g. smoking and inadequate physical activity levels) were determined. Adult participants underwent anthropometric evaluation, medical examination and blood sampling. Results: The risk-factor profile for chronic lifestyle diseases revealed that self-reported hypertension and physical inactivity were ranked the highest risk factor for the rural and urban groups respectively. The cumulative risk-factor profile showed that 40.1% of the rural and 34.4% of the urban study population had three or more risk factors for chronic lifestyle diseases. Furthermore, 52.2% of rural and 39.7% of urban participants had three or more risk factors for metabolic syndrome.Conclusion: This study confirmed that the worldwide increase in the prevalence of chronic lifestyle diseases can be attributed to a more sedentary lifestyle, illustrated in the urban study population, and increasing obesity. The rural study population had a higher prevalence of risk factors for metabolic syndrome.

Lecithin:cholesterol acyltransferase (LCAT) is the enzyme responsible for cholesterol esterification in plasma. LCAT is a major factor in HDL remodeling and metabolism, and it has long been believed to play a critical role in macrophage reverse cholesterol transport (RCT). The effect of LCAT on human atherogenesis is still controversial. In the present study, the plasma LCAT concentration was measured in all subjects (n = 540) not on drug treatment at the time of enrollment in the multicenter, longitudinal, observational IMPROVE study. Mean and maximum intima-media thickness (IMT) of the whole carotid tree was measured by B-mode ultrasonography in all subjects. In the entire cohort, LCAT quartiles were not associated with carotid mean and maximum IMT (P for trend 0.95 and 0.18, respectively), also after adjustment for age, gender, HDL-cholesterol (HDL-C), and triglycerides. No association between carotid IMT and LCAT quartiles was observed in men (P=0.30 and P=0.99 for mean and maximum IMT, respectively), whereas carotid IMT increased with LCAT quartiles in women (P for trend 0.14 and 0.019 for mean and maximum IMT, respectively). The present findings support the concept that LCAT is not required for an efficient reverse cholesterol transport and that a low plasma LCAT concentration and activity is not associated with increased atherosclerosis.

The bacterial core genome is of intense interest and the volume of whole genome sequence data in the public domain available to investigate it has increased dramatically. The aim of our study was to develop a model to estimate the bacterial core genome from next-generation whole genome sequencing data and use this model to identify novel genes associated with important biological functions. Five bacterial datasets were analysed, comprising 2096 genomes in total. We developed a Bayesian decision model to estimate the number of core genes, calculated pairwise evolutionary distances (p-distances) based on nucleotide sequence diversity, and plotted the median p-distance for each core gene relative to its genome location. We designed visually-informative genome diagrams to depict areas of interest in genomes. Case studies demonstrated how the model could identify areas for further study, e.g. 25% of the core genes with higher sequence diversity in the Campylobacter jejuni and Neisseria meningitidis genomes encoded hypothetical proteins. The core gene with the highest p-distance value in C. jejuni was annotated in the reference genome as a putative hydrolase, but further work revealed that it shared sequence homology with beta-lactamase/metallo-beta-lactamases (enzymes that provide resistance to a range of broad-spectrum antibiotics) and thioredoxin reductase genes (which reduce oxidative stress and are essential for DNA replication) in other C. jejuni genomes. Our Bayesian model of estimating the core genome is principled, easy to use and can be applied to large genome datasets. This study also highlighted the lack of knowledge currently available for many core genes in bacterial genomes of significant global public health importance.

INTRODUCTION: Advanced glycation endproducts (AGEs) may be involved in the development of atherosclerosis, beyond diabetes and renal disease. Skin autofluorescence (AF) is a non-invasive marker for AGEs. We examined whether skin AF is increased in (subclinical) atherosclerosis and associated with the degree of atherosclerosis independent of diabetes and renal function. METHODS: A cross-sectional study of 223 patients referred for primary (n = 163) or secondary (n = 60) prevention between 2006 and 2012 was performed. Skin AF was measured using the AGE-Reader. Ultrasonography was used to assess plaques in carotid and femoral arteries and computed tomography for the calculation of the coronary artery calcium score (CACS; in primary prevention only). Primary prevention patients were divided into a group with subclinical atherosclerosis defined as >1 plaque or CACS>100 (n = 67; age 53 year [interquartile range 48-56]; 49% male) and without (controls; 96; 43 [38-51]; 55%). Secondary prevention were patients with peripheral arterial disease (60; 64 [58-70]; 73%). RESULTS: Skin AF was higher in subclinical and clinical atherosclerosis compared with controls (skin AF 2.11 [interquartile range 1.83-2.46] and 2.71 [2.15-3.27] vs. 1.87 [1.68-2.12] respectively; P = 0.005 and

Diabetes (DM) and impaired glucose tolerance (IGT) detection are conventionally based on glycemic criteria. Skin autofluorescence (SAF) is a noninvasive proxy of tissue accumulation of advanced glycation endproducts (AGE) which are considered to be a carrier of glycometabolic memory. We compared SAF and a SAF-based decision tree (SAF-DM) with fasting plasma glucose (FPG) and HbA1c, and additionally with the Finnish Diabetes Risk Score (FINDRISC) questionnaire±FPG for detection of oral glucose tolerance test (OGTT)- or HbA1c-defined IGT and diabetes in intermediate risk persons.Participants had ≥1 metabolic syndrome criteria. They underwent an OGTT, HbA1c, SAF and FINDRISC, in adition to SAF-DM which includes SAF, age, BMI, and conditional questions on DM family history, antihypertensives, renal or cardiovascular disease events (CVE).218 persons, age 56 yr, 128M/90F, 97 with previous CVE, participated. With OGTT 28 had DM, 46 IGT, 41 impaired fasting glucose, 103 normal glucose tolerance. SAF alone revealed 23 false positives (FP), 34 false negatives (FN) (sensitivity (S) 68%; specificity (SP) 86%). With SAF-DM, FP were reduced to 18, FN to 16 (5 with DM) (S 82%; SP 89%). HbA1c scored 48 FP, 18 FN (S 80%; SP 75%). Using HbA1c-defined DM-IGT/suspicion ≥6%/42 mmol/mol, SAF-DM scored 33 FP, 24 FN (4 DM) (S76%; SP72%), FPG 29 FP, 41 FN (S71%; SP80%). FINDRISC≥10 points as detection of HbA1c-based diabetes/suspicion scored 79 FP, 23 FN (S 69%; SP 45%).SAF-DM is superior to FPG and non-inferior to HbA1c to detect diabetes/IGT in intermediate-risk persons. SAF-DM's value for diabetes/IGT screening is further supported by its established performance in predicting diabetic complications.

Objectives: The objectives of this study were firstly to determine HIV (human immunodeficiency virus) prevalence in the rural Free State, secondly to classify the stages of HIV by utilising CD4 (cluster of differentiation 4) counts, and thirdly to measure differences in haematological abnormalities between HIV-uninfected and HIV-infected participants. Method: Blood specimens were obtained from 552 participants in Springfontein (36.3%), Trompsburg (30.1%) and Philippolis (33.5%). Participants were between 25–64 years of age, of which 28.1% were male (mean age 47.3 years) and 71.9% were female (mean age 46.0 years). The primary screening for HIV status was performed using the Enzygnost® HIV Integral II Ag/Ab test and confirmed by the Vironostica® HIV Uni-Form II Ag/Ab test. Full blood counts were performed on all participants, but CD4 counts were only performed on HIV-positive serum. Results: The overall prevalence of HIV was 17.1%, with the peak prevalence in female participants (41.3%) occurring in the age group of 31–40 years, and in male participants (37.9%) in the age group of 41–50 years. Most HIV-uninfected participants (40.9%) were 51–60 years of age, whilst most HIV-infected participants were 31–40 years (35.6%) of age. The lowest mean CD4 count (276 cells/mm3) was observed in the age group 41–50 years, which was significantly lower than a mean count of 459 cells/mm3 in the age group 31–40 years (p ≤ 0.05). Haemoglobin was significantly reduced in HIV-infected male participants (p < 0.01) and female participants (p < 0.000 1), as ware white blood cell counts (p < 0.001), neutrofil counts (p < 0.005) and lymphocyte counts (p < 0.005). Peak prevalence of HIV in terms of age occurred later (between 31–40 years) than previously described and was reflected by a delayed low CD4 count (41–50 years). Conclusion: The low CD4 counts and anaemia were probably indicative of a generally ill study population. Participants in need of medical care should be identified and referred for management and follow-up.

BACKGROUND: Most longitudinal studies showed increased relative mortality in individuals with type 2 diabetes mellitus until now. As a result of major changes in treatment regimes over the past years, with more stringent goals for metabolic control and cardiovascular risk management, improvement of life expectancy should be expected. In our study, we aimed to assess present-day life expectancy of type 2 diabetes patients in an ongoing cohort study. METHODOLOGY AND PRINCIPAL FINDINGS: We included 973 primary care type 2 diabetes patients in a prospective cohort study, who were all participating in a shared care project in The Netherlands. Vital status was assessed from May 2001 till May 2007. Main outcome measurement was life expectancy assessed by transforming actual survival time to standardised survival time allowing adjustment for the baseline mortality rate of the general population. At baseline, mean age was 66 years, mean HbA(1c) 7.0%. During a median follow-up of 5.4 years, 165 patients died (78 from cardiovascular causes), and 17 patients were lost to follow-up. There were no differences in life expectancy in subjects with type 2 diabetes compared to life expectancy in the general population. In multivariate Cox regression analyses, concentrating on the endpoints 'all-cause' and cardiovascular mortality, a history of cardiovascular disease: hazard ratio (HR) 1.71 (95% confidence interval (CI) 1.23-2.37), and HR 2.59 (95% CI 1.56-4.28); and albuminuria: HR 1.72 (95% CI 1.26-2.35), and HR 1.83 (95% CI 1.17-2.89), respectively, were significant predictors, whereas smoking, HbA(1c), systolic blood pressure and diabetes duration were not. CONCLUSIONS: This study shows a normal life expectancy in a cohort of subjects with type 2 diabetes patients in primary care when compared to the general population. A history of cardiovascular disease and albuminuria, however, increased the risk of a reduction of life expectancy. These results show that, in a shared care environment, a normal life expectancy is achievable in type 2 diabetes patients.