Harrowing is often used to reduce weed competition, generally using a constant intensity across a whole field. The efficacy of weed harrowing in wheat and barley can be optimized, if site-specific conditions of soil, weed infestation and crop growth stage are taken into account. This study aimed to develop and test an algorithm to automatically adjust the harrowing intensity by varying the tine angle and number of passes. The field variability of crop leaf cover, weed density and soil density was acquired with geo-referenced sensors to investigate the harrowing selectivity and crop recovery. Crop leaf cover and weed density were assessed using bispectral cameras through differential images analysis. The draught force of the soil opposite to the direction of travel was measured with electronic load cell sensor connected to a rigid tine mounted in front of the harrow. Optimal harrowing intensity levels were derived in previously implemented experiments, based on the weed control efficacy and yield gain. The assessments of crop leaf cover, weed density and soil density were combined via rules with the aforementioned optimal intensities, in a linguistic fuzzy inference system (LFIS). The system was evaluated in two field experiments that compared constant intensities with variable intensities inferred by the system. A higher weed density reduction could be achieved when the harrowing intensity was not kept constant along the cultivated plot. Varying the intensity tended to reduce the crop leaf cover, though slightly improving crop yield. A real-time intensity adjustment with this system is achievable, if the cameras are attached in the front and at the rear or sides of the harrow.

Intermittent claudication (IC) is pain caused by chronic occlusive arterial disease, that develops in a limb during exercise and is relieved with rest. Buflomedil is a vasoactive agent used to treat peripheral vascular disease. However, its clinical efficacy for IC has not yet been critically examined. This is an update of a Cochrane review first published in 2000, and previously updated in 2007 and 2008.To evaluate the available evidence on the efficacy of buflomedil for IC.For this update the Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched January 2013) and CENTRAL (2012, Issue 12).Double-blinded, randomized controlled trials (RCTs) in patients with IC (Fontaine stage II) receiving oral buflomedil compared with placebo. Pain-free walking distance (PFWD) and maximum walking distance (MWD) were analysed by standardized exercise test.Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information.We included two RCTs with 127 participants. Both RCTs showed moderate improvements in PFWD for patients on buflomedil. This improvement was statistically significant for both trials (WMD 75.1 m, 95% confidence interval (CI) 20.6 to 129.6; WMD 80.6 m, 95% CI 3.0 to 158.2), the latter being a wholly diabetic population. For both RCTs, MWD gains were statistically significant with wide confidence intervals (WMD 80.7 m, 95% CI 9.4 to 152; WMD 171.4 m, 95% CI 51.3 to 291.5), respectively.There is little evidence available to evaluate the efficacy of buflomedil for IC. Most trials were excluded due to poor quality. The two included trials showed moderately positive results; these are undermined by publication bias since we know of at least another four unpublished, irretrievable, and inconclusive studies.Buflomedil's benefit is small in relation to safety issues and its narrow therapeutic range.

The frequency of candidiasis has increased dramatically in recent years. Candida albicans is the most common species. However, other species which are pathogenic and resistant to usual antifungal agents beginning to emerge. These include Candida dubliniensis and Candida africana, which share morphological similarities with Candida albicans. Thus, it is of interest to correctly identify the fungal isolates.To seek these new species among Candida strains isolated in Dakar.Oropharyngeal and vaginal swabs were performed at Fann Universitary Hospital in Dakar. The strains were identified by the germ tube test, the chlamydospore production test and an auxanogram. Then identification by PCR targeting the hyphal wall protein 1(hwp1) gene, was performed for the discrimination between Candida albicans, Candida dubliniensis and Candida africana.In total, 243 yeasts were isolated from samples including 231 in vaginal swab and 12 in oropharyngeal swab. Species identified by phenotypic methods are Candida albicans, which is the most frequent, Candida tropicalis, Candida glabrata, Candida dubliniensis, Candida kefyr and Candida lusitaniae. PCR performed on the 150 strains germ tube test positive identifies three Candida africana, 109 Candida albicans and no strain of Candida dubliniensis.This study isolates Candida africana for the first time in Senegal. Further studies on a larger sample will better know the actual proportion of these three species among the isolated yeasts.

Preclinical studies have shown synergistic antitumour activity by inhibition of insulin-like growth factor-1 receptor (IGF-1R) and mTOR. The expression of IGF-1R seems to be crucial for this effect. We investigated the safety and efficacy of the combination of the IGF-1R antibody cixutumumab and the mTOR inhibitor temsirolimus in patients with chemotherapy-refractory bone and soft-tissue sarcomas according to IGF-1R expression by immunohistochemistry.We undertook a multicentre, open-label, phase 2 study in 19 cancer centres in the USA. Patients aged at least 16 years with a histologically confirmed diagnosis of bone or soft-tissue sarcoma were allocated on the basis of IGF-1R expression by immunohistochemistry to one of three treatment groups: IGF-1R-positive soft-tissue sarcoma (group A), IGF-1R-positive bone sarcomas (group B), or IGF-1R-negative bone and soft-tissue sarcoma (group C). Patients received weekly treatment with cixutumumab (6 mg/kg, intravenous) and temsirolimus (25 mg, intravenous flat dose) in 6-week cycles. A Simon optimal two-stage design was used for every arm. The primary endpoint was progression-free survival (PFS) at 12 weeks by intention-to-treat analysis in the first 54 patients assigned to every treatment arm. Although patients still remain on treatment, this trial has completed enrolment and this represents the final analysis. This study is registered with ClinicalTrials.gov, number NCT01016015.Between Nov 18, 2009, and April 11, 2012, 388 patients were screened for IGF-1R expression and 54 were assigned to each arm. 17 of 54 patients in the IGF-1R-positive soft-tissue sarcoma group (31%; one-sided 95% CI lower bound 21%; two-sided 90% CI 21-43), 19 of 54 in IGF-1R-positive bone sarcoma group (35%; one-sided 95% CI lower bound 24%; two-sided 90% CI 24-47), and 21 of 54 in the IGF-1R-negative group (39%, one-sided 95% CI lower bound 28%; two-sided 90% CI 28-51) were progression free at 12 weeks. On April 6, 2011, the protocol was amended to include three additional patients in the IGF-1R-positive soft-tissue sarcoma group (total of 57 patients) and nine more in the IGF-1R-negative group (total of 63 patients). There were 2546 adverse events reported during the study, 214 (8%) of which were grade 3-4. The most common grade 3-4 toxicities in the 174 treated patients were anaemia in 16 (9%) patients, hyperglycaemia in 18 (10%), hypophosphataemia in 16 (9%), lymphopenia in 25 (14%), oral mucositis in 19 (11%), and thrombocytopenia in 19 (11%).The combination of cixutumumab and temsirolimus shows clinical activity in patients with sarcoma and forms a basis for future trials. However, IGF-1R expression by immunohistochemistry is not predictive of clinical outcome after treatment with this combination.National Cancer Institute and CycleforSurvival Fund, Memorial Sloan-Kettering Cancer Center.

OBJECTIVE:

To investigate the effect of peripheral neuropathy and cognition on gait performance in older adults with type 2 diabetes mellitus.

DESIGN:

Cross-sectional study.

SETTING:

Community and residential aged care setting.

PARTICIPANTS:

Older adults (N=101; 56 patients with diabetes, 28 with peripheral neuropathy and 28 without peripheral neuropathy; and 45 matched controls).

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

Spatiotemporal gait parameters were recorded under 3 conditions: simple, counting backward by 3 from 40, and reciting animal names. The Mini-Mental State Examination and the clock drawing test were used to estimate cognitive impairment levels.

RESULTS:

Compared with controls, older adults with diabetes walked slower, took shorter strides during all walking conditions, and showed more gait variability especially during dual-task conditions. Gait patterns did not differ between participants suffering from diabetes mellitus with and without neuropathy. Compared with normal walking, dual-task conditions affected all gait parameters similarly in all groups. Backward counting affected gait more than animal naming in participants with diabetes but not in healthy controls. Additional analyses in older adults with diabetes showed that participants with impaired cognitive function walked slower, took shorter strides, had shorter double support time, and increased gait variability compared with participants with intact cognitive function.

CONCLUSIONS:

This study showed that gait parameters are affected in older adults with type 2 diabetes. Gait was further affected by reduced cognitive function, irrespective of the presence of neuropathy.

BACKGROUND:

The purpose of Occupational Therapy (OT) educational programs is to graduate effective clinicians who join the job market with competencies consistent with the expected entry-level practice. To attain an effective process of clinical competence development, OT educational programs design competence-based curricula to instill pre-licensure readiness in their graduating students for entry-level work-related practice.

OBJECTIVES:

The purpose of the study was to perform a retrospective outcome competence assessment for evaluating OT students participating in the first three consecutive offerings of a graduate seminar intended to assess and increase pre-licensure skills and knowledge required for entry-level evidence-based work-related practice. The assessment examined differences in post vs. pre-seminar National Board Certificate Occupational Therapy (NBCOT) practice test score caused by (a) main time of test-taking effect; (b) main class effect; and (c) tine and class interaction effect.

PARTICIPANTS:

62 students.

METHODS:

A total of 62 students who graduated from the program during the three academic years 2008, 2009 and 2010 participated in the study.

RESULTS:

Post vs. pre-seminar NBCOT practice test score was significantly higher across the three-year period and increased significantly in each of the three classes. Interaction effect did not alter the pattern of post vs. pre-seminar score increase in each class.

CONCLUSIONS:

The significant time and class main effects validated the effectiveness of the seminars in increasing post vs. pre-seminar practice test score in each of the three classes. The significant time x class interaction effect validated the pattern of post vs. pre-seminar score increase regardless of the class sequence.

There are still uncertainties about the role of the hippocampus (HPC) in memory consolidation. One theory, systems consolidation, states that the HPC is required for the initial storage of certain memories that subsequently become established in non-HPC networks through a lengthy process, involving an interaction with the HPC. A similar process may underlie the ability of multiple, distributed learning episodes of contextual fear conditioning to create a HPC-independent context fear memory, in a memory task that does not undergo systems consolidation with the mere passage of time [5]. The current study examined whether post-learning HPC activity is necessary to establish these HPC-independent context memories through distributed learning episodes. Rats received either three or six context conditioning sessions over the course of three days. The HPC-dependence of context memories was assessed using multisite, temporary inactivation of the HPC using ropivacaine during retention testing. We established that six conditioning sessions, but not three, created a memory that could be retrieved while the HPC was inactive. To directly test our hypothesis, HPC was inactivated after half of the six context-shock pairings in an independent group of rats. The rats were then tested for retention of context fear in the absence of HPC activity. Post-learning inactivation of the HPC did not affect the establishment of a HPC-independent context memory. These results favor the idea that at least one memory system outside the HPC can acquire context memories independently.

Cancer is a growing co-morbidity among HIV-infected patients worldwide. With the scale-up of antiretroviral therapy (ART) in developing countries, cancer will contribute more and more to the HIV/AIDS disease burden. Our objective was to estimate the association between HIV infection and selected types of cancers among patients hospitalized for diagnosis or treatment of cancer in West Africa.A case-referent study was conducted in referral hospitals in Côte d'Ivoire and Benin. Each participating clinical ward enrolled all adult patients seeking care for a confirmed diagnosis of cancer and clinicians systematically proposed an HIV test. HIV prevalence was compared between AIDS-defining cancers and a subset of selected non-AIDS defining cancers to a referent group of non-AIDS defining cancers not reported in the literature to be positively or inversely associated with HIV. An unconditional logistic model was used to estimate odds ratios (OR) and their 95% confidence intervals (CI) of the risk of being HIV-infected for selected cancers sites compared to a referent group of other cancers.The HIV overall prevalence was 12.3% (CI 10.3-14.4) among the 1,017 cancer cases included. A total of 442 patients constituted the referent group with an HIV prevalence of 4.7% (CI 2.8-6.7). In multivariate analysis, Kaposi sarcoma (OR 62.2 [CI 22.1-175.5]), non-Hodgkin lymphoma (4.0 [CI 2.0-8.0]), cervical cancer (OR 7.9 [CI 3.8-16.7]), anogenital cancer (OR 11.6 [CI 2.9-46.3]) and liver cancer (OR 2.7 [CI 1.1-7.7]) were all associated with HIV infection.In a time of expanding access to ART, AIDS-defining cancers remain highly associated with HIV infection. This is to our knowledge, the first study reporting a significant association between HIV infection and liver cancer in sub-Saharan Africa.

We sought to document the association of Human immunodeficiency Virus (HIV) infection and immunodeficiency with oncogenic Human Papillomavirus (HPV) infection in women with no cervical neoplastic lesions identified through a cervical cancer screening programme in Côte d'Ivoire.A consecutive sample of women stratified on their HIV status and attending the national blood donor clinic or the closest HIV clinic was recruited during a cervical cancer screening programme based on the visual inspection. Diagnosis of HPV infection and genotype identification were based on the Linear Array; HPV test.A total of 445 (254 HIV-positive and 191 HIV-negative) women were included. The prevalence of oncogenic HPV infection was 53.9% (95% confidence interval (CI) 47.9-59.9) in HIV-positive women and 33.7% (95% CI 27.1-40.3) in HIV-negative women (odds ratio (OR)=2.3 (95% CI 1.5-3.3)). In multivariate analysis, HIV-positive women with a CD4 count <200 cells mm(3) or between 200 and 499 cells mm(3) were more likely to harbour an oncogenic HPV compared with women with a CD4 count ≥500 cells mm(3) with OR of 2.8 (95% CI 1.1-8.1) and 1.7 (95% CI 1.0-2.9), respectively.A high prevalence of oncogenic HPV was found in women with no cervical neoplastic lesions, especially in HIV-positive women. Despite antiretroviral use, immunodeficiency was a main determinant of the presence of oncogenic HPV.

The incidence of syphilis in Denmark is rising. In 2010, 377 new cases of syphilis were reported, 36 of these cases in women. Since January 1st 2010 all pregnant women are offered an antenatal syphilis test. This resulted in the finding of seven cases of syphilis among pregnant women in 2010. This article summarises the clinical and serological findings in syphilis and describes the treatment of the disease, with focus on pregnancy and congenital infection.