Factors related to human-vector contact that modify the likelihood of malaria transmission during a contained Plasmodium falciparum outbreak in Praia, Cabo Verde.

Background: Determining the reproductive rate and how it varies over time and space (RT) provides important insight to understand transmission of a given disease and inform optimal strategies for controlling or eliminating it. Estimating RT for malaria is difficult partly due to the widespread use of interventions and immunity to disease masking incident infections. A malaria outbreak in Praia, Cabo Verde in 2017 provided a unique opportunity to estimate RT directly, providing a proxy for the intensity of vector-human contact and measure the impact of vector control measures. Methods: Out of 442 confirmed malaria cases reported in 2017 in Praia, 321 (73%) were geolocated and informed this analysis. RT was calculated using the joint likelihood of transmission between two cases, based on the time (serial interval) and physical distance (spatial interval) between them. Log-linear regression was used to estimate factors associated with changes in RT, including the impact of vector control interventions. A geostatistical model was developed to highlight areas receptive to transmission where vector control activities could be focused in future to prevent or interrupt transmission. Results: The RT from individual cases ranged between 0 and 11 with a median serial- and spatial-interval of 34 days [interquartile range (IQR): 17-52] and 1,347 m (IQR: 832-1,985 m), respectively. The number of households receiving indoor residual spraying (IRS) 4 weeks prior was associated with a reduction in RT by 0.84 [95% confidence interval (CI) 0.80-0.89; p-value <0.001] in the peak-and post-epidemic compared to the pre-epidemic period. Conclusions: Identifying the effect of reduced human-vector contact through IRS is essential to determining optimal intervention strategies that modify the likelihood of malaria transmission and can inform optimal intervention strategies to accelerate time to elimination. The distance within which two cases are plausibly linked is important for the potential scale of any reactive interventions as well as classifying infections as imported or introduced and confirming malaria elimination.

Advanced cervical cancer therapy: concurrent radiation therapy and cisplatin chemotherapy for advanced cervical cancer--a toxicity report.

It is estimated that in 1988 there will be 12,900 cancers of the uterine cervix, representing 2.6% of cancers in women. Radiation therapy has been the primary mode of therapy/palliation; for the past 15-20 years survival results achieved with radiotherapy have plateaued. Attempts have been made to find agents to use with radiation aimed at decreasing recurrence and increasing survival. Phase II studies suggest cisplatin may be an excellent agent to combine with radiotherapy. This study was performed to evaluate the toxicity of this combination. Between December 10, 1980, and August 29, 1986, nine patients with advanced cervical cancer and poor prognosis and one patient with recurrent disease were enrolled. The Gynecologic Oncology Group (GOG) criteria for adverse effects were used in this study. Hematologic, gastrointestinal, genitourinary, and skin parameters were examined. Most adverse criteria had a score of 2 or less. Grade 2 nausea/vomiting was the most frequent problem. Anemia was the next most frequent and was the most serious problem encountered. Overall, the toxicity was acceptable; therefore it seems appropriate to proceed to larger studies to evaluate efficacy.

Guanine modification during chemical DNA synthesis.

Base modification during solid-phase phosphoramidite synthesis of oligodeoxynucleotides has been investigated. We have discovered chemical modification that converts dG and dG-containing oligomers to a fluorescent form. This modification has been linked to N,N-dimethylaminopyridine (DMAP), an acylation catalyst, which can displace phosphate triester adducts at the 6-position of guanine. Further, we have found that this fluorescent intermediate can be converted in ammonium hydroxide solution to 2,6 diaminopurine deoxyribonucleoside (2,6 DAP), a potentially mutagenic nucleoside analog. We have shown that N-methylimidazole (NMI) in place of DMAP eliminates the fluorescent species and reduces 2,6 DAP contamination.

Ideologies and intervention strategies in an urban sample of drug-abuse agencies.

The study assessed the usefulness of a "levels of analysis" criterion for distinguishing ideological orientations in an urban sample of agencies working with drug-abuse clients: 39 directors reported on their programs' goals, and on their personal philosophies about the causes of drug-abuse problems. The authors used Frank and Atkins' procedures to classify goals and philosophies based on individual, family/group, or social systems levels of analysis. As predicted, agency goals better accounted for program and organizational differences than directors' philosophies: Agencies with social systems level goals characteristically combined advocacy strategies with community networking and outreach activities. However, an unexpected finding was that agencies with individual level goals were most likely to work with poor and minority clients. The discussion emphasizes the importance of an ideological/organizational/community context for evaluating intervention strategies in community-based agencies.