To investigate the possibility of West Nile virus (WNV) introduction into South Korea, the National Veterinary Research and Quarantine Service has conducted nationwide surveillance of WNV activity in dead wild birds since 2005. Surveillance conducted during 2005–2008 found no evidence of WNV activity. Wild birds are considered the principal hosts of West Nile virus (WNV). In the United States, surveillance of birds for WNV is used to quickly detect outbreaks and take action against its spread. The sampling of sick or dead birds can indicate WNV in a region before human and equine cases occur (Aegypius monachus) in the Vladivostok region of Russia, which is adjacent to the Korean peninsula (Bubulcus ibis) in the Russian Far Eastern Region during 2002–2004 , cinereous vultures, bean geese , and white-fronted geese , fly from Russia to South Korea during the winter for the breeding season , which have been identified as potential sources of WNV for resident birds  and included samples from dead wild birds. A total of 715 wild birds (belonging to 72 species) from all regions of South Korea were found dead and were examined during 2005–2008. All carcasses underwent postmortem examination, during which samples were obtained for diagnosis. In 2005, a total of 51 samples were tested; 167 samples were tested in 2006, 239 in 2007, and 258 in 2008. Taxonomic families of the collected birds and their migratory status are shown in Carcasses were subjected to necropsy, and brains and kidneys were obtained. Organs were homogenized in phosphate-buffered saline (10% suspension) and centrifuged. Ten 50% tissue culture infectious doses of a stock WNV were used as a control for antigen detection. WNV RNA in samples was investigated by reverse transcription–PCR with primers (Table). Information on the RNA extraction and the reverse transcription–PCR used is available in the During 2005–2008, we analyzed 1,309 organ samples (639 brain and 670 kidney) from dead birds for WNV RNA. WNV was not detected in these samples. Diagnostic examination of wild birds as a part of the nationwide surveillance has not detected patterns or clusters of birds with evidence of neurologic disease or viral encephalitides suggestive of WNV infection. Several cases of mass die-offs among wild birds were the result of chemical poisoning (Our surveillance of wild birds conducted during 2005–2008 supports the hypothesis that WNV has not reached South Korea and corroborates findings of previous reports. In a study conducted at the National Institute of Health, Korea Centers for Disease Control and Prevention, 2,275 pools of mosquitoes were tested for WNV RNA; results for all samples obtained during 2006–2008 were negative (Although our surveillance found no evidence of WNV in South Korea, WNV could be introduced into this country in the near future. Moreover, several species of mosquitoes with the ability to transmit WNV have been identified in South Korea. Turell et al. reported that mosquitoes captured in Paju County, Gyeonggi Province, South Korea, were highly susceptible to WNV infection when they fed on viremic chickens (Introduction of WNV into South Korea would undoubtedly become a major public health problem. An outbreak similar to the one that occurred in New York during 1999 could result in the disease becoming endemic to the country. Continued surveillance of dead wild birds is essential to enable prompt detection of WNV. Additionally, WNV surveillance programs in South Korea should continue to examine cases of viral encephalitis in horses and mass deaths among birds. Temperature increases caused by climate change should also be taken into account, and vigilant monitoring of emerging arboviruses, in addition to WNV, will be required. Finally, increased cooperation between the government and other agencies, such as wildlife conservation organizations and horse-racing authorities, is needed for early detection of WNV disease and development of effective veterinary and public health strategies.Reverse Transcription PCR Methods.


Stress and anxiety are endemic problems in western societies and have negative effects on health, wellbeing and cognitive function. Low Energy Neurofeedback System (LENS) is a form of Neurofeedback (NFB) with promising clinical reports supporting its use in addressing these problems. However, research is needed, and this exploratory study was conducted to test compliance; evaluate an innovative blinding procedure and outcome-measure inventories; provide data to calculate sample size and power; and collect preliminary evidence on efficacy of LENS for addressing stress, anxiety and cognitive function in medical students.We utilized a randomized, double-blind, placebo controlled design, and recruited twenty medical students from the National College of Natural Medicine, aged 25-58. Participants were randomized to a series of six LENS (n=10) or sham treatments (n=10) over a period of seven weeks. Exploratory outcome measures included the Perceived Stress Scale (PSS), State and Trait Anxiety Inventory (STAI), Wechsler Abbreviated Scale of Intelligence (WASI), Trail Making Test A and B test (TMT), and the Brown Peterson Task (BPT).Of 20 participants, 17 attended all sessions, one missed a single session, and two were dropped from the study. All participants and blinded researchers reported remaining blinded throughout the study. Power analysis of each outcome measure showed greatest sensitivity using the PSS and STAI State form. No significant between group changes were observed with any outcome measures.The study design and novel blinding procedure were successful for maintaining participant compliance and blinding. The tests utilized to assess cognitive function are likely not sensitive enough for our study population, which consisted of highly functional individuals. However, the PSS and STAI questionnaires may be sensitive and useful tools for evaluating efficacy of LENS in a future appropriately powered trial. Further study with a larger sample is necessary for assessing efficacy of LENS treatment.


Recently an increased attention has been focused on the development of green methods for the purpose of improving rate and selectivity of this reaction. In recent years, ionic liquids (ILs) have gained a lot of attention as green solvents in organic synthesis and other chemical processes. This is mainly due to their favorable inherent properties such as chemical and thermal stability, no measurable vapor pressure, nontoxicity, nonflammability, catalytic ability, high polarity, ease to recycle, etc. Diels–Alder reactions of isoprene 1) and acrylic acid (2)  basis set and the obtained results are in good agreement with experimental outcomes.


The construction of comprehensive reference libraries is essential to foster the development of DNA barcoding as a tool for monitoring biodiversity and detecting invasive species. The looper moths of British Columbia (BC), Canada present a challenging case for species discrimination via DNA barcoding due to their considerable diversity and limited taxonomic maturity.By analyzing specimens held in national and regional natural history collections, we assemble barcode records from representatives of 400 species from BC and surrounding provinces, territories and states. Sequence variation in the barcode region unambiguously discriminates over 93% of these 400 geometrid species. However, a final estimate of resolution success awaits detailed taxonomic analysis of 48 species where patterns of barcode variation suggest cases of cryptic species, unrecognized synonymy as well as young species.A catalog of these taxa meriting further taxonomic investigation is presented as well as the supplemental information needed to facilitate these investigations. For monitoring biodiversity and detecting invasive species, knowing what species exist in a given location is paramount. However, the subtle morphological characters that separate closely related species often demand expert interpretation e.g. , forcingTo continue the development of DNA barcoding as a tool for biodiversity monitoring and invasive species detection, it is necessary to both construct complete reference libraries and assess their efficacy for discriminating species. The taxa for which barcoding delivers results that are discordant with current taxonomy are of particular interest — they generally warrant further investigation as they may represent overlooked species Alsophila pometaria (Harris)) and invasive pests such as the winter moth (Operophtera brumata (L.)). Because most larvae and adults possess cryptic coloration, they are a notoriously tough group in which to discriminate species. To further complicate matters, most North American geometrid genera are in need of revision. This latter gap is now being addressed through an ‘integrative approach’ The loopers or inchworm moths (Lepidoptera: Geometridae) are one of the largest insect families, composed of nearly 23,000 species worldwide The geometrids of British Columbia (BC), Canada present a challenging case for DNA barcoding. There are presently 349 species known from the province — a large fauna with varying levels of taxonomic maturity (JRD unpublished). In this study, we assemble representatives of nearly all these species, from BC and the surrounding region, and from geographically separated individuals, to examine patterns of barcode divergence. We test the hypothesis that the barcode region is able to reliably discriminate geometrid species as demonstrated in other taxa see  and deteCallizzia amorata Packard (Epipleminae), the sole BC representative of the Uraniidae, sister group to the Geometridae , Royal BC Museum , Canadian Forest Service , University of British Columbia's Spencer Collection , Washington State University's James Entomological Collection , University of Idaho's WFBARR Collection , Northern Forestry Centre  and University of Alberta's Strickland Collection . An effort was made to sample at least five geographically distinct specimens for each species, to best appraise the genetic variation across its range. Specimens less than 30 years old were chosen when possible to avoid problems associated with DNA degradation. Some of the specimens may have been misidentified due to the difficulty of the group and lack of an expert curator in most of the collections. Where availability of taxonomic literature and time permitted, species identifications were corrected prior to or following DNA analysis by examining genitalia and external morphology of the vouchered specimens. In addition, a few specimens were freshly collected on targeted collecting trips, or by making requests to entomologists in the region. All specimens were labeled, databased and imaged and made publicly available on the Barcode of Life Data Systems (BOLD) c oxidase I (COI) gene followed a variety of high-throughput techniques recently developed at the Canadian Centre for DNA Barcoding (www.barcodinglife.ca). The full-length primers LepF1 and LepR1 One or two legs were removed from each dried specimen and stored in an individual tube of a 96-tube sample box (Matrix Technologies) or an individual well of a microplate. DNA extraction, amplification, and sequencing of the barcode region of the mitochondrial cytochrome sensuTo investigate the efficacy of barcodes to differentiate geometrid species, sequence divergence within and between species was calculated using the Kimura 2-parameter model Minoa murinata (Scopoli)). Of the 349 species listed for BC (JRD unpublished), only Hydrelia brunneifasciata (Packard) was not successfully barcoded. Most species were represented by multiple samples , but 62 species had only a single COI barcode. All but nine sequences were greater than 500 bp  and therefore meet the ‘BARCODE data standard’  or surrounding provinces, territories and states (N = 966). The remainder was collected in other North American regions (N = 35) and from a single German specimen  suggesting our sampling strategy was representative for all taxa. There were 26 instances of high intra-specific divergence (>3%) among the 338 species with multiple samples  was 16-fold higher than mean intraspecific variation , the distributions of intra- and interspecific divergences showed limited overlap . There w samples . Of thes samples . ConversIn summary, two tangible products have arisen from the current study. First, a comprehensive reference library was constructed for the Geometridae of British Columbia that can be employed immediately for biodiversity monitoring and invasive species detection. This library provides species-level resolution in over 93% of cases, and resolution to a congeneric species pair or group in the remaining cases. This small proportion of recognized taxa that apparently do not possess diagnostic barcodes, as well the fraction of species potentially housing cryptic species, constitutes the second product — a catalog of taxa that require taxonomic investigation. Moreover, this catalog includes the materials necessary to facilitate the investigations — a database of specimens vouchered in permanent collections, each linked to publicly available genetic and collateral data. Used in combination, these components can accelerate integrative taxonomic studies Figure S1Neighbour-joining tree for 400 species of Geometridae and Uraniidae from British Columbia, Canada and surrounding provinces, territories and states. BOLD process IDs and collection localities are provided for each sequence.(PDF)Click here for additional data file.Table S1List of specimens analyzed in the present study. Specimen accessions, BOLD process IDs, GenBank accessions, collection localities, and the storing institution are provided for each specimen.(PDF)Click here for additional data file.


Differences between women and men in political and economic empowerment, education, and health risks are well-documented. Similar gender inequities in access to care and medicines have been hypothesized but evidence is lacking.We analyzed 2002 World Health Survey data for 257,922 adult respondents and 80,932 children less than 5 years old from 53 mostly low and middle-income countries. We constructed indicators of need for, access to, and perceptions of care, and we described the number of countries with equal and statistically different proportions of women and men for each indicator. Using multivariate logistic regression models, we estimated effects of gender on our study outcomes, overall and by household poverty.Women reported significantly more need for care for three of six chronic conditions surveyed, and they were more likely to have at least one of the conditions . Among those with reported need for care, there were no consistent differences in access to care between women and men overall  or by household poverty. Of concern, access to care for chronic conditions was distressingly low among both men and women in many countries, as was access to preventive services among boys and girls less than 5 years old.These cross-country results do not suggest a systematic disadvantage of women in access to curative care and medicines for treating selected chronic conditions or acute symptoms, or to preventive services among boys and girls. Gender differences have become a key global concern. Governments Increased risk of death among women from child birth, unsafe abortion, gender-related violence, and sexually transmitted diseases including HIV infection This research uses large-scale survey data to address the following questions: Are there systematic gender differences in need for and access to treatment for chronic and acute conditions among adults; or in access to preventive or curative care among children under 5 years old?The study was determined to be exempt from human subjects review by the Human Studies Committee of Harvard Pilgrim Health Care.We used data from the World Health Survey (WHS) The adult respondent answered mostly closed-ended questions about health problems, care seeking, and care received for themselves and for the youngest child under 5 years old in the household; they also provided information about household characteristics including assets, expenditures, and insurance coverage of members. We have previously reported on household access to care, burden of health care expenditures, and household risk protection For the present analysis, we constructed indicators of need for care; access to care and medicines; and perceptions of the health care system.adults' need for health care and medicines, we assessed reports of moderate, bad, or very bad health and moderate, severe, or extreme limitations in daily activities; having ever been diagnosed with or in the past 12 months experienced symptoms of one or more of six chronic conditions ; and needing care in the past year for acute symptoms . The target chronic conditions included in the WHS were selected due to a high global burden of disease and were assessed using questions from established survey tools, where available To describe children's need for care as the youngest child less than 5 years in the household having ever experienced fever, diarrhoea, or another illness.We defined adult respondents, we defined access to care and medicines for a chronic condition as having received medications or other treatments during the past two weeks for the six target chronic conditions. For those who reported need for acute care in the past year, we defined overall access to acute care as receiving care when last needed for high fever, severe diarrhoea, or cough and access to medicines as getting all or most medicines prescribed during the last health care encounter for conditions generally treatable with medicines .For children under 5 years, we defined access to care according to specific measures in the WHS, namely having received: at least one Vitamin A capsule in the past 12 months; one measles and at least one diphtheria, tetanus, or whooping cough (DPT) vaccination; all three DPT vaccinations; or care for fever, diarrhoea, or any other illness when last needed. We also defined access to malaria treatment in children as having received any treatment for malaria and an antimalarial prescribed by a medical professional during the last episode of fever.For perceptions of care: one indicator of satisfaction with “the way health care runs” in their country and indicators of perceived discrimination based on feelings of having been treated worse by outpatient health care providers because of gender, type of illness, social class, or lack of money.We defined several measures of respondents' We characterized households and respondents according to socioeconomic and demographic characteristics, including: household size greater than or equal to 6 members; having a household member age 60 years and older and/or a child under 5 years; highest education of any household member as none or less than primary school; household wealth in the lowest two income quintiles based on household assets (described as “poor”); urban location; coverage of household members  by mandatory or voluntary health insurance; and respondent age , marital status, and education .The WHS employed a complex survey design with differing weights, stratification, and clustering in each country. Our descriptive within-country analyses adjust for the survey design where possible, using sample weights provided with the data. We describe results for men and women respondents and for girls and boys, both for all households and separately for poor households.We used multi-country individual-level logistic regression models (without country-level survey sampling weights) to explore the relationships between gender and need for care, access to care and medicines, and perceptions of care. To assess whether gender effects differed by household poverty, we included gender and poverty interaction terms in the models and estimated gender effects among those in the lowest two income quintiles (“poor”) versus the other three income quintiles (“non-poor”). We also used robust variance estimation In all multivariate analyses, estimates of gender differences are adjusted for the household and respondent characteristics listed above. Since we selected household and respondent characteristics on conceptual grounds, we did not apply variable elimination strategies. We used SAS version 9.1 for the analyses and p<0.05 as the significance threshold. Study data were provided in de-identified country datasets by the WHO.We analyzed data from 257,922 adult respondents and 80,932 children less than 5 years old from 53 mostly low and middle income countries More than one-third of respondents rated their health as moderate, bad, or very bad. The percentage of individuals reporting chronic conditions varied across countries, but was generally small , S5, S6.Across countries, larger proportions of women reported need for care than men . In moreIn more than half of the countries, significantly greater percentages of women reported diagnoses of arthritis, angina , and depIn multivariate analyses , women wAcross countries, generally less than half of adults diagnosed with a chronic condition reported receiving medication or other treatments in the past 2 weeks . Women aIn multivariate analyses, women with arthritis, asthma, and depression reported receiving medication treatment for these conditions significantly more frequently than men. The genders did not differ significantly in access to medications for all chronic conditions measured, or for angina, schizophrenia, and diabetes; in access to acute care when last needed; or in access to prescribed medicines during the last encounter .Of interest, women were significantly more likely to report being satisfied with their country's health care system than men. There were no gender differences in perceptions of discrimination in outpatient care due to gender; but women were significantly less likely than men to report perceived discrimination due to type of illness, social class, or lack of money .Rates of immunization and Vitamin A coverage varied greatly across countries; of concern, in half of countries, only 50% or less of children under 5 years old received at least one measles and DPT vaccine or Vitamin A prophylaxis . In mostFor all child and most adult care variables studied, the effect of gender did not differ significantly by household poverty . For theIn light of well-known gender gaps in health, education, economic participation and opportunity, and political empowerment Based on a standardized survey of large populations of adults and children from 53 countries in six regions, our results suggest that women in many countries report significantly more need for health care and medicines than men. However, contrary to expectations, we did not find consistent differences across countries in indicators of access to treatment between women and men needing care. Similarly, there were few significant differences in selected indicators of access to preventive or curative care for children. In addition, gender and care relationships among poor households were similar to those among non-poor households. Thus, although situations in individual countries How can we explain the discrepancy between our findings and prior expectations of gender inequities disadvantaging women? First, adult respondents to the WHS were a heterogeneous group both within and across countries in terms of health needs, access to care, and their determinants; thus, noise could have masked statistical relationships between gender and access to care. Further, relatively few respondents reported chronic conditions, which may in part be due to self-reported ascertainment of these conditions in the WHS. Given self-reported need for chronic care, relatively few respondents reported having access to care. Similarly, in some countries, larger than expected proportions of children under 5 years of age were reported to not have been sick. Thus, samples could have been too small to detect significant gender differences. However, given the overall large WHS sample sizes and number of countries, we would expect to see consistent trends emerge to support evidence of gender inequity, either overall or among the poor; yet our analyses do not show such trends. In addition, we cannot exclude differential reporting of symptoms, diagnoses, or treatments between men and women; given the heterogeneity of cultures represented in the survey, such differences may have biased our results toward the Null.We did not examine areas of widely-reported health disadvantages for women, such as physical and sexual violence, sexually transmitted diseases, HIV/AIDS, or pregnancy and child birth and cannot comment on possible inequity in access to care for these health needs or on the social factors that might increase women's health risks Our findings that women report equal or greater prevalence of common health problems and equal access to needed care is consistent with evidence from a number of recent studies, including a report on management of diabetes and cardiovascular risk factors in seven countries Several factors may increase rates of diagnoses and access to care among women. Women have more frequent interactions with the health care system, both because of reproductive health needs and because they serve as family caregivers. They may thus have more opportunity for diagnosis and treatment of the types of acute and chronic conditions we studied. In addition, female community health care workers may facilitate access to care for women Importantly, the low reported levels of chronic and preventive care for both women and men are disconcerting. For example, in 10 of 52 countries with sufficient data, less than a third of adults with diagnosed diabetes reported treatment. With the prevalence of chronic conditions increasing, health system interventions to enable affordable access to long-term therapy are urgently needed From these data, we cannot know whether women and men utilize the same providers or receive the same quality of health care. Gender-stratified assessment of the management of chronic conditions in seven countries seemed to indicate more ineffective management of blood glucose, blood pressure, and hypercholesterolemia among women with diabetes in four low and middle income countries We also do not know whether women and men faced similar circumstances when negotiating access to care within households and health care systems, or experienced the same economic consequences of accessing care. Given that women generally have less power and are poorer than men The WHO has called for increased attention to gender and poverty in health research More empirical studies are needed to provide evidence about the interrelationships of gender, poverty, and access to health care and medicines, while social and behavioural studies are needed to understand reasons for differences where they exist, negative impacts on health, and potential mechanisms to redress them. These interrelationships are likely to differ by culture, geography, health system structure, and extent of social protection. Given the dearth of empirical literature, we need studies in a wider variety of settings to begin to disentangle the distinct roles of poverty and gender in determining perceptions of illness, patterns of care seeking, access to services, quality of the care, clinical effectiveness, economic impacts, and consumer satisfaction. Documenting specific gender differences in medicines access, use, and affordability would highlight key policy issues and potential solutions to achieve gender equity.Table S1Arthritis diagnosis and treatment.(XLSX)Click here for additional data file.Table S2Angina diagnosis and treatment.(XLSX)Click here for additional data file.Table S3Asthma diagnosis and treatment.(XLSX)Click here for additional data file.Table S4Depression diagnosis and treatment.(XLSX)Click here for additional data file.Table S5Schizophrenia diagnosis and treatment.(XLSX)Click here for additional data file.Table S6Diabetes diagnosis and treatment.(XLSX)Click here for additional data file.Table S7Need for and access to care among adults.(XLSX)Click here for additional data file.Table S8Need for and access to care among children.(XLSX)Click here for additional data file.


Controlling behavior is more common and can be equally or more threatening than physical or sexual violence. This study sought to determine the role of husband/partner controlling behavior and power relations within intimate relationships in the lifetime risk of physical and sexual violence in Nigeria.This study used secondary data from a cross-sectional nationally-representative survey collected by face-to-face interviews from women aged 15 - 49 years in the 2008 Nigeria Demographic and Health Survey. Utilizing a stratified two-stage cluster sample design, data was collected frrm 19 216 eligible with the DHS domestic violence module, which is based on the Conflict Tactics Scale (CTS). Multivariate logistic regression analysis was used to determine the role of husband/partner controlling behavior in the risk of ever experiencing physical and sexual violence among 2877 women aged 15 - 49 years who were currently or formerly married or cohabiting with a male partner.Women who reported controlling behavior by husband/partner had a higher likelihood of experiencing physical violence , and women resident in rural areas and working in low status occupations had increased likelihood of experiencing physical IPV. Controlling behavior by husband/partner was associated with higher likelihood of experiencing physical violence . In addition, women who justified wife beating and earned more than their husband/partner were at higher likelihood of experiencing physical and sexual violence. In contrast, women who had decision-making autonomy had lower likelihood of experiencing physical and sexual violence.Controlling behavior by husband/partner significantly increases the likelihood of physical and sexual IPV, thus acting as a precursor to violence. Findings emphasize the need to adopt a proactive integrated approach to controlling behavior and intimate partner violence within the society. It is commonly accepted that control and power are underlying factors for sexual and other forms of violence by intimate partners ,2. Contrfeminist theory, which posits that societal-level power imbalances within patriarchal societies create structural factors that work directly or/and indirectly to validate a male-dominated social order and family structure that often result in men exercising power and control over women in several ways, one of which is violence [feminist theory; i) controlling behavior, which is used to assess male-dominated family structures and social order of patriarchal societies that encourage men to exercise control over women, as well as test the hypothesis that controlling behavior is a precursor to violence and is associated with increased likelihood of violence; and ii) women's justification of wife beating by a husband/partner, which is reflective of the cultural context in which the women reside, and traditional societal norms that legally permit a man to inflict physical punishment on his wife/partner, with the women generally accepting such violent acts against them. Patriarchal perspectives posit that violence may occur as a response to a man's feeling of powerlessness as well as of being threatened by a loss of control over an independent spouse [patriarchal perspectives in this study.The approach in this study takes into consideration that control within the relationship has multiple forms and sources, and its manifestation may be influenced by personal attributes, institutional roles and cultural contexts . It examviolence ,17. In tt spouse . Items wResource perspectives on the other hand posit that it is the relative resources of male partners and women rather than social roles or norms that determine the balance of power within intimate relationships thereby increasing the risk of IPV [resource perspectives.k of IPV . A key ek of IPV . Individk of IPV ,20. Womek of IPV . For insk of IPV . Thus, ik of IPV ,22. Thussocial exchange theory, also posits that interpersonal dimensions of control and power can be expressed by decision-making autonomy, and the ability to engage in actions against a partner's wishes. Thus, greater power is held by the partner who maintains control over his/her partner's actions and decision-making within the relationship. Decision-making autonomy is used to assess social exchange theory in this study.A variant of the resource perspective, i) assess the prevalence of controlling behavior, physical and sexual intimate partner violence against women; and ii) to assess the role of husband/partner controlling behavior in the risks of physical and sexual intimate partner violence against women.The aims of this study were to: I hypothesized that women who reported less power within their relationship would most likely be victims of controlling behavior and be at a increased risk of physical and sexual IPV.This study used data from the 2008 Nigeria Demographic and Health Survey (NDHS). This is a cross-sectional population-based survey that utilizes a stratified two-stage cluster sample design based on the list of enumeration areas developed from the 2006 Population Census sampling frame. A full report and detailed description of the sampling procedures are presented elsewhere . All womi) pushing, shaking or throwing something at her; ii) slapping her or twisting her arm; iii) punching or hitting her with something harmful; iv) kicking or dragging her; v) strangling or burning her; vi) threatening her with a weapon (e.g. gun or knife); and vii) attacking her with a weapon. Sexual violence referred to any exposure to one or several of the following acts against women by a current or former husband or partner ever: i) forced sexual intercourse; and ii) other sexual acts when undesired. Exposure to each of these types of violent acts were scored as 1 (any experience of violence ever) and 0 (no experience of violence ever). Reliability of the items, measured by Cronbach's alpha (α) was established prior to analyses .IPV exposure is defined as any acts of physical, emotional and sexual abuse by a current or former partner whether cohabiting or not . Using ta) Controlling behavior, the main exposure variable of interest, was assessed as a composite dichotomous "yes" or "no" variable made up of responses to six questions about whether present or former husband/partner had control issues i.e. if husband/partner: jealous if she talks with other men, accuses her of unfaithfulness, does not permit her to meet her friends, tries to limit her contact with family, insists on knowing where she is, and doesn't trust her with money. Women who responded "yes" to one or several of the control questions formed one group of the dichotomy, and the women that responded "no" to all the controlling attitude questions formed the other group of the dichotomy. Similar scales have been used in other studies [ studies ,28. Cronb) Other measures of relationship control included: i) justifies wife beating, a composite variable created from responses to five questions about whether the women would justify partner abuse of a woman for one of these reasons: if she goes out without telling him; if she neglects the children; if she argues with him; if she refuses to have sex with him; and if she burns the food. Responses were transformed into a single dichotomous "yes" or "no" variable. Women who responded "yes" to one or several of these attitude questions formed one group of the dichotomy, and women who responded "no" to all the attitude questions formed the other group of the dichotomy. Cronbach's alpha for justifies wife beating was .88; and ii) autonomy in domestic decisions, a composite variable assessed as a dichotomous "yes" or "no" variable created from responses to 5 questions about whether the women had the final say regarding: large household purchases; daily household purchases; visits to family or friends; own health; and deciding what to do with husband's money. Women whose response was either "respondent alone" or "respondent and husband/partner" to one or several of these questions formed one group of the dichotomy, while women who responded "respondent and other person in the household" and "no" to all these questions formed the other group of the dichotomy. Cronbach's alpha for autonomy in domestic decisions was .89.c) Variables reflecting relationship inequalities included: i) spouses' relative earning; ii) spouses' relative education; iii) spouses' relative age. Each of these variables was categorized as "same", "less", and "more" in comparison to husband/partner; and iv) type of union, categorized as monogamy (i.e. no other wife) and polygamy (i.e. ≥ 1 other wife).d) Demographic and socioeconomic variables as confounders included: i) women's age, grouped as ≤ 24, 25 - 34, ≥ 35 years; ii) women's education and iii) partner's education, categorized as no education, primary education, and secondary or higher education; iv) women's occupation and v) partner's occupation, categorized as professional, technical management; clerical, sales, skilled manual; agricultural self-employed, agricultural employee, household & domestic, unskilled manual; and not working (not working category was excluded in partner's occupation for having only 3 respondents); and vi) place of residence, categorized as urban and rural.This study is based on analysis of secondary data with all participant identifiers removed. The survey procedure and instruments used have received ethical approval from the National Ethics Committee in the Federal Ministry of Health of Nigeria and the Ethics Committee of the Opinion Research Corporation Macro international, Inc. . Permission to use the DHS data in this study was obtained from ORC Macro Inc.p < 0.05. Model 1 contained only husband/ partner's controlling behavior so as to show the gross effects of controlling behavior on the risk of physical and sexual violence before netting out the effects of other variables.Cross-tabulation was used to study the association between physical and sexual violence (outcome) and the key variables (exposures), using Pearson's chi-squared test (χ) to analyze significant differences, as well as variables indicating controlling behavior. Multivariate logistic regression analysis was used to examine the association between outcome and exposure variables, and results presented in the form of relative risk (RR) and 95% confidence intervals (CI). Covariates were entered and statistical significance using p-values was set at Model 2 added variables reflecting other measures of control in relationships (justifies wife beating and decision-making autonomy), and Model 3 further added variables reflecting possible relationship inequality . Model 4 included demographic and socioeconomic characteristics . Missing data were excluded from the analyses. The analyses were performed using PASW Statistics version18.0 .The lifetime prevalence of controlling behavior was high with a significant proportion of women reporting exposure to at least one form of controlling behavior (63%) by their husband/male partner. The lifetime prevalence of physical violence was 15% and of sexual violence was 3%.p< 0.000), and 563 (85%) had been exposed to sexual violence (p< 0.000). In addition, 1749  and 439  of the women who justified wife beating had been exposed to physical and sexual violence, respectively. Of the women who had decision-making autonomy, 2105  had been exposed to physical violence and 478  had been exposed to sexual violence. More women in monogamous relationships  reported being subjected to physical violence (p< 0.023) compared to those in polygamous relationships, and 290 (44%) women in monogamous relationships reported experiencing sexual violence (p< 0.000). More women with clerical/sales/services/skilled manual occupations , whose partner had secondary or higher education  and were agricultural self-employed/ agricultural employee/household & domestic/unskilled manual workers  had experienced physical violence, while more women who were clerical/sales/services/skilled manual workers  had experienced sexual violence.The proportion of respondents who reported items measuring controlling behavior are presented according to physical and sexual IPV in Figure A higher proportion of the women reported experiencing physical violence by their husband/ partner who had secondary of higher education n = 1285; 45%), and were agricultural self-employed/ agricultural employee/household & domestic/unskilled manual workers . Finally, more women resident in rural areas had experience physical violence  and sexual violence   in the unadjusted analysis (Model 1); this association remained even more significant after adjusting for demographic and socioeconomic characteristics  in Model 4. In the final model (Model 4), other measures of controlling behavior (justifies wife beating and decision-making autonomy), relationship inequalities (spouses' relative earnings), demographic and socioeconomic characteristics (women's occupation and place of residence) were significantly associated with physical violence after adjusting for possible confounding with these variables. Women who justified wife beating had a higher likelihood of experiencing physical abuse  than women who did not justify wife beating, and women with decision-making autonomy had lower likelihood of experiencing physical abuse  than women without decision-making autonomy. Women who earned more than their spouse/partner , who were agricultural self-employed/agricultural employee/ household & domestic/ unskilled manual workers , and those residing in rural areas  had a higher likelihood of experiencing physical violence compared to women who earned as much as their husbands/partners, who were professional/technical/ management workers, and resided in urban areas, respectively  in the unadjusted analysis (Model 1). This association remained highly significant  after controlling for confounding in Model 4. The likelihood of experiencing sexual violence were higher for women who justify wife beating , and for women who earned more than their husband/partner . In contrast, women who had decision-making autonomy  had a significantly lower likelihood of experiencing sexual violence compared to women who did not have decision-making autonomy  , older w.3% , oldControlling behavior by husband/partner was strongly associated with both physical and sexual IPV, consistent with study findings from other regions ,11,32, asocial exchange theory, and could be based on the premise that a woman's higher status within the household act as protective factors and afford her the ability to resist controls over her life or resist the denial of her rights [Women's justification of traditional societal norms of wife beating by a husband/partner was a strong correlating factor for physical and sexual IPV; consistent with another other study . This isr rights , therebyr rights .resource perspectives. Women who neither posses enough economic resources to leave their intimate relationship nor are less able to negotiate change are economically dependent on their husband/partner, making them subject to increased controlling behavior and higher risk of physical violence, as previously shown [This study also provides evidence of relationship inequalities (women earning more than their spouse) being a strong correlating factor for physical violence, and an even stronger correlating factor for sexual violence, consistent with another study , therebyly shown .Working as agricultural self-employed/agricultural employee/household & domestic/ unskilled manual workers was a strong risk factor for physical violence among the women, consistent with other studies indicating increased risk of physical IPV for women in lower socioeconomic occupations . This marare disease assumption i.e. when the probability of an event is low, is one such circumstance. The benchmark commonly used being less than 10% [Results of the logistic regression analysis were expressed as relative risks (RRs) because relative risks and odds ratios are essentially equivalent under certain circumstances. The than 10% ,45. In tThe large numbers of respondents, the survey being nationally-representative and enabling the generalization of the results across the country, variables in the DHS surveys being defined similarly across countries making results comparable across countries are major strengths of this study. The limitations of this study include its use of single types of abuse in isolation from the others, which does not control for co-occurrence with other types of violence and its significance for understanding the effects of abuse on victims. The cross-sectional nature of the data makes it difficult to determine causal inference; for instance, it was not possible to determine whether women's justification of wife beating by a husband/partner was influenced by personal experiences of IPV or form traditional norms alone. Finally, the women's report of their husband/partner's use of control tactics may be subject to exaggeration. However, this is considered to be fairly accurate estimates .This study provided evidence that in countries such as Nigeria in which intimate partner violence is widely accepted in response to women's transgression of traditional gender norms, power within intimate relationships is multidimensional, relative, dependent on the social and cultural contexts, and involves some level of inequity in the distribution of resources. This author believes like others , that inThis study indicated that controlling behavior by husband/partner was strongly associated with physical and sexual violence. It stresses the fact that factors associated with physical and sexual violence are multifaceted, and that the context in which women live predispose them to violence by conferring power upon men to use controlling behavior and acts of physical and sexual violence against women under certain circumstances, such as when women justify wife beating, earn less than their husband/partner, have low status occupations, and reside in rural areas. It also indicates the importance of increasing women's decision-making autonomy as a means of reducing the risk of controlling behavior and acts of physical and sexual violence against women. This study provides evidence for the need for a proactive integrated approach to empower women economically, promote social environments that are intolerant towards controlling behavior and intimate partner violence, thus breaking the norms that sustain women's vulnerability to violence within the society.The author declares that they have no competing interests.DA was responsible for the conceptualization of the study, performed the statistical analysis, and drafting of the manuscript.The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/11/511/prepub


The Journal of Therapeutic Ultrasound has been established to provide an open access, online venue for the exponentially growing body of work in biomedical ultrasound therapy. Journal of Therapeutic Ultrasound (JTU), a newly launched, online, open-access journal designed to accelerate the development of focused ultrasound and its adoption in the clinic.Welcome to the n = 2 exp((t - 1970)/6), with coefficient of determination R2 = 0.965 and time constant τ = 6 years. In 2011, therapeutic ultrasound received attention from the popular press; following a presentation at TEDMED 2011 by Dr. Yoav Medan [Time Magazine named focused ultrasound therapy as one of the 50 Best Inventions of 2011 in its 2011 November 28 issue [Biomedical therapy was among the earliest applications of ultrasound, preceding solid state electronics and inexpensive computers by decades. However, there was insufficient commercialization for therapeutic ultrasound devices to be grandfathered into the Medical Device Amendments of 1976 to the United States Federal Food, Drug, and Cosmetic Act . In the av Medan , Time MaAdoption of new International Electrotechnical Commission standards  by regulatory agencies such as the United States Food and Drug Administration (FDA), the European Commission, the Japanese Pharmaceuticals and Medical Device Agency (PMDA), and the Chinese State Food and Drug Administration (SFDA) will enable more rapid approval of devices and, therefore, more clinical applications. Thus, the exponential growth is likely to continue with a predicted output of 3,600 articles by 2015.In order to serve this growing demand, this journal was originally proposed by Dr. Neal Kassell, Chairman of the Focused Ultrasound Foundation, in collaboration with Dr. Lawrence Crum, Past President of the International Society for Therapeutic Ultrasound (ISTU). JTU serves as the official journal of these two organizations. The 26 members of its editorial board represent 10 countries.The Journal accepts research articles, case reports, reviews, meeting reports, and study protocols, along with supplemental materials. Appropriate topics include translational and clinical research in all areas of therapeutic ultrasound, including stimulation, inhibition, destruction, or modification of tissue function or structure via focused ultrasound.Peer review follows the traditional closed model with a minimum of two reviewers. Authors are encouraged to carefully follow reporting standards for ultrasound dose  and to fAs an online journal, JTU offers authors unlimited color images and support for additional materials such as audio and video files. Another advantage is rapid publication following acceptance after successful completion of peer review.Open access means that authors retain full rights to their articles through the Creative Commons license and that articles will reach a wide audience including developing countries and mainstream media. Articles will be deposited with PubMed Central upon publication without the 6- to 12-month delay which is common among restricted access journals.Author fees are waived through 2014 through support provided by the Focused Ultrasound Foundation.The Journal is intended to reach scientists and clinical practitioners interested in broadening their knowledge in the field of therapeutic ultrasound, including MR-guided and ultrasound-guided focused ultrasound surgery, high intensity focused ultrasound, and non-ablative ultrasound therapies. By reaching audiences around the world, it will play a key role in advancing clinical applications of therapeutic ultrasound.


Genetic variants in nicotinic acetylcholine receptor and alcohol metabolism genes have been associated with propensity to smoke tobacco and drink alcohol, respectively, and also implicated in genetic susceptibility to head and neck cancer. In addition to smoking and alcohol, tobacco chewing is an important oral cancer risk factor in India. It is not known if these genetic variants influence propensity or oral cancer susceptibility in the context of this distinct etiology.CHRNA5), rs578776 (CHRNA3), rs1229984 (ADH1B), rs698 (ADH1C), rs1573496 (ADH7), and rs4767364 (ALDH2).We examined 639 oral and pharyngeal cancer cases and 791 controls from two case-control studies conducted in India. We investigated six variants known to influence nicotine addiction or alcohol metabolism, including rs16969968 . Presence of the variant allele contributed to approximately 13% difference in chewing frequency compared to non-carriers. While no association was observed between rs16969968 and oral cancer risk , rs578776 was modestly associated with a 16% decreased risk of oral cancer . There was little evidence for association between polymorphisms in genes encoding alcohol metabolism and oral cancer in this population.The The association between rs16969968 and number of chewing events implies that the effect on smoking propensity conferred by this gene variant extends to the use of smokeless tobacco. Cancers of the oral cavity and pharynx contribute to nearly 400,000 new cases each year worldwide, more than half of which occur in India. Each year over 200,000 die of the disease, and over a third of these deaths occur in India CHRN) gene cluster CHRN receptor subunit variants, rs16969968 and rs578776 have been consistently associated with lung cancer risk and smoking behavior in several populations ADH and ALDH, respectively) have been associated with head and neck cancer risk ADH and ALDH2 variants in this population.Genome-wide association studies (GWAS) have successfully identified disease susceptibility loci to various complex diseases CHRN variants and propensity to smoke extends to non-smoking forms of tobacco use (ii) examine if CHRN genetic variants influence susceptibility to oral cancer risk in India, (iii) clarify the association between the potential causal variants in the 4q23 (ADH) and 12q (ALDH2) locus and the risk of oral cancer in India.In this study we aimed to (i) determine whether the association between Written informed consent was obtained from all participants. The IARC multi-center study was approved centrally by the Cancer Institute Ethical Committee at Chennai, India and the overall study was approved by the IARC Ethical Review Committee at the International Agency for Research on Cancer (IARC), Lyon, France. The Mumbai study was approved by the Hospital Ethics Committee of the Tata Memorial Hospital & Cancer Research Institute at Mumbai, India.The present analysis utilized cases and controls from two previously conducted studies in India: the International multicenter oral cancer study (IARC study), and the Mumbai study. The IARC study was coordinated by the International Agency for Research on Cancer (IARC) across nine countries during 1996 to 1999. The study recruited cases and controls from three centers across India, including Bangalore, Chennai and Trivandrum. Cases were histologically or pathologically confirmed primary cancers of the oral cavity and oropharynx. Hospital based controls, one for each case frequency matched for age (5 year period), sex and center were recruited. The overall study participation rate was 93%, details have been described elsewhere Genomic DNA was extracted from blood samples using the QIAamp 96 DNA Blood Kit , or with Puregene chemistry  on an Autopure instrument (Gentra Systems) in the IARC study. In the Mumbai study, DNA was extracted following standard protocol by Sambrook et al khaini, mawa, mishri, zarda, gudakhu and gutkha are all formulations containing tobacco with different flavoring agents, pan masala is an areca nut product that does not contain tobacco, to which tobacco may be added externally. Duration and frequency of exposure to tobacco and alcohol were calculated in each study as described previously pan masala in the IARC study, and tobacco with lime, pan masala, khaini, mawa, mishri, zarda, gudakhu, snuff and gutkha in the Mumbai study. Chewing frequency was calculated as the cumulative number of chewing events per day, taking into account overlapping periods of exposure. For the calculation of lifetime alcohol consumption, the percentage of ethanol was estimated as 40% for spirits , 3% for beer and 5% for toddy (except in the Mumbai study). Smoking, chewing and alcohol related oral cancer risk was calculated using logistic regression models adjusted for age, sex, level of education and center. The corresponding attributable fractions were calculated based on the formula: p (ec)x(OR-1)/OR; where p(ec) is the proportion of exposed among cases CHRN variants and propensity to use tobacco was assessed using linear regression models with log transformed number of cigarette equivalents smoked per day, or number of chewing events per day as the outcome variable. Results represent the fold-change in the number of cigarettes smoked per day or the number of chewing events per day for each copy of the rare allele. These analyses were adjusted for age, sex, center and case-control status. Similar analyses were performed to examine the association between ADH/ALDH2 variants and the propensity to drink alcohol, measured as number of drinks of ethanol consumed per day. All statistical analyses were performed using STATA version 11 , and the reported p-values are two sided.Data on alcohol consumption, tobacco use, chewing and smoking were collected in both the participating studies. The definition of drinker, smoker and chewer were consistent across both studies and included individuals who responded confirming ever use of alcohol, ever smoking any tobacco product , ever use of any smokeless tobacco product with or without betel quid. Several forms of smokeless tobacco are consumed in India, while ADH1B), rs698 (ADH1C) and rs1573496 (ADH7) and the nicotine dependence gene variant rs16969968 were less common among Indians compared to previous studies in predominantly western populations. On the other hand, rs578776 was more common among Indians (table2).The distribution of all six variants examined in the present analysis was consistent with expectations of genotype distributions based on the Hardy-Weinberg principle. The allele frequencies were similar across the participating studies (data not shown). We found that the variants in alcohol dehydrogenase genes- rs1229984 , by gender (p-heterogeneity =  0.33). Although no effect modification by smoking or chewing status was observed, a statiscally non-significant oddds ratio of 1.22 (95% CI =  0.69– 2.13) was observed in chewers and smokers . We obseWe examined variants in genes related to alcohol metabolism since they were strongly associated with head and neck cancer in previous studies. None of the four variants  examined, showed any association with oral cancer risk . We alsoCHRN variants, rs16969968 and rs578776, have been associated with nicotine addiction and lung cancer risk and these associations appear to be independent CHRN variants also extends to the propensity to chew tobacco, a relevant oral cancer risk factor in the Indian population.The CHRN variants and chewing dependence could be potentially higher than that observed in the present study. Previous studies have demonstrated that UADT cancer risk associated with rs16969968 is higher among women and for cancers of the oral cavity and larynx Several formulations of smokeless tobacco are commercially available and commonly used in India; these were grouped together in this study. The number of chewing events per day was recorded in both studies included in this analysis; however it is important to note that this does not reflect the amount of product chewed each time and hence, constitutes a potential source of misclassification of exposure. Given that we observe a measurable association with such a crude estimate implies that the true effect of the ADH genes, correlated as a consequence of linkage disequilibrium, are located in the 4q23 locus. Three alleles, rs1229984, rs698 and rs1573496 within the ADH locus have been associated with UADT cancer risk in Europeans and other Asian populations ADH variants may influence oral and neck cancer risk in India, in particular rs698 ALDH2 variant rs4767364, identified through a recent UADT GWAS The CHRN gene cluster may contribute to oral cancer susceptibility in India. In this study, rs16969968 variant was associated with increased propensity to chew tobacco, and rs578776 was associated with decreased chewing propensity and oral cancer risk. Larger studies will be required to clarify the extent of risk modification mediated by propensity to use tobacco. This study also indicates that variants in alcohol metabolizing genes appear to be less important to oral cancer susceptibility in India. These data reiterate the importance of disease etiology, the relative contribution of risk factors and their impact in replication of GWAS identified risk loci across populations.To the best of our knowledge, we report for the first time that the association between 15q25 locus and propensity to smoke extends to tobacco chewing. We also provide suggestive evidence that 15q25 region containing the Table S1Variants in alcohol metabolizing genes and alcohol consumption levels. Fold-change were derived from linear regression models adjusted for age, sex, center and case-control status. Log transformed number of alcoholic drinks per day was treated as the outcome variable for each of the respective genetic variant as the explanatory.(DOCX)Click here for additional data file.


To present preliminary data from LEAPS into IM, the Leadership and Education Program for Students in Integrative Medicine, an innovative program designed to foster the development of the next generation of medical student leaders in Integrative Medicine (IM). Medical students selected from across North America engaged in hands-on and didactic IM education, leadership skills, self-care, and community building curricula with leading experts serving as teachers/mentors. Our goal was to evaluate LEAPS impact on several IM related behaviors in participants immediately following and several months after the program.Allopathic and osteopathic medical students who completed the LEAPS into IM program in 2010 (N=20) and 2011 (N=30) were surveyed at the conclusion of the week-long program and quarterly thereafter via an anonymous IRB approved survey. Questions explored participants’ utilization of Integrative Medicine resources in self-care and IM referral for family, friends, and patients. Satisfaction with medicine was also measured. Additional questions included other exposure to integrative medicine educational material over time.Students exhibited increased utilization of yoga, group activities, exercise, and healthy nutrition a year after conclusion of the program. A significant drop in group support activity at 6 months correlated with a drop off in return of follow-up surveys and an apparent reduction in satisfaction with standard medical education. Comparison across years showed similar results.The LEAPS into IM Program appears to be effective in enhancing student utilization of select Integrative Medicine resources and referrals. A significant correlation exists between continued engagement with Integrative Medicine and the support given by groups of like-minded individuals.


Trypanosoma cruzi, which causes about 20 000 annual deaths. Although Chagas disease is endemic to certain regions of Latin America, migratory flows have enabled its expansion into areas where it was previously unknown. Economic, social and cultural factors play a significant role in its presence and perpetuation. This systematic review aims to provide a comprehensive overview of qualitative research on Chagas disease, both in endemic and non-endemic countries.Globally, more than 10 million people are infected with Searches were carried out in ten databases, and the bibliographies of retrieved studies were examined. Data from thirty-three identified studies were extracted, and findings were analyzed and synthesized along key themes. Themes identified for endemic countries included: socio-structural determinants of Chagas disease; health practices; biomedical conceptions of Chagas disease; patient's experience; and institutional strategies adopted. Concerning non-endemic countries, identified issues related to access to health services and health seeking.The emergence and perpetuation of Chagas disease depends largely on socio-cultural aspects influencing health. As most interventions do not address the clinical, environmental, social and cultural aspects jointly, an explicitly multidimensional approach, incorporating the experiences of those affected is a potential tool for the development of long-term successful programs. Further research is needed to evaluate this approach. Social and cultural factors are increasingly recognized as relevant to the likelihood of infection with Chagas disease as well as the health seeking practices of those affected. In response, qualitative methods have been used more often to study such factors. This is the first systematic review to focus on the socio-cultural dimensions of Chagas disease. The findings suggest that transdisciplinary approaches, which incorporate preventive and treatment activities, and consider populations' living conditions and their culturally informed understandings of health, might be a tool to reduce Chagas disease incidence in the long-term. Trypanosoma cruzi. Most live in Latin American countries, where the parasite is endemic According to the World Health Organization (WHO), globally, more than 10 million people are infected with The persistence of Chagas disease – as with most NTD – is linked to social, cultural, historical, political and economic processes Work Package 6: Social and Cultural Context to Health Seeking of Latin American Migrants in Europe, this systematic review aims to provide a comprehensive overview of qualitative research on Chagas disease, both in endemic and non-endemic countries. Specific objectives include identifying qualitative studies through a systematic search strategy; describing the state of qualitative research; and synthesizing, analyzing and interpreting themes that have emerged Since 1990, the number of Chagas-related publications has shown a linear increase www.cohemi-project.eu. Ten databases were examined using combinations of terms  were conducted in Latin America: Argentina (12), Brazil (7), Bolivia (2), Peru (2), Venezuela (2), Paraguay (1) and Colombia (1). Of the twelve studies carried out in Argentina, half were by the same author; this was also the case for two articles from Brazil. In non-endemic countries, studies were conducted in Europe: Spain (4) and Italy (1); and one in USA.Most of the studies were based on individual interviews (24). In ten cases, this was the only reported technique for collecting data; twelve articles reported the complementary use of either: individual interviews and participant observation (7); individual and group interviews (2); individual interviews and participatory tools (1); individual interviews and other techniques (2); in three articles, researchers utilized more than two techniques. Finally, four articles reported participatory methods; discourse analysis techniques (2); and focus groups (2). Most of the articles have been published since 2008 See .Chagas disease occurs in specific contexts marked by socio-cultural, political, economic, environmental and historical circumstances. Certain structural changes may influence the environment and people's living conditions, which, in turn, may trigger triatomin infestation (the Chagas disease insect vector) and provoke a higher risk of infection. Briceño-León Several reviewed studies focused on migration and stigmatization of infected people as pathways that caused their living conditions to deteriorate. Bayer et al. Hygienic habits, household clutter, or cohabitation with domesticated animals were often identified as behaviors influencing Chagas prevention, and the persistence of the triatomine vector in dwellings naturalization and normalization of Chagas disease However, this was not always the case, and other authors, including Sanmartino in subsequent research, suggested that increased knowledge of Chagas disease was not always enough to change practices socio-cultural representations, was however seen as crucial to understand behavior and explain why knowledge about Chagas disease does not always imply behavior change pilagá) point of view, disease causation was explained in personalistic terms, or as violation of taboos or social norms. Preventive and curative practices may be therefore deeply linked to such representations, rather than the parasite or insect-vector. In Bolivia Insight into different ways of thinking about Chagas disease, its Particular ways of thinking about Chagas disease are not unique to target populations. Scientists' and health professionals' understandings are also developed in specific contexts and can affect their work. Kreimer et al. Addressing health professionals' understandings of Chagas disease in an Argentinean urban context and in Brazil, Sanmartino Studies that addressed experiences of Chagas disease from the sufferer's perspective showed how social groups described a variety of conceptions about the disease Evaluating the first Chagas' preventive programs in Brazil, Magnani et al. Trypanosoma was conflated with diagnosis of Chagas disease. A positive serology saw infected individuals identify themselves as sick, was sufficient to promote feelings of discomfort, and caused individual and social suffering. In all these situations, the patient-provider relationship was identified a key element in patients making sense of the disease In contrast, studies in Brazil There is no effective vaccine for Chagas disease and treatments are not 100% effective . Therefore, in endemic countries, the main strategies to combat the disease involve prevention interventions, control of blood banks and monitoring pregnant women. Preventive strategies have focused on controlling the most common vector through three principal interventions Four studies In non-endemic countries, Chagas control is based on screening protocols for migrants considered at risk of infection. Several studies highlighted the importance of monitoring migrants' access and utilization of health services Gender relationships and identity also influenced migrants' patterns of healthcare utilization: men were less likely to utilize healthcare services because they associated seeking help with weakness, which challenged their ideals of masculinity. Furthermore, due to their social role as breadwinners, men prioritized their families' economic situation over their own health- Studies emphasized the importance of developing community-oriented programs A study conducted in Madrid Regarding treatment, some patients claimed that it could lengthen life, and hence was a guarantee of achieving migratory goals As the work of Bastien The reviewed articles identified pathways that lead certain social groups into conditions that increase their vulnerability to Chagas disease With regard to prevention and control activities, behavioral change approaches at an individual and community level have had varying degrees of success. In the reviewed literature, there were two general approaches. In one approach a population's lack of knowledge and its members' beliefs were assumed to be “cultural obstacles” to behavior change or to care seeking The reviewed highlights an important question: how can awareness about Chagas disease and triatomines be raised in social groups that do not conceive them as a health threat? Scholars have suggested that people's understandings of Chagas and the social context that influences their living conditions are key to explain the disease not being considered a threat In relation to local ways of thinking about Chagas disease, a second question arose about how to recognize local knowledge and build bridges with biomedicine Further research is required to contextualize socio-cultural factors and processes associated with Chagas disease in different countries and amongst different social groups: differentiated by class, ethnicity, geography, gender and age. This necessitates the study of Chagas disease in relation to the socio-cultural, economical, political, historical processes that enable its appearance and persistence, as well as the different experiences of Chagas disease. Research concerning policies and programs to address the socio-structural factors is needed to reduce the burden of Chagas disease; understanding the elements that hinder the development and implementation of such policies is also important.In most countries, there is a general lack of qualitative studies informing locally and nationally appropriate strategies. Contextualized research on migratory flows, how they interact with living conditions, and their links with Chagas incidence is necessary. In addition, research on changing risk behaviors for infection that takes into account the processes that place social groups in different positions of vulnerability is required. Such approaches are rare in research on and interventions for Chagas, though they may be crucial for policy and action guidance.There is a lack of information concerning health seeking behaviors and their underlying processes in endemic countries. As studies described self-care practices Because Chagas disease is considered a zoonosis that cannot be eradicated, long-term entomological surveillance systems are required social remittancesSome topics were scarcely addressed in the qualitative research on Chagas. For example, a transnational approach Further research on transdisciplinary approaches to addressing Chagas disease is required.The review includes papers in three languages, giving a broad overview of research conducted in different contexts, with varied health systems and at different points in the development of Chagas programs. To retrieve literature that is not electronically indexed, grey literature was also searched and incorporated. Screening was carried out in duplicate and discrepancies were solved with consensus between reviewers. Biomedical aspects of Chagas disease are embedded in socio-cultural and environmental contexts. The literature reviewed shows how qualitative social science provides key tools to understand this socio-cultural context.This review is a potentially useful resource for policy makers, clinicians, researchers and patients. A number of findings are particularly important for the design and implementation of policies, strategies and programs. Social and structural processes are essential to explain the emergence, persistence and re-emergence of Chagas disease. However, few studies address strategies aimed at influencing the socio-structural context, and there is a general lack transferring their results in practice. Different social groups – influenced by ethnicity, socio-economic status, age, urban/rural context - experience different social conditions that influence their Chagas-related experiences and behaviors. Understanding how socio-cultural processes differentially affect these groups is key to designing and promoting appropriate interventions, adapted to populations and contexts, and considering their specific needs. Behavioral change approaches should consider how social conditions and the local representations of health and disease influence the practices related to Chagas.Chagas disease requires an explicitly multidimensional approach, in which prevention, control and care strategies and programs are designed and implemented jointly, and in which the social and biomedical sciences, together with the experience of those affected, are incorporated and articulated.Appendix S1List of documents, location of data and main topic. Endemic countries.(TIFF)Click here for additional data file.Appendix S2List of documents, location of data and main topic. Non endemic countries.(TIFF)Click here for additional data file.Checklist S1Prisma checklist.(DOC)Click here for additional data file.


It was preceded by two satellite meetings, six workshops and five tutorials. Details of the conference are available through the conference website (http://www.eccb12.org) and will later be archived at eccb.iscb.org/2012/.This special issue comprises the proceedings papers accepted for presentation at the 11th European Conference on Computational Biology (ECCB 2012), which was held from 9 to 12 September 2012 at the Conference Center Basel, Switzerland. This year's conference was organized by the SIB Swiss Institute of Bioinformatics and also served as the 10th [BC]ECCB is the top European conference in computational biology and bioinformatics, and together with ISMB and RECOMB one of the major international conference series in computational biology. The conference brings together scientists working in a broad range of disciplines, including bioinformatics, computational and molecular biology, medicine and systems biology. It covers computational methods for analysis of the tremendously growing amount of data in the life sciences, and approaches for modeling and simulation of increasingly complex systems in molecular biology, medicine and pharmaceutical research. The scope of the conference evolves each year to address the latest developments in biological applications of mathematical modeling and computational methods.ECCB is held in a different country or region each year, and incorporates the annual national or regional meeting where it is held. Every other year, it is held jointly with the Intelligent Systems in Molecular Biology (ISMB). Past editions of ECCB have been held in Vienna (AT) (with ISMB), Ghent (BE), Stockholm (SE) (joint with ISMB), Cagliari (IT), Vienna (AT) (with ISMB), Eilat (IL), Madrid (ES), Glasgow (UK) (with ISMB), Paris (FR) and Saarbrücken (DE).The ECCB 2012 conference featured keynote lectures by distinguished speakers: The opening keynote lecture was delivered by Nobel price laureate Aaron Ciechanover (Technion - Israel Institute of Technology), followed by Barry Honig , Laurent Keller (University of Lausanne), Gene Myers , Mihaela Zavolan (Biozentrum University of Basel & SIB) and the EMBO keynote lecture by Søren Brunak .The conference topics span all areas of methodological developments for computational biology and innovative applications of computational methods to molecular biology. This year, the conference was organized in 11 topic areas: ‘Applied and Translational Bioinformatics’, ‘Bioimaging, Spatial-temporal Modeling and Data Visualization’, ‘Bioinformatics of Health and Disease, Biomarkers and Personalized Medicine’, ‘Databases, Ontologies, and Text Mining’, ‘Evolution, Phylogeny, and Comparative Genomics’, ‘Macromolecular Structure, Dynamics and Function’, ‘Mutations, Variations, and Population Genomics’, ‘Protein Interactions, Molecular Networks, and Proteomics’, ‘Regulation, Pathways, and Systems Biology’, ‘Sequencing and Sequence Analysis’ and ‘Technology and Software (TechTrack)’.http://www.easychair.org). The same system was used for discussing papers in cases where the reviewers had different opinions about the relevance or quality of the contribution. After a consensus had been reached by the reviewers, a final selection was carried out by the area chairs and the conference chairs, discussing the outcome in the form of a phone conference. In total, 48 papers were conditionally accepted, pending revision. After acceptance notices were sent, the authors had 2 weeks to modify their papers according to the suggestions made by the reviewers and to respond to the reviewers’ comments. Modified papers and authors’ responses were reexamined during the next week to ensure each paper was modified appropriately in response to the reviewers’ comments. We were pleased that all conditionally accepted papers were finally accepted. These 48 (14% accepted rate) contributions are included in this special issue. Collectively, the authors of the 48 accepted papers come from 19 countries across 4 continents, with 60 authors from North America, 95 from Europe, 27 from Asia (excluding Israel), 4 from Israel and 3 authors from Saudi Arabia. The conference papers are available in open access in electronic format, both through online open access to the journal Bioinformatics and on the electronic documentation distributed to the conference participants on USB memory cards.Following the call for proceedings papers, we received a record number of 340 submissions—which corresponds to a ~60% increase compared to the previous ECCB in 2010. The manuscripts were assessed by a program committee of 350 reviewers and 191 co-reviewers. The reviewing process in each topic area was coordinated by two area chairs (see next article), and the different areas were coordinated by the Conference Chairs. Within each area, the area chairs assigned the papers to expert referees; in general each paper was reviewed by three PC members, with a few cases where we could only secure two referee reports. The whole process was carried out through the EasyChair conference reviewing system .During the weekend preceding the conference, two satellite meetings, six workshops and five tutorials were organized: on Saturday, 8 September, a special symposium celebrated the 10th anniversary of the UniProt project: in 2002, 40 years after the first comprehensive collection of protein sequences, the ‘Atlas of Protein Sequence and Structure’, was published, the SWISS-PROT and TrEMBL protein sequence databases at the European Bioinformatics Institute (EBI) and the SIB Swiss Institute of Bioinformatics, and the Protein Information Resource (PIR) in Washington, joined forces to create UniProt. At this symposium, renowned speakers gave insight into their work, highlighting how protein databases are underpinning life sciences.The Student Council of the International Society for Computational Biology organized its second European Student Council Symposium (ESCS), chaired by Pedro Lopes  and Florian Heer . The meeting gave students the opportunity to present their work to an international audience and to build a network and exchange ideas and knowledge within the computational biology community.On Saturday and Sunday, 8 and 9 September, the Sixth International Workshop on Machine Learning in Systems Biology (MLSB) was organized as a 2-day workshop by Karsten Borgwardt (Max Planck Institutes & Eberhard Karls Universität Tübingen) and Gunnar Rätsch . MLSB provides a scientific forum for the exchange between researchers from Systems Biology and Machine Learning.All other workshops and tutorials were organized as 1-day events on Sunday 9 September: the workshop ‘Annotation, Interpretation and Management of Mutations (AIMM)’ focused on extraction and reuse of genotype–phenotype knowledge from scientific literature and databases. It was chaired by Christopher Baker  and Dietrich Rebholz-Schuhmann . The workshop ‘Computational Proteomics: From Mass Spectrometry to Protein Complexes’ organized by Markus Müller , Alexander Schmidt  and Jacques Colinge  addressed computational aspects of Mass spectrometry analysis.cis-regulatory sequences. The program was organized by Wyeth W. Wasserman , Virginie Bernard , Jonathan Lim and Anthony Mathelier .The workshop ‘Bioinformatics Training for Life Scientists: Showcases and Challenges from Tutors’ Perspectives’ organized by Patricia Palagi (SIB Swiss Institute of Bioinformatics), Vicky Schneider , Allegra Via , Celia van Gelder  focused on training in bioinformatics for life scientists from the perspective of the trainer. It aimed to provide a platform for those involved in bioinformatics training to meet, confront and share experiences, as well as discuss future directions and collaboration in joint efforts. The workshop ‘Imaging Analysis and Computational Modeling for Cancer and its Therapy’ organized by Petros Koumoutsakos and Gabor Szekely (ETHZ) presented the state of the art in imaging, analysis and modeling of cancer and its therapy. Special focus was laid on recent developments in optical microscopy, small animal and clinical imaging, data analysis tools, mathematical models and computations of cancer formation and progression. The workshop ‘Detecting Transcription Factor Binding Sites with ChIP-Seq Data and Predicting Damaging Cis-Regulatory Variations’ addressed genome re-sequencing data analysis for the prediction of variations within The purpose of the tutorial program at ECCB is to provide participants with lectures and hands-on training covering topics relevant to the bioinformatics field. It offers participants an opportunity to learn about new areas of bioinformatics research, to get an introduction to important established topics, or to develop advanced skills in areas they are already familiar with. At ECCB 2012, tutorials on six different topics were organized: ‘Applications of Bio-Ontologies in Large-Scale Data-Driven Science: A Practical Introduction’ by Barry Smith , and Janna Hastings (European Bioinformatics Institute and University of Geneva); ‘Protein Evolution: From Sequence to Structure to Function’ by Christine Orengo and Romain Studer  and Nicholas Furnham ; ‘GWAS: Statistics and Bioinformatics to Analyse Genotype to Phenotype Relationships from Molecular Traits to Disease Phenotypes’ by Christoph Lippert  and Oliver Stegle ; ‘Inferring Genetic Diversity from Next-generation Sequencing Data: Computational Methods and Biomedical Applications’ by Niko Beerenwinkel (ETH Zurich and SIB), Karin J. Metzner  and Volker Roth ; and ‘Reads to Biological Patterns: End-to-End Differential Expression Analysis of RNA Sequencing Data Using Bioconductor’ by Simon Anders and Wolfgang Huber (EMBL), Michal Okoniewski (ETHZ) and Mark Robinson (University of Zurich & SIB).Encouraging the participation of young scientists has always been a central goal of the ECCB conference because the conference is a great opportunity for education and networking for early stage scientists. Thanks to contributions from several academic sponsors, our host organizations, previous editions of ECCB and our commercial sponsors, we could provide 114 conference fellowships to PhD and postdoc applicants from all over the world. Presenters and contributors to oral presentations were given priority. Unfortunately, several applicants had to be turned down due to limitations of available resources.2 Basel Computational Biology Conference for funding 114 fellowships to facilitate the participation of young talented scientists early in their career. We highly appreciate the support by our host institutions, the SIB Swiss Institute of Bioinformatics, the Biozentrum University of Basel, and the Swiss Systems Biology Initiative SystemsX.ch. We are especially grateful to our platinum sponsors Basel Area and IBM. We would like to thank all our partner and sponsors: the Netherlands Bioinformatics Centre NBIC, CONVEY Computers, F. Hoffmann-La Roche Ltd, HP, BBRC, Interpharma, FMI Friedrich Miescher Institute, Bioalps, Competence Center Computational Sciences University Basel, Novartis Pharma, Syngenta, BASF, Merck Serono and the canton of the city of Basel. We would like to thank EMBO for supporting the EMBO keynote lecture by Soren Brunak.Organizing ECCB would not be possible without the generous support by partner organizations, funding agencies and sponsors. We are especially grateful to the Swiss Foundation for Excellence and Talent in Biomedical Research, SIB Swiss Institute of Bioinformatics, ISCB International Society for Computational Biology, the University of Basel, the Swiss Academy of Medical Sciences and the [BC]It is our pleasure to thank all the people and organizations that made ECCB 2012 possible. Our first thanks go to the program committee of reviewers and co-reviewers, and in particular the area chairs. A swift and effective review process is at the heart of a conference like ECCB. Reviewing 340 proceedings manuscripts and 100 highlight paper submissions in just a few weeks is truly challenging, especially since many members of the program committee had been involved in reviewing for ISMB shortly before. The dedication and hard work of the program committee was quite simply the key to the high quality of the conference.We are grateful to the ECCB steering committee for their support to the organization of the conference: in particular, the advice and guidance from previous organizers Anna Tramontano, Yves Moreau and Michal Linial was crucial. Anna, thank you so much for answering our questions at any time of day (and night)!Logistics is crucial for a successful conference. We are grateful to the Oxford University Press production team for the preparation of this special issue, to Congress Center Basel for the venue organization. The local administration team at the Biozentrum of the University of Basel did an incredible job, and we owe them a great debt: Katja Jenni, Rita Manohar, Sarah Güthe, Lorenza Bordoli and Yvonne Steger for preparing the meeting and organizing the registration, Markus Stöckli from Billboard for the poster and website design, Andrew Waterhouse for the registration and poster submission system, JanWelker and Konstantin Arnold for IT support, Jocelyne Boquet for handling the financial administration.Finally, the most important ingredient to the success of a conference are the scientific contributions and discussions: we are grateful to the authors of all submitted manuscripts, keynote speakers, presenters of selected papers, tutorial lecturers, workshop organizers and contributors, poster authors and to all the participants. Thank you for making this conference a success.


The Transcultural Diabetes Nutrition Algorithm (tDNA) is a clinical tool designed to facilitate implementation of therapeutic lifestyle recommendations for people with or at risk for type 2 diabetes. Cultural adaptation of evidence-based clinical practice guidelines (CPG) recommendations is essential to address varied patient populations within and among diverse regions worldwide. The Canadian version of tDNA supports and targets behavioural changes to improve nutritional quality and to promote regular daily physical activity consistent with Canadian Diabetes Association CPG, as well as channelling the concomitant management of obesity, hypertension, dyslipidemia, and dysglycaemia in primary care. Assessing glycaemic index (GI)  and glycaemic load (GL)  will be a central part of the Canadian tDNA and complement nutrition therapy by facilitating glycaemic control using specific food selections. This component can also enhance other metabolic interventions, such as reducing the need for antihyperglycaemic medication and improving the effectiveness of weight loss programs. This tDNA strategy will be adapted to the cultural specificities of the Canadian population and incorporated into the tDNA validation methodology. Type 2 diabetes (T2D) is a chronic disease with hyperglycaemia as its characteristic feature, resulting from defects in insulin secretion and/or insulin action . The dishttp://www.diabetes.ca/diabetes-and-you/nutrition/just-basics/Accessed January 24, 2013).Canadian census data show that more than 200 tongues are spoken in Canada, 60 being aboriginal. The mother tongue reported by 6.8 million Canadians (21% of the population) differs from English or French, the two official languages of the country. Another 4.7 million Canadians speak a language at home by order of prevalence: Punjabi, Chinese, Spanish, Italian, German, Cantonese, Tagalog, Arabic, and Mandarin (Statistic Canada). Challenged by this situation, the Canadian Diabetes Association (CDA) has begun to tailor its nutrition therapy tool, Just the Basics, to the cultural and personal tastes of individuals of varied ethnicities who have T2D  for nutrition therapy  were pubThe process of modifying the tDNA to Canada involved a group of experts who reviewed and considered revising all of the topics outlined in the global template . These rChanges brought to the global tDNA template and different points of significance are highlighted in the results section of this report.As a result of our revision, the modified algorithm focused on the process of adapting healthy behaviours rather than weight loss; behaviour leading to improved diet and regular physical activity became the interventional target. Emphasis was placed also on increasing patient and provider awareness of the process of change and of improvements to lifestyle behaviour over time. The resultant objective of tDNA Canada became support of behavioural change through simple and effective dietary and physical activity advice at the primary care level. Additionally, a quick, simple, pragmatic, validated questionnaire to assess combined work and leisure time physical activity shown to be associated with mortality in a prospective population study was found to be feasible for use in clinical practice . The algAs in the global tDNA, initially, ethnooncultural identification and geographic location are assessed concurrently with individual risk stratification, the latter described by Yusuf et al. . In CanaSpecific to the Canadian tDNA, 2 when lifestyle interventions have failed to achieve and maintain weight goals. Minimally invasive surgical approaches should be used by a well-established surgical team that includes experts in nutritional and psychological support. Bariatric surgery is now becoming an accepted option for the management of T2D and has been shown to be superior to medical management for its treatment [Certain approaches from the global tDNA  were adareatment . PresentAdopting healthy behaviour rather than only attaining sustained weight loss was defined as the main objective of the Canadian tDNA. This objective is consistent with CDA CPG, which recommend that self-management education incorporating knowledge and skill development, as well as cognitive behavioural interventions, should be implemented for people with diabetes (CDA CPG 2008) . To optiThe Canadian tDNA is to promote low-GI carbohydrate foods within a healthy dietary pattern. GI provides an assessment of the quality of carbohydrate-containing foods based on their effect on postprandial blood glucose . To decrThe product of mean GI and total carbohydrate intake is known as glycaemic load (GL) and has also been explored in therapeutic studies. A low GL was found to improve the efficiency of weight loss advice over 4 weeks  and imprThe Canadian tDNA integrates and emphasizes physical activity. The recommendations are based on evidence from prospective observational studies showing that individuals who perform such levels of activity have reduced risk of premature total and cardiovascular mortality as well as reduced risk of developing T2D –30. The In addition to aerobic training, moderate-to-high intensity resistance training is beneficial in order to maintain lean body mass, particularly in the aging population of patients with T2D –41. As tFurthermore, interventions such as motivational interviewing, which is a specific way of helping people recognize and formulate an action plan to address specific lifestyle changes, can be useful for clients who are reluctant or ambivalent about changing behaviour . The strIndeed, it must be remembered that patients find adherence to appropriate dietary patterns exceptionally difficult to maintain consistently and that recommended dietary patterns are not well followed. Furthermore, in the past, diabetes nutrition therapy has emphasized individual macronutrient and micronutrient components and their adequacy. Although studying individual nutrients may lead to an understanding of important biological mechanisms, it has been recognized more recently that providing practical advice or identifing strategies on how people eat is not sufficient. Rather, assessment of dietary patterns offers a comprehensive and complementary approach to apply nutritional principles to “real life”  and to iP = 0.0009 for trend), whereas CHD risk increased with increasing quintile for Western Pattern score . These analyses may provide useful evidence for making specific food-based dietary recommendations within the context of the existing dietary guidelines; however, their impact as part of clinical treatment for diabetes has not been studied.Studies reviewed by Kris-Etherton et al. provide evidence that food-based approaches and dietary patterns reduce risk for cardiovascular disease . For insThe Dietary Approaches to Stop Hypertension (DASH) Study demonstrated that a dietary pattern high in fruits, vegetables, and low-fat dairy products, coupled with sodium restriction, reduced hypertension and, consequently, is included here as a dietary intervention for hypertensive patients with T2D . MoreoveValidated evaluation tools and simple/efficient processes for monitoring/surveillance are essential to the success of tDNA. Establishing efficacy is important, but it is also essential to identify techniques, tools, and environmental factors that contributed to, or detracted from, the success of implementing the intervention . NutrienAdapting the global tDNA template to a Canadian society led to the recognition that primary care practitioners need to participate as active and key promoters of healthy lifestyle behaviour with other members of the health professional team. Their involvement entails the development of simple, quick, and effective methods to assess nutritional and physical activity behaviours that put patients at risk and requires the implementation of strategies to help change thi behaviour in a sustainable manner. The foods in the environment of Canadians with T2D should be nutritionally adequate, culturally acceptable through appropriate food and distribution systems, physically and economically accessible at all times, and safe and secure in order to enable adoption of behaviour that promotes optimal diabetes care and make healthy food choices the norm. Furthermore, simple tools should be put in place to first evaluate sedentary behaviour and physical activity habits of patients and then support economically viable solutions to help patients increase their physical activity habits and regular exercise level. Above all, primary care practitioners should buy-in on the impact of healthy lifestyle behaviours on diabetes management by adopting this behaviour themselves. The Canadian tDNA is a first step.