Epidemiology of Primary Multidrug-Resistant Tuberculosis,Vladimir Region,Russia

We studied the epidemiology of drug-resistant tuberculosis (TB) in Vladimir Region, Russia, in 2012. Most cases of multidrug-resistant TB (MDR TB) were caused by transmission of drug-resistant strains, and >33% were in patients referred for testing after mass radiographic screening. Early diagnosis of drug resistance is essential for preventing transmission of MDR TB.     

Comparison of first trimester transvaginal anatomy scan to the second trimester structural survey in normal weight and obese populations: a pilot study

Purpose: To compare visualization of first trimester fetal anatomic transvaginal ultrasound (TVUS) to the second trimester transabdominal anatomic ultrasound (TAU) in normal weight and obese patients.

Materials and methods: In a prospective cross-sectional study design, 25 women underwent a TVUS between 12 and 14 weeks, and a TAU at 18–22 weeks. For each anatomic structure, the percentage of patients achieving optimal visualization was recorded. Risk ratios for visualizing a structure in the second trimester versus the first were calculated.

Results: Twenty-five patients underwent a TVUS and 24 completed the TAU. The average BMI in the obese and nonobese groups was 34?kg/m² and 23?kg/m², respectively. All structures were more consistently visualized during the TAU for the both groups. The cardiac views, hands and feet were more difficult to visualize in all the patients at both scan times but were more frequently visualized in the TAU. For the obese patients, hands, feet, cardiac and spine views were less frequently visualized in both the scans. The posterior fossa and profile views were more difficult to obtain in the TVUS.

Conclusions: The first trimester TVUS detects many of the structures assessed during an anatomic survey; however, it is not superior to the second trimester TAU in normal weight and obese patients.     

Non‐nutritional uses of food in traditional Appalachian culture

Food has both nutritional and non‐nutritional functions and this paper reports some non‐nutritional uses of food in traditional Appalachian culture. The emphasis is upon occult and non‐occult uses of food in folk medicine. Specific examples of rituals are presented as collected in Appalachia. It is suggested that these traditions have been maintained due to the strength of the reference groups.     

Advancing equity,diversity, and inclusion in the American College of Neuropsychopharmacology (ACNP): advances,challenges, and opportunities to accelerate progress

It is increasingly accepted that higher levels of excellence and innovation in research can be achieved by organizations that promote equity, diversity, and inclusion across several domains including ethnicity and gender. The purpose of this commentary is to provide an overview of the methods used to increase diversity within ACNP, as well as recommendations for accelerating progress. Annual membership surveys confirm increases in female membership and leadership positions, slower but encouraging signals for “Asian” and “Hispanic” members, and less progress for African American and other ethnic populations. Meetings have become visibly more diverse, due in part to ethnic minority travel awards and apparently increasing diversity among guest attendees. Evidence of increasing inclusion includes well-attended networking events and minority-relevant programming, active communications about diversity-related events and resources, and strong statements by ACNP leadership that embrace diversity as a core value and support collaboration among key committees and task forces to identify and implement pro-inclusion and diversity-enhancing efforts. We believe ACNP can accelerate progress with more scientifically valid approaches to assessing diversity and inclusion. The current membership survey includes five outmoded ethnic options and postmeeting surveys that are not designed to assess inclusion efforts and consequences. Measures should be developed that better characterize diversity and assess efforts to reduce the barriers that exist for potential non-White populations (e.g., annual membership and meeting attendance costs). Increased collaboration with NIH and other organizations that are committed to these same goals may also contribute to acceleration of progress by ACNP and other scientific organizations.Subject terms: Medical research, Neuroscience     

Birth prevalence and characteristics of congenital toxoplasmosis in Sergipe,North‐east Brazil

Objectives To estimate, by neonatal screening, the birth prevalence of congenital toxoplasmosis among live‐born infants in Sergipe state, Brazil, and to investigate the clinical features of affected infants. Methods Dried blood spot specimens obtained from 15 204 neonates were assayed for the presence of anti‐T. gondii IgM antibodies. Duplicate retesting was done in infants with positive and borderline results. Confirmatory testing in peripheral blood samples consisted of testing for anti‐T. gondii IgG and IgM in infants and mothers. Those with possible congenital toxoplasmosis were evaluated and followed up to a median age of 20 months. Congenital infection was confirmed in the presence of persisting anti‐T. gondii IgG antibodies beyond 12 months of age. All infants with confirmed infection were treated with pyrimethamine, sulfadiazine and folinic acid for 1 year. Results Fifty‐three infants had detectable IgM in dried blood spot specimens. Confirmatory testing was reactive in 39/50, of which, 38 completed follow‐up. Six of 15 204 newborns were diagnosed with congenital toxoplasmosis, resulting in an estimated birth prevalence of four per 10 000 [CI 95% 1.4–8.0]. Four infants (67%) showed signs of congenital toxoplasmosis in their first year of life; three (75%) had retinochoroidal scars, and one had cerebral calcifications. Two infants remained asymptomatic until 20 months of age. Conclusions The birth prevalence of congenital toxoplasmosis is high in the Brazilian state of Sergipe, with most of the infants showing ocular lesions. Preventive measures are strongly warranted.