International Field Trial Research Articles

ICD-11 Primary Psychotic Disorders: What is New and May be Relevant for Treatment Selection and Outcome?

ICD-11 was released by WHO in 2018 and approved by the World Health Assembly (WHA) in 2019. The revision for all chapters was guided by the principles of global applicability, scientific validity and clinical utility. The new chapter for mental health is termed 06 Mental, Behavioural or Neurodevelopmental Disorders (MBND). The ICD-11 with its chapter on Mental, Behavioural or Neurodevelopmental Disorders, its Mortality and Morbidity Statistics (MMS), Coding Tool and Reference Guide, Clinical Descriptions and Diagnostic Guidelines (CDDG), and other tools for translation and implementation offers an innovative approach for individualised diagnosis, treatment and care of people with mental disorders. For supporting the international process of implementation, WHO has installed an International Advisory Group for Training and Implementation of ICD-11 MBND. Development, Concept and Structure of ICD-11 will be presented. Selected changes from ICD-10 to ICD-11 like new diagnostic categories, revision of diagnostic criteria, introduction of dimensional symptom qualifiers or course descriptors, and options for complex coding with regard to their innovative strength, controversial potential and impact on diagnostics, treatment and care will be briefly discussed. National challenges for implementation - partly informed by international field trials, administrative, organisational, educational and training requirements - will be outlined. The new ICD-11 chapter on Schizophrenia or other primary psychotic disorders will serve as an example to discuss potential impact on treatment selection and outcome.DisclosureNo significant relationships.

Outcomes from international field trials with Male Aedes Sound Traps: Frequency-dependent effectiveness in capturing target species in relation to bycatch abundance.

Aedes aegypti and Aedes albopictus vector dengue, chikungunya and Zika viruses. With both species expanding their global distributions at alarming rates, developing effective surveillance equipment is a continuing priority for public health researchers. Sound traps have been shown, in limited testing, to be highly species-specific when emitting a frequency corresponding to a female mosquito wingbeat. Determining male mosquito capture rates in sound traps based on lure frequencies in endemic settings is the next step for informed deployment of these surveillance tools. We field-evaluated Male Aedes Sound Traps (MASTs) set to either 450 Hz, 500 Hz, 550 Hz or 600 Hz for sampling Aedes aegypti and/or Aedes albopictus and compared catch rates to BG-Sentinel traps within Pacific (Madang, Papua New Guinea) and Latin American (Molas, Mexico and Orange Walk Town, Belize) locations. MASTs set to 450–550 Hz consistently caught male Ae. aegypti at rates comparable to BG-Sentinel traps in all locations. A peak in male Ae. albopictus captures in MASTs set at 550 Hz was observed, with the lowest mean abundance recorded in MASTs set to 450 Hz. While significantly higher abundances of male Culex were sampled in MASTs emitting lower relative frequencies in Molas, overall male Culex were captured in significantly lower abundances in the MASTs, relative to BG-Sentinel traps within all locations. Finally, significant differences in rates at which male Aedes and Culex were positively detected in trap-types per weekly collections were broadly consistent with trends in abundance data per trap-type. MASTs at 550 Hz effectively captured both male Ae. aegypti and Ae. albopictus while greatly reducing bycatch, especially male Culex, in locations where dengue transmission has occurred. This high species-specificity of the MAST not only reduces staff-time required to sort samples, but can also be exploited to develop an accurate smart-trap system—both outcomes potentially reducing public health program expenses.

Development and Validation of the Krio Version of the WHOQOL-BREF for Use in Sierra Leone

Formal measures of subjective well-being are needed to assure that health and psychosocial support services in Sierra Leone are objectively evaluated and evidence-based. The purpose of this study was to evaluate a Krio version of the brief form of the World Health Organization’s Quality of Life (WHOQOL-BREF) questionnaire. A convenience sample of 425 adult Sierra Leoneans was verbally interviewed in the northern province of Bombali, using a previously piloted version of the scale, as well as a short demographic survey. Descriptive, correlational, and inferential statistics were used to assess evidence of reliability and validity in a manner similar to the WHOQOL-BREF international field trial. Cronbach’s alpha for the four domains ranged from 0.55 to 0.72 and improved when the three negatively phrased items requiring reversed scoring were removed, as well as when all items were treated as a unidimensional scale (alpha = 0.83). Patients scored significantly lower scores on all four subscales and the question assessing overall quality of health question. Persons with no formal education had lower scores on Physical, Psychological, and Environmental domains, as well as the two overall quality of life and health questions. Age was negatively correlated with Physical, Psychological, and Social domains, as well as the questions for overall quality of life and quality of health. Multiple regression analyses found Physical, Psychological, and Environmental domains to be significantly associated with questions assessing overall quality of life and quality of health. Twenty-three out of 24 items correlated highest to their expected domain, but 10 also correlated above 0.40 on another domain. Confirmatory factor analysis allowing for two pairs of error variances to co-vary showed good fit with the original scale’s four domain model (χ2/df = 3.02; CFI = .833; RMSEA = .069, 90% CI = 0.063–0.076). The results indicate that the new scale shares many of the same psychometric properties as the original WHOQOL-BREF and is appropriate for health-related research. Future studies with the WHOQOL and other quality of life instruments should use caution when developing negatively phrased items in scale development, particularly when planned for use across multiple settings, as they may yield unwanted method effects and adversely impact test reliability and internal structure.

Impact of an intervention to support hearing and vision in dementia: The SENSE-Cog Field Trial.

ObjectivesHearing, vision, and cognitive impairment commonly co‐occur in older adults. Improving sensory function may positively impact outcomes in people with dementia (PwD). We developed a “sensory intervention” (SI) to support hearing and vision in PwD. Here, we report the findings of an international open‐label field trial, and nested case series, to explore the impact of the SI on dementia‐related outcomes.MethodsThis was a home‐based trial conducted in France, England, and Cyprus. Participants were people with mild‐to‐moderate dementia and hearing and/or vision impairment (n = 19) and their study partners (unpaid carers; n = 19). The “basic” SI included a hearing and vision assessment and provision of glasses and/or hearing aids. A subsample received the “extended” SI with additional weekly visits from a sensory support therapist (SST). Exploratory analyses of dementia‐related, health utility and resource utilisation outcomes were performed.ResultsQuality of life (QoL) and sensory functional ability improved. Change in QoL exceeded the threshold for a minimum clinically important difference. There was a modest improvement (in absolute terms) post intervention in behavioural disturbance, self‐efficacy, and relationship satisfaction. Study partner time assisting instrumental activities of daily living (iADL) and supervision decreased by about 22 and 38 hours per month, respectively, although time for personal ADL support increased. Qualitative data supported effectiveness of the intervention: PwD were more socially engaged, less isolated, less dependent on study partners, and had improved functional ability and communication.ConclusionsThese findings support the need for a definitive randomised controlled trial (RCT) to evaluate the effectiveness of the intervention.

Challenges facing genetically improving underutilised crops: progress in bambara groundnut

Underlying a number of the biological challenges that bambara groundnut (Vigna subterranea (L.) Verdc.) faces NDASH an exemplar of underutilised crop species in general - there is a lack of: A) quantitative and comparative data on traits of farmer-defined importance; B) purified genetic lines, mixes and controlled crosses; C) knowledge of optimal field management and genotype-by-environment interactions; D) replicated and properly designed multi-locational field trials leading to locally selected cultivars. Bambara groundnut is a drought tolerant legume that has significant local importance in certain parts of sub-Saharan Africa and Southeast Asia. BamYIELD and its predecessor programmes have worked on overcoming its limitations, such as photoperiod sensitivity that restricts fruiting between a relatively small range of photoperiods (i.e., at or near 12-h day lengths), crossbred contrasting lines for mapping traits of importance, such as peduncle length, and explored the socio-economic issues surrounding crop production in Ghana, Nigeria and Indonesia. Progress has accelerated recently and near future plans include an international multi-locational field trial system that will serve as a germplasm evaluation and trait selection programme to both increase advantageous characteristics like drought tolerance and reduce bottlenecks like the food crop's long cooking time. The programme links multiple partners across Africa and Asia, including the International Institute for Tropical Institute, Nigeria, and Bogor Agricultural University, Indonesia. A component of the field trials programme will be an association genetics panel that will consist of 500 accessions from around the world to be developed by single genotype line selection for phenotyping and genotyping. In addition, nutritional/food profiling will take place on a range of genotypes in various agro-environments and value added products are being developed. The overall framework and methodological toolkit being designed by BamYIELD will be applicable to many other underutilised crops.

Značaj žetvenih ostataka u proizvodnji kukuruza

Harvest residues of field crops are important for matter cycling in the agroecosystem, especially when organic fertilizers are not applied in adequate amounts. The aim of this study was to assess the influence of increasing nitrogen doses and harvest residues (HR) on corn yield. The international stationary field trial (ISDV) has been established on a calcareous chernozem soil, at Rimski Šančevi, on Institute of Field and Vegetable Crops, Novi Sad. This paper review two-year average yields on corn hybrid NS 3022. The trial had six treatments, three with HR (0, 100, 200 kg N ha-1 ) and three without HR (0, 100, 200 kg N ha1 ). The experiment was set up in three-crop rotation (corn, soybean, wheat). The average yield with and without HR treatments was 7.22 t ha-1 . The average yield obtained on treatments with HR was 7.64 t ha-1 , which was higher by 0.85 t ha-1 (12.52%) than the average yield on treatments without HR (6.79 t ha-1 ). The highest yield on treatments with HR was achieved with 100 kg N ha-1 a (8.44 t ha-1 ) while the highest yield on treatments without HR was obtained with 200 kg N ha-1 (8.56 t ha-1). On average, HR increased the yield of corn grain in the control treatment by 1.18 t ha-1 . To achieve good yields of corn grain, optimal nitrogen doses on treatments with HR should range from 100 kg N ha-1 to 200 kg N ha-1 , while on treatments without HR optimal doses of nitrogen should be closer to 200 kg N ha-1.

One prophage WO gene rescues cytoplasmic incompatibility in Drosophila melanogaster

Wolbachia are maternally inherited, intracellular bacteria at the forefront of vector control efforts to curb arbovirus transmission. In international field trials, the cytoplasmic incompatibility (CI) drive system of wMel Wolbachia is deployed to replace target vector populations, whereby a Wolbachia-induced modification of the sperm genome kills embryos. However, Wolbachia in the embryo rescue the sperm genome impairment, and therefore CI results in a strong fitness advantage for infected females that transmit the bacteria to offspring. The two genes responsible for the wMel-induced sperm modification of CI, cifA and cifB, were recently identified in the eukaryotic association module of prophage WO, but the genetic basis of rescue is unresolved. Here we use transgenic and cytological approaches to demonstrate that maternal cifA expression independently rescues CI and nullifies embryonic death caused by wMel Wolbachia in Drosophila melanogaster Discovery of cifA as the rescue gene and previously one of two CI induction genes establishes a "Two-by-One" model that underpins the genetic basis of CI. Results highlight the central role of prophage WO in shaping Wolbachia phenotypes that are significant to arthropod evolution and vector control.

The DSM-5 Cultural Formulation Interview: Bridging Barriers Toward a Clinically Integrated Cultural Assessment in Psychiatry

The Diagnostic and Statistical Manual of Mental Disorders , fifth edition, (DSM-5) Cultural Formulation Interview (CFI) is a systematic, semi-structured interview developed to guide clinicians on conducting a cultural assessment in routine mental health settings. An international field trial with 318 patients, 75 clinicians, and 86 family members in 6 countries found the core version of the CFI to be feasible, acceptable, and clinically useful, and a growing evidence base has led to its inclusion in worldwide mental health services. We review the definition of culture that underlies the CFI, its development and components, and how to apply it in care. We also focus on barriers to its implementation and how these are being addressed by investigators and clinicians. The cultural formulation approach stemming from DSM-IV , of which the DSM-5 CFI is the latest iteration, constitutes the cultural competence paradigm with the largest evidence base in mental health service delivery. [ Psychiatr Ann. 2018;48(3):154–159.]

Piezoelectric wave generation system for condition assessment of field water pipelines

ABSTRACTThe condition assessment of pipelines is central to the management of water systems but is only conducted sporadically due to the limited range and practical constraints of current technologies. This paper describes the successful international field trial of a new condition assessment approach that was tested in live water pipeline networks of large cities during peak water demand and traffic conditions. The system, referred to as PIPE SONAR (PCT/EP2015/059540), uses a piezoelectric actuator capable of generating customized, small amplitude (<0.4 m) pressure signals. The field trial involved 1600 individual field tests covering 31 sites of water networks in New Zealand and China, across nine different pipe materials and pipe diameters ranging from 100 mm to 600 mm. The results of the condition assessment were independently confirmed using hydrant tests, low frequency transient tests, and direct inspection through excavation.

Feasibility, acceptability and clinical utility of the Cultural Formulation Interview: Mixed-methods results from the DSM-5 international field trial

BackgroundThere is a need for clinical tools to identify cultural issues in diagnostic assessment.AimsTo assess the feasibility, acceptability and clinical utility of the DSM-5 Cultural Formulation Interview (CFI) in routine clinical practice.MethodMixed-methods evaluation of field trial data from six countries. The CFI was administered to diagnostically diverse psychiatric out-patients during a diagnostic interview. In post-evaluation sessions, patients and clinicians completed debriefing qualitative interviews and Likert-scale questionnaires. The duration of CFI administration and the full diagnostic session were monitored.ResultsMixed-methods data from 318 patients and 75 clinicians found the CFI feasible, acceptable and useful. Clinician feasibility ratings were significantly lower than patient ratings and other clinician-assessed outcomes. After administering one CFI, however, clinician feasibility ratings improved significantly and subsequent interviews required less time.ConclusionsThe CFI was included in DSM-5 as a feasible, acceptable and useful cultural assessment tool.

Alleviating health risks associated with rainwater harvesting

Perceived and real public health risks associated with the quality of water from alternative water sources and supply systems, such as rainwater harvesting (RWH) and grey water reuse, continue to restrict their uptake in many countries. One option to alleviate these health risks is to treat alternative water to potable standard at the point of use (POU) as opposed to the point of supply, as undertaken in centralised systems. This paper presents the results of three international empirical field trials of a novel POU RWH treatment device. The results indicate that where the harvested rainwater did not contain elevated levels of pesticides or physico-chemical determinands, the POU device was able to reduce levels in outlet water to meet UK, EU and World Health Organization potable standards. Regarding microbiological determinands, such as total viable counts and coliforms, and microbial pathogens, such as Pseudomonas aeruginosa and Legionella spp., the device achieved reduction to potable standard and full pathogen removal, respectively. Thus, while it is possible to treat harvested rainwater to potable standard with a POU device, whether it is desirable to do so to alleviate risks for all end uses remains a question for further debate.

Perspectives of family members participating in cultural assessment of psychiatric disorders: Findings from the DSM-5 International Field Trial

Despite the important roles families play in the lives of many individuals with mental illness across cultures, there is a dearth of data worldwide on how family members perceive the process of cultural assessment as well as to how to best include them. This study addresses this gap in our knowledge through analysis of data collected across six countries as part of a DSM-5 Field Trial of the Cultural Formulation Interview (CFI). At clinician discretion, individuals who accompanied patients to the clinic visit (i.e. patient companions) at the time the CFI was conducted were invited to participate in the cultural assessment and answer questions about their experience. The specific aims of this paper are (1) to describe patterns of participation of patient companions in the CFI across the six countries, and (2) to examine the comparative feasibility, acceptability, and clinical utility of the CFI from companion perspectives through analysis of both quantitative and qualitative data. Among the 321 patient interviews, only 86 (at four of 12 sites) included companions, all of whom were family members or other relatives. The utility, feasibility and acceptability of the CFI were rated favourably by relatives, supported by qualitative analyses of debriefing interviews. Cross-site differences in frequency of accompaniment merit further study.

Girls' quality of life prior to detention in relation to psychiatric disorders, trauma exposure and socioeconomic status.

Practice and research on detained girls has mainly been problem oriented, overlooking these minors' own perspective on and satisfaction with life. The aim of this study was to examine how girls evaluate multiple domains of quality of life (QoL) and how each domain is affected by psychiatric (co)morbidity, trauma, and socioeconomic status (SES). An abbreviated version of the World Health Organization (WHO) QoL Instrument was used to assess the girls' (N = 121; M(age) = 16.28) QoL prior to detention. This self-report questionnaire consists of two benchmark items referring to their overall QoL and health, and 24 remaining items measuring their QoL regarding four domains (physical health, psychological health, social relationships, and environment). The Diagnostic Interview Schedule for Children-IV was used to assess the past-year prevalence of psychiatric disorders and life-time trauma exposure. Detained girls perceived their QoL almost as good as the 12- to 20-year-olds from the WHO's international field trial on all but one domain (i.e., psychological health). They were most satisfied with their social relationships and least satisfied with their psychological health. Psychiatric disorders, trauma, and low SES were distinctively and negatively related to various domains of QoL. The girls' psychological health was most adversely affected by psychosocial and socioeconomic problems, while these variables had an almost negligible impact on their satisfaction with their social relationships. The particularity of each domain of QoL supports a multidimensional conceptualization of QoL. Regarding treatment, psychological health appears as a domain of major concern, while social relationships might serve as a source of resilience.

EPA-1462 – ICD-11: update and field trials on psychotic disorders

Introduction Within the efforts to revise the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the Work Group on the Classification of Psychotic Disorders appointed by the World Health Organization (WHO) has proposed several changes, which will be put to test in international field trials in spring 2014. Objectives The objectives of the field trials are to test whether the proposed revisions lead to an increase of clinical utility, reliability and validity of the classification of psychotic disorders. Aims WHO field trials target the following questions: (a) do clinicians apply the ICD-11 psychotic disorder diagnostic guidelines and discriminate among the descriptions consistently, (b) do the ICD-11 symptom specifiers lead to an incremental improvement over ICD-10 subtypes concerning reliability and clinical description, and (c) which is the optimal scale for the ICD-11 symptom severity specifiers. In further field trials, the effects of training on reliability in the use of symptom severity scales will be examined. Methods Report of current developments. Results Schizophrenia subtypes will be replaced by six symptom specifiers, including a specifier for cognitive impairment. First-rank symptoms schizophrenia will be de-emphasized, course specifiers have been reformulated. ICD-11 includes stricter criteria for schizoaffective disorder and major restructuring of ATPD and delusional disorders. Conclusions Moderate to pronounced changes will be made to chapters on psychotic disorders. Proposed changes are likely to have impact on treatment planning, prognostic decision making, research, which will be tested in the ICD-11 field trials. Abstract topic: 31 Schizophrenia

Barriers to Implementing the DSM-5 Cultural Formulation Interview: A Qualitative Study

The Outline for Cultural Formulation (OCF) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) marked an attempt to apply anthropological concepts within psychiatry. The OCF has been criticized for not providing guidelines to clinicians. The DSM-5 Cultural Issues Subgroup has since converted the OCF into the Cultural Formulation Interview (CFI) for use by any clinician with any patient in any clinical setting. This paper presents perceived barriers to CFI implementation in clinical practice reported by patients (n = 32) and clinicians (n = 7) at the New York site within the DSM-5 international field trial. We used an implementation fidelity paradigm to code debriefing interviews after each CFI session through deductive content analysis. The most frequent patient threats were lack of differentiation from other treatments, lack of buy-in, ambiguity of design, over-standardization of the CFI, and severity of illness. The most frequent clinician threats were lack of conceptual relevance between intervention and problem, drift from the format, repetition, severity of patient illness, and lack of clinician buy-in. The Subgroup has revised the CFI based on these barriers for final publication in DSM-5. Our findings expand knowledge on the cultural formulation by reporting the CFI's reception among patients and clinicians.

Establishment and Validation of Analytical Reference Panels for the Standardization of Quantitative BCR-ABL1 Measurements on the International Scale

Current guidelines for managing Philadelphia-positive chronic myeloid leukemia include monitoring the expression of the BCR-ABL1 (breakpoint cluster region/c-abl oncogene 1, non-receptor tyrosine kinase) fusion gene by quantitative reverse-transcription PCR (RT-qPCR). Our goal was to establish and validate reference panels to mitigate the interlaboratory imprecision of quantitative BCR-ABL1 measurements and to facilitate global standardization on the international scale (IS). Four-level secondary reference panels were manufactured under controlled and validated processes with synthetic Armored RNA Quant molecules (Asuragen) calibrated to reference standards from the WHO and the NIST. Performance was evaluated in IS reference laboratories and with non-IS-standardized RT-qPCR methods. For most methods, percent ratios for BCR-ABL1 e13a2 and e14a2 relative to ABL1 or BCR were robust at 4 different levels and linear over 3 logarithms, from 10% to 0.01% on the IS. The intraassay and interassay imprecision was <2-fold overall. Performance was stable across 3 consecutive lots, in multiple laboratories, and over a period of 18 months to date. International field trials demonstrated the commutability of the reagents and their accurate alignment to the IS within the intra- and interlaboratory imprecision of IS-standardized methods. The synthetic calibrator panels are robust, reproducibly manufactured, analytically calibrated to the WHO primary standards, and compatible with most BCR-ABL1 RT-qPCR assay designs. The broad availability of secondary reference reagents will further facilitate interlaboratory comparative studies and independent quality assessment programs, which are of paramount importance for worldwide standardization of BCR-ABL1 monitoring results and the optimization of current and new therapeutic approaches for chronic myeloid leukemia.

Proposed new diagnoses of anxious depression and bodily stress syndrome in ICD-11-PHC: an international focus group study

The World Health Organization is revising the primary care classification of mental and behavioural disorders for the International Classification of Diseases (ICD-11-Primary Health Care (PHC)) aiming to reduce the disease burden associated with mental disorders among member countries. To explore the opinions of primary care professionals on proposed new diagnostic entities in draft ICD-11-PHC, namely anxious depression and bodily stress syndrome (BSS). Qualitative study with focus groups of primary health-care workers, using standard interview schedule after draft ICD-11-PHC criteria for each proposed entity was introduced to the participants. Nine focus groups with 4-15 participants each were held at seven locations: Austria, Brazil, Hong Kong, New Zealand, Pakistan, Tanzania and United Kingdom. There was overwhelming support for the inclusion of anxious depression, which was considered to be very common in primary care settings. However, there were concerns about the 2-week duration of symptoms being too short to make a reliable diagnosis. BSS was considered to be a better term than medically unexplained symptoms but there were disagreements about the diagnostic criteria in the number of symptoms required. Anxious depression is well received by primary care professionals, but BSS requires further modification. International field trials will be held to further test these new diagnoses in draft ICD-11-PHC.

AS01-01 - Recent controversies in diagnosis and management of paraphilias

Paraphilias are defined as sexually arousing fantasies, urges, or behaviors involving either nonhuman objects; suffering or humiliation of oneself or one's partner; or children or other non-consenting persons. In the DSM classification, paraphilias are subsumed under sexual disorders, while in the ICD paraphilias are classified as disorders of adult personality and behavior (disorders of sexual preference). Historically, some have advocated eliminating paraphilias or radically revising their definitions, while others suggested adhering to their traditional definitions. The classification and definition of paraphilias is complicated by cultural and societal underpinning, and the unclear boundaries between “normal” and “abnormal” sexuality. The diagnostic criteria of some paraphilias (e.g., pedophilia) are also complicated by the differences between the medical and the legal concepts of these entities. The recent attempts to introduce two new diagnoses, hypersexual disorder and paraphilic coercive disorder, into the DSM system stirred passionate scientific discussions about those two diagnoses and about paraphilias in general. This presentation reviews the pros and cons of classifying paraphilias as sexual disorders and of including the new diagnoses of hypersexual disorder (unclear borders with “normality”) and paraphillic coercive disorder (unclear distinction between this entity and sexual sadism). In addition, this presentation reviews some of the more and/or less accepted methods of paraphilia management, such as pharmacotherapy and castration (chemical, surgical). Several aspects of the classification and diagnosis of paraphilias remain controversial and some of the proposed changes seem unwarranted. Resolving diagnostic and management controversies could be helped by large multicenter and international field trials.

One-year clinical and parasitological follow-up of dogs treated with marbofloxacin for canine leishmaniosis

The purpose of this international, multicentric, and non-comparative field trial was to obtain complementary data on long-term clinical and parasitological follow-up of dogs treated with marbofloxacin for canine leishmaniosis (CanL). Seventy-four dogs with clinical signs of CanL and without severe renal failure were recruited in France, Spain and Italy, and 61 of them were part of the analysis. Each dog was treated with palatable tablets of marbofloxacin at 2mg/kg once a day for 28 days. A clinical and parasitological follow-up was performed regularly up to 12 months. Efficacy was demonstrated in 42 dogs (68.9%), within 51 days (mean value), 10 of them (23.8%) being clinically cured after 3 months. A decrease of 61% in the sum of clinical scores was observed after 3 months. Haemato-biochemical parameters improved in general, supporting the observed clinical efficacy. Relapse was observed in 20/38 dogs (52.6%) approximately 5.5 months after treatment completion. The blood parasite load generally developed in conformity with the clinical outcome, even if exceptions were not rare. Lymph nodes remained positive by culture or PCR for a long time, even in dogs for which a good clinical response was observed. Despite the incomplete parasite clearance, as is also the case with other anti-leishmanial drugs, these results nevertheless confirm the relevance of marbofloxacin as a CanL treatment.

The potential of lentil (Lens culinaris L.) as a whole food for increased selenium, iron, and zinc intake: preliminary results from a 3 year study

Micronutrient malnutrition, especially selenium (Se), iron (Fe), and zinc (Zn) deficiency, is a major global health problem. Previous attempts to prevent micronutrient malnutrition through food fortification, supplementation, and enrichment of staple crops has had limited success. Canadian grown lentils are rich in micronutrients Fe (73–90 mg kg−1), Zn (44–54 mg kg−1), Se (425–673 μg kg−1), and have very low concentrations of phytic acid (2.5–4.4 mg g−1). Our preliminary studies using a Caco-2 cell model show that the uptake of Fe from lentils is relatively greater than that of most other staple food crops. Moreover, preliminary results from our human nutrition study in Sri Lanka show an increased trend in blood Se concentration after lentil consumption. This article briefly overviews our previously published results as well as data from international lentil field trials, and describes the potential for biofortified lentil to provide a whole food solution to combat global human micronutrient malnutrition.