Mode Of Acquisition Research Articles

Substance use during pregnancy and postpartum among individuals with perinatally-acquired HIV in the United States

Use of cannabis and alcohol were common during pregnancy and the first year postpartum among people with HIV in the United States (2007–2019), but there were no major differences in substance use during pregnancy based on mode of HIV acquisition. The relatively high prevalence of substance use in this population, particularly postpartum alcohol and cannabis use, warrants further attention.

Recurrence and propagation of past functions through mineral facilitated horizontal gene transfer

Horizontal gene transfer is one of the most important drivers of bacterial evolution. Transformation by uptake of extracellular DNA is traditionally not considered to be an effective mode of gene acquisition, simply because extracellular DNA is degraded in a matter of days when it is suspended in e.g. seawater. Recently the age span of stored DNA was increased to at least 2 Ma. Here, we show that Acinetobacter baylyi can incorporate 60 bp DNA fragments adsorbed to common sedimentary minerals and that the transformation frequencies scale with mineral surface properties. Our work highlights that ancient environmental DNA can fuel the evolution of contemporary bacteria. In contrast to heritable stochastic mutations, the processes by which bacteria acquire new genomic material during times of increased stress and needs, indicate a non-random mechanism that may propel evolution in a non-stochastic manner.

A complementary approach for detecting biological signals through a semi-automated feature selection tool.

Untargeted metabolomics is often used in studies that aim to trace the metabolic profile in a broad context, with the data-dependent acquisition (DDA) mode being the most commonly used method. However, this approach has the limitation that not all detected ions are fragmented in the data acquisition process, in addition to the lack of specificity regarding the process of fragmentation of biological signals. The present work aims to extend the detection of biological signals and contribute to overcoming the fragmentation limits of the DDA mode with a dynamic procedure that combines experimental and in silico approaches. Metabolomic analysis was performed on three different species of actinomycetes using liquid chromatography coupled with mass spectrometry. The data obtained were preprocessed by the MZmine software and processed by the custom package RegFilter. RegFilter allowed the coverage of the entire chromatographic run and the selection of precursor ions for fragmentation that were previously missed in DDA mode. Most of the ions selected by the tool could be annotated through three levels of annotation, presenting biologically relevant candidates. In addition, the tool offers the possibility of creating local spectral libraries curated according to the user's interests. Thus, the adoption of a dynamic analysis flow using RegFilter allowed for detection optimization and curation of potential biological signals, previously absent in the DDA mode, being a good complementary approach to the current mode of data acquisition. In addition, this workflow enables the creation and search of in-house tailored custom libraries.

Israeli neonatal herpes simplex infection: Unique epidemiology and clinical profile

AbstractTo gather national level data on Israeli neonatal HSV (NHSV) infection and to evaluate the distinct clinical characteristics of NHSV and neonatal enteroviral meningitis (NEM). Israeli NHSV patients, hospitalized between January 2015 and April 2022 in 22 medical centers were assessed, together with NEM patients, hospitalized at Sheba Medical Center during the same period. NHSV demographic and clinical characteristics were documented and compared to those of NEM. Eighty‐five NHSV (73% males) and 130 NEM (62% males) patients were included. The incidence of NHSV was 5.9/100 000 live births, the common phenotype and HSV type were SEM (53%) and HSV1 (91%), respectively. Horizontal transmission was suspected in 50% cases (of which 67% underwent a Jewish ritual circumcision with direct wound sucking, 33% had relatives with highly suspicious herpetic lesions). Compared with NEM, NHSV tends to present with rash (14% vs. 60%, p‐value < 0.01) and seizures (0% vs. 6%, p‐value 0.02), while fever, irritability and poor feeding appear more frequently in NEM (94% vs. 18%, p‐value < 0.01; 37% vs. 1%, p‐value < 0.01; 25% vs. 1%, p‐value < 0.01 respectively). Of NEM patients, 28% were treated with acyclovir. Our results mark a decrease in the incidence rate of NHSV in Israel and a prominent mode of horizontal infection acquisition. We underscore the unique localized phenotype of NHSV, in contrast to enterovirus, which tends to cause a systemic disease with constitutional symptoms. These findings should be considered when evaluating the need for comprehensive empirical treatment for HSV in the context of neonatal fever, or according to a certain clinical presentation.

Pan-pathogen deep sequencing of nosocomial bacterial pathogens in Italy in spring 2020: a prospective cohort study

Nosocomial infections pose a considerable risk to patients who are susceptible, and this is particularly acute in intensive care units when hospital-associated bacteria are endemic. During the first wave of the COVID-19 pandemic, the surge of patients presented a significant obstacle to the effectiveness of infection control measures. We aimed to assess the risks and extent of nosocomial pathogen transmission under a high patient burden by designing a novel bacterial pan-pathogen deep-sequencing approach that could be integrated with standard clinical surveillance and diagnostics workflows. We did a prospective cohort study in a region of northern Italy that was severely affected by the first wave of the COVID-19 pandemic. Inpatients on both ordinary and intensive care unit (ICU) wards at the San Matteo hospital, Pavia were sampled on multiple occasions to identify bacterial pathogens from respiratory, nasal, and rectal samples. Diagnostic samples collected between April 7 and May 10, 2020were cultured on six different selective media designed to enrich for Acinetobacter baumannii, Escherichia coli, Enterococcus faecium, Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus pneumoniae, and DNA from each plate with positive growth was deep sequenced en masse. We used mSWEEP and mGEMS to bin sequencing reads by sequence cluster for each species, followed by mapping with snippy to generate high quality alignments. Antimicrobial resistance genes were detected by use of ARIBA and CARD. Estimates of hospital transmission were obtained from pairwise bacterial single nucleotide polymorphism distances, partitioned by within-patient and between-patient samples. Finally, we compared the accuracy of our binned Acinetobacter baumannii genomes with those obtained by single colony whole-genome sequencing of isolates from the same hospital. We recruited patients from March 1to May 7, 2020. The pathogen population among the patients was large and diverse, with 2148species detections overall among the 2418sequenced samples from the 256patients. In total, 55sequence clusters from key pathogen species were detected at least five times. The antimicrobial resistance gene prevalence was correspondingly high, with key carbapenemase and extended spectrum ß-lactamase genes detected in at least 50 (40%) of 125patients in ICUs. Using high-resolution mapping to infer transmission, we established that hospital transmission was likely to be a significant mode of acquisition for each of the pathogen species. Finally, comparison with single colony Acinetobacter baumannii genomes showed that the resolution offered by deep sequencing was equivalent to single-colony sequencing, with the additional benefit of detection of co-colonisation of highly similar strains. Our study shows that a culture-based deep-sequencing approach is a possible route towards improving future pathogen surveillance and infection control at hospitals. Future studies should be designed to directly compare the accuracy, cost, and feasibility of culture-based deep sequencing with single colony whole-genome sequencing on a range of bacterial species. Wellcome Trust, European Research Council, Academy of Finland Flagship program, Trond Mohn Foundation, and Research Council of Norway.

Clinical characteristics of women with HIV in the RESPOND cohort: A descriptive analysis and comparison to men.

Women with HIV are globally underrepresented in clinical research. Existing studies often focus on reproductive outcomes, seldom focus on older women, and are often underpowered to assess sex/gender differences. We describe CD4, HIV viral load (VL), clinical characteristics, comorbidity burden, and use of antiretroviral therapy (ART) among women with HIV in the RESPOND study and compare them with those of the men in RESPOND. RESPOND is a prospective, multi-cohort collaboration including over 34 000 people with HIV from across Europe and Australia. Demographic and clinical characteristics, including CD4/VL, comorbidity burden, and ART are presented at baseline, defined as the latter of 1 January 2012 or enrolment into the local cohort, stratified by age and sex/gender. We further stratify men by reported mode of HIV acquisition, men who have sex with men (MSM) and non-MSM. Women account for 26.0% (n = 9019) of the cohort, with a median age of 42.2 years (interquartile range [IQR] 34.7-49.1). The majority (59.3%) of women were white, followed by 30.3% Black. Most women (75.8%) had acquired HIV heterosexually and 15.9% via injecting drug use. Nearly half (44.8%) were receiving a boosted protease inhibitor, 31.4% a non-nucleoside reverse transcriptase inhibitor, and 7.8% an integrase strand transfer inhibitor. The baseline year was 2012 for 73.2% of women and >2019 for 4.2%. Median CD4 was 523 (IQR 350-722) cells/μl, and 73.6% of women had a VL <200 copies/mL. Among the ART-naïve population, women were more likely than MSM but less likely than non-MSM (p < 0.001) to have CD4 <200 cells/μL and less likely than both MSM and non-MSM (p < 0.001) to have VL ≥100 000 copies/mL. Women were also more likely to be free of comorbidity than were both MSM and non-MSM (p < 0.0001). RESPOND women are diverse in age, ethnicity/race, CD4/VL, and comorbidity burden, with important differences relative to men. This work highlights the importance of stratification by sex/gender for future research that may help improve screening and management guidelines specifically for women with HIV.

Clinical Impact of Vancomycin MIC on Outcomes in Patients With Coagulase-negative Staphylococcal Bacteremia

Coagulase-negative staphylococci (CoNS) are Gram-positive organisms that are a known component of normal skin flora and the most common cause of nosocomial bacteremia. For CoNS species, the vancomycin MIC breakpoint for susceptibility set by the Clinical and Laboratory Standards Institute is ≤4 µg/mL. There has been published reports of vancomycin heteroresistance in CoNS with vancomycin MICs of 2 to 4 µg/mL. The aim of this retrospective cohort analysis was to assess the clinical impact of vancomycin MICs <2 µg/mL versus ≥2 µg/mL in adult patients with CoNS bloodstream infections. Adult patients admitted to University Medical Center New Orleans with a blood culture positive for CoNS were assessed. The primary outcome was difference in 30-day mortality. Secondary outcomes were in-hospital, all-cause mortality; duration of bacteremia; hospital length of stay; and percentage of oxacillin-resistant CoNS. There was no difference in mortality in the vancomycin MIC <2 µg/mL group versus the vancomycin MIC ≥2 µg/mL group at 30 days (15.4% vs 17.4%; P = 1). In-hospital, all-cause mortality was also not different between groups (11.5% vs 13%; P = 1). Hospital length of stay between groups was 28.2 days versus 21 days (P = 0.692). Median duration of bacteremia was 1 day in both groups (P = 0.975), and median scheduled duration of antibiotic therapy was 14.9 days and 19.5 days (P = 0.385). The source and mode of acquisition of CoNS were similar between groups. Of all CoNS isolates, 58.7% (44 of 75) were oxacillin resistant. Staphylococcus epidermidis was the most common CoNS species at 66.7% (50 of 75). Of all isolates, 30.7% (23 of 75) had a vancomycin MIC ≥2 µg/mL, and 87% (20 of 23) of these were S. epidermidis. There was a higher percentage of S. epidermidis in the vancomycin MIC ≥2 µg/mL group than in the MIC <2 µg/mL group (87% vs 57.7%; P = 0.012). CoNS with a vancomycin MIC ≥2 µg/mL were also more likely to be oxacillin resistant (78.3% vs 50%; P = 0.005). There was no difference in clinical outcomes in adult patients with a CoNS bloodstream infection with a vancomycin MIC <2 µg/mL versus ≥2 µg/mL. At present, vancomycin remains appropriate empiric therapy for CoNS bloodstream infection. Further research is needed to determine if there is a true clinical impact of a vancomycin MIC ≥2 µg/mL in CoNS infections.

일본의 독도 고유영토론 고찰

It is said that the inherent territory theory was invented by Japan. Japan, which lost a lot of territory after its defeat in World War II, began to raise claims of ‘inherent territory’ in order to recover such territory. The first time the claim of ‘inherent territory (固有の領土)’ was used for the two islands, Habomai and Shikotan, on the border with Russia. Afterwards, in 1956, Japanese Foreign Minister Mamoru Shigemitsu stated in a speech to the National Assembly that Dokdo was also Japan's inherent territory. In general, ‘inherent territory’ means ‘national territory that has never historically become the territory of another country’ or ‘unique national territory that has not been newly acquired through the mode of territorial acquisition.’ It is distinguished from ‘territory possessed since the establishment of a modern state’ or ‘territory possessed ab origine at the time of the establishment of a modern state, and territory acquired by gains after the establishment of the state.’ Inherent territory is understood to include three aspects: 1) the temporal and historical part, 2) the mode of territorial acquisition, and 3) the absence of foreign domination. Although the inherent territory theory seems similar to historical title at first glance, it is reasonable to believe that the inherent territory theory claimed by Japan is virtually impossible to apply not only under international law but also in actual reality, and is unlikely to be accepted as a theory under international law.

Predictors of vaccination card retention in Tamale Metropolis, Ghana.

The home-based vaccination card is an important health record for determining vaccination status of children during surveys, particularly in low- and middle-income countries. However, there are limited evidence on the factors that influence its retention in Ghana. We assessed the predictors of vaccination card retention in Tamale Metropolis, Ghana. We conducted a cross-sectional study from 21st December 2022 to 10th January 2023 among children aged 0-59 months in the Tamale Metropolis. Multi-stage sampling was used to select caregivers of children aged 0-59 months for enrolment in the study. Data were collected using validated questionnaire through face-to-face interviews of caregivers. A vaccination card was retained if it was presented for physical inspection by research assistants. The factors that influence vaccination card retention were determined in a multivariate logistic regression analysis at p<0.05. A total of 1,532 eligible children were enrolled in this study. Vaccination card retention was 91.5%. Negative predictors of card retention included: being resident in the Nyohini (AOR = 0.28; 95% CI = 0.15-0.50) and Tamale Central (AOR = 0.51; 95% CI = 0.29-0.90) sub-Metro areas and being caregivers of children aged 24-59 months (AOR = 0.39; 95% CI = 0.22-0.68). On the other hand, paying for the vaccination card (AOR = 5.14; 95% CI = 2.95-8.95) was a positive predictor of vaccination card retention. In this study, vaccination card retention among children aged 0-59 months was higher than national estimates. Vaccination card retention was mainly influenced by sub-Metro area, age of child and mode of acquisition of the card such as out-of-pocket payment. There is need to design and deliver tailored messages including the importance of vaccination card retention to caregivers of children based on geographic context. Additionally, the policy on sale of vaccination cards should be revised to allow for cost sharing to enhance its retention.

Inferring mode of acquisition from lithic conveyance: A pesky middle-range problem

Inferring mode of acquisition from lithic conveyance is a long-standing middle-range problem. Given archaeologists’ reliance on patterns of lithic conveyance to understand how prehistoric populations organized themselves in relation to their landscape, its resources, and each other, resolution of this problem would be significant. Drawing on research in the North American Great Basin and Middle Atlantic, we argue that the concepts archaeologists often use to derive insight into landscape use and sociocultural organization from patterns of lithic conveyance warrant greater scrutiny. We argue that archaeologists may better be able to infer landscape use and sociocultural organization from patterns of lithic conveyance if we remember that our conceptions (e.g., residential and logistical mobility, direct and indirect procurement, embedded and “dis”embedded procurement) sit in physical and social space – landscapes characterized by the distribution of food and nonfood resources (including stone), as well as other people.

CONSTRAINTS FACING AGROSILVOPASTORAL PRACTICES AMONG HOUSEHOLDS IN OGUN STATE, NIGERIA

Agrosilvopastoral practices are recognized as a link between agriculture, forestry and a sustainable strategy for land management, particularly in tropical and subtropical developing nations. This study examined the limitations of agrosilvopastoral practices among households in Ogun State. A well thought out questionnaire was used to gather information from 240 respondents in total. Descriptive statistics were used to analyze the data collected. Findings revealed that agrosilvopastoral practices were dominated by men, with a mean age and family size of 54 years and 6 persons respectively. More over half (62.25%) of the farmers were literate with mean years of experience in farming being 26years. Result revealed that inadequate capital (1st) is the most serious challenge facing the agrosilvopastoral households, followed by insect infestation (2nd), instability in market price (3rd), inadequate access to land for farming (4th), high cost of transportation (5th), insufficient market centers (6th), source of inputs (7th), technical knowledge (8th), mode of land acquisition (9th) and animal destruction of crops (10th). The study thereby recommends that extension workers from different organizations should educate farmers about agrosilvopastoral practices through seminars, and backing being offered to farmers in the terms of loans, hybrid seeds and credit provision for increased production.

Parallel cognitive maps for multiple knowledge structures in the hippocampal formation.

The hippocampal-entorhinal system uses cognitive maps to represent spatial knowledge and other types of relational information. However, objects can often be characterized by different types of relations simultaneously. How does the hippocampal formation handle the embedding of stimuli in multiple relational structures that differ vastly in their mode and timescale of acquisition? Does the hippocampal formation integrate different stimulus dimensions into one conjunctive map or is each dimension represented in a parallel map? Here, we reanalyzed human functional magnetic resonance imaging data from Garvert et al. (2017) that had previously revealed a map in the hippocampal formation coding for a newly learnt transition structure. Using functional magnetic resonance imaging adaptation analysis, we found that the degree of representational similarity in the bilateral hippocampus also decreased as a function of the semantic distance between presented objects. Importantly, while both map-like structures localized to the hippocampal formation, the semantic map was located in more posterior regions of the hippocampal formation than the transition structure and thus anatomically distinct. This finding supports the idea that the hippocampal-entorhinal system forms parallel cognitive maps that reflect the embedding of objects in diverse relational structures.

Biochemical assessment of spironolactone oral suspension in human plasma using ultra‐performance liquid chromatography‐tandem mass spectrometry: Application toward pharmacokinetic study

AbstractSpironolactone is one of the non‐selective mineralocorticoid receptor antagonists acting as anti‐diuretic drugs. Spironolactone is reported to possess mild to severe hyperkalemia which could often result in fatal conditions. Although several analytical methods for evaluating spironolactone as tablet dosage forms have been established in human biological systems, it is crucial to highlight that these approaches are still limited to the suspension dosage form. In this study, we have quantified spironolactone suspension in human plasma with an efficient, sensitive, and optimized ultra‐performance liquid chromatography (UPLC)‐tandem mass spectrometry‐based bioanalytical method using a deuterated internal standard method. A reverse phase UPLC analysis and mass spectrometric detection was performed using electrospray ionization in positive ion mode as an interface, and multiple reaction monitoring as a mode of acquisition. The retention of Spironolactone (SL) and Spironolactone d7 (SL‐d7) was found to be around 6.15 and 6.07 min, respectively. The linearity range was 1.007–100.224 ng/mL for SL with 0.1 mL sample volume. The method was successfully applied to the pharmacokinetic study of spironolactone in healthy male volunteers by administrating 25 mg/5 mL oral suspension and is in accordance with bioanalytical guidelines.

A Mobile English Learning Platform Based on Data Mining and Personalized Recommendations

Abstract As mobile technology advances, mobile English learning platforms have increasingly become the predominant mode of language acquisition. However, traditional platforms often suffer from inefficiency due to a lack of targeted and personalized recommendations. This paper explores the enhancement of mobile English learning platforms through the application of customized recommendation algorithms and data mining techniques. We have developed a system architecture composed of a user layer, a business layer, and a data layer, employing Spark and Support Vector Machine (SVM) for parallel data processing. Our approach integrates a collaborative filtering algorithm and a hybrid recommendation model, utilizing user information alongside the dual-tower model Deep Structured Semantic Model (DSSM) and the Deep Interest Network (DIN). Experimental results demonstrate that our recommendation model significantly surpasses traditional models in precision, recall, and F1 scores, with the F1 score improving by approximately 0.1 to 0.4. Furthermore, learners using this platform showed superior outcomes in homework completion, test scores, learning quality, and sustained learning enthusiasm compared to a control group, with an overall improvement of 15.48 points in English proficiency scores. In summary, this study validates the effectiveness of a mobile English learning platform that synergizes data mining with personalized recommendation algorithms to enhance both learning efficiency and user satisfaction.

Dissolved nitrogen uptake versus nitrogen fixation: Mode of nitrogen acquisition affects stable isotope signatures of a diazotrophic cyanobacterium and its grazer.

Field studies suggest that changes in the stable isotope ratios of phytoplankton communities can be used to track changes in the utilization of different nitrogen sources, i.e., to detect shifts from dissolved inorganic nitrogen (DIN) uptake to atmospheric nitrogen (N2) fixation by diazotrophic cyanobacteria as an indication of nitrogen limitation. We explored changes in the stable isotope signature of the diazotrophic cyanobacterium Trichormus variabilis in response to increasing nitrate (NO3-) concentrations (0 to 170 mg L-1) under controlled laboratory conditions. In addition, we explored the influence of nitrogen utilization at the primary producer level on trophic fractionation by studying potential changes in isotope ratios in the freshwater model Daphnia magna feeding on the differently grown cyanobacteria. We show that δ 15N values of the cyanobacterium increase asymptotically with DIN availability, from -0.7 ‰ in the absence of DIN (suggesting N2 fixation) to 2.9 ‰ at the highest DIN concentration (exclusive DIN uptake). In contrast, δ 13C values of the cyanobacterium did not show a clear relationship with DIN availability. The stable isotope ratios of the consumer reflected those of the differently grown cyanobacteria but also revealed significant trophic fractionation in response to nitrogen utilization at the primary producer level. Nitrogen isotope turnover rates of Daphnia were highest in the absence of DIN as a consequence of N2 fixation and resulting depletion in 15N at the primary producer level. Our results highlight the potential of stable isotopes to assess nitrogen limitation and to explore diazotrophy in aquatic food webs.

Clinico-epidemiological characteristics of adolescents and young adults living with HIV in Ghana.

sub-Saharan Africa is experiencing a boom in the number of adolescents and young adults living with HIV (AYALHIV). Existing HIV intervention programs are mainly for children and adults living with HIV, with little attention paid to AYALHIV. Characterizing this population is necessary for planning, and designing, AYALHIV-centered HIV intervention programs. a retrospective single-center, hospital-based chart review was conducted at the largest HIV clinic in Ghana. We examined routinely collected data for AYALHIV (aged 10-24 years) on antiretroviral therapy (ART) for at least 1 year and in active care from 1st January to 31st December 2019. Data was collected using a structured data extraction form. The Chi-square and the Student´s t-test were used to compare characteristics between adolescents and young adults. of 252 AYALHIV, 68% (172/252) were adolescents with a median age of 17 years (IQR 13-19); 32% were young adults with a median age of 22 years (IQR: 20-24). Most (56.7% (143/252)) AYALHIV were female. Almost 40% were orphans. Eighty-six percent of AYALHIV had HIV type I infection. The commonest mode of HIV acquisition among adolescents was vertical transmission (70.5%) and that among young adults was via unprotected sex (31.3%). Eighty-eight percent (88%) of AYALHIV were on non-nucleoside reverse transcriptase inhibitors-based regimen. The viral suppression rate among AYALHIV was 78%. the study shows there is a growing population of AYALHIV most of which are adolescents. About two-fifths were orphans. Policymakers and HIV programs should ensure AYALHIV-centred interventions are developed for this vulnerable population.

’n Perdepaspoort, logboek, mantel of die invecta et illata in huureiendom is geen objekte van ’n retensiereg van die besitter nie

A retentor derives no real security right from either an obligatory agreement or a real agreement with the owner of the thing he is retaining under his lien. Therefore he is not on the same footing as the holder of a right of hypothec, mortgage or pledge who is in possession of the thing of another as holder of a limited right of real security. With the exception of the pledgee with an additional entitlement agreed to by the pledgor to use the object of the pledge (pactum antichreseos), it is common to all the said limited real security figures that the retainer derives no entitlement to take advantage of the property of another in his possession. However, notwithstanding the fact that he may derive no benefit from his withholding of the object, he is responsible for preserving the object against damage or risk at his own expense as the de facto custodian of the object, although no agreement of bailment came about. It would be wrong to assume randomly that all examples of rightful retention of another’s goods are examples of liens. It may also be the entitlement of a limited real security right such as the tacit hypothec of a landlord or patron of a restaurant. The ius retentionis of the holder of a lien is merely the limited entitlement of the creditor without any preceding agreement between the owner of the object being retained and the creditor entitling the latter to retain it as long as the owner as debtor is in default of paying his dues to the holder of the lien for costs incurred by the latter regarding the object of the lien. No lien comes into play unless the required nexus exists regarding the parties involved and the object retained. In contrast, in the cases of a tacit hypothec of a landlord or innkeeper, there is no question of any coherence or nexus between the claim of the landlord to the invecta et illata or hotel-keeper to the coat of the guest as creditor and the object being retained. Subject to special statutory regulation, no limited real security right can be established on an integral part of a thing. Only a thing that meets all the requirements as an object of a real right can be the object of a real right and this also applies to a limited real right. Possession of a thing requires exclusive control over it and not simply possession of an integral part or symbol of the object of the debtor’s real right of ownership if the object is classified as a movable. Possession is, however, no requirement for a derivative mode of acquisition of a real right on immovable property. It is submitted that mere possession of the passport of a horse or the logbook of an aeroplane does not suffice as symbolic possession of the horse or the aeroplane. Withholding part of the due performance under a reciprocal agreement until the counterparty has fully performed or because by agreement the debtor wishes eg to occupy the new house for three months to see what defects in the construction comes to light before delivering the agreed retention money to the builder, is no example of a lien. The retaining of the agreed portion of the final performance by the mandator is neither an entitlement of a limited real right nor a lien. This is part of the agreed terms of the building contract and any attempt by the creditor to compel performance before the condition had been met can be averted with the exceptio non adimpleti contractus.

Access to medicines for the treatment of systemic arterial hypertension and type 2 diabetes mellitus in the Brazilian population: data from the 2019 Brazilian National Health Survey

This study aimed to measure access to medicines for the treatment of systemic arterial hypertension and type 2 diabetes mellitus in Brazil according to the mode of acquisition, as well as to analyze the factors associated with this access, based on data from the 2019 Brazilian National Survey of Health (PNS, acronym in Portuguese). Socioeconomic data and data related to the use of medicines by people aged 15 and over were analyzed in relation to access via the Brazilian Popular Pharmacy Program (PFPB, acronym in Portuguese) and via public services. The majority of Brazilians who took part in the PNS reported using medication to control hypertension in the previous 15 days (91.5%) and using oral medication for diabetes (95.2%) and/or insulin (70%). Most participants obtained oral medication for hypertension and type 2 diabetes mellitus via PFPB (45.2% and 53.6%, respectively), and the factors that most negatively influenced this access were older age, lower income, lower schooling, very poor self-rated health and not having private health insurance. Access to insulin, on the other hand, was most often via the public health service (69.7%), and the factors that most negatively influenced this access were black/mixed-race skin color, lower income, very poor self-rated health and not having private health insurance. Generally, the importance of the PFPB as a policy to increase access to essential medicines in Brazil was highlighted, considering the free supply of antihypertensive and antidiabetic drugs.

Regspraak: Skynverwekking deur ’n derde ten koste van ’n eienaar se rei vindicatio – reëlreg in stryd met gevestigde uitsprake van die hoogste hof van appèl

The owner who wanted to sell her used luxury bush trailer agreed with an accredited agent of the manufacturer of the trailer to park it on their premises in Wellington where it would be available for viewing by prospective buyers. She explicitly agreed with the manager of the company that she would retain all registration documents regarding the trailer and would personally enter into the final obligatory and real agreements when a suitable interested buyer was identified. It was, however, agreed that the finalisation of the asking price would be at the discretion of the agent, provided that she received her indicated set reserved minimum price. This would allow the agent to negotiate with an interested buyer for a price that would leave it with some profit. When an interested buyer was identified, the agent, however, neglected to inform the buyer of the conditions and refrained to disclose that neither he nor the agency held the necessary ius disponendi to transfer ownership, although he accepted the transferred sum as significantly inflated final payment for the purchased trailer. He never disclosed to the owner that her trailer had found a buyer and was no longer in his possession. Nor did he transfer the amount as agreed to the account of the owner. When she discovered the fraud, she immediately instituted the rei vindicatio to retrieve her property. There was no real agreement between the owner and the buyer and consequently she retained her ownership and should be entitled to the rei vindicatio as remedy. The buyer could rely on his remedy under the law of contract (for eviction) because he was not placed in vacua possessio and was entitled to restitution of the amount paid. He was thus not without remedy. The court, however, dismissed the owner’s application for the rei vindicatio with costs because in the court’s judgment the poor buyer was entitled to the defence of his bona fides. South African law does not recognise the bona fides of a buyer as a separate mode of acquisition of ownership. The recognised defence of estoppel is not mentioned by name in the judgment, although some of the case law that was referred to concerned that defence. The judgment, however, does not instil confidence that all the requirements for that defence had been mastered. At the very least the judgment does not disclose how the court was satisfied that those requirements were all met. The mere fact that the buyer alleged that he had been misled by the agent to believe that, in exchange for the transfer of the full asking price he would receive ownership of the trailer, is irrelevant, as would be the excuse of the receiver of stolen goods who was gullible enough to think the thief selling the stolen property had the ius disponendi to transfer ownership. The judgment does not disclose how the buyer would be able to renew the yearly registration of the trailer because the true owner was still holding back all the relevant registration documents and the successful reliance on estoppel does not alter the material legal position regarding the ownership. Clearly the misrepresentation of a fraudulent third party should not result in the effective loss of the owner’s entitlements to her property. The defence of estoppel can successfully be relied on against the rei vindicatio of the owner only if the estoppel asserter can prove that he acted to his detriment because of the misrepresentation of the owner as estoppel denier, who acted negligently. The misrepresentation must have been so flagrant that the reasonable person in his position as the estoppel asserter would also have acted to his detriment on it. In this matter the judgment does not disclose how the court established that the reasonable person in the position of the true owner of the trailer would have acted otherwise to prevent an unknown third party as prospective buyer from being misled by the fraudulent agent who pretended to be either the owner or authorised agent with ius disponendi. What more could the owner have done than to retain all the relevant registration documents to forewarn third parties of the limited powers of the agency? Attaching large neon-coloured stickers to the vehicle to publish the limited powers of the agency does not seem practical. It is submitted that no negligence can be found in the conduct of the owner, because it was on par with what could be expected from the reasonable person in her shoes. It is submitted that the reasonable person in the position of the buyer would by contrast not have been so gullible as to transfer the significant amount of the asking price without ascertaining that the alleged seller had the registration documents to transfer ownership as proof of his ius disponendi.

Conditions for modifying the mode of land acquisition for road development

Conditions for modifying the mode of land acquisition for road development