Community-based directly observed therapy (DOT) versus clinic DOT for tuberculosis: a systematic review and meta-analysis of comparative effectiveness.

Background: Directly observed therapy (DOT), as recommended by the World Health Organization, is used in many countries to deliver tuberculosis (TB) treatment. The effectiveness of community-based (CB DOT) versus clinic DOT has not been adequately assessed to date. We compared TB treatment outcomes of CB DOT (delivered by community health workers or community volunteers), with those achieved through conventional clinic DOT. Methods: We performed a systematic review and meta-analysis of studies before 9 July 2014 comparing treatment outcomes of CB DOT and clinic DOT. The primary outcome was treatment success; the secondary outcome was loss to follow-up. Results: Eight studies were included comparing CB DOT to clinic DOT, one a randomised controlled trial. CB DOT outperformed clinic DOT treatment success (pooled odds ratio (OR) of 1.54, 95% confidence interval (CI) 1.01 – 2.36, p = 0.046, I2 heterogeneity 84%). No statistically significant difference was found between the two DOT modalities for loss to follow-up (pooled OR 0.86, 95% CI 0.48 to 1.55, p = 0.62, I2 83%). Conclusions: Based on this systematic review, CB DOT has a higher treatment success compared to clinic DOT. However, as only one study was a randomised controlled trial, the findings have to be interpreted with caution

Calculation of the relative metastabilities of proteins in subcellular compartments of Saccharomyces cerevisiae

[abridged] Background: The distribution of chemical species in an open system at metastable equilibrium can be expressed as a function of environmental variables which can include temperature, oxidation-reduction potential and others. Calculations of metastable equilibrium for various model systems were used to characterize chemical transformations among proteins and groups of proteins found in different compartments of yeast cells. Results: With increasing oxygen fugacity, the relative metastability fields of model proteins for major subcellular compartments go as mitochondrion, endoplasmic reticulum, cytoplasm, nucleus. In a metastable equilibrium setting at relatively high oxygen fugacity, proteins making up actin are predominant, but those constituting the microtubule occur with a low chemical activity. A reaction sequence involving the microtubule and spindle pole proteins was predicted by combining the known intercompartmental interactions with a hypothetical program of oxygen fugacity changes in the local environment. In further calculations, the most-abundant proteins within compartments generally occur in relative abundances that only weakly correspond to a metastable equilibrium distribution. However, physiological populations of proteins that form complexes often show an overall positive or negative correlation with the relative abundances of proteins in metastable assemblages. Conclusions: This study explored the outlines of a thermodynamic description of chemical transformations among interacting proteins in yeast cells. The results suggest that these methods can be used to measure the degree of departure of a natural biochemical process or population from a local minimum in Gibbs energy.Comment: 32 pages, 7 figures; supporting information is available at http://www.chnosz.net/yeas

Characteristics of HIV-1 Discordant Couples Enrolled in a Trial of HSV-2 Suppression to Reduce HIV-1 Transmission: The Partners Study

Background: The Partners HSV-2/HIV-1 Transmission Study (Partners Study) is a phase III, placebo-controlled trial of daily acyclovir for genital herpes (HSV-2) suppression among HIV-1/HSV-2 co-infected persons to reduce HIV-1 transmission to their HIV-1 susceptible partners, which requires recruitment of HIV-1 serodiscordant heterosexual couples. We describe the baseline characteristics of this cohort. Methods: HIV-1 serodiscordant heterosexual couples, in which the HIV-1 infected partner was HSV-2 seropositive, had a CD4 count ≥250 cells/mcL and was not on antiretroviral therapy, were enrolled at 14 sites in East and Southern Africa. Demographic, behavioral, clinical and laboratory characteristics were assessed. Results: Of the 3408 HIV-1 serodiscordant couples enrolled, 67% of the HIV-1 infected partners were women. Couples had cohabitated for a median of 5 years (range 2–9) with 28% reporting unprotected sex in the month prior to enrollment. Among HIV-1 susceptible participants, 86% of women and 59% of men were HSV-2 seropositive. Other laboratory-diagnosed sexually transmitted infections were uncommon (500 relative to <350, respectively, p<0.001). Conclusions: The Partners Study successfully enrolled a cohort of 3408 heterosexual HIV-1 serodiscordant couples in Africa at high risk for HIV-1 transmission. Follow-up of this cohort will evaluate the efficacy of acyclovir for HSV-2 suppression in preventing HIV-1 transmission and provide insights into biological and behavioral factors determining heterosexual HIV-1 transmission. Trial Registration ClinicalTrials.gov NCT0019451

Unconventional Low-Cost Fabrication and Patterning Techniques for Point of Care Diagnostics

The potential of rapid, quantitative, and sensitive diagnosis has led to many innovative ‘lab on chip’ technologies for point of care diagnostic applications. Because these chips must be designed within strict cost constraints to be widely deployable, recent research in this area has produced extremely novel non-conventional micro- and nano-fabrication innovations. These advances can be leveraged for other biological assays as well, including for custom assay development and academic prototyping. The technologies reviewed here leverage extremely low-cost substrates and easily adoptable ways to pattern both structural and biological materials at high resolution in unprecedented ways. These new approaches offer the promise of more rapid prototyping with less investment in capital equipment as well as greater flexibility in design. Though still in their infancy, these technologies hold potential to improve upon the resolution, sensitivity, flexibility, and cost-savings over more traditional approaches

Personalized early detection and prevention of breast cancer: ENVISION consensus statement

Abstract: The European Collaborative on Personalized Early Detection and Prevention of Breast Cancer (ENVISION) brings together several international research consortia working on different aspects of the personalized early detection and prevention of breast cancer. In a consensus conference held in 2019, the members of this network identified research areas requiring development to enable evidence-based personalized interventions that might improve the benefits and reduce the harms of existing breast cancer screening and prevention programmes. The priority areas identified were: 1) breast cancer subtype-specific risk assessment tools applicable to women of all ancestries; 2) intermediate surrogate markers of response to preventive measures; 3) novel non-surgical preventive measures to reduce the incidence of breast cancer of poor prognosis; and 4) hybrid effectiveness–implementation research combined with modelling studies to evaluate the long-term population outcomes of risk-based early detection strategies. The implementation of such programmes would require health-care systems to be open to learning and adapting, the engagement of a diverse range of stakeholders and tailoring to societal norms and values, while also addressing the ethical and legal issues. In this Consensus Statement, we discuss the current state of breast cancer risk prediction, risk-stratified prevention and early detection strategies, and their implementation. Throughout, we highlight priorities for advancing each of these areas

Analytic image concept combined to SENSE reconstruction

Two approaches of reconstructing undersampled partial k-space data, acquired with multiple coils are compared: homodyne detection combined with SENSE (HM_SENSE) and analytic image reconstruction combined with SENSE (AI_SENSE). The latter overcomes limitations of HM_ SENSE by considering aliased images as analytic thus avoiding the need for phase correction required for HM_SENSE. MATERIALS AND METHODS: In vivo imaging experiments were carried out in male Lewis rats using both gradient echo and spin echo sequences. Accelerated images obtained by using the various reconstruction algorithms were compared to fully sampled reference images both qualitatively and quantitatively. RESULTS: For the various sampling patterns evaluated, both HM_SENSE and AI_SENSE were found to yield robust image reconstruction with small deviations from the reference image. Even for high acceleration factors AI_SENSE still provided useful results and was found superior compared to HM_SENSE. CONCLUSION: Combination of partial k-space sampling and parallel image acquisition allows for further acceleration of data acquisition as compared to each method alone. Image reconstruction from undersampled data sets using the AI_SENSE algorithm was found to considerably reduce reconstruction errors and artifacts observed for HM_SENSE reconstruction caused by errors in phase estimation

Terminal platinum(II) phosphido complexes : synthesis, structure, and thermochemistry

A series of terminal Pt(II) phosphido complexes Pt(dppe)(Me)(PRR') (R = H; R' = Mes* (1), R' = Mes (2), R' = Ph (3), R' = Cy (4); R = R' = Mes (5); R = R' = Ph (6); R = R' = Cy (7); R = R' = Et (8); R = Ph, R' = i-Bu (9)) has been prepared by proton transfer from the appropriate phosphine to the methoxide ligand of Pt(dppe)(Me)(OMe) (10) (dppe = Ph2PCH2-CH2PPh2; Mes* = 2,4,6-(t-Bu)(3)C6H2; Mes = 2,4,6-Me3C6H2; Cy = cyclo-C6H11). Complexes 1 and 2 were also made by deprotonation of the cations [Pt(dppe)(Me)(PH2Ar)][BF4] (Ar = Mes* (13); Ar = Mes (14)). For comparison to 1, the arylthiolate and aryloxide complexes Pt(dppe)(Me)(EMes*) (E = S (11); E = O (12)) were also prepared from 10. NMR studies of the proton-transfer equilibria between Pt(dppe)(Me)(X), Pt(dppe)(Me)(Y), and the acids HY and HX (see Bryndza, H. E.; Fong, L. K.; Paciello, R. A.; Tam, W.; Bercaw, J. E. J. Am. Chem. Sec. 1987, 109, 1444-1456 and Bryndza, H. E.; Domaille, P. J.; Tam, W.; Fong, L. K.; Paciello, R. A.; Bercaw, J. E. Polyhedron 1988, 7, 1441-1452) provide an approximate partial ranking of Pt-P bond strengths in this series: Pt-PHPh > Pt-PHMes > Pt-PHMes*; Pt-PPh2 > Pt-PMes(2). Complementary solution calorimetry investigations probe the role of entropic effects on the equilibria. Both steric and electronic factors appear to be important in controlling relative Pt-P bond strengths. The Pt-S bonds in 11 and Pt(dppe)(Me)(SPh) are stronger than the analogous Pt-P bonds in 1 and 3. Complexes 1 and 5.THF were structurally characterized by X-ray crystallography

Shrink-film configurable multiscale wrinkles for functional alignment of human embryonic stem cells and their cardiac derivatives

A biomimetic substrate for cell-culture is fabricated by plasma treatment of a prestressed thermoplastic shrink film to create tunable multiscaled alignment "wrinkles". Using this substrate, the functional alignment of human embryonic stem cell derived cardiomyocytes is demonstrated. © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.link_to_subscribed_fulltex