Novel cruzain inhibitors for the treatment of Chagas' disease.

The protozoan parasite Trypanosoma cruzi, the etiological agent of Chagas' disease, affects millions of individuals and continues to be an important global health concern. The poor efficacy and unfavorable side effects of current treatments necessitate novel therapeutics. Cruzain, the major cysteine protease of T. cruzi, is one potential novel target. Recent advances in a class of vinyl sulfone inhibitors are encouraging; however, as most potential therapeutics fail in clinical trials and both disease progression and resistance call for combination therapy with several drugs, the identification of additional classes of inhibitory molecules is essential. Using an exhaustive virtual-screening and experimental validation approach, we identify several additional small-molecule cruzain inhibitors. Further optimization of these chemical scaffolds could lead to the development of novel drugs useful in the treatment of Chagas' disease

Nanomaterial structure determination using XUV diffraction

Diffraction using coherent XUV radiation is used to study the structure of nanophotonic materials, in this case an ordered array of 196nm spheres. Crystal structure and defects are visible, and the nanomaterial dielectric constant determined

The public sector nursing workforce in Kenya: a county-level analysis.

BACKGROUND: Kenya's human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. This work describes the public sector nursing workforce likely to be inherited by the counties, and examines the relationships between nursing workforce density and key indicators. METHODS: National nursing deployment data linked to nursing supply data were used and analyzed using statistical and geographical analysis software. Data on nurses deployed in national referral hospitals and on nurses deployed in non-public sector facilities were excluded from main analyses. The densities and characteristics of the public sector nurses across the counties were obtained and examined against an index of county remoteness, and the nursing densities were correlated with five key indicators. RESULTS: Of the 16,371 nurses in the public non-tertiary sector, 76% are women and 53% are registered nurses, with 35% of the nurses aged 40 to 49 years. The nursing densities across counties range from 1.2 to 0.08 per 1,000 population. There are statistically significant associations of the nursing densities with a measure of health spending per capita (P value = 0.0028) and immunization rates (P value = 0.0018). A higher county remoteness index is associated with explaining lower female to male ratio of public sector nurses across counties (P value <0.0001). CONCLUSIONS: An overall shortage of nurses (range of 1.2 to 0.08 per 1,000) in the public sector countrywide is complicated by mal-distribution and varying workforce characteristics (for example, age profile) across counties. All stakeholders should support improvements in human resources information systems and help address personnel shortages and mal-distribution if equitable, quality health-care delivery in the counties is to be achieved

Link Mining for Kernel-based Compound-Protein Interaction Predictions Using a Chemogenomics Approach

Virtual screening (VS) is widely used during computational drug discovery to reduce costs. Chemogenomics-based virtual screening (CGBVS) can be used to predict new compound-protein interactions (CPIs) from known CPI network data using several methods, including machine learning and data mining. Although CGBVS facilitates highly efficient and accurate CPI prediction, it has poor performance for prediction of new compounds for which CPIs are unknown. The pairwise kernel method (PKM) is a state-of-the-art CGBVS method and shows high accuracy for prediction of new compounds. In this study, on the basis of link mining, we improved the PKM by combining link indicator kernel (LIK) and chemical similarity and evaluated the accuracy of these methods. The proposed method obtained an average area under the precision-recall curve (AUPR) value of 0.562, which was higher than that achieved by the conventional Gaussian interaction profile (GIP) method (0.425), and the calculation time was only increased by a few percent

Cost-effectiveness of left ventricular assist devices (LVADs) for patients with advanced heart failure : analysis of the British NHS Bridge to Transplant (BTT) program

Background: A previous cost-effectiveness analysis showed that bridge to transplant (BTT) with early design left ventricular assist devices (LVADs) for advanced heart failure was more expensive than medical management while appearing less beneficial. Older LVADs were pulsatile, but current second and third generation LVADs are continuous flow pumps. This study aimed to estimate comparative cost-effectiveness of BTT with durable implantable continuous flow LVADs compared to medical management in the British NHS. Methods and results: A semi-Markov multi-state economic model was built using NHS costs data and patient data in the British NHS Blood and Transplant Database (BTDB). Quality-adjusted life years (QALYs) and incremental costs per QALY were calculated for patients receiving LVADs compared to those receiving inotrope supported medical management. LVADs cost £80,569 ($127,887) at 2011 prices and delivered greater benefit than medical management. The estimated probabilistic incremental cost-effectiveness ratio (ICER) was £53,527 ($84,963)/QALY (95%CI: £31,802–£94,853; $50,479–$150,560) (over a lifetime horizon). Estimates were sensitive to choice of comparator population, relative likelihood of receiving a heart transplant, time to transplant, and LVAD costs. Reducing the device cost by 15% decreased the ICER to £50,106 ($79,533)/QALY. Conclusions: Durable implantable continuous flow LVADs deliver greater benefits at higher costs than medical management in Britain. At the current UK threshold of £20,000 to £30,000/QALY LVADs are not cost effective but the ICER now begins to approach that of an intervention for end of life care recently recommended by the British NHS. Cost-effectiveness estimates are hampered by the lack of randomized trials

Visible, Near-Infrared, and Mid-Infrared Spectral Characterization of Hawaiian Fumarolic Alteration Near Kilauea's December 1974 Flow: Implications for Spectral Discrimination of Alteration Environments on Mars

The December 1974 flow in the SW rift zone at Kilauea Volcano, Hawaii, has been established as a Mars analog due to its physical, chemical, and morphological properties, as well as its interaction with the outgassing plume from the primary Kilauea caldera. We focus on a solfatara site that consists of hydrothermally altered basalt and alteration products deposited in and around a passively degassing volcanic vent situated directly adjacent to the December 1974 flow on its northwest side. Reflectance spectra are acquired in the visible/near-infrared (VNIR) region and emission spectra in the mid-infrared (MIR) range to better understand the spectral properties of hydrothermally altered materials. The VNIR signatures are consistent with silica, Fe-oxides, and sulfates (Ca, Fe). Primarily silica-dominated spectral signatures are observed in the MIR and changes in spectral features between samples appear to be driven by grain size effects in this wavelength range. The nature of the sample coating and the thermal emission signatures exhibit variations that may be correlated with distance from the vent. Chemical analyses indicate that most surfaces are characterized by silica-rich material, Fe-oxides, and sulfates (Ca, Fe). The silica and Fe-oxide-dominated MIR/VNIR spectral signatures exhibited by the hydrothermally altered material in this study are distinct from the sulfate-dominated spectral signatures exhibited by previously studied low-temperature aqueous acid-sulfate weathered basaltic glass. This likely reflects a difference in open vs. closed system weathering, where mobile cations are removed from the altered surfaces in the fumarolic setting. This work provides a unique infrared spectral library that includes martian analog materials that were altered in an active terrestrial solfatara (hydrothermal) setting. Hydrothermal environments are of particular interest as they potentially indicate habitable conditions. Key constraints on the habitability and astrobiological potential of ancient aqueous environments are provided through detection and interpretation of secondary mineral assemblages; thus, spectral detection of fumarolic alteration assemblages observed from this study on Mars would suggest a region that could have hosted a habitable environment