Early mortality and loss to follow-up in HIV-infected children starting antiretroviral therapy in Southern Africa.

BACKGROUND: Many HIV-infected children in Southern Africa have been started on antiretroviral therapy (ART), but loss to follow up (LTFU) can be substantial. We analyzed mortality in children retained in care and in all children starting ART, taking LTFU into account. PATIENTS AND METHODS: Children who started ART before the age of 16 years in 10 ART programs in South Africa, Malawi, Mozambique, and Zimbabwe were included. Risk factors for death in the first year of ART were identified in Weibull models. A meta-analytic approach was used to estimate cumulative mortality at 1 year. RESULTS: Eight thousand two hundred twenty-five children (median age 49 months, median CD4 cell percent 11.6%) were included; 391 (4.8%) died and 523 (7.0%) were LTFU in the first year. Mortality at 1 year was 4.5% [95% confidence interval (CI): 2.8% to 7.4%] in children remaining in care, but 8.7% (5.4% to 12.1%) at the program level, after taking mortality in children and LTFU into account. Factors associated with mortality in children remaining in care included age [adjusted hazard ratio (HR) 0.37; 95% CI: 0.25 to 0.54 comparing > or =120 months with <18 months], CD4 cell percent (HR: 0.56; 95% CI: 0.39 to 0.78 comparing > or =20% with <10%), and clinical stage (HR: 0.12; 95% CI: 0.03 to 0.45 comparing World Health Organization stage I with III/IV). CONCLUSIONS: In children starting ART and remaining in care in Southern Africa mortality at 1 year is <5% but almost twice as high at the program level, when taking LTFU into account. Age, CD4 percentage, and clinical stage are important predictors of mortality at the individual level

Identifying Barriers to Justice for Formerly Incarcerated Women of Color in Connecticut

Identifying specific challenges faced by women of color transitioning out of the prison system in Connecticut is critical to developing comprehensive support services following incarceration. However, there is little research on how race, gender, and past incarceration intersect to form unique barriers to justice for formerly incarcerated women of color. Disseminating a digital survey to formerly incarcerated women of color affiliated with the Connecticut nonprofit, Her Time, we collected primarily quantitative data to assess which social services were and were not received and identify the role of Her Time in supporting clients following incarceration. We found that transportation, housing, and employment support were the most frequently requested services following incarceration for respondents, that Her Time was most effective in providing participants with community support, PTSD resources, and education services. These findings have implications for Her Time, the Connecticut re-entry system, and formerly incarcerated Black and Brown women

The Role of Lymph Node Fine-Needle Aspiration in Penile Cancer in the Sentinel Node Era

Penile squamous cell carcinoma (SCC) is an uncommon condition in Western countries. Inguinal lymph nodes dissection can be curative in 20%–60% of node positive patients. However, there is a high complication rates from the dissection, thus accurate diagnosis of inguinal lymph nodes metastasis is required. Current non invasive methods to detect lymph nodes metastasis are unreliable. Dynamic Sentinel Node Biopsy (DNSB), ultrasonography (US), and fine needle aspiration (FNA) cytology were proposed to in an attempt to detect sentinel lymph node (SLN). Despite the initial high rate of false negative results, recent DSNB showed improved survival compared to wait and see policy as well as reduced mortality compared to prophylactic inguinal lymphadenectomy. In addition, the US guided FNA shown 100% of specificity in detecting clinically occult lymph nodes metastasis. We proposed an algorithm for management of lymph nodes in penile cancer and suggest that FNA with US guidance should be performed in all high risk patients and that therapeutic dissection should be performed if findings are positive

A Kallikrein 15 (KLK15) single nucleotide polymorphism located close to a novel exon shows evidence of association with poor ovarian cancer survival.

BACKGROUND: KLK15 over-expression is reported to be a significant predictor of reduced progression-free survival and overall survival in ovarian cancer. Our aim was to analyse the KLK15 gene for putative functional single nucleotide polymorphisms (SNPs) and assess the association of these and KLK15 HapMap tag SNPs with ovarian cancer survival. RESULTS: In silico analysis was performed to identify KLK15 regulatory elements and to classify potentially functional SNPs in these regions. After SNP validation and identification by DNA sequencing of ovarian cancer cell lines and aggressive ovarian cancer patients, 9 SNPs were shortlisted and genotyped using the Sequenom iPLEX Mass Array platform in a cohort of Australian ovarian cancer patients (N = 319). In the Australian dataset we observed significantly worse survival for the KLK15 rs266851 SNP in a dominant model (Hazard Ratio (HR) 1.42, 95% CI 1.02-1.96). This association was observed in the same direction in two independent datasets, with a combined HR for the three studies of 1.16 (1.00-1.34). This SNP lies 15 bp downstream of a novel exon and is predicted to be involved in mRNA splicing. The mutant allele is also predicted to abrogate an HSF-2 binding site. CONCLUSIONS: We provide evidence of association for the SNP rs266851 with ovarian cancer survival. Our results provide the impetus for downstream functional assays and additional independent validation studies to assess the role of KLK15 regulatory SNPs and KLK15 isoforms with alternative intracellular functional roles in ovarian cancer survival.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Maternal Provisioning of Alkaloid Defenses are Present in Obligate but not Facultative Egg Feeding Dendrobatids

Poison frogs sequester alkaloid defenses from a diet of largely mites and ants. As a result, frogs are defended against certain predators and microbial infections. Frogs in the genus Oophaga exhibit complex maternal care, wherein mothers transport recently hatched tadpoles to nursery pools and return regularly to supply developing tadpoles with unfertilized (nutritive) eggs. Developing tadpoles are obligate egg feeders. Further, female O. pumilio and O. sylvatica maternally provision their nutritive eggs with alkaloid defenses, providing protection to their developing tadpoles at a vulnerable life-stage. In another genus of poison frog, Ranitomeya, tadpoles only receive and consume eggs facultatively, and it is currently unknown if mothers also provision these eggs (and thus their tadpoles) with alkaloid defenses. Here, we provide evidence that mother frogs of another species in the genus Oophaga (Oophaga granulifera) also provision alkaloid defenses to their tadpoles. We also provide evidence that Ranitomeya imitator and R. variabilis eggs and tadpoles do not contain alkaloids, suggesting that mother frogs in this genus do not provision alkaloid defenses to their offspring. Our findings suggest that among dendrobatid poison frogs, maternal provisioning of alkaloids may be restricted to the obligate egg-feeding members of Oophaga

Detection of Mitochondrial COII DNA Sequences in Ant Guts as a Method for Assessing Termite Predation by Ants

Termites and ants contribute more to animal biomass in tropical rain forests than any other single group and perform vital ecosystem functions. Although ants prey on termites, at the community level the linkage between these groups is poorly understood. Thus, assessing the distribution and specificity of ant termitophagy is of considerable interest.We describe an approach for quantifying ant-termite food webs by sequencing termite DNA (cytochrome c oxidase subunit II, COII) from ant guts and apply this to a soil-dwelling ant community from tropical rain forest in Gabon. We extracted DNA from 215 ants from 15 species. Of these, 17.2% of individuals had termite DNA in their guts, with BLAST analysis confirming the identity of 34.1% of these termites to family level or better. Although ant species varied in detection of termite DNA, ranging from 63% (5/7; Camponotus sp. 1) to 0% (0/7; Ponera sp. 1), there was no evidence (with small sample sizes) for heterogeneity in termite consumption across ant taxa, and no evidence for species-specific ant-termite predation. In all three ant species with identifiable termite DNA in multiple individuals, multiple termite species were represented. Furthermore, the two termite species that were detected on multiple occasions in ant guts were in both cases found in multiple ant species, suggesting that anttermite food webs are not strongly compartmentalised. However, two ant species were found to consume only Anoplotermes-group termites, indicating possible predatory specialisation at a higher taxonomic level. Using a laboratory feeding test, we were able to detect termite COII sequences in ant guts up to 2 h after feeding, indicating that our method only detects recent feeding events. Our data provide tentative support for the hypothesis that unspecialised termite predation by ants is widespread and highlight the use of molecular approaches for future studies of ant-termite food webs

Hollow silicon microneedle fabrication using advanced plasma etch technologies for applications in transdermal drug delivery

A novel production process flow is presented here for the manufacture of hollow silicon microneedles using deep reactive-ion etching (DRIE) technology. The patent-pending three-step process flow has been developed to produce multiple arrays of sharp-tipped, hollow microneedles, which facilitate easy insertion and controlled fluid injection into excised skin samples. A bevelled tip and vertical sidewalls for the microneedle have been achieved with good uniformity, despite >45% open etch area. Processing steps and etch challenges are discussed, and preliminary skin testing results are presented, showing effective needle insertion and delivery of fluorescent dye into ex vivo skin from human breast tissue

Clonal Hematopoiesis and Clinical Outcomes in Metastatic Castration-Resistant Prostate Cancer Patients Given Androgen Receptor Pathway Inhibitors (Alliance A031201).

PURPOSE: Mutations in hematopoietic progenitor cells accumulate with age leading to clonal expansion, termed clonal hematopoiesis (CH). CH in the general population is associated with hematopoietic neoplasms and reduced overall survival (OS), predominantly through cardiovascular adverse events (CVAE). Because androgen receptor pathway inhibitors (ARPI) used in metastatic castration-resistant prostate cancer (mCRPC) are also associated with CVAEs and because CH negatively impacted survival in an advanced solid tumor cohort, we hypothesized that CH in mCRPC may be associated with increased CVAEs and inferior survival. EXPERIMENTAL DESIGN: A targeted DNA sequencing panel captured common CH mutations in pretreatment blood samples from 957 patients enrolled in Alliance A031201: a randomized trial of enzalutamide ± abiraterone/prednisone in the first-line mCRPC setting. The primary outcome was the impact of CH on OS; the secondary outcomes were progression-free survival (PFS) and CVAEs. RESULTS: Baseline comorbidities were similar by CH status. No differences in OS/progression-free survival were detected regardless of treatment arm or the variant allele frequency threshold used to define CH [primary: 2% (normal-CH, N-CH); exploratory: 0.5% (low-CH) and 10% (high-CH, H-CH)]. Patients with H-CH (7.2%) and TET2-mutated N-CH (6.0%) had greater odds of any CVAE (14.5% vs. 4.0%; P = 0.0004 and 12.3% vs. 4.2%; P = 0.010, respectively). More major CVAEs were observed in patients with H-CH (5.8% vs. 1.9%; P = 0.042) and N-CH (3.4% vs. 1.8%; P = 0.147). CONCLUSIONS: CH did not affect survival in patients with mCRPC treated with ARPIs in A031201. H-CH and TET2-mutated CH were associated with more CVAEs. These findings inform the risk/benefit discussion about ARPIs in mCRPC

The GHSR1a antagonist LEAP2 regulates islet hormone release in a sex-specific manner

© 2024, [BioScientifica]. This is an author produced version of a paper published in Journal of Endocrinology uploaded in accordance with the publisher’s self- archiving policy. The final published version (version of record) is available online at the link. Some minor differences between this version and the final published version may remain. We suggest you refer to the final published version should you wish to cite from it. LEAP2, a liver-derived antagonist for theghrelin receptor, GHSR1a, counteracts effects of ghrelin on appetite and energybalance. Less is known about its impact on blood glucose-regulating hormonesfrom pancreatic islets. Here we investigate whether acyl-ghrelin (AG) and LEAP2regulate islet hormone release in a cell type- and sex-specific manner. Hormonecontent from secretion experiments with isolated islets from male and femalemice was measured by radioimmunoassay and mRNA expression by qPCR. LEAP2enhanced insulin secretion in islets from males (p&lt;0.01) but not females(p&gt;0.2), whilst AG-stimulated somatostatin release was significantlyreversed by LEAP2 in males (p&lt;0.001) but not females (p&gt;0.2). Glucagonrelease was not significantly affected by AG and LEAP2. Ghsr1a, Ghrelin,Leap2, Mrap2, Mboat4 and Sstr3 islet mRNA expression did notdiffer between sexes whereas the SSTR3 antagonist MK4256 enhanced glucose-induced insulin secretion in islets from males only. In control male islets maintained without 17-betaoestradiol (E2),AG exerted an insulinostatic effect (p&lt;0.05), with a trend towards reversalby LEAP2 (p=0.06). Both were abolished by 72h E2 pre-treatment (10 nmol/l,p&gt;0.2). AG-stimulated somatostatin release was inhibited by LEAP2 fromcontrol (p&lt;0.001) but not E2-treated islets (p&gt;0.2). LEAP2and AG did not modulate insulin secretion from MIN6 beta cells and Mrap2was downregulated (P&lt;0.05) and Ghsr1a upregulated (P&lt;0.0001) inislets from Sst-/- mice. Our findings show that AG and LEAP2regulate insulin and somatostatin release in an opposing and sex-dependentmanner, which in males can be modulated by E2. We suggest that regulation ofSST release is a key starting point for understanding the role of GHSR1a inislet function and glucose metabolism.

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms