Iron metabolism of in­testinal mucosa in various blood diseases

For the investigation of iron metabolism in the intestinal mucosa in various&#12288;blood diseases, intestinal biopsy (duodenum) was performed on 10 healthy controls&#12288;and 35 cases with various blood diseases. The following are&#12288;the results&#12288;of the studies on distribution of stainable&#12288;iron, amounts of non-hemin iron in the&#12288;biopsied materials, and iron uptake of the intestinal epithelial cells.&#12288;1) An evaluation of distribution of stainable iron by Berlin&#12288;blue reaction&#12288;showed none or very mild degree, if any,&#12288;inhealthy controls, an increase in&#12288;aplastic anemia,&#12288;pernicious anemia, some of leukemias and in iron deficiency anemia following iron therapy, and a decrease in&#12288;idiopathic hypochromic anemia, anchylostomiasis anemia,&#12288;anemia with cancer, myxedema, hemolytic anemia,&#12288;and in&#12288;some of leukemias. Some of anemia with cancer, however,&#12288;showed an&#12288;increase of a certain degree. In iron absorption tests, no changes were found other than a very mild increase in aplastic anemia. 2) Non-hemin iron was 70-112&#947;/g in healthy controls, increased in aplastic anemia approximately to 100-200&#947;/g, ranging 40-130&#947;/g in leukemia, and decreased in idiopathic hypochromic anemia and in anemia with cancer ranging 30-60&#947;/g and 30-50&#947;/g respectively. Amounts of non-hemin iron and serum iron or sideroblasts show a fair correlation. The fractionation of nonhemin iron in aplastic anemia didn't show any difference in relationship of each fraction from healthy controls despite the increased amount in the former. 3) A radioautographic evaluation of iron uptake by intestinal epithelium was performed by our device for evaluation of intestinal absorption capacity. The iron uptake was mild in healthy controls, almost none in aplastic anemia, and marked in iron deficiency anemia where it was decreased approximately to the level of healthy controls following iron therapy. 4) The intestinal tissue iron showed a series of changes similar to those of iron present in the serum or erythroblasts, and the non-hemin iron in the intestinal mucosa is inversely correlated with iron uptake of epithelium and is considered to regulate the absorption according to its amount.</p

Impact of early initiation versus national standard of care of antiretroviral therapy in Swaziland's public sector health system : study protocol for a stepped-wedge randomized trial

Background: There is robust clinical evidence to support offering early access to antiretroviral treatment (ART) to all HIV-positive individuals, irrespective of disease stage, to both improve patient health outcomes and reduce HIV incidence. However, as the global treatment guidelines shift to meet this evidence, it is still largely unknown if early access to ART for all (also referred to as "treatment as prevention" or " universal test and treat") is a feasible intervention in the resource-limited countries where this approach could have the biggest impact on the course of the HIV epidemics. The MaxART Early Access to ART for All (EAAA) implementation study was designed to determine the feasibility, acceptability, clinical outcomes, affordability, and scalability of offering early antiretroviral treatment to all HIV-positive individuals in Swaziland's public sector health system. Methods: This is a three-year stepped-wedge randomized design with open enrollment for all adults aged 18 years and older across 14 government-managed health facilities in Swaziland's Hhohho Region. Primary endpoints are retention and viral suppression. Secondary endpoints include ART initiation, adherence, drug resistance, tuberculosis, HIV disease progression, patient satisfaction, and cost per patient per year. Sites are grouped to transition two at a time from the control (standard of care) to intervention (EAAA) stage at each four-month step. This design will result in approximately one half of the total observation time to accrue in the intervention arm and the other half in the control arm. Our estimated enrolment number, which is supported by conservative power calculations, is 4501 patients over the course of the 36-month study period. A multidisciplinary, mixed-methods approach will be adopted to supplement the randomized controlled trial and meet the study aims. Additional study components include implementation science, social science, economic evaluation, and predictive HIV incidence modeling. Discussion: A stepped-wedge randomized design is a causally strong and robust approach to determine if providing antiretroviral treatment for all HIV-positive individuals is a feasible intervention in a resource-limited, public sector health system. We expect our study results to contribute to health policy decisions related to the HIV response in Swaziland and other countries in sub-Saharan Africa

Predictors of linkage to care following community-based HIV counseling and testing in rural Kenya

Despite innovations in HIV counseling and testing (HCT), important gaps remain in understanding linkage to care. We followed a cohort diagnosed with HIV through a community-based HCT campaign that trained persons living with HIV/AIDS (PLHA) as navigators. Individual, interpersonal, and institutional predictors of linkage were assessed using survival analysis of self-reported time to enrollment. Of 483 persons consenting to follow-up, 305 (63.2%) enrolled in HIV care within 3 months. Proportions linking to care were similar across sexes, barring a sub-sample of men aged 18–25 years who were highly unlikely to enroll. Men were more likely to enroll if they had disclosed to their spouse, and women if they had disclosed to family. Women who anticipated violence or relationship breakup were less likely to link to care. Enrolment rates were significantly higher among participants receiving a PLHA visit, suggesting that a navigator approach may improve linkage from community-based HCT campaigns.Vestergaard Frandse

Optimization of PET protocol and interrater reliability of 18F-PSMA-11 imaging of prostate cancer

Background Several scan parameters for PET imaging with F-18-PSMA-11 such as dosage, acquisition time and scan duration were evaluated to determine the most appropriate scan protocol, as well as the effect of furosemide administration on lesion visualization. Forty-four patients were randomly assigned to a dosage group (2.0 +/- 0.2 or 4.0 +/- 0.4 MBq/kg F-18-PSMA-11). All patients received a full-body PET/CT 1 h and 3 h after radiotracer injection with a scan duration of 3 min/bed position. For comparison of the scan duration, images were reconstructed for 1.5 and 3 min/bed position. Patients were intravenously administered 0.5 mg/kg furosemide with a maximum dose of 40 mg. To evaluate the furosemide effect, 22 additional patients were recruited and received one full-body PET/CT 1 h after administration of 2.0 +/- 0.2 MBq/kg F-18-PSMA-11 with a scan duration of 3 min/bed position. To this group, no furosemide was administered. Images were scored on image quality using a 7-point scale and each suspicious lesion was described. To assess interrater reliability, two nuclear physicians scored all scans independently and described all observed suspicious lesions. Results The 4 MBq/kg group received for all reconstructed images (60 min p.i., 1.5 and 3 min/bed position and 180 min p.i., 1.5 and 3 min/bed position) the highest median image quality score compared to the 2 MBq/kg group (p values < 0.01). When comparing all reconstructed images, the highest image quality score was given to images at 60 min p.i., 3 min/bed position for both dosage groups (score 5 and 6 for 2 and 4 MBq/kg, respectively). The addition of furosemide administration decreased the interference score with one point (p = 0.01106) and facilitated the evaluation of lesions in proximity to the ureters. The interrater reliability for the comparison of each lesion separately after more than 40 F-18-PSMA-11 scan readings showed an increasing kappa value from 0.78 (95% CI, 0.65-0.92) to 0.94 (95% CI, 0.87-1). Conclusion Although the results indicate an administered activity of 4.0 +/- 0.4 MBq/kg, preference will be given to 2.0 +/- 0.2 MBq/kg due to the small difference in absolute score (max 1 point) and the ALARA principle. For evaluation of lesions in proximity to the ureters, the co-administration of a diuretic can be useful. The increase of the kappa value from 0.78 to 0.94 suggests a learning curve in the interpretation of F-18-PSMA-11 images

Summer Diapause of the Clover Leaf Weevil, \u3ci\u3eHypera Punctata,\u3c/i\u3e and Lesser Clover Leaf Weevil, \u3ci\u3eHypera Nigrirostris,\u3c/i\u3e in Wisconsin

Low respiration rates, immobility, lack of feeding, and undeveloped reproductive systems confirmed a summer diapause in the overwintered and current-year adults of the clover leaf weevil, Hypera punctata, and lesser clover leaf weevil, Hypera nigrirostris. The prolonged summer diapause and extended winters in Wisconsin set strict limitations on the available time for damaging populations to develop on red clover, Trifolium pratense thus assuring the status of these weevils as minor pests

Six-Month Mortality among HIV-Infected Adults Presenting for Antiretroviral Therapy with Unexplained Weight Loss, Chronic Fever or Chronic Diarrhea in Malawi.

In sub-Saharan Africa, early mortality is high following initiation of antiretroviral therapy (ART). We investigated 6-month outcomes and factors associated with mortality in HIV-infected adults being assessed for ART initiation and presenting with weight loss, chronic fever or diarrhea, and with negative TB sputum microscopy

Class I Gap-formation in Highly-viscous Glass-ionomer Restorations: Delayed vs Immediate Polishing

This in vitro study evaluated the effects of delayed versus immediate polishing to permit maturation of interfacial gap-formation around highly viscous conventional glass-ionomer cement (HV-GIC) in Class I restorations, together with determining the associated mechanical properties. Cavity preparations were made on the occlusal surfaces of premolars. Three HV-GICs (Fuji IX GP, GlasIonomer FX-II and Ketac Molar) and one conventional glass-ionomer cement (C-GIC, Fuji II, as a control) were studied, with specimen subgroups (n=10) for each property measured. After polishing, either immediately (six minutes) after setting or after 24 hours storage, the restored teeth were sectioned in a mesiodistal direction through the center of the model Class I restorations. The presence or absence of interfacial-gaps was measured at 1000× magnification at 14 points (each 0.5-mm apart) along the cavity restoration interface (n=10; total points measured per group = 140). Marginal gaps were similarly measured in Teflon molds as swelling data, together with shear-bond-strength to enamel and dentin, flexural strength and moduli. For three HV-GICs and one C-GIC, significant differences (p<0.05) in gap-incidence were observed between polishing immediately and after one-day storage. In the former case, 80–100 gaps were found. In the latter case, only 9–21 gaps were observed. For all materials, their shear-bond-strengths, flexural strength and moduli increased significantly after 24-hour storage.</p

Highlights from the 24th conference on retroviruses and opportunistic infections, 13-16 February 2017, Seattle, Washington, USA

From the 13th to 16th February 2017, researchers from around the world convened for the 24th annual Conference on Retroviruses and Opportunistic Infections (CROI) at the Washington State Convention Center in Seattle, Washington. The conference was organised by the International Antiviral Society-USA (IAS-USA) in partnership with the CROI Foundation. The conference included over 1000 oral and poster presentations of peer-reviewed original research as well as lectures and symposia featuring insights from leading basic, translational and clinical researchers. Highlighted here are key data presented at the conference

The dancer as a performing athlete: physiological considerations.

The physical demands placed on dancers from current choreography and performance schedules make their physiology and fitness just as important as skill development. However, even at the height of their professional careers, dancers' aerobic power, muscular strength, muscular balance, bone and joint integrity are the 'Achilles heels' of the dance-only selection and training system. This partly reflects the unfounded view, shared by sections of the dance world, that any exercise training that is not directly related to dance would diminish dancers' aesthetic appearances. Given that performing dance itself elicits only limited stimuli for positive fitness adaptations, it is not surprising that professional dancers often demonstrate values similar to those obtained from healthy sedentary individuals of comparable age in key fitness-related parameters. In contrast, recent data on male and female dancers revealed that supplementary exercise training can lead to improvements of such fitness parameters and reduce incidents of dance injuries, without interfering with key artistic and aesthetic requirements. It seems, however, that strict selection and training regimens have succeeded in transforming dance to an activity practised by individuals who have selectively developed different flexibility characteristics compared with athletes. Bodyweight targets are normally met by low energy intakes, with female dance students and professional ballerinas reported to consume below 70% and 80% of the recommended daily allowance of energy intake, respectively, while the female athlete 'triad' of disordered eating, amenorrhoea and osteoporosis is now well recognised and is seen just as commonly in dancers.An awareness of these factors will assist dancers and their teachers to improve training techniques, to employ effective injury prevention strategies and to determine better physical conditioning. However, any change in the traditional training regimes must be approached cautiously to ensure that the aesthetic content of the dance is not affected by new training techniques. Since physiological aspects of performing dance have been viewed primarily in the context of ballet, further scientific research on all forms of dance is required