Validation study of mHealth technology in HIV to improve empowerment and healthcare utilisation: research and innovation to generate evidence for personalised care (EmERGE)

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Positive outcomes: validity, reliability and responsiveness of a novel person-centred outcome measure for people with HIV

Objectives Despite successful treatment, people living with HIV experience persisting and burdensome multidimensional problems. We aimed to assess the validity, reliability and responsiveness of Positive Outcomes, a patient-reported outcome measure for use in clinical practice. Methods In all, 1392 outpatients in five European countries self-completed Positive Outcomes, PAM-13 (patient empowerment), PROQOL-HIV (quality of life) and FRAIL (frailty) at baseline and 12 months. Analysis assessed: (a) validity (structural, convergent and divergent, discriminant); (b) reliability (internal consistency, test-retest); and (c) responsiveness. Results An interpretable four-factor structure was identified: ‘emotional wellbeing’, ‘interpersonal and sexual wellbeing’, ‘socioeconomic wellbeing’ and ‘physical wellbeing’. Moderate to strong convergent validity was found for three subscales of Positive Outcomes and PROQOL (ρ = −0.481 to −0.618, all p < 0.001). Divergent validity was found for total scores with weak ρ (−0.295, p < 0.001). Discriminant validity was confirmed with worse Positive Outcomes score associated with increasing odds of worse FRAIL group (4.81-fold, p < 0.001) and PAM-13 level (2.28-fold, p < 0.001). Internal consistency for total Positive Outcomes and its factors exceeded the conservative α threshold of 0.6. Test-retest reliability was established: those with stable PAM-13 and FRAIL scores also reported median Positive Outcomes change of 0. Improved PROQOL-HIV score baseline to 12 months was associated with improved Positive Outcomes score (r = −0.44, p < 0.001). Conclusions Positive Outcomes face and content validity was previously established, and the remaining validity, reliability and responsiveness properties are now demonstrated. The items within the brief 22-item tool are designed to be actionable by health and social care professionals to facilitate the goal of person-centred care

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

2 Triterpenoid Saponins From Heinsia-crinata

Two new triterpenoid saponins isolated from the root bark of Heinsia crinata were characterized as heinsiagenin A-3 beta-O-(beta-D-glucopyranosyl-(1 --> 2)-beta-D-glucopyranosyl-(1 --> 6)-[alpha-L-rhamnopyranosyl-(1 --> 2)]-beta-D-glucopyranosyl-(1 --> 2)-beta-D-glucopyranoside) and heinsiagenin A-3 beta-O-(alpha-L-rhamnopyranosyl-(1 --> 2)-beta-D-glucopyranosyl(1 --> 2)-beta-D-glucopyranoside). The structures were deduced mainly from a combination of 1- and 2D NMR experiments

A Dosimetric Quality Audit of Photon Beams By the Belgian-hospital-physicist-association

Since 1987, a dosimetric standardization process has been started by the Belgian Hospital Physicist Association (BHPA). As part of this project, on-site visits were performed by a voluntary team, by request of the local physicist. They included mechanical checks on treatment machines and simulators and a dosimetric intercomparison of photon beams, following the EORTC methodology. Until now 16 centres have participated. Dose measurements were performed in order to evaluate the uniformity in dosimetry after the adoption by the BHPA members of the Nederlandse Commissie voor Stralingsdosimetrie (NCS) code of practice for photon beams [7,9]. Doses were measured with an ionization chamber in water under NCS reference conditions and under other conditions in 13 cobalt beams and 24 high energy X-ray beams from 4 to 25 MV. Under reference conditions, the mean ratio of measured to stated dose is 0.999 (+/- 0.010) and 1.006 (+/- 0.23) for cobalt and X-ray beams, respectively, with a difference between the extreme values (DELTA) of 0.042 for cobalt beams and 0.084 for X-ray beams. In other conditions, the spread is a little larger for all beams. The results are comparable, but with a smaller dispersion, with those of other national and international similar dose intercomparisons and show the importance of applying a common protocol. The results of mechanical checks show some large deviations in digital displays and indicate the need for a systematic mechanical and beam alignment quality assurance programme

Palladium catalyzed synthesis of Ca2+ indicators with aryl bithiophene and terthiophene fluorophores

Five new fluorescent indicators for Ca2+ were synthesized using the Stille reaction. They all consist of the tricarboxylate chelator APTRA (o-aminophenol-N,N,O-triacetic acid) linked to a (substituted) bithiophene or terthiophene fluorophore. The dissociation constants Kd measured via fluorimetric titrations at 21°C in 100 mM KCl buffered solution, pH 7.05, for the Ca2+ complexes with the new probes are in the range between 10 and 40 µM. © 2005 Elsevier Ltd. All rights reserved.IDO/00/001 G.0320.00N.A. wishes to thank Professor Dr. S. Icli for his support. A.K. and S.S.S. are grateful to the DWTC (Belgium) for a postdoctoral fellowship. The authors are grateful to the University Research Fund of the K.U. Leuven for IDO-grant IDO/00/001 and to the FWO for grant G.0320.00. The DWTC through IAP-V-03 is thanked for continuing support. -

COVID-19: impact of vaccination in myeloma patients.

No abstract availabl

Divergent pathways in the intramolecular Diels-Alder reaction of 2(1H)-pyrazinones substituted at the 3-position with a phenylalkyne containing side chain

2(1H)-Pyrazinones bearing an X-(o-C6H4)-C=C-R moiety (X=O or MI; R=H, Ph or TMS) at position 3 were subjected to intramolecular Diels-Alder reaction. For the ether compounds (X=O) cycloaddition-elimination occurred readily to produce either benzofuro[2,3-c]pyridin-1(2-H)-ones or benzofuro[2,3-b]pyridines. For the aniline derivatives (X=NH, R=H or TMS) thermolysis in acetic anhydride resulted in a similar product distribution of beta-carbolinones and alpha-carbolines which. however, differed from that obtained previously in refluxing tetrahydronaphthalene. This result is explained by the cycloaddition proceeding from the aniline NH-acetylated precursor. However, the aniline derivatives with Ph as the acetylenic end group (X=NH, R=Ph) reacted via a divergent pathway to produce N-(2-oxopyrazin-3-yl)-2-Ph-substituted indoles. (C) 1999 Elsevier Science Ltd. All rights reserved.status: publishe