WHO 2010 Guidelines for Prevention of Mother-to-Child HIV Transmission in Zimbabwe: Modeling Clinical Outcomes in Infants and Mothers

The Zimbabwean national prevention of mother-to-child HIV transmission (PMTCT) program provided primarily single-dose nevirapine (sdNVP) from 2002-2009 and is currently replacing sdNVP with more effective antiretroviral (ARV) regimens.Published HIV and PMTCT models, with local trial and programmatic data, were used to simulate a cohort of HIV-infected, pregnant/breastfeeding women in Zimbabwe (mean age 24.0 years, mean CD4 451 cells/µL). We compared five PMTCT regimens at a fixed level of PMTCT medication uptake: 1) no antenatal ARVs (comparator); 2) sdNVP; 3) WHO 2010 guidelines using "Option A" (zidovudine during pregnancy/infant NVP during breastfeeding for women without advanced HIV disease; lifelong 3-drug antiretroviral therapy (ART) for women with advanced disease); 4) WHO "Option B" (ART during pregnancy/breastfeeding without advanced disease; lifelong ART with advanced disease); and 5) "Option B+:" lifelong ART for all pregnant/breastfeeding, HIV-infected women. Pediatric (4-6 week and 18-month infection risk, 2-year survival) and maternal (2- and 5-year survival, life expectancy from delivery) outcomes were projected.Eighteen-month pediatric infection risks ranged from 25.8% (no antenatal ARVs) to 10.9% (Options B/B+). Although maternal short-term outcomes (2- and 5-year survival) varied only slightly by regimen, maternal life expectancy was reduced after receipt of sdNVP (13.8 years) or Option B (13.9 years) compared to no antenatal ARVs (14.0 years), Option A (14.0 years), or Option B+ (14.5 years).Replacement of sdNVP with currently recommended regimens for PMTCT (WHO Options A, B, or B+) is necessary to reduce infant HIV infection risk in Zimbabwe. The planned transition to Option A may also improve both pediatric and maternal outcomes

Analysis and Optimization of Accumulation-Mode Varactor for RF ICs

This paper presents a novel RF IC varactor implemented in standard CMOS process. This device has shown a remarkable tuning range of 150#, sensitivity of 300##V, and quality factor of 23 at 1 GHz. A physical model of the varactor is presented and con#rmed with measured data. Using the model derived, optimization has shown that a Q as high as 200 can be achieved. I. Introduction High quality on-chip varactors are essential to monolithic integration of voltage-controlled oscillators in a Si-based RF ICs. Conventionally, on-chip varactors have been implemented with pn junctions under reverse bias or MOS capacitors in depletion-inversion regime. PN-junction varactors have been reported with quality factor #Q# of less than 7 for capacitance of 1#10 pF at 0.9#2.4 GHz. Typical MOS capacitors can achieve higher Q #14#GHz#pF# with larger capacitance per area #1#. In this paper, we presentanovel varactor based on an NMOS-like structure biased in accumulation-depletion regime. A physical model i..

Improving the NHS demands more than just extra money [Letter]

erry Young, professor On behalf of Steve Allder, consultant neurologist, Plymouth Hospitals NHS Trust; Sally Brailsford, professor of management science, University of Southampton; Rob Berry, head of innovation, KSSAHSN; Harald Braun, operations director, i5 Health; Claire Cordeaux, executive director, Health and Social Care, Simul8 Corporation; Thierry Chaussalet, professor, University of Westminster; Keith Davies, managing director, i5 Health; Laurent Debenedetti, CEO, Gordian Laser; Mike Farrar, independent consultant; Paul Harper, professor of operational research, Cardiff University; John King, founder, ETHOS Partnership; Peter Lacey, founding partner, Whole Systems Partnership; Loy Lobo, founder, Wegyanik; Justin Lyon, CEO, Simudyne; Adele Marshall, professor of statistics, Queen’s University, Belfast; Sally McClean, professor of mathematics, University of Ulster; Douglas McKelvie, partner, Symmetric Partnership LLP; David Paynton, GP, Southampton; Adam Pollard, research director, Pollard Systems; Paul Schmidt, consultant in acute medicine, Portsmouth Hospitals NHS Trust; Sada Soorapanth, associate professor, San Francisco State University