Using biomarkers to predict TB treatment duration (Predict TB): a prospective, randomized, noninferiority, treatment shortening clinical trial

Background : By the early 1980s, tuberculosis treatment was shortened from 24 to 6 months, maintaining relapse rates of 1-2%. Subsequent trials attempting shorter durations have failed, with 4-month arms consistently having relapse rates of 15-20%. One trial shortened treatment only among those without baseline cavity on chest x-ray and whose month 2 sputum culture converted to negative. The 4-month arm relapse rate decreased to 7% but was still significantly worse than the 6-month arm (1.6%, P<0.01).  We hypothesize that PET/CT characteristics at baseline, PET/CT changes at one month, and markers of residual bacterial load will identify patients with tuberculosis who can be cured with 4 months (16 weeks) of standard treatment.Methods: This is a prospective, multicenter, randomized, phase 2b, noninferiority clinical trial of pulmonary tuberculosis participants. Those eligible start standard of care treatment. PET/CT scans are done at weeks 0, 4, and 16 or 24. Participants who do not meet early treatment completion criteria (baseline radiologic severity, radiologic response at one month, and GeneXpert-detectable bacilli at four months) are placed in Arm A (24 weeks of standard therapy). Those who meet the early treatment completion criteria are randomized at week 16 to continue treatment to week 24 (Arm B) or complete treatment at week 16 (Arm C). The primary endpoint compares the treatment success rate at 18 months between Arms B and C.Discussion: Multiple biomarkers have been assessed to predict TB treatment outcomes. This study uses PET/CT scans and GeneXpert (Xpert) cycle threshold to risk stratify participants. PET/CT scans are not applicable to global public health but could be used in clinical trials to stratify participants and possibly become a surrogate endpoint. If the Predict TB trial is successful, other immunological biomarkers or transcriptional signatures that correlate with treatment outcome may be identified. TRIAL REGISTRATION: NCT02821832

Chemical and electrical characteristics of annealed Ni/Au and Ni/Ir/Au contacts on AlGaN

The evolution of Ni/Au and Ni/Ir/Au metal contacts deposited on AlGaN was investigated at different annealing temperatures. The samples were studied with electrical and chemical composition techniques. I-V characteristics of the Schottky diodes were optimum after 500 and 600 ºC annealing for Ni/Au and Ni/Ir/Au based diodes, respectively. The depth profiles of the contacts were measured by x-ray photoelectron spectroscopy and time of flight secondary ion mass spectroscopy. These chemical composition techniques were used to examine the evolution of the metal contacts in order to verify the influence the metals have on the electrical properties of the diodes. The insertion of Ir as a diffusion barrier between Ni and Au effected the electrical properties, improving the stability of the contacts at high temperatures. Gold diffuses into the AlGaN film, degrading the electrical properties of the Ni/Au diode. At 500 ºC, the insertion of Ir, however, prevented the in-diffusion of Au into the AlGaN substrate.The National Research Foundation of South Africa (Grant specific unique reference number (UID) 87352).http://www.journals.elsevier.com/physica-b-condensed-matterhb2017Physic

Towards Room Temperature Thermochromic Coatings with controllable NIR-IR modulation for solar heat management & smart windows applications

Solar heat management & green air-conditioning are among the major technologies that could mitigate heat islands phenomenon while minimizing significantly the CO2 global foot-print within the building & automotive sectors. Chromogenic materials in general, and thermochromic smart coatings especially are promising candidates that consent a noteworthy dynamic solar radiation Infrared (NIR-IR) regulation and hence an efficient solar heat management especially with the expected increase of the global seasonal temperature. Within this contribution, two major challenging bottlenecks in vanadium oxide based smart coatings were addressed. It is validated for the first time that the NIR-IR modulation of the optical transmission (∆TTRANS = T(T〈TMIT) − T(T〉TMIT) of Vanadium oxide based smart coatings can be controlled & tuned. This upmost challenging bottle-neck controllability/tunability is confirmed via a genuine approach alongside to a simultaneous drastic reduction of the phase transition temperature TMIT from 68.8 °C to nearly room temperature. More precisely, a substantial thermochromism in multilayered V2O5/V/V2O5 stacks equivalent to that of standard pure VO2 thin films but with a far lower transition temperature, is reported. Such a multilayered V2O5/V/V2O5 thermochromic system exhibited a net control & tunability of the optical transmission modulation in the NIR-IR (∆TTRANS) via the nano-scaled thickness’ control of the intermediate Vanadium layer. In addition, the control of ∆TTRANS is accompanied by a tremendous diminution of the thermochromic transition temperature from the elevated bulk value of 68.8 °C to the range of 27.5–37.5 ºC. The observed remarkable and reversible thermochromism in such multilayered nano-scaled system of V2O5/V/V2O5 is likely to be ascribed to a noteworthy interfacial diffusion, and an indirect doping by alkaline ions diffusing from the borosilicate substrate. It is hoped that the current findings would contribute in advancing thermochromic smart window technology and their applications for solar heat management in glass windows in general, skyscraper especially & in the automotive industry. If so, this would open a path to a sustainable green air-conditioning with zero-energy input

An early career in the military: A developmental-contextual perspective

Young professional military officers' experience of their internal career development was studied longitudinally from a life-span, life-space approach. Significant transitions between the life roles of worker, student and leisurite, with concomitant changes in their value system, away from traditional military values towards occupationalism, were confirmed. Gender differences were found for the work and community roles as well as in the developmental patterns of the need for authority, creativity, cultural identity, physical activities, social relationships and variety. Significant differences between the career development profiles of military and civilian students with regard to life roles were revealed. Opsomming Jong militere beroepsoffisiere se belewenis van hulle interne loopbaanontwikkeling is longitudinaal uit 'n lewenspan-Iewensruimte benadering bestudeer. Beduidende oorgange tussen die werk-, studie- en ontspanningsrolle met gepaardgaande veranderinge in hulle waardestelsel, weg van tradisionele militere waardes in die rigting van 'n beroepsgeoriënteerde waardestelsel, is bevestig. Geslagsverskille is gevind wat betref die werk- en gemeenskapsrolle sowel as in die volgende ontwikkelingspatrone: 'n behoefte aan outoriteit, kreatiwiteit, kulturele identiteit, fisiese aktiwiteite, sosiale verhoudings en verskeidenheid. Beduidende verskille met betrekking tot lewensrolle het in die loopbaanontwikkelingsprofiele van militere en burgerlike studente aan die lig gekom

Vigilantism: A theoretical perspective as applied to people's courts in post-1994 South Africa

The article investigated vigilantism as phenomenon in South Africa. A metatheoretical framework was developed through which the constructed contextual and specific criteria were tested against one case study on people’s courts. The probability of the occurrence of vigilantism is more likely if the following context criteria are present Society experiences a state in disequilibrium, the state is dysfunctional, power vacuums exist and high levels of violence occur. People’s courts have been a continuous phenomenon in post-1994 South Africa. People’s courts qualify as vigilante groups and the context in which they occur is in line with the identified context criteria. This research has shown that vigilantism is a reality in post-1994 South Africa and a real threat to the authority of the state and requires the state’s attention and immediate action

A meta-analysis into the effect of lateral-wedged insoles with subtalar strapping versus traditional insoles in adults with medial knee osteoarthritis.

To  systematically  identify,  collate,  and  analyze  the  current available evidence  for  the  effectiveness  of  lateral-wedged  insoles,  with subtalar strapping,  on  reducing  pain,  improving  function  and  improving  the femoral-tibial  angle  (FTA),  in  adults  with  medial  knee osteoarthritis compared to traditional insoles without subtalar strapping.Six computerised databases, namely Cochrane Library, CiNAHL, PEDro, BIOMED central,  PubMed  and  ScienceDirect  were  searched. The  included articles were  then  all  rated  using  the  PEDro  scale  to  determine  their meth-odological quality.  Homogeneous data were pooled in a meta-analysis using Review Manager (REVMAN) software.  Where statistical pooling of the results was not possible, findings were summarised in narrative form. Three randomised controlled trials were selected for this review. The average PEDro score was 5.7. A meta-analysis demonstrated that lateral-wedged insoles with subtalar strapping significantly reduced pain in the short-term (p=0.004). The review found that lateral-wedge insoles with subtalar strapping significantly decreased pain in the short-term and seemed to have a positive effect on the FTA in the long-term, when compared to traditional insoles without  subtalar strapping. The lateral-wedge insole with subtalar strapping may provide a financially feasible adjunctive self-management treatment for knee OA and should be considered before invasive procedures such as surgery