Building the field of health policy and systems research: framing the questions.

In the first of a series of articles addressing the current challenges and opportunities for the development of Health Policy & Systems Research (HPSR), Kabir Sheikh and colleagues lay out the main questions vexing the field

Oral human papillomavirus (HPV) infection in men who have sex with men: prevalence and lack of anogenital concordance.

To estimate the prevalence of oral detectable human papillomavirus (HPV) DNA in HIV-negative men who have sex with men (MSM) attending a sexual health clinic in London and concordance with anogenital HPV infection. Such data are important to improve our understanding of the epidemiology of oral HPV and the potential use of vaccines to prevent oropharyngeal cancers

Curves orthogonal to a vector field in Euclidean spaces

A curve is rectifying if it lies on a moving hyperplane orthogonal to its curvature vector. In this work, we extend the main result of [B.-Y. Chen, Tamkang J. Math. \textbf{48} (2017) 209--214] to any space dimension: we prove that rectifying curves are geodesics on the hypersurface of higher dimensional cones. We later use this association to characterize rectifying curves that are also slant helices in three-dimensional space as geodesics of circular cones. In addition, we consider curves that lie on a moving hyperplane normal to (i) one of the normal vector fields of the Frenet frame and to (ii) a rotation minimizing vector field along the curve. The former class is characterized in terms of the constancy of a certain vector field normal to the curve, while the latter contains spherical and plane curves. Finally, we establish a formal mapping between rectifying and spherical curves in any dimension.Comment: 12 pages; keywords: Rectifying curve, geodesic, cone, spherical curve, plane curve, slant heli

Effect of HIV infection and antiretroviral therapy on hepatitis B virus (HBV)-specific T cell responses in patients who have resolved HBV infection

Coinfection with hepatitis B virus (HBV) is a common occurrence in human immunodeficiency virus (HIV)–positive patients and an increasing cause of morbidity and mortality. The CD8+ T cell response is critical for long-term control of HBV in patients resolving acute infection. Here, we examine the effect of HIV on HBV-specific CD8+ T cell responses in patients who have resolved HBV infection. A cross-sectional study showed a reduction in HBV-specific CD8+ T cell responses in HIV-positive, HBV-immune patients, compared with those in HIV-negative, HBV-immune patients. A longitudinal study of a subgroup of patients examined whether this attrition could be reversed by effective antiretroviral therapy. The introduction of highly active antiretroviral therapy (HAART) resulted in reconstitution of some HBV-specific CD4+ and CD8+ T cell responses, in association with restoration of CD4+ T cell counts. These data provide a mechanism to account for the observed impairment of control of HBV infection in the setting of HIV infection and support the ability of HAART to reconstitute functionally active T cell responses

Incorporating Biomarker Stratification into STAMPEDE: an Adaptive Multi-arm, Multi-stage Trial Platform

The treatment and outcomes for advanced prostate cancer have experienced significant progress over recent years. Importantly, the additional benefits of 'up front' chemotherapy (docetaxel) and abiraterone, over and above conventional androgen deprivation, have been separately demonstrated in the multi-arm, multi-stage (MAMS) STAMPEDE protocol, which continues recruitment to other questions. Alongside this, insights into the underlying molecular biology and, inevitably, the molecular heterogeneity of prostate cancer are opening the door to new therapeutic approaches. Incorporating this understanding and testing these hypotheses within STAMPEDE brings new challenges to the MAMS approach, but has the potential to further improve the outlook for this disease

Biologia reprodutiva da surucucu Lachesis muta (Serpentes: Viperidae) da Floresta Atlântica brasileira

The Neotropical genus Lachesis Daudin, 1803 includes snakes restricted to the humid forests of Central and South America. The species L. muta is the most widely dispersed, occurring throughout the Amazon rainforest, and with an isolated population in the Atlantic Forest, from the north of the state of Ceará to the south of the state of Rio de Janeiro, Brazil. We present information about the reproductive biology of L. muta from a large series of samples gathered in southern Bahia. Mature males L. muta are larger than females. Degree of sexual size dimorphism (SSD) is 0.16. Vitellogenic follicles and eggs are not distributed equally throughout the year. Clutch size was 3–14 oviductal eggs and was positively correlated with female SVL. Testes volume and ductus deferens diameter in mature individuals did not vary significantly throughout the year. The reproductive pattern of L. muta differs from that of the phylogenetically related genera because L. muta is oviparous, and has a discontinuous cycle and reproductive synchrony between the sexes.O gênero Neotropical Lachesis Daudin, 1803 inclui serpentes restritas às florestas úmidas da América do Sul e Central. A espécie Lachesis muta é mais amplamente distribuída, ocorrendo em toda a Floresta Amazônica e com uma população isolada na Mata Atlântica, desde o norte do estado do Ceará, ao sul do estado do Rio de Janeiro, Brasil. Apresentamos informações sobre a biologia reprodutiva de L. muta a partir da análise de uma grande série de amostras recolhidas no sul da Bahia. Os machos maduros de L. muta foram maiores que as fêmeas. O grau de dimorfismo sexual (SSD) foi 0,16. Folículos vitelogênicos e ovos não foram distribuídos homogeneamente ao longo do ano. O tamanho da ninhada foi 3–14 ovos e positivamente correlacionado com o CRC das fêmeas. O volume testicular e o diâmetro dos ductos deferentes nos indivíduos maduros não apresentaram variação significativa ao longo do ano. O padrão reprodutivo de L. muta difere daquele de gêneros filogeneticamente relacionados, pois essa espécie é ovípara, tem ciclo descontínuo e sincronia reprodutiva entre os sexos

Maximum Confidence Quantum Measurements

We consider the problem of discriminating between states of a specified set with maximum confidence. For a set of linearly independent states unambiguous discrimination is possible if we allow for the possibility of an inconclusive result. For linearly dependent sets an analogous measurement is one which allows us to be as confident as possible that when a given state is identified on the basis of the measurement result, it is indeed the correct state.Comment: 4 pages, 2 figure

The EU and Asia within an evolving global order: what is Europe? Where is Asia?

The papers in this special edition are a very small selection from those presented at the EU-NESCA (Network of European Studies Centres in Asia) conference on "the EU and East Asia within an Evolving Global Order: Ideas, Actors and Processes" in November 2008 in Brussels. The conference was the culmination of three years of research activity involving workshops and conferences bringing together scholars from both regions primarily to discuss relations between Europe and Asia, perceptions of Europe in Asia, and the relationship between the European regional project and emerging regional forms in Asia. But although this was the last of the three major conferences organised by the consortium, it in many ways represented a starting point rather than the end; an opportunity to reflect on the conclusions of the first phase of collaboration and point towards new and continuing research agendas for the future

The menopause transition in women living with HIV: current evidence and future avenues of research

As the life expectancy of people living with HIV improves as a result of antiretroviral therapy, increasing numbers of women living with HIV (WLHIV) are now reaching menopausal age. The menopause transition in WLHIV remains a relatively overlooked area in clinical HIV research. Whilst there is some evidence to suggest that WLHIV experience menopause at an earlier age and that they have more menopausal symptoms, there is no clear consensus in the literature around an impact of HIV infection on either timing or symptomatology of the menopause. Data are also conflicting on whether HIV-related factors such as HIV viral load and CD4 cell count have an impact on the menopause. Furthermore, menopausal symptoms in WLHIV are known to go under-recognised by both healthcare providers and women themselves. There is likely to be a burden of unmet health needs among WLHIV transitioning through the menopause, with significant gaps in the evidence base for their care. With this in mind, we have developed the PRIME study (Positive Transitions Through the Menopause). This mixed-methods observational study will explore, for the first time in the UK, the impact of the menopause on the health and wellbeing of 1500 ethnically diverse WLHIV. In establishing a cohort of women in their midlife and following them up longitudinally, we hope to develop a nuanced understanding of the gendered aspects of ageing and HIV, informing the provision of appropriate services for WLHIV to ensure that they are supported in maintaining optimal health and wellbeing as they get older