The prevalence of renal impairment in individuals seeking HIV testing in Urban Malawi

Background: Chronic kidney disease (CKD) poses a major health threat to people living in low- and middle-income countries, especially when it is combined with HIV, antiretroviral treatment (ART) or communicable and non-communicable diseases. Data about the prevalence of CKD and its association with other diseases is scarce, particularly in HIV-negative individuals. This study estimated the prevalence of CKD in individuals who were either HIV-positive (and ART-naïve) or HIV-negative in an urban Malawian population. Methods: This cross-sectional study was conducted at a HIV Testing and Counselling Centre in Lilongwe, Malawi. Consecutive clients who were ≥18 years and consented to participate were enrolled over a 3-month period. Clients were screened for potential renal disease and other conditions. Their blood pressure was measured, urine examined via dipstick and albumin/creatinine ratio and blood drawn for creatinine, cystatin C and sero-markers for schistosomiasis. Estimated glomerular filtration (eGFR) rate was calculated using a cystatin C-based formula and classified according to the matching CKD stages by K/DOQI (The National Kidney Foundation Kidney Disease Outcome Quality Initiative). We performed a descriptive analysis and compared differences between HIV-positive (and ART naïve) and -negative participants. Results: Out of 381 consecutive clients who were approached between January and March 2012, 366 consented and 363 (48% female; 32% HIV-positive) were included in the analysis. Reasons for exclusion were missing samples or previous use of ART. HIV-positive and negative clients did not differ significantly with regard to age, sex or medical history, but they did differ for BMI—21.3 (±3.4) vs. 24 (±5.1), respectively (p < 0.001). Participants also differed with regard to serum cystatin C levels, but not creatinine. Reduced kidney function (according to CKD stages 2–5) was significantly more frequent 15.5 vs. 3.6%, respectively (p  < 0.001) among HIV-positive clients compared to the HIV-negative group. Differences in renal function were most pronounced in the eGFR range 60–89 ml/min/1.73 m2 accompanied by proteinuria with results as 11.2% vs. 1.2%, respectively for clients who were HIV-positive vs. HIV-negative (p = 0.001). Conclusions: Reduced glomerular filtration and/or proteinuria occurred in 15.5% of HIV-positive, and 3.6% of HIV-negative patients in this urban Malawian cohort. Since generalized renal monitoring is not feasible in Malawi or other resource-limited countries, strategies to identify patients at risk for higher stages of CKD and appropriate preventive measures are needed for both HIV-positive and HIV-negative patients

Trifluoroacetic acid deposition from emissions of HFO-1234yf in India, China, and the Middle East

We have investigated trifluoroacetic acid (TFA) formation from emissions of HFO-1234yf (CF3CFH2), its dry and wet deposition, and rainwater concentration over India, China, and the Middle East with GEOS-Chem and WRFChem models. We estimated the TFA deposition and rainwater concentrations between 2020 and 2040 for four previously published HFO-1234yf emission scenarios to bound the possible levels of TFA. We evaluated the capability of GEOS-Chem to capture the wet deposition process by comparing calculated sulfate in rainwater with observations. Our calculated TFA amounts over the USA, Europe, and China were comparable to those previously reported when normalized to the same emission. A significant proportion of TFA was found to be deposited outside the emission regions. The mean and the extremes of TFA rainwater concentrations calculated for the four emission scenarios from GEOS-Chem and WRF-Chem were orders of magnitude below the no observable effect concentration. The ecological and human health impacts now, and the continued use of HFO-1234yf in India, China, and the Middle East, are estimated to be insignificant based on the current understanding, as summarized by Neale et al. (2021)

Trifluoroacetic acid deposition from emissions of HFO-1234yf in India, China, and the Middle East

We have investigated trifluoroacetic acid (TFA) formation from emissions of HFO-1234yf (CF3CFH2), its dry and wet deposition, and rainwater concentration over India, China, and the Middle East with GEOS-Chem and WRF-Chem models. We estimated the TFA deposition and rainwater concentrations between 2020 and 2040 for four previously published HFO-1234yf emission scenarios to bound the possible levels of TFA. We evaluated the capability of GEOS-Chem to capture the wet deposition process by comparing calculated sulfate in rainwater with observations. Our calculated TFA amounts over the USA, Europe, and China were comparable to those previously reported when normalized to the same emission. A significant proportion of TFA was found to be deposited outside the emission regions. The mean and the extremes of TFA rainwater concentrations calculated for the four emission scenarios from GEOS-Chem and WRF-Chem were orders of magnitude below the no observable effect concentration. The ecological and human health impacts now, and the continued use of HFO-1234yf in India, China, and the Middle East, are estimated to be insignificant based on the current understanding, as summarized by Neale et al. (2021)

Understanding Change in Romantic Relationship Expectations of International Female Students from Turkey

In the light of grounded theory, the authors explored change in romantic relationship expectations of international students. Twelve female graduate students from Turkey were interviewed and several themes were identified explaining the presence and absence of change in participants’ attitudes toward romantic relationships. The findings are discussed in relation to acculturation and direction for future research is presented

Football friends: adolescent boys’ friendships inside an English professional football (soccer) academy.

This qualitative research draws on data from semi-structured, in-depth interviews to examine the friendships of twelve adolescent (14 and 15-year-old) boys within a professional football club Academy: a setting marked by competition for places. Findings highlight how boys fail to develop ‘deep’ friendships with other boys inside the club; their peer-relationships, even when described as ‘friendships,’ are devoid of trust and emotional intimacy. Instead, ‘being mates’ is experienced within parameters of instrumentalism and individualism leading to superficial and inauthentic friendships. There is some indication that boys developed closer friendships with boys outside of the Academy, suggesting that competition is implicated negatively in friendship-building and hinders the capabilities of these boys to develop close friendships with teammates. Concluding this paper, we acknowledge limitations of our data, discuss implications and challenges for football academies, and highlight directions for future research

An Association of Cancer Physicians' strategy for improving services and outcomes for cancer patients.

The Association of Cancer Physicians in the United Kingdom has developed a strategy to improve outcomes for cancer patients and identified the goals and commitments of the Association and its members.The ACP is very grateful to all of its members who have expressed views on the development of the strategy and to the sponsors of our workshops and publications, especially Cancer Research UK and Macmillan Cancer SupportThis is the final version of the article. It was first available from Cancer Intelligence via http://dx.doi.org/10.3332/ecancer.2016.60

Denial of long-term issues with agriculture on tropical peatlands will have devastating consequences

Non peer reviewe