The challenges of technological innovation in HIV

The challenges of transferring biomedical advances and non-biomedical technological innovations in HIV prevention and treatment to the field, are a theme of this year’s XVII International AIDS Conference. In the HIV field, innovations are often understood in exclusively biomedical or psychosocial terms. Related to these understandings are well-worn disciplinary distinctions. Thus vaccines and drug treatments are typically understood as biotechnological. They are seen as the proper preserve of laboratory studies and clinical trials that are charged with the creation of biotechnologies to protect human bodies from HIV infection or reduce damaging effects when infection has occurred. By contrast, innovations in safer-sex campaigns and other forms of behavioural prevention are generally considered the mainstay of the social sciences. Research from these fields is intended to provide insights into the beliefs and practices that might inform policy and programmes aimed at individual behaviours. Interdisciplinary collaborations generally involve social-science study of human experiences of and responses to biomedical phenomena. Good examples are the studies of adherence to HIV antiretroviral drug treatments and studies of the effect of antiretrovirals on concepts of risk and risk behaviours. In such studies, the innovation is often taken to be separate from the individuals that participate in it. The goal is to understand how the initiative affects or is experienced by participants

Discovery of high-entropy ceramics via machine learning

AbstractAlthough high-entropy materials are attracting considerable interest due to a combination of useful properties and promising applications, predicting their formation remains a hindrance for rational discovery of new systems. Experimental approaches are based on physical intuition and/or expensive trial and error strategies. Most computational methods rely on the availability of sufficient experimental data and computational power. Machine learning (ML) applied to materials science can accelerate development and reduce costs. In this study, we propose an ML method, leveraging thermodynamic and compositional attributes of a given material for predicting the synthesizability (i.e., entropy-forming ability) of disordered metal carbides. The relative importance of the thermodynamic and compositional features for the predictions are then explored. The approach’s suitability is demonstrated by comparing values calculated with density functional theory to ML predictions. Finally, the model is employed to predict the entropy-forming ability of 70 new compositions; several predictions are validated by additional density functional theory calculations and experimental synthesis, corroborating the effectiveness in exploring vast compositional spaces in a high-throughput manner. Importantly, seven compositions are selected specifically, because they contain all three of the Group VI elements (Cr, Mo, and W), which do not form room temperature-stable rock-salt monocarbides. Incorporating the Group VI elements into the rock-salt structure provides further opportunity for tuning the electronic structure and potentially material performance

Simulation of Blood Flow and Nanoparticle Transport in a Stenosed Carotid Bifurcation and Pseudo-Arteriole

Numerical simulation of flow through a realistic bifurcated carotid artery geometry with a stenosis has been conducted for comparison to experimental measurements. The behaviour of simplified therapeutic nanoparticles in relatively low concentration was observed using a discrete particle approach. The role of size (diameters from 500 nm to 50 nm) in determining particle residence time and the potential for both desirable and undesirable wall interactions was investigated. It was found that mean particle residence time reduced with decreasing particle diameter, and the percentage of particles experiencing one or more wall interactions increased simultaneously. Further simulations were conducted on a scaled-down version of the geometry which approximated the size and flow conditions of an arteriole with capillary branches, and in this instance the mean residence time increased with decreasing particle diameter, owing largely to the greater influence of Brownian motion. 33% of all 50 nm particles were involved in wall interactions, indicating that smaller particles would have a greater ability to target, for instance, cancerous tumours in such regions

From Marx to Gramsci to us: Laboratory to prison, and back

Marx and Gramsci remain two of the most constant presences and inspirations for those on the left. Yet there is a persistent sense that we have still to get them right. Perhaps this indicates that sources like this are now fully classics, to be returned, and returned to. In the case of Marx and Gramsci, a series of major works published in the Brill Historical Materialism series breaks new ground as well as returning to older controversies, both resolved and unresolved. Apart from remaining arguments concerning the status of materials unpublished in their own lifetimes, the major tension that emerges here is that between the task of immanent, contextual philology and the challenge of reading ‘Marx for today’ or ‘Gramsci for today’. The tension between text and context, and the question of what travels, conceptually persists

Design and development of the Australian and New Zealand (ANZ) myeloma and related diseases registry

© 2016 The Author(s). Background: Plasma cell dyscrasias (PCD) are a spectrum of disorders resulting from the clonal expansion of plasma cells, ranging from the pre-malignant condition monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma (MM). MM generates a significant burden of disease on the community and it is predicted that it will increase in both incidence and prevalence owing to an ageing population and longer survival secondary to new therapeutic options. Robust and comprehensive clinical data are currently lacking but are required to define current diagnostic, investigational and management patterns in Australia and New Zealand (ANZ) for comparison to both local and international guidelines for standards of care. A clinical registry can provide this information and subsequently support development of strategies to address any differences, including providing a platform for clinical trials. The Myeloma and Related Diseases Registry (MRDR) was developed to monitor and explore variations in practices, processes and outcomes in ANZ and provide benchmark outcomes nationally and internationally for PCD. This paper describes the MRDR aims, development and implementation and discusses challenges encountered in the process. Methods: The MRDR was established in 2012 as an online database for a multi-centre collaboration across ANZ, collecting prospective data on patients with a diagnosis of MGUS, MM, solitary plasmacytoma or plasma cell leukaemia. Development of the MRDR required multi-disciplinary team participation, IT and biostatistical support as well as financial resources. Results: More than 1250 patients have been enrolled at 23 sites to date. Here we describe how database development, data entry and securing ethics approval have been major challenges for participating sites and the coordinating centre, and our approaches to resolving them. Now established, the MRDR will provide clinically relevant and credible monitoring, therapy and 'real world' outcome data, to support the conduction of high quality studies. In addition, the Myeloma 1000 sub-study is establishing a repository of paired peripheral blood specimens from registry patients to study mechanisms underlying disease progression. Conclusion: Establishment of the MRDR has been challenging, but it is a valuable investment that will provide a platform for coordinated national and international collaboration for clinical research in PCD in ANZ

Rethinking the Poverty-disease Nexus: the Case of HIV/AIDS in South Africa

While it is well-established that poverty and disease are intimately connected, the nature of this connection and the role of poverty in disease causation remains contested in scientific and social studies of disease. Using the case of HIV/AIDS in South Africa and drawing on a theoretically grounded analysis, this paper reconceptualises disease and poverty as ontologically entangled. In the context of the South African HIV epidemic, this rethinking of the poverty-disease dynamic enables an account of how social forces such as poverty become embodied in the very substance of disease to produce ontologies of HIV/AIDS unique to South Africa

A wager on the future: a practicable response to HIV pre-exposure prophylaxis (PrEP) and the stubborn fact of process

In this article we focus on public health’s wager on the social implications of a daily antiretroviral pill to prevent HIV, referred to as PrEP (pre-exposure prophylaxis). The wager is shown to rely on modes of inquiry overly tied to what is known of the present in order to predict the future. Although such inquiry is not unusual when social research is called upon to assist health policy, predictive methodologies are unable to appreciate the dynamic and thus indeterminate nature of process. We ask: what mode of inquiry might practicably appreciate that what happens in the present will have a bearing on the future, without foreclosing on unknown possibles? Drawing on speculative and pragmatic philosophy, we reflect on our own qualitative research on PrEP to suggest that conventional methodological approaches can contribute to the future without seeking to determine what it will become

PrEP (HIV pre-exposure prophylaxis) and its possibilities for clinical practice

In this article, we reflect on the possibilities that PrEP (HIV pre-exposure prophylaxis) raises for HIV specialist clinicians. Often neglected, yet a direct participant at the intersection of a complex tension within public health debates on how to reduce HIV transmission and the sexual sociability of individuals, we reflect on current thinking of health practitioners involved in the day-to-day practice of prescribing PrEP. Drawing on interviews with practitioners in the context of UK sexual health and HIV specialist medicine, while bearing in mind neoliberal critiques and process studies of medical science, we propose that PrEP invites the possibility for reconstituting approaches to sex and risk

Frontiers in microphotonics: tunability and all-optical control

The miniaturization of optical devices and their integration for creating adaptive and reconfigurable photonic integrated circuits requires effective platforms and methods to control light over very short distances. We present here several techniques an