Appropriate counseling approach to disclose HIV status to HIV-infected children: Chiradzulu, Malawi

Mexico AIDS Conference 200

Application de la théorie des indices de sélection à des caractères répétés. Exemple de la sélection sur la prolificité chez le porc

International audienc

Nurses and medical assistants taking charge: task-shifting HIV care and HAART initiation in resource-constrained and rural Malawi

Mexico AIDS Conference 200

Cost and cost‐effectiveness of a simplified treatment model with direct‐acting antivirals for chronic hepatitis C in Cambodia

Background & Aims In 2016, Médecins Sans Frontières established the first general population Hepatitis C virus (HCV) screening and treatment site in Cambodia, offering free direct‐acting antiviral (DAA) treatment. This study analysed the cost‐effectiveness of this intervention. Methods Costs, quality adjusted life years (QALYs) and cost‐effectiveness of the intervention were projected with a Markov model over a lifetime horizon, discounted at 3%/year. Patient‐level resource‐use and outcome data, treatment costs, costs of HCV‐related healthcare and EQ‐5D‐5L health states were collected from an observational cohort study evaluating the effectiveness of DAA treatment under full and simplified models of care compared to no treatment; other model parameters were derived from literature. Incremental cost‐effectiveness ratios (cost/QALY gained) were compared to an opportunity cost‐based willingness‐to‐pay threshold for Cambodia ($248/QALY). Results The total cost of testing and treatment per patient for the full model of care was$925(IQR $668‐1631), reducing to$376(IQR $344‐422) for the simplified model of care. EQ‐5D‐5L values varied by fibrosis stage: decompensated cirrhosis had the lowest value, values increased during and following treatment. The simplified model of care was cost saving compared to no treatment, while the full model of care, although cost‐effective compared to no treatment ($187/QALY), cost an additional $14 485/QALY compared to the simplified model, above the willingness‐to‐pay threshold for Cambodia. This result is robust to variation in parameters. Conclusions The simplified model of care was cost saving compared to no treatment, emphasizing the importance of simplifying pathways of care for improving access to HCV treatment in low‐resource settings

Application of tethered ruthenium catalysts to asymmetric hydrogenation of ketones, and the selective Hydrogenation of aldehydes

An improved method for the synthesis of tethered ruthenium(II) complexes of monosulfonylated diamines is described, together with their application to the hydrogenation of ketones and aldehydes. The complexes were applied directly, in their chloride form, to asymmetric ketone hydrogenation, to give products in excess of 99% ee in the best cases, using 30 bar of hydrogen at 60 °C, and to the selective reduction of aldehydes over other functional groups

Mechanistic and Kinetic Investigation on the Formation of Palladacyclopentadiene Complexes. A Novel Interpretation Involving a Bimolecular Self Reaction of a Monoalkyne Intermediate

The stoichiometric reaction between the complex [Pd(eta(2)-dmfu)(BiPy)] (dmfu = dimethylfumarate; BiPy = 2,2'-bipyridine) and the deactivated alkynes dmbd (dimethyl-2-butynedioate) and pna (methyl (4-nitrophenyl)propynoate), providing the respective palladacyclopentadienes, was investigated. The mechanism leading to the palladacyclopentadiene derivative involves a bimolecular self-rearrangement of the monoalkyne intermediate [Pd(eta(2)-alk)(BiPy)] (alk = dmbd, pna), followed by the customary attack of the free alkyne on the intermediate [Pd(eta(2)-alk)(BiPy)] itself and on the elusive and highly reactive "naked palladium" [Pd(BiPy)(0)] formed. The alkyne pna proved to be less effective in the displacement of dmfu than dmbd. The reaction under stoichiometric equimolar conditions of the latter with [Pd(eta(2)-dmfu)(BiPy)] allows the direct determination of the bimolecular self-reaction rate constant k(c) and consequently the assessment of all the rate constants involved in the overall mechanistic network

Submesoscale Instability in the Straits of Florida

The Florida Current (FC) flows in the Straits of Florida (SoF) and connects the Loop Current in the Gulf of Mexico to the Gulf Stream (GS) in the western Atlantic Ocean. Its journey through the SoF is at time characterized by the formation and presence of mesoscale but mostly submesoscale frontal eddies on the cyclonic side of the current. The formation of those frontal eddies was investigated in a very high-resolution two-way nested simulation using the Regional Oceanic Modeling System (ROMS). Frontal eddies were either locally formed or originated from outside the SoF. The northern front of the incoming eddies was susceptible to superinertial shear instability over the shelf slope when the eddies were pushed up against the slope by the FC. Otherwise, incoming eddies could be advected, relatively unaffected by the current, when in the southern part of the straits. In the absence of incoming eddies, submesoscale eddies were locally formed by the roll-up of superinertial barotropically unstable vorticity filaments when the FC was pushed up against the shelf slope. The vorticity filaments were intensified by the friction-induced bottom-layer vorticity flux as previously demonstrated by Gula et al. in the GS. When the FC retreated farther south, negative-vorticity west Florida shelf waters overflowed into the SOF and led to the formation of submesoscale eddies by baroclinic instability. The instability regimes, that is, the submesoscale frontal eddies formation, appear to be controlled by the lateral "sloshing" of the FC in the SoF

Submesoscale Instability in the Straits of Florida

International audienceThe Florida Current (FC) flows in the Straits of Florida (SoF) and connects the Loop Current in the Gulf of Mexico to the Gulf Stream (GS) in the western Atlantic Ocean. Its journey through the SoF is at time characterized by the formation and presence of mesoscale but mostly submesoscale frontal eddies on the cyclonic side of the current. The formation of those frontal eddies was investigated in a very high-resolution two-way nested simulation using the Regional Oceanic Modeling System (ROMS). Frontal eddies were either locally formed or originated from outside the SoF. The northern front of the incoming eddies was susceptible to superinertial shear instability over the shelf slope when the eddies were pushed up against the slope by the FC. Otherwise, incoming eddies could be advected, relatively unaffected by the current, when in the southern part of the straits. In the absence of incoming eddies, submesoscale eddies were locally formed by the roll-up of superinertial barotropically unstable vorticity filaments when the FC was pushed up against the shelf slope. The vorticity filaments were intensified by the friction-induced bottom-layer vorticity flux as previously demonstrated by Gula et al. in the GS. When the FC retreated farther south, negative-vorticity west Florida shelf waters overflowed into the SOF and led to the formation of submesoscale eddies by baroclinic instability. The instability regimes, that is, the submesoscale frontal eddies formation, appear to be controlled by the lateral "sloshing" of the FC in the SoF