Institutionalizing Provider-Initiated HIV Testing and Counselling for Children: An Observational Case Study from Zambia

Background: Provider-initiated testing and counselling (PITC) is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia’s Southern Province, and serving a catchment area of 1.2 million people. Methods and Principal Findings: Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS) uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074), 98.5 % of children were counselled, and 98.2 % were tested. Of children tested (n = 4983), 15.5 % were determined HIVinfected; 77.6 % of these results were determined by DNA polymerase chain reaction (PCR) testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital’s inpatient and outpatient departments (n = 1342), 99.3 % were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PIT

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Development and characterization of a novel C-terminal inhibitor of Hsp90 in androgen dependent and independent prostate cancer cells

Background: The molecular chaperone, heat shock protein 90 (Hsp90) has been shown to be overexpressed in a number of cancers, including prostate cancer, making it an important target for drug discovery. Unfortunately, results with N-terminal inhibitors from initial clinical trials have been disappointing, as toxicity and resistance resulting from induction of the heat shock response (HSR) has led to both scheduling and administration concerns. Therefore, Hsp90 inhibitors that do not induce the heat shock response represent a promising new direction for the treatment of prostate cancer. Herein, the development of a C-terminal Hsp90 inhibitor, KU174, is described, which demonstrates anti-cancer activity in prostate cancer cells in the absence of a HSR and describe a novel approach to characterize Hsp90 inhibition in cancer cells.Methods: PC3-MM2 and LNCaP-LN3 cells were used in both direct and indirect in vitro Hsp90 inhibition assays (DARTS, Surface Plasmon Resonance, co-immunoprecipitation, luciferase, Western blot, anti-proliferative, cytotoxicity and size exclusion chromatography) to characterize the effects of KU174 in prostate cancer cells. Pilot in vivo efficacy studies were also conducted with KU174 in PC3-MM2 xenograft studies.Results: KU174 exhibits robust anti-proliferative and cytotoxic activity along with client protein degradation and disruption of Hsp90 native complexes without induction of a HSR. Furthermore, KU174 demonstrates direct binding to the Hsp90 protein and Hsp90 complexes in cancer cells. In addition, in pilot in-vivo proof-of-concept studies KU174 demonstrates efficacy at 75 mg/kg in a PC3-MM2 rat tumor model.Conclusions: Overall, these findings suggest C-terminal Hsp90 inhibitors have potential as therapeutic agents for the treatment of prostate cancer.Peer reviewedBiochemistry and Molecular Biolog

Refining the Data Collection Methodology of Outdoor Forensic Scenes Involving Scattered Human Remains Using Close-Range Photogrammetry

The documentation of outdoor forensic crime scenes involving human remains poses multiple challenges to law enforcement officials documenting the context of the scene. More rigorous protocols for the documentation of these scenes are needed, and recent advances in technology open up the possibility of three-dimensional (3D) documentation of the scene. More commonly used in archaeological contexts, close-range photogrammetry (CRP) creates reliable 3D models through triangulation of overlapping points between multiple photographs. This documentation technique allows for the preservation of the entire 3D context and the virtual manipulation without evidence destruction. However, CRP has only been preliminarily used in the field of forensic archaeology. To further refine data collection and processing protocols for the use of CRP on forensic scenes, four mock crime scenes on different complex ground surfaces involving a surface scatter of human remains were created. Photographs were collected using a Nikon D7200 camera and processed using Agisoft Metashape Professional. The first scene, a mixed surface dominated by leaves, was used to test the number of images that should be incorporated into a 3D scene. The second (mixed surface dominated by grass), third (mixed surface dominated by pine needles), and fourth (ground surface of mixed leaves and dirt) scenes were used to test data collection techniques, the capability of documenting a scene using CRP on different complex surfaces, as well as to illustrate complex variables that may affect the final model. Accuracy was determined through an estimation of the final root mean square error (RMSE) and visual analysis of qualitative errors. Results show that CRP can be used to accurately and reliably document the 3D context of real-life scenes in a time-efficient and cost-effective manner. This new methodology should be integrated into current forensic crime scene documentation and may eventually replace current methods of mapping the scene context

Reviews

Reviews Edward J. Sullivan. Ken Wilber: Thought as Passion. (Frank Visser, 2003). Gabriele Rico. A Way to Move: Rhetorics of Emotion and Composition Studies. (Ed. Dale Jacobs and Laura R. Micciche, 2003). Megan Brown. Living the Narrative Life: Stories as a Tool for Meaning Making. (Gian S. Pagnucci, 2004). Kim McCollum-Clark. Personally Speaking: Experience as Evidence in Academic Discourse. (Candace Spigelman, 2004)

Length-dependent MRI of hereditary neuropathy with liability to pressure palsies.

OBJECTIVE: Hereditary neuropathy with liability to pressure palsies (HNPP) is caused by heterozygous deletion of the peripheral myelin protein 22 (PMP22) gene. Patients with HNPP present multifocal, reversible sensory/motor deficits due to increased susceptibility to mechanical pressure. Additionally, age-dependent axonal degeneration is reported. We hypothesize that length-dependent axonal loss can be revealed by MRI, irrespective of the multifocal phenotype in HNPP. METHODS: Nerve and muscle MRI data were acquired in the proximal and distal leg of patients with HNPP (n = 10) and matched controls (n = 7). More specifically, nerve magnetization transfer ratios (MTR) were evaluated to assay proximal-to-distal gradients in nerve degeneration, while intramuscular fat percentages (F RESULTS: F INTERPRETATION: Despite the multifocal nature of the HNPP phenotype, muscle

Occupation of Either Site for the Neurosteroid Allopregnanolone Potentiates the Opening of the GABAA Receptor Induced from Either Transmitter Binding Site

Potentiating neuroactive steroids are potent and efficacious modulators of the GABAA receptor that act by allosterically enhancing channel activation elicited by GABA. Steroids interact with the membrane-spanning domains of the α subunits of the receptor, whereas GABA binds to pockets in the interfaces between β and α subunits. Steroid interaction with a single site is known to be sufficient to produce potentiation, but it is not clear whether effects within the same β-α pair mediate potentiation. Here, we have investigated whether the sites for GABA and steroids are functionally linked (i.e., whether the occupancy of a steroid site selectively affects activation elicited by GABA binding to the transmitter binding site within the same β-α pair). For that, we used receptors formed of mutated concatenated subunits to selectively eliminate one of the two GABA sites and one of the two steroid sites. The data demonstrate that receptors containing a single functional GABA site are potentiated by the neurosteroid allopregnanolone regardless of whether the steroid interacts with the α subunit from the same or the other β-α pair. We conclude that steroids potentiate the opening of the GABAA receptor induced by either agonist binding site