HIV and TB co-infection in South Sudan: a three year retrospective study

Objective: To determine the prevalence of HIV/TB co-infection among patients attending the HIV clinic at Juba Teaching Hospital (JTH) from 2011 to 2013.Method and Materials: This was a retrospective study using data abstracted from the registration book in the HIV clinic. A data sheet was used to collect relevant variables. Data were entered, organized and analyzed using SPSS Version 20 Software. A p-value of 0.05 or less was considered significant.Results: Out of 2,577 patients attending the HIV clinic in JTH from 2011 to 2013, 2,547 (99%) were included in this study. Of these, 27.4% were seen in 2011, 34.1% in 2012 and 38.5% in 2013. There were 1,010 (39.7%) males and 1,537(60.3%) females with a male to female ratio of 2:3. The mean age (x, SD, range) was 30.8 +/-10.8 (0.2-68) years which for males was 33.3+/- 12.2 (1-68) years and 29.1+/-9.5 (0.2-65) years for females. There were 2,318 (91%) HIV monoinfected patients and 229 (9%) HIV/TB co-infected patients. There were 122 HIV/TB co-infected males and 107 females. 39.3% of patients with HIV/TB were aged 25-34 years, and 9.3% were aged 0 14 years. The p-value between the groups and within the groups was statistically significant at p= 0.005. Munuki payam had the highest percentage (31.7%) of HIV/TB co-infection.Conclusion: HIV/TB remains a major challenging health problem with a prevalence of 9%

Effect of cylinder deactivation on tribological performance of piston compression ring and connecting rod bearing

Thermo-mixed-hydrodynamics of compression rings and big-end bearings are presented. Frictional losses under normal engine operating conditions for a gasoline engine and those with cylinder deactivation (CDA) are predicted. With CDA, the combustion chamber pressure increases in the active cylinders, whilst some residual pressure remains in the deactivated ones. For the former, the increased in-cylinder temperatures reduce viscous friction, whilst reducing the load carrying capacity, promoting increased boundary interactions. In deactivated cylinders, lower contact temperatures yield increased viscous friction. Overall, a 5% improvement in expended fuel is expected with the application of CDA. However, 10% of these gains are expended due to increased friction. The study demonstrates the need to consider total system effects when introducing new technologies such as CDA

A community-based geological reconstruction of Antarctic Ice Sheet deglaciation since the Last Glacial Maximum

A robust understanding of Antarctic Ice Sheet deglacial history since the Last Glacial Maximum is important in order to constrain ice sheet and glacial-isostatic adjustment models, and to explore the forcing mechanisms responsible for ice sheet retreat. Such understanding can be derived from a broad range of geological and glaciological datasets and recent decades have seen an upsurge in such data gathering around the continent and Sub-Antarctic islands. Here, we report a new synthesis of those datasets, based on an accompanying series of reviews of the geological data, organised by sector. We present a series of timeslice maps for 20 ka, 15 ka, 10 ka and 5 ka, including grounding line position and ice sheet thickness changes, along with a clear assessment of levels of confidence. The reconstruction shows that the Antarctic Ice sheet did not everywhere reach the continental shelf edge at its maximum, that initial retreat was asynchronous, and that the spatial pattern of deglaciation was highly variable, particularly on the inner shelf. The deglacial reconstruction is consistent with a moderate overall excess ice volume and with a relatively small Antarctic contribution to meltwater pulse 1a. We discuss key areas of uncertainty both around the continent and by time interval, and we highlight potential priorities for future work. The synthesis is intended to be a resource for the modelling and glacial geological community

Adjuvant bevacizumab for melanoma patients at high risk of recurrence: survival analysis of the AVAST-M trial

Background: Bevacizumab is a recombinant humanised monoclonal antibody to vascular endothelial growth factor shown to improve survival in advanced solid cancers. We evaluated the role of adjuvant bevacizumab in melanoma patients at high risk of recurrence. Patients and methods: Patients with resected AJCC stage IIB, IIC and III cutaneous melanoma were randomised to receive either adjuvant bevacizumab (7.5?mg/kg i.v. 3 weekly for 1?year) or standard observation. The primary end point was detection of an 8% difference in 5-year overall survival (OS) rate; secondary end points included disease-free interval (DFI) and distant metastasis-free interval (DMFI). Tumour and blood were analysed for prognostic and predictive markers. Results: Patients (n=1343) recruited between 2007 and 2012 were predominantly stage III (73%), with median age 56?years (range 18-88?years). With 6.4-year median follow-up, 515 (38%) patients had died [254 (38%) bevacizumab; 261 (39%) observation]; 707 (53%) patients had disease recurrence [336 (50%) bevacizumab, 371 (55%) observation]. OS at 5?years was 64% for both groups [hazard ratio (HR) 0.98; 95% confidence interval (CI) 0.82-1.16, P?=?0.78). At 5?years, 51% were disease free on bevacizumab versus 45% on observation (HR 0.85; 95% CI 0.74-0.99, P?=?0.03), 58% were distant metastasis free on bevacizumab versus 54% on observation (HR 0.91; 95% CI 0.78-1.07, P?=?0.25). Forty four percent of 682 melanomas assessed had a BRAFV600 mutation. In the observation arm, BRAF mutant patients had a trend towards poorer OS compared with BRAF wild-type patients (P?=?0.06). BRAF mutation positivity trended towards better OS with bevacizumab (P?=?0.21). Conclusions: Adjuvant bevacizumab after resection of high-risk melanoma improves DFI, but not OS. BRAF mutation status may predict for poorer OS untreated and potential benefit from bevacizumab. Clinical Trial Information: ISRCTN 81261306; EudraCT Number: 2006-005505-64

Genome-wide association meta-analysis of corneal curvature identifies novel loci and shared genetic influences across axial length and refractive error.

Corneal curvature, a highly heritable trait, is a key clinical endophenotype for myopia - a major cause of visual impairment and blindness in the world. Here we present a trans-ethnic meta-analysis of corneal curvature GWAS in 44,042 individuals of Caucasian and Asian with replication in 88,218 UK Biobank data. We identified 47 loci (of which 26 are novel), with population-specific signals as well as shared signals across ethnicities. Some identified variants showed precise scaling in corneal curvature and eye elongation (i.e. axial length) to maintain eyes in emmetropia (i.e. HDAC11/FBLN2 rs2630445, RBP3 rs11204213); others exhibited association with myopia with little pleiotropic effects on eye elongation. Implicated genes are involved in extracellular matrix organization, developmental process for body and eye, connective tissue cartilage and glycosylation protein activities. Our study provides insights into population-specific novel genes for corneal curvature, and their pleiotropic effect in regulating eye size or conferring susceptibility to myopia

State of the world’s plants and fungi 2020

Kew’s State of the World’s Plants and Fungi project provides assessments of our current knowledge of the diversity of plants and fungi on Earth, the global threats that they face, and the policies to safeguard them. Produced in conjunction with an international scientific symposium, Kew’s State of the World’s Plants and Fungi sets an important international standard from which we can annually track trends in the global status of plant and fungal diversity

Multi-trait genome-wide association study identifies new loci associated with optic disc parameters

A new avenue of mining published genome-wide association studies includes the joint analysis of related traits. The power of this approach depends on the genetic correlation of traits, which reflects the number of pleiotropic loci, i.e. genetic loci influencing multiple traits. Here, we applied new meta-analyses of optic nerve head (ONH) related traits implicated in primary open-angle glaucoma (POAG); intraocular pressure and central corneal thickness using Haplotype reference consortium imputations. We performed a multi-trait analysis of ONH parameters cup area, disc area and vertical cup-disc ratio. We uncover new variants; rs11158547 in PPP1R36-PLEKHG3 and rs1028727 near SERPINE3 at genome-wide significance that replicate in independent Asian cohorts imputed to 1000 Genomes. At this point, validation of these variants in POAG cohorts is hampered by the high degree of heterogeneity. Our results show that multi-trait analysis is a valid approach to identify novel pleiotropic variants for ONH

Evaluation of periodic contributors to climatic temperature fluctuations from historic data

The purpose of this study is to fit the record of mean global temperature anomalies by using a logarithmic function of the atmospheric carbon dioxide concentration and to determine any periodic contributors to the temperature anomaly record

Evaluation of periodic contributors to climatic temperature fluctuations from historic data

The purpose of this study is to fit the record of mean global temperature anomalies by using a logarithmic function of the atmospheric carbon dioxide concentration and to determine any periodic contributors to the temperature anomaly record