Rapid testing may not improve uptake of HIV testing and same day results in a rural South African community: a cohort study of 12,000 women

<p>Background: Rapid testing of pregnant women aims to increase uptake of HIV testing and results and thus optimize care. We report on the acceptability of HIV counselling and testing, and uptake of results, before and after the introduction of rapid testing in this area.</p> <p>Methods and Principal Findings: HIV counsellors offered counselling and testing to women attending 8 antenatal clinics, prior to enrolment into a study examining infant feeding and postnatal HIV transmission. From August 2001 to April 2003, blood was sent for HIV ELISA testing in line with the Prevention of Mother-to-Child Transmission (PMTCT) programme in the district. From May 2003 to September 2004 women were offered a rapid HIV test as part of the PMTCT programme, but also continued to have ELISA testing for study purposes. Of 12,323 women counselled, 5,879 attended clinic prior to May 2003, and 6,444 after May 2003 when rapid testing was introduced; of whom 4,324 (74.6%) and 4,810 (74.6%) agreed to have an HIV test respectively. Of the 4,810 women who had a rapid HIV test, only 166 (3.4%) requested to receive their results on the same day as testing, the remainder opted to return for results at a later appointment. Women with secondary school education were less likely to agree to testing than those with no education (AOR 0.648, p<0.001), as were women aged 21–35 (AOR 0.762, p<0.001) and >35 years (AOR 0.756, p<0.01) compared to those <20 years.</p> <p>Conclusions: Contrary to other reports, few women who had rapid tests accepted their HIV results the same day. Finding strategies to increase the proportion of pregnant women knowing their HIV results is critical so that appropriate care can be given.</p&gt

Is the biology of breast cancer in Africa changing?

Background: Incidence of breast cancer (BC) is increasing in Africa, with higher case-mortality compared to non-African settings. Prior studies have shown that BC in Africa has a much higher proportion of estrogen-receptor (ER) negative and triple negative (TN) cancers, subsets with poorer prognosis regardless of the setting. However, there is growing evidence that these differences may partly be attributed to prior study designs and resources.Objectives: To determine the status of hormone receptor ER, PR and growth factor Her2 status on breast cancer.Design: A prospective study.Setting: Histopathology and immunohistochemistry laboratary at Moi Teaching and Referral HospitalSubjects: Tissue specimens from 100 breast cancer patients.Results: Patients mean age at the time of diagnosis was 45 years, 98% of cases were in women, 90% were infiltrating ductal carcinoma, and the majority were poorly differentiated. Sixty-two percent were ER positive 44% were PR positive and 22% were Her-2 /neu . Twenty-four percent of cases were TN.Conclusion: With improved access to in-country reliable IHC, our study supports the growing data that African breast cancer is not radically biologically different from breast cancers outside Africa

Comparison of genetic diversities in native and alien populations of hoary mustard (Hirschfeldia incana [L.] Lagreze-Fossat)

Increased selfing and inbreeding and, consequently, depauperate genetic diversities are commonly expected for alien colonies. We compared RAPDs data for native (southern Europe) and alien (British Isles) populations of hoary mustard (Hirschfeldia incana). This species is normally out-breeding, but it is capable of self- fertilization. Contrary to the common expectations, genetic diversities in native and alien populations were similar, without any strong evidence of decreased levels of genetic diversities in alien populations. A variety of factors may have contributed to this observation, including high variation in founding groups, founders originating from multiple H. incana source populations, and high rates of past and/or current gene flow. A review of other studies showed that this pattern of similar genetic diversities in native and alien populations was not unusual but has been regularly observed in other invasive plant species

Obstetrical and Neonatal Perspectives on Prematurity

Premature birth before 37 weeks of gestation is the most common cause of infant mortality worldwide. Many pre-term infants who survive are impacted by both short- and long-term morbidity. Efforts by obstetricians and neonatologists have led to significant advances in reducing preterm birth and improving outcomes. In 2014, infant mortality in the United States was the lowest on record. However, additional work is still urgently needed to reduce the burden of preterm birth on patients, families, and society. We believe that this work requires strong collaboration between obstetricians and neonatologists. We selected topics for this theme issue with this goal in mind. This issue highlights current evidence as it relates to pressing topics on premature birth in the fields of obstetrics and neonatology

Collaboratively Understanding and Improving Outcomes for the Mother, Fetus, and Infant

Birth is an incredibly exciting and yet potentially dangerous period for a woman and her fetus, who attempts to navigate the complex transition to neonatal life. Many events during this period establish or disrupt long-lasting health for both the mother and her infant. The challenges during this period are too numerous to quantify, but yield oppor-tunities for prevention and treatment strategies to improve perinatal care and neonatal outcomes. In this issue of Clinics of Perinatology, we highlight these opportunities by including articles that span across obstetrics and neonatology

Hydromagnetic Short Bearing

This article deals with the performance of a hydromagnetic short porous bearing. An electrically conducting lubricant in the presence of a transverse magnetic field has been taken into consideration while the plates are electrically conducting. The related Reynolds’ equation governing the fluid film pressure is solved under suitable boundary conditions to get the pressure distribution leading to the computation of load carrying capacity. The results presented in graphical form establish that the bearing system registers an improved performance due to hydromagnetization. Besides, the load carrying capacity increases considerably with respect to the conductivity. It is revealed that the negative effect of porosity and the ratio of breadth to height can be neutralized up to a considerable extent by the positive effect of hydromagnetization suitably choosing the plate conductivity and the aspect ratio. It is found that the hydromagnetization presents the friction at both the plates to be equal

An evaluation of the relative efficacy of an open airway, an oxygen reservoir and continuous positive airway pressure 5 cmH2O on the non-ventilated lung

Publisher's copy made available with the permission of the publisher © Australian Society of AnaesthetistsThe aim of this study, during one-lung ventilation, was to evaluate if oxygenation could be improved by use of a simple oxygen reservoir or application of 5 cmH2O continuous positive airway pressure (CPAP) to the non-ventilated lung compared with an open airway. Twenty-three patients with lung malignancy, undergoing thoracotomy requiring at least 60 minutes of one-lung ventilation before lung lobe excision, were studied. After routine induction and establishment of one-lung ventilation, the three treatments were applied in turn to the same patient in a sequence selected randomly. The first treatment was repeated as a fourth treatment and these results of the repeated treatment averaged to minimize the effect of slow changes. Arterial oxygenation was measured by an arterial blood gas 15 minutes after the application of each treatment. Twenty patients completed the study. Mean PaO2 (in mmHg) was 210.3 (SD 105.5) in the 'OPEN' treatment, 186.0 (SD 109.2) in the 'RESERVOIR' treatment, and 240.5 (SD 116.0) in the 'CPAP' treatment. This overall difference was not quite significant (P=0.058, paired ANOVA), but comparison of the pairs showed that there was a significant better oxygenation only with the CPAP compared to the reservoir treatments (t=2.52, P=0.021). While the effect on the surgical field was not apparent in most patients, in one patient surgery was impeded during CPAP. Our results show that the use of a reservoir does not give oxygenation better than an open tube, and is less effective than the use of CPAP 5 cmH2O on the non-ventilated lung during one-lung ventilation.J. Slimani, W. J. Russell, C. Jurisevichttp://www.aaic.net.au/Article.asp?D=200404

Quantum Chaos in Open versus Closed Quantum Dots: Signatures of Interacting Particles

This paper reviews recent studies of mesoscopic fluctuations in transport through ballistic quantum dots, emphasizing differences between conduction through open dots and tunneling through nearly isolated dots. Both the open dots and the tunnel-contacted dots show random, repeatable conductance fluctuations with universal statistical proper-ties that are accurately characterized by a variety of theoretical models including random matrix theory, semiclassical methods and nonlinear sigma model calculations. We apply these results in open dots to extract the dephasing rate of electrons within the dot. In the tunneling regime, electron interaction dominates transport since the tunneling of a single electron onto a small dot may be sufficiently energetically costly (due to the small capacitance) that conduction is suppressed altogether. How interactions combine with quantum interference are best seen in this regime.Comment: 15 pages, 11 figures, PDF 2.1 format, to appear in "Chaos, Solitons & Fractals

The influence of νh11/2 occupancy on the magnetic moments of collective 21+ states in A∼100 fission fragments

AbstractThe magnetic moments of Iπ=21+ states in even–even A∼100 fission fragments have been measured using the Gammasphere array, using the technique of time-integral perturbed angular correlations. The data are interpreted within the context of the interacting boson model (IBA2) leading to the suggestion of a strong νh11/2 component in the deformed 21+ states of this region

ProxiMAX randomisation:a new technology for non-degenerate saturation mutagenesis of contiguous codons

Back in 2003, we published ‘MAX’ randomisation, a process of non-degenerate saturation mutagenesis using exactly 20 codons (one for each amino acid) or else any required subset of those 20 codons. ‘MAX’ randomisation saturates codons located in isolated positions within a protein, as might be required in enzyme engineering, or else on one face of an alpha-helix, as in zinc finger engineering. Since that time, we have been asked for an equivalent process that can saturate multiple, contiguous codons in a non-degenerate manner. We have now developed ‘ProxiMAX’ randomisation, which does just that: generating DNA cassettes for saturation mutagenesis without degeneracy or bias. Offering an alternative to trinucleotide phosphoramidite chemistry, ProxiMAX randomisation uses nothing more sophisticated than unmodified oligonucleotides and standard molecular biology reagents. Thus it requires no specialised chemistry, reagents nor equipment and simply relies on a process of saturation cycling comprising ligation, amplification and digestion for each cycle. The process can encode both unbiased representation of selected amino acids or else encode them in pre-defined ratios. Each saturated position can be defined independently of the others. We demonstrate accurate saturation of up to 11 contiguous codons. As such, ProxiMAX randomisation is particularly relevant to antibody engineering