An international study to characterise recently acquired HIV infection in Estonia, Poland, and Ukraine.

Serological methods to differentiate recent from non-recent HIV infections were introduced to routine surveillance in Poland, Estonia and Ukraine, to estimate HIV incidence and to characterise those newly-diagnosed and infected. Establishing the characteristics of populations at greatest risk of HIV enables appropriate and target prevention and intervention strategies to be developed, reducing risk of onward transmission. Using existing testing services within each country, residual samples from newly-diagnosed persons were tested for evidence of recent infection using an avidity assay. Data were collated in 2013-2014 using modified existing methods in Kiev City, Poland, and Estonia. Diagnosis rates for Kiev City, Poland and Estonia were 21.5, 1.2 and 29.7 per 100,000 population, respectively. Incidence estimates for Kiev City were 21.5 per 100,000 population, with 6.5% classified as recent. The disproportionate distribution of HIV were among men who have sex with men (MSM) and persons who inject drugs (PWID) was evident. Uncorrected estimates for Poland and Estonia were 30% and 44%, respectively. This work enables targeted public health action and health promotion work to be made, laying the foundation for local and national guidelines

The Relationship between ECOG-PS, mGPS, BMI/WL Grade and Body Composition and Physical Function in Patients with Advanced Cancer

Cancer remains one of the leading causes of mortality worldwide and the associated reduction in physical function has a marked impact on both quality of life and survival. The aim of the present study was to examine the relationship between Eastern Cooperative Oncology Group-Performance status (ECOG-PS), modified Glasgow Prognostic Score (mGPS), Body Mass Index/Weight Loss grade (BMI/WL grade), and Computerised Tomography (CT)-derived body composition measurement and physical function in patients with advanced cancer. Nine sites contributed prospective data on patient demographics, ECOG-PS, mGPS, physical function tests, and CT-derived body composition. Categorical variables were analysed using χ2 test for linear-by-linear association, or χ2 test for 2-by-2 tables. Associations were analysed using binary logistic regression. A total of 523 cancer patients (266 males, 257 females) were included in the final analysis and most had metastatic disease (83.2%). The median overall survival was 5.6 months. On multivariate binary logistic regression analysis, a high ECOG-PS remained independently associated with a low skeletal muscle index (p < 0.001), low skeletal muscle density (p < 0.05), and timed up and go test failure (p < 0.001). A high mGPS remained independently associated with a low skeletal muscle density (p < 0.05) and hand grip strength test failure (p < 0.01). A high BMI/WL grade remained independently associated with a low subcutaneous fat index (p < 0.05), low visceral obesity (p < 0.01), and low skeletal muscle density (p < 0.05). In conclusion, a high ECOG-PS and a high mGPS as outlined in the ECOG-PS/mGPS framework were consistently associated with poorer body composition and physical function in patients with advanced cancer

Gene expression drives the evolution of dominance.

Dominance is a fundamental concept in molecular genetics and has implications for understanding patterns of genetic variation, evolution, and complex traits. However, despite its importance, the degree of dominance in natural populations is poorly quantified. Here, we leverage multiple mating systems in natural populations of Arabidopsis to co-estimate the distribution of fitness effects and dominance coefficients of new amino acid changing mutations. We find that more deleterious mutations are more likely to be recessive than less deleterious mutations. Further, this pattern holds across gene categories, but varies with the connectivity and expression patterns of genes. Our work argues that dominance arises as a consequence of the functional importance of genes and their optimal expression levels

Life Table Analysis for Immatures and Female Adults of the Predatory Beetle, Delphastus catalinae, Feeding on Whiteflies Under Three Constant Temperatures

Immature development and reproductive life history of Delphastus catalinae (Horn) (Coleoptera: Coccinellidae) feeding on Bemisia tabaci biotype B (Gennadius) (Homoptera: Aleyrodidae) (= B. argentifolii Bellows and Perring) immatures was studied at three constant temperatures: 22, 26 and 30 °C. Lower developmental threshold temperatures (T0) were estimated at 9 and 9.9 °C, for males and females, respectively. Female adults weighed slightly more than males (0.587 and 0.505 mg, respectively). As temperature increased from 22 to 30 °C, developmental time from eggs to eclosion of the adult declined from 24 to 15 days. Thermal units required for immature development was ∼300 degree-days. Percentage egg hatch declined at increasing temperatures, but no significant effect of time was found. The intrinsic rate of increase, r, increased from 0.048 to 0.082 and doubling time decreased from 14.44 to 8.45 days as temperature increased from 22 to 26 °C. Mean daily fecundity was modeled as a function of time and temperature to create a 3-dimensional surface. Overall, Delphastus catalinae was found to perform better at 22 and 26 °C while 30 °C was detrimental to immature development and adult reproduction

Oncological considerations of skin-sparing mastectomy

AIM: To review evidence concerning the oncological safety of performing skin-sparing mastectomy (SSM) for invasive breast cancer and ductal carcinoma in situ (DCIS). Furthermore, the evidence concerning RT in relation to SSM and the possibility of nipple preservation was considered. METHODS: Literature review facilitated by Medline and PubMed databases. FINDINGS: Despite the lack of randomised controlled trials, SSM has become an accepted procedure in women undergoing mastectomy and immediate reconstruction for early breast cancer. Compared to non-skin-sparing mastectomy (NSSM), SSM seems to be oncologically safe in patients undergoing mastectomy for invasive tumours smaller than 5 cm, multicentric tumours, DCIS or risk-reduction. However, the technique should be avoided in patients with inflammatory breast cancer or in those with extensive tumour involvement of the skin in view of the high risk of local recurrence. SSM with nipple areola complex (NAC) preservation appears to be oncologically safe, provided the tumour is not close to the nipple and a frozen section protocol for the retro-areolar tissue is followed. Although radiotherapy (RT) does not represent a contraindication to SSM, the latter should be used with caution if postoperative RT is likely, since it detracts from the final cosmetic outcome

Oncological outcome and patient satisfaction with skin-sparing mastectomy and immediate breast reconstruction: a prospective observational study

<p>Abstract</p> <p>Background</p> <p>The management of early breast cancer (BC) with skin-sparing mastectomy (SSM) and immediate breast reconstruction (IBR) is not based on level-1 evidence. In this study, the oncological outcome, post-operative morbidity and patients' satisfaction with SSM and IBR using the latissimus dorsi (LD) myocutaneous flap and/or breast prosthesis is evaluated.</p> <p>Methods</p> <p>137 SSMs with IBR (10 bilateral) were undertaken in 127 consecutive women, using the LD flap plus implant (n = 85), LD flap alone (n = 1) or implant alone (n = 51), for early BC (n = 130) or prophylaxis (n = 7). Nipple reconstruction was performed in 69 patients, using the trefoil local flap technique (n = 61), nipple sharing (n = 6), skin graft (n = 1) and Monocryl mesh (n = 1). Thirty patients underwent contra-lateral procedures to enhance symmetry, including 19 augmentations and 11 mastopexy/reduction mammoplasties. A linear visual analogue scale was used to assess patient satisfaction with surgical outcome, ranging from 0 (not satisfied) to 10 (most satisfied).</p> <p>Results</p> <p>After a median follow-up of 36 months (range = 6-101 months) there were no local recurrences. Overall breast cancer specific survival was 99.2%, 8 patients developed distant disease and 1 died of metastatic BC. There were no cases of partial or total LD flap loss. Morbidities included infection, requiring implant removal in 2 patients and 1 patient developed marginal ischaemia of the skin envelope. Chemotherapy was delayed in 1 patient due to infection. Significant capsule formation, requiring capsulotomy, was observed in 85% of patients who had either post-mastectomy radiotherapy (PMR) or prior radiotherapy (RT) compared with 13% for those who had not received RT. The outcome questionnaire was completed by 82 (64.6%) of 127 patients with a median satisfaction score of 9 (range = 5-10).</p> <p>Conclusion</p> <p>SSM with IBR is associated with low morbidity, high levels of patient satisfaction and is oncologically safe for T(is), T1 and T2 tumours without extensive skin involvement.</p

Evolution of predator dispersal in relation to spatio-temporal prey dynamics : how not to get stuck in the wrong place!

Peer reviewedPublisher PD

Life Table Analysis for Immatures and Female Adults of the Predatory Beetle, Delphastus catalinae, Feeding on Whiteflies Under Three Constant Temperatures

Immature development and reproductive life history of Delphastus catalinae (Horn) (Coleoptera: Coccinellidae) feeding on Bemisia tabaci biotype B (Gennadius) (Homoptera: Aleyrodidae) (= B. argentifolii Bellows and Perring) immatures was studied at three constant temperatures: 22, 26 and 30 °C. Lower developmental threshold temperatures (T0) were estimated at 9 and 9.9 °C, for males and females, respectively. Female adults weighed slightly more than males (0.587 and 0.505 mg, respectively). As temperature increased from 22 to 30 °C, developmental time from eggs to eclosion of the adult declined from 24 to 15 days. Thermal units required for immature development was ∼300 degree-days. Percentage egg hatch declined at increasing temperatures, but no significant effect of time was found. The intrinsic rate of increase, r, increased from 0.048 to 0.082 and doubling time decreased from 14.44 to 8.45 days as temperature increased from 22 to 26 °C. Mean daily fecundity was modeled as a function of time and temperature to create a 3-dimensional surface. Overall, Delphastus catalinae was found to perform better at 22 and 26 °C while 30 °C was detrimental to immature development and adult reproduction