High rate of virological failure and low rate of switching to second-line treatment among adolescents and adults living with HIV on first-line ART in Myanmar, 2005-2015.

BACKGROUND: The number of people living with HIV on antiretroviral treatment (ART) in Myanmar has been increasing rapidly in recent years. This study aimed to estimate rates of virological failure on first-line ART and switching to second-line ART due to treatment failure at the Integrated HIV Care program (IHC). METHODS: Routinely collected data of all adolescent and adult patients living with HIV who were initiated on first-line ART at IHC between 2005 and 2015 were retrospectively analyzed. The cumulative hazard of virological failure on first-line ART and switching to second-line ART were estimated. Crude and adjusted hazard ratios were calculated using the Cox regression model to identify risk factors associated with the two outcomes. RESULTS: Of 23,248 adults and adolescents, 7,888 (34%) were tested for HIV viral load. The incidence rate of virological failure among those tested was 3.2 per 100 person-years follow-up and the rate of switching to second-line ART among all patients was 1.4 per 100 person-years follow-up. Factors associated with virological failure included: being adolescent; being lost to follow-up at least once; having WHO stage 3 and 4 at ART initiation; and having taken first-line ART elsewhere before coming to IHC. Of the 1032 patients who met virological failure criteria, 762 (74%) switched to second-line ART. CONCLUSIONS: We found high rates of virological failure among one third of patients in the cohort who were tested for viral load. Of those failing virologically on first-line ART, about one quarter were not switched to second-line ART. Routine viral load monitoring, especially for those identified as having a higher risk of treatment failure, should be considered in this setting to detect all patients failing on first-line ART. Strategies also need to be put in place to prevent treatment failure and to treat more of those patients who are actually failing

Discovery of common and rare genetic risk variants for colorectal cancer.

To further dissect the genetic architecture of colorectal cancer (CRC), we performed whole-genome sequencing of 1,439 cases and 720 controls, imputed discovered sequence variants and Haplotype Reference Consortium panel variants into genome-wide association study data, and tested for association in 34,869 cases and 29,051 controls. Findings were followed up in an additional 23,262 cases and 38,296 controls. We discovered a strongly protective 0.3% frequency variant signal at CHD1. In a combined meta-analysis of 125,478 individuals, we identified 40 new independent signals at P < 5 × 10-8, bringing the number of known independent signals for CRC to ~100. New signals implicate lower-frequency variants, Krüppel-like factors, Hedgehog signaling, Hippo-YAP signaling, long noncoding RNAs and somatic drivers, and support a role for immune function. Heritability analyses suggest that CRC risk is highly polygenic, and larger, more comprehensive studies enabling rare variant analysis will improve understanding of biology underlying this risk and influence personalized screening strategies and drug development.Goncalo R Abecasis has received compensation from 23andMe and Helix. He is currently an employee of Regeneron Pharmaceuticals. Heather Hampel performs collaborative research with Ambry Genetics, InVitae Genetics, and Myriad Genetic Laboratories, Inc., is on the scientific advisory board for InVitae Genetics and Genome Medical, and has stock in Genome Medical. Rachel Pearlman has participated in collaborative funded research with Myriad Genetics Laboratories and Invitae Genetics but has no financial competitive interest

Deciphering colorectal cancer genetics through multi-omic analysis of 100,204 cases and 154,587 controls of European and east Asian ancestries

In the version of this article initially published, the author affiliations incorrectly listed “Candiolo Cancer Institute FPO-IRCCS, Candiolo (TO), Italy” as “Candiolo Cancer Institute, Candiolo, Italy.” The change has been made to the HTML and PDF versions of the article

Fine-mapping analysis including over 254,000 East Asian and European descendants identifies 136 putative colorectal cancer susceptibility genes

Genome-wide association studies (GWAS) have identified more than 200 common genetic variants independently associated with colorectal cancer (CRC) risk, but the causal variants and target genes are mostly unknown. We sought to fine-map all known CRC risk loci using GWAS data from 100,204 cases and 154,587 controls of East Asian and European ancestry. Our stepwise conditional analyses revealed 238 independent association signals of CRC risk, each with a set of credible causal variants (CCVs), of which 28 signals had a single CCV. Our cis-eQTL/mQTL and colocalization analyses using colorectal tissue-specific transcriptome and methylome data separately from 1299 and 321 individuals, along with functional genomic investigation, uncovered 136 putative CRC susceptibility genes, including 56 genes not previously reported. Analyses of single-cell RNA-seq data from colorectal tissues revealed 17 putative CRC susceptibility genes with distinct expression patterns in specific cell types. Analyses of whole exome sequencing data provided additional support for several target genes identified in this study as CRC susceptibility genes. Enrichment analyses of the 136 genes uncover pathways not previously linked to CRC risk. Our study substantially expanded association signals for CRC and provided additional insight into the biological mechanisms underlying CRC development

Geographical disparities and determinants of anaemia among women of reproductive age in Myanmar: analysis of the 2015-2016 Myanmar Demographic and Health Survey

Anaemia is a significant public heath challenge in Myanmar. In 2015-2016, the first demographic and health survey was done in Myanmar, and showed that almost half of all pregnant women and anaemia

Page Segmentation and Document Layout Analysis for Scanned Image by using Smearing Algorithm

This paper presents a feature-based system which utilizes domain knowledge to segment and classify scanned image documents. Documents usually consists of a mixture of text and image. Text block possesses an interesting property that the x-profile or y-profile of text block is a periodic pattern. Image block possesses generate the connectivity histogram by summing the number of dark pixels with the same connectivity value. Initially, one-scan run-length smearing algorithm (RLSA) with block merging is proposed to segment the document. After segmentation process, the next task is to classify the segmented block. The classification task is then performed based on the rules induced from the features or primitives associated with each document. In this system, proper use of domain knowledge is proved to be effective in accelerating the segmentation speed and decreasing the classification error

Synthesis and Characterization of LaMnO3Nanofibers by Electrospinning Techique

This paper aimed to prepare the synthesis of LaMnO3 nanofibers by electrospinning technique using a solution that contained polyvinyl alcohol (PVA) and a sol-gel solution of LaMnO3. LaMnO3/PVA perovskite-type nanofibers were obtained after annealed at 500°C, 600°C, 700°C and 800°C for 2h respectively. Thermal properties of LaMnO3 samples were examined by TG-DTA. Phase formation and crystal structure of LaMnO3 nanopowders were characterized by X-ray diffraction (XRD). FESEM images revealed that LaMnO3 as-spun nanofibers on Al foils were attracted to be between 60-120 nm in diameters with electrospinning set-up for 15 min. The crystal structure, fiber diameters and morphology of LaMnO3 nanofibers were influenced by the calcination temperatures. The qualifications of LaMnO3 nanofibers were successfully yielded by the electronspinning technique as final products

Growth and Characterization of Electrospun LaMnO3 Nanofibers by Electrospinning Technique

The polycrystalline perovskite structure of LaMnO3 nanofibers was obtained by calcination of the PVA/[LaCl3+MnCl2+(NH4)2CO3] composite at 600°C with electrospinning technique. The decomposition and crystalline behavior of sample were examined by Thermogravimetric and Simultaneous Differential Thermal Analysis (TG-DTA). The crystal structure and phase formation were characterized by X-ray Diffraction (XRD). Scanning Electron Microscopy (SEM) was performed and the diameters of the LaMnO3 nanofibers were calculated to be 42 nm and 55 nm with different spinning intervals at 600°C. SEM analysis was also carried out to examine the fiber diameters and morphological properties

Molecular Detection of Class 1 Integron Gene and Antibiotics Susceptibility Patterns of Pseudomonas Species Isolated from Clinical Specimens

Pseudomonas species is a common cause of health care acquired infection and also stand in second place in WHO critical list for antimicrobial resistance. Acquisition of antibiotic resistance gene in pathogenic bacteria has been a growing problem worldwide. The presence of resistance gene in class 1 integrons is associated with multi- drug resistance among Pseudomonas species. This study aimed to detect the class 1 integron and antibiotic susceptibility patterns of Pseudomonas species isolated from clinical specimens at No. (1) Defence Services General Hospital (1000-bedded) during the period of January to September 2020. The hospital and laboratory based descriptive study was conducted among the clinical samples received at Microbiology laboratory. Isolation, identification and antimicrobial susceptibility testing were performed by Vitek 2 automated systems. All Pseudomonas species were tested for the presence of class 1 integron by PCR. In this study, 77 Pseudomonas species isolated from various clinical specimens. According to the finding, the most common resistance was observed towards cefotaxime (97.4%), while resistance to amikacin was less observed among isolates (22%). Out of 77 Pseudomonas species isolates, 54 (70%) were multidrug resistant (MDR) according to CLSI 2020 guidelines. Among the multidrug resistance, 38 (95%) isolates were class 1 integron positive (p&lt;0.001) and 16 (43.24%) were class 1 integron negative (p&lt;0.001). Therefore, this finding indicates the strong association between the presence of class 1 integron and multidrug resistance. Therefore, integrons play an important role in acquisition and dissemination of antibiotics resistance genes among Pseudomonas species

Dielectric properties of composite LaMnO3 nanofiber by electrospinning technique

Electrospinning technique has been extensively developed as a simple and vasatile method for drawing nanofibers from polymer solutions. Lanthanum Maganite La1-x MnxO3 (x = 0.02 mol) nanofibers were obtained by calcinations of PVA/LaMnO3 composite at different temperatures with electrospinning utilizing sol-gel precursors. Novel polycrystalline LaMnO3 nanofibers were yielded at 500 °C, 600 °C and 700 °C for 2 h as the final products. Field Emission Scanning Electron Microscopy (FESEM) was employed to study the fiber diameter of samples. The average diameter of the LaMnO3 nanofibers was found to be in the range of 85 nm to 150 nm at different temperatures. The dielectric properties of LaMnO3 nanofibers were identified by C-f, r-f, tan - f and ac-f characteristics. The results obtained from this research will lead to enable new levels of electronic applications, biomedical applications and protective clothing