Examining the effects of HIV self-testing compared to standard HIV testing services in the general population: A systematic review and meta-analysis

BACKGROUND: We updated a 2017 systematic review and compared the effects of HIV self-testing (HIVST) to standard HIV testing services to understand effective service delivery models among the general population. METHODS: We included randomized controlled trials (RCTs) comparing testing outcomes with HIVST to standard testing in the general population and published between January 1, 2006 and June 4, 2019. Random effects meta-analysis was conducted and pooled risk ratios (RRs) were reported. The certainty of evidence was determined using the GRADE methodology. FINDINGS: We identified 14 eligible RCTs, 13 of which were conducted in sub-Saharan Africa. Support provided to self-testers ranged from no/basic support to one-on-one in-person support. HIVST increased testing uptake overall (RR:2.09; 95% confidence interval: 1.69-2.58; INTERPRETATION: HIVST appears to be safe and effective among the general population in sub-Saharan Africa with a range of delivery models. It identified and linked additional people with HIV to care. These findings support the wider availability of HIVST to reach those who may not otherwise access testing

Globrauneine A–F: six new triterpenoid esters from the leaves of Globimetula braunii

Phytochemical study was conducted on the leaves of Globimetula braunii which is a hemi parasitic plant belonging to the family Loranthaceae. Extraction was carried out using cold extraction method with increasing polarity of solvents i.e n-hexane, CH2Cl2 and MeOH. The components were separated by chromatographic technique and the structures of the compounds were elucidated by extensive spectroscopic analyses including MS, FTIR, 1D and 2D NMR, HRMS and chemical methods. Six new pentacyclic triterpenoid esters named as globrauneine A (1), globrauneine B (2), globrauneine C (3), globrauneine D (4), globrauneine E (5), and globrauneine F (6), together with six known compounds (7 – 12) were successfully isolated from the leaves of G. braunii growing on Piliostigma thonningii. These results depict a substantial support to the chemotaxonomy of the genus Globimetula

Importance and Significance of UF/MF Membrane Systems in Desalination Water Treatment

The proposed chapter addresses a comprehensive overview of the history and future outlook of ultrafiltration/microfiltration (UF/MF) membrane for desalination water pretreatment. Known theories on UF/MF membrane formation from phase inversion (Dr/wet) systems can be prolonged to define the consequences of high or low molecular weight additives. Also, direct material reengineering and surface modification for high-performance anti-fouling of UF/MF membranes are also highlighted. Before the modern final polymeric film, the characterization techniques, particularly molecular weight cut-off, pore size, pore size distribution, and microbiological activity classification, on to the UF/MF membrane surface were presented, respectively. Lab scale to commercial scale UF/MF membrane configuration and market size of UF/MF membranes for pretreatment desalination are described. The significance of UF/MF provided here as an unconventional approach for desalination water pretreatment is in contrast with the current conventionally used technologies. The recent development made in the integration of established desalination processes, such as spiral wound reverse osmosis (SWRO), multi-stage flash (MSF), multi-effect distillation (MED), electrodialysis (ED) desalination, and UF pretreatment, is addressed. Finally, the influence of UF/MF on desalination water pretreatment step on to the energy cost of desalination process system is discussed

Complementarity of Semileptonic BB to K2∗(1430)K_2^*(1430) and K∗(892)K^*(892) Decays in the Standard Model with Fourth Generation

The $B\rightarrow K_{2}^{\ast}(1430)l^{+}l^{-}$ $(l=\mu,\tau)$ decays are analyzed in the Standard Model extended to fourth generation of quarks (SM4). The decay rate, forward-backward asymmetry, lepton polarization asymmetries and the helicity fractions of the final state $K^{*}_{2}(1430)$ meson are obtained using the form factors calculated in the light cone sum rules (LCSR) approach. We have utilized the constraints on different fourth generation parameters obtained from the experimental information on $K$, $B$ and $D$ decays and from the electroweak precision data to explore their impact on the $B\rightarrow K_{2}^{\ast}(1430)l^{+}l^{-}$ decay. We find that the values of above mentioned physical observables deviate deviate significantly from their minimal SM predications. We also identify a number of correlations between various observables in $B\rightarrow K_{2}^{\ast}(1430)l^{+}l^{-}$ and $B\rightarrow K^{\ast}(892)l^{+}l^{-}$ decays. Therefore a combined analysis of these two decays will compliment each other in the searches of SM4 effects in flavor physics.Comment: 28 pages, 12 figure

Statefinder Parameter for Varying G in Three Fluid System

In this work, we have considered variable G in flat FRW universe filled with the mixture of dark energy, dark matter and radiation. If there is no interaction between the three fluids, the deceleration parameter and statefinder parameters have been calculated in terms of dimensionless density parameters which can be fixed by observational data. Also the interaction between three fluids has been analyzed due to constant $G$. The statefinder parameters also calculated in two cases: pressure is constant and pressure is variable.Comment: 5 pages, Accepted for publication in "Astrophysics and Space Science

Country uptake of WHO recommendations on differentiated HIV testing services approaches: a global policy review

OBJECTIVES: In 2015 and 2016, WHO issued guidelines on HIV testing services (HTS) highlighting recommendations for a strategic mix of differentiated HTS approaches. The policy review examines the uptake of differentiated HTS approaches recommendations in national policies. METHODS: Data were extracted from national policies published between January 2015 and June 2019. The WHO-recommended HTS approaches included facility-based testing, community-based testing, HIV self-testing and provider-assisted referral (or assisted partner notification). Other supportive recommendations include pre-test information, post-test counselling, lay provider testing and rapid testing. Descriptive analyses were conducted to examine inclusion of recommendations in national policies. RESULTS: Of 194 countries worldwide, 65 published policies were identified; 24 WHO Africa region (AFR) countries (51%, 24/47), 21 WHO European region (EUR) (40%, 21/53), 6 WHO Eastern Mediterranean region (EMR) (29%, 6/21), 5 Pan-American region (AMR) (14%, 5/35), 5 Western Pacific Region (WPR) (19%, 5/27) and 4 WHO South East Asia Region (SEAR) (36%, 4/11). Only five countries included all recommendations. 63 included a minimum of one. 85% (n=55) included facility-based testing for pregnant women, 75% (n=49) facility-based testing for key populations, 74% (n=48) community-based testing for key populations, 69% (n=45) rapid testing, 57% (n=37) post-test counselling, 45% (n=29) lay provider testing, 38% (n=25) HIV self-testing, 29% (n=19) pre-test information and 25% (n=16) provider-assisted referral. The proportion in each region that included at least one recommendation were: 100% AFR (24/47), 100% EMR (6/6), 100% AMR (5/5), 100% WPR (5/5), 100% SEAR (4/4) and 95% EUR (20/21). AFR followed by EMR included the highest number of reccomendations. CONCLUSION: There was substantial variability in the uptake of the WHO-differentiated HTS recommendations. Those in EMR included the most WHO-differentiated HTS recommendation followed by AFR. Countries within AMR included the least number of recommendations. Ongoing advocacy and efforts are needed to support the uptake of the WHO-differentiated HTS recommendations in country policies as well as their implementation

Reconstruction of some cosmological models in f(R,T) gravity

In this paper, we reconstruct cosmological models in the framework of $f(R,T)$ gravity, where $R$ is the Ricci scalar and $T$ is the trace of the stress-energy tensor. We show that the dust fluid reproduces $\Lambda$CDM, phantom-non-phantom era and the phantom cosmology. Further, we reconstruct different cosmological models including, Chaplygin gas, scalar field with some specific forms of $f(R,T)$. Our numerical simulation for Hubble parameter shows good agreement with the BAO observational data for low redshifts $z<2$.Comment: 12 pages, 2 figure

Country adherence to WHO recommendations to improve the quality of HIV diagnosis: a global policy review.

INTRODUCTION: Ensuring a correct and timely HIV diagnosis is critical. WHO publishes guidelines on HIV testing strategies that maximise the likelihood of correctly determining one's HIV status. A review of national HIV testing policies in 2014 found low adherence to WHO guidelines. We updated this review to determine adherence to current recommendations. METHODS: We conducted a comprehensive policy review through April 2018. We extracted data on HIV testing strategies, recommendations on HIV retesting prior to antiretroviral therapy (ART) initiation and pre-exposure prophylaxis (PrEP)-related HIV testing information. Descriptive analyses disaggregated by region were conducted to ascertain adherence to recommendations and to describe testing strategy characteristics. RESULTS: Of 91 policies included, 26% (n=24/91) adhered to WHO recommendations. Having a two-assay testing strategy to rule-in HIV infection as opposed to the recommended three-assay testing strategy was a major reason for non-adherence. Of 72 country policies providing sufficient information, 31% (n=22) recommended retesting for HIV prior to initiating ART. Of 25 countries and two regions reporting PrEP-related HIV testing guidelines, almost all recommended testing prior to initiating PrEP and every 3 months during PrEP use. CONCLUSIONS: Global adherence to WHO recommendations for HIV testing strategies have improved since 2014 but remain low. We found adherence existed on a continuum. Such a system provides insights into how countries can move towards adherence by making relatively minor changes to testing strategies. Guidance from WHO on the role of new HIV testing technologies within testing algorithms and identifying ways to simplify testing guidance is warranted

An efficient modulation technique to mitigate nonlinearities in optical OFDM

The optical OFDM (O-OFDM) system is a growing technology for next generation high-speed optical communication. Two types of O-OFDM; CO-OFDM (Coherent- Optical OFDM) and Direct-current-based optical OFDM (DCOFDM) are discussed. Mach–Zehnder modulators (MZMs) are used in up-converter part of CO-OFDM system to convert the RF signal to optical signal when the light cannot directly modulate for higher speed. The MZM has a cosine behavior with high nonlinear characteristic that affects the system performance. This paper aims to investigate an efficient pulse modulation technique for mitigating nonlinearity effect in the Mach-Zehnder modulator of CO-OFDM system. It also highlights the proposed method, an efficient CO-OFDM system to solve the existing nonlinearity issue. This technique influences positively on OSNR to reduce non linearity over different distances of optical channel and improve the system performance in terms of power consumption and bandwidth efficiency

Exergoeconomic optimization of a shell-and-tube heat exchanger

The paper presents an economic optimization of a STHX with two commonly adopted (i.e., Kern and Bell-Delaware) and one rarely explored (i.e., Wills-Johnston) methods. A detailed numerical code concerning thermal, hydraulic, exergy, and economic analysis of STHX is developed for all three methods. Normalized sensitivity analysis, parametric study, and Genetic Algorithm are used to ascertain the most influential parameters and optimize the total cost. It is observed that the calculations made using the Wills-Johnston method were reasonably close to the Bell-Delaware method. While the Kern method showed a significant deviation in the shell side calculations because of the several assumptions in this method. The parametric analysis showed that increasing the mass flow rate and the number of baffles increased the operating cost because of an exponential increase in the pressure drops. Finally, the optimization reduced the heat transfer area by ~26.4%, capital cost by ~20%, operational cost by ~50%, total cost by ~22%, and the stream cost by ~21%