In South Africa (SA), adolescent girls and young women (AGYW) aged 15 - 24 years account for nearly 25% of all new HIV infections in the country. The intersection of substance use and sexual risk ...continues to drive the HIV epidemic among AGYW. For example, methaqualone, also known as Mandrax, has sedative effects that may affect women’s ability to negotiate condom use during sex, refuse sex without a condom, or consent to sex, thereby increasing their risk for HIV. Consequently, it is critical to understand how Mandrax use affects HIV risk among AGYW and to assess awareness of and willingness to use biomedical HIV prevention methods, such as pre-exposure prophylaxis (PrEP), among AGYW who use Mandrax. To examine the role of Mandrax use in sexual behaviours and investigate the extent to which AGYW who use Mandrax are aware of and willing to initiate PrEP. Data for this report were derived from baseline and 6-month follow-up data provided by 500 AGYW participating in a cluster-randomised trial assessing the efficacy of a young woman-focused intervention to reduce substance use and HIV risk. AGYW who self-identified as black African or coloured, reported using substances, reported condomless sex in the past 3 months, and had discontinued school early were recruited from 24 community clusters across Cape Town, SA. Following consent/assent, participants provided biological specimens to test for recent drug use (including Mandrax) and completed the self-report questionnaire.Logistic regression analysis revealed that the AGYW who had a positive test result for Mandrax use were less likely to use a condom with their main partner (p=0.01), and almost three times more likely to use alcohol and/or other drugs before or during their last act of sexual intercourse (p0.10) or willingness to use PrEP (p>0.10), but 70% of AGYW who used Mandrax were willing to initiate PrEP.The study findings highlight how Mandrax use may contribute to HIV risk among SA AGYW. Key decision-makers should consider incorporating substance use prevention efforts into existing HIV reduction programmes and equip youth-friendly clinics with the resources to identify AGYW who use Mandrax and offer them PrEP.
The β-decay scheme of 138Te and the level structure of 138I is reported for the first time. The experiment was performed at the Radioactive Isotope Beam Factory of RIKEN, as one of the EUROBALL-RIKEN ...Cluster Array campaigns. Secondary radioactive ions, including 138Te and 138Sb, were produced by the in-flight fission of a 238U beam with the energy of 345 MeV per nucleon. From the β decay of 138Te, the level scheme of 138I was supplemented with new spin and parity assignments, such as the low-lying negative-parity states and a positive-parity 1+ state. This 1+ state can be interpreted as being associated with the π0h11/2⊗ν0h9/2 partner orbital configuration populated by the Gamow-Teller transition between a neutron in the 0h9/2 orbital and a proton in the 0h11/2 orbital. Details of the structure of 138I are discussed in terms of the proton-neutron interactions and Gamow-Teller transition strength within the theoretical context of shell-model calculations.
A growing number of youth suffer from obesity and in particular severe obesity for which intensive lifestyle intervention does not adequately reduce excess adiposity. A treatment gap exists wherein ...effective treatment options for an adolescent with severe obesity include intensive lifestyle modification or metabolic and bariatric surgery while the application of obesity pharmacotherapy remains largely underutilized. These youth often present with numerous obesity‐related comorbid diseases, including hypertension, dyslipidemia, prediabetes/type 2 diabetes, obstructive sleep apnea, nonalcoholic fatty liver disease, musculoskeletal problems, and psychosocial issues such as depression, anxiety, and social stigmatization. Current pediatric obesity treatment algorithms for pediatric primary care providers focus primarily on intensive lifestyle intervention with escalation of treatment intensity through four stages of intervention. Although a recent surge in the number of Food and Drug Administration‐approved medications for obesity treatment has emerged in adults, pharmacotherapy options for youth remain limited. Recognizing treatment and knowledge gaps related to pharmacological agents and the urgent need for more effective treatment strategies in this population, discussed here are the efficacy, safety, and clinical application of obesity pharmacotherapy in youth with obesity based on current literature. Legal ramifications, informed consent regulations, and appropriate off‐label use of these medications in pediatrics are included, focusing on prescribing practices and prescriber limits.
The diagnosis of acute pyelonephritis in adults is predominantly made by a combination of typical clinical features of flank pain, high temperature and dysuria combined with urinalysis findings of ...bacteruria and pyuria. Imaging is generally reserved for patients who have atypical presenting features or in those who fail to respond to conventional therapy. In addition, early imaging may be useful in diabetics or immunocompromised patients. In such patients, imaging may not only aid in making the diagnosis of acute pyelonephritis, but more importantly, it may help identify complications such as abscess formation. In this pictorial review, we discuss the role of modern imaging in acute pyelonephritis and its complications. We discuss the growing role of cross-sectional imaging with computed tomography (CT) and novel magnetic resonance imaging (MRI) techniques that may be used to demonstrate both typical as well as unusual manifestations of acute pyelonephritis and its complications. In addition, conditions such as emphysematous and fungal pyelonephritis are discussed.
With the advances in affordable three-dimensional (3D) printing technology, 3D reconstruction and patient-specific 3D printed models are establishing a crucial role in the field of medicine for both ...educational purposes and procedural planning. 3D printed models provide physicians with increased 3D perception and tactile feedback, and enable a team-based approach to operational planning. However, performing an effective 3D reconstruction requires an in-depth understanding of the software features to accurately segment and reconstruct the human anatomy of interest from preacquired image data from multiple modalities such as computer tomography, 3D angiography and magnetic resonance imaging, and the different 3D printers/materials available in the market today. Increased understanding of this technology may benefit radiologists by developing techniques and tricks specific to interventional radiology and establishing a criterion to determine when to use these. Thus, the purpose of this manuscript is to provide physicians with an update on currently available 3D reconstruction software as well as printers and materials. Our initial experience using this technology is introduced based on a specific case of developing a 3D printed aorta for a patient with severe stenosis of the abdominal aorta.
The change of the shell structure in atomic nuclei, so-called “nuclear shell evolution”, occurs due to changes of major configurations through particle-hole excitations inside one nucleus, as well as ...due to variation of the number of constituent protons or neutrons. We have investigated how the shell evolution affects Gamow-Teller (GT) transitions that dominate the β decay in the region below 132Sn using the newly obtained experimental data on a long-lived isomer in 127Ag. The T1/2=67.5(9) ms isomer has been identified with a spin and parity of (27/2+) at an excitation energy of 1942−20+14 keV, and found to decay via an internal transition of an E3 character, which competes with the dominant β-decay branches towards the high-spin states in 127Cd. The underlying mechanism of a strong GT transition from the 127Ag isomer is discussed in terms of configuration-dependent optimization of the effective single-particle energies in the framework of a shell-model approach.
MiTES 中等位基因 PRDM12 突变 Moss, C.; Srinivas, S. M.; Sarveswaran, N. ...
British journal of dermatology (1951),
November 2018, 2018-11-00, 20181101, Letnik:
179, Številka:
5
Journal Article
Isomeric states were observed in nuclei produced in an experiment at the RIKEN Nishina Center Radioactive Isotope Beam Factory following the in-flight fission of a 345 MeV/nucleon
238
U beam. Isomers ...reported in nuclei spanning a predicted prolate-oblate shape change boundary,
111
Zr (
E
=
283.1
keV;
τ
=
0.326
(
63
)
μ
s),
112
Nb (
E
=
44.2
keV;
τ
=
0.094
(
26
)
μ
s),
113
Nb (
E
=
135.4
keV;
τ
=
0.846
(
80
)
μ
s), and
115
Mo (
E
=
198.6
keV;
τ
=
63
(
4
)
μ
s), are compared to potential-energy surface calculations which gave a selection of low-lying configurations for each nucleus. Tentative assignments of ground and excited states were made based on energy similarities to the calculations, reduced transition probabilities of the decays, and constraints of transition multipolarities from
γ
-ray coincidence measurements. These assignments are suggestive of significant deformation being persistent for
N
>
70
in this region. In addition, isomers in
108
Nb,
109
Nb,
113
Tc,
117
Ru,
119
Ru,
120
Rh, and
122
Rh, not spanning the prolate-oblate transition discussed, are presented.
Summary
Background
Oral systemic immunomodulatory medication is regularly used off‐licence in children with severe atopic eczema. However, there is no firm evidence regarding the effectiveness, ...safety, cost‐effectiveness and impact on quality of life from an adequately powered randomized controlled trial (RCT) using systemic medication in children.
Objectives
To assess whether there is a difference in the speed of onset, effectiveness, side‐effect profile and reduction in flares post‐treatment between ciclosporin (CyA) and methotrexate (MTX), and also the cost‐effectiveness of the drugs. Treatment impact on quality of life will also be examined in addition to whether FLG genotype influences treatment response. In addition, the trial studies the immune–metabolic effects of CyA and MTX.
Methods
Multicentre, parallel group, assessor‐blind, pragmatic RCT of 36 weeks’ duration with a 24‐week follow‐up period. In total, 102 children aged 2–16 years with moderate‐to‐severe atopic eczema, unresponsive to topical treatment will be randomized (1 : 1) to receive MTX (0·4 mg kg−1 per week) or CyA (4 mg kg−1 per day).
Results
The trial has two primary outcomes: change from baseline to 12 weeks in Objective Severity Scoring of Atopic Dermatitis (o‐SCORAD) and time to first significant flare following treatment cessation.
Conclusions
This trial addresses important therapeutic questions, highlighted in systematic reviews and treatment guidelines for atopic eczema. The trial design is pragmatic to reflect current clinical practice.
What's already known about this topic?
Oral systemic immunomodulatory medication is regularly used off‐licence in children with severe atopic eczema.
Ciclosporin is the commonest first‐line systemic agent used in this context, but methotrexate has emerged as an important therapeutic alternative.
There is currently no adequately powered randomized controlled trial that compares both treatments in children.
What does this study add?
The TREatment of severe Atopic eczema Trial (TREAT) addresses this gap and compares the effectiveness, safety, cost‐effectiveness and impact on patient's quality of life of these two drugs.
TREAT also examines the effects of both drugs using systemic and cutaneous markers of inflammation and the effect of filaggrin (FLG) genotype and T‐cell cytokine signatures on treatment response.
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Plain language summary available online
Although a number of network emulation tools exist, they vary on the level of fidelity of the emulation. Furthermore, most of all emulate a network completely virtually, not allowing for ...hardware-in-the-loop as part of the emulation. This paper presents an architecture for a cyber-physical emulation test range that operates at high fidelity and allows for incorporation of hardware-in-the-loop with no customization required. The system, which is built on top of VMware, allows for emulation of any network providing that all nodes can either be virtualized or physically attached to the system. Network testing, including penetration testing, can be performed at a high level of fidelity.
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