Long-lasting insecticidal nets (LLINs) have played an important role in reducing the global malaria burden since 2000. They are a core prevention tool used widely by people at risk of malaria. The ...Vector Control Prequalification mechanism of the Word Health Organization (WHO-Vector Control PQ) established the testing and evaluation guidelines for LLINs before registration for public use. In the present study, two new brands of deltamethrin-impregnated nets (Yahe.sup.R LN and Panda.sup.R Net 2.0) were evaluated in an experimental hut against wild pyrethroid-resistant Anopheles gambiae s.l. in M'Bé nearby Bouaké, central Côte d'Ivoire. The performance of Yahe.sup.R LN and Panda.sup.R Net 2.0 was compared with that of PermaNet 2.0, conventionally treated nets (CTN), and untreated net to assess the blood-feeding inhibition, deterrence, induced exophily, and mortality. Cone bioassay results showed that Panda.sup.R Net 2.0, PermaNet 2.0 and Yahe.sup.R LN (both unwashed and washed 20 times) induced > 95% knockdown or > 80% mortality of the susceptible Anopheles gambiae Kisumu strain. With the pyrethroid-resistant M'Bé strain, mortality rate for all treated nets did not exceed 70%. There was a significant reduction in entry and blood feeding (p < 0.05) and an increase in exophily and mortality rates (p < 0.05) with all treatments compared to untreated nets, except the CTNs. However, the personal protection induced by these treated nets decreased significantly after 20 washes. The performance of Panda.sup.R Net 2.0 was equal to PermaNet.sup.R 2.0 in terms of inhibiting blood feeding, but better than PermaNet.sup.R 2.0 in terms of mortality. This study showed that Yahe.sup.R LN and Panda.sup.R Net 2.0 met the WHO Pesticide Evaluation Scheme (WHOPES) criteria to undergo phase III trial at the community level. Due to an increasing spread and development of pyrethroid resistance in malaria vectors, control of malaria transmission must evolve into an integrated vector management relying on a large variety of efficient control tools.
Background:
In West Africa, female sex workers are at increased risk of HIV acquisition and transmission. HIV self-testing could be an effective tool to improve access to and frequency of HIV testing ...to female sex workers, their clients and partners. This article explores their perceptions regarding HIV self-testing use and the redistribution of HIV self-testing kits to their partners and clients.
Methods:
Embedded within ATLAS, a qualitative study was conducted in Côte-d’Ivoire, Mali, and Senegal in 2020. Nine focus group discussions were conducted. A thematic analysis was performed.
Results:
A total of 87 participants expressed both positive attitudes toward HIV self-testing and their willingness to use or reuse HIV self-testing. HIV self-testing was perceived to be discreet, confidential, and convenient. HIV self-testing provides autonomy from testing by providers and reduces stigma. Some perceived HIV self-testing as a valuable tool for testing their clients who are willing to offer a premium for condomless sex. While highlighting some potential issues, overall, female sex workers were optimistic about linkage to confirmatory testing following a reactive HIV self-testing. Female sex workers expressed positive attitudes toward secondary distribution to their partners and clients, although it depended on relationship types. They seemed more enthusiastic about secondary distribution to their regular/emotional partners and regular clients with whom they had difficulty using condoms, and whom they knew enough to discuss HIV self-testing. However, they expressed that it could be more difficult with casual clients; the duration of the interaction being too short to discuss HIV self-testing, and they fear violence and/or losing them.
Conclusion:
Overall, female sex workers have positive attitudes toward HIV self-testing use and are willing to redistribute to their regular partners and clients. However, they are reluctant to promote such use with their casual clients. HIV self-testing can improve access to HIV testing for female sex workers and the members of their sexual and social network.
•Cr-toxicity altered the polyamine and phenolic contents in the leaves of KM plants.•Ploidy level of rootstock had significant impact on polyamine biosynthesis and degradation in Kinnow ...mandarin.•High Cr-tolerance of double-diploid plants to Cr-toxicity is attributed to greater polyamine and phenolic contents in leaves.
The present investigation was executed to determine the effect of rootstock ploidy level on polyamine metabolism and phenolic acid contents in leaves. Kinnow mandarin (Citrus nobilis Lour × Citrus deliciosa Ten) plants were grafted on the diploid (2x) and double-diploid (4x) of Poncirus trifoliata (L.) Raf, Citrus reshni, and Citrus limonia Osbeck. Plants were grown in greenhouse under controlled conditions and fertigated with nutrient solution containing chromium (0.75 mM). After four-months of growth under chromium (Cr) stress, polyamines (free, soluble-conjugated and insoluble-bound) and phenolic acid contents (PAC): p-hydroxybenzoic acid (PHBA), ferulic acid (FA), p-coumaric acid (PCA), gallic acid (GA) and vanillic acid (VA) in leaves were investigated. Enzymes activity of polyamine biosynthesis, i.e., arginine decarboxylase (ADC), ornithine decarboxylase (ODC), S-adenosylmethionine decarboxylase (SAMDC) and spermidine synthase (SpdS), and polyamine degradation, i.e., polyamine oxidase (PAO) and diamine oxidase (DAO), were also determined. Chromium stress caused reductions in polyamine contents (PAC) and enzymes of polyamines biosynthesis. The responses of Kinnow mandarin (KM) plants grafted on diploid or double-diploid rootstocks showed a similar trend, although Cr-stress induced more drastic effects in diploid grafted plants. In the case of polyamine degradative enzymes, Cr-stress enhanced the PAO and DAO activities, but diploid grafted plants showed greater increases than those grafted on double-diploid rootstocks. Cr-stress inhibited the activities of enzymes of polyamine biosynthesis, but inhibition was expressed more in diploid-grafted plants than in double-diploid grafted plants. So, polyamine biosynthesis and degradation were less affected by Cr-toxicity in double-diploid grafted plants than in diploid grafted plants. Similarly, KM plants with double-diploid rootstocks had greater accumulation of phenolic acid contents in their leaves. Combining the findings of our previous reports and the data of the current study, it is suggested that higher polyamine and phenolic acid content accumulation in double-diploid grafted plants strengthens the antioxidative defense system of the Kinnow mandarin plants by regulating the ROS homeostasis and stabilization of membranes under Cr-toxicity. Therefore, higher levels of polyamines and PACs augmented the Cr-tolerance potential of KM plants grafted on double-diploid rootstocks.
Men who have sex with men (MSM) are considered to be at significant risk for sexually transmitted infections (STI) and bloodborne viruses including viral hepatitis types B, C, and D (HBV, HCV, and ...HDV) and human T-cell leukemia virus types 1 and 2 (HTLV 1&2). This study aimed to assess the seroprevalence and correlates of HBV, HCV, HDV, and HTLV 1&2 antibodies among MSM in Ouagadougou, Burkina Faso.
We conducted a cross-sectional survey to assess the biological and behavourial characteristics among MSM in Ouagadougou from January to April 2013. Serum specimens obtained were tested for the presence of HBV, HCV, HDV and HTLV-1&2 infections. MSM 18 years and older were recruited using respondent driven sampling (RDS). Population estimates and 95% confidence intervals (CI) adjusted for the RDS design were calculated using RDS Analysis Tool (RDSAT) version 6.0.1 (RDS, Inc., Ithaca, NY). Bivariate and multivariate logistic regression analyses were conducted to assess correlates of these infections using Stata 14.
A total of 329 MSM were tested. Prevalence was 20.4% (95% CI: 16.4-25.1) for HBV, 11.0% (95% CI: 8.0-14.8) for HCV, and 0.0% for HDV. Anti-HTLV 1&2 antibodies were found in 4.0% (95% CI: 2.3-6.8) of MSM. Factors independently associated with HBV infection were lack of condom use during the last anal sex act with a main male sexual partner and experience of condom tearing during anal sex. Presence of anti-HTLV 1&2 antibodies was associated with history of genital or anal lesions and injection drug use. None of the variables included in our study were associated with HCV.
This study shows that HBV, HCV and HTLV 1&2 prevalence among MSM in Burkina is high and suggests that comprehensive STI prevention and sexual health education services for this group are needed.
Consultations for sexually transmitted infection (STI) provide an opportunity to offer HIV testing to both patients and their partners. This study describes the organisation of HIV self-testing ...(HIVST) distribution during STI consultations in Abidjan (Côte d'Ivoire) and analyse the perceived barriers and facilitators associated with the use and redistribution of HIVST kits by STI patients.
A qualitative study was conducted between March and August 2021 to investigate three services providing HIVST: an antenatal care clinic (ANC), a general health centre that also provided STI consultations, and a dedicated STI clinic. Data were collected through observations of medical consultations with STI patients (N = 98) and interviews with both health professionals involved in HIVST distribution (N = 18) and STI patients who received HIVST kits for their partners (N = 20).
In the ANC clinic, HIV testing was routinely offered during the first prenatal visit. HIVST was commonly offered to women who had been diagnosed with an STI for their partner's use (27/29 observations). In the general health centre, two parallel pathways coexisted: before the consultation, a risk assessment tool was used to offer HIV testing to eligible patients and, after the consultation, patients who had been diagnosed with an STI were referred to a care assistant for HIVST. Due to this HIV testing patient flow, few offers of HIV testing and HIVST were made in this setting (3/16). At the dedicated STI clinic, an HIVST video was played in the waiting room. According to the health professionals interviewed, this video helped reduce the time required to offer HIVST after the consultation. Task-shifting was implemented there: patients were referred to a nurse for HIV testing, and HIVST was commonly offered to STI patients for their partners' use (28/53). When an HIVST was offered, it was generally accepted (54/58). Both health professionals and patients perceived HIVST positively despite experiencing a few difficulties with respect to offering HIVST to partners and structural barriers associated with the organisation of services.
The organisation of patient flow and task-shifting influenced HIV testing and offers of HIVST kits. Proposing HIVST is more systematic when HIV testing is routinely offered to all patients. Successful integration requires improving the organisation of services, including task-shifting.
Abstract Background Recent discovery of cystic fibrosis transmembrane conductance regulator expression in human skeletal muscle suggests that CF patients may have intrinsic skeletal muscle ...abnormalities potentially leading to functional impairments. The aim of the present study was to determine whether CF patients with mild to moderate lung disease have altered skeletal muscle contractility and greater muscle fatigability compared to healthy controls. Methods Thirty adults (15 CF and 15 controls) performed a quadriceps neuromuscular evaluation using single and paired femoral nerve magnetic stimulations. Electromyographic and mechanical parameters during voluntary and magnetically-evoked contractions were recorded at rest, during and after a fatiguing isometric task. Quadriceps cross-sectional area was determined by magnetic resonance imaging. Results Some indexes of muscle contractility tended to be reduced at rest in CF compared to controls ( e.g. , mechanical response to doublets stimulation at 100 Hz: 74 ± 30 Nm vs 97 ± 28 Nm, P = 0.06) but all tendencies disappeared when expressed relative to quadriceps cross-sectional area ( P > 0.5 for all parameters). CF and controls had similar alterations in muscle contractility with fatigue, similar endurance and post exercise recovery. Conclusions We found similar skeletal muscle endurance and fatigability in CF adults and controls and only trends for reduced muscle strength in CF which disappeared when normalized to muscle cross-sectional area. These results indicate small quantitative (reduced muscle mass) rather than qualitative (intrinsic skeletal muscle abnormalities) muscle alterations in CF with mild to moderate lung disease.
La sélection génétique est un moyen pour augmenter la productivité des races endémiques dans des environnements hostiles. La trypanotolérance du bovin N’Dama a été l’argument central de la mise en ...œuvre des programmes de sélection de cette race en Gambie, au Mali et au Sénégal. Ces programmes ont eu des trajectoires différentes selon les objectifs, le processus de conception et les stratégies développées. L’analyse de ces trajectoires aiderait à mieux comprendre leurs succès et leurs échecs. Pour ce faire, une étude comparative de ces programmes a été réalisée en se basant sur une littérature scientifique publiée et non publiée et des entretiens avec les acteurs. L’analyse a d’abord consisté à décrire chaque programme. Une discussion a ensuite été menée pour évaluer les facteurs de succès et d’échec. Cette analyse a montré que ces facteurs dépendent de l’intérêt des éleveurs en lien avec leurs objectifs de production et leurs pratiques, de la stratégie utilisée tenant compte de l’intégration ou non de la trypanotolérance dans les critères de sélection, et de la mobilisation des ressources financières et humaines. Ces programmes de sélection ont aussi généré un capital d’expériences, dont la valorisation permettrait d’améliorer les systèmes actuels et de bâtir des programmes durables de sélection pour les systèmes d’élevage à faibles niveaux d’intrants dans les pays en développement.
Genetic selection is a way to increase the productivity of endemic breeds in hostile environments. Trypanotolerance of N’Dama cattle has been the central argument for the implementation of breeding programs for this breed in Gambia, Mali and Senegal. These programs have had different trajectories depending on the objectives, the design process and the strategies developed. The analysis of these trajectories would help to better understand their successes and failures. To this end, a comparative study of these programs is carried out based on published and unpublished scientific literature and interviews with stakeholders. The analysis first consisted in describing each program. A discussion is then held to assess the success and failure factors. This analysis showed that these factors depend on the interest of farmers in relation to their production objectives and practices, the strategy used, whether or not trypanotolerance is included in the selection criteria, and the mobilization of financial and human resources. These breeding programs have also generated a wealth of experience that could be used to improve current systems and build sustainable breeding programs for low-input livestock systems in developing countries.
Computational models of cardiac electrophysiology are promising tools for reducing the rates of non-response patients suitable for cardiac resynchronization therapy (CRT) by optimizing electrode ...placement. The majority of computational models in the literature are mesh-based, primarily using the finite element method (FEM). The generation of patient-specific cardiac meshes has traditionally been a tedious task requiring manual intervention and hindering the modeling of a large number of cases. Meshless models can be a valid alternative due to their mesh quality independence. The organization of challenges such as the CRT-EPiggy19, providing unique experimental data as open access, enables benchmarking analysis of different cardiac computational modeling solutions with quantitative metrics. We present a benchmark analysis of a meshless-based method with finite-element methods for the prediction of cardiac electrical patterns in CRT, based on a subset of the CRT-EPiggy19 dataset. A data assimilation strategy was designed to personalize the most relevant parameters of the electrophysiological simulations and identify the optimal CRT lead configuration. The simulation results obtained with the meshless model were equivalent to FEM, with the most relevant aspect for accurate CRT predictions being the parameter personalization strategy (e.g., regional conduction velocity distribution, including the Purkinje system and CRT lead distribution).
Abstract
Background
Neutropenia may limit the use of valganciclovir treatment for cytomegalovirus (CMV) infection following hematopoietic cell transplant (HCT). A phase 2 study indicated efficacy of ...maribavir with fewer treatment-limiting toxicities than valganciclovir.
Methods
In this multicenter, double-blind, phase 3 study, patients with first asymptomatic CMV infection post-HCT were stratified and randomized 1:1 to maribavir 400 mg twice daily or valganciclovir (dose-adjusted for renal clearance) for 8 weeks with 12 weeks of follow-up. The primary endpoint was confirmed CMV viremia clearance at week 8 (primary hypothesis of noninferiority margin of 7.0%). The key secondary endpoint was a composite of the primary endpoint with no findings of CMV tissue-invasive disease at week 8 through week 16. Treatment-emergent adverse events (TEAEs) were assessed.
Results
Among patients treated (273 maribavir; 274 valganciclovir), the primary endpoint of noninferiority of maribavir was not met (maribavir, 69.6%; valganciclovir, 77.4%; adjusted difference: −7.7%; 95% confidence interval CI: −14.98, −.36; lower limit of 95% CI of treatment difference exceeded −7.0%). At week 16, 52.7% and 48.5% of patients treated (maribavir and valganciclovir, respectively) maintained CMV viremia clearance without tissue-invasive disease (adjusted difference: 4.4%; 95% CI: −3.91, 12.76). With maribavir (vs valganciclovir), fewer patients experienced neutropenia (16.1% and 52.9%) or discontinued due to TEAEs (27.8% and 41.2%). Discontinuations were mostly due to neutropenia (maribavir, 4.0%; valganciclovir, 17.5%).
Conclusions
Although noninferiority of maribavir to valganciclovir for the primary endpoint was not achieved based on the prespecified noninferiority margin, maribavir demonstrated comparable CMV viremia clearance during post-treatment follow-up, with fewer discontinuations due to neutropenia.
Clinical Trials Registration. NCT02927067 AURORA.
Noninferiority of maribavir to valganciclovir was not met for the primary endpoint of CMV viremia clearance at study week 8. However, maribavir had comparable post-treatment CMV viremia clearance to valganciclovir, and was associated with a lower incidence of treatment-limiting neutropenia.
Graphical Abstract
Graphical Abstract
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