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BACKGROUND The transition to dolutegravir-containing antiretroviral therapy (ART) in low- and middle-income countries (LMICs) was complicated by an initial safety signal in May 2018 suggesting that exposure to dolutegravir at conception was possibly associated with infant neural tube defects. On the basis of additional evidence, in July 2019, the World Health Organization recommended dolutegravir for all adults and adolescents living with HIV. OBJECTIVE To describe dolutegravir uptake and disparities by sex and age group in LMICs. DESIGN Observational cohort study. SETTING 87 sites that began using dolutegravir in 11 LMICs in the Asia-Pacific; Caribbean, Central and South America network for HIV epidemiology (CCASAnet); and sub-Saharan African regions of the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium. PATIENTS 134��672 patients aged 16 years or older who received HIV care from January 2017 through March 2020. MEASUREMENTS Sex, age group, and dolutegravir uptake (that is, newly initiating ART with dolutegravir or switching to dolutegravir from another regimen). RESULTS Differences in dolutegravir uptake among females of reproductive age (16 to 49 years) emerged after the safety signal. By the end of follow-up, the cumulative incidence of dolutegravir uptake among females 16 to 49 years old was 29.4% (95% CI, 29.0% to 29.7%) compared with 57.7% (CI, 57.2% to 58.3%) among males 16 to 49 years old. This disparity was greater in countries that began implementing dolutegravir before the safety signal and initially had highly restrictive policies versus countries with a later rollout. Dolutegravir uptake was similar among females and males aged 50 years or older. LIMITATION Follow-up was limited to 6 to 8 months after international guidelines recommended expanding access to dolutegravir. CONCLUSION Substantial disparities in dolutegravir uptake affecting females of reproductive age through early 2020 are documented. Although this disparity was anticipated because of country-level restrictions on access, the results highlight its extent and initial persistence. PRIMARY FUNDING SOURCE National Institutes of Health.

Open-framework germanates show interesting pore structures due to their flexible building units. Germanates with different topology built from the Ge9 cluster can be prepared in several amine systems. This paper reports, the Si modified germanate ICMM6 (denoted as HUT-2) prepared in ethylene diamine solution through a hydrothermal synthesis route. HUT-2 is a silicogermanate with space group C2221 (a=12.1299(6) Å, b=13.9329(11) Å, c=14.2205(6) Å, V=2403.33(25) Å3) formed by the Si modified Ge9 cluster. A variation of unit cell parameters is observed that is in accordance with Si-content. Powder X-ray diffraction, ICP and TGA-DSC analysis were recorded to determine the Si-composition at the tetrahedral sites. Structure refinements against the X-ray powder diffraction (XRPD) pattern determined the occupancy of Si at the two tetrahedral sites. An approximate Si/Ge ratio of 0.13-0.18 is obtained based on these characterizations. TGA-DSC analysis showed obvious weight loss of amine at 315 °C, which is higher than the reported pure germanate ICMM6. This further confirms the existence of Si within the structure of HUT-2. © 2010 WILEY-VCH Verlag GmbH and Co. KGaA.

In this paper, a new chaotic system is discussed. Some basic dynamical properties are studied , and we also deal with the finite-time chaos control and synchronization of the new chaotic system. Based on the finite-time stability theory, the control law are proposed to drive chaos to equilibria within finite time, and the control law and the parameter update law are proposed to realize finite-time synchronization of the new chaotic system under unknown parameters. The controller is simple and robust to noise. Numerical simulations are given to show the effectiveness of the proposed controllers.

A 300-sow farrow-to-finish herd in New South Wales was infected with influenza pandemic (H1N1) 2009 (H1N1/09) virus in July 2009 and became the first recorded case of influenza in pigs in Australia. The outbreak resulted from human-to-pig transmission. Clinical signs in affected pigs were mild compared with overseas reports of 'classical' swine influenza virus and included coughing and decreased appetite in a small proportion of non-lactating breeding stock, weaners, growers and finishers. A diagnosis of H1N1/09 influenza virus infection was confirmed using a combination of serology (haemagglutination inhibition, blocking enzyme-linked immunosorbent assay) and real-time reverse transcription polymerase chain reaction. Attempts at virus isolation were unsuccessful. Results of a longitudinal study of pigs on this farm suggested that the virus continued to circulate for 9 weeks after the onset of infection, but was not present 6 months later. This report highlights the difficulties in preventing transmission of H1N1/09 influenza virus from infected humans to pigs during a human pandemic.

Atmospheric aerosol extinction coefficient vertical profiles of near-surface in Hefei western suburb were measured by a CCD lidar system in the day and night,which could fill the gap of the traditional Mie-scattering lidar system especially in the blind area and overlapped region.By comparison of the aerosol extinction coefficient retrieved by Mie-scattering aerosol lidar and CCD lidar at night,the reliability of the CCD lidar system was verified,and the daytime detection of the CCD lidar system was feasible.Profiles of atmospheric aerosol extinction coefficient for 10-180 maltitude were obtained with high spatial resolution,of which the highest resolution was up to 1 cm.Two cases of aerosol extinction coefficient profiles showed that the aerosol extinction coefficient was not monotone decreasing in vertical direction,at the same time,changed violently in the day.The spatio-temporal evolution of aerosol extinction coefficient retrieved by CCD lidar showed that the overall aerosol had a tendency to reduce as the day getting dark.The daytime detection of aerosol extinction coefficient profile by using CCD lidar is credible and fulfilled.

Dyslipidemia is a common feature in immunosuppressed patients, such as kidney and bone marrow transplantation recipients and patients with breast, prostate or gynecological carcinoma or acute lymphoblastic leukemia. In addition, high levels of oxidatively modified low-density lipoproteins (oxLDLs) are closely associated with carcinogenesis. There are, however, no reports on the association between the serum oxLDL levels and the expression of important immunomodulatory molecules in patients with hematological disorders. In the present study, 39 patients with hematological disorders were stratified into four groups: Two groups with malignancies [chronic myeloid leukemia (CML) and acute myeloblastic leukemia (AML)] and two groups without malignancies [myelodysplastic syndrome (MDS) and iron deficiency anemia (IDA)]. Immunomodulatory molecules were monitored in these groups. The enzyme-linked immunosorbent assay results indicated that the plasma oxLDL levels were significantly higher in patients with AML or CML than those in patients with MDS or IDA. The quantitative polymerase chain reaction results revealed that the expression of numerous important immunomodulatory elements, including tumor-related genes, immunological and inflammatory cytokines, defense-responsive genes, genes regulating cell proliferation, adhesion and migration molecules and leukocyte chemotaxis genes, showed considerable variation in patients with hematological disorders, particularly in those with MDS or IDA, as compared with the expression in the healthy volunteers. The present study demonstrated that, in patients with a hematological malignancy (either AML or CML), the activation of numerous immune response-related molecules was inhibited. Thus, an association between hematological malignancies and dyslipidemia, i.e. high levels of oxLDL, is suggested. Further research is necessary to investigate how oxLDL influences cancer progression.

A new method for path transverse wind velocity survey was introduced by analyzing time lagged covariance function of different separation sub-apertures of Hartmann wavefront sensor. A theoretical formula was logically deduced for the light propagation path transverse wind velocity profile. According to the difference of path weighting function for different sub apertures spacing, how to select reasonable path weighting functions was analyzed. Using a Hartmann wavefront sensor, the experiment for measuring path transverse velocity profile along 1 000 m horizontal propagating path was carried out for the first time to our knowledge. The experiment results were as follows. Path transverse averaged velocity from sensor had a good consistency with transverse velocity from the wind anemometer sited near the path receiving end. As the path was divided into two sections, the path transverse velocity of the first section had also a good consistency with that of the second one. Because of different specific underlaying surface of light path, the former was greater than the later over all experiment period. The averaged values were 1.273 and 0.952 m x s(-1) respectively. The path transverse velocity of second section and path transverse averaged velocity had the same trend of decrease and increase with time. The correlation coefficients reached 0.86.

This paper discusses the significance of applying nonlinear theory to examine the complexity of social and economic evolution. First, we generally examine possible implications of nonlinear theory for analyzing the complexity of human societies. Second, we select two socio-economic models to illustrate our viewpoints.

The influence of warfarin pharmacogenomics on major bleeding risk has been little studied in long-term users and non-specialist care settings. We conducted a case-control study to evaluate associations between CYP2C9*2/*3, VKORC1(1173), and CYP4F2*3 variants and major bleeding among patients treated with warfarin in a community setting. We calculated major bleeding odds ratios, adjusting for race, duration of warfarin use, age, gender, and body mass index. In 265 cases and 305 controls with 3.4 and 3.7 mean years of warfarin use, respectively, CYP4F2*3 was associated with decreased major bleeding risk (odds ratio: 0.62; 95% confidence interval: 0.43-0.91). CYP2C9*2/*3 and VKORC1(1173) had null associations overall, but there was a nonsignificant increase in major bleeding risk in patients with duration

Background. The aim of this study was to compare the efficacy of a new tool (the hepatic section vascular blocker, HSVB) with hepatic pedicle clamping and hemihepatic vascular exclusion to control bleeding during liver resection for cancer.Methods. Clinical data on 117 patients who underwent liver resection from 2004 to 2009 were analysed retrospectively. Forty-two patients had liver resection using the HSVB (group A), in 35 patients hemihepatic vascular exclusion was used (group B), and in 40 patients hepatic pedicle clamping with a Pringle manoeuvre was used (group C). Blood loss, operative time, postoperative hepatic function and complications were compared.Results. Mean blood loss and operative time in group A were significantly less than in groups B (p=0.026 and p

Association between dietary protein and fracture risk is unclear. We examined association between energy-adjusted protein intake and hip fracture risk in elders. The risk of hip fracture was reduced in upper quartiles of protein intake when compared with lowest quartile. Studies of the association between dietary protein intake and hip fracture risk are conflicting. Therefore, we examined protein intake and hip fracture risk in a population-based group of elderly men and women. Five hundred seventy-six women and 370 men from the Framingham Osteoporosis Study with no previous history of hip fracture completed Food Frequency Questionnaires. Energy-adjusted protein intake was evaluated as a continuous variable and as quartiles. Incidence rates and hazard ratios were calculated, adjusting for age, BMI, sex, and energy intake. Among 946 participants (mean age 75 years), mean protein intake was found to be 68 gm/d. Increased protein intake was associated with a decreased risk of hip fracture compared to those in the lowest quartile of protein intake (Q2 HR = 0.70, Q3 HR = 0.56, and Q4 HR = 0.63; all p values ≥ 0.044), p for trend was 0.07. When a threshold effect was considered (Q2–4 vs Q1), intakes in the higher quartiles combined were associated with a significantly lower risk for hip fracture (HR = 0.63; p = 0.04). Our results are consistent with reduced risk of hip fracture with higher dietary protein intake. Larger prospective studies are needed to confirm and extend this finding in elderly men and women.

We describe in detail the labelling of interleukin-2 with I-123 (I-123-IL2), its biochemical characterization, the in vitro binding assay and its use for the in vivo detection of tissues infiltrated with mononuclear cells. Human recombinant IL2 was labelled using an enzymatic method and its biochemical characterization was performed using high performance liquid chromatography (HPLC) analysis of cyanogen bromide-cleaved protein. In vitro biological and binding assays were performed on CTLL-2 cell line and on activated peripheral blood lymphocytes. In vivo studies were performed 1 h after administration of 2-3 mCi of I-123-IL2 in 10 newly diagnosed type 1 diabetes patients, five pre-diabetic patients, 10 Hashimoto's thyroiditis patients, 10 coeliac disease patients and 10 normal volunteers. I-123-IL2 scintigraphy allowed the in vivo detection and quantification of activated mononuclear cells in several affected tissues. In detail, I-123-IL2 accumulation was detected in the thyroid of all patients affected by Hashimoto's thyroiditis, in the bowel of all coeliac disease patients and in the pancreas of all pre-type 1 diabetic patients. By contrast, in newly diagnosed type 1 diabetics, I-123-IL2 scan was positive in five of the 10 studied patients. I-123-IL2 scintigraphy may be useful for studying autoimmune phenomena in vivo and in diagnostic protocols to evaluate the presence of other tissue involvement in patients with an organ-specific autoimmune disease. ((C) 2003 Lippincott Williams Wilkins).