Augmenting Azoles with Drug Synergy to Expand the Antifungal Toolbox.

Fungal infections impact the lives of at least 12 million people every year, killing over 1.5 million. Wide-spread use of fungicides and prophylactic antifungal therapy have driven resistance in many serious fungal pathogens, and there is an urgent need to expand the current antifungal arsenal. Recent research has focused on improving azoles, our most successful class of antifungals, by looking for synergistic interactions with secondary compounds. Synergists can co-operate with azoles by targeting steps in related pathways, or they may act on mechanisms related to resistance such as active efflux or on totally disparate pathways or processes. A variety of sources of potential synergists have been explored, including pre-existing antimicrobials, pharmaceuticals approved for other uses, bioactive natural compounds and phytochemicals, and novel synthetic compounds. Synergy can successfully widen the antifungal spectrum, decrease inhibitory dosages, reduce toxicity, and prevent the development of resistance. This review highlights the diversity of mechanisms that have been exploited for the purposes of azole synergy and demonstrates that synergy remains a promising approach for meeting the urgent need for novel antifungal strategies.

Hybrid Learning: For Better or Worse? The Effect of Hybrid Learning on Grades and Attitudes of First-year Engineers in Chemistry

In this study, we investigated the effects of online supplemental instruction (SI) and hybrid learning on first-year students who were enrolled in a required first-year general chemistry class for engineers at Northeastern University during the Fall 2020 semester. During the COVID-19 pandemic, concerns about spreading contagion compelled many universities to switch to either fully remote or hybrid learning, the latter an instructional method which combines in-person and remote instruction. Studies have reported conflicting outcomes for online and hybrid instruction, with some showing that students taking classes in an online or hybrid environment perform worse than their in-person counterparts [1], and others showing that online or hybrid learning can be more effective than in-person learning [2]. The impact of online and hybrid learning models on academic outcomes and attitudes of first year engineering students, specifically those matriculating during the COVID-19 pandemic, merits further attention and was the motivation for our study. Approximately two decades ago, the College of Engineering at Northeastern University developed the Connections SI program, which provides first-year engineering students with structured group peer tutoring. In recent years, the Connections team has reported how factors such as student and instructor gender, pre-matriculation credit, and previous experience with SI affected use of SI during the first year and academic outcomes (e.g., GPA) during students' first year through graduation. Specifically, we found that female undergraduates who regularly used SI during enrollment in required first-semester general chemistry had higher rates of retention within engineering and higher first-semester GPAs compared to their male counterparts [3] - [9]. This current study explored how offering SI online during the Fall 2020 semester influenced students' participation in SI and whether previous experiences with online learning affected academic outcomes and behaviors. We also looked at whether there were correlations among hybrid course instruction, use of online SI, and course grades in general chemistry and overall GPAs this past fall. We then compared these outcomes to our previous findings from multiple reports for a recent group of students who had graduated and only had in-person classes and SI [4]. We found that chemistry course grades and course completion rates were higher in Fall 2020 than in Fall 2013, suggesting that online SI and hybrid course instruction did not negatively impact first-semester academic outcomes. However, students in Fall 2020 who attended class in person multiple times weekly, under the University's rotating weekly schedule, had higher GPAs than students who attended class in person only two-to-four times monthly. Participation in SI was impacted by the hybrid format: a lower percentage of students attended SI when it was held remotely in Fall 2020 compared to when SI was held in person in Fall 2013. However, a slightly higher percentage of males used SI during Fall 2020 compared to Fall 2013, while a significantly lower percentage of females used SI during Fall 2020 compared to Fall 2013. Among users of SI, females having significantly higher chemistry course grades and first semester GPAs than males. Based on analysis of surveys offered to enrolled students, we also found that students' attitudes towards online learning at the end but not the beginning of the semester had a significant correlation with their chemistry course grades and GPAs. © American Society for Engineering Education, 2021

Changes in HIV testing services after COVID-19 in 11 sub-saharan african countries

Background: The COVID-19 pandemic has interrupted the implementation of many HIV prevention programs supported by the US President's Emergency Plan for AIDS Relief (PEPFAR), especially in sub-Saharan Africa. We evaluated the effects of COVID-19 pandemic (e.g., lockdowns, lack of personal protective equipment, community fears) on efforts to reach the UNAIDS 90-90-90 targets by HIV case finding using index testing (IT) and provider-initiated testing and counseling (PITC) as well as HIV treatment initiation. Methods: We conducted a descriptive analysis using programmatic data from persons aged 15 years and older reported to PEPFAR from 11 purposefully selected countries in sub-Saharan Africa. We calculated the percentage change in reported HIV case finding indicators during the COVID period, defined as January-June 2020, as compared to the pre-COVID period, during the same time frame in the preceding year, January-June 2019. Results: Of the 11 countries, persons tested for HIV through PITC declined in seven (64%) and persons testing positive declined in 10 (91%), comparing the COVID to pre-COVID periods (see Table 1). Across all countries, total HIV testing and total number of persons testing positive by PITC decreased by 20% and 23% when comparing the COVID to the pre-COVID period, respectively. In parallel, five of the 11 countries (Cameroon, DRC, Mozambique, Nigeria, South Africa) saw an increase in both IT and HIV case finding through IT, in COVID as compared to the pre-COVID period. Across all countries, total IT increased by 13% and HIV case finding through IT increased by 17% when comparing the COVID to the pre-COVID period. The number of HIV-positive people linked to treatment decreased in seven (64%) countries during the COVID period compared to pre- COVID. Across all countries, an increase of 3% in those HIV-positive people linked to treatment. Conclusion: While testing through PITC decreased during the COVID period, testing and case finding through IT increased. The increase in IT may reflect the actions of healthcare facilities and providers to ensure that HIV-exposed individuals identified by an index case were still tested. Focusing on IT may help programs effectively identify HIV-positive people, even during a pandemic or other disturbance.