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1.
Meat Sci ; 216: 109579, 2024 Oct.
Article in English | MEDLINE | ID: mdl-38959639

ABSTRACT

Fatty acid profile, physicochemical composition, and carcass traits of 32 young Nellore bulls were assessed following the supplementation of Acacia mearnsii extract at levels of 0, 10, 30, and 50 g/kg of total dry matter (DM) in a completely randomized experiment with four treatments and eight replicates. Adding 50 g/kg DM of condensed tannins (CT) from Acacia mearnsii in the bulls' diet reduced DM intake, average daily gain, and meat lipid oxidation (P ≤ 0.05). The pH, centesimal composition, collagen, and meat color indexes of the longissimus muscle were not altered by the addition of Acacia mearnsii (P > 0.05). Cooling loss increased (P = 0.049) linearly. Including Acacia mearnsii in diet reduced the Warner-Bratzler shear force (WBSF, P = 0.018) of longissimus muscle of the bulls. The concentration of C16:0, C17:0, C24:0, t9,10,11,16-18:1, c9t11-18:2, C18:2n-6, C20:4n-6, 20:5n-3, 22:5n-3, and 22:6n-3 in the muscle increased due to the addition of Acacia in the diet (P ≤ 0.05), with the highest muscle concentrations caused by the addition of 10 to 30 g Acacia. c9-18:1 and t16-18:1 reduced linearly. Æ©SFA, Æ©BI, Æ©cis- and Æ©MUFA, Æ©n-3, Æ©n-6, and Æ©PUFA (P ≤ 0.05) quadratically increased at higher concentrations of addition of Acacia, above 30 g/kg DM. It is recommended to include Acacia mearnsii extract up to 30 g/kg total DM in diets for young bulls as it improves CLA, PUFA and TI and reduces lipid oxidation. Acacia mearnsii extract as source of CT at 50 g/kg DM negatively impacted the young bulls performance.


Subject(s)
Acacia , Animal Feed , Diet , Fatty Acids , Muscle, Skeletal , Plant Extracts , Red Meat , Animals , Cattle , Acacia/chemistry , Male , Red Meat/analysis , Muscle, Skeletal/chemistry , Animal Feed/analysis , Fatty Acids/analysis , Diet/veterinary , Plant Extracts/chemistry , Color , Shear Strength , Dietary Supplements
3.
Zootaxa ; 5343(3): 281-295, 2023 Sep 08.
Article in English | MEDLINE | ID: mdl-38221375

ABSTRACT

The genus Diestramima comprises 41 species from Asia with 31 species distributed in China. In this study, we reconstruct the phylogeny tree of Diestramima species by maximum likelihood and Bayesian inference based on three mitochondrial genes (COI, 12S and 16S). The result indicates that the phylogenetic results are coherent with that based on five molecular markers (COI, 12S, 16S, 18S and 28S). Moreover, two new species, D. pingmengensis sp. nov. He & Zong and D. gulinjingensis. sp. nov. Zong & He are described. Their validities are also supported by morphological features. Furthermore, D. sichuanensis Zhu & Shi, 2022 is treated as a junior synonym of D. guangxiensis Qin, Wang, Liu & Li, 2016 based on both morphological and molecular features.


Subject(s)
Orthoptera , Male , Animals , Orthoptera/genetics , Phylogeny , Bayes Theorem , Animal Distribution , Animal Structures , Body Size , Organ Size , China
5.
Article in English | WPRIM (Western Pacific) | ID: wpr-987198

ABSTRACT

Background@#The Philippines is among the countries with the fastest growth rate of HIV cases in the Asia-Pacific Region. HIV/AIDS stigma and discrimination are recognized as major barriers, directly and indirectly inflicting harm to people living with HIV/AIDS (PLWHA). Despite this, there is a lack of studies regarding HIV/AIDS discrimination in the Philippines. This study aimed to assess the association between comprehensive knowledge on HIV/AIDS and discriminatory attitudes towards PLWHA among women in the Philippines. @*Methodology@#Secondary data analysis was done using the Philippine National Demographic Health Survey (2017). Twenty two thousand eight hundred thirteen (22,813) Filipino women aged 15-49 years old were included in this study. Multiple logistic regression was performed to determine the association between comprehensive knowledge and discriminatory attitudes. The final model was built using the change in estimate criterion and sampling weights were applied. @*Results@#More than 3 out of 4 (76.87%) had discriminatory attitudes towards PLWHA, whereas only 1 out of 4 (26.24%) had comprehensive knowledge on HIV/AIDS. Results of multiple logistic regression reveal that women without comprehensive knowledge are 2.53 times more likely to have discriminatory attitudes towards PLWHA (OR= 2.53, 95% CI =2.26-2.84). @*Conclusion@#Given that women without comprehensive knowledge are more likely to have discriminatory attitudes, HIV/AIDS campaigns may be strengthened by integrating necessary concepts in comprehensive sexual education and conducting more active nationwide information and education campaign efforts. Moreover, there is a need to formally evaluate the overall effectiveness of existing interventions.


Subject(s)
HIV , Acquired Immunodeficiency Syndrome , Sex Education
6.
Cancer Med ; 10(17): 5775-5782, 2021 09.
Article in English | MEDLINE | ID: mdl-34254464

ABSTRACT

BACKGROUND: In men with metastatic castration-resistant prostate cancer (mCRPC) with primarily bone metastases, radium-223 (223 Ra) improves overall survival (OS). However, the selection of 223 Ra is not guided by specific validated clinicopathologic factors, and thus outcomes are heterogeneous. PATIENTS AND METHODS: This retrospective survival analysis was performed in men with mCRPC treated with 223 Ra at our cancer center. Demographics and disease characteristics were collected. OS was calculated using the Kaplan-Meier method (log-rank). The potential prognostic factors were determined using both univariable (UVA) and multivariable analysis (MVA) (Cox-regression) methods. RESULTS: In total, 150 patients with a median age of 74 years (52-93) received 223 Ra between May 2015 and July 2018, and 58% had 6-20 bone metastases. Ninety-four (63%) patients received >4 223 Ra doses, and 56 (37%) received ≤4. The following pre-treatment factors were analyzed (median [range]): eastern cooperative oncology group performance status (ECOG PS), (1 [0-3]); Albumin (ALB), (39 g/L [24-47]); alkaline phosphatase (ALP), (110 U/L [35-1633]); and prostate-specific antigen (PSA), (49 µg/L [0.83-7238]). The median OS for all patients was 14.5 months (95% CI: 11.2-18). These factors were associated with poor survival outcomes in UVA and MVA: ALB <35 g/L, ALP >150 U/L, ECOG PS 2-3, and PSA >80 µg/L. By assigning one point for each of these factors, a prognostic model was developed, wherein three distinct risk groups were identified: good, 0-1 (n = 103); intermediate, 2 (n = 30); and poor risk, 3-4 points (n = 17). The median OS was 19.4, 10.0, and 3.1 months, respectively (p < 0.001). CONCLUSIONS: Pre-treatment ALB, ALP, ECOG, and PSA, were significantly correlated with OS and could guide treatment selection for men with mCRPC by identifying those who are most or least likely to benefit from 223 Ra. Validation in an independent dataset is required prior to widespread clinical utilization.


Subject(s)
Prostatic Neoplasms, Castration-Resistant/drug therapy , Radium/therapeutic use , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Prognosis , Prostatic Neoplasms, Castration-Resistant/mortality , Prostatic Neoplasms, Castration-Resistant/pathology , Radium/pharmacology , Retrospective Studies , Survival Analysis , Treatment Outcome
8.
J Biol Regul Homeost Agents ; 34(4): 1285-1296, 2020.
Article in English | MEDLINE | ID: mdl-32894933

ABSTRACT

It has been reported that micro ribonucleic acid (miR)-424 is an important molecule in cerebral ischemia. However, the precise mechanism of action and biological effects of miR-424 remain to be further explored. miR-424 mimic and miR-424 inhibitor were injected via the caudal vein in rats, and the effect of miR-424 expression on brain tissue damage induced by middle cerebral artery occlusion (MCAO) was detected. The miR-424 mimic-induced changes in genomic levels were detected via the gene chip assay, and the signaling pathways regulated by miR-424 and its potential targets were explored combined with target prediction. Then the effect of miR-424 mimic on apoptosis of PC12 cells induced by oxygen-glucose deprivation (OGD) was determined using Annexin V/PI assay. Finally, drosophila mothers against decapentaplegic protein 7 (Smad7) was overexpressed to further verify the mechanism of action of miR-424 mimic. Compared with that in the sham group, the expression of miR-424 in brain tissues significantly declined in the model group. The results of 2,3,5-triphenyltetrazolium chloride (TTC) staining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay revealed that the miR-424 mimic obviously reduced the cerebral infarction area and apoptosis level of brain tissues, while the miR-424 inhibitor obviously increased the cerebral infarction area and apoptosis level of brain tissues. It was found, using bioinformatics and KEGG enrichment analysis, that differentially expressed genes induced by miR-424 were significantly enriched in the transforming growth factor-ß (TGF-ß) signaling pathway. According to the results of reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Western blotting, the miR-424 mimic could evidently lower the expression of Smad7, thus activating the TGF-ß1/Smad3 signaling pathway. Overexpression of Smad7 could weaken the protective effect of miR-424 mimic on ischemic-hypoxic cells. Increasing the expression of miR-424 can inhibit Smad7 to activate the TGF-ß1/Smad3 signaling pathway, thereby exerting a protective effect against the brain tissue damage induced by MCAO.


Subject(s)
Signal Transduction , Animals , Apoptosis , MicroRNAs/genetics , Neurons , Rats , Rats, Sprague-Dawley , Smad3 Protein , Transforming Growth Factor beta1/genetics
11.
J Gastrointest Oncol ; 11(2): 356-365, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32399276

ABSTRACT

BACKGROUND: A microscopically positive (R1) resection margin following resection for gastric and esophageal cancers has been documented to be a poor prognostic factor. The optimal strategy and impact of different modalities of adjuvant treatment for an R1 resection margin remain unclear. METHODS: A retrospective analysis was performed for patients with gastric and esophageal adenocarcinoma treated at the Princess Margaret Cancer Centre (PMCC) from 2006-2016. Electronic medical records of all patients with an R1 resection margin were reviewed. Kaplan-Meier and Cox proportional hazards methods were used to analyze recurrence free survival (RFS) and overall survival (OS) with stage and neoadjuvant treatment as covariates in the multivariate analysis. RESULTS: We identified 69 gastric and esophageal adenocarcinoma patients with a R1 resection. Neoadjuvant chemoradiation was used in 13% of patients, neoadjuvant chemotherapy in 12%, surgery alone in 75%. Margins involved included proximal in 30%, distal in 14%, radial in 52% and multiple margins in 3% of patients. Pathological staging showed 3% with stage I disease, 20% stage II and 74% stage III. Adjuvant therapy was given in 52% of R1 pts (28% CRT, 20% chemotherapy alone, 3% radiation alone, 1% reoperation). Median RFS was 14.1 months [95% confidence interval (CI), 11.1-17.2]. The site of first recurrence was 72% distant, 12% mixed, 16% locoregional alone. Median OS was 34.5 months (95% CI, 23.3-57.9) for all patients. There was no significant difference in RFS (adjusted P=0.26) or OS (adjusted P=0.83) comparing modality of adjuvant therapy. CONCLUSIONS: Most patients with positive margins after resection for gastric and esophageal cancer had advanced pathologic stage and prognosis was poor. Our study did not find improved RFS or OS with adjuvant treatment and only one patient had reresection. The main failure pattern was distant recurrence, suggesting that patients being considered for adjuvant radiotherapy (RT) should be carefully selected. Further studies are required to determine factors to select patients with good prognosis despite a positive margin, or those who may benefit from adjuvant treatment.

12.
Cancer Med ; 9(9): 3023-3032, 2020 05.
Article in English | MEDLINE | ID: mdl-32130793

ABSTRACT

BACKGROUND: The goal of surveillance testing is to enable curative salvage therapy through early disease detection, however supporting evidence in gastroesophageal adenocarcinoma is limited. We evaluated frequency of successful salvage therapy and outcomes in patients who underwent surveillance. METHODS: A single-site, retrospective cohort study was conducted to identify all patients who received curative resection for gastroesophageal adenocarcinoma. Surveillance testing were those investigations not triggered by abnormal symptoms, physical examination, or blood tests. Successful salvage therapy was any potentially curative therapy for disease recurrence which resulted in postrecurrence disease-free survival ≥2 years. Time-to-event data were analyzed using the Kaplan-Meier method and log rank tests. RESULTS: Between 2011 and 2016, 210 consecutive patients were reviewed. Esophageal (14%), gastroesophageal junction (40%), and gastric adenocarcinomas (45%) were treated with surgery alone (29%) or multimodality therapy (71%). Adjuvant therapy was administered in 35%. At median follow-up of 38.3 months, 5-year overall survival (OS) rate was 56%. Among 97 recurrences, 53% were surveillance-detected, and 46% were symptomatic. None was detected by surveillance endoscopy. Median time-to-recurrence (TTR) was 14.8 months. Recurrences included locoregional only (4%), distant (86%), and both (10%). Salvage therapy was attempted in 15 patients, 4 were successful. Compared to symptomatic recurrences, patients with surveillance-detected recurrences had longer median OS (36.2 vs 23.7 months, P = .004) and postrecurrence survival (PRS, 16.5 vs 4.6 months, P < .001), but similar TTR (16.2 vs 13.3 months, P = .40) and duration of palliative chemotherapy (3.9 vs 3.3 months, P = .64). CONCLUSIONS: Among patients surveyed, 96% of recurrences were distant, and salvage therapy was successful in only 1.9% of patients. Longer OS in patients with surveillance-detected compared to symptomatic recurrences was not associated with significant earlier disease detection, and may be contributed by differences in disease biology. Further prospective data are warranted to establish the benefit of surveillance testing in gastroesophageal adenocarcinoma.


Subject(s)
Adenocarcinoma/mortality , Esophageal Neoplasms/mortality , Esophagogastric Junction/pathology , Neoplasm Recurrence, Local/mortality , Salvage Therapy , Stomach Neoplasms/mortality , Adenocarcinoma/pathology , Adenocarcinoma/surgery , Adult , Aged , Aged, 80 and over , Esophageal Neoplasms/pathology , Esophageal Neoplasms/surgery , Esophagogastric Junction/surgery , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Prognosis , Retrospective Studies , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Survival Rate
13.
JCO Oncol Pract ; 16(2): e201-e210, 2020 02.
Article in English | MEDLINE | ID: mdl-32045549

ABSTRACT

PURPOSE: As novel hormonal therapies, such as abiraterone and enzalutamide, move into earlier stages of treatment of advanced prostate cancer, there are significant cost implications. We used the ASCO Value Framework (AVF) and European Society of Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale (MCBS) to quantify and compare the incremental clinical benefit and costs of these agents in the metastatic castration-resistant prostate cancer (mCRPC) and metastatic castration-sensitive prostate cancer (mCSPC) settings. METHODS: We searched PubMed for randomized phase III trials of abiraterone and enzalutamide in mCRPC and mCSPC. Incremental clinical benefit was quantified using the AVF and ESMO-MCBS by 2 independent assessors. Incremental drug costs were calculated using average wholesale prices (AWPs) from the RED BOOK Online. RESULTS: In mCRPC, 2 abiraterone trials (COU-AA-301 and COU-AA-302) and 2 enzalutamide trials (AFFIRM and PREVAIL) met search criteria. AVF scores ranged from 46.3 to 66.6, suggesting clinical benefit; ESMO-MCBS scores ranged from 3 to 5, with lower clinical benefit in the mCRPC predocetaxel setting. The overall incremental AWP ranged from $83,460.94 to $205,128.85. In mCSPC, 4 trials met criteria (LATITUDE, STAMPEDE, ENZAMET, and ARCHES; AVF scores were 79.8, 33.3, 59, and 17, respectively). All of the studies showed benefit except ARCHES. By ESMO-MCBS, both LATITUDE and STAMPEDE showed benefit (score for 4 for both studies); ENZAMET and ARCHES were not evaluable. The overall cost of treatment was significantly higher in the mCSPC setting. CONCLUSION: The AVF and ESMO-MCBS frameworks generated slightly different results but suggested that abiraterone and enzalutamide show clinical benefit in both mCRPC and mCSPC but trended to lower clinical benefit and increased costs in earlier disease stages. Further refinement of the AVF and ESMO-MCBS is needed to facilitate their use and their ability to inform clinical practice in a rapidly changing treatment landscape.


Subject(s)
Medical Oncology , Prostatic Neoplasms , Androstenes/therapeutic use , Benzamides , Humans , Male , Nitriles , Phenylthiohydantoin , Prostatic Neoplasms/drug therapy
14.
Plant Cell Physiol ; 60(7): 1420-1439, 2019 Jul 01.
Article in English | MEDLINE | ID: mdl-31093670

ABSTRACT

Chloroplasts, mitochondria and vacuoles represent characteristic organelles of the plant cell, with a predominant function in cellular metabolism. Chloroplasts are the site of photosynthesis and therefore basic and essential for photoautotrophic growth of plants. Mitochondria produce energy during respiration and vacuoles act as internal waste and storage compartments. Moreover, chloroplasts and mitochondria are sites for the biosynthesis of various compounds of primary and secondary metabolism. For photosynthesis and energy generation, the internal membranes of chloroplasts and mitochondria are equipped with electron transport chains. To perform proper electron transfer and several biosynthetic functions, both organelles contain transition metals and here iron is by far the most abundant. Although iron is thus essential for plant growth and development, it becomes toxic when present in excess and/or in its free, ionic form. The harmful effect of the latter is caused by the generation of oxidative stress. As a consequence, iron transport and homeostasis have to be tightly controlled during plant growth and development. In addition to the corresponding transport and homeostasis proteins, the vacuole plays an important role as an intracellular iron storage and release compartment at certain developmental stages. In this review, we will summarize current knowledge on iron transport and homeostasis in chloroplasts, mitochondria and vacuoles. In addition, we aim to integrate the physiological impact of intracellular iron homeostasis on cellular and developmental processes.


Subject(s)
Iron/metabolism , Plants/metabolism , Chloroplasts/metabolism , Homeostasis , Mitochondria/metabolism , Plant Physiological Phenomena , Plastids/metabolism
15.
Adv Mater ; 30(7)2018 Feb.
Article in English | MEDLINE | ID: mdl-29315902

ABSTRACT

Chameleons are masters of light, expertly changing their color, pattern, and reflectivity in response to their environment. Engineered materials that share this tunability can be transformative, enabling active camouflage, tunable holograms, and novel colorimetric medical sensors. While progress has been made in creating artificial chameleon skin, existing schemes often require external power, are not continuously tunable, and may prove too stiff or bulky for applications. Here, a chemically tunable, large-area metamaterial is demonstrated that accesses a wide range of colors and refractive indices. An ordered monolayer of nanoresonators is fabricated, then its optical response is dynamically tuned by infiltrating its polymer substrate with solvents. The material shows a strong magnetic response with a dependence on resonator spacing that leads to a highly tunable effective permittivity, permeability, and refractive index spanning negative and positive values. The unity-order index tuning exceeds that of traditional electro-optic and photochromic materials and is robust to cycling, providing a path toward programmable optical elements and responsive light routing.

16.
Pediatr Infect Dis J ; 36(3): 307-310, 2017 03.
Article in English | MEDLINE | ID: mdl-27879556

ABSTRACT

There are few data on gynecomastia in HIV-infected children. Within the UK/Ireland's national cohort, 56 of 1873 (3%) HIV-infected children had gynecomastia, of which 10 (0.5%) were severe. All 10 had received antiretroviral therapy for a median of 27.5 (21, 42) months; 4 of 10 had received efavirenz, 7 of 10 and 6 of 10 had received stavudine and/or didanosine respectively. Five were nonreversible, despite changing antiretroviral therapy, and required breast reduction surgery.


Subject(s)
Gynecomastia , HIV Infections/complications , HIV Infections/epidemiology , Adolescent , Anti-Retroviral Agents/adverse effects , Anti-Retroviral Agents/therapeutic use , Child , Cohort Studies , Female , Gynecomastia/chemically induced , Gynecomastia/complications , Gynecomastia/epidemiology , HIV Infections/drug therapy , Humans , Ireland/epidemiology , Male , Prevalence , United Kingdom/epidemiology
17.
Clin Infect Dis ; 63(10): 1380-1387, 2016 Nov 15.
Article in English | MEDLINE | ID: mdl-27581764

ABSTRACT

BACKGROUND: There is limited evidence about the cognitive performance of older adolescents with perinatally acquired human immunodeficiency virus (HIV) compared with HIV-negative (HIV-) adolescents. METHODS: A total of 296 perinatally HIV-infected (PHIV+) and 97 HIV- adolescents (aged 12-21 and 13-23 years, respectively) completed 12 tests covering 6 cognitive domains. The HIV- participants had PHIV+ siblings and/or an HIV-infected mother. Domain-specific and overall (NPZ-6) z scores were calculated for PHIV+ participants, with or without Centers for Disease Control and Prevention (CDC) stage C disease, and HIV- participants. Linear regression was performed to explore predictors of NPZ-6. RESULTS: One hundred twenty-five (42%) of the PHIV+ and 31 (32%) of the HIV- participants were male; 251 (85%) and 69 (71%), respectively, were black African; and their median ages (interquartile range) were 16 (15-18) and 16 (14-18) years, respectively. In PHIV+ participants, 247 (86%) were receiving antiretroviral therapy, and 76 (26%) had a previous CDC C diagnosis. The mean (standard deviation) NPZ-6 score was -0.81 (0.99) in PHIV+ participants with a CDC C diagnosis (PHIV+/C), -0.45 (0.80) in those without a CDC C diagnosis (PHIV+/no C), and -0.32 (0.76) in HIV- participants (P < .001). After adjustment, there was no difference in NPZ-6 scores between PHIV+/no C and HIV- participants (adjusted coefficient, -0.01; 95% confidence interval, -.22 to .20). PHIV+/C participants scored below the HIV- group (adjusted coefficient, -0.44; -.70 to -.19). Older age predicted higher NPZ-6 scores, and black African ethnicity and worse depression predicted lower NPZ-6 scores. In a sensitivity analysis including PHIV+ participants only, no HIV-related factors apart from a CDC C diagnosis were associated with NPZ-6 scores. CONCLUSIONS: Cognitive performance was similar between PHIV+/no C and HIV- participants and indicated relatively mild impairment compared with normative data. The true impact on day-to-day functioning needs further investigation.


Subject(s)
Cognitive Dysfunction , HIV Infections/epidemiology , Adolescent , Adult , Anti-Retroviral Agents/therapeutic use , Black People , Child , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/etiology , Cohort Studies , England/epidemiology , Female , HIV Infections/complications , HIV Infections/drug therapy , HIV Infections/physiopathology , HIV-1 , Humans , Infectious Disease Transmission, Vertical , Male , Risk Factors , Young Adult
18.
Mitochondrial DNA A DNA Mapp Seq Anal ; 27(3): 1959-60, 2016 05.
Article in English | MEDLINE | ID: mdl-25329254

ABSTRACT

Three individual-specific DNA libraries of the deep-sea scleractinian coral Solenosmilia variabilis (Duncan, 1873) were constructed to obtain complete mitochondrial genomes using the 454 Life Science pyrosequencing system. Two mitogenomes were successfully assembled: both were 15,968 bp in length, with base composition of A (24.2%), T (41.1%), C (13.7%) and G (21.0%). The genome contains 13 protein-coding genes, 2 ribosomal RNA genes, 2 transfer RNA genes and a D-loop region. The two mitogenomes were almost identical, with only 5 nucleotide differences (0.03%), including a synonymous substitution within the nad1, nad2 and nad4L genes, and two transversions in the D-loop region. This inter-individual variation indicates that these genes and/or region are potential candidates as molecular markers for population genetic research. The mitogenome of S. variabilis will be useful for future phylogenetic and phylogeographic studies of deep-sea corals.


Subject(s)
Anthozoa/genetics , Genetic Variation , Genome, Mitochondrial , Animals , Base Pairing/genetics , Base Sequence , DNA, Mitochondrial/genetics , Genes, Mitochondrial , RNA, Ribosomal/genetics , RNA, Transfer/genetics
19.
Lancet HIV ; 2(4): e151-8, 2015 Apr.
Article in English | MEDLINE | ID: mdl-26413561

ABSTRACT

BACKGROUND: About a third of children with HIV have virological failure within 2 years of beginning antiretroviral treatment (ART). We assessed the probability of switch to second-line ART or virological re-suppression without switch in children who had virological rebound on first-line ART in the UK and Ireland. METHODS: In this study, we used data reported to the Collaborative HIV Paediatric Study (CHIPS), a national multicentre observational cohort. We included children with virological rebound (confirmed viral load>400 copies per mL after suppression<400 copies per mL) on first-line ART. We did a competing-risk analysis to estimate the probability of switch to second-line treatment, confirmed resuppression (two consecutive viral load measurments<400 copies per mL) without switch, and continued viral load above 400 copies per mL without switch. We also assessed factors that predicted a faster time to switch. FINDINGS: Of the 900 children starting first-line ART who had a viral load below 400 copies per mL within a year of starting treatment, 170 (19%) had virological rebound by a median of 20·6 months (IQR 9·7­40·5). At rebound, median age was 10·6 years (5·6­13·4), median viral load was 3·6 log10 copies per mL (3·1­4·2), and median CD4% was 24% (17­32). 89 patients (52%) switched to second-line ART at a median of 4·9 months (1·7­13·4) after virological rebound, 53 (31%) resuppressed without switch (19 [61%] of 31 patients on a first-line regimen that included a protease inhibitor and 31 [24%] of 127 patients on a first-line regimen that included a non-nucleoside reverse transcriptase inhibitor; NNRTI), and 28 (16%) neither resuppressed nor switched. At 12 months after rebound, the estimated probability of switch was 38% (95% CI 30­45) and of resuppression was 27% (21­34). Faster time to switch was associated with a higher viral load (p<0·0001), later calendar year at virological rebound (p=0·02), and being on an NNRTI-based or triple nucleoside reverse transcriptase inhibitor-based versus protease-inhibitor-based first-line regimen (p=0·001). INTERPRETATION: A third of children with virological rebound resuppressed without switch. Clinicians should consider the possibility of resuppression with adherence support before switching treatment in children with HIV. FUNDING: NHS England (London Specialised Commissioning Group).


Subject(s)
Anti-HIV Agents/administration & dosage , HIV Infections/drug therapy , Reverse Transcriptase Inhibitors/administration & dosage , Viral Load/drug effects , Adolescent , Antiretroviral Therapy, Highly Active , CD4 Lymphocyte Count , Child , Child, Preschool , Disease Progression , Drug Administration Schedule , England/epidemiology , Female , HIV Infections/epidemiology , HIV Infections/immunology , Humans , Ireland/epidemiology , Male , Practice Guidelines as Topic , Treatment Outcome , Viral Load/immunology
20.
Nano Lett ; 15(3): 1891-7, 2015 Mar 11.
Article in English | MEDLINE | ID: mdl-25647523

ABSTRACT

NaYF4:Yb(3+),Er(3+) nanoparticle upconverters are hindered by low quantum efficiencies arising in large part from the parity-forbidden nature of their optical transitions and the nonoptimal spatial separations between lanthanide ions. Here, we use pressure-induced lattice distortion to systematically modify both parameters. Although hexagonal-phase nanoparticles exhibit a monotonic decrease in upconversion emission, cubic-phase particles experience a nearly 2-fold increase in efficiency. In-situ X-ray diffraction indicates that these emission changes require only a 1% reduction in lattice constant. Our work highlights the intricate relationship between upconversion efficiency and lattice geometry and provides a promising approach to modifying the quantum efficiency of any lanthanide upconverter.

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