Temporal Dynamics of Subclinical Malaria in Different Transmission Zones of Myanmar.

Countries in the Greater Mekong Subregion have committed to eliminate Plasmodium falciparum malaria by 2025. Subclinical malaria infections that can be detected by highly sensitive polymerase chain reaction (PCR) testing in asymptomatic individuals represent a potential impediment to this goal, although the extent to which these low-density infections contribute to transmission is unclear. To understand the temporal dynamics of subclinical malaria in this setting, a cohort of 2,705 participants from three epidemiologically distinct regions of Myanmar was screened for subclinical P. falciparum and P. vivax infection using ultrasensitive PCR (usPCR). Standard rapid diagnostic tests (RDTs) for P. falciparum were also performed. Individuals who tested positive for malaria by usPCR were followed for up to 12 weeks. Regression analysis was performed to estimate whether the baseline prevalence of infection and the count of repeated positive tests were associated with demographic, behavioral, and clinical factors. At enrollment, the prevalence of subclinical malaria infection measured by usPCR was 7.7% (1.5% P. falciparum monoinfection, 0.3% mixed P. falciparum and P. vivax, and 6.0% P. vivax monoinfection), while P. falciparum prevalence measured by RDT was just 0.2%. Prevalence varied by geography and was higher among older people and in those with outdoor exposure and travel. No difference was observed in either the prevalence or count of subclinical infection by time of year, indicating that even in low-endemicity areas, a reservoir of subclinical infection persists year-round. If low-density infections are shown to represent a significant source of transmission, identification of high-risk groups and locations may aid elimination efforts.

The Parasol Protocol: An Implementation Science Study of HIV Continuum of Care Interventions for Gay Men and Transgender Women in Burma/Myanmar.

BACKGROUND: Efforts to improve HIV diagnosis and antiretroviral therapy (ART) initiation among people living with HIV and reduce onward transmission of HIV rely on innovative interventions along multiple steps of the HIV care continuum. These innovative methods are particularly important for key populations, including men who have sex with men (MSM) and transgender women (TW). The HIV epidemic in Myanmar is concentrated among key populations, and national efforts now focus on reducing stigma and improving engagement of MSM and TW in HIV prevention and care. OBJECTIVE: This study aims to test the use of several innovations to address losses in the HIV care continuum: (1) use of respondent-driven sampling (RDS) to reach and engage MSM and TW in HIV testing, (2) HIV self-testing (HIVST) to increase HIV testing uptake and aid early diagnosis of infection, (3) community-based CD4 point-of-care (POC) technology to rapidly stage HIV disease for those who are HIV infected, and (4) peer navigation support to increase successful health system navigation for HIV-infected MSM and TW in need of ART or HIV engagement in care. METHODS: To assess the effect of HIVST, we will implement a randomized trial in which MSM and TW adults in the greater Yangon metropolitan area who are HIV uninfected will be recruited via RDS (N=366). Participants will complete a baseline socio-behavioral survey and will be randomized to standard, voluntary counseling and testing (VCT) or to HIVST. Biologic specimens will be collected during this baseline visit for confirmatory testing using dried blood spots. Participants will be asked to return to the study office to complete a second study visit in which they will report their HIV test result and answer questions on the acceptability of the assigned testing method. Aim 1 participants with confirmed HIV infection and who are not engaged in care (N=49) will be offered direct enrollment into Aims 2 and 3, which include immediate CD4 POC and the option for peer navigation, respectively. Aims 2 and 3 participants will be prospectively followed for 12 months with data collection including interviewer-administered sociobehavioral survey, CD4 POC, and viral load testing occurring biannually. Participants who accept peer navigation will be compared to those who decline peer navigation. Analyses will estimate the impact of CD4 POC on engagement in care and the impact of peer navigation on ART adherence and viral load. RESULTS: Formative qualitative research was conducted in June and September 2015 and led to further refinement of recruitment methods, HIVST instructions and counseling, and peer navigation methods. Aim 1 recruitment began in November 2015 with subsequent enrollment into Aims 2 and 3 and is currently ongoing. CONCLUSIONS: These innovative interventions may resolve gaps in the HIV care continuum among MSM and TW and future implementation may aid in curbing the HIV epidemic among MSM and TW in Myanmar.

Group 13 Superacid Adducts of [PCl2N]3.

Irrespective of the order of the addition of reagents, the reactions of [PCl2N]3 with MX3 (MX3 = AlCl3, AlBr3, GaCl3) in the presence of water or gaseous HX give the air- and light-sensitive superacid adducts [PCl2N]3·HMX4. The reactions are quantitative when HX is used. These reactions illustrate a Lewis acid/Brønsted acid dichotomy in which Lewis acid chemistry can become Brønsted acid chemistry in the presence of adventitious water or HX. The crystal structures of all three [PCl2N]3·HMX4 adducts show that protonation weakens the two P-N bonds that flank the protonated nitrogen atom. Variable-temperature NMR studies indicate that exchange in solution occurs in [PCl2N]3·HMX4, even at lower temperatures than those for [PCl2N]3·MX3. The fragility of [PCl2N]3·HMX4 at or near room temperature and in the presence of light suggests that such adducts are not involved directly as intermediates in the high-temperature ring-opening polymerization (ROP) of [PCl2N]3 to give [PCl2N]n. Attempts to catalyze or initiate the ROP of [PCl2N]3 with the addition of [PCl2N]3·HMX4 at room temperature or at 70 °C were not successful.

Surface-Enhanced Infrared Spectroscopy and Neutron Reflectivity Studies of Ubiquinone in Hybrid Bilayer Membranes under Potential Control.

Surface-enhanced infrared adsorption spectroscopy (SEIRAS) and neutron reflectometry (NR) were employed to characterize ubiquinone (UQ) containing hybrid bilayer membranes. The biomimetic membrane was prepared by fusing phospholipid vesicles on a hydrophobic octadecanethiol monolayer self-assembled on a thin gold film. Using SEIRAS, the assembly of the membrane is monitored in situ. The presence of ubiquinone is verified by the characteristic carbonyl peaks from the quinone ester. A well-ordered distal lipid leaflet results from fusion of vesicles with and without the addition of ubiquinone. With applied potential, the hybrid bilayer membrane in the absence of UQ behaves in the same way as previously reported solid supported phospholipid membranes. When ubiquinone is incorporated in the membrane, electric field induced changes in the distal leaflet are suppressed. Changes in the infrared vibrations of the ubiquinone due to applied potential indicate the head groups are located in both polar and nonpolar environments. The spectroscopic data reveal that the isoprenoid unit of the ubiquinone is likely lying in the midplane of the lipid bilayer while the head has some freedom to move within the hydrophobic core. The SEIRAS experiments show redox behavior of UQ incorporated in a model lipid membrane that are otherwise inaccessible with traditional electrochemistry techniques.

Group 13 Lewis acid adducts of [PCl2N]3.

Phosphazene polymers are classically synthesized by the high-temperature, ring-opening polymerization (ROP) of [PCl(2)N](3) to give [PCl(2)N](n), followed by functionalization of [PCl(2)N](n) with different side groups. We investigated the interactions of [PCl(2)N](3) with Lewis acids because Lewis acids have been used to induce the high-temperature ROP of [PCl(2)N](3). The reactions of [PCl(2)N](3) with MX(3) (M = group 13, X = halides), under strict anaerobic conditions gave adducts [PCl(2)N](3)·MX(3). Adducts were characterized by X-ray crystallography and multinuclear and variable-temperature NMR studies, and mechanistic understanding of their fluxional behavior in solution was achieved. The properties of the [PCl(2)N](3)·MX(3) adducts at or near room temperature strongly suggests that such adducts are not involved directly as intermediates in the high-temperature ROP of [PCl(2)N](3).

Crown ether complexes of HPCl6.

The reactions of HCl, PCl5, and a crown ether (12-crown-4 or 18-crown-6) in CHCl3 under anaerobic conditions give complexes of the superacid HPCl6: [H(12-crown-4)][PCl6 ] and [H(18-crown-6)2][PCl6]. The crystal structures indicate that the proton lies roughly in the center of the 12-crown-4 molecule in [H(12-crown-4)][PCl6 ] whereas it lies between two oxygen atoms of two different 18-crown-6 molecules in [H(18-crown-6)2][PCl6].

Cadmium concentration in sea bottom sediment and its potential risk in the upper Gulf of Thailand.

Untreated or partially treated waste water discharge from industrial and domestic sources entering the Upper Gulf of Thailand have been reported to increase cadmium concentration in bottom sediment. This study was directed at providing a better understanding of cadmium transformation in the sediment from the area. Sediment samples collected from Chao Phraya River mouth (CPY), Bang Pakong River mouth (BPK) and Klong Dan estuary (KD) located in the Upper Gulf of Thailand were analyzed for cadmium concentration in various sediment particle size fractions. Using laboratory microcosms, cadmium release from sediment as affected by salinity and sediment redox condition was studied. A higher concentration of cadmium (0.2-0.6 microg/g dry weight) was measured in finer sediment particle size fractions (<0.075 mm) as compared to courser fractions at all sampling stations. Cadmium release from the sediment to water was influenced by both salinity and redox condition. Sediment was spiked with 10 ppm cadmium which is the cadmium level in sediment adopted by the Australia and New Zealand sediment quality guidelines which can cause adverse environmental impacts. Experiments conducted showed soluble cadmium concentration at sediment oxidation reduction conditions representative of bottom sediment were at levels that can adversely impact aquatic organisms, according to the PCADMIUM water quality guideline. In Thailand, there is no sediment quality guideline. Based on these experiments, 10 ppm of cadmium in sediment was recommended as a regulatory guidelines for allowable levels of cadmium in sediment in the study area.

In situ neutron reflectometry investigation of gold-chemisorbed PEO layers of varying chain density: relationship of layer structure to protein resistance.

In work reported previously [L.D. Unsworth, H. Sheardown, J.L. Brash, Langmuir 21 (2005) 1036] we investigated protein interactions with polyethylene oxide (PEO) layers formed by chemisorption of thiol-PEO on gold. It was shown that, as a function of surface chain density, protein adsorption passed through a minimum. In follow-on work reported here, neutron reflectometry (NR) was used to investigate the formation and properties (volume fraction and chain density) of such PEO layers in situ, i.e., in contact with water. Chain density was varied by varying solubility conditions (far from and near the cloud point) and chemisorption time. Neutron experiments were carried out using neutrons of de Broglie wavelength 2.37 A. Contrast matching techniques were used to improve sensitivity. Layers formed under high solubility conditions were found to have PEO volume fraction, layer thickness and chain density of 0.33, 28 A, and 0.56 chains/nm2, respectively, after 0.5 h chemisorption; and 0.31, 28.5 A, and 0.59 chains/nm2, respectively, after 11 h, suggesting that the layer is fully formed within 0.5 h. Both chain density and PEO volume fraction in the chemisorbed layers were significantly greater when the layers were formed under low solubility conditions. The PEO layers shown in our previous work to have maximum protein resistance were found to have a PEO volume fraction of approximately 40%. Moreover the limiting volume fraction in the PEO films formed under low solubility conditions was approximately 57%, a value similar to the solubility limit of PEO in aqueous solution, suggesting that local regions in the layers may be phase separated under these conditions. This may result in increased hydrophobicity and may explain why protein adsorption was found to increase on the layers of higher chain density.

Chemisorption of thiolated poly(ethylene oxide) to gold: surface chain densities measured by ellipsometry and neutron reflectometry.

Physical property studies of surfaces formed by chemisorption of polyethylene oxide (PEO) onto gold are reported. Such surfaces have potential as model materials for elucidation of the mechanism of resistance to protein adsorption by PEO surfaces. Thiolated monomethoxy poly(ethylene oxide) (PEO) was chemisorbed onto gold-coated silicon wafers under various conditions such that different surface chain densities were achieved. Chain density was varied by controlling PEO solubility (proximity to cloud-point conditions) as well as chemisorption time. Films prepared with PEO of molecular weight 750, 2000, and 5000 g/mol were studied. Chain densities determined in the dry state by ellipsometry were found to be in the range of 0.4-0.7, 0.33-0.58, and 0.12-0.30 chains/nm(2) for MW 750, 2000, and 5000 PEO, respectively. Chain density was found to decrease with increasing molecular weight and to increase as cloud-point conditions were approached. PEO-layer mass densities and chain densities were determined independently by neutron reflectometry. Under low-solubility conditions and for a 4-h chemisorption time, film mass and chain density values of 1.0 +/-0.3 g cm(-3) and 1.8 +/- 0.9 chains/nm(2) were found for MW 750 PEO, and 0.82 +/- 0.02 g cm(-3) and 0.23 +/- 0.07 chains/nm(2) for MW 5000 PEO. Ellipsometry data for these systems yielded graft densities of 0.63 +/- 0.13 and 0.30 +/- 0.02 chains/nm(2), respectively. Using the mass densities obtained from the neutron data in the ellipsometry calculations, chain densities of 0.6 +/- 0.3 and 0.25 +/- 0.02 chains/nm(2), respectively, were obtained for the MW 750 and 5000 films. The ellipsometry and neutron data for the MW 5000 system are thus in agreement within experimental error. In general, the chain-density values are much higher than those corresponding to layers of unperturbed random coil PEO ("mushrooms"), suggesting that the PEO layers are in the brush regime with the chains in an extended conformation.

X-ray and neutron reflectometry investigation of Langmuir-Blodgett films of cellulose ethers.

Langmuir-Blodgett films of a series of cellulose ethers are investigated by X-ray and neutron reflectometry. Two types of samples are considered: simple alkyl ethers of cellulose and derivatives obtained by the alkylation of (2-hydroxypropyl)cellulose (HPC). All of the cellulose ethers form stable monolayers at the air-water interface. Significant differences are, however, found in the surface pressure-area compression isotherms. Ethers prepared from HPC typically exhibit larger limiting molecular areas and higher surface pressures than the corresponding simple cellulose ethers. The ease of monolayer transfer to hydrophobic silicon substrates differs greatly from one type of molecule to another. Successful transfer conditions are found only for ethers that form stable monolayers at sufficiently high surface pressures. Surprisingly, deuterated HPC ethers, prepared for neutron reflectivity measurements, exhibit monolayer properties significantly different from those of their hydrogenated analogues. Although essentially identical limiting molecular areas are found, the surface pressure corresponding to a characteristic plateau transition in the compression isotherm is found to decrease by about 8-10 mN m(-1) upon side chain deuteration. X-ray reflectivity results show a linear increase of film thickness with the number of deposited layers, indicating a regular and reproducible transfer. Observed average layer spacings are, however, significantly smaller than the calculated length of fully extended side chains. Neutron reflectivity curves recorded for composite LB films composed of both deuterated and hydrogenated polymers exhibit regular Keissig fringes, but no Bragg peak. This result indicates that these LB films do not possess an internal periodic structure and the initial layer-by-layer organization is lost by large interlayer diffusion.