Hermannmccoy9723

s. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.BACKGROUND Evidence to inform cryptococcal antigen (CrAg)-screening guidelines among antiretroviral therapy (ART)-experienced populations are lacking. We performed a study evaluating the utility of reflex CrAg-screening in Gaborone, Botswana. METHODS CD4 count data were collected from samples tested at the HIV reference laboratory from 2014-2016. CrAg screening was performed on samples with CD4 ≤100 cells/µL beginning January 2015. The proportion of CD4 counts ≤100 cells/µL was determined and the frequency and utility of repeat CrAg-testing described. Analyses were performed to ascertain the impact of ART-status on CrAg-prevalence and outcomes, and whether baseline CrAg titers could be used for risk stratification. RESULTS Overall, 5.6% (3,335/59,300) of individuals tested had a CD4 ≤100 cells/μL; 2,108 samples with CD4 ≤100 cells/μl from 1,645 unique patients were CrAg-tested. Over half of samples were from ART-experienced individuals 40.9% (863) on ART, and 12.1% (255) defaulters; 22% (463) of CrAg tests were on repeat samples. CrAg-prevalence was 4.8% (72/1,494, 95%CI3.8-6.0%) among outpatients and 21.9% (32/151, 95%CI15.3-28.5%) among inpatients. CrAg-prevalence rates did not differ significantly by ART-status, but 6-month mortality was significantly lower in CrAg-positive individuals on ART at screening. Ten new CrAg-positives were identified through repeat testing. A CrAg titer cut-point of ≥180 provided the best discrimination for 6-month survival. CONCLUSIONS CrAg-positivity rates in an ART-experienced population were comparable to those seen in ART-naïve populations. Repeat screening identified individuals who seroconverted to CrAg-positivity and were at risk of cryptococcal disease. CrAg titers ≥180 can help identify the individuals at highest risk of death for more intensive management. © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.BACKGROUND This study assessed characteristics of sanitation and hygiene facilities in a slum community in Kampala, Uganda. METHODS We conducted a household-based cross-sectional study among 395 households in Kasubi slum using a semi-structured questionnaire and observational checklist to collect data. RESULTS Almost 98.0% (387/395) of households owned a sanitation facility and 77.0% (298/387) shared it with other households. The most common type of sanitation facility was a pit latrine with slab (66.9% [259/387]). Most (90.5% [305/337]) latrines had a door or shutter, a roof (92.9% [313/337]) and a depth >1.5 m (68.2% [229/337]). Overall, 21.3% (84/395) and 65.6% (259/395) of households had improved and functional sanitation facilities, respectively. Only 16.5% (65/395) of the households had a hand-washing facility. Enarodustat molecular weight Student-led (adjusted prevalence rate [PR] 2.67 [95% confidence interval [CI] 1.83-3.94]) and households that owned their house (adjusted PR 2.17 [95% CI 1.33-3.53]) were 2.67 and 2.17 times more likely to have improved sanitation facilities, respectively. Households that owned their house (adjusted PR 1.90 [95% CI 1.18-3.05]) were 1.9 times more likely to possess a hand-washing facility. CONCLUSIONS The coverage of improved sanitation and hygiene facilities was low. The majority of households were using a shared pit latrine with a slab that had no hand-washing facility. Sanitation and hygiene interventions should prioritize improving sanitation and hygiene facilities. © The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.Spontaneous preterm birth is a global health issue affecting up to 20% of pregnancies, and leaves a legacy of neurodevelopmental complications. Inflammation has been implicated in a significant proportion of preterm births, where pro-inflammatory insults trigger production of additional pro-inflammatory and pro-labor mediators. Thus, novel therapeutics that can target inflammation may be a novel avenue for preventing preterm birth and improving adverse fetal outcomes. Short-chain fatty acids (SCFAs), such as butyrate and propionate, are dietary metabolites produced by bacterial fermentation of fibre in the gut. SCFAs are known to possess anti-inflammatory properties and have been found to function through G-coupled-receptors and histone deacetylases. Therefore, this study aimed to investigate the effect of SCFAs on pro-inflammatory and pro-labor mediators in an in vitro model of preterm birth. Primary human cells isolated from myometrium and fetal membranes (decidua, amnion mesenchymal and amnion epithelial cropean Society of Human Reproduction and Embryology. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.BACKGROUND Chemokine signaling may contribute to progression of low grade gliomas (LGGs) by altering tumor behavior or impacting the tumor microenvironment. In this study, we investigated the role of CX3CR1 signaling in malignant transformation of LGGs. METHODS Ninety patients with LGGs were genotyped for the presence of common CX3CR1 V249I polymorphism and examined for genotype dependent alterations in survival, gene expression, and tumor microenvironment. A genetically-engineered mouse model was leveraged to model endogenous intracranial gliomas with targeted expression of CX3CL1 and CX3CR1, individually or in combination. RESULTS LGG patients who were heterozygous (V/I; n = 43) or homozygous (I/I; n = 2) for the CX3CR1 V249I polymorphism had significantly improved median overall (14.8 versus 9.8 years, P less then 0.05) and progression-free survival (8.6 versus 6.5 years, P less then 0.05) compared to those with the wild type genotype (V/V; n = 45). Tumors from the V/I + I/I group exhibited significantly decreased levels of CCL2 and MMP9 transcripts, correlating with reduced intratumoral M2 macrophage infiltration and microvessel density. In an immunocompetent mouse model of LGGs, co-expression of CX3CL1 and CX3CR1 promoted a more malignant tumor phenotype characterized by increased microglia/macrophage infiltration and microvessel density, resulting in shorter survival. CONCLUSIONS CX3CR1 V249I polymorphism is associated with improved overall and progression-free survival in LGGs. CX3CR1 signaling enhances accumulation of tumor associated microglia/macrophages and angiogenesis during malignant transformation. © The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.