Smithdowd8191

INTRODUCTION Real-time electronic adherence monitoring (EAM) systems could inform on-going risk assessment for HIV viraemia and be used to personalize viral load testing schedules. We evaluated the potential of real-time EAM (transferred via cellular signal) and standard EAM (downloaded via USB cable) in rural Uganda to inform individually differentiated viral load testing strategies by applying machine learning approaches. METHODS We evaluated an observational cohort of persons living with HIV and treated with antiretroviral therapy (ART) who were monitored longitudinally with standard EAM from 2005 to 2011 and real-time EAM from 2011 to 2015. Super learner, an ensemble machine learning method, was used to develop a tool for targeting viral load testing to detect viraemia (>1000 copies/ml) based on clinical (CD4 count, ART regimen), viral load and demographic data, together with EAM-based adherence. Using sample-splitting (cross-validation), we evaluated area under the receiver operating characteristic curveof tests by 69%, but resulted in delayed detection of viraemia a mean of 74 days for 84% of individuals with viraemia. Similar rules derived from standard EAM also resulted in potential testing frequency reductions. CONCLUSIONS Our machine learning approach demonstrates potential for combining EAM data with other clinical measures to develop a selective testing rule that reduces number of viral load tests ordered, while still identifying those at highest risk for viraemia. © 2020 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.Mitochondria are cellular organelles that orchestrate a vast range of biological processes, from energy production and metabolism to cell death and inflammation. Despite this seemingly symbiotic relationship, mitochondria harbour within them a potent agonist of innate immunity their own genome. Release of mitochondrial DNA into the cytoplasm and out into the extracellular milieu activates a plethora of different pattern recognition receptors and innate immune responses, including cGAS-STING, TLR9 and inflammasome formation leading to, among others, robust type I interferon responses. In this Review, we discuss how mtDNA can be released from the mitochondria, the various inflammatory pathways triggered by mtDNA release and its myriad biological consequences for health and disease. © 2020 The Authors. Published under the terms of the CC BY 4.0 license.The COVID-19 pandemic has rapidly evolved and changed our way of life in an unprecedented manner. The emergence of COVID-19 has impacted transplantation worldwide. The impact has not been just restricted to issues pertaining to donors or recipients, but also health care resource utilization as the intensity of cases in certain jurisdictions exceeds available capacity. Here we provide a personal viewpoint representing different jurisdictions from around the world in order to outline the impact of the current COVID-19 pandemic on organ transplantation. Based on our collective experience, we discuss mitigation strategies such as donor screening, resource planning and a staged approach to transplant volume considerations as local resource issues demand. We also discuss issues related to transplant-related research during the pandemic, the role of transplant infectious diseases and the influence of transplant societies for education and disseminating current information. This article is protected by copyright. All rights reserved.Chemical reactions induced by plasmons achieve effective solar-to-chemical energy conversion. However, the mechanism of these reactions, which generate a strong electric field, hot carriers, and heat through the excitation and decay processes, is still controversial. In addition, it is not fully understood which factor governs the mechanism. To obtain mechanistic knowledge, we investigated the plasmon-induced dissociation of a single-molecule strongly chemisorbed on a metal surface, two O2 species chemisorbed on Ag(110) with different orientations and electronic structures, using a scanning tunneling microscope (STM) combined with light irradiation at 5 K. A combination of quantitative analysis by the STM and density functional theory calculations revealed that the hot carriers are transferred to the antibonding (π*) orbitals of O2 strongly hybridized with the metal states and that the dominant pathway and reaction yield are determined by the electronic structures formed by the molecule-metal chemical interaction. © 2020 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.Photothermal therapy (PTT) has attracted great attention due to its non-invasive and effective cancer therapy. Various photothermal agents (PTAs) including organic PTAs and inorganic PTAs have been developed in the last decades. Organic PTAs based on small molecular dyes exhibit great potential in future clinical applications considering their good biocompatibility and easy chemical modification or functionalization. Dactinomycin research buy In this review, we discuss the recent progress of organic PTAs based on small molecular dyes for enhanced PTT. We summary the strategies to improve the light penetration of PTAs, methods to enhance the photothermal conversion efficiency, how to optimize the PTAs delivery into deep tumors, and how to resist photobleaching under repeated laser irradiation. We hope this review can arise the interest of the researchers into the field of PTAs based on small molecular dyes and fabricate next-generation PTAs for non-invasive cancer therapy. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.BACKGROUND Early involvement of palliative care and advance care planning improves quality of life outcomes and survival for patients with advanced lung cancer, however there are barriers to implementation. AIMS AND METHODS A single-centre prospective audit reviewing "Goals of Care" (GOC) form completion and palliative care referrals in an oncology clinic was undertaken with the aim of increasing GOC completion and palliative care referrals for patients with advanced lung cancer. Involved physicians attended a communication skills course and then received a communication-priming interventions. Clinicopathological factors associated with GOC completion and palliative care referral were explored. RESULTS 84 patients receiving palliative treatment for advanced lung cancer were enrolled. Clinicopathological factors, such as poorer performance status were associated with higher likelihood of GOC completion (p = 0.018) prior to the intervention. Male sex (p = 0.023), absence of a sensitising EGFR mutation or ALK rearrangement (p = 0.