Paving the way for affordable and equitable liposomal amphotericin B access worldwide.

Amphotericin B has long been crucial for treating many serious infectious diseases, such as invasive fungal infections and visceral leishmaniasis, particularly for patients who are immunocompromised, including those with advanced HIV infection. The conventional amphotericin B deoxycholate formulation has largely been replaced in high-income countries with liposomal amphotericin B (LAmB), which has many advantages, including lower rates of adverse events, such as nephrotoxicity and anaemia. Despite an evident need for LAmB in low-income and middle-income countries, where mortality from invasive fungal infections is still substantial, many low-income and middle-income countries still often use the amphotericin B deoxycholate formulation because of a small number of generic formulations and the high price of the originator LAmB.

Access to Medicines for Treating People With Cryptococcal Meningitis.

Cryptococcal meningitis accounts for 1 in 5 AIDS-related deaths globally. World Health Organization guidelines strongly recommend a single high dose of liposomal amphotericin B as part of preferred treatment, but this drug remains unaffordable in most low- and middle-income countries. A proactive approach is needed from manufacturers and other stakeholders to improve access.

A Global Building Occupant Behavior Database.

This paper introduces a database of 34 field-measured building occupant behavior datasets collected from 15 countries and 39 institutions across 10 climatic zones covering various building types in both commercial and residential sectors. This is a comprehensive global database about building occupant behavior. The database includes occupancy patterns (i.

Understanding occupants' behaviour, engagement, emotion, and comfort indoors with heterogeneous sensors and wearables.

We conducted a field study at a K-12 private school in the suburbs of Melbourne, Australia. The data capture contained two elements: First, a 5-month longitudinal field study In-Gauge using two outdoor weather stations, as well as indoor weather stations in 17 classrooms and temperature sensors on the vents of occupant-controlled room air-conditioners; these were collated into individual datasets for each classroom at a 5-minute logging frequency, including additional data on occupant presence. The dataset was used to derive predictive models of how occupants operate room air-conditioning units.

Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission.

Viral hepatitis is a major public health threat and a leading cause of death worldwide. Annual mortality from viral hepatitis is similar to that of other major infectious diseases such as HIV and tuberculosis. Highly effective prevention measures and treatments have made the global elimination of viral hepatitis a realistic goal, endorsed by all WHO member states.

Strategies for access to affordable hepatitis C testing and treatment in Asia.

Purpose Of Review: With increasing availability of generic direct-acting antivirals (DAAs) and associated price reductions, various governments, multilateral institutions, and donors have started providing testing and treatment for hepatitis C virus (HCV) infection. More data on the quality of these generic medicines and on cost-effectiveness of their use are becoming widely available. This review seeks to describe some of the treatment programs for HCV that are evolving in Cambodia, India, Indonesia, Malaysia, Myanmar, and Thailand.

Leave no one behind: response to new evidence and guidelines for the management of cryptococcal meningitis in low-income and middle-income countries.

In 2018, WHO issued guidelines for the diagnosis, prevention, and management of HIV-related cryptococcal disease. Two strategies are recommended to reduce the high mortality associated with HIV-related cryptococcal meningitis in low-income and middle-income countries (LMICs): optimised combination therapies for confirmed meningitis cases and cryptococcal antigen screening programmes for ambulatory people living with HIV who access care. WHO's preferred therapy for the treatment of HIV-related cryptococcal meningitis in LMICs is 1 week of amphotericin B plus flucytosine, and the alternative therapy is 2 weeks of fluconazole plus flucytosine.

Outcomes of Primary Endodontic Therapy Provided by Endodontic Specialists Compared with Other Providers.

Introduction: The objective of this study was to compare the outcomes of initial nonsurgical root canal therapy for different tooth types provided by both endodontists and other providers.

Methods: By using an insurance company database, 487,476 initial nonsurgical root canal therapy procedures were followed from the time of treatment to the presence of an untoward event indicated by Current Dental Terminology codes for retreatment, apical surgery, or extraction. Population demographics were computed for provider type and tooth location.

Circadian rhythms in axillary skin surface pH.

Sweat and skin surface pH are critical parameters in determining the performance of antiperspirants. The mechanism of action, the so-called 'plug theory' first proposed by Reller and Luedders, involves the expression of eccrine sweat onto the surface of the skin into which the solid antiperspirant salts, typically an aluminium chlorohydrate or zirconium aluminium glycine, dissolve. The resultant acidic 'solution' then diffuses with time into the sweat glands, where it hydrolyses in more alkaline sweat and forms an amorphous metal hydroxide agglomerate that physically plugs the ducts some 20-100 mum into the glands.

Erroneous gender differences in axillary skin surface/sweat pH.

Assessing accurately the pH of axillary eccrine sweat is of vital importance in the antiperspirant industry. Eccrine sweat pH is a critical parameter in determining the effectiveness of antiperspirants; antiperspirant salts dissolve in sweat and diffuse into the sweat glands, where the resultant acidic solution hydrolyses in more alkaline sweat forming an amorphous metal hydroxide gel, thereby restricting the flow of eccrine sweat. Comparison of the skin surface and sweat pH of males and females reported in the literature shows that, although consistent male/female differences have been observed on the forearm, determination of significant gender-based pH differences across other sites are less conclusive.

Effect of antiperspirants on whole body sweat rate and thermoregulation.

It is well established that the evaporation of sweat from the human body surface is the main mechanism by which heat balance is maintained following a rise in body core temperature. Since the introduction of the first brand name antiperspirant in the United States during the early 1900s, antiperspirant products designed to control underarm wetness have grown to represent one of the largest cosmetic categories in most global markets. However, although axillary sweating only constitutes less than 1% of whole body sweat rate, consumers, particularly in hot countries, have begun to articulate the concern that antiperspirants may interfere with the body's natural cooling process.

A comparison of bupivacaine-fentanyl-morphine with bupivacaine-fentanyl-diamorphine for caesarean section under spinal anaesthesia.

In a randomised double-blind trial, postoperative analgesia and side effects of intrathecal morphine 0.1 mg and intrathecal diamorphine 0.25 mg were compared.

Combined spinal epidural anaesthesia for caesarean section: a randomised comparison of Oxford, lateral and sitting positions.

Maternal position during induction of intrathecal anaesthesia for caesarean section influences block height and haemodynamic stability. In a randomised study of 90 women presenting for elective caesarean section using combined spinal-epidural anaesthesia, three positions were compared--the Oxford position (group O), the right lateral to supine wedged (group R) and the sitting to supine wedged (group S). Hyperbaric bupivacaine 12.

Na+/H+ exchangers in the human eccrine sweat duct.

Using an anti-NHE1 antibody, we demonstrate the presence of a Na+/H+ exchanger of isoform 1 (NHE1) in the human eccrine sweat duct. A strong staining was observed at the basolateral membrane of the outer cell layer (NHE1basal), at the junction between inner and outer cells layers (NHE1inter), and along the lateral membranes (NHE1later) of all cells of the duct. At the luminal membrane, no staining was demonstrated either for NHE1 or NHE3.

V-type H+-ATPase in the human eccrine sweat duct: immunolocalization and functional demonstration.

We investigated for the presence of a vacuolar-type H+-ATPase (V-ATPase) in the human eccrine sweat duct (SD). With the use of immunocytochemistry, an anti-V- ATPase antibody showed a strong staining at the apical membrane and a weaker one in the cytoplasm. Cold preservation followed by rewarming did not alter this staining pattern.

Vacuolar-type H+ -ATPase distribution in unstimulated and acetylcholine-activated isolated human eccrine sweat glands.

The presence and cellular distribution of subunits of the V1 sector of the vacuolar-type H+ -ATPase (V-ATPase) was investigated in isolated human eccrine sweat glands. In every instance, V-ATPase was located in the cytoplasm and apical membranes of the luminal cells of the reabsorptive duct segment. In the secretory coil, both diffuse and perinuclear staining was demonstrated in the secretory cells, with additional expression at the apical and basolateral membranes and on the intercellular canaliculi.