Each year, an estimated 590,000 infants acquire human immunodeficiency virus type 1 (HIV) infection from their mothers, mostly in developing countries that are unable to implement interventions now standard in the industrialized world. In resource-poor settings, the HIV pandemic has eroded hard-won gains in infant and child survival. Recent clinical trial results from international settings suggest that short-course antiretroviral regimens could significantly reduce perinatal HIV transmission worldwide if research findings could be translated into practice. This article reviews current knowledge of mother-to-child HIV transmission in developing countries, summarizes key findings from the trials, outlines future research requirements, and describes public health challenges of implementing perinatal HIV prevention interventions in resource-poor settings. Public health efforts must also emphasize primary prevention strategies to reduce incident HIV infections among adolescents and women of childbearing age. Successful implementation of available perinatal HIV interventions could substantially improve global child survival.

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As Moore's law reaches its end, traditional computing technology based on the Von Neumann architecture is facing fundamental limits. Among them is poor energy efficiency. This situation motivates the investigation of different processing information paradigms, such as the use of spiking neural networks (SNNs), which also introduce cognitive characteristics. As applications at very high scale are addressed, the energy dissipation needs to be minimized. This effort starts from the neuron cell. In this context, this paper presents the design of an original artificial neuron, in standard 65 nm CMOS technology with optimized energy efficiency. The neuron circuit response is designed as an approximation of the Morris-Lecar theoretical model. In order to implement the non-linear gating variables, which control the ionic channel currents, transistors operating in deep subthreshold are employed. Two different circuit variants describing the neuron model equations have been developed. The first one features spike characteristics, which correlate well with a biological neuron model. The second one is a simplification of the first, designed to exhibit higher spiking frequencies, targeting large scale bio-inspired information processing applications. The most important feature of the fabricated circuits is the energy efficiency of a few femtojoules per spike, which improves prior state-of-the-art by two to three orders of magnitude. This performance is achieved by minimizing two key parameters: the supply voltage and the related membrane capacitance. Meanwhile, the obtained standby power at a resting output does not exceed tens of picowatts. The two variants were sized to 200 and 35 μm2 with the latter reaching a spiking output frequency of 26 kHz. This performance level could address various contexts, such as highly integrated neuro-processors for robotics, neuroscience or medical applications.

Objectives To determine the ability and accuracy of the S-100β protein in predicting prognosis after a moderate or severe traumatic brain injury.Design Systematic review and meta-analysis of randomised controlled trials and observational studies.Data sources Medline, Embase, Cochrane Central Register of Controlled Trials, BIOSIS (from their inception to April 2012), conference abstracts, bibliographies of eligible articles, and relevant narrative reviews.Study selection Two reviewers independently reviewed citations and selected eligible studies, defined as cohort studies or randomised control trials including patients with moderate or severe traumatic brain injury and evaluating the prognostic value of S-100β protein. Outcomes evaluated were mortality, score on the Glasgow outcome scale, or brain death.Data extraction Two independent reviewers extracted data using a standardised form and evaluated the methodological quality of included studies. Pooled results were presented with geometric means ratios and analysed with random effect models. Prespecified sensitivity analyses were performed to explain heterogeneity. ResultsThe search strategy yielded 9228 citations. Two randomised controlled trials and 39 cohort studies were considered eligible (1862 patients). Most studies (n=23) considered Glasgow outcome score ≤3 as an unfavourable outcome. All studies reported at least one measurement of S-100β within 24 hours after traumatic brain injury. There was a significant positive association between S-100β protein concentrations and mortality (12 studies: geometric mean ratio 2.55, 95% confidence interval 2.02 to 3.21, I

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IMPORTANCEThe management of patients with syncope in the emergency department (ED) is challenging because no robust risk tool available has been recommended for clinical use.OBJECTIVE To validate the Canadian Syncope Risk Score (CSRS) in a new cohort of patients with syncope to determine its ability to predict 30-day serious outcomes not evident during index ED evaluation. DESIGN, SETTING, AND PARTICIPANTSThis prospective multicenter cohort study conducted at 9 EDs across Canada included patients 16 years and older who presented to EDs within 24 hours of syncope. Patients were enrolled from March 2014 to April 2018. MAIN OUTCOMES AND MEASURES Baseline characteristics, CSRS predictors, and 30-day adjudicated serious outcomes, including arrhythmic (arrhythmias, interventions for arrhythmia, or unknown cause of death) and nonarrhythmic (myocardial infarction, structural heart disease, pulmonary embolism, or hemorrhage) serious outcomes, were collected. Calibration and discrimination characteristics for CSRS validation were calculated. RESULTS A total of 3819 patients were included (mean [SD] age 53.9 [22.8] years; 2088 [54.7%] female), of whom 139 (3.6%) experienced 30-day serious outcomes, including 13 patients (0.3%) who died. In the validation cohort, there were no differences between the predicted and observed risk, the calibration slope was 1.0, and the area under the receiver operating characteristic curve was 0.91 (95% CI, 0.88-0.93). The empirical probability of a 30-day serious outcome during validation was 3.64% (95% CI, 3.09%-4.28%) compared with the model-predicted probability of 3.17% (95% CI, 2.66%-3.77%; P = .26). The proportion of patients with 30-day serious outcomes increased from 3 of 1631 (0.3%) in the very-low-risk group to 40 of 78 (51.3%) in the very-high-risk group (Cochran-Armitage trend test P < .001). There was a similar significant increase in the serious outcome subtypes with increasing CSRS risk category. None of the very-low-risk and low-risk patients died or experienced ventricular arrhythmia. At a threshold score of −1 (2145 of 3819 patients), the CSRS sensitivity and specificity were 97.8% (95% CI, 93.8%-99.6%) and 44.3% (95% CI, 42.7%-45.9%), respectively. CONCLUSIONS AND RELEVANCEThe CSRS was successfully validated and its use is recommended to guide ED management of patients when serious causes are not identified during index ED evaluation. Very-low-risk and low-risk patients can generally be discharged, while brief hospitalization can be considered for high-risk patients. We believe CSRS implementation has the potential to improve patient safety and health care efficiency.

Purpose of the studyThis study aims to describe all unsolicited electronic invitations received from potential predatory publishers or fraudulent conferences over a 12-month period following the first publication as a corresponding author of a junior academician.Study designUnsolicited invitations received at an institutional email address and perceived to be sent by predatory publishers or fraudulent conferences were collected.ResultsA total of 502 invitations were included of which 177 (35.3%) had subject matter relevant to the recipient’s research interests and previous work. Two hundred and thirty-seven were invitations to publish a manuscript. Few disclosed the publication fees (32, 13.5%) but they frequently reported accepting all types of manuscripts (167, 70.5%) or emphasised on a deadline to submit (165, 69.6%). Invitations came from 39 publishers (range 1 to 87 invitations per publisher). Two hundred and ten invitations from a potential fraudulent conference were received. These meetings were held in Europe (97, 46.2%), North America (65, 31.0%), Asia (20.4%) or other continents (5, 2.4%) and came from 18 meeting organisation groups (range 1 to 137 invitations per organisation). Becoming an editorial board member (30), the editor-in-chief (1), a guest editor for journal special issue (6) and write a book chapter (11) were some of the roles offered in the other invitations included while no invitation to review a manuscript was received.ConclusionsYoung researchers are commonly exposed to predatory publishers and fraudulent conferences following a single publication as a corresponding author. Academic institutions worldwide need to educate and inform young researchers of this emerging problem.

the FI-ED conformed to characteristics previously reported. A FI, developed and validated from a brief geriatric assessment tool could be used to identify ED patients at higher risk of adverse events.