Background: Using methadone maintenance therapy (MMT) clinics to deliver antiretroviral therapy (ART) is an effective strategy to promote treatment initiation and adherence for HIV-positive drug users. This paper describes the implementation barriers perceived by service providers for an intervention pilot designed to integrate ART services in MMT clinics. Methods: The study was conducted in six MMT clinics in Sichuan province, China. Two service providers selected from each of the six clinics underwent training in administering ART. The trained providers delivered ART-related services in their clinics. A focus group was conducted among the service providers to assess their experiences and perceived challenges in delivering integrated services. Results: Barriers at policy, institutional, provider, and client levels were identified. Policy level barriers included household registration restrictions and a lack of insurance coverage for testing expenses. Inefficient coordination between treatment sites and MMT clinics was an obstacle at the institutional level. Insufficient training and added workload were barriers at the provider level. Finally, conflict with daily dosing habits was identified as the primary reason that clients did not accept ART. Conclusion: Although integrating ART into MMT clinics is beneficial, multilevel barriers to implementation need to be addressed. This study documents the need for treatment transferability and insurance coverage, protection of client confidentiality, proper provider training, coordination with treatment sites, and individualized ART service for MMT clients.

A novel, nearly isothermal, nonselective-membrane separation process, membrane vapor extraction (MVE), efficiently recovers butanol from a dilute aqueous solution, for example, from a fermentation broth (Liu et al., 2015). In MVE, feed and solvent liquids are not in contact; they are separated by vapor. Therefore, compared to conventional extraction, MVE avoids formation of difficult-to-separate emulsions. In MVE, a semi-volatile aqueous solute (e.g., butanol) vaporizes at the upstream side of a membrane, diffuses as a vapor through the membrane pores, and subsequently condenses and dissolves into a high-boiling nonpolar solvent, favorable to the solute but not to water. Design analysis of a 1.5-m long, 30-m2membrane-area countercurrent MVE unit for processing 2-wt% aqueous butanol by dodecane solvent at 40 °C indicates over 90% recovery of the feed butanol with essentially no water loss and with very low energy requirement (Liu et al., 2015). The separation factor is over 1500. However, the published design study gives no experimental evidence for the calculated MVE separation. Here, we present experimental data to validate the MVE process. We use an omniphobic (i.e., hydrophobic and oleophobic), 0.2-µm pore-diameter Versapor®200 R membrane (Pall Corporation, Exton, PA) housed in a 6-cm wide by 10-cm long plate-and-frame channeled flow cell with 0.8-cm gap thickness. Membrane transfer area is 28 cm2. The membrane flow cell is designed for minimal axial concentration change and is operated in the transient mode between two recirculating flow loops. 2-wt% aqueous butanol is extracted into dodecane or mesitylene at 25 or 40 °C. Also, 1.5-wt% furfural is extracted into dodecane at 40 °C. Since vapor transport across the membrane contributes minimal resistance, MVE performance is governed by mass transfer through feed and solvent boundary layers. Mass-transfer coefficients are determined from the Graetz-Lévêque analysis of laminar thin-slit flow (Bird et al., 2002). Predicted extraction performance agrees well with experiment using no adjustable parameters. Consistent with the initial multistage-design analysis (Liu et al., 2015), our new bench-scale experimental results confirm that MVE is a viable separation process to recover dilute semi-volatile biosolutes from water with minimal energy requirement. Preliminary analysis of downstream solute recovery from the extract via distillation is more efficient than that for pervaporation because of insignificant water carry over through the MVE membrane.

The causes of individual relapses in children with acute lymphoblastic leukemia (ALL) remain incompletely understood. We evaluated the contribution of germline genetic factors to relapse in 2225 children treated on Children's Oncology Group trial AALL0232. We identified 302 germline single-nucleotide polymorphisms (SNPs) associated with relapse after adjusting for treatment and ancestry and 715 additional SNPs associated with relapse in an ancestry-specific manner. We tested for replication of these relapse-associated SNPs in external data sets of antileukemic drug pharmacokinetics and pharmacodynamics and an independent clinical cohort. 224 SNPs were associated with rapid drug clearance or drug resistance, and 32 were replicated in the independent cohort. The adverse risk associated with black and Hispanic ancestries was attenuated by addition of the 4 SNPs most strongly associated with relapse in these populations (for blacks: model without SNPs hazard ratio (HR)=2.32, P=2.27 × 10^-4, model with SNPs HR=1.07, P=0.79; for Hispanics: model without SNPs HR=1.7, P=8.23 × 10^-5, model with SNPs HR=1.31, P=0.065). Relapse SNPs associated with asparaginase resistance or allergy were overrepresented among SNPs associated with relapse in the more asparaginase intensive treatment arm (20/54 in Capizzi-methorexate arm vs 8/54 in high-dose methotrexate arm, P=0.015). Inherited genetic variation contributes to race-specific and treatment-specific relapse risk.

The CUORE (Cryogenic Underground Observatory for Rare Events) experiment will search for neutrinoless double beta decay in 130 Te. Observation of the process would unambiguously establish that neutrinos are Majorana particles as well as provide information about the absolute neutrino mass scale and mass hierarchy.The CUORE setup will consist of an array of 988 tellurium dioxide crystals (containing 206 kg of 130 Te in total), operated as bolometers at a temperature of ∼10mK. The experiment is now under construction at the Gran Sasso National Laboratory in Italy. As a first step towards CUORE, a tower (CUORE-0) has been assembled and is taking data. Here a detailed description of the CUORE-0 tower and its performance is reported. The status of the CUORE experiment and its expected sensitivity will then be discussed. © 2014 Springer Science+Business Media New York.

With 741 kg of TeO2crystals and an excellent energy resolution of 5 keV (0.2%) at the region of interest, the CUORE (Cryogenic Underground Observatory for Rare Events) experiment aims at searching for neutrinoless double beta decay of130Te with unprecedented sensitivity. Expected to start data taking in 2015, CUORE is currently in an advanced construction phase at LNGS. CUORE projected neutrinoless double beta decay half-life sensitivity is 1.6 × 1026y at 1σ (9.5 × 1025y at the 90 % confidence level), in five years of live time, corresponding to an upper limit on the effective Majorana mass in the range 40-100 meV (50-130 meV). Further background rejection with auxiliary bolometric detectors could improve CUORE sensitivity and competitiveness of bolometric detectors towards a full analysis of the inverted neutrino mass hierarchy. CUORE-0 was built to test and demonstrate the performance of the upcoming CUORE experiment. It consists of a single CUORE tower (52 TeO2bolometers of 750 g each, arranged in a 13 floor structure) constructed strictly following CUORE recipes both for materials and assembly procedures. An experiment its own, CUORE-0 is expected to reach a sensitivity to the ββ(0ν) half-life of130Te around 3×1024y in one year of live time. We present an update of the data, corresponding to an exposure of 18.1 kg y. An analysis of the background indicates that the CUORE performance goal is satisfied while the sensitivity goal is within reach.

We present a study of the sensitivity and discovery potential of CUORE, a bolometric double-beta decay experiment under construction at the Laboratori Nazionali del Gran Sasso in Italy. Two approaches to the computation of experimental sensitivity for various background scenarios are presented, and an extension of the sensitivity formulation to the discovery potential case is also discussed. Assuming a background rate of 10^-2 cts/(keV kg y), we find that, after 5 years of live time, CUORE has a 1 sigma sensitivity to the neutrinoless double-beta decay half-life of T_1/2(1 sigma) = 1.6 \times 10^26 y and thus a potential to probe the effective Majorana neutrino mass down to 40-100 meV; the sensitivity at 1.64 sigma, which corresponds to 90% C.L., will be T_1/2(1.64 sigma) = 9.5 \times 10^25 y. This range is compared with the claim of observation of neutrinoless double-beta decay in 76Ge and the preferred range of the neutrino mass parameter space from oscillation results.

The CUORE (Cryogenic Underground Observatory for Rare Events) experiment will search for neutrinoless double beta decay in {Mathematical expression}Te. Observation of the process would unambiguously establish that neutrinos are Majorana particles as well as provide information about the absolute neutrino mass scale and mass hierarchy.The CUORE setup will consist of an array of 988 tellurium dioxide crystals (containing 206 kg of {Mathematical expression}Te in total), operated as bolometers at a temperature of {Mathematical expression}10 mK. The experiment is now under construction at the Gran Sasso National Laboratory in Italy. As a first step towards CUORE, a tower (CUORE-0) has been assembled and is taking data. Here a detailed description of the CUORE-0 tower and its performance is reported. The status of the CUORE experiment and its expected sensitivity will then be discussed. © 2014 Springer Science+Business Media New York.