Details of the search questions and strategy (including the defin

Details of the search questions and strategy (including the definition of populations, interventions and outcomes) are outlined in Appendix 2. BHIVA adult ART guidelines were last published in 2008 [4]. For the 2012 guidelines the literature search dates were 1 January 2008 to 16 September 2011 and included MEDLINE, EMBASE and the Cochrane library. Abstracts from selected conferences (see Appendix 2) were searched between 1 January 2009 and 16

September 2011. For each topic and healthcare question, evidence was identified and evaluated by Writing Group members C646 chemical structure with expertise in the field. Using the modified GRADE system (Appendix 1), panel members were responsible for assessing and grading the quality of evidence for predefined outcomes across studies and developing and grading

the strength of recommendations. An important aspect of evaluating evidence is an understanding of the design and analysis of clinical trials, including the use of surrogate marker data. Limited further searches concerning specific third agents (rilpivirine [RPV] and elvitegravir [ELV]/cobicistat [COBI]) covering the period from September 2011 were carried out in 2013. For a number of questions, GRADE evidence profile and summary of findings tables were constructed, using predefined and rated treatment outcomes (Appendix 3), to help achieve consensus for key recommendations

and aid transparency of the process. Before final approval by the Writing Group, the guidelines were published online for public consultation and an external peer review was commissioned. BHIVA views the involvement of patient and community representatives in the guideline development process as essential. The Writing Group included two patient representatives appointed through the UK HIV Community Advisory Board (UK CAB) who were involved in all aspects of the guideline development Cell press process. In addition, two meetings with patients and community representatives were held to discuss and receive feedback and comment on the proposed guideline recommendations. The first was held before the Writing Group’s consensus meeting and the second as part of the public consultation process. The GRADE Working Group [3] has developed an approach to grading evidence that moves away from initial reliance on study design to consider the overall quality of evidence across outcomes. BHIVA has adopted the modified GRADE system for its guideline development.

Since the widespread introduction of HAART, the duration of respo

Since the widespread introduction of HAART, the duration of responses to treatment for KS has increased [66] and no further randomized trials have compared liposomal anthracyclines with nonencapsulated, anthracycline-based regimens. The safety and tolerability of these drugs in combination with HAART has been evaluated. In one study of 54 patients, 82% had a see more response within 8 weeks and the PLD-HAART combination was well tolerated with no evidence of suppression of CD4 cell counts [95]. In a cohort study of 50 patients treated with concomitant HAART and liposomal anthracycline chemotherapy for

KS, there was no decline in CD4 cell count or rise in HIV viral load [96]. These findings suggest that standard opportunistic infection prophylaxis guidelines may be followed when treating patients with liposomal anthracycline chemotherapy for KS. Based on the response rates, median response durations and the toxicity profile, liposomal anthracyclines are considered first-line chemotherapy for advanced KS (level of evidence 1A). Like vinca alkaloids, taxanes bind to the β subunit of α/β tubulin

and disrupt microtubules leading to mitotic arrest and subsequent cell death. Paclitaxel also promotes Romidepsin price apoptosis by binding to Bcl-2 via the same mechanism [97]. In a number of phase II trials, paclitaxel was shown to have single-agent activity against AIDS-KS; furthermore, these studies included a number of patients who had previously received anthracyclines [98–102]. One

Phase II study of paclitaxel (135 mg/m2 every 3 weeks) for KS, enrolled 28 patients and reported a response rate of 71%. This included four (14%) patients who had received anthracyclines but Methisazone no patients received HAART [99]. A second, larger study of 56 patients included 20 (36%) who received a protease inhibitor at some stage during the study and 40 (70%) who had received prior therapy for KS that included liposomal anthracyclines in 17 (30%). The overall objective response rate was 59% and the median response duration was 10.4 months [100]. A first-line study for advanced, symptomatic KS randomized 73 patients between paclitaxel 100 mg/m2 every 2 weeks and PLD 20 mg/m2 every 3 weeks; 73% patients received HAART (see Table 3.3) [103]. Treatment was associated with significant improvements in pain and swelling, for both arms. There was no significant difference between the arms in response rates, progression-free or overall survival at 2 years, and slightly higher rates of grade 3–4 toxicity for paclitaxel (84% vs. 66%, p = 0.07). Progression-free survival for both arms in this study was higher than those reported in the pre-HAART era. Pharmacokinetic studies revealed higher paclitaxel levels in patients taking protease inhibitors, though this did not have any obvious clinical impact [104]. Two studies have addressed the role of paclitaxel as second-line chemotherapy.

HIV, for which risk was overestimated by 75% of our FBT, has rece

HIV, for which risk was overestimated by 75% of our FBT, has received extensive public media attention worldwide, and Shell followed suit between 2003 and 2006 by launching awareness programs in over 60 countries. We postulate that global efforts to focus detailed information on high-risk groups only would aid in dispelling disproportionate fear among those at low risk. The statistical association of BAY 57-1293 datasheet typhoid risk overestimation with seeking company health advice demonstrates overexaggeration of typhoid

risk specifically within Shell’s travel clinic.[11] More careful evaluation of the real typhoid risk to the traveler would allow Shell health care professionals to reduce the number of unnecessary typhoid vaccinations. More accurate knowledge will nevertheless do little to reduce infectious disease-related morbidity if it does not lead to preventative

Z-VAD-FMK ic50 behavior. For this, adequate time to complete required vaccination schedules is paramount, and it is therefore of concern that almost one third (27%) of trips were planned within 2 weeks of departure. There is evidence to suggest that both short-notice and business travelers tend to adopt more high-risk behavior.[12] We cannot make conclusive statements about compliance, as preventative behavior was not measured in our survey. However, these previous findings imply that the sizeable group of Shell FBT embarking on short-notice trips may be at higher risk of acquiring disease

than the rest of the cohort. Several drawbacks to this study require attention. First, self-registration of FBT and the voluntary nature of the questionnaire may have introduced responder bias; FBT with more confidence in the accuracy of their risk perception, for instance, may have been more likely to complete the survey, thus raising knowledge scores. Second, our specific FBT definition also necessitates caution when comparing this cohort to other business travelers. Additionally, traveler risk depends as much on the individual travel profile as on trip location, so WHO country prevalence data are an imprecise proxy marker for traveler risk. The 55% FBT underestimation Reverse transcriptase of polio risk, for instance, is artificially high. Wild transmission occurring within local populations of countries with poorly implemented childhood immunization programs (including the common FBT destinations of India and Nigeria) is of negligible actual risk to a vaccinated traveler.[13] Our study would have benefited greatly from closer assessment of vaccination status, as well as trip features such as location, hygiene standards, access to health services, and FBT adherence to simple prevention measures. We can only hypothesize, based on the high level of compliance to malaria prophylaxis among the same FBT (92%),[5] that adherence to prevention measures for other infectious diseases would also be high.

The latter confirms our previous results from heterologous expres

The latter confirms our previous results from heterologous expression systems. Collectively, our results indicate that Zn2+ at low concentrations Selleck GS-1101 enhances LTP by modulating P2X receptors. Although it is not yet clear which purinergic receptor subtype(s) is responsible for these effects on LTP, the data presented here suggest that P2X4 but not P2X7 is involved. “
“Despite its fundamental relevance for representing the emotional world surrounding us, human affective neuroscience research has

widely neglected the auditory system, at least in comparison to the visual domain. Here, we have investigated the spatiotemporal dynamics of human affective auditory processing using time-sensitive whole-head magnetoencephalography. A novel and highly challenging affective associative learning procedure, ‘MultiCS conditioning’, involving multiple conditioned stimuli (CS) per affective category, was adopted to test whether previous findings from intramodal conditioning of multiple click-tones with an equal number of auditory emotional scenes (Bröckelmann et al., 2011 J. Neurosci., 31, 7801) would generalise to crossmodal conditioning of multiple click-tones with an electric Palbociclib supplier shock as single aversive somatosensory unconditioned stimulus (UCS). Event-related magnetic fields were recorded in response to

40 click-tones before and after four contingent pairings of 20 CS with a shock and the other half remaining unpaired. In line with previous findings from intramodal MultiCS conditioning we found an affect-specific modulation of

the auditory N1m component 100–150 ms post-stimulus within a distributed frontal–temporal–parietal neural network. Increased activation for shock-associated tones was lateralised to right-hemispheric regions, whereas unpaired safety-signalling tones were preferentially processed in the left hemisphere. Participants did not Rebamipide show explicit awareness of the contingent CS–UCS relationship, yet behavioural conditioning effects were indicated on an indirect measure of stimulus valence. Our findings imply converging evidence for a rapid and highly differentiating affect-specific modulation of the auditory N1m after intramodal as well crossmodal MultiCS conditioning and a correspondence of the modulating impact of emotional attention on early affective processing in vision and audition. Despite its fundamental relevance for representing the emotional world surrounding us (King & Nelken, 2009), affective neuroscience research has rarely been concerned with how emotionally salient auditory stimuli are processed by the human brain. The few existing studies applying hemodynamic measures have revealed affect-specific prioritised processing of auditory stimuli within a distributed network of emotion-related and sensory-specific brain regions, comprising the amygdala and prefrontal and temporal cortex (Hugdahl et al., 1995; Morris et al., 1997; Royet et al.

All these results led us to the conclusion that Sch9 regulated lo

All these results led us to the conclusion that Sch9 regulated localization of Bcy1 via Zds1. Bcy1 modification was found to be dependent on Yak1 (Griffioen et al., 2001). It was reported that faster-migrating iso-form of Bcy1-HA was detected in exponential phase wild-type cells, whereas a predominant slower-migrating iso-form of Bcy1-HA was

detected in stationary phase wild-type cells. But a predominant faster-migrating iso-form of Bcy1-HA was detected Osimertinib clinical trial in yak1Δ mutant in either exponential phase or stationary phase. Recently, we reported that the faster-migrating iso-form of Bcy1-HA was detected in sch9Δ mutant cells, either in exponential phase or in stationary phase (Zhang et al., 2011). To investigate whether Sch9 regulated Bcy1 phosphorylation via Yak1, we tested whether Sch9 affected the protein level of Yak1. Figure 7a, shows that the protein level of Yak1 in log-phase glucose-grown sch9Δ cells (Line 2) was markedly lower than in log phase glucose-grown W303-1A (Line 1). The protein level of Yak1 in stationary phase W303-1A (Line 3) was dramatically lower than in the log-phase W303-1A (Line 1), whereas a predominant slower-migrating iso-form Selleck SB525334 of Yak1-HA was detected in stationary phase sch9Δ (Line 4). As shown in Fig. 7b, the protein level of Yak1 in glycerol-grown sch9Δ cells was markedly lower than in glycerol-grown W303-1A (Line 1). Phosphatase treatment of this

slower-migrating iso-form of Yak1-HA resulted in the fast-migrating iso-form of Yak1-HA (Fig. 7b). These results suggest that Sch9 is involved in the regulation of Yak1 phosphorylation. In multicellular organisms, AKAPs targeted PKA holoenzyme to specific subcellular locations (Griffioen & Thevelein, 2002). AKAP-mediated targeting of PKA was thought to confer spatio-temporal control of PKA signaling to phosphorylate specific localized substrates. Compartmentalization of signal transduction pathways is an important spatio-temporal control of PKA signaling. In this way, signaling molecules of the same pathway are

brought into close vicinity, thereby increasing the probability that they only affect each other appropriately. Recently, we reported that Bcy1 was predominately localized in nucleus in sch9Δ cells, whereas a large part of catalytic subunits of PKA transferred from nucleus into cytoplasm in sch9Δ cells (Zhang et al., 2011). Thus the liberated catalytic subunits were not restricted by the regulatory subunits and consequently able to phosphorylate preferentially substrates located nearby (e.g. fructose-1,6-bisphosphatase, trehalase), all leading to a high PKA activity phenotype of sch9Δ cells. Our research indicated that Sch9 regulated localization of Bcy1 via Zds1. In yeast, Zds1 may act as the anchor protein of PKA. We report for the first time that Sch9 and Zds1 interact physically. However, the mechanisms of Sch9 regulating Zds1 still need to be clarified.

The experiments were prepared in

triplicate and repeated

The experiments were prepared in

triplicate and repeated three times. Bacterial cultures were centrifuged at 3000 g for 5 min at 4 °C to pellet the cells. The supernatants were removed and the bacterial cells were washed with sterile water three times. Then the cells were resuspended in PDB dilutions (PDB 1 : 50) to yield different working concentrations (0.33, 1, 1.67, 2.33, 3.0 and 3.67 × 107 CFU mL−1, using dilution plating on nutrient agar). These solutions were used to bioassay for trap formation. The negative controls were PDB dilutions (PDB 1 : 50). The experiments were prepared in triplicate and repeated three times. Bacteria buy Alectinib cells were obtained as described above and resuspended in PDB dilutions (1 : 50) containing 20% v/v bacterial cell-free

culture filtrate to yield different working concentrations (0.33, 1, 1.67, 2.33, 3.0 and 3.67 × 107 CFU mL−1). These solutions were used to bioassay for trap formation. The negative controls were 20% NB (v/v) prepared by PDB dilutions (PDB 1 : 50). The experiments were prepared in triplicate BAY 73-4506 and repeated three times. Bacterial cells were resuspended to yield working concentrations of 1.67 × 107 CFU mL−1 in PDB dilutions (1 : 50) containing 5%, 10%, 20%, 30% or 40% v/v bacterial cell-free culture filtrates. These solutions were used to assay trap formation. Four control plates were included in each test run. Two control plates were PDB dilutions (PDB 1 : 50) containing 5% NB (v/v) without or with bacterial cells (final concentration, 1.67 × 107 CFU mL−1). And the other two were PDB dilutions (PDB 1 : 50) containing 40% NB (v/v) without or with bacterial cells (final concentration, 1.67 × 107 CFU mL−1). The experiments were prepared in triplicate and repeated three times. Arthrobotrys oligospora conidia were cocultivated with bacterial cells (final concentration, 1.67 × 107 CFU mL−1) containing or not containing 20%

bacterial cell-free culture filtrates in PDB dilution (PDB Carnitine palmitoyltransferase II 1 : 50). Arthrobotrys oligospora conidia were cocultivated (PDB 1 : 50) with bacterial cells (final concentration, 1.67 × 107 CFU mL−1) in sterile water. Negative controls were PDB dilution (PDB 1 : 50) containing 20% NB (v/v) or sterile water. Fungal pellets absorbed by variable volume pipette were placed into another Petri plate and washed with 10 mL sterile water three times, mounted on a stub and coated with gold. The specimens were examined using a FEI Quanta 200 scanning electron microscope from FEI Company (Hillsboro) in the high-vacuum mode at 20 kV. Each treatment was performed in duplicate and the experiment was repeated three times. Bacterial cells were resuspended to a working concentration of 1.67 × 107 CFU mL−1 prepared by sterile water or a nutrient solution consisting of PDB, a series of dilutions of PDB (1 : 5, 1 : 10, 1 : 20, 1 : 30, 1 : 50, 1 : 100, 1 : 200) containing 20% v/v bacterial cell-free culture filtrates. These solutions were used to assay trap formation.

Control rats (n = 6; implanted but not

Control rats (n = 6; implanted but not Compound Library price stimulated) and rats that did not develop SE during stimulation (non-SE rats; killed 3–4 months after stimulation (n = 4), were also included. Rats were disconnected from the EEG recording set-up and deeply anaesthetized with pentobarbital (Nembutal, intraperitoneally, 60 mg/kg). For immunocytochemistry, the animals were perfused through the ascending aorta with 300 mL of 0.37% Na2S solution, followed by 300 mL 4% paraformaldehyde in 0.1 m phosphate buffer, pH 7.4. Thereafter, the brains were removed, incubated for 72 h in 0.3 m EDTA, pH 6.7 (Merck,

Amsterdam, The Netherlands) and paraffin embedded. Paraffin-embedded tissue was sectioned at 6 μm, mounted on pre-coated glass slides (Star Frost, Waldemar Knittel GmbH, Brunschweig, Germany) and used for in situ hybridizations and immunocytochemistry. Horizontal sections were analysed at a mid-level of the brain (5300–6100 μm below cortex surface). In situ hybridization

was performed on two adjacent serial hippocampal sections from each group (control, n = 6; 24 h, n = 4; 1 week, n = 6; 3–4 months, n = 6). Two additional serial slices were used for the double-staining, combining in situ hybridization with immunocytochemistry (in the same slices) with different antibodies, as described below. The human cases included in this study were obtained from the files of the Department of Neuropathology of the Academic Medical Center (AMC, University of Amsterdam) and the VU University Medical Center (VUMC). Ten patients LEE011 ic50 Decitabine purchase underwent resection of the hippocampus for medically intractable TLE. Informed consent was obtained for the use of brain tissue and for access to medical records for research

purposes. All samples were obtained and used in a manner compliant with the Declaration of Helsinki. Two neuropathologists reviewed all cases independently. In six cases a pathological diagnosis of HS (without extra-hippocampal pathology) was made. The HS specimens include four cases of classical HS (grade 3, mesial temporal sclerosis type 1a) and two cases of severe HS (grade IV; mesial temporal sclerosis type 1b; Wyler et al., 1992; Blumcke et al., 2007). Four non-HS cases, in which a focal lesion (ganglioglioma not involving the hippocampus proper) was identified, were also included to provide a comparison group to HS cases. Control hippocampal tissue was obtained at autopsy from five patients without history of seizures or other neurological diseases. Brain tissue from a patient with viral encephalitis was also used for in situ hybridization (as positive control for miR-146a expression). All autopsies were performed within 12 h after death. Table 1 summarizes the clinical features of TLE and control cases.

In this case, the conditions for the generation of the MRM-trigge

In this case, the conditions for the generation of the MRM-triggered spectra were as follows: DP ramped from 25 to 50, CE 15-45, CXP 12. AHL with or

without a 3-oxo or a 3-hydroxy substitution and with an acyl side chain length of 4 (C4-HSL, 3-oxo-C4-HSL and 3-hydroxy-C4-HSL), 6 (C6-HSL, 3-oxo-C6-HSL and 3-176 hydroxy-C6- HSL), 7 (C7-HSL), 8 (C8-HSL, 3-oxo-C8-HSL and 3-hydroxy-C8-HSL), 10 (C10-HSL, 3-oxo-C10-HSL and 3-hydroxy-C10-HSL), 12 (C12-HSL, 3-oxo-C12-HSL and 3-hydroxy-C12-HSL), 13 (C13-HSL, 3-oxo-C13-HSL and 3-hydroxy-C13-HSL) or 14 (C14-HSL, 3-oxo-C14-HSL and 3-hydroxy-C14-HSL) were used as standards. Acyl-HSLs were identified and confirmed by comparing both the elution time and the spectra from any peaks obtained with those of the standards. Chromobacterium AZD4547 cell line violaceum-based solid plate assays (McClean et al., 1997) were carried out to detect AHL degradation activity in T. maritimum NCIMB2154T. Two different sensor strains were used to detect AHL degradation. Chromobacterium violaceum CV026 (McClean et al., 1997) was used to measure the degradation of C6-HSL and C. violaceum VIR07 was used to measure the degradation of C10-HSL (Morohoshi et al., 2008). Twenty microlitres

of stock solutions of C6-HSL or C10-HSL were added to 500 μL of an overnight culture of T. maritimum NCIMB2154T Epacadostat in vivo in MB (final concentration 2 μg mL−1) and incubated for 24 h at 20 °C. The same amount of AHL was added to 500 μL of spent culture medium obtained from a 24-h-old culture by filtration through 0.22 μm. The amount of remaining AHL in the culture media of T. maritimum was evaluated in LB plates overlaid with 5 mL of semi-solid LB agar seeded with 500 μL of overnight cultures of C. violaceum CV026 for C6-HSL or C. violaceum VIR07 for C10-HSL. Fifty microlitres of Nutlin-3 culture supernatants were loaded in wells and adjusted to 100 μL with distilled water. Sterile MB and MB plus C4 or C10-SHLs were set as controls. The same experiment was carried out in FMM broth (data not

shown). Plates were incubated for 12–24 h and the production of violacein was examined. To evaluate the possible type of AHL degradation activity, two flasks with 15 mL of FMM were supplemented with C10-HSL to a final concentration of 2 μg mL−1. One of them was inoculated with 1 mL of a 48-h culture of T. maritimum NCIMB2154T and the other was maintained as control. Flasks were incubated in a shaker at 22 °C under soft agitation (110 r.p.m.). After 24 h, 500 μL of normal and acidified culture media were extracted three times with ethyl acetate, dehumidified onto MgSO4, evaporated under nitrogen flux and resuspended in acetonitrile for LC-MS analysis as described above. Before inoculation, 500 μL of FMM+C10-HSL were also extracted and the value of C10-HSL obtained was used to calculate the percentage of degradation.

We therefore propose that this particular

link should be

We therefore propose that this particular

link should be taken into consideration in future studies to better understand the presently hidden carbon fluxes within the microbial trophic food webs. “
“Afipia felis, a Gram-negative alphaproteobacterium, selleck inhibitor has been implicated as one of the causative agents of cat scratch disease. To identify and begin to examine the virulence traits of this organism, we developed and tested a highly efficient transposon delivery system and a stable plasmid vector expressing green fluorescent protein. The transposome system is based on a Tn5-derived transposon and a phage restriction endonuclease type I inhibitor. Electroporation of this construct produced a library of >2600 mutants, which were screened for flagella biosynthesis mutants using a monoclonal antibody to Afipia flagellin. Insertion loci for two selected mutants were located in the genes for flagellin and flagellin biosynthesis FlhA, confirming the validity of the approach. Afipia felis is a Gram-negative alphaproteobacterium and one of the causative agents of cat scratch disease, a usually benign lymphadenopathy (English et al.,

1988). The genus Afipia comprises 10 species with some evidence that Afipiae other than A. felis can also be pathogenic under certain circumstances. Afipia felis is a facultative intracellular bacterium, it inhabits an unusual and

not classically endocytic compartment in murine macrophages and it can invade some nonprofessionally phagocytic mammalian selleckchem cells (Birkness et al., 1992; La Scola et al., 2000; Lührmann et al., 2001). We were interested in studying the molecular basis of A. felis pathogenicity; however, no tools were available. Therefore, we designed and tested a transposon mutagenesis system and a stable vector that expressed green fluorescent protein (GFP) in Afipia. With the future availability of genome sequences from Afipia, it would be possible to genetically complement mutants of interest. Work by others had shown that transposomes, linear Tn5-derived transposon constructs with purified hyperactive transposase already attached (Goryshin et al., 2000), could be successfully used Edoxaban for the mutagenesis of a wide range of bacteria, such as Gram-positive Rhodococcus (Sydor et al., 2008), Gram-negative Bartonella henselae (Riess et al., 2003) and Francisella tularensis (Kawula et al., 2004). Technical advantages of this system include the irreversibility of the mutagenesis, as bacteria do not normally provide the Tn5 transposase functions in trans making these mutations stable. In addition, no donor bacteria are necessary to introduce the transposome, because, here, introduction is by electroporation.

This study has certain limitations While other research used onl

This study has certain limitations. While other research used only surrogate markers for region of origin, we classified regions of origin based on participants’ nationality,

which is most frequently used for international comparison at present [35]. selleck kinase inhibitor However, use of nationality cannot discriminate between those who have immigrant status and those who have adopted Swiss nationality by marriage, which has important social implications. Another limitation is that it was not possible to make regular comprehensive linkages with the national death registry, for legal and technical reasons. With respect to cohort participation, undocumented immigrants do not even seek medical care in the existing network of HIV practitioners. Therefore, the participation bias is probably still underestimated. The strength of the SHCS is its national representativeness. Of note, a recent comparison with sales data from pharmaceutical companies revealed that 75% of the antiretroviral drugs sold in Switzerland from 2006 to 2008 were prescribed to participants in the SHCS [14]. Further, the nationwide network enabled us to assess cohort nonparticipation. In conclusion, numbers of HIV-infected

immigrants are increasing in the SHCS but immigrants are underrepresented in the SHCS, and are more likely to be lost to follow-up. Our data on nonparticipation, ART status and LTFU suggest that quality of care for immigrants may be less optimal, although healthcare Navitoclax insurance for all persons living in Switzerland

is mandatory. Thus, qualitative research is needed to analyse underlying reasons for nonparticipation Epothilone B (EPO906, Patupilone) and LTFU of immigrants, also taking into account gender differences. To increase enrolment in the SHCS, enhance adherence to cohort visits and increase ART uptake and adherence to ART, for the benefit of vulnerable groups in Switzerland, and in Europe generally, we propose (i) to motivate immigrants to participate in the cohort and encourage them to remain in the cohort; (ii) to make use of mediators from sub-Saharan Africa with training in the support of people with HIV infection; (iii) to recruit male mediators who are able to follow up African men in a gender-sensitive way; (iv) to obtain information on the structural characteristics of local immigrant communities and enhance the empowerment of immigrants; and (v) to improve the training of Swiss healthcare providers in transcultural competency [36]. We are grateful to all participants in the SHCS, and to the care givers, study nurses and data managers. Furthermore, we thank Martin Gebhardt from the Swiss Federal Office of Public Health for discussing HIV surveillance data with us.