HPV vaccines: a controversial issue?

Controversy still exists over whether the benefits of the available HPV vaccines outweigh the risks and this has suppressed uptake of the HPV vaccines in comparison to other vaccines. Concerns about HPV vaccine safety have led some physicians, healthcare officials and parents to withhold the recommended vaccination from the target population. The most common reason for not administering the prophylactic HPV vaccines are concerns over adverse effects. The aim of this review is the assessment of peer-reviewed scientific data related to measurable outcomes from the use of HPV vaccines throughout the world with focused attention on the potential adverse effects. We found that the majority of studies continue to suggest a positive risk-benefit from vaccination against HPV, with minimal documented adverse effects, which is consistent with other vaccines. However, much of the published scientific data regarding the safety of HPV vaccines appears to originate from within the financially competitive HPV vaccine market. We advocate a more independent monitoring system for vaccine immunogenicity and adverse effects to address potential conflicts of interest with regular systematic literature reviews by qualified individuals to vigilantly assess and communicate adverse effects associated with HPV vaccination. Finally, our evaluation suggests that an expanded use of HPV vaccine into more diverse populations, particularly those living in low-resource settings, would provide numerous health and social benefits.

Diagnosing schistosomiasis: where are we?

In light of the World Health Organization's initiative to extend schistosomiasis morbidity and mortality control programs by including a disease elimination strategy in low endemic settings, this paper reviews diagnostic tools described during the last decades and provide an overview of ongoing efforts in making an efficient diagnostic tool available worldwide. A literature search on PubMed using the search criteria schistosomiasis and diagnosis within the period from 1978 to 2013 was carried out. Articles with abstract in English and that used laboratory techniques specifically developed for the detection of schistosomiasis in humans were included. Publications were categorized according to the methodology applied (parasitological, immunological, or molecular) and stage of development (in house development, limited field, or large scale field testing). The initial research generated 4,535 publications, of which only 643 met the inclusion criteria. The vast majority (537) of the publications focused on immunological techniques; 81 focused on parasitological diagnosis, and 25 focused on molecular diagnostic methods. Regarding the stage of development, 307 papers referred to in-house development, 202 referred to limited field tests, and 134 referred to large scale field testing. The data obtained show that promising new diagnostic tools, especially for Schistosoma antigen and deoxyribonucleic acid (DNA) detection, which are characterized by high sensitivity and specificity, are being developed. In combination with international funding initiatives these tools may result in a significant step forward in successful disease elimination and surveillance, which is to make efficient tests accessible and its large use self-sustainable for control programs in endemic countries.

Comparative evaluation under routine conditions of the nitrate reduction assay, the proportion assay and the MGIT 960 assay for drug susceptibility testing of clinical isolates of Mycobacterium tuberculosis

The performance of the nitrate reductase assay (NRA) was compared with the proportion method (PM) on Lowenstein-Jensen medium and the BACTEC MGIT960 assay under routine conditions using 160 clinical isolates of Mycobacterium tuberculosis with a high proportion of resistant strains. The mean time to obtain results was 8.8 days and the overall agreements between NRA and PM and NRA and M960 were 95% and 94%, respectively. NRA was easy to perform and represents a useful tool for the rapid screening of drug-resistant M. tuberculosis strains in low-resource countries.

Prevalence of HIV type 1 drug resistance mutations in treatment-naïve and experienced patients from resource-limited settings with universal access to antiretroviral therapy: a survey in two small Brazilian cities

Concerns have been raised that universal availability of antiretroviral agents in resource-limited settings might lead to the emergence and spread of resistant strains. We present the largest survey on human immunodeficiency virus type 1 (HIV-1) resistance among treatment-naïve and experienced patients followed in small, relatively underprivileged cities in Brazil with universal availability to standard of care antiretroviral combinations. Samples were collected between 2004 and 2006 from 95 patients followed in the cities of Saquarema and Santo Antonio de Pádua, state of Rio de Janeiro. A proviral fragment encompassing protease and reverse transcriptase (RT) regions was generated and drug susceptibility level was inferred. Among 50 strains from drug-naïve subjects, one (2%) had intermediate-level resistance to RT inhibitors. Among 38 patients on therapy as of sampling, 28 (73.7%) had plasma viral load (PVL) below detection limit (26 of whom without evidence of resistance mutations) and 11 (28.9%) harbored strains with reduced susceptibility. Only two strains harbored both protease and RT inhibitor mutations. Among seven patients who were off-treatment as of sampling, two (28.5%) harbored strains with reduced susceptibility to RT inhibitors. The relatively high frequency of undetectable PVL among patients on treatment and the overall low prevalence of resistance-associated mutations are reassuring. Continued surveillance, however, is necessary.

Cutaneous sporotrichosis treatment with potassium iodide: a 24 year experience in São Paulo state, Brazil

BACKGROUND: Sporotrichosis is a subacute or chronic disease caused by a dimorphic fungus, Sporothrix schenckii. The first and most traditional treatment is potassium iodide in satured solution (SSKI) used by DE BEURMANN in 1907. For its effectiveness, it is still used for cutaneous sporotrichosis. OBJECTIVE: To evaluate the treatment of cutaneous sporotrichosis with SSKI in relation to clinical cure, side effects, length of treatment and reactivation. METHODS: We conducted a retrospective analysis of medical records over a 24-year period (1981-2005). Patients of all ages who were treated in the hospital´s division of dermatology were included in the study providing that they had a positive culture of S. schenckii. Satured solution of potassium iodide (3 to 6g per day) was the treatment prescribed. For children, half of the dose was prescribed. RESULTS: The lymphocutaneous disease was prevalent, the cure rate was 94.7%, side effects were described in 5.5% of the cases, mean length of treatment was 3.5 months and possible reactivation was observed in 11.1%. CONCLUSION: SSKI is an effective drug, with many side effects, but with low frequency. Resolution was for maximum six months of treatment. SSKI has been found to be a very effective drug in this retrospective study of culture-proven cases of cutaneous and lymphocutaneous sporotrichosis. It should be used as first drug of choice especially in resource-limited settings.

Resource partitioning and ecomorphological variation in two syntopic species of Lebiasinidae (Characiformes) in an Amazonian stream

ABSTRACTResource partitioning is important for species coexistence. Species with similar ecomorphology are potential competitors, especially when phylogenetically close, due to niche conservatism. The aim of this study was to investigate the resource partitioning among populations of two species of lebiasinids (Copella nigrofasciata and Pyrrhulina aff. brevis) that co-occur in a first-order Amazonian stream, analyzing the trophic ecology, feeding strategies and ecomorphological attributes related to the use of food and space by these species. Fish were captured in May and September 2010. The stomach contents of 60 individuals were analyzed and quantified volumetrically to characterize the feeding ecology of both species. Eleven morphological attributes were measured in 20 specimens and combined in nine ecomorphological indices. Both species had an omnivorous-invertivorous diet and consumed predominantly allochthonous items. Both showed a tendency to a generalist diet, but intrapopulational variation in resource use was also detected. Overall feeding niche overlap was high, but differed between seasons: low during the rainy season and high in the dry season. In the latter, the food niche overlap was asymmetric because C. nigrofasciata consumed several prey of P. aff. brevis, which reduced its food spectrum. The ecomorphological analysis suggests that C. nigrofasciatahas greater swimming capacity (greater relative length of caudal peduncle) than P. aff. brevis, which has greater maneuverability and tendency to inhabit lentic environments (greater relative depth of the body). Our results demonstrate that these species have similar trophic ecology and suggest a spatial segregation, given by morphological differences related to locomotion and occupation of habitat, favoring their coexistence.

A genotyping study of human immunodeficiency virus type-1 drug resistance in a small Brazilian municipality

In Brazil, surveillance studies on antiretroviral drug resistance among drug-naïve and treatment-experienced patients have focused primarily on patients living in large urban centers. As the epidemic spreads towards small municipalities and the innermost parts of the country, it will be essential to monitor the prevalence of antiretroviral drug resistance in these areas. We report the first survey on the prevalence of antiretroviral drug resistance in a small Brazilian municipality. Between July 1999 and March 2005, 72 adult human immunodeficiency virus type-1(HIV-1)-infected patients received care at the Municipal HIV/AIDS Program of the small, southeastern municipality of Miracema, state of Rio de Janeiro. A genotyping study of antiretroviral drug resistance was performed in 54 patients. Among 27 samples from treatment-experienced patients, 9 (33.3%) harbored strains with reduced drug susceptibility. Among these, 6 had reduced susceptibility to reverse transcriptase (RT) inhibitors and 3 to both RT and protease inhibitors. No primary antiretroviral drug resistance was recorded among 27 drug-naïve subjects. The relatively low prevalence of resistance mutations in the Miracema cohort argues against the concern that resource-poor settings should not implement widespread accessibility to standard of care antiretroviral combinations due to the possibility of sub-optimal adherence leading to the emergence and spread of drug-resistant strains.

Papaya seedlings growth using a low-cost, automatic watering controller

The study assessed growth and physiological parameters of 'Sunrise Golden' and 'Tainung 01' papaya seedlings grown in 280mL plastic tubes and watered using a low-cost automatic irrigation system adjusted to operate at substrate water tension for starting irrigation (STI) of 3.0, 6.0 or 9.0 kPa. The water depths applied by the dripping system and drainage were monitored during germination and seedling growth. Germination, emergence velocity index (EVI), leaf area, plant height, shoot and root dry weight, stomatal conductance, relative water content (RWC) and relative chlorophyll content (RCC) were evaluated. Soil nutrient levels were determined by electrical conductivity (EC). Water use efficiency (WUE) corresponded to the ratio of plant dry mass to depth of water applied. STI settings did not affect papaya germination or EVI. System configuration to 3.0 and 6.0 kPa STI exhibited the highest drainage and lowest EC and RCC, indicating soil nutrient loss and plant nutrient deficiency. Drainage was greater in tubes planted with the 'Tainung 01' variety, which developed smaller root systems and lower stomatal conductance than 'Sunrise Golden' seedlings. The highest values for shoot dry weight and WEU were obtained at 6.0 kPa STI for 'Sunrise Golden' (0.62 g and 0.69 g L-1) and at 9.0 kPa in 'Tainung 01' (0.35 g and 0.82 g L-1). RWC at 9.0 kPa STI was lower than at 3.0 kPa in both varieties. The results indicate that the low-cost technology developed for irrigation automation is promising. Even so, new studies are needed to evaluate low-flow irrigation systems as well as the nutrient and water needs of different papaya varieties.

Nasal CPAP in the delivery room for newborns with extremely low birth weight in a hospital in a developing country

The objective of this study was to determine the feasibility of the use of continuous positive airway pressure installed prophylactically in the delivery room (DR-CPAP), for infants with a birth weight between 500 and 1000 g in settings with limited resources. During 23 months, infants with a birth weight between 500 and 1000 g consecutively received DR-CPAP. A total of 33 infants with low birth weight were enrolled, 16 (48.5%) were females. Only 14 (42.4%) received antenatal corticosteroids and only 2 of those 14 (14.3%) infants weighing 500-750 g were not intubated in the delivery room, and apnea was given as the reason for intubation of these patients. Of the 19 infants in the 751-1000 g weight range, 9 (47.4%) were intubated in the delivery room, 6 due to apnea and 3 due to respiratory discomfort. For DR-CPAP to be successful, it is probably necessary for preterm babies to be more prepared at birth to withstand the respiratory effort without the need for intubation. Antenatal corticosteroids and better prenatal monitoring are fundamental for success of DR-CPAP.

Chinese energy policy progress and challenges in the transition to low carbon development, 2006-2013

If the world is not to jeopardize the chances for human life on Earth, climate change must be mitigated; therefore, achieving low carbon development is crucial. China is the world's greatest GHG emitter, energy producer and energy consumer; investigating its energy-climate policy developments and international positions are of utmost importance to understand and tackle current stumbling blocks of the global energy and climate governance.

Selection of full-sib families of Panicum maximum Jacq under low light conditions

The silvopastoral system is a viable technological alternative to extensive cattle grazing, however, for it to be successful, forage grass genotypes adapted to reduced light need to be identified. The objective of this study was to select progenies of Panicum maximum tolerant to low light conditions for use in breeding programs and to study the genetic control and performance of some traits associated with shade tolerance. Six full-sib progenies were evaluated in full sun, 50% and 70% of light reduction in pots and subjected to cuttings. Progeny genotypic values ​​(GV) increased with light reduction in relation to plant height (H) and specific leaf area (SLA). The traits total dry mass accumulation (DM) and leaf dry mass accumulation (LDM) had GV higher in 50% shade and intermediate in 70% shade. The GV of tiller number (TIL) and root dry mass accumulation (RDM) decreased with light reduction. The highest positive correlations were obtained for the traits H and RDM with SLA and DM; the highest negative correlations were between TIL and SLA and RDM, and H and LDM. The progenies showed higher tolerance to 50% light reduction and, among them, two stood out and will be used in breeding programs. It was also found that it is not necessary to evaluate some traits under all light conditions. All traits had high broad sense heritability and high genotypic correlation between progenies in all light intensities. There is genetic difference among the progenies regarding the response to different light intensities, which will allow selection for shade tolerance

Budgeting and resource allocation in universities: a public choice approach

The calls for colleges and universities to improve their productivity are coming thick and fast in Brazil. Many studies are suggesting evaluation systems and external criteria to control the quality of teaching and research in universities. Since universities and colleges are not profit-oriented organizations (considering only the legitimate and serious research and teaching organizations, of course), the traditional microeconomics and administrative variables used to measure efficiency do not have any direct function. An alternative would be to create an "as if" market control system to evaluate performance in universities and colleges. Internal budget and resources allocation mechanism can be used as incentive instruments to improve quality and productivity. It will be the main issue of this article.

COGNITIVE LEGITIMACY, RESOURCE ACCESS, AND ORGANIZATIONAL OUTCOMES

Previous research has demonstrated the importance of developing legitimacy initiatives in order to create new business opportunities, satisfy shareholders, and obtain access to resources. Within this framework, cognitive legitimacy plays a key role. Through a case study of six Spanish public universities, the authors measure the relationship between cognitive legitimacy, access to resources, and organizational results. The results support the assertion that organizations with more cognitive legitimacy have greater access to resources and improved their results. This study contributes with muchneeded empirical research on cognitive legitimacy and demonstrates its usefulness as an explanative factor of organizational success.

Enterprise Resource Planning governamental: a percepção dos servidores atuantes no Projeto Ciclo do Ministério da Justiça quanto à implementação

Indubitavelmente, a implementação de sistemas de gestão integrada é fator consolidado em empresas privadas; no entanto, em empresas públicas é relativamente recente e inovadora. Em 2009, o Ministério da Justiça (MJ) foi um dos pioneiros ao firmar parceria com a Universidade Federal do Rio Grande do Norte (UFRN) para a implantação de sistemas de gestão integrada. Com o decorrer dos processos de implementação surge a necessidade de identificar se o acordo surtiu os efeitos a que se destinou, bem como é pertinente a análise da implementação de um Enterprise Resource Planning (ERP) governamental em uma empresa pública, haja vista que existe uma tendência de que se repita em outras instituições governamentais. Assim, o principal objetivo deste artigo é identificar a percepção dos usuários quanto ao processo de implementação de sistemas integrados de gestão vinculados ao Projeto Ciclo, no âmbito da Secretaria Executiva do MJ, destacando suas principais dificuldades e benefícios. A fim de atingir o objetivo da pesquisa foi realizada uma pesquisa quali-quantitativa, cujo procedimento técnico foi o estudo de caso. Verificou-se que os usuários do sistema reconhecem sua importância como apoio à tomada de decisão, que estão cientes do papel que desempenham no processo de implementação e que a tecnologia da informação (TI) é fundamental para se obter melhoria nos processos executados. Ademais, percebe-se os avanços que um ERP governamental pode proporcionar a empresas públicas, destacando-se o planejamento e a confiabilidade das informações.