Progress towards Elimination of HIV Mother-to-Child Transmission in the Dominican Republic from 1999 to 2011

In 1999, prevention of mother-to-child transmission (pMTCT) using antiretrovirals was introduced in the Dominican Republic (DR). Highly active antiretroviral therapy (HAART) was introduced for immunosuppressed persons in 2004 and for pMTCT in 2008. To assess progress towards MTCT elimination, data from requisitions for HIV nucleic acid amplification tests for diagnosis of HIV infection in perinatally exposed infants born in the DR from 1999 to 2011 were analyzed. The MTCT rate was 142/1,274 (11.1%) in 1999–2008 and 12/302 (4.0%) in 2009–2011 (), with a rate of 154/1,576 (9.8%) for both periods combined. This decline was associated with significant increases in the proportions of women who received prenatal HAART (from 12.3% to 67.9%) and infants who received exclusive formula feeding (from 76.3% to 86.1%) and declines in proportions of women who received no prenatal antiretrovirals (from 31.9% to 12.2%) or received only single-dose nevirapine (from 39.5% to 19.5%). In 2007, over 95% of DR pregnant women received prenatal care, HIV testing, and professionally attended delivery. However, only 58% of women in underserved sugarcane plantation communities (2007) and 76% in HIV sentinel surveillance hospitals (2003–2005) received their HIV test results. HIV-MTCT elimination is feasible but persistent lack of access to critical pMTCT measures must be addressed.

Assessment of silicone polymer composites for the trace extraction of herbicides : a tool for environmental forensics

Passive samplers are not only a versatile tool to integrate environmental concentrations of pollutants, but also to avoid the use of live sentinel organisms for environmental monitoring. This study introduced the use of magnetic silicone polymer composites (Fe-PDMS) as passive sampling media to pre-concentrate a wide range of analytes from environmental settings. The composite samplers were assessed for their accumulation properties by performing lab experiments with two model herbicides (Atrazine and Irgarol 1051) and evaluated for their uptake properties from environmental settings (waters and sediments). The Fe-PDMS composites showed good accumulation of herbicides and pesticides from both freshwater and saltwater settings and the accumulation mechanism was positively correlated with the log Kow value of individual analytes. Results from the studies show that these composites could be easily used for a wide number of applications such as monitoring, cleanup, and/or bioaccumulation modeling, and as a non-intrusive and nondestructive monitoring tool for environmental forensic purposes.

Prisons, Profits, and Hard Labor: A Brief History of Convict Labor In Florida

The purpose of this research is to develop a broader understanding of the system in Florida. Specifically, I am looking at the privatization of convict labor programs by the Prison Rehabilitative Industries and Diversified Enterprises Corporation (PRIDE) in the 1980s and 1990s in state correctional institutions. This research will contribute to historiography of prisons in Florida in the context of the developing research about the Prison-Industrial Complex. Many scholars studying the Prison-Industrial Complex have drawn comparisons to today’s prison industries and the convict lease system of the late 19th and early 20th centuries, seeing the prison system go full circle drawing attention to the exploitative and institutionally racist nature of the modern prison system. This researched showed that the trend other scholars have studied also exist in Florida and Florida was actually a pioneer in the Prison-Industrial Complex. It was the first state to privatize its convict labor programs, becoming a model for other states. This research also shows that political and economic motivations were the primary forces governing prison policies, rather than education, rehabilitation, and safety. To complete this project, I analyzed articles from South Florida newspapers, such as the Sun-Sentinel and the Miami Herald, published during this period as well as literature published by the Department of Corrections. The United States has the highest rate of incarceration in the world and spends more money on prisons than education. Being such a large part of country, prisons warrant more critical study. This research will shed light on the nature of prisons, specifically here in Florida, in the hopes of seeking alternatives.

Prisons, Profits, and Hard Labor: A Brief History of Convict Labor In Florida

The purpose of this research is to develop a broader understanding of the system in Florida. Specifically, I am looking at the privatization of convict labor programs by the Prison Rehabilitative Industries and Diversified Enterprises Corporation (PRIDE) in the 1980s and 1990s in state correctional institutions. This research will contribute to historiography of prisons in Florida in the context of the developing research about the Prison-Industrial Complex. Many scholars studying the Prison-Industrial Complex have drawn comparisons to today’s prison industries and the convict lease system of the late 19th and early 20th centuries, seeing the prison system go full circle drawing attention to the exploitative and institutionally racist nature of the modern prison system. This researched showed that the trend other scholars have studied also exist in Florida and Florida was actually a pioneer in the Prison-Industrial Complex. It was the first state to privatize its convict labor programs, becoming a model for other states. This research also shows that political and economic motivations were the primary forces governing prison policies, rather than education, rehabilitation, and safety. To complete this project, I analyzed articles from South Florida newspapers, such as the Sun-Sentinel and the Miami Herald, published during this period as well as literature published by the Department of Corrections. The United States has the highest rate of incarceration in the world and spends more money on prisons than education. Being such a large part of country, prisons warrant more critical study. This research will shed light on the nature of prisons, specifically here in Florida, in the hopes of seeking alternatives.

Hydrography, current and microstructure measurements from R/V Håkon Mosby cruise HM2012610 to the Faroe Bank Channel overflow region

This data set includes the profiling measurements collected from ship during the cruise HM 2012610 onboard the Research Vessel Håkon Mosby. The cruise was conducted under the project entitled "Faroe Bank Channel Overflow: Dynamics and Mixing Research", with an objective to investigate the mixing and entrainment of the dense oceanic overflow from the Faroe Bank Channel. The profiling measurements delivered with this data set include conventional conductivity-temperature-depth (CTD) measurements, current profile measurements using a lowered acoustic Doppler Current Profiler (LADCP) system and ocean microstructure measurements using a vertical microstructure profiler (VMP2000). The observational programme was designed to measure turbulence and mixing in the overflow plume which, in addition to the shear-induced mixing at the plume-ambient interface, is hypothesized to be influenced by several processes including mesoscale eddies, secondary circulation and internal waves.

Segurança do paciente em terapia intensiva neonatal: identificação e análise de eventos adversos

The patient safety is a major concern in health services for its global dimension, as evidenced by the fragility of care processes that predispose an occurrence of adverse events. These events in a neonatal intensive care unit are considered serious and hazardous to lives of newborns. The present study aimed to identify and analyze adverse events in a neonatal intensive care unit based in Trigger Tool. It is an epidemiological, cross-sectional , exploratory, retrospective study with quantitative, descriptive and analytical approach, performed in 2015 at a school hospital. The sample was not probabilistic, involving 116 newborns who met the eligibility criteria. Data collection was performed by retrospective review of medical records, using a specific kind of "trigger" instrument, composed of sentinel events in neonatology, adapted from the American model used by the Vermont-Oxford Network. Data were analyzed using descriptive and inferential statistics. The chi-square test for linear trend was used to assess the associations between the variables of interest. The research received a favorable agreement from Ethics Committee of the Federal University of Rio Grande do Norte, under number 1055533, and Presentation Certificate for Ethics Assessment 43894515.6.0000.5537. The results show among investigated newborns, 110 experienced at least one adverse event during their stay, with a total of 391 medical records analyzed and rate of 3.37 events per patient. Prevailed the preterm newborns with low birth weight, from mother who had hypertensive diseases during pregnancy and urinary tract infection. The average hospitalization time was 25 days, associated with hospital-acquired infections events (p = 0.01). Among the identified adverse events stood out the events related to thermoregulation disorders (39.0%), with prevalence of hypothermia (26.0%), followed by health care-related infections (16.4%) and blood glucose disorders, hypoglycemia (9.00%) and hyperglycemia (6.64%). Most of these incidents were classified in categories E and F, which represents that there was damage small proportion. Due to these damages come from the care practice with newborn, 78% were classified as avoidable. There was statistically significant association between the variable birth weight with infections (p = 0.006) as well as peri/intraventricular bleeding (p = 0.02), hypoglycemia (p = 0.021), hyperglycemia (p = 0.001), hyperthermia (p = 0.39) and death (p=0,02). Gestational age was associated with seizures (p = 0.002), hyperglycemia (p=0.017) e hyperthermia (p=0.027). The security institution culture was reported by the health workers as intermediate, even though the number of adverse events found in only one unit of service indicates that there is much to be done. Thus the high rate of adverse events identified in the neonatal intensive care unit reinforces the necessity to elaborate specific preventive strategies for this risk environment.

Segurança do paciente em terapia intensiva neonatal: identificação e análise de eventos adversos

The patient safety is a major concern in health services for its global dimension, as evidenced by the fragility of care processes that predispose an occurrence of adverse events. These events in a neonatal intensive care unit are considered serious and hazardous to lives of newborns. The present study aimed to identify and analyze adverse events in a neonatal intensive care unit based in Trigger Tool. It is an epidemiological, cross-sectional , exploratory, retrospective study with quantitative, descriptive and analytical approach, performed in 2015 at a school hospital. The sample was not probabilistic, involving 116 newborns who met the eligibility criteria. Data collection was performed by retrospective review of medical records, using a specific kind of "trigger" instrument, composed of sentinel events in neonatology, adapted from the American model used by the Vermont-Oxford Network. Data were analyzed using descriptive and inferential statistics. The chi-square test for linear trend was used to assess the associations between the variables of interest. The research received a favorable agreement from Ethics Committee of the Federal University of Rio Grande do Norte, under number 1055533, and Presentation Certificate for Ethics Assessment 43894515.6.0000.5537. The results show among investigated newborns, 110 experienced at least one adverse event during their stay, with a total of 391 medical records analyzed and rate of 3.37 events per patient. Prevailed the preterm newborns with low birth weight, from mother who had hypertensive diseases during pregnancy and urinary tract infection. The average hospitalization time was 25 days, associated with hospital-acquired infections events (p = 0.01). Among the identified adverse events stood out the events related to thermoregulation disorders (39.0%), with prevalence of hypothermia (26.0%), followed by health care-related infections (16.4%) and blood glucose disorders, hypoglycemia (9.00%) and hyperglycemia (6.64%). Most of these incidents were classified in categories E and F, which represents that there was damage small proportion. Due to these damages come from the care practice with newborn, 78% were classified as avoidable. There was statistically significant association between the variable birth weight with infections (p = 0.006) as well as peri/intraventricular bleeding (p = 0.02), hypoglycemia (p = 0.021), hyperglycemia (p = 0.001), hyperthermia (p = 0.39) and death (p=0,02). Gestational age was associated with seizures (p = 0.002), hyperglycemia (p=0.017) e hyperthermia (p=0.027). The security institution culture was reported by the health workers as intermediate, even though the number of adverse events found in only one unit of service indicates that there is much to be done. Thus the high rate of adverse events identified in the neonatal intensive care unit reinforces the necessity to elaborate specific preventive strategies for this risk environment.

Retrieval of grassland biophysical parameters using multitemporal optical and radar satellite data

The amount and quality of available biomass is a key factor for the sustainable livestock industry and agricultural management related decision making. Globally 31.5% of land cover is grassland while 80% of Ireland’s agricultural land is grassland. In Ireland, grasslands are intensively managed and provide the cheapest feed source for animals. This dissertation presents a detailed state of the art review of satellite remote sensing of grasslands, and the potential application of optical (Moderate–resolution Imaging Spectroradiometer (MODIS)) and radar (TerraSAR-X) time series imagery to estimate the grassland biomass at two study sites (Moorepark and Grange) in the Republic of Ireland using both statistical and state of the art machine learning algorithms. High quality weather data available from the on-site weather station was also used to calculate the Growing Degree Days (GDD) for Grange to determine the impact of ancillary data on biomass estimation. In situ and satellite data covering 12 years for the Moorepark and 6 years for the Grange study sites were used to predict grassland biomass using multiple linear regression, Neuro Fuzzy Inference Systems (ANFIS) models. The results demonstrate that a dense (8-day composite) MODIS image time series, along with high quality in situ data, can be used to retrieve grassland biomass with high performance (R2 = 0:86; p < 0:05, RMSE = 11.07 for Moorepark). The model for Grange was modified to evaluate the synergistic use of vegetation indices derived from remote sensing time series and accumulated GDD information. As GDD is strongly linked to the plant development, or phonological stage, an improvement in biomass estimation would be expected. It was observed that using the ANFIS model the biomass estimation accuracy increased from R2 = 0:76 (p < 0:05) to R2 = 0:81 (p < 0:05) and the root mean square error was reduced by 2.72%. The work on the application of optical remote sensing was further developed using a TerraSAR-X Staring Spotlight mode time series over the Moorepark study site to explore the extent to which very high resolution Synthetic Aperture Radar (SAR) data of interferometrically coherent paddocks can be exploited to retrieve grassland biophysical parameters. After filtering out the non-coherent plots it is demonstrated that interferometric coherence can be used to retrieve grassland biophysical parameters (i. e., height, biomass), and that it is possible to detect changes due to the grass growth, and grazing and mowing events, when the temporal baseline is short (11 days). However, it not possible to automatically uniquely identify the cause of these changes based only on the SAR backscatter and coherence, due to the ambiguity caused by tall grass laid down due to the wind. Overall, the work presented in this dissertation has demonstrated the potential of dense remote sensing and weather data time series to predict grassland biomass using machine-learning algorithms, where high quality ground data were used for training. At present a major limitation for national scale biomass retrieval is the lack of spatial and temporal ground samples, which can be partially resolved by minor modifications in the existing PastureBaseIreland database by adding the location and extent ofeach grassland paddock in the database. As far as remote sensing data requirements are concerned, MODIS is useful for large scale evaluation but due to its coarse resolution it is not possible to detect the variations within the fields and between the fields at the farm scale. However, this issue will be resolved in terms of spatial resolution by the Sentinel-2 mission, and when both satellites (Sentinel-2A and Sentinel-2B) are operational the revisit time will reduce to 5 days, which together with Landsat-8, should enable sufficient cloud-free data for operational biomass estimation at a national scale. The Synthetic Aperture Radar Interferometry (InSAR) approach is feasible if there are enough coherent interferometric pairs available, however this is difficult to achieve due to the temporal decorrelation of the signal. For repeat-pass InSAR over a vegetated area even an 11 days temporal baseline is too large. In order to achieve better coherence a very high resolution is required at the cost of spatial coverage, which limits its scope for use in an operational context at a national scale. Future InSAR missions with pair acquisition in Tandem mode will minimize the temporal decorrelation over vegetation areas for more focused studies. The proposed approach complements the current paradigm of Big Data in Earth Observation, and illustrates the feasibility of integrating data from multiple sources. In future, this framework can be used to build an operational decision support system for retrieval of grassland biophysical parameters based on data from long term planned optical missions (e. g., Landsat, Sentinel) that will ensure the continuity of data acquisition. Similarly, Spanish X-band PAZ and TerraSAR-X2 missions will ensure the continuity of TerraSAR-X and COSMO-SkyMed.

Selection of a network of large lakes and reservoirs suitable for global environmental change analysis using Earth Observation

The GloboLakes project, a global observatory of lake responses to environmental change, aims to exploit current satellite missions and long remote-sensing archives to synoptically study multiple lake ecosystems, assess their current condition, reconstruct past trends to system trajectories, and assess lake sensitivity to multiple drivers of change. Here we describe the selection protocol for including lakes in the global observatory based upon remote-sensing techniques and an initial pool of the largest 3721 lakes and reservoirs in the world, as listed in the Global Lakes and Wetlands Database. An 18-year-long archive of satellite data was used to create spatial and temporal filters for the identification of waterbodies that are appropriate for remote-sensing methods. Further criteria were applied and tested to ensure the candidate sites span a wide range of ecological settings and characteristics; a total 960 lakes, lagoons, and reservoirs were selected. The methodology proposed here is applicable to new generation satellites, such as the European Space Agency Sentinel-series.

Seawater carbonate chemistry and protein sports of barnicle Balanus amphitrite during experiments, 2011

The majority of benthic marine invertebrates have a complex life cycle, during which the pelagic larvae select a suitable substrate, attach to it, and then metamorphose into benthic adults. Anthropogenic ocean acidification (OA) is postulated to affect larval metamorphic success through an altered protein expression pattern (proteome structure) and post-translational modifications. To test this hypothesis, larvae of an economically and ecologically important barnacle species Balanus amphitrite, were cultured from nauplius to the cyprid stage in the present (control) and in the projected elevated concentrations of CO2 for the year 2100 (the OA treatment). Cyprid response to OA was analyzed at the total proteome level as well as two protein post-translational modification (phosphorylation and glycosylation) levels using a 2-DE based proteomic approach. The cyprid proteome showed OA-driven changes. Proteins that were differentially up or down regulated by OA come from three major groups, namely those related to energy-metabolism, respiration, and molecular chaperones, illustrating a potential strategy that the barnacle larvae may employ to tolerate OA stress. The differentially expressed proteins were tentatively identified as OA-responsive, effectively creating unique protein expression signatures for OA scenario of 2100. This study showed the promise of using a sentinel and non-model species to examine the impact of OA at the proteome level.

(Table 2) Lipid fluxes derived from sediment trap samples

Phytoplankton is a sentinel of marine ecosystem change. Composed by many species with different life-history strategies, it rapidly responds to environment changes. An analysis of the abundance of 54 phytoplankton species in Galicia (NW Spain) between 1989 and 2008 to determine the main components of temporal variability in relation to climate and upwelling showed that most of this variability was stochastic, as seasonality and long term trends contributed to relatively small fractions of the series. In general, trends appeared as non linear, and species clustered in 4 groups according to the trend pattern but there was no defined pattern for diatoms, dinoflagellates or other groups. While, in general, total abundance increased, no clear trend was found for 23 species, 14 species decreased, 4 species increased during the early 1990s, and only 13 species showed a general increase through the series. In contrast, series of local environmental conditions (temperature, stratification, nutrients) and climate-related variables (atmospheric pressure indices, upwelling winds) showed a high fraction of their variability in deterministic seasonality and trends. As a result, each species responded independently to environmental and climate variability, measured by generalized additive models. Most species showed a positive relationship with nutrient concentrations but only a few showed a direct relationship with stratification and upwelling. Climate variables had only measurable effects on some species but no common response emerged. Because its adaptation to frequent disturbances, phytoplankton communities in upwelling ecosystems appear less sensitive to changes in regional climate than other communities characterized by short and well defined productive periods.

Respiratory virus-associated severe acute respiratory illness (SARI) and viral clustering in Malawian children in a setting with a high prevalence of HIV, malaria and malnutrition

BACKGROUND:  We used four years of paediatric severe acute respiratory illness (SARI) sentinel surveillance in Blantyre, Malawi to identify factors associated with clinical severity and co-viral clustering.

METHODS:  From January 2011 to December 2014, 2363 children aged 3 months to 14 years presenting to hospital with SARI were enrolled. Nasopharyngeal aspirates were tested for influenza and other respiratory viruses. We assessed risk factors for clinical severity and conducted clustering analysis to identify viral clusters in children with co-viral detection.

RESULTS:  Hospital-attended influenza-positive SARI incidence was 2.0 cases per 10,000 children annually; it was highest children aged under 1 year (6.3 cases per 10,000), and HIV-infected children aged 5 to 9 years (6.0 cases per 10,000). 605 (26.8%) SARI cases had warning signs, which were positively associated with HIV infection (adjusted risk ratio [aRR]: 2.4, 95% CI: 1.4, 3.9), RSV infection (aRR: 1.9, 95% CI: 1.3, 3.0) and rainy season (aRR: 2.4, 95% CI: 1.6, 3.8). We identified six co-viral clusters; one cluster was associated with SARI with warning signs.

CONCLUSIONS:  Influenza vaccination may benefit young children and HIV infected children in this setting. Viral clustering may be associated with SARI severity; its assessment should be included in routine SARI surveillance.

Special Issues in the Young and Pregnant Patient with Breast Cancer

This chapter presents a series of multiple choice questions and answers on the special issues in the young and pregnant patient with breast cancer. It also presents a series of case studies with questions and answers on the special issues in the young and pregnant patient with breast cancer. The chapter examines whether the genomic testing by Oncotype DX or MammaPrint be helpful in managing the patient. It also examines the factors that are the most important in determining the risk of chemotherapyinduced amenorrhea (CIA) in the patient, and a role for sentinel lymph node biopsy (SLNB) in patients diagnosed with breast cancer during pregnancy. The chapter discusses counselling of a patient who became accidentally pregnant on maintenance therapy with trastuzumab or tamoxifen. In addition, It examines the options that could be offered to preserve fertility.

Identification, diversity and distribution patterns of fish larvae in Khark & Kharko Coralline Islands ecosystem – Persian Gulf, by GIS method

Khark & Kharko Islands are the last Northern point for fringing coral reefs in Iranian side of the Persian Gulf. These Coralline habitats are the Protected Area and Wildlife Refugees with the total area of 2400 ha which located in the territory of Bushehr Province. This research carried out during 2006-2007 with monthly sampling from 12 stations, which selected around Islands and inshore waters with maximum depth of 20 meter. Sampling was conducted using by Bongo-Net plankton sampler with 500μ of mesh size. Totally, 1808 specimen from 45 family fish larvae was identified in studied area, including: 21 coralline fish larva families and 24 shore fish larvae such as pelagic and demersal fishes which some of them known as indicator, sentinel or endemic species for coral reef ecosystems. The results was shown that coral reef diversity in coral reefs (Khark & Kharko Islands) is more than other habitats such as estuary and river mouth, creeks, mangrove forest sites, and off shore water of the Persian Gulf and Oman Sea Iranian side. Among Identified families, Clupeidae, Blenniidae, Sillaginidae, Atherinidae and Tripterygiidae; with more abundance were dominant families in studied area. The pick of fish larvae abundance family were estimated in spring. There were significant differences between seasonally abundance and sub areas, but there were not significant differences in diversity indexes between Khark and Kharko stations with coastal stations (p< 0.05). The mean abundance of fish larvae were estimated 18.7083 larvae under 10m² of sea surface, and the mean diversity indexes and evenness were estimated 0.7135 and 0.565342 consequently, that was showed the area is under ecological stress for fish larvae, and wasn’t stable. Therefore, from the ecological point of view, only some of the fish larvae groups as like Clupeidae were dominant. Thus, they were the main cause of the fish larvae abundance change in studied area. Due to geographical location of Khark and Kharko Islands and among the environmental parameters, Its seems that the condition of sea current is the main cause for present or absent and distribution patterns of fish larvae in area. Abundance of fish larvae in west of Islands was higher than eastern parts in the spring. But this condition will be reversed in eastern part of Island and several coastal stations, so that the Islands surrounding clock wise current to cause fish larvae distribution patterns.