Risk for Pneumocystis carinii transmission among patients with pneumonia: a molecular epidemiology study.

We report a molecular typing and epidemiologic analysis of Pneumocystis carinii pneumonia (PCP) cases diagnosed in our geographic area from 1990 to 2000. Our analysis suggests that transmission from patients with active PCP to susceptible persons caused only a few, if any, PCP cases in our setting.

Evolution of Trypanosoma cruzi: clarifying hybridisations, mitochondrial introgressions and phylogenetic relationships between major lineages

Several different models of Trypanosoma cruzi evolution have been proposed. These models suggest that scarce events of genetic exchange occurred during the evolutionary history of this parasite. In addition, the debate has focused on the existence of one or two hybridisation events during the evolution of T. cruzi lineages. Here, we reviewed the literature and analysed available sequence data to clarify the phylogenetic relationships among these different lineages. We observed that TcI, TcIII and TcIV form a monophyletic group and that TcIII and TcIV are not, as previously suggested, TcI-TcII hybrids. Particularly, TcI and TcIII are sister groups that diverged around the same time that a widely distributed TcIV split into two clades (TcIVS and TcIVN). In addition, we collected evidence that TcIII received TcIVSkDNA by introgression on several occasions. Different demographic hypotheses (surfing and asymmetrical introgression) may explain the origin and expansion of the TcIII group. Considering these hypotheses, genetic exchange should have been relatively frequent between TcIII and TcIVS in the geographic area in which their distributions overlapped. In addition, our results support the hypothesis that two independent hybridisation events gave rise to TcV and TcVI. Consequently, TcIVS kDNA was first transferred to TcIII and later to TcV and TcVI in TcII/TcIII hybridisation events.

X-chromosome SNP analyses in 11 human Mediterranean populations show a high overall genetic homogeneity except in North-west Africans (Moroccans).

BACKGROUND: Due to its history, with a high number of migration events, the Mediterranean basin represents a challenging area for population genetic studies. A large number of genetic studies have been carried out in the Mediterranean area using different markers but no consensus has been reached on the genetic landscape of the Mediterranean populations. In order to further investigate the genetics of the human Mediterranean populations, we typed 894 individuals from 11 Mediterranean populations with 25 single-nucleotide polymorphisms (SNPs) located on the X-chromosome. RESULTS: A high overall homogeneity was found among the Mediterranean populations except for the population from Morocco, which seemed to differ genetically from the rest of the populations in the Mediterranean area. A very low genetic distance was found between populations in the Middle East and most of the western part of the Mediterranean Sea.A higher migration rate in females versus males was observed by comparing data from X-chromosome, mt-DNA and Y-chromosome SNPs both in the Mediterranean and a wider geographic area.Multilocus association was observed among the 25 SNPs on the X-chromosome in the populations from Ibiza and Cosenza. CONCLUSION: Our results support both the hypothesis of (1) a reduced impact of the Neolithic Wave and more recent migration movements in NW-Africa, and (2) the importance of the Strait of Gibraltar as a geographic barrier. In contrast, the high genetic homogeneity observed in the Mediterranean area could be interpreted as the result of the Neolithic wave caused by a large demic diffusion and/or more recent migration events. A differentiated contribution of males and females to the genetic landscape of the Mediterranean area was observed with a higher migration rate in females than in males. A certain level of background linkage disequilibrium in populations in Ibiza and Cosenza could be attributed to their demographic background.

Evaluation of PCC Long-Term Durability Using Intermediate Sized Gravels to Optimize Mix Gradations, April 2010

With the implementation of the 2000 Q-MC specification, an incentive is provided to produce an optimized gradation to improve placement characteristics. Also, specifications for slip-formed barrier rail have changed to require an optimized gradation. Generally, these optimized gradations have been achieved by blending an intermediate aggregate with the coarse and fine aggregate. The demand for this intermediate aggregate has been satisfied by using crushed limestone chips developed from the crushing of the parent concrete stone. The availability, cost, and physical limitations of crushed limestone chips can be a concern. A viable option in addressing these concerns is the use of gravel as the intermediate aggregate. Unfortunately, gravels of Class 3I durability are limited to a small geographic area in Mississippi river sands north of the Rock River. Class 3 or Class 2 durability gravels are more widely available across the state. The durability classification of gravels is based on the amount and quality of the carbonate fraction of the material. At present, no service histories or research exists to assess the impact of using Class 3 or 2 durability gravels would have on the long-term durability of Portland cement concrete (PCC) pavement requiring Class 3I aggregate.

Mehrsprachigkeit im Mittelalter. Kulturelle, literarische, sprachliche und didaktische Konstellationen in europäischer Perspektive. Mit Fallstudien zu den "Disticha Catonis"

Communication and the literary production of the Middle Ages were an integral part of a complex linguistic situation. Latin, the Western European language of education and administration, stood in contrast to the vernacular languages, which in turn were divided into different dialects. Different vernacular languages often existed in the same geographic area. This anthology approaches this topic, which has not been systematically covered until now, from an interdisciplinary perspective. It discusses fundamental methodological issues and surviving linguistic and literary documents from the 8th up to the 16th century.

Impact of antibiotic resistance on chemotherapy for pneumococcal infections

Over the past three decades, penicillin-resistant pneumococci have emerged worldwide. In addition, penicillin-resistant strains have also decreased susceptibility to other β-lactams (including cephalosporins) and these strains are often resistant to other antibiotic groups, making the treatment options much more difficult. Nevertheless, the present in vitro definitions of resistance to penicillin and cephalosporins in pneumococci could not be appropriated for all types of pneumococcal infections. Thus, current levels of resistance to penicillin and cephalosporin seem to have little, if any, clinical relevance in nonmeningeal infections (e.g., pneumonia or bacteremia). On the contrary, numerous clinical failures have been reported in patients with pneumococcal meningitis caused by strains with MICs ≥ 0.12 μg/ml, and penicillin should never be used in pneumococcal meningitis except when the strain is known to be fully susceptible to this drug. Today, therapy for pneumococcal meningitis should mainly be selected on the basis of susceptibility to cephalosporins, and most patients may currently be treated with high-dose cefotaxime (±) vancomycin, depending on the levels of resistance in the patient's geographic area. In this review, we present a practical approach, based on current levels of antibiotic resistance, for treating the most prevalent pneumococcal infections. However, it should be emphasized that the most appropriate antibiotic therapy for infections caused by resistant pneumococci remains controversial, and comparative, randomized studies are urgently needed to clarify the best antibiotic therapy for these infections

Incidencia territorial de la política universitaria

La tendencia descentralizadora impulsada por la política universitaria española ha tenido, sin lugar a dudas, un impacto importante sobre la economía de las regiones en las que se ha asentado una Universidad de nueva creación. Los estudios del impacto económico de la Universidad sobre el área geográfica en la que se desenvuelve, son un importante instrumento para justificar e incentivar la descentralización geográfica de la educación superior, especialmente en tiempos en los que las rigideces presupuestarias exigen racionalizar al máximo los niveles de gasto público. Una de las técnicas habitualmente utilizadas para evaluar los efectos de la Universidad sobre la economía regional, es la basada en el análisis input-output. Dicho análisis estima el impacto total del gasto, incluyendo los efectos directos, los efectos indirectos y los efectos inducidos del consumo. La metodología input-output es precisamente, la que se aplica en este trabajo para poder cuantificar el impacto que las actividades de la Universidad de Lleida han tenido sobre la economía territorial.

Multi-scale effects of nestling diet on breeding performance in a terrestrial top predator inferred from stable isotope analysis

Inter-individual diet variation within populations is likely to have important ecological and evolutionary implications. The diet-fitness relationships at the individual level and the emerging population processes are, however, poorly understood for most avian predators inhabiting complex terrestrial ecosystems. In this study, we use an isotopic approach to assess the trophic ecology of nestlings in a long-lived raptor, the Bonelli"s eagle Aquila fasciata, and investigate whether nestling dietary breath and main prey consumption can affect the species" reproductive performance at two spatial scales: territories within populations and populations over a large geographic area. At the territory level, those breeding pairs whose nestlings consumed similar diets to the overall population (i.e. moderate consumption of preferred prey, but complemented by alternative prey categories) or those disproportionally consuming preferred prey were more likely to fledge two chicks. An increase in the diet diversity, however, related negatively with productivity. The age and replacements of breeding pair members had also an influence on productivity, with more fledglings associated to adult pairs with few replacements, as expected in long-lived species. At the population level, mean productivity was higher in those population-years with lower dietary breadth and higher diet similarity among territories, which was related to an overall higher consumption of preferred prey. Thus, we revealed a correspondence in diet-fitness relationships at two spatial scales: territories and populations. We suggest that stable isotope analyses may be a powerful tool to monitor the diet of terrestrial avian predators on large spatio-temporal scales, which could serve to detect potential changes in the availability of those prey on which predators depend for breeding. We encourage ecologists and evolutionary and conservation biologists concerned with the multi-scale fitness consequences of inter-individual variation in resource use to employ similar stable isotope-based approaches, which can be successfully applied to complex ecosystems such as the Mediterranean.

Distribution of the human leukocyte antigen class II alleles in Brazilian patients with chronic hepatitis C virus infection

Hepatitis C virus (HCV) infection is a global medical problem. The current standard of treatment consists of the combination of peginterferon plus ribavirin. This regimen eradicates HCV in 55% of cases. The immune response to HCV is an important determinant of disease evolution and can be influenced by various host factors. HLA class II may play an important role in immune response against HCV. The objective of the present study was to determine the distribution of HLA class II (DRB1 and DQB1) alleles, their association with chronic HCV infection and their response to interferon therapy. One hundred and two unrelated white Brazilian patients with chronic HCV infection, 52 responders (45 males and 7 females) and 50 non-responders (43 males and 7 females) to antiviral treatment, were included in the study. Healthy Brazilian bone marrow donors of Caucasian origin from the same geographic area constituted the control group (HLA-DRB1, N = 99 and HLA-DQB1, N = 222 individuals). HLA class II genotyping was performed using a low-resolution DRB1, DQB1 sequence-specific primer amplification. There were higher frequencies of HLA-DRB1*13 (26.5 vs 14.1%) and HLA-DQB1*02 (52.9 vs 38.7%) in patients compared with controls; however, these were not significantly different after P correction (Pc = 0.39 and Pc = 0.082, respectively). There was no significant difference between the phenotypic frequencies of HLA-DRB1 (17.3 vs 14.0%) and HLA-DQB1 alleles in responder and non-responder HCV patients. The HLA-DRB1*07 allele was significantly more common in HCV patients (33.3 vs 12.1%) than in controls (Pc = 0.0039), suggesting that the HLA-DRB1*07 allele is associated with chronic HCV infection.

Psychiatric services utilization in completed suicides of a youth centres population

Affiliation: Johanne Renaud & Claude Marquette : CHU Ste-Justine, Université de Montréal

Surveillance de maladies chroniques à l'aide des données administratives : cas de l'asthme au Québec

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal.

Analyse d’implantation du programme de prévention de la transmission du VIH de la mère à l’enfant au Bénin

Problématique : Implanté en 2004 au Bénin, le programme national de prévention de la transmission du VIH de la mère à l’enfant (PTME) semble globalement bien implanté. Toutefois une enquête, en 2005, révèle certaines difficultés, particulièrement au niveau de la couverture du programme: seulement 70 à 75 % des femmes enceintes vues en consultations prénatales ont été dépistées et 33 % des 1150 femmes dépistées séropositives ont accouché suivant le protocole de PTME. En outre, d’un site à un autre, on relève une grande variation dans la couverture en termes de dépistage et de suivi des femmes enceintes infectées. Cette faiblesse dans la couverture nous a amené à questionner le contexte organisationnel dans lequel le programme est implanté. Objectif : L’objectif général de cette thèse est d’analyser l'implantation de la PTME au Bénin. Le premier objectif spécifique consiste à identifier et comprendre les enjeux reliés à la façon de rejoindre les femmes enceintes dans le cadre du dépistage. Le second consiste à comprendre le contexte d’implantation et son influence sur la mise en œuvre de la PTME. Méthodologie : Cette recherche évaluative s’appuie sur une étude de cas. Six maternités ont été sélectionnées avec le souhait de représenter les différents contextes d’organisation des services. Les données ont été collectées par observation non participante, entrevues semi-dirigées (n=41) réalisées avec des prestataires de services, analyse documentaire des rapports d’activités des maternités et par questionnaires administrés aux femmes enceintes en consultations prénatales (n=371). Résultats : Le premier article a permis d'apprécier le caractère libre et éclairé du consentement au dépistage. Une majorité des femmes enceintes, suivies dans les centres privés, ont été dépistées sans être effectivement informées de la PTME alors que les femmes fréquentant les autres maternités connaissent mieux les composantes de la PTME. Le caractère volontaire du consentement des femmes est généralement respecté sur tous les sites. Le deuxième article porte sur l'analyse de la qualité du conseil pré-test. Seulement 54% des femmes enceintes ont participé à un conseil en groupe et 80% à un conseil individuel. Dans les centres où sont dispensées des séances d'information de groupe, la qualité est meilleure que dans les centres qui dispensent un conseil individuel exclusif. Le troisième article analyse l'influence du contexte d'implantation sur la mise en œuvre du programme. Parmi les facteurs qui contribuent favorablement à la mise en œuvre on relève la proximité d’un centre de référence et la coordination des activités de PTME dans une zone géographique, la responsabilisation du prestataire dédié à la PTME, la supervision formative régulière accompagnée de séances de discussion collective et l’implication des médiatrices dans la recherche active des perdues de vues. A l’opposé, la responsabilisation des médiatrices pour la réalisation du conseil individuel et du dépistage ne favorise pas une bonne mise en œuvre de la PTME. Conclusion : Nos résultats montrent qu'il est possible de jouer sur l'organisation des services de santé dans le cadre du programme du PTME pour améliorer la façon dont le programme est implanté tant dans les centres privés que publics, sans que cela ne représente un ajout net de ressources. C'est le cas de l’amélioration de la qualité du conseil et du dépistage, de l’implantation du processus interne d’apprentissage organisationnel et de la coordination des services.

Resiliencia y variables socio demográficas: implicaciones en la dirección de organizaciones

En el ámbito organizacional es necesario interiorizar y aplicar conceptos que generen herramientas que hagan posible el adecuado funcionamiento de las empresas a efectos de mejorar los resultados en términos económicos. Es importante entender las circunstancias que rodean al mundo y así mismo la manera en la que este funciona, ya que cada vez se ve influenciado por culturas y rasgos que difieren según el espacio geográfico en el que se desarrolle la actividad. Por este motivo es importante identificar personas que influencien positivamente a las organizaciones y sean agentes de cambio que desarrollen planes y estrategias que sean comunes a los objetivos de la organización orientando todos sus esfuerzos a la consecución de metas que la misma se proponga. En las empresas es claro que pueden presentarse problemas que encierren cualquier ámbito, como el personal, empresarial o familiar, lo cual a su vez puede generar desmotivación y falta de ánimo entre quienes desarrollen el rol de líder haciendo que sus responsabilidades no se cumplan a cabalidad. Sin embargo, estos deben tener la capacidad de anteponerse ante este tipo de adversidades de manera profesional con el fin de equilibrar sus emociones y superar el obstáculo de manera satisfactoria, sin pensar en resultados negativos y siendo un ejemplo para sus seguidores; dicha capacidad hoy en día se denomina resiliencia. Por esta razón, a lo largo de este trabajo se realizará una revisión teórica que tendrá como objeto identificar los aspectos generales del concepto de resiliencia y de igual forma encontrar la importancia de este estudio dentro del ámbito organizacional. Así mismo, se analizará la relación existente entre la resiliencia y las variables socio-demográficas: edad, nivel de estudios, estrato económico y género. Dicho análisis se hará posible con la ayuda de estudios realizados a nivel latinoamericano en países como: México, Perú y Colombia.

Museum of the City of São Paulo: A new paradigm of City Museums in the Era of Megalopolises

The City is a tomography of the present, indicating to the future, strata of past times. Nowadays city growth averages one million people every week; while back in 1950 there were eighty six cities with more than one million inhabitants, today they are four hundred all over the world. However the most significant effect of the urban process is, doubtless, the explosion of megacities. It took one century for the urban population – around three point four billion inhabitants – to surpass the number of people in the country, but United Nations projections indicate that by 2025, urban population will reach 61% of the total. Creating a new city museum in São Paulo requires that, in a first analysis, one should consider as geographic area of study some fifteen hundred square kilometres corresponding to the patrimonial intervention area. That is the area of the Municipality, politically divided into ninety six districts where eleven million people live, while approximately twenty million people live in the metropolitan area

On-farm management of rice genetic diversity: understanding farmers' knowledge on rice ecosystems and varietal development

The paper highlights the methodological development of identifying and characterizing rice (Oryza sativa L.) ecosystems and the varietal deployment process through participatory approaches. Farmers have intricate knowledge of their rice ecosystems. Evidence from Begnas (mid-hill) and Kachorwa (plain) sites in Nepal suggests that farmers distinguish ecosystems for rice primarily on the basis of moisture and fertility of soils. Farmers also differentiate the number, relative size and specific characteristics of each ecosystem within a given geographic area. They allocate individual varieties to each ecosystem, based on the principle of ‘best fit’ between ecosystem characteristics and varietal traits, indicating that competition between varieties mainly occurs within the ecosystems. Land use and ecosystems determine rice genetic diversity, with marginal land having fewer options for varieties than more productive areas. Modern varieties are mostly confined to productive land, whereas landraces are adapted to marginal ecosystems. Researchers need to understand the ecosystems and varietal distribution within ecosystems better in order to plan and execute programmes on agrobiodiversity conservation on-farm, diversity deployment, repatriation of landraces and monitoring varietal diversity. Simple and practical ways to elicit information on rice ecosystems and associated varieties through farmers’ group discussion at village level are suggested.