Late Entry into HIV Care: Estimated Impact on AIDS Mortality Rates in Brazil, 2003-2006

Background: Worldwide, a high proportion of HIV-infected individuals enter into HIV care late. Here, our objective was to estimate the impact that late entry into HIV care has had on AIDS mortality rates in Brazil. Methodology/Principal Findings: We analyzed data from information systems regarding HIV-infected adults who sought treatment at public health care facilities in Brazil from 2003 to 2006. We initially estimated the prevalence of late entry into HIV care, as well as the probability of death in the first 12 months, the percentage of the risk of death attributable to late entry, and the number of avoidable deaths. We subsequently adjusted the annual AIDS mortality rate by excluding such deaths. Of the 115,369 patients evaluated, 50,358 (43.6%) had entered HIV care late, and 18,002 died in the first 12 months, representing a 16.5% probability of death in the first 12 months (95% CI: 16.3-16.7). By comparing patients who entered HIV care late with those who gained timely access, we found that the risk ratio for death was 49.5 (95% CI: 45.1-54.2). The percentage of the risk of death attributable to late entry was 95.5%, translating to 17,189 potentially avoidable deaths. Averting those deaths would have lowered the 2003-2006 AIDS mortality rate by 39.5%. Including asymptomatic patients with CD4(+) T cell counts >200 and <= 350 cells/mm(3) in the group who entered HIV care late increased this proportion by 1.8%. Conclusions/Significance: In Brazil, antiretroviral drugs reduced AIDS mortality by 43%. Timely entry would reduce that rate by a similar proportion, as well as resulting in a 45.2% increase in the effectiveness of the program for HIV care. The World Health Organization recommendation that asymptomatic patients with CD4(+) T cell counts <= 350 cells/mm(3) be treated would not have a significant impact on this scenario.

New genes of Xanthomonas citri subsp citri involved in pathogenesis and adaptation revealed by a transposon-based mutant library

Background: Citrus canker is a disease caused by the phytopathogens Xanthomonas citri subsp. citri, Xanthomonas fuscans subsp. aurantifolli and Xanthomonas alfalfae subsp. citrumelonis. The first of the three species, which causes citrus bacterial canker type A, is the most widely spread and severe, attacking all citrus species. In Brazil, this species is the most important, being found in practically all areas where citrus canker has been detected. Like most phytobacterioses, there is no efficient way to control citrus canker. Considering the importance of the disease worldwide, investigation is needed to accurately detect which genes are related to the pathogen-host adaptation process and which are associated with pathogenesis. Results: Through transposon insertion mutagenesis, 10,000 mutants of Xanthomonas citri subsp. citri strain 306 (Xcc) were obtained, and 3,300 were inoculated in Rangpur lime (Citrus limonia) leaves. Their ability to cause citrus canker was analyzed every 3 days until 21 days after inoculation; a set of 44 mutants showed altered virulence, with 8 presenting a complete loss of causing citrus canker symptoms. Sequencing of the insertion site in all 44 mutants revealed that 35 different ORFs were hit, since some ORFs were hit in more than one mutant, with mutants for the same ORF presenting the same phenotype. An analysis of these ORFs showed that some encoded genes were previously known as related to pathogenicity in phytobacteria and, more interestingly, revealed new genes never implicated with Xanthomonas pathogenicity before, including hypothetical ORFs. Among the 8 mutants with no canker symptoms are the hrpB4 and hrpX genes, two genes that belong to type III secretion system (TTSS), two hypothetical ORFS and, surprisingly, the htrA gene, a gene reported as involved with the virulence process in animal-pathogenic bacteria but not described as involved in phytobacteria virulence. Nucleic acid hybridization using labeled cDNA probes showed that some of the mutated genes are differentially expressed when the bacterium is grown in citrus leaves. Finally, comparative genomic analysis revealed that 5 mutated ORFs are in new putative pathogenicity islands. Conclusion: The identification of these new genes related with Xcc infection and virulence is a great step towards the understanding of plant-pathogen interactions and could allow the development of strategies to control citrus canker.

Professional development and a discussion of the professional preparation provided by information and library science degree programs in public universities in Madrid, 2000-2005

A study was designed to determine how the degree programs in Information and library science available in 2000-2005 at the public universities of Madrid fit the tabour market needs of their students. The methodology used was the development of a questionnaire addressed to graduates. Although the number of surveys completed is not high (118), the authors believe that the results obtained permit a series of conclusions that may be extrapolated to the entire cohort.

The AdapLib Library for Execution of Adaptive Devices: Architecture and Use

In this paper it is presented the theoretical background, the architecture (using the ""4+1"" model), and the use of the library for execution of adaptive devices, AdapLib. This library was created seeking to be accurate to the adaptive devices theory, and to allow its easy extension considering the specific details of solutions that employ this kind of device. As an example, it is presented a case study in which the library was used to create a proof of concept to monitor and diagnose problems in an online news portal.

Catalogue of manuscripts from the Hayes Collection in the University of Queensland Library

Index to correspondence and manuscript material on literary and historical matters, mostly in Queensland and New South Wales, Australia held in the Fryer Library, University of Queensland - UQFL2. Authors and subjects include J.H.M. Abbott, Archer Family, E. Armitage, R. Bedford, H.S. Bloxome, E.J. Brady, 'Broadside', F. Broomfield, A.H. Chisholm, C.B. Christesen, R.H. Croll, Z. Cross, F.W.S. Cumbrae-Stewart, E. Dark, D. Deamer, C.J. Dennis, J. Devaney, E.M. England, P. Fitzgerald, R.D. Fitzgerald, Dame Mary Gilmore, C. Gittins, A.L. Gordon (criticism), P. Grano, M. Haley, W.A. Horn, R.G. Howarth, J. Howlett Ross, E.H. Lane, H. Lane, F.J. McAuley, D. McConnel, G. McCrae, K. (S) Mackenzie, P. Miles, J.K. Moir, C.P. Mountford, A. Muir, D.A. O'Brien, J.H. O'Dwyer, W.H. Ogilvie, M. Potter, T. Playford, H. Power, Queensland Authors' and Artists' Association, I. Southall, W. Sowden, A.G. Stephens, P.R. Stephensen, H. Tyron, A.J. Vogan, B. Vrepont, T. Welsby, H.R. White and Duke of Windsor. Also personal papers of Father Hayes, relating to his activities as parish priest.

Simon and Becky Endnote library

This is a general future of tobacco library - it's pretty big and needs a cleanup, all in good time!

Entrance, Bulae Library, Lae

View to entrance from exterior.

Corner connection detail, Sunshine Coast University Library, Maroochydore

Detailed external view of north-west elevation corner.

North-west elevation, Sunshine Coast University Library, Maroochydore

North-west elevation as seen from library forecourt.

Northern entrance court under construction, Sunshine Coast University Library, Maroochydore

View to library entrance court under construction.

North-west elevation and entrance court, Sunshine Coast University Library, Maroochydore

View of entrance court under construction, with north-west elevation behind.

Part of south-east elevation, Sunshine Coast University Library, Maroochydore

View to part of south-east elevation with skillion roof, corrugated steel sheeting and concrete block.

Steel cladding to south-east corner, Sunshine Coast University Library, Maroochydore

View to south-east corner, clad in corrugated steel sheeting with colonnade below.

Colonnade to south-west elevation, Sunshine Coast University Library, Maroochydore

View from south-east as seen from exterior.

Entrance verandah, Sunshine Coast University Library, Maroochydore

View along north-east entrance verandah.