Integrating tuberculosis and HIV care in the primary care setting in South Africa.

BACKGROUND: In many countries including South Africa, the increasing human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics have impacted significantly on already weakened public health services. This paper reviews the scope, process and performance of the HIV and TB services in a primary care setting where antiretroviral therapy is provided, in Khayelitsha, South Africa, in order to assess whether there is a need for some form of integration. METHODS: The scope and process of both services were assessed through observations of the service and individual and group interviews with key persons. The performance was assessed by examining the 2001-2002 reports from the health information system and clinical data. RESULTS: The TB service is programme oriented to the attainment of an 85% cure rate amongst smear-positive patients while the HIV service has a more holistic approach to the patient with HIV. The TB service is part of a well-established programme that is highly standardized. The HIV service is in the pilot phase. There is a heavy load at both services and there is large degree of cross-referral between the two services. There are lessons that can be learnt from each service. There is an overlap of activities, duplication of services and under-utilization of staff. There are missed opportunities for TB and HIV prevention, diagnosis and management. CONCLUSIONS: The study suggests that there may be benefits to integrating HIV and TB services. Constraints to this process are discussed

Evaluating the Consortia Purchase: Journal Usage in a Multi-Institution Setting

When two or more institutions share a license, how do they measure use and value? For over a decade, the Levy Library at the Icahn School of Medicine at Mount Sinai, the Sid and Ruth Lapidus Library at the New York University School of Medicine, and New York University Libraries at New York University have shared several publisher packages and journal title subscriptions. In this paper, we present our analysis of usage data to assess the value of some of these consortial arrangements in their totality and to each library. Based on this analysis, we were able to adjust how each institution contributes to consortial arrangements. The paper will discuss challenges in analyzing consortial arrangements based on usage data and offer suggestions for how consortia-based acquisitions can be an effective allocation of library funds and strengthen support for the library in its institution

Development and deployment of an at-home strength and conditioning program to support a phase I trial in persons with chronic spinal cord injury

Study design Nonrandomized clinical trial (NCT02354625).Objectives As a part of a Phase I clinical trial to assess the safety of autologous human Schwann cells (ahSC) in personswith chronic spinal cord injury (SCI), participants engaged in a multimodal conditioning program pre- and post-ahSCtransplantation. The program included a home-based strength and endurance training program to prevent lack of fitness andposttransplantation detraining from confounding potential ahSC therapeutic effects. This paper describes development,deployment, outcomes, and challenges of the home-based training program.Setting University-based laboratory.Methods Development phase: two men with paraplegia completed an 8-week laboratory-based ‘test’ of the home-basedprogram. Deployment phase: the first four (two males, two females) participant cohort of the ahSC trial completed theprogram at home for 12 weeks pre and 20 weeks post ahSC transplant.Results Development phase: both participants improved their peak aerobic capacity (VO2peak) (≥17%), peak power output(POpeak) (≥8%), and time to exhaustion (TTE) (≥7%). Deployment phase: pretransplant training minimally increased fitness inthe two male participants (≥6% POpeak and ≥9% TTE). The two women had no POpeak changes and slight TTE changes (+2.6and −1.2%, respectively.) All four participants detrained during the posttransplant recovery period. After posttransplantretraining, all four participants increased TTE (4–24%), three increased VO2peak (≥11%), and two increased POpeak (≥7%).Conclusions Home-based strength and condition programs can be effective and successfully included in therapeutic SCItrials. However, development of these programs requires substantial content knowledge and experience

Planning Prices and Livestock Budgets

This publication provides tables and worksheets for calculating budgets for beef cows and calves, stockers and feeders, feeding calves and yearlings, ewes and lambs, feeding lambs, market hogs, feeder pigs, milk, dairy, laying hens, goose, and turkey production

Ditches show systematic impacts on soil and vegetation properties across the Swedish forest landscape

Novel mapping methods using AI have led to improved mapping of the extent of drainage systems, but the full scope of the effects of drainage on ecosystems has yet to be understood. By combining ditches mapped with remote sensing and AI methods with soil data from the Swedish Forest Soil Inventory, and vegetation data from the National Forest Inventory we identified 4 126 survey plots within 100 m of a ditch. The inventory data span across three biomes; the northern boreal zone, the hemiboreal zone, and the temperate zone. We explored if soils and vegetation close to ditches were indeed different from the surrounding landscape. The large number of plots spread widely across the Swedish forest landscape spanning different physiographic regions, climates, topography, soils, and vegetation made it possible to identify the general effect of drainage on soil properties, tree productivity, and plant species composition. We found a surprisingly large amount of ditches on mineral soils (50-70%, depending on the definition of peatlands). Forest growth was affected, with higher growth rates of trees closer to ditches, particularly Norway spruce. Sphagnum mosses - a key indicator of wet soils - were less common near ditches, where they were replaced by feather mosses. The soil bulk density was higher closer to ditches, as was the concentration of metals that are typically associated with organic matter (Al), while concentrations of metals with a lower affinity for organic material decreased toward ditches (Na, K, Mg). The results from mineral soils and peat soils often differed. For example, N and tree volume increased toward ditches, but on different levels for peat and mineral soils, while the thickness of the humus layer and Pleurozium schreberi cover showed opposite patterns for the different soils. Clearly, ditches have affected the entire Swedish forest landscape, driving it towards a drier, more spruce-dominated productive forested ecosystem and away from wetland ecosystems like mires and littoral areas along streams. Furthermore, the biogeochemistry of the soils and understory species cover near ditches have changed, potentially irreversibly, at least within human time frames, and have implications for restoration goals and the future of forestry

Session 4: What Should Be the Conditions on Libraries Digitizing, Maintaining and Making Available Copyrighted Works?

A discussion of the conditions that should be applied to libraries and archives in their digitizing, maintaining and making available copyrighted works

Sigma1 Targeting to Suppress Aberrant Androgen Receptor Signaling in Prostate Cancer.

Suppression of androgen receptor (AR) activity in prostate cancer by androgen depletion or direct AR antagonist treatment, although initially effective, leads to incurable castration-resistant prostate cancer (CRPC) via compensatory mechanisms including resurgence of AR and AR splice variant (ARV) signaling. Emerging evidence suggests that Sigma1 (also known as sigma-1 receptor) is a unique chaperone or scaffolding protein that contributes to cellular protein homeostasis. We reported previously that some Sigma1-selective small molecules can be used to pharmacologically modulate protein homeostasis pathways. We hypothesized that these Sigma1-mediated responses could be exploited to suppress AR protein levels and activity. Here we demonstrate that treatment with a small-molecule Sigma1 inhibitor prevented 5α- dihydrotestosterone-mediated nuclear translocation of AR and induced proteasomal degradation of AR and ARV, suppressing the transcriptional activity and protein levels of both full-length and splice-variant AR. Consistent with these data, RNAi knockdown of Sigma1 resulted in decreased AR levels and transcriptional activity. Furthermore, Sigma1 physically associated with ARV7 and A

Prospectus, February 21, 1979

INTERNATIONAL STUDENT DAY; International students send invitation to PC; Krannert plays start Feb. 21; Register at PC for WIU term; Astronomy Club goes on trip; Life workshop coming; PC campus to be part of museum exhibit; Energy course offered; Blood drive; You\u27ll have fun, fun, fun in the PC gameroom; Parkland\u27s \u27brothers\u27 enter contest; Computer used for first time; PCA represents Parkland faculty; PC women to sponsor reading; Financial help for young women; PC sponsors health program; Classifieds; WPCD\u27s Top Ten for the week of Feb. 19; PC to host B-ball tourney; Divorce rate keeps rising, one million annual divorces; VA has best seller available from gov\u27t; Sectionals are coming; Four win meet; Women Cobras out for revengehttps://spark.parkland.edu/prospectus_1979/1025/thumbnail.jp

Primary weathering rates, water transit times, and concentration-discharge relations:a theoretical analysis for the critical zone

The permeability architecture of the critical zone exerts a major influence on the hydrogeochemistry of the critical zone. Water flow path dynamics drive the spatiotemporal pattern of geochemical evolution and resulting streamflow concentration-discharge (C-Q) relation, but these flow paths are complex and difficult to map quantitatively. Here we couple a new integrated flow and particle tracking transport model with a general reversible Transition State Theory style dissolution rate law to explore theoretically how C-Q relations and concentration in the critical zone respond to decline in saturated hydraulic conductivity (K-s) with soil depth. We do this for a range of flow rates and mineral reaction kinetics. Our results show that for minerals with a high ratio of equilibrium concentration (C-eq) to intrinsic weathering rate (R-max), vertical heterogeneity in K-s enhances the gradient of weathering-derived solute concentration in the critical zone and strengthens the inverse stream C-Q relation. As C-eq/R-max decreases, the spatial distribution of concentration in the critical zone becomes more uniform for a wide range of flow rates, and stream C-Q relation approaches chemostatic behavior, regardless of the degree of vertical heterogeneity in K-s. These findings suggest that the transport-controlled mechanisms in the hillslope can lead to chemostatic C-Q relations in the stream while the hillslope surface reaction-controlled mechanisms are associated with an inverse stream C-Q relation. In addition, as C-eq/R-max decreases, the concentration in the critical zone and stream become less dependent on groundwater age (or transit time)