The case for Option B and Optional B+: Ensuring that South Africa’s commitment to eliminating mother-to-child transmission of HIV becomes a reality

In a previous issue of the Southern African Journal of HIV Medicine, Pillay and Black summarised the trade-offs of the safety of efavirenz use in pregnancy (Pillay P, Black V. Safety, strength and simplicity of efavirenz in pregnancy. Southern African Journal of HIV Medicine 2012;13(1):28-33.). Highlighting the benefits of the World Health Organization’s proposed options for the prevention of mother-to-child transmission (PMTCT) of HIV, the authors argued that the South African government should adopt Option B as national PMTCT policy and pilot projects implementing Option B+ as a means of assessing the individual- and population-level effect of the intervention. We echo this call and further propose that the option to remain on lifelong antiretroviral therapy, effectively adopting PMTCT Option B+, be offered to pregnant women following the cessation of breastfeeding, for their own health, following the provision of counselling on associated benefits and risks. Here we highlight the benefits of Options B and B+

The Competition Commission Health Market Inquiry Report: An overview and key imperatives

The Competition Commission’s Health Market Inquiry (HMI) is the most systematic and comprehensive investigation carried out into the South African private health sector. The recommendations as set out in the HMI Final Report merit extensive discussion and debate, as they could – if implemented – have far-reaching consequences for the future of the healthcare system. The objective of this article is to contribute to this discussion by providing an overview of the key findings and recommendations of the HMI and highlighting the resultant key imperatives at this critical juncture of policy development

Review: Khayelitsha 2001 - 2011: 10 years of primary care HIV and TB programmes

Tuberculosis (TB) and HIV care in Khayelitsha, and in South Africa as a whole, has overcome numerous obstacles in the past three decades. This article highlights what has been achieved in Khayelitsha, describes the key clinical programme and policy changes that have supported universal coverage for HIV and TB care over the last 10 years, and outlines the challenges for the next decade

A Ground Control Station for Collaborative Unmanned Surface Vehicles

[ES] El Centro de Control de Tierra (CCT) es uno de los elementos imprescindibles para la supervisión y control de vehículos autónomos que realizan misiones complejas. En la actualidad cada vez hay más aplicaciones donde se utilizan múltiples vehículos autónomos y el tradicional Centro de Control está evolucionando para ser capaz de gestionar diversos vehículos y operadores. Este artículo presenta las características más relevantes de un CCT adaptable y versátil, especialmente diseñado para que un equipo heterogéneo de operadores puedan monitorizar y supervisar el funcionamiento colaborativo de un conjunto heterogéneo de vehículos autónomos. Entre estas características destacan la posibilidad de, según las necesidades de los operadores y de la misión, 1) reconfigurar cuál (y cómo) es la información que se muestra de cada vehículo a cada operador, 2) definir alarmas que atraigan la atención de los operadores ante determinados eventos (y liberen su carga de trabajo mientras estos no se den) y 3) re-asignar en tiempo real la gestión de los vehículos a los diferentes operadores. Para alcanzarlas, se ha realizado un cuidadoso diseño de la arquitectura software del CCT, que se detalla en el artículo y que se encuentra formada por: un módulo de comunicaciones; un módulo planificador de alto nivel; un módulo (replicable en tantos equipos como se desee) de monitorización y supervisión de vehículos; y tantos módulos comandadores como vehículos diferentes existan en la misión. Este CCT ha sido desarrollado dentro del proyecto de investigación SALACOM (Sistema Autónomo de Localización y Actuación ante Contaminantes en el Mar), en el que dos barcos autónomos maniobran de forma colaborativa para desplegar una barrera para la contención de un vertido contaminante en el mar ydonde la incorporación del operador en la supervisión y control de las maniobras de los vehículos es un requisito imprescindible para dar seguridad y confianza a la operación realizada. Finalmente, se presenta un caso de uso del Centro de Control de Tierra donde se realiza una maniobra de seguimiento entre dos vehículos autónomos de superficie.[EN] The Ground Control Station (GCS) is one of the essential elements to supervise and control autonomous vehicles performing complex missions. The increasing number of systems that involve multiple autonomous vehicles is making traditional GCSs evolve to let them handle dierent vehicles and operators. In this article, we present the more relevant properties of a versatile adaptable GCS that has been especially designed to let multiple operators, each using a dierent computer equipment, be in charge of controlling a heterogeneous team of autonomous vehicles. Its main properties are the possibility of 1) reconfiguring which information is displayed to each operator, 2) defining alarms to draw the operators attention when required, and 3) re-assigning, in real-time, the vehicles to dierent operators. These properties are supported by a distributed design of the GCS software architecture, presented in the paper and consistent of: a communication module, a high level planner, replicable monitoring and supervising units, and as many commanders as vehicles within each mission. This GCS has been developed within SALACOM (an autonomous system for locating and acting against sea spills), where two Unmanned Surface Vehicles (USVs) cooperate to collect a sea spill under the supervision of several operators that are responsible of the security of the mission. Finally, this paper also presents a case of use of the GCS within a real-world experiment involving two USVs performing leader-follower formation maneouvres.Los autores del art´ıculo quieren agradecer al Ministerio de Econom´ıa y Competitividad español su apoyo a través del proyecto SALACOM (DPI2013-46665-C2-1-R).Bonache Seco, J.; Dormido Canto, J.; Montalvo Martinez, M.; López-Orozco, J.; Besada Portas, E.; De La Cruz Garcia, J. (2017). Centro de Control de Tierra para Colaboración de Vehículos Autónomos Marinos. Revista Iberoamericana de Automática e Informática industrial. 15(1):1-11. https://doi.org/10.4995/riai.2017.8737OJS111151ASTM, 2017. Committee F41 on unmanned maritime vehicle systems (umvs). [Online] https://www.astm.org/COMMITTEE/F41.htm.ASV, 2017. Asview control system. [Online] http://asvglobal.com/asviewcontrol-system/.Besada-Portas, E., Lopez-Orozco, J. A., Besada, J., Jesus, M., 2011. Multisensor fusion for linear control systems with asynchronous, out-of-sequence and erroneous data. Automatica 47 (7), 1399-1408. https://doi.org/10.1016/j.automatica.2011.02.030Besada-Portas, E., Lopez-Orozco, J. A., de la Cruz, J., 2002. Unified fusion system based on bayesian networks for autonomous mobile robots. In: Information Fusion, 2002. Proceedings of the Fifth International Conference on. Vol. 2. IEEE, pp. 873-880. https://doi.org/10.1109/ICIF.2002.1020900Bonache Seco, J. A., López Orozco, J. A., Besada Portas, E., de la Cruz, J. M., 2016. Centro de control versátil: Estado actual y evolución hacia la adaptabilidad. CEA, pp. 979-986.Bürkle, A., Segor, F., Kollmann, M., Sch¨onbein, R., 2011. Universal ground control station for heterogeneous sensors. Journal On Advances in Telecommunications, IARIA 3 (3), 152-161.Burmeister, H.-C., Bruhn, W., Rødseth, Ø. J., Porathe, T., 2014. Autonomous unmanned merchant vessel and its contribution towards the e-navigation implementation: The munin perspective. International Journal of e-Navigation and Maritime Economy 1, 1-13.Cummings, M. L., How, J. P., Whitten, A., Toupet, O., 2012. The impact of human-automation collaboration in decentralized multiple unmanned vehicle control. Proceedings of the IEEE 100 (3), 660-671. https://doi.org/10.1109/JPROC.2011.2174104de la Cruz, J. M., Lopez-Orozco, A, J., Besada Portas, E., Aranda Almansa, J., 2016. Control de formaciones de vehículos marinos de superficie con restricciones de entrada. CEA, pp. 1044-1051.de la Cruz, J. M., Lopez-Orozco, A, J., Besada Portas, E., Moreno Salinas, D., Aranda Almansa, J., 2014. Seguimiento de caminos para formaciones de vehículos marinos de superficie.de la Cruz, J. M., Lopez-Orozco, J. A., Besada-Portas, E., Aranda-Almansa, J., 2015. A streamlined nonlinear path following kinematic controller. In: 2015 IEEE International Conference on Robotics and Automation (ICRA). IEEE, pp. 6394-6401. https://doi.org/10.1109/ICRA.2015.7140097Heo, J., Kim, S., Kwon, Y., 2016. Design of ground control station for operation of multiple combat entities. Journal of Computer and Communications 4, 66-71. https://doi.org/10.4236/jcc.2016.45010Lalish, E., Morgansen, K. A., 2008. Decentralized reactive collision avoidance for multivehicle systems. In: Proceedings of the 47th IEEE Conference on Decision and Control. IEEE, pp. 1218-1224. https://doi.org/10.1109/CDC.2008.4738894Lapierre, L., Soetanto, D., 2007. Nonlinear path-following control of an auv. Ocean engineering 34 (11), 1734-1744. https://doi.org/10.1016/j.oceaneng.2006.10.019LibrePilot, 2015. Software suite to control multicopter and other rc-models. [Online] https://www.librepilot.org/site/index.html, accedido en marzo de 2017.Lindemuth, M., Murphy, R., Steimle, E., Armitage, W., Dreger, K., Elliot, T., Hall, M., Kalyadin, D., Kramer, J., Palankar, M., et al., 2011. Sea robot assisted inspection. IEEE robotics & automation magazine 18 (2), 96-107. https://doi.org/10.1109/MRA.2011.940994MAVLINK, 2017. Micro air vehicle communication protocol. [Online] http://qgroundcontrol.org/mavlink/start, accedido en Marzo, 2017.Moreno-Salinas, D., Besada-Portas, E., López-Orozco, J., Chaos, D., de la Cruz, J., Aranda, J., 2015. Symbolic regression for marine vehicles identification. IFAC-PapersOnLine 48 (16), 210-216. https://doi.org/10.1016/j.ifacol.2015.10.282Mupparapu, S. S., Chappell, S. G., Komerska, R. J., Blidberg, D. R., Nitzel, R., Benton, C., Popa, D. O., Sanderson, A. C., 2004. Autonomous systems monitoring and control (asmac)-an auv fleet controller. In: Autonomous Underwater Vehicles, 2004 IEEE/OES. IEEE, pp. 119-126.Murphy, R. R., Steimle, E., Griffin, C., Cullins, C., Hall, M., Pratt, K., 2008. Cooperative use of unmanned sea surface and micro aerial vehicles at hurricane wilma. Journal of Field Robotics 25 (3), 164-180. https://doi.org/10.1002/rob.20235Park, S., Deyst, J., How, J. P., 2007. Performance and lyapunov stability of a nonlinear path following guidance method. Journal of Guidance, Control, and Dynamics 30 (6), 1718-1728. https://doi.org/10.2514/1.28957Patterson, M. C., Mulligan, A., Boiteux, F., 2013. Safety and security applications for micro-unmanned surface vessels. In: 2013 OCEANS-San Diego. IEEE, pp. 1-6.QGroundControl, 2017. A uav control station. [Online] http://qgroundcontrol.com/, accedido en Marzo de 2017.Ribas, D., Palomeras, N., Ridao, P., Carreras, M., Mallios, A., 2012. Girona 500 auv: From survey to intervention. IEEE ASME Transactions on Mechatronics 17 (1), 46-53. https://doi.org/10.1109/TMECH.2011.2174065STANAG4586, 2012. Standard interfaces of uav control system (ucs) for nato uav interoperability, ed. 3. NATO standardization agency (nsa). [Online] http://nso.nato.int/nso/nsdd/listpromulg.html.Sutton, R., Sharma, S., Xao, T., 2011. Adaptive navigation systems for an unmanned surface vehicle. Journal of Marine Engineering & Technology 10 (3), 3-20.Walter, B. E., Knutzon, J. S., Sannier, A. V., Oliver, J. H., 2004. Virtual uav ground control station. In: AIAA 3rd Unmanned Unlimited Technical Conference, Workshop and Exhibit. https://doi.org/10.2514/6.2004-6320WGSM, 2017. Wave glider management system. [Online] https://www.liquidrobotics.com/platform/software/

Impact of regulated and emerging pollutants and microplastics in marine ecosystems (IMPACTA project)

Marine ecosystems are nowadays subjected to a massive input of synthetic chemicals from everywhere. Unfortunately only a small portion of them is being monitored, and it is necessary to identify which pollutants can produce adverse impacts in the marine environment. IMPACTA project (CTM2013-48194-C3) is characterizing the distribution of regulated and emerging contaminants and microplastics in marine sediments, and evaluating the biological effects that they can cause (sing sublethal embryotoxicity tests, endocrine disruption and biomarkers). Sensitive and selective analytical methods are being developed and validated for pharmaceuticals, perfluorinated compounds, organophosphorus pesticides, triazines, personal care products, nonylphenols and alkylated PAHs in sediments. Thus, relevant pollutants present in coastal and offshore areas will be identified. Furthermore potential toxic effects of the contaminants present in coastal sediments are being assessed through embryotoxicity bioassays and also the biological effects on different marine species as a consequence of their exposition to specific compounds. Another relevant contribution of this project will be the assessment of the impact of micro-plastics, first time in the Spanish coastal areas. Their potential toxic effects and their role in the transference of pollutants in the marine environment are being assessed. The concentration and composition of microplastics in sediments and demersal fish stomachs are being characterized, and their potential biological effects on marine invertebrates are also being investigated

Compuestos orgánicos en aguas del estuario del Río Miño. Proyecto "TEAM-Miño"

Comunicación presentada al II Congreso Internacional de Ingeniería Civil y Territorio. Agua, Cultura y Sociedad. Vigo, 20 y 21 de Mayo de 2013.Los resultados de este trabajo se engloban en el Marco del proyecto TEAM-Miño “Transferencia de herramientas para la Evaluación, Ordenación, Gestión y Educación Ambiental en Estuarios” financiado por la Unión Europea (POCTEP 2007-2013), que pretende desarrollar herramientas comunes para la tipificación y clasificación del estado ecológico de las masas de agua de transición del sur de Galicia y norte de Portugal, con la finalidad de colaborar en la implantación de la Directiva Marco del Agua. Se han analizado 19 muestras de agua recogidas a lo largo del río Miño y sus afluentes. En ellas se han determinado diferentes contaminantes de amplio interés industrial y ambiental, como hidrocarburos aromáticos policíclicos (HAP), compuestos organoestánnicos, alquilfenoles y bisfenol A. Salvo excepciones, los niveles encontrados en las muestras no son elevados (<0,1 μg/L). La mayoría de los HAPs se encuentran por debajo de los límites de cuantificación del método analítico (MQL), siendo el compuesto mayoritario el naftaleno. Los compuestos organoestánnicos tampoco han sido detectados. Los alquilfenoles están presentes en todos los puntos muestreados (<MQL-1 μg/L), mientras que el bisfenol A se ha encontrado únicamente en dos de ellos, pero a altas concentraciones (>3 μg/L). En ningún caso las concentraciones medidas superan los límites establecidos en la Directiva 2008/105/CE

A Non-Targeted Approach Unravels the Volatile Network in Peach Fruit

Volatile compounds represent an important part of the plant metabolome and are of particular agronomic and biological interest due to their contribution to fruit aroma and flavor and therefore to fruit quality. By using a non-targeted approach based on HS-SPME-GC-MS, the volatile-compound complement of peach fruit was described. A total of 110 volatile compounds (including alcohols, ketones, aldehydes, esters, lactones, carboxylic acids, phenolics and terpenoids) were identified and quantified in peach fruit samples from different genetic backgrounds, locations, maturity stages and physiological responses. By using a combination of hierarchical cluster analysis and metabolomic correlation network analysis we found that previously known peach fruit volatiles are clustered according to their chemical nature or known biosynthetic pathways. Moreover, novel volatiles that had not yet been described in peach were identified and assigned to co-regulated groups. In addition, our analyses showed that most of the co-regulated groups showed good intergroup correlations that are therefore consistent with the existence of a higher level of regulation orchestrating volatile production under different conditions and/or developmental stages. In addition, this volatile network of interactions provides the ground information for future biochemical studies as well as a useful route map for breeding or biotechnological purposes

Digital messaging to support control for type 2 diabetes (StAR2D): a multicentre randomised controlled trial

Background Failure to take medicines for diabetes as prescribed contributes to poor outcomes from the condition. Mobile phones are ubiquitous and short message service (SMS) texts have shown promise as a low-cost intervention. We tested the effectiveness of SMS-text messaging in improving outcomes in adults with type 2 diabetes. Methods StAR2D was a 12-month two-arm randomised trial of SMS-text messaging and usual care in Cape Town, South Africa and Lilongwe, Malawi. Messages used behaviour change theory and were developed with patients and staff. The intervention group received four messages each week. The primary outcome was change in HbA1c. Secondary outcomes were the proportion of patients who collected > 80% medication and changes in systolic blood pressure, lipids, cardiovascular risk, and the proportion of the participants reaching treatment goals. Results The trial took place between 1 October, 2016 and 1 October 2018, 1186 participants were randomised to intervention (593) and control (593) groups. 91% of participants completed follow-up. There was a reduction in HbA1c (DCCT) in both groups but not in mean change (95% CI) between groups (− 0.08% (− 0.31 to 0.16) (IFCC − 0.82 mmol/mol (− 3.44 to 1.79). There was a small but not significant increase in the proportions of participants likely to have collected 80% or more of medication (Relative risk 1.11 (0.84 to 1.47; P = 0.47). There was a significant difference between groups in change in systolic blood pressure from baseline of 3.46 mmHg (1.48 to 5.44, P = 0.001) in favour of the intervention group. The between group difference in change in 10-year risk of coronary heart disease was − 0.71% (− 1.46 to 0.04, P = 0.064). The proportion of participants meeting treatment goals in the intervention group was 36.0% and in the control group 26.8% (Relative risk 1.36 (1.13 to 1.63, P = 0.001). Participants reported many challenges to adherence despite finding messages acceptable and useful. Conclusions Whilst SMS text messages do not lead to improved glycaemia in these low-resource settings there appeared to be an impact on blood pressure and achievement of treatment goals but the mechanisms for this are unclear. Text messages alone, may be unsuccessful unless accompanied by health system strengthening and other forms of self-management support for type 2 diabetes. Trial registration Trial registration: ISRCTN, ISRCTN70768808. Registered 1 July 2015, http://www.isrctn.com/I ISRCTN70768808