The Diagnostic Laboratory Hub: A New Health Care System Reveals the Incidence and Mortality of Tuberculosis, Histoplasmosis, and Cryptococcosis of PWH in Guatemala.

A Diagnostic Laboratory Hub (DLH) was set up in Guatemala to provide opportunistic infection (OI) diagnosis for people with HIV (PWH). Patients newly presenting for HIV, PWH not receiving antiretrovirals (ARVs) for >90 days but returned to care (Return/Restart), and PWH on ARVs with symptoms of OIs (ARV treatment) were prospectively included. Screening for tuberculosis, nontuberculous mycobacteria (NTM), histoplasmosis, and cryptococcosis was done. Samples were couriered to the DLH, and results were transmitted electronically. Demographic, diagnostic results, disease burden, treatment, and follow-up to 180 days were analyzed. In 2017, 1953 patients were included, 923 new HIV infections (an estimated 44% of all new HIV infections in Guatemala), 701 on ARV treatment, and 315 Return/Restart. Three hundred seventeen (16.2%) had an OI: 35.9% tuberculosis, 31.2% histoplasmosis, 18.6% cryptococcosis, 4.4% NTM, and 9.8% coinfections. Histoplasmosis was the most frequent AIDS-defining illness; 51.2% of new patients had <200 CD4 cells/mm3 with a 29.4% OI incidence; 14.3% of OIs in new HIV infections occurred with CD4 counts of 200-350 cells/mm3. OIs were the main risk factor for premature death for new HIV infections. At 180 days, patients with OIs and advanced HIV had 73-fold greater risk of death than those without advanced disease who were OI-free. The DLH OI screening approach provides adequate diagnostic services and obtains relevant data. We propose a CD4 screening threshold of <350 cells/mm3. Mortality remains high, and improved interventions are required, including expansion of the DLH and access to antifungal drugs, especially liposomal amphotericin B and flucytosine.Financial support. This work was supported by Global Action Fund for Fungal Infections and JYLAG, a charity Foundation based in Switzerland (E.A. received this funding under the proposal: “Minimising HIV deaths through rapid fungal diagnosis and better care in Guatemala”). Other contributions came from AIDS Health Foundation (AHF) Guatemala, Intrahealth International and Ministry of health in Guatemala (MSPAS).S

High-accuracy numerical models of Brownian thermal noise in thin mirror coatings

Brownian coating thermal noise in detector test masses is limiting the sensitivity of current gravitational-wave detectors on Earth. Therefore, accurate numerical models can inform the ongoing effort to minimize Brownian coating thermal noise in current and future gravitational-wave detectors. Such numerical models typically require significant computational resources and time, and often involve closed-source commercial codes. In contrast, open-source codes give complete visibility and control of the simulated physics and enable direct assessment of the numerical accuracy. In this article, we use the open-source SpECTRE numerical-relativity code and adopt a novel discontinuous Galerkin numerical method to model Brownian coating thermal noise. We demonstrate that SpECTRE achieves significantly higher accuracy than a previous approach at a fraction of the computational cost. Furthermore, we numerically model Brownian coating thermal noise in multiple sub-wavelength crystalline coating layers for the first time. Our new numerical method has the potential to enable fast exploration of realistic mirror configurations, and hence to guide the search for optimal mirror geometries, beam shapes and coating materials for gravitational-wave detectors.Comment: 9 pages, 5 figures. Results are reproducible with the ancillary input file

Informe final: Priorizando inversiones en agricultura sostenible adaptada al clima en Guatemala

El siguiente informe abordará los resultados del primer y segundo taller de Priorización de Inversiones en Agricultura Sostenible Adaptada al Clima realizados los días 7 de Agosto de 2014 y 18 de Junio de 2015 respectivamente, en Ciudad de Guatemala, Guatemala. A través de las secciones se presentarán cada una de las actividades desarrolladas durante los eventos, y al mismo tiempo se hará un breve análisis de los principales resultados obtenidos junto con unas conclusiones finales. La información aquí presentada, será el insumo necesario para completar el ciclo de priorización de prácticas ASAC dentro del Marco de Priorización e iniciar una etapa de construcción del entorno favorable para la adopción y escalamiento de portafolios de prácticas de Agricultura Sostenible Adaptada al Clima (ASAC) con la colaboración articulada entre el MAGA y los diferentes actores involucrados e identificados durante el proceso

El primer año de la pandemia – ¿Qué hemos aprendido del SARS-CoV-2/COVID-19?

Editorial (no Summary)Editorial (Sin resumen

Infectious Diseases, Social, Economic and Political Crises, Anthropogenic Disasters and Beyond: Venezuela 2019 – Implications for Public Health and Travel Medicine

During last months, there have been a significant increase in the evidences showing the catastrophic health situation in Venezuela. There are multiple epidemics, increase in emerging and reemerging infectious, tropical and parasitic diseases as consequences of the social, economic and political crises, which would be considered today a clearly anthropogenic disaster. Venezuela is facing in 2019, the worse sanitary conditions, with multiple implications for public health and travel medicine. So far, from a global perspective, this situation will be an impediment for the achievement of the sustainable development goals (SDG) in 2030. In this multiauthor review, there is a comprehensive analysis of the situation for infectious diseases, non-communicable diseases, their impact in the Americas region, given the migration crisis as well as the comparative status of the SDG 2030. This discussion can provide input for prioritizing emerging health problems and establish a future agenda