Sexual network characteristics, condomless anal intercourse, and the HIV care cascade among MSM living with controlled versus uncontrolled HIV infection in Lima, Peru: a population-based cross-sectional analysis

Background: Despite high rates of HIV transmission among men who have sex with men (MSM) in Lima, Peru, limited data exist on the sexual network characteristics or risk factors for secondary HIV transmission among MSM with uncontrolled HIV infection. We report the frequency of serodiscordant, condomless anal intercourse (CAI) and associated sexual network characteristics among MSM in Lima with detectable HIV viremia and compare to those with undetectable viremia. Methods: This cross-sectional analysis includes MSM who tested positive for HIV-1 during screening for a trial of partner management and STI control (June 2022–January 2023). Participants were tested for HIV, gonorrhoea, chlamydia, and syphilis, and completed questionnaires on their demographic characteristics, sexual identity and behaviour, sexual network structures and engagement in HIV care. Findings: Of 665 MSM, 153 (23%) had detectable (>200 copies/mL) viremia. 75% (499/662) of men living with HIV were previously diagnosed, with 94% (n = 469/499) reporting that they were on ART, and 93% (n = 436/469) virally suppressed. 96% (n = 147/153) of men with detectable viremia reported serodiscordant CAI with at least one of their last three sexual partners, and 74% (n = 106/144) reported the same with all three of their recent partners. In contrast, 62% (n = 302/489) of men with undetectable viral load reported serodiscordant CAI with all of their last three partners (p < 0.01). Interpretation: 23% of men living with HIV in Peru had detectable viremia, of whom almost all (96%) reported recent serodiscordant CAI. The primary gap in the HIV care cascade lies in awareness of HIV serostatus, suggesting that improved access to HIV testing could be a key prevention strategy in Peru. Funding: Funding for this study was provided by NIH/ NIMH grants R01 MH118973 (PI: Clark) and R25 MH087222 (PI: Clark).National Institutes of HealthRevisión por pare

Challenges to climate change adaptation in coastal small towns:Examples from Ghana, Uruguay, Finland, Denmark, and Alaska

The ability of a coastal settlement to adapt to climate change is largely dependent upon access to a range of resources, which many coastal towns and small cities lack. Coastal small towns of less than 10,000 are therefore at a significant disadvantage compared to larger settlements when it comes to adaptation. One way to begin to overcome this disadvantage is to compare coastal small towns in order to identify efficiencies and support knowledge sharing. In this article we present and analyse five case studies of coastal small towns: Fuvemeh, Ghana; Kiyú, Uruguay; Hanko, Finland; Lemvig, Denmark; and Nome, Alaska, USA. A number of key outcomes and lessons were identified which highlights the need for a formal network of international coastal small towns to encourage and develop knowledge sharing practices going forward. A further lesson is the importance of using a range of indicators in order to establish the regional/national importance of a town. Basing this solely on population size can result in an erroneous interpretation of the significance (and therefore adaptive capacity) of a coastal small town. Finally, despite many barriers to adaptation in coastal small towns, being small offers some potential advantages, such as the possibility of being able to form a community consensus more easily, using 3D visualisations for adaptation planning, and having managed realignment as a realistic management option. It is imperative that climate change resilience in coastal small towns is increased by focussing on overcoming barriers and developing appropriate adaptation approaches by governments, non-governmental organisations, business, and researchers

[Ascenso al Nalón] [Material gráfico]

Contiene fotografías pertenecientes al archivo fotográfico del diario "Región", publicadas entre 1969 y 1980Algunas fotos no indica autoría. El resto firmadas por Información Gráfica Sierra (Oviedo), Estudios Jubar (Mieres), Estudios Lumier (Avilés), Foto Gutiérrez (Pravia), Foto Segura (Oviedo), y Foto E. Gar (Oviedo

[Futbolistas asturianos VIII] [Material gráfico]

Contiene fotografías pertenecientes al archivo fotográfico del diario "Región", publicadas entre 1963 y 1983Algunas fotos no indican autoría; el resto firmadas por Foto E. Gar (Oviedo), Foto Sierra (Oviedo), Foto Arsenio (Trubia, Oviedo), Foto Segura (Oviedo), Reportajes Fotográficos Marcos (Avilés), Foto Vázquez (Olloniego), Foto Gutiérrez (Navia

The avoidance of G-CSF and the addition of prophylactic corticosteroids after autologous stem cell transplantation for multiple myeloma patients appeal for the at-home setting to reduce readmission for neutropenic fever

Background Autologous stem cell transplantation (ASCT) remains the standard of care for young multiple myeloma (MM) patients; indeed, at-home ASCT has been positioned as an appropriate therapeutic strategy. However, despite the use of prophylactic antibiotics, neutropenic fever (NF) and hospital readmissions continue to pose as the most important limitations in the outpatient setting. It is possible that the febrile episodes may have a non-infectious etiology, and engraftment syndrome could play a more significant role. The aim of this study was to analyze the impact of both G-CSF withdrawal and the addition of primary prophylaxis with corticosteroids after ASCT. Methods Between January 2002 and August 2018, 111 MM patients conditioned with melphalan were managed at-home beginning +1 day after ASCT. Three groups were established: Group A (n = 33) received standard G-CSF post-ASCT; group B (n = 32) avoided G-CSF post-ASCT; group C (n = 46) avoided G-CSF yet added corticosteroid prophylaxis post-ASCT. Results The incidence of NF among the groups was reduced (64%, 44%, and 24%; P2 (OR 6.1; P = 0.002) and G-CSF avoidance plus corticosteroids (OR 0.1; P60 years (OR 14.6; P = 0.04) and G-CSF avoidance plus corticosteroids (OR 0.07; P = 0.05). Conclusions G-CSF avoidance and corticosteroid prophylaxis post ASCT minimize the incidence of NF in MM patients undergoing at-home ASCT. This approach should be explored in a prospective randomized clinical trial

Lo tangible e intangible del diseño

1 archivo PDF (366 páginas)"El Departamento de Evaluación del Diseño, en el Tiempo de la División de Ciencias y Artes para el Diseño de la Universidad Autónoma Metropolitana, Azcapotzalco, publica este libro colectivo, donde se aborda la discusión y el análisis sobre "Lo tangible e intangible del diseño". Este libro tiene como finalidad el profundizar en distintas posiciones teóricas, metodológicas y empíricas, donde un grupo interdisciplinario de profesores investigadores del Departamento de Evaluación, desde la arquitectura, los estudios urbanos, la educación, la historia, la semiótica, el diseño de la comunicación gráfica y el industrial; buscan convergencias y discuten divergencias que puedan generar servir como referentes intelectuales y teóricos, en el diseño. Este libro es resultado del Cuarto Coloquio Departamental: Lo tangible e Intangible del Diseño. Evaluación de Objetos, Espacios, Mensajes, realizado durante el mes de septiembre del año 2004, el cual se constituyó como un espacio para el intercambio de experiencias académicas y profesionales, desde una perspectiva interdisciplinaria, centrada en la reflexión y la discusión sobre la manera de cómo se puede analizar, definir y evaluar, lo tangible y lo intangible en el diseño"

Comunicar ciencia en México: fundamentos, estudios y experiencias

Este libro representa un nuevo hito en la consolidación de los estudios sobre comunicación, ciencia y cultura en América Latina pues articula un extenso intercambio de voces y experiencias que nutren la reflexión y el debate colectivo sobre el conocimiento tecnocientífico y su comunicación pública y destaca la participación profesional de las mujeres en este campo, así como los modos en que la comunicación pública de la ciencia en México se ha ido desplazando del conocimiento científico, en sí mismo, para centrarse en la comprensión y puesta en común de las muy complejas y diversas problemáticas que impactan la vida social y natural.ITESO, A.C

Preclinical Evaluation of Caprylic Acid-Fractionated IgG Antivenom for the Treatment of Taipan (Oxyuranus scutellatus) Envenoming in Papua New Guinea

articulo (arbitrado) -- Universidad de Costa Rica, Instituto de Investigaciones Clodomiro Picado, 2011Background: Snake bite is a common medical emergency in Papua New Guinea (PNG). The taipan, Oxyuranus scutellatus, inflicts a large number of bites that, in the absence of antivenom therapy, result in high mortality. Parenteral administration of antivenoms manufactured in Australia is the current treatment of choice for these envenomings. However, the price of these products is high and has increased over the last 25 years; consequently the country can no longer afford all the antivenom it needs. This situation prompted an international collaborative project aimed at generating a new, low-cost antivenom against O. scutellatus for PNG. Methodology/Principal Findings: A new monospecific equine whole IgG antivenom, obtained by caprylic acid fractionation of plasma, was prepared by immunising horses with the venom of O. scutellatus from PNG. This antivenom was compared with the currently used F(ab’)2 monospecific taipan antivenom manufactured by CSL Limited, Australia. The comparison included physicochemical properties and the preclinical assessment of the neutralisation of lethal neurotoxicity and the myotoxic, coagulant and phospholipase A2 activities of the venom of O. scutellatus from PNG. The F(ab’)2 antivenom had a higher protein concentration than whole IgG antivenom. Both antivenoms effectively neutralised, and had similar potency, against the lethal neurotoxic effect (both by intraperitoneal and intravenous routes of injection), myotoxicity, and phospholipase A2 activity of O. scutellatus venom. However, the whole IgG antivenom showed a higher potency than the F(ab’)2 antivenom in the neutralisation of the coagulant activity of O. scutellatus venom from PNG. Conclusions/Significance: The new whole IgG taipan antivenom described in this study compares favourably with the currently used F(ab’)2 antivenom, both in terms of physicochemical characteristics and neutralising potency. Therefore, it should be considered as a promising low-cost candidate for the treatment of envenomings by O. scutellatus in PNG, and is ready to be tested in clinical trials.This study was supported by Vicerrectoría de Investigación, Universidad de Costa Rica (project 741-A9-003); the PNG Office of Higher Education, CTP Limited (Milne Bay Estates), and the Australian Venom Research Unit (University of Melbourne), which is funded by the Australian Government Department of Health and Ageing, the Australia Pacific Science Foundation and Snowy Nominees. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto Clodomiro Picado (ICP

Influence of elevated-CRP level-related polymorphisms in non-rheumatic Caucasians on the risk of subclinical atherosclerosis and cardiovascular disease in rheumatoid arthritis

Association between elevated C-reactive protein (CRP) serum levels and subclinical atherosclerosis and cardiovascular (CV) events was described in rheumatoid arthritis (RA). CRP, HNF1A, LEPR, GCKR, NLRP3, IL1F10, PPP1R3B, ASCL1, HNF4A and SALL1 exert an influence on elevated CRP serum levels in non-rheumatic Caucasians. Consequently, we evaluated the potential role of these genes in the development of CV events and subclinical atherosclerosis in RA patients. Three tag CRP polymorphisms and HNF1A, LEPR, GCKR, NLRP3, IL1F10, PPP1R3B, ASCL1, HNF4A and SALL1 were genotyped in 2,313 Spanish patients by TaqMan. Subclinical atherosclerosis was determined in 1,298 of them by carotid ultrasonography (by assessment of carotid intima-media thickness-cIMT-and presence/absence of carotid plaques). CRP serum levels at diagnosis and at the time of carotid ultrasonography were measured in 1,662 and 1,193 patients, respectively, by immunoturbidimetry. Interestingly, a relationship between CRP and CRP serum levels at diagnosis and at the time of the carotid ultrasonography was disclosed. However, no statistically significant differences were found when CRP, HNF1A, LEPR, GCKR, NLRP3, IL1F10, PPP1R3B, ASCL1, HNF4A and SALL1 were evaluated according to the presence/absence of CV events, carotid plaques and cIMT after adjustment. Our results do not confirm an association between these genes and CV disease in RA