Programmatic and Individual-level Factors Associated with CD4 Cell Count at HAART Initiation and Survival Among Treatment-naïve Patients Initiating HAART in sub-Saharan Africa.

People living with HIV in low- and middle-income countries, on average, initiate antiretroviral therapy (ART) in the advanced stages of the infection (i.e. when the CD4 cell count has dropped below the recommended threshold for ART initiation) despite more than a decade since the start of scale-up of ART [1-4]. Late ART initiation is associated with higher patient morbidity and mortality, increased risk of secondary transmission in the population and higher healthcare cost [5-10]. Knowledge of HIV status is a critical first step to initiate ART [11-14]. Yet, half of the people living with HIV in sub-Saharan Africa are not aware of their status [15]. The World Health Organization, the Joint United Nations Programme on HIV/AIDS and other institutions support adoption of active screening for HIV (i.e. testing asymptomatic people for HIV) to help identify and treat people living with HIV before progressing to the advanced stages of the infection [11, 14, 16, 17]. The role of active screening on earlier initiation of ART and patient survival has not been examined. In this dissertation, I reviewed and synthesized the literature to identify barriers to ART initiation operating in low- and middle-income countries. I examined the role of active screening on patient CD4 cell count at ART initiation (a measure of HIV-disease progression) and survival, and investigated patient CD4 cell count at ART initiation as a potential mediator of the active screening-patient survival association. The databases Ovid Medline, PsycINFO, CINAHL, Scopus and Cochrane Reviews were searched as part of the literature review. Of 265 articles reviewed, thirty-five met the eligibility criteria and were therefore selected for the review. Mixed linear regression models with random intercepts and Marginal Cox Proportional models with robust sandwich estimators of variance were fitted as part of the statistical analyses for this dissertation. Patient, programmatic, and contextual variables were considered for statistical adjustment. Data for the analyses came from twenty-nine HIV/AIDS care and treatment sites in Kenya, Uganda, and Tanzania participating in the International Epidemiologic Databases to Evaluate AIDS (IeDEA) initiative. Patient level data were collected from 45,359 subjects who initiated ART between 2003 and 2008 in the twenty-nine sites. Site programmatic and contextual level data were collected via two structured questionnaires. The critical review of the literature led to the identification of 1) individual, programmatic and societal-level barriers to HIV testing, enrolling into care, and ART initiation; and 2) barriers pertaining to lack of knowledge of HIV/AIDS and ART (e.g. HIV/AIDS symptomatology, ART benefits, ART toxicity), limited accessibility to services, poor quality of services, shortage of staff, and HIV-related stigma as the most prominent barriers. Results of the analyses show that patients in sites with predominantly "Active Screening Entry Points" initiated ART, on average, with CD4 cell counts 24 cells/µL higher than patients in sites with mainly "non-Active Screening Entry Points." However, the gain in CD4 cell count did not translate into a statistically significant estimate of survival advantage for these patients [HR (95% CI): 0.82 (0.64 - 1.06)] though the results are in the expected directions. The modest gain in mean CD4 cell count, and the documented benefits of active screening (e.g. high acceptability, increased number of patients tested and higher rate of identification of previously undiagnosed people living with HIV) support adoption of this intervention particularly in regions with a high HIV burden and where a low proportion of the population is unaware of their HIV status

The Automated Root Exudate System (ARES): a method to apply solutes at regular intervals to soils in the field.

Root exudation is a key component of nutrient and carbon dynamics in terrestrial ecosystems. Exudation rates vary widely by plant species and environmental conditions, but our understanding of how root exudates affect soil functioning is incomplete, in part because there are few viable methods to manipulate root exudates in situ. To address this, we devised the Automated Root Exudate System (ARES), which simulates increased root exudation by applying small amounts of labile solutes at regular intervals in the field. The ARES is a gravity-fed drip irrigation system comprising a reservoir bottle connected via a timer to a micro-hose irrigation grid covering c. 1 m2; 24 drip-tips are inserted into the soil to 4-cm depth to apply solutions into the rooting zone. We installed two ARES subplots within existing litter removal and control plots in a temperate deciduous woodland. We applied either an artificial root exudate solution (RE) or a procedural control solution (CP) to each subplot for 1 min day-1 during two growing seasons. To investigate the influence of root exudation on soil carbon dynamics, we measured soil respiration monthly and soil microbial biomass at the end of each growing season. The ARES applied the solutions at a rate of c. 2 L m-2 week-1 without significantly increasing soil water content. The application of RE solution had a clear effect on soil carbon dynamics, but the response varied by litter treatment. Across two growing seasons, soil respiration was 25% higher in RE compared to CP subplots in the litter removal treatment, but not in the control plots. By contrast, we observed a significant increase in microbial biomass carbon (33%) and nitrogen (26%) in RE subplots in the control litter treatment. The ARES is an effective, low-cost method to apply experimental solutions directly into the rooting zone in the field. The installation of the systems entails minimal disturbance to the soil and little maintenance is required. Although we used ARES to apply root exudate solution, the method can be used to apply many other treatments involving solute inputs at regular intervals in a wide range of ecosystems

Restricción de crecimiento intrauterino

ResumenLa restricción del crecimiento intrauterino es una importante causa de morbilidad y mortalidad perinatal, con consecuencias que pueden tener implicancias hasta en la vida adulta. No existen estrategias terapéuticas a la fecha por lo que, su manejo consiste principalmente en su diagnóstico y seguimiento para definir el momento de finalizar el embarazo, equilibrando los riesgos de prematurez con la morbimortalidad esperada para cada condición fetal. En el presente artículo se describen las claves del diagnóstico, clasificación y seguimiento de acuerdo a estándares actuales que permitan el adecuado manejo clínico.SummaryIntrauterine growth restriction is a major cause of perinatal morbidity and mortality with consequences that may have implications even in adulthood. No treatment have currently available, so, management is mainly based in diagnosis and monitoring in order to choose the right time to delivery, balancing the risks of prematurity with the expected morbidity and mortality. A precise diagnosis, classification and fetal surveillance according to current standards is discussed

Peachy Parallel Assignments (EduHPC 2018)

Peachy Parallel Assignments are a resource for instructors teaching parallel and distributed programming. These are high-quality assignments, previously tested in class, that are readily adoptable. This collection of assignments includes implementing a subset of OpenMP using pthreads, creating an animated fractal, image processing using histogram equalization, simulating a storm of high-energy particles, and solving the wave equation in a variety of settings. All of these come with sample assignment sheets and the necessary starter code.Departamento de Informática (Arquitectura y Tecnología de Computadores, Ciencias de la Computación e Inteligencia Artificial, Lenguajes y Sistemas Informáticos)Facilitar la inclusión de ejercicios prácticos de programación paralela en cursos de Computación Paralela o de alto rendimiento (HPC)Comunicación en congreso: Descripción de ejercicios prácticos con acceso a material ya desarrollado y probado

Optimal feeder flow control for grid connected microgrids

The optimal management of distributed energy resources is one of theexisting challenges for the deployment of microgrids. When microgrids op-erate under feeder flow control mode, trying to maintain a constant self-consumption, generators adapt their output power to compensate load andnon-dispatchable generation variations. So, due to the uncertainty, findingthe optimal operation point is an important task that can become complex.This paper proposes an optimal power flow problem formulation for feederflow controlled microgrids. It is formulated as a mixed integer second ordercone program considering the optimal power flow equations in its relaxedform and uncertainty by means of stochastic formulation. In addition, analgorithm is developed in order to find a feasible optimum solution of theoriginal non-relaxed problem. The proposed algorithm can also be used inother optimal power flow problems with the condition that they must usethe same relaxation. The algorithm is validated through the IEEE 33-Busdistribution test system.Postprint (author's final draft

Plasma iron concentrations and systemic inflammatory response syndrome in neonatal foals

Sparse information regarding plasma iron concentration in neonatal foals and its utility as an inflammatory marker in this population has been published. To determine the physiologic plasma iron concentration in neonatal foals. To assess its utility as an inflammatory marker to predict systemic inflammatory response syndrome (SIRS) and as a prognostic marker. Forty-seven ill neonatal foals admitted to a referral equine hospital were divided in 2 groups based on the SIRS criteria (24 SIRS and 23 non-SIRS). Two control groups of 43 hospital and 135 stud farm healthy neonatal foals were also included. Observational prospective study. Data were summarized by mean and its 95% confidence interval and absolute frequency and percentage for quantitative andqualitative variables. One-way ANOVA, ANCOVA (group and age effects) and Dunnett as posthoc analysis were used to compare plasma iron concentration among groups. Neonatal foals with SIRS did not have had any statistically significant different plasma iron concentrations compared to non-SIRS (P = .56) and stud farm control group (P = .99), 172.8 μg/dL (95% CI; 126.0-219.6), 193.1 μg/dL (139.1-247.2), and 181.8 μg/dL (171.3-192.4), respectively. Plasma iron concentration had a large variability in healthy neonatal foals, and was negatively correlated with age in hospital controls (rho = −0.387) and sick neonatal foals (rho = −0.598) (P < .001). Plasma iron was not a useful marker of SIRS in neonatal foals and was not associated with outcome

Uso de Candida guilliermondii como alternativa biológica en la deshidratación de uchuva (Physalis peruviana)

Microbiólogo (a) IndustrialPregrad

Efecto de un programa de coordinación para la mejora de la técnica del pase de fútbol en jugadores de la categoría pre-infantil del Club Forindez

72 paginas : graficas, fotografiasEl presente trabajo de investigación, busca determinar el efecto de un programa de coordinación en la mejora de la técnica del pase de fútbol, en los deportistas de la categoría pre- infantil del Club Academia Forindez de la ciudad de Zipaquirá, Cundinamarca. En esta investigación se evaluaron 25 deportistas mediante la aplicación de pre-test, test de control y post- test de coordinación dinámica general, precisión de pase, equilibrio, test de Illinois, y prueba de desplazamiento con balón, dando como resultado en el test de desplazamiento con balón una media de 14,73 segundos en la primer toma, esto corresponde a una calificación de 6 puntos según la tabla de baremación, sin tener una mejoría significativa al comparar con el post-test, donde se obtuvo una media de 14,59 segundos siendo la misma calificación dentro de la tabla de baremación. En el test de precisión de pase se evidenció que la media de los jugadores en la ejecución del ejercicio con la pierna derecha fue de 3,36 aciertos en el pre-test, y luego en el post-test, se ve una leve mejora siendo la media de 3,56 aciertos. De acuerdo a los resultados, se pudo concluir que es necesario trabajar una mayor cantidad de tiempo en la coordinación para que esta tenga una mejora significativa en el fundamento técnico de pases en fútbol.The present research work seeks to determine the effect of a coordination program on the improvement of the soccer pass technique, in the athletes of the pre-infant category of the Academia Forindez Club of the city of Zipaquirá, Cundinamarca. In this research, 25 athletes were evaluated through the application of pre-test, control test and post-test of general dynamic coordination, accuracy of pass, balance, Illinois test, and displacement test with balloon, resulting in the test of displacement with balloon an average of 14.73 seconds in the first shot, this corresponds to a score of 6 points according to the scoreboard, without having a significant improvement when compared with the post-test, where an average of 14 was obtained. , 59 seconds being the same rating within the scoreboard. In the pass precision test it was evident that the average of the players in the execution of the exercise with the right leg was 3.36 hits in the pre-test, and then in the post-test, a slight improvement is seen being the average of 3.56 hits. According to the results, it was concluded that it is necessary to work a greater amount of time in the coordination so that this has a significant improvement in the technical foundation of you pass in soccer.Incluye biblografíaPregradoProfesional en Ciencias del Deport

Fresh Osteochondral Resurfacing of the Patellofemoral Joint

Large osteochondral lesions of the knee in young patients continue to be a challenge for orthopaedic surgeons and the focus of continual research. This is particularly true if the injury is a consequence of a dysplastic trochlea and involves both articular surfaces of the biomechanically complex patellofemoral joint. To obtain a healthy and congruent patellofemoral joint, the use of a bipolar fresh osteochondral allograft transplantation of the patella and trochlea is one of the few options to biologically treat these injuries. This would achieve a replacement of the entire articular surface of the patellofemoral joint with a high number of viable chondrocytes and respect the unique structural characteristics of the cartilage. The aim of this study was to obtain symptomatic and functional improvements while delaying the timing of prosthetic surgery. We present a reproducible although demanding surgical technique to perform a bipolar fresh osteochondral allograft transplantation of the patella and trochlea