'I don't want anyone to know': Experiences of obtaining access to HIV testing by Eastern European, non-European Union sex workers in Amsterdam, the Netherlands.

Historically, the Netherlands has hosted a large number of migrant sex workers. Since sex work is considered a legal profession it might serve as an example of better access to health services, including HIV testing, at least for those working within the legal framework. However, migrant sex workers, especially non-European Union (EU) nationals, might not be eligible to register for official employment and thus face obstacles in obtaining access to health services, becoming essentially invisible. This study examined context-specific vulnerabilities of migrant female sex workers (FSWs) from Belarus, Moldova, Russia and Ukraine, whether and how they have access to HIV testing compared to other EE, non-EU migrant FSWs in Amsterdam in the Netherlands. We conducted a multi-stakeholder perspective study from November 2015 to September 2017 in Amsterdam. The study comprised 1) semi-structured interviews with key stakeholders (N = 19); 2) in-depth interviews with Eastern European, non-EU migrant FSWs (N = 5) and field observations of the escort agency working with them; and 3) in-depth interviews with key stakeholders (N = 12). We found six key barriers to HIV testing: 1) migration and sex-work policies; 2) stigma, including self-stigmatization; 3) lack of trust in healthcare providers or social workers; 4) low levels of Dutch or English languages; 5) negative experience in accessing healthcare services in the home country; and 6) low perceived risk and HIV-related knowledge. Having a family and children, social support and working at the licensed sex-work venues might facilitate HIV testing. However, Internet-based sex workers remain invisible in the sex-work industry. Our findings indicate the importance of addressing women's diverse experiences, shaped by intrapersonal, interpersonal, community, network and policy-level factors, with stigma being at the core. We call for the scaling up of outreach interventions focusing on FSWs and, in particular, migrant FSWs working onlin

Errors in transrectal ultrasonic planimetry of the prostate: Computer simulation of volumetric errors applied to a screening population

Three systemic errors in routine ultrasonic planimetric volume measurements of the prostate were assessed. A computer model using ellipsoids was used to simulate the step section technique and different forms of rotational movements of the prostate during planimetry. The planimetric volume was up to 12% smaller than the exact volume, depending on the degree of rotational movement, the shape, and the length of the ellipsoid. In vivo study of a screening popul

Impact assessment of different battery energy storage technologies in distribution grids with high penetration of renewable energies

The need for increasing further the penetration of Renewable Energy Sources (RESs) is demanding a change in the way distribution grids are managed. In particular, the RESs intermittent and stochastic nature is finding in Battery Energy Storage (BES) systems its most immediate countermeasure. This work presents a reality-based assessment and comparison of the impact of three different BES technologies on distribution grids with high RES penetration, namely Li-ion, Zn-Air and Redox Flow. To this end, a benchmark distribution grid with real prosumers’ generation and load profiles is considered, with the RES penetration purposely scaled up in such a way as to violate the grid operational limits. Then, further to the BES(s) placement on the most affected grid location(s), the impact of the three BES types is assessed considering two Use Cases: 1) Voltage & Congestion Management and 2) Peak Shaving & Energy shifting. Assessment is conducted by evaluating a set of technical Key Performance Indicators (KPIs), together with a simplified economic analysis. © 2022, European Association for the Development of Renewable Energy, Environment and Power Quality (EA4EPQ). All rights reserved

Ability to cause erythema migrans differs between Borrelia burgdorferi sensu lato isolates

Background: Lyme borreliosis is a tick-borne disease caused by Borrelia burgdorferi sensu lato. The variety of characteristic and non-specific clinical manifestations is partially explained by its genetic diversity. We investigated the ability of B. burgdorferi sl isolates to cause erythema migrans. Methods. The genetic constellation of isolates from ticks was compared to isolates found in erythema migrans. PCR and sequence analysis was performed on the plasmid-encoded ospC and the chromosomal 5S-23S rDNA spacer region (IGS). Results: Seven different B. burgdorferi sl genospecies were identified in 152 borrelia isolates from ticks and erythema migrans biopsies. B afzelii (51%) and B. garinii (27%) were the most common in ticks. From the 44 sequences obtained from erythema migrans samples 42 were B. afzelii, one B. garinii and one B. bavariensis. Significant associations with erythema migrans formation were found for four IGS and two ospC types. Five from 45 ospC types were associated with more than one genospecies. Conclusions: B. burgdorferi sl isolates differ in their propensity to cause erythema migrans. These differences were also found within genospecies. In other words, although B. afzelii was mostly associated with erythema migrans, some B. afzelii isolates had a low ability to cause erythema migrans. Our data further support the occurrence of plasmid exchange between borrelia genospecies under natural conditions

Experimental evidence for inherent Lévy search behaviour in foraging animals

Recently, Lévy walks have been put forward as a new paradigm for animal search and many cases have been made for its presence in nature. However, it remains debated whether Lévy walks are an inherent behavioural strategy or emerge from the animal reacting to its habitat. Here, we demonstrate signatures of Lévy behaviour in the search movement of mud snails (Hydrobia ulvae) based on a novel, direct assessment of movement properties in an experimental set-up using different food distributions. Our experimental data uncovered clusters of small movement steps alternating with long moves independent of food encounter and landscape complexity. Moreover, size distributions of these clusters followed truncated power laws. These two findings are characteristic signatures of mechanisms underlying inherent Lévy-like movement. Thus, our study provides clear experimental evidence that such multi-scale movement is an inherent behaviour rather than resulting from the animal interacting with its environmen

Flushing of an intravenous catheter: a cause for unreliable laboratory results

Introduction: Phlebotomy is an error-prone process in which mistakes are difficult to reveal. This case report describes the effect on laboratory results originating from a blood sample collected in close proximity to an intravenous catheter. Materials and methods: A 69-year-old male patient was referred to the Emergency department where pneumonia was suspected. Phlebotomy was performed to collect blood samples to assess electrolytes, renal function, liver function, infection and haematological parameters. Results: The laboratory analysis showed reduced potassium and calcium concentrations. To prevent life-threatening cardiac failure the clinician decided to correct those electrolytes. Remarkably, the electrocardiogram showed no abnormalities corresponding to hypokalaemia and hypocalcaemia. This observation, in combination with an overall increase in laboratory parameters with the exception of sodium and chloride, led to the suspicion of a preanalytical error. Retrospectively, an intravenous catheter was inserted in close proximity of the puncture place but no continuous infusion was started prior to phlebotomy. However, the intravenous catheter was flushed with sodium chloride. Since potential other causes were excluded, the flushing of the intravenous catheter with sodium chloride prior to phlebotomy was the most probable cause for the deviating laboratory results and subsequently for the unnecessary potassium and calcium suppletion. Conclusion: This case underlines the importance of caution in the interpretation of laboratory results obtained from specimens that are collected in the proximity of an intravenous catheter, even in the absence of continuous infusion

Alinhamento interpessoal, representacional e morfossintático na Gramática Discursivo-Funcional

Este artigo se debruça sobre o mapeamento entre os Níveis Interpessoal, Representacional e Morfossintático da gramática, o chamado alinhamento, segundo o arcabouço da Gramática Discursivo-Funcional (GDF). Propõe uma tipologia das línguas baseada no que a sua organização morfossintática codifica: distinções pragmáticas (p.ex. em Tagalo), distinções semânticas (p.ex. em Achém), ou distinções inerentes à morfossintaxe (p.ex. em Inglês, Basco ou a língua Kham). A inclusão tanto do Sujeito como do Objeto e de línguas tanto acusativas como ergativas no tratamento do alinhamento morfossintático permitiu-nos abranger tipos tipologicamente mais variáveis e demonstrar o potencial da GDF para a análise contrastiva das línguas.<br>Within the framework of Functional Discourse Grammar (FDG), alignment concerns the relations between the Interpersonal, Representational and Morphosyntactic Levels of grammar. This article proposes a typology of languages based upon what we find to be encoded in their morphosyntactic organization: pragmatic distinctions (as in Tagalog), semantic distinctions (as in Acheh), or distinctions inherent to the morphosyntax (as in English, Basque and Kham). By including both subject and object, and both accusative and ergative languages in our treatment of morphosyntactic alignment, we provide a better coverage of typological variation and show the potential of FDG for cross-linguistic analysis