Early mortality and loss to follow-up in HIV-infected children starting antiretroviral therapy in Southern Africa.

BACKGROUND: Many HIV-infected children in Southern Africa have been started on antiretroviral therapy (ART), but loss to follow up (LTFU) can be substantial. We analyzed mortality in children retained in care and in all children starting ART, taking LTFU into account. PATIENTS AND METHODS: Children who started ART before the age of 16 years in 10 ART programs in South Africa, Malawi, Mozambique, and Zimbabwe were included. Risk factors for death in the first year of ART were identified in Weibull models. A meta-analytic approach was used to estimate cumulative mortality at 1 year. RESULTS: Eight thousand two hundred twenty-five children (median age 49 months, median CD4 cell percent 11.6%) were included; 391 (4.8%) died and 523 (7.0%) were LTFU in the first year. Mortality at 1 year was 4.5% [95% confidence interval (CI): 2.8% to 7.4%] in children remaining in care, but 8.7% (5.4% to 12.1%) at the program level, after taking mortality in children and LTFU into account. Factors associated with mortality in children remaining in care included age [adjusted hazard ratio (HR) 0.37; 95% CI: 0.25 to 0.54 comparing > or =120 months with <18 months], CD4 cell percent (HR: 0.56; 95% CI: 0.39 to 0.78 comparing > or =20% with <10%), and clinical stage (HR: 0.12; 95% CI: 0.03 to 0.45 comparing World Health Organization stage I with III/IV). CONCLUSIONS: In children starting ART and remaining in care in Southern Africa mortality at 1 year is <5% but almost twice as high at the program level, when taking LTFU into account. Age, CD4 percentage, and clinical stage are important predictors of mortality at the individual level

High contrast imaging at the LBT: the LEECH exoplanet imaging survey

In Spring 2013, the LEECH (LBTI Exozodi Exoplanet Common Hunt) survey began its $\sim$130-night campaign from the Large Binocular Telescope (LBT) atop Mt Graham, Arizona. This survey benefits from the many technological achievements of the LBT, including two 8.4-meter mirrors on a single fixed mount, dual adaptive secondary mirrors for high Strehl performance, and a cold beam combiner to dramatically reduce the telescope's overall background emissivity. LEECH neatly complements other high-contrast planet imaging efforts by observing stars at L' (3.8 $\mu$m), as opposed to the shorter wavelength near-infrared bands (1-2.4 $\mu$m) of other surveys. This portion of the spectrum offers deep mass sensitivity, especially around nearby adolescent ($\sim$0.1-1 Gyr) stars. LEECH's contrast is competitive with other extreme adaptive optics systems, while providing an alternative survey strategy. Additionally, LEECH is characterizing known exoplanetary systems with observations from 3-5$\mu$m in preparation for JWST.Comment: 12 pages, 5 figures. Proceedings of the SPIE, 9148-2

Security Policies of India, Brazil and South Africa – Regional Security Contexts as Constraints for a Common Agenda

In the course of the last decade, the IBSA states (India, Brazil, South Africa) have increased their weight in the shifting global order, particularly in economic affairs. Can the same be said about the IBSA states' position in the international security hierarchy? After locating the IBSA coalition in the shifting world order, we analyze its member states' willingness and capacity to coordinate their security policies and build a common global security agenda. In addition, we explore the state of and perspectives on bi- and trilateral collaboration initiatives on defense and armaments between India, Brazil and South Africa. A key reason for the mostly modest results of global security agenda coordination and cross-regional defense collaboration is that the prevailing security concerns of each country are located at the regional level. Therefore, the starting point of an assessment of the prospects of IBSA's security cooperation and its potential impact on the strategic global landscape has to be a comparative evaluation of the regional security environments, focusing on overlaps and potential synergies between the national security policies of the three state actors.Im Verlauf der letzten Dekade konnten die IBSA-Staaten (Indien, Brasilien, Südafrika) ihre Position in der sich verschiebenden Weltordnung erheblich verbessern; das gilt insbesondere für ihren Einfluss auf globale Handelsfragen. Lässt sich ein ähnlicher Aufstieg der IBSA-Staaten in der internationalen Sicherheitsordnung konstatieren? Die Autoren verorten die IBSA-Koalition in der sich verschiebenden Weltordnung und analysieren die Bereitschaft und Fähigkeit der drei Staaten, ihre Sicherheitsstrategien zu koordinieren und eine gemeinsame Sicherheitsagenda zu entwerfen. Ferner werden die Bedingungen und Perspektiven biund trilateraler Verteidigungs- und Rüstungszusammenarbeit untersucht. Im Ergebnis zeichnen sich bisher allenfalls anfängliche Bemühungen bei der Zusammenarbeit im Verteidigungssektor und bei der Entwicklung einer globalen Sicherheitsagenda ab. Ausschlaggebend dafür sind die primär auf der regionalen Ebene liegenden Sicherheitsprioritäten der IBSA-Staaten. Die perspektivische Bewertung des potenziellen Einflusses der Staatenkoalition auf globale Sicherheitsfragen erfolgt demnach vor dem Hintergrund der regionalen Sicherheitsstrategien Indiens, Brasiliens und Südafrikas. Dabei stehen mögliche Überschneidungen und Synergien zwischen den regionalen Sicherheitsstrategien im Zentrum des Interesses

2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death the Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC) Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC)

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Impact of COVID-19 Pandemic on TAVR Activity: A Worldwide Registry

Background: The COVID-19 pandemic had a considerable impact on the provision of structural heart intervention worldwide. Our objectives were: 1) to assess the impact of the COVID-19 pandemic on transcatheter aortic valve replacement (TAVR) activity globally; and 2) to determine the differences in the impact according to geographic region and the demographic, development, and economic status of diverse international health care systems. Methods: We developed a multinational registry of global TAVR activity and invited individual TAVR sites to submit TAVR implant data before and during the COVID-19 pandemic. Specifically, the number of TAVR procedures performed monthly from January 2019 to December 2021 was collected. The adaptive measures to maintain TAVR activity by each site were recorded, as was a variety of indices relating to type of health care system and national economic indices. The primary subject of interest was the impact on TAVR activity during each of the pandemic waves (2020 and 2021) compared with the same period pre–COVID-19 (2019). Results: Data were received from 130 centers from 61 countries, with 14 subcontinents and 5 continents participating in the study. Overall, TAVR activity increased by 16.7% (2,337 procedures) between 2018 and 2019 (ie, before the pandemic), but between 2019 and 2020 (ie, first year of the pandemic), there was no significant growth (–0.1%; –10 procedures). In contrast, activity again increased by 18.9% (3,085 procedures) between 2020 and 2021 (ie, second year of the pandemic). During the first pandemic wave, there was a reduction of 18.9% (945 procedures) in TAVR activity among participating sites, while during the second and third waves, there was an increase of 6.7% (489 procedures) and 15.9% (1,042 procedures), respectively. Further analysis and results of this study are ongoing and will be available at the time of the congress. Conclusion: The COVID-19 pandemic initially led to a reduction in the number of patients undergoing TAVR worldwide, although health care systems subsequently adapted, and the number of TAVR recipients continued to grow in subsequent COVID-19 pandemic waves. Categories: STRUCTURAL: Valvular Disease: Aorti

ARIA digital anamorphosis : Digital transformation of health and care in airway diseases from research to practice

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.Peer reviewe

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals &lt;1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data