Virologic and Immunologic Failure, Drug Resistance and Mortality during the First 24 Months Postpartum among HIV-Infected Women Initiated on Antiretroviral Therapy for Life in the Mitra plus Study, Dar es Salaam, Tanzania.

In the Mitra plus study of prevention of mother-to-child transmission of HIV-1, which included 501 women in Dar es Salaam, Tanzania, triple antiretroviral therapy (ART) was given from late pregnancy throughout breastfeeding up to 6 months postnatally. Here we report findings in a sub-cohort of women with ≤200 CD4cells/μL at enrolment who were continued on ART for life and followed up during 24 months after delivery to determine virologic and immunologic responses, drug resistance and mortality. Blood samples for viral load and CD4 counts testing were collected at enrolment and at 3, 6, 12 and 24 months postpartum. HIV drug resistance testing was performed at 12 months. Data analysis included descriptive statistics and multivariate analysis using Generalized Estimated Equations of 73 women with at least two postpartum assessments. The mortality analysis included 84 women who had delivered. The proportion of women with a viral load≥400 copies/mL was 97% (71/73) at enrolment, 16% (11/67), 22% (15/69), 61% (36/59) and 86% (48/56) at 3, 6, 12 and 24 months postpartum, respectively. The proportion of women with immunologic failure was 12% (8/69), 25% (15/60) and 41% (24/58) at 6, 12 and 24 months, respectively. At 12 months, drug resistance was demonstrated in 34% (20/59), including 12 with dual-class resistance. Self-report on drug adherence was 95% (64/68), 85% (56/66), 74% (39/53) and 65% (30/46) at 3, 6, 12 and 24 months, respectively. The mortality rate was 5.9% (95% CI 2.5-13.7%) at 24 months. The probability of virologic and immunologic failure was significantly higher among women who reported non-perfect adherence to ART at month 24 postpartum. Following an initial decline of viral load, virologic failure was common at 12 and 24 months postpartum among women initiated on ART for life during pregnancy because of low CD4 cell counts. A high proportion of viremic mothers also had resistance mutations. However, at 24 months follow-up, the mortality rate was still fairly low. Continuous adherence counseling and affordable means of monitoring of the virologic response are crucial for successful implementation of the WHO Option B+ guidelines to start all HIV-infected pregnant women on ART for life

Reconstructing Racially Polarized Voting

Racially polarized voting makes minorities more vulnerable to discriminatory changes in election laws and therefore implicates nearly every voting rights doctrine. In Thornburg v. Gingles , the Supreme Court held that racially polarized voting is a necessary—but not a sufficient—condition for a vote dilution claim under Section 2 of the Voting Rights Act. The Court, however, has recently questioned the propriety of recognizing the existence of racially polarized voting. This colorblind approach threatens not only the Gingles factors but also Section 2’s constitutionality. The Court treats racially polarized voting as a modern phenomenon. But the relevant starting point is the 1860s, not the 1960s. Prior to the Fifteenth Amendment’s passage, Republicans received overwhelming support from newly enfranchised Black voters in the former Confederate States and expected that support to continue. The Reconstruction Framers were thus attentive to the realities of racially polarized voting and openly recognized that extending the franchise would empower Black voters to mobilize politically and protect their own interests. Racially polarized voting was a feature—not a bug—in the passage and ratification of the Fifteenth Amendment. Accordingly, this Article argues that the Court’s treatment of racially polarized voting as a constitutional taboo is historically unfounded and doctrinally incoherent. There are significant implications for acknowledging the role of racially polarized voting during Reconstruction. This historical insight moves vote dilution claims—and their predicate finding of racially polarized voting—far closer to the heart of the Reconstruction Amendments and challenges the Court’s hostility to race-based redistricting. It is powerful evidence that Congress is well within its enforcement authority to remedy and deter dilutive measures that exploit racially polarized voting. Finally, reconstructing racially polarized voting helps reorient voting rights doctrine toward a Fifteenth Amendment framework

Iteroparity and its contribution to life-history variation in Atlantic salmon

Evolution of iteroparity is shaped by the trade-off between current and future reproduction.We studied variation in iteroparity among 205 050 individual Atlantic salmon caught in 179 rivers spanning 14◦ of latitude. The proportion of repeat spawners (iteroparous individuals) averaged 3.8% and ranged from 0% to 26% across rivers. Females were more often repeat spawners than males and had lower cost of reproduction in terms of lost body mass between spawning events. Proportion of repeat spawners for a given sea age at maturity, and the ratio of alternate to consecutive repeat spawners, increased with increasing population mean sea age at maturity. By combining smolt age, sea age at maturity, and age at additional spawning events, we identified 141 unique life-history types, and repeat spawners contributed 75% of that variation. Our results show that repeat spawners are important for life-history variation and suggest that the association between mean sea age and the frequency of repeat spawning is adaptive rather than a pleiotropic side effect arising from selection on sea age. age at maturity, life-history evolution, local adaptation, repeat spawning, trade-offpublishedVersio

Ein roter Streifen am Horizont: Untersuchung zu den Frauen in der Arbeiterbewegung

This is the contribution "Ein roter Streifen am Horizont: Untersuchung zu den Frauen in der Arbeiterbewegung" of MTS 10 (1990)

Kinetics of coal desulphurization by Acidianus brierleyi

Acidianus brierleyi was demonstrated to remove pyritic sulphur from coal. A. brierleyi was also found capable of catalyzing the removal of what is normally reported as organic sulphur from coal 171US34. A kinetic analysis was performed by assuming a first order reaction. The first order kinetics allowed a comparison with literature data for Thiobacillus ferrooxidans. Also, formation of jarosite was taken into account in the analysis. The simple first order kinetics was observed to fit the data on removal of sulphur satisfactorily