WHO Clinical Staging of HIV Infection and Disease, Tuberculosis and Eligibility for Antiretroviral Treatment: Relationship to CD4 Lymphocyte Counts.

SETTING: Thyolo district, Malawi. OBJECTIVES: To determine in HIV-positive individuals aged over 13 years CD4 lymphocyte counts in patients classified as WHO Clinical Stage III and IV and patients with active and previous tuberculosis (TB). DESIGN: Cross-sectional study. METHODS: CD4 lymphocyte counts were determined in all consecutive HIV-positive individuals presenting to the antiretroviral clinic in WHO Stage III and IV. RESULTS: A CD4 lymphocyte count of < or = 350 cells/microl was found in 413 (90%) of 457 individuals in WHO Stage III and IV, 96% of 77 individuals with active TB, 92% of 65 individuals with a history of pulmonary TB (PTB) in the last year, 91% of 89 individuals with a previous history of PTB beyond 1 year, 81% of 32 individuals with a previous history of extra-pulmonary TB, 93% of 107 individuals with active or past TB with another HIV-related disease and 89% of 158 individuals with active or past TB without another HIV-related disease. CONCLUSIONS: In our setting, nine of 10 HIV-positive individuals presenting in WHO Stage III and IV and with active or previous TB have CD4 counts of < or = 350 cells/microl. It would thus be reasonable, in this or similar settings where CD4 counts are unavailable for clinical management, for all such patients to be considered eligible for antiretroviral therapy

Trocas de energia entre a superfície e atmosfera durante a estação seca no semi-árido nordestino.

O principal objetivo desse estudo é avaliar as trocas turbulentas de energia entre a superfície e a atmosfera acima da Caatinga, e verificar a influência de alguns parâmetros meteorológicos nessas trocas.A Biblioteca possui os resumos em papel

x509-free access to WLCG resources

Access to WLCG resources is authenticated using an x509 and PKI infrastructure. Even though HEP users have always been exposed to certificates directly, the development of modern Web Applications by the LHC experiments calls for simplified authentication processes keeping the underlying software unmodified. In this work we will show a solution with the goal of providing access to WLCG resources using the user's home organisations credentials, without the need for user-acquired x509 certificates. In particular, we focus on identity providers within eduGAIN, which interconnects research and education organisations worldwide, and enables the trustworthy exchange of identity-related information. eduGAIN has been integrated at CERN in the SSO infrastructure so that users can authenticate without the need of a CERN account. This solution achieves x509-free access to Grid resources with the help of two services: STS and an online CA. The STS (Security Token Service) allows credential translation from the SAML2 format used by Identity Federations to the VOMS-enabled x509 used by most of the Grid. The IOTA CA (Identifier-Only Trust Assurance Certification Authority) is responsible for the automatic issuing of short-lived x509 certificates. The IOTA CA deployed at CERN has been accepted by EUGridPMA as the CERN LCG IOTA CA, included in the IGTF trust anchor distribution and installed by the sites in WLCG. We will also describe the first pilot projects which are integrating the solution.Peer reviewe

Secondary forest as a counterbalance on the deforestation effects: its role on evapotranspiration and water use efficiency.

Published in 19th EGU General Assembly, EGU2017

Management of multi- and extensively drug-resistant tuberculosis in Ukraine: how well are we doing?

Setting: A tertiary care facility in Ukraine, a high multi- and extensively drug-resistant tuberculosis (MDR/XDR-TB) burden country. Objectives: To assess the management and treatment outcomes of MDR, pre-XDR-TB and XDR-TB. Design: Cohort study using programme data, 2006–2011. Results: Of 484 individuals with drug-resistant TB, 217 (45%) had MDR-, 153 (32%) pre-XDR- and 114 (24%) XDR-TB. Of all resistant types completing the intensive phase of treatment, 322 (67%) were alive and had culture converted. This included 157 (72%) with MDR- and 61 (54%) with XDR-TB. At the end of the continuation phase of treatment, 106 (22%) had treatment success and 378 (78%) had unfavourable outcomes, including 110 (23%) failures, 21 (4%) deaths, 71 (15%) losses to follow-up and 176 (36%) with an unknown outcome. This was associated with more than one lung cavity being affected, a history of treatment with second-line anti-tuberculosis drugs, poor adherence and XDR-TB. A total of 226 (47%) patients reported at least one adverse drug reaction, the most common being gastrointestinal and vestibular toxicity. Conclusion: Outcomes of MDR- and XDR-TB were satisfactory in the intensive phase; however, this was not sustained during the ambulatory period. If we are to do better, urgent measures are needed to improve ambulatory management, including making safer, shorter and more effective drug regimens available

Aplicação do modelo de vegetação dinâmica IBIS às condições de floresta de terra firme na região central da Amazônia.

É fundamental para os Modelos de Vegetação Dinâmica Global (DVGM na sigla em inglês) representar corretamente o ciclo diário, as variações sazonais e interanuais das trocas de massa e energia entre o ecossistema e a atmosfera, a hidrologia do solo, a fenologia das plantas e a evolução do estoque de carbono do ecossistema. Este estudo dedica-se a validação e calibração do DVGM IBIS (Integrated Biosphere Simulator) para um ecossistema de floresta tropical úmida de terra firme, localizada na Reserva Biológica do Cuieiras do INPA. Foram utilizados nove anos de dados meteorológicos da torre de fluxo K34, como também dados de diâmetro de árvores, medidas de sonda de nêutrons, de liteira fina e foi realizado um ajuste nos parâmetros físicos do solo do modelo. Os resultados indicam que o modelo representa bem o balanço hídrico, assim como o saldo de radiação e o fluxo de calor latente, porém não representa tão bem os fluxos de calor sensível e de CO2, o índice de área foliar (LAI) e os estoques de liteira fina e biomassa. Os resultados mostram a necessidade de definir um tipo funcional de planta específico para representar a floresta tropical úmida de terra firme da Amazônia e a inclusão de uma subrotina de eventos severos

Effect of smoke and clouds on the transmissivity of photosynthetically active radiation inside the canopy

Biomass burning activities emit high concentrations of aerosol particles to the atmosphere. Such particles can interact with solar radiation, decreasing the amount of light reaching the surface and increasing the fraction of diffuse radiation through scattering processes, and thus has implications for photosynthesis within plant canopies. This work reports results from photosynthetically active radiation (PAR) and aerosol optical depth (AOD) measurements conducted simultaneously at Reserva Biol&#243;gica do Jaru (Rondonia State, Brazil) during LBA/SMOCC (Large-Scale Biosphere-Atmosphere Experiment in Amazonia/ Smoke, Aerosols, Clouds, Rainfall, and Climate) and RaCCI (Radiation, Cloud, and Climate Interactions in the Amazon during the Dry-to-Wet Transition Season) field experiments from 15 September to 15 November 2002. AOD values were retrieved from an AERONET (Aerosol Robotic Network) radiometer, MODIS (Moderate Resolution Spectroradiometer) and a portable sunphotometer from the United States Department of Agriculture &ndash; Forest Service. Significant reduction of PAR irradiance at the top of the canopy was observed due to the smoke aerosol particles layer. This radiation reduction affected turbulent fluxes of sensible and latent heats. The increase of AOD also enhanced the transmission of PAR inside the canopy. As a consequence, the availability of diffuse radiation was enhanced due to light scattering by the aerosol particles. A complex relationship was identified between light availability inside the canopy and net ecosystem exchange (NEE). The results showed that the increase of aerosol optical depth corresponded to an increase of CO₂ uptake by the vegetation. However, for even higher AOD values, the corresponding NEE was lower than for intermediate values. As expected, water vapor pressure deficit (VPD), retrieved at 28m height inside the canopy, can also affect photosynthesis. A decrease in NEE was observed as VPD increased. Further studies are needed to better understand these findings, which were reported for the first time for the Amazon region under smoky conditions

Instruments Measuring Self-Care in Children and Young Adults With Chronic Conditions: A Systematic Review

: Children and young adults (CYAs) with chronic conditions need to engage in self-care to improve their quality of life. This study aimed to retrieve the literature on instruments to assess self-care in CYAs living with chronic conditions and evaluate the psychometric proprieties of the instruments retrieved. A systematic literature review was conducted on six databases to identify peer-reviewed papers that described or used an evaluation instrument of self-care in CYAs with chronic conditions. Twenty-three articles describing 11 instruments of self-care were identified. Five instruments (45.45%) were developed for specific diseases, while six (54.54%) for various chronic illnesses. Most of the instruments were focused on treatment adherence within self-care maintenance (i.e., behaviors to maintain illness stability), excluding the monitoring of clinical parameters or the management of exacerbations. This review provides an overview of available instruments that measure self-care in CYAs with chronic conditions, which health professionals could use for patient education

Trocas de energia e fluxo de carbono entre a vegetação de caatinga e atmosfera no Nordeste brasileiro.

Neste estudo foram avaliadas as variações sazonais dos fluxos de dióxido de carbono, de vapor de água e de energia em área de caatinga nativa, no nordeste do Brasil. A taxa de evapotranspiração (LE) do sistema é muito baixa tanto na estação seca quanto na estação chuvosa devido à baixa disponibilidade de água na região, com valores próximos de zero no final da estação seca. Durante a estação seca, cerca de 60 % da energia disponível (Rn) foi utilizada para aquecer o ar (H) e LE correspondeu a 10% de Rn, em média. Durante a estação chuvosa essas taxas foram, respectivamente, 46 e 17%. Quanto ao fluxo de CO2, o ecossistema atua como sumidouro de CcO2 no início da estação seca, quando o solo ainda contém umidade decorrente da estação chuvosa anterior, bem como na estação chuvosa. Já no final da estação seca, quando os estômatos se fecham e há uma redução significativa no folhedo em função do déficit hídrico, a taxa de fotossíntese torna-se nula e o sistema passa a atuar como fonte de CcO2

Methane flux, vertical gradient and mixing ratio measurements in a tropical forest

Measurements of CH&lt;sub&gt;4&lt;/sub&gt; mixing ratio, vertical gradients and turbulent fluxes were carried out in a tropical forest (Reserva Biológica Cuieiras), about 60 km north of Manaus, Brazil. The methane mixing ratio and flux measurements were performed at a height of 53 m (canopy height 35 m). In addition, vertical CH&lt;sub&gt;4&lt;/sub&gt; gradients were measured within the canopy using custom made air samplers at levels of 2, 16 and 36 m above ground. The methane gradients within the canopy reveal that there is a continuous methane source at the surface. No clear evidence for aerobic methane emission from the canopy was found. The methane fluxes above the canopy are small but consistently upwards with a maximum early in the morning. The measured fluxes are in agreement with the observed CH&lt;sub&gt;4&lt;/sub&gt; gradient in the canopy. In the morning hours, a strong canopy venting peak is observed for both CH&lt;sub&gt;4&lt;/sub&gt; and CO&lt;sub&gt;2&lt;/sub&gt;, but for CO&lt;sub&gt;2&lt;/sub&gt; this peak is then superimposed by photosynthetic uptake, whereas the peak lasts longer for CH&lt;sub&gt;4&lt;/sub&gt;. Monthly averaged diurnal cycles of the CH&lt;sub&gt;4&lt;/sub&gt; mixing ratio show a decrease during daytime and increase during nighttime. The magnitude of the difference in CH&lt;sub&gt;4&lt;/sub&gt; mixing ratio between day and night gradually increases throughout the wet season. The fluxes required to explain the nighttime increase are in agreement with the nighttime fluxes measured above the canopy, which implies that the CH&lt;sub&gt;4&lt;/sub&gt; increase in the nighttime boundary layer originates from local sources