Situation analysis of the integration of family planning services in postpartum, postabortion and prevention of mother to child transmission programs in the Dominican Republic

A diagnostic study of the provision and use of contraception in postpartum, postabortion, and prevention of mother-to-child transmission (PMTCT) programs in the Dominican Republic was conducted with funding from USAID. The objectives of the study were to assess the contraceptive knowledge, attitudes, and behaviors of providers and clients; the degree to which information, counseling, and delivery are implemented in postpartum, postabortion, and PMTCT services; the quality of these services; and the readiness of postpartum, postabortion, and PMTCT services to offer contraceptive services. The report finds that family planning services are linked to antenatal, delivery, and postpartum care in most of the health units visited and, to a lesser degree, to the integral care provided for persons living with HIV. These and other key findings were shared with the MOH directors of maternal and child health services and other stakeholders. Based on this project’s findings, the report lists key recommendations to improve postpartum and postabortion family planning services in the Dominican Republic

Use of the industrial property system in Colombia (2018): A supervised learning application

The purpose of this paper is to establish ways to predict the spatial distribution of the use of the intellectual property system from information on industrial property applications and grants (distinctive signs and new creations) and copyright registrations in 2018. This will be done using supervised learning algorithms applied to information on industrial property applications and grants (trademarks and new creations) and copyright registrations in 2018. Within the findings, 4 algorithms were identified with a level of explanation higher than 80%: (i) Linear Regression, with an elastic network regularization; (ii) Stochastic Gradient Descent, with Hinge loss function, Ringe regularization (L2) and a constant learning rate; (iii) Neural Networks, with 1,000 layers, with Adam’s solution algorithm and 2,000 iterations; (iv) Random Forest, with 10 tree

The time course of different neuromuscular adaptations to short‑term downhill running training and their specific relationships with strength gains

Purpose: Due to its eccentric nature, downhill running (DR) training has been suggested to promote strength gains through neuromuscular adaptations. However, it is unknown whether short-term chronic DR can elicit such adaptations. Methods: Twelve untrained, young, healthy adults (five women, seven men) took part in four weeks’ DR, comprising 10 sessions, with running speed equivalent to 60-65% maximal oxygen uptake (V̇O2max, assessed at weeks 0 and 4). Isometric and isokinetic knee-extensor maximal voluntary torque (MVT), vastus lateralis (VL) muscle morphology/architecture (anatomical cross-sectional area, ACSA; physiological CSA, PCSA; volume; fascicle length, Lf; pennation angle, PA) and neuromuscular activation (VL EMG) were assessed at weeks 0, 2 and 4. Results: MVT increased by 9.7-15.2% after four weeks (p<0.01). VL EMG during isometric MVT increased by 35.6±46.1% after four weeks (p<0.05) and correlated with changes in isometric MVT after two weeks (r=0.86, p=0.001). VL ACSA (+2.9±2.7% and +7.1±3.5%) and volume (+2.5±2.5% and +6.6±3.2%) increased after two and four weeks, respectively (p<0.05). PCSA (+3.8±3.3%), PA (+5.8±3.8%) and Lf (+2.7±2.2%) increased after four weeks (p<0.01). Changes in VL volume (r=0.67, p=0.03) and PCSA (r=0.71, p=0.01) correlated with changes in concentric MVT from two-to-four weeks. V̇O2max (49.4±6.2 vs. 49.7±6.3 mL∙kg-1∙min-1) did not change after four weeks (p=0.73). Conclusion: Just four weeks’ moderate-intensity DR promoted neuromuscular adaptations in young, healthy adults, typically observed after high-intensity eccentric resistance training. Neural adaptations appeared to contribute to most of the strength gains at two and four weeks, while muscle hypertrophy seemed to contribute to MVT changes from two-to-four weeks only

Haemodynamic and clinical effects of ularitide in decompensated heart failure

Aims Ularitide is a synthetic form of urodilatin, a natriuretic peptide produced in the kidney with vasodilating, natriuretic, and diuretic effects, that offers promise for the management of decompensated heart failure (DHF). We assessed the efficacy and safety of ularitide in treating patients with DHF. Methods and results In this Phase II randomized, double-blind, placebo-controlled trial, 221 DHF patients received either placebo (n=53) or ularitide at 7.5 ng/kg/min (n=60), 15 ng/kg/min (n=53), or 30 ng/kg/min (n=55) as a 24-h continuous infusion. At 6 h, ularitide demonstrated a significant decrease in pulmonary capillary wedge pressure (P=0.052, P=0.000004, P=0.000002, respectively) and improved dyspnoea score in the 7.5, 15, and 30 ng/kg/min ularitide group (P=0.0026, P=0.0026, P=0.0013, respectively). Ularitide reduced systemic vascular resistance and increased cardiac index for the 15 and 30 ng/kg/min groups (P=0.017, P=0.00002, respectively). Systolic blood pressure (BP) decreased dose dependency. Heart rate and serum creatinine were unchanged through day 3. Most frequently reported drug-related adverse events through day 3 in all ularitide groups were dose-dependent BP decrease and hypotension. Conclusion Ularitide lowered cardiac filling pressures and improved dyspnoea without apparent early deleterious effects on renal function in DHF patients. These results suggest that ularitide may play a role in the management of DHF

Ascorbic acid supplementation attenuates exercise-induced bronchoconstriction in patients with asthma

SummaryBackgroundPrevious research has shown that diet can modify the bronchoconstrictor response to exercise in asthmatic subjects.ObjectiveDetermine the effect of ascorbic acid supplementation on pulmonary function and several urinary markers of airway inflammation in asthmatic subjects with exercise-induced bronchoconstriction (EIB).MethodsEight asthmatic subjects with documented EIB participated in a randomized, placebo controlled double-blind crossover trial. Subjects entered the study on their usual diet and were placed on either 2 weeks of ascorbic acid supplementation (1500mg/day) or placebo, followed by a 1-week washout period, before crossing over to the alternative diet. Pre- and post-exercise pulmonary function, asthma symptom scores, fraction of exhaled nitric oxide (FENO), and urinary leukotriene (LT) C4–E4 and 9α, 11β-prostagladin (PG)F2] were assessed at the beginning of the trial (usual diet) and at the end of each treatment period.Results: The ascorbic acid diet significantly reduced (p<0.05) the maximum fall in post-exercise FEV1 (−6.4±2.4%) compared to usual (−14.3±1.6%) and placebo diet (−12.9±2.4%). Asthma symptoms scores significantly improved (p<0.05) on the ascorbic acid diet compared to the placebo and usual diet. Post-exercise FENO, LTC4–E4 and 9α, 11β-PGF2 concentration was significantly lower (p<0.05) on the ascorbic acid diet compared to the placebo and usual diet.ConclusionAscorbic acid supplementation provides a protective effect against exercise-induced airway narrowing in asthmatic subjects

Applications of multi-walled carbon nanotube in electronic packaging

Thermal management of integrated circuit chip is an increasing important challenge faced today. Heat dissipation of the chip is generally achieved through the die attach material and solders. With the temperature gradients in these materials, high thermo-mechanical stress will be developed in them, and thus they must also be mechanically strong so as to provide a good mechanical support to the chip. The use of multi-walled carbon nanotube to enhance the thermal conductivity, and the mechanical strength of die attach epoxy and Pb-free solder is demonstrated in this work

In Vitro Effects of Pirfenidone on Cardiac Fibroblasts: Proliferation, Myofibroblast Differentiation, Migration and Cytokine Secretion

Cardiac fibroblasts (CFs) are the primary cell type responsible for cardiac fibrosis during pathological myocardial remodeling. Several studies have illustrated that pirfenidone (5-methyl-1-phenyl-2-[1H]-pyridone) attenuates cardiac fibrosis in different animal models. However, the effects of pirfenidone on cardiac fibroblast behavior have not been examined. In this study, we investigated whether pirfenidone directly modulates cardiac fibroblast behavior that is important in myocardial remodeling such as proliferation, myofibroblast differentiation, migration and cytokine secretion. Fibroblasts were isolated from neonatal rat hearts and bioassays were performed to determine the effects of pirfenidone on fibroblast function. We demonstrated that treatment of CFs with pirfenidone resulted in decreased proliferation, and attenuated fibroblast α-smooth muscle actin expression and collagen contractility. Boyden chamber assay illustrated that pirfenidone inhibited fibroblast migration ability, probably by decreasing the ratio of matrix metalloproteinase-9 to tissue inhibitor of metalloproteinase-1. Furthermore, pirfenidone attenuated the synthesis and secretion of transforming growth factor-β1 but elevated that of interleukin-10. These direct and pleiotropic effects of pirfenidone on cardiac fibroblasts point to its potential use in the treatment of adverse myocardial remodeling

Couple-oriented prenatal HIV counseling for HIV primary prevention: an acceptability study

<p>Abstract</p> <p>Background</p> <p>A large proportion of the 2.5 million new adult HIV infections that occurred worldwide in 2007 were in stable couples. Feasible and acceptable strategies to improve HIV prevention in a conjugal context are scarce. In the preparatory phase of the ANRS 12127 Prenahtest multi-site HIV prevention trial, we assessed the acceptability of couple-oriented post-test HIV counseling (COC) and men's involvement within prenatal care services, among pregnant women, male partners and health care workers in Cameroon, Dominican Republic, Georgia and India.</p> <p>Methods</p> <p>Quantitative and qualitative research methods were used: direct observations of health services; in-depth interviews with women, men and health care workers; monitoring of the COC intervention and exit interviews with COC participants.</p> <p>Results</p> <p>In-depth interviews conducted with 92 key informants across the four sites indicated that men rarely participated in antenatal care (ANC) services, mainly because these are traditionally and programmatically a woman's domain. However men's involvement was reported to be acceptable and needed in order to improve ANC and HIV prevention services. COC was considered by the respondents to be a feasible and acceptable strategy to actively encourage men to participate in prenatal HIV counseling and testing and overall in reproductive health services.</p> <p>Conclusions</p> <p>One of the keys to men's involvement within prenatal HIV counseling and testing is the better understanding of couple relationships, attitudes and communication patterns between men and women, in terms of HIV and sexual and reproductive health; this conjugal context should be taken into account in the provision of quality prenatal HIV counseling, which aims at integrated PMTCT and primary prevention of HIV.</p