57Fe Mössbauer spectroscopy studies of chondritic meteorites from the Atacama Desert, Chile: Implications for weathering processes

Some terrestrial areas have climatic and geomorphologic features that favor the preservation, and therefore, accumulation of meteorites. The Atacama Desert in Chile is among the most important of such areas, known as dense collection areas. This desert is the driest on Earth, one of the most arid, uninhabitable locals with semi-arid, arid and hyper-arid conditions. The meteorites studied here were collected from within the dense collection area of San Juan at the Central Depression and Coastal Range of Atacama Desert. [superscript 57]Fe Mössbauer spectroscopy was used for quantitative analysis of the degree of weathering of the meteorites, through the determination of the proportions of the various Fe-bearing phases and in particular the amount of oxidized iron in the terrestrial alteration products. The abundance of ferric ions in weathered chondrites can be related to specific precursor compositions and to the level of terrestrial weathering. The aim of the study was the identification, quantification and differentiation of the weathering products in the ordinary chondrites found in the San Juan area of Atacama Desert

The evolution of Military Health in Valencia during the Spanish Civil War (1936-1939)

Antecedentes y objetivos: Tras la insurrección militar del 18 de julio de 1936 el Ejército de la República quedó parcialmente desarticulado, resultando afectada la Sanidad Militar. En el caso de Valencia, ésta fue asumida rápidamente por el Comité Sanitario Popular, un organismo revolucionario que lideró la respuesta sanitaria de Valencia a la Guerra Civil. Posteriormente, el Gobierno Republicano procedió a recuperar el poder a través de medidas de carácter centralizador, como fue la militarización de algunos hospitales. Fue entonces cuando volvió a articularse una auténtica Sanidad Militar. El objetivo de este trabajo es estudiar la evolución de la Sanidad Militar en Valencia, una de las zonas republicanas más importantes. Material y métodos: Se analiza la documentación generada por los abundantes hospitales instalados en la ciudad de Valencia, estudiando los cambios que se produjeron tras la militarización de algunos centros sanitarios. Esta información ha sido consultada en el Archivo de la Excma. Diputación Provincial de Valencia. Resultados: La Sanidad Militar en Valencia durante la Guerra Civil española atravesó varias etapas, evolucionado desde la improvisación inicial a la posterior organización. Conclusiones: Se establece una relación bidireccional entre el grado de organización de la Sanidad Militar y la efectividad de la tropa.Precedents and purposes: After the military insurrection of July 18, 1936 the Republican Army remained partially dismantled, affecting Military Health. In case of Valencia, it was assumed rapidly by Sanitary Popular Committee, a revolutionary organism that led the sanitary response of Valencia to the Civil War. Later, the Republican Government proceeded to recover power throghout centralizing measures, as the militarization of some hospitals. At this the time an authentic Military Health returned to be articulated. The aim of this work is to study the evolution of Military Health in Valencia, one of the most important republican zones. Material and method: Documentation generated by the abundant hospitals installed in the city of Valencia is analyzed, studying as well changes that took place after militarization of some sanitary centers. This information has been consulted in the File of the County Council of Valencia. Results: Military Health in Valencia during the Spanish Civil War went through several stages, as it evolved from initial improvisation to later organization. Conclusions: A bidirectional relation is established between the degree of Military Health organization and troop’s efficiency.Medicin

Health care on the Teruel front during the first republican military campaign (August 1936-February 1937).

Antecedentes y objetivos: La insurrección militar del 18 de julio de 1936 triunfó en la ciudad de Teruel. No existía ningún otro territorio dominado por los militares sublevados tan próximo a Valencia como la ciudad aragonesa. Así pues, a lo largo del verano de 1936, Teruel quedó rodeada por los milicianos valencianos, que, no obstante, no consiguieron tomar la ciudad. El objetivo de este trabajo es estudiar cómo se articuló la asistencia sanitaria de los milicianos valencianos que participaron en la primera campaña para conquistar Teruel. Asimismo, se pretende analizar las causas más frecuentes de baja entre los milicianos. Material y métodos: Las fuentes analizadas serán los partes médicos emitidos por los diferentes hospitales instalados en la provincia de Teruel. Por otro lado, analizaremos la correspondencia entre el jefe de los Servicios Sanitarios del frente de Teruel y los responsables sanitarios valencianos. Esta información ha sido consultada en el Archivo de la Excma. Diputación Provincial de Valencia (A.D.P.V.). Resultados: Los hospitales instalados en Teruel durante la primera campaña republicana no estaban coordinados entre si. Por otra parte, el frío causó la mayor parte de las bajas que sufrieron los milicianos valencianos. Conclusiones: La asistencia sanitaria durante las operaciones desarrolladas para conquistar Teruel entre agosto de 1936 y febrero de 1937 no estuvo correctamente organizada, lo que contribuyó al fracaso final de las milicias valencianas. Además, estas milicias no fueron equipadas adecuadamente, lo que explica que las infecciones respiratorias provocadas por el frío causaran más bajas que las armas de fuego.Precedents and purposes: The military uprising of 18 July 1936 triumphed in the city of Teruel. No other territory under rebel control was as close to Valencia as this Aragonese city. Thus, throughout the summer of 1936, Teruel was surrounded by Valencian militiamen, who, however, failed to take control of the city. The aim of this paper is to study how health care was organised for the Valencian militiamen who participated in the first campaign to conquer Teruel. Likewise, the most frequent causes of casualties among militiamen are analysed. Material anb method: The sources analysed are medical reports issued by different hospitals set up in the province of Teruel. Furthermore, we will analyse the correspondence between the head of the Health Services on the Teruel front and Valencian health officials. This information has been consulted in the Archives of the Provincial Council of Valencia (A.D.P.V.). Results: There was not coordination among the hospitals set up in Teruel during the first republican campaign. On the other hand, most of the Valencian militiamen casualties were caused by the cold weather. Conclusions: Health care during the operations developed to conquer Teruel between August 1936 and February 1937 was not organised correctly, which contributed to the final failure of the Valencian militias. In addition, these militias were not equipped properly, which explains that respiratory infections provoked by the cold weather caused more casualties than firearms.Medicin

Epidemiological and transmissibility analysis of influenza A(H1N1)v in a southern hemisphere setting: Peru

We present a preliminary analysis of 1,771 confirmed cases of influenza A(H1N1)v reported in Peru by 17 July including the frequency of the clinical characteristics, the spatial and age distribution of the cases and the estimate of the transmission potential. Age-specific frequency of cases was highest among school age children and young adults, with the lowest frequency of cases among seniors, a pattern that is consistent with reports from other countries. Estimates of the reproduction number lie in the range of 1.2 to 1.7, which is broadly consistent with previous estimates for this pandemic in other regions. Validation of these estimates will be possible as additional data become available

Rubella metapopulation dynamics and importance of spatial coupling to the risk of congenital rubella syndrome in Peru

Rubella is generally a mild childhood disease, but infection during early pregnancy may cause spontaneous abortion or congenital rubella syndrome (CRS), which may entail a variety of birth defects. Consequently, understanding the age-structured dynamics of this infection has considerable public health value. Vaccination short of the threshold for local elimination of transmission will increase the average age of infection. Accordingly, the classic concern for this infection is the potential for vaccination to increase incidence in individuals of childbearing age. A neglected aspect of rubella dynamics is how age incidence patterns may be moulded by the spatial dynamics inherent to epidemic metapopulations. Here, we use a uniquely detailed dataset from Peru to explore the implications of this for the burden of CRS. Our results show that the risk of CRS may be particularly severe in small remote regions, a prediction at odds with expectations in the endemic situation, and with implications for the outcome of vaccination. This outcome results directly from the metapopulation context: specifically, extinction–re-colonization dynamics are crucial because they allow for significant leakage of susceptible individuals into the older age classes during inter-epidemic periods with the potential to increase CRS risk by as much as fivefold

Adherence to Tuberculosis Therapy among Patients Receiving Home-Based Directly Observed Treatment: Evidence from the United Republic of Tanzania.

\ud \ud Non-adherence to tuberculosis (TB) treatment is the leading contributor to the selection of drug-resistant strains of Mycobacterium tuberculosis and subsequent treatment failure. Tanzania introduced a TB Patient Centred Treatment (PCT) approach which gives new TB patients the choice between home-based treatment supervised by a treatment supporter of their own choice, and health facility-based treatment observed by a medical professional. The aim of this study was to assess the extent and determinants of adherence to anti-TB therapy in patients opting for home-based treatment under the novel PCT approach. In this cross-sectional study, the primary outcome was the percentage of patients adherent to TB therapy as detected by the presence of isoniazid in urine (IsoScreen assay). The primary analysis followed a non-inferiority approach in which adherence could not be lower than 75%. Logistic regression was used to examine the influence of potentially predictive factors. A total of 651 new TB patients were included. Of these, 645 (99.1%) provided urine for testing and 617 patients (95.7%; 90%CI 94.3-96.9) showed a positive result. This result was statistically non-inferior to the postulated adherence level of 75% (p<0.001). Adherence to TB therapy under home-based Directly Observed Treatment can be ensured in programmatic settings. A reliable supply of medication and the careful selection of treatment supporters, who preferably live very close to the patient, are crucial success factors. Finally, we recommend a cohort study to assess the rate of adherence throughout the full course of TB treatment

Changes in the Viral Distribution Pattern after the Appearance of the Novel Influenza A H1N1 (pH1N1) Virus in Influenza-Like Illness Patients in Peru

Background: We describe the temporal variation in viral agents detected in influenza like illness (ILI) patients before and after the appearance of the ongoing pandemic influenza A (H1N1) (pH1N1) in Peru between 4-January and 13-July 2009. Methods: At the health centers, one oropharyngeal swab was obtained for viral isolation. From epidemiological week (EW) 1 to 18, at the US Naval Medical Research Center Detachment (NMRCD) in Lima, the specimens were inoculated into four cell lines for virus isolation. In addition, from EW 19 to 28, the specimens were also analyzed by real time-polymerase-chainreaction (rRT-PCR). Results: We enrolled 2,872 patients: 1,422 cases before the appearance of the pH1N1 virus, and 1,450 during the pandemic. Non-pH1N1 influenza A virus was the predominant viral strain circulating in Peru through (EW) 18, representing 57.8% of the confirmed cases; however, this predominance shifted to pH1N1 (51.5%) from EW 19–28. During this study period, most of pH1N1 cases were diagnosed in the capital city (Lima) followed by other cities including Cusco and Trujillo. In contrast, novel influenza cases were essentially absent in the tropical rain forest (jungle) cities during our study period. The city of Iquitos (Jungle) had the highest number of influenza B cases and only one pH1N1 case. Conclusions: The viral distribution in Peru changed upon the introduction of the pH1N1 virus compared to previous months. Although influenza A viruses continue to be the predominant viral pathogen, the pH1N1 virus predominated over the other influenza A viruses

Syndromic Surveillance: Adapting Innovations to Developing Settings

The tools and strategies of syndromic surveillance, say the authors, hold promise for improving public health security in developing countries

Cost-Effective Strategies for Mitigating a Future Influenza Pandemic with H1N1 2009 Characteristics

Background: We performed an analysis of the cost-effectiveness of pandemic intervention strategies using a detailed, individual-based simulation model of a community in Australia together with health outcome data of infected individuals gathered during 2009–2010. The aim was to examine the cost-effectiveness of a range of interventions to determine the most cost-effective strategies suitable for a future pandemic with H1N1 2009 characteristics. Methodology/Principal Findings: Using transmissibility, age-stratified attack rates and health outcomes determined from H1N1 2009 data, we determined that the most cost-effective strategies involved treatment and household prophylaxis using antiviral drugs combined with limited duration school closure, with costs ranging from $632 to$777 per case prevented. When school closure was used as a sole intervention we found the use of limited duration school closure to be significantly more cost-effective compared to continuous school closure, a result with applicability to countries with limited access to antiviral drugs. Other social distancing strategies, such as reduced workplace attendance, were found to be costly due to productivity losses. Conclusion: The mild severity (low hospitalisation and case fatality rates) and low transmissibility of H1N1 2009 meant that health treatment costs were dominated by the higher productivity losses arising from workplace absence due to illness and childcare requirements following school closure. Further analysis for higher transmissibility but with the same, mild severit

Defining the True Sensitivity of Culture for the Diagnosis of Melioidosis Using Bayesian Latent Class Models

BACKGROUND: Culture remains the diagnostic gold standard for many bacterial infections, and the method against which other tests are often evaluated. Specificity of culture is 100% if the pathogenic organism is not found in healthy subjects, but the sensitivity of culture is more difficult to determine and may be low. Here, we apply Bayesian latent class models (LCMs) to data from patients with a single Gram-negative bacterial infection and define the true sensitivity of culture together with the impact of misclassification by culture on the reported accuracy of alternative diagnostic tests. METHODS/PRINCIPAL FINDINGS: Data from published studies describing the application of five diagnostic tests (culture and four serological tests) to a patient cohort with suspected melioidosis were re-analysed using several Bayesian LCMs. Sensitivities, specificities, and positive and negative predictive values (PPVs and NPVs) were calculated. Of 320 patients with suspected melioidosis, 119 (37%) had culture confirmed melioidosis. Using the final model (Bayesian LCM with conditional dependence between serological tests), the sensitivity of culture was estimated to be 60.2%. Prediction accuracy of the final model was assessed using a classification tool to grade patients according to the likelihood of melioidosis, which indicated that an estimated disease prevalence of 61.6% was credible. Estimates of sensitivities, specificities, PPVs and NPVs of four serological tests were significantly different from previously published values in which culture was used as the gold standard. CONCLUSIONS/SIGNIFICANCE: Culture has low sensitivity and low NPV for the diagnosis of melioidosis and is an imperfect gold standard against which to evaluate alternative tests. Models should be used to support the evaluation of diagnostic tests with an imperfect gold standard. It is likely that the poor sensitivity/specificity of culture is not specific for melioidosis, but rather a generic problem for many bacterial and fungal infections