Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunities

Patients seeking emergency care have higher HIV prevalence than the general population, but HIV testing is often not offered in these settings, constituting missed opportunities for HIV testing. Semi structured interviews were conducted withemergency department health workers in a secondary hospital in Brazil. Interviews were recorded, transcribed, and analyzed for themes related to barriers and facilitator to HIV testing in emergency departments (EDs) and strategies to implement HIV screening programs. Currently, most providers reported only offering HIV testing when suspecting that the health problem that motivated the patient to seek care could be HIV-related. Although some providers believed that EDs would not be appropriate to implement screening programs, acceptability of HIV screening programs in this setting was overall high, particularly among nurses. Barriers to increasing HIV testing in EDs included concerns about time, understaffing, and increased costs. The initial triage was identified as a leverage point to obtain consent for HIV screening. Advantages and limitations of HIV screening programs at initial triage, testing blood samples collected for other reasons, and for patients undergoing emergency surgical procedures are discussed. EDs in medium income countries constitute a potential scenario to implement HIV screening programs, and such programs may benefit from empowering nursing staff to that end.Los pacientes que acuden a urgencias presentan una prevalencia del VIH superior a la de la población general, pero a menudo no se ofrecen pruebas del VIH en estos entornos, lo que constituye una pérdida de oportunidades para realizarlas. Se realizaronentrevistas semiestructuradas a trabajadores sanitarios del servicio de urgencias de un hospital secundario de Brasil. Las entrevistas fueron grabadas, transcritas y analizadas en busca de temas relacionados con las barreras y los facilitadores de las pruebas del VIH en los servicios de urgencias (SU) y las estrategias para implementar programas de cribado del VIH. En la actualidad, la mayoría de los proveedores informaron que sólo ofrecen la prueba del VIH cuando sospechan que el problema de salud que motivó al paciente a buscar atención podría estar relacionado con el VIH. Aunque algunos proveedores creían que los SUH no serían apropiados para implementar programas de cribado, la aceptación de los programas de cribado del VIH en este entorno era en general alta, especialmente entre las enfermeras. Los obstáculos para aumentar las pruebas del VIH en los SUH incluían la preocupación por el tiempo, la falta de personal y el aumento de los costes. El triaje inicial se identificó como un punto de apoyo para obtener el consentimiento para el cribado del VIH. Se discuten las ventajas y limitaciones de los programas de cribado del VIH en el triaje inicial, el análisis de muestras de sangre recogidas por otras razones, y para los pacientes sometidos a procedimientos quirúrgicos de emergencia. Los SUH de países de renta media constituyen un escenario potencial para implementar programas de cribado del VIH, y dichos programas pueden beneficiarse de la capacitación del personal de enfermería para tal fin.Os pacientes que procuram atendimento de emergência têm maior prevalência de HIV do que a população em geral, mas o teste de HIV muitas vezes não é oferecido nesses ambientes, o que constitui oportunidades perdidas para o teste de HIV. Foram realizadas entrevistas semiestruturadas com profissionais de saúde do departamento de emergência em um hospital secundário no Brasil. As entrevistas foram gravadas, transcritas e analisadas quanto a temas relacionados a barreiras e facilitadores do teste de HIV em departamentos de emergência (EDs) e estratégias para implementar programas de triagem de HIV. Atualmente, a maioria dos provedores relatou que só oferece testes de HIV quando suspeita que o problema de saúde que motivou o paciente a procurar atendimento pode estar relacionado ao HIV. Embora alguns provedores acreditassem que os departamentos de emergência não seriam apropriados para implementar programas de triagem, a aceitabilidade dos programas de triagem de HIV nesse ambiente foi, em geral, alta, especialmente entre os enfermeiros. As barreiras para aumentar os testes de HIV nos DEs incluíam preocupações com o tempo, falta de pessoal e aumento dos custos. A triagem inicial foi identificada como um ponto de alavancagem para obter o consentimento para a triagem de HIV. São discutidas as vantagens e as limitações dos programas de triagem de HIV na triagem inicial, no teste de amostras de sangue coletadas por outros motivos e para pacientes submetidos a procedimentos cirúrgicos de emergência. As salas de emergência em países de renda média constituem um cenário em potencial para a implementação de programas de triagem de HIV, e esses programas podem se beneficiar da capacitação da equipe de enfermagem para esse fim

Recording Lifetime Behavior and Movement in an Invertebrate Model

Characterization of lifetime behavioral changes is essential for understanding aging and aging-related diseases. However, such studies are scarce partly due to the lack of efficient tools. Here we describe and provide proof of concept for a stereo vision system that classifies and sequentially records at an extremely fine scale six different behaviors (resting, micro-movement, walking, flying, feeding and drinking) and the within-cage (3D) location of individual tephritid fruit flies by time-of-day throughout their lives. Using flies fed on two different diets, full sugar-yeast and sugar-only diets, we report for the first time their behavioral changes throughout their lives at a high resolution. We have found that the daily activity peaks at the age of 15–20 days and then gradually declines with age for flies on both diets. However, the overall daily activity is higher for flies on sugar-only diet than those on the full diet. Flies on sugar-only diet show a stronger diurnal localization pattern with higher preference to staying on the top of the cage during the period of light-off when compared to flies on the full diet. Clustering analyses of age-specific behavior patterns reveal three distinct young, middle-aged and old clusters for flies on each of the two diets. The middle-aged groups for flies on sugar-only diet consist of much younger age groups when compared to flies on full diet. This technology provides research opportunities for using a behavioral informatics approach for understanding different ways in which behavior, movement, and aging in model organisms are mutually affecting

Search for Charginos with a Small Mass Difference with the Lightest Supersymmetric Particle at \sqrt{s} = 189 GeV

A search for charginos nearly mass-degenerate with the lightest supersymmetric particle is performed using the 176 pb^-1 of data collected at 189 GeV in 1998 with the L3 detector. Mass differences between the chargino and the lightest supersymmetric particle below 4 GeV are considered. The presence of a high transverse momentum photon is required to single out the signal from the photon-photon interaction background. No evidence for charginos is found and upper limits on the cross section for chargino pair production are set. For the first time, in the case of heavy scalar leptons, chargino mass limits are obtained for any \tilde{\chi}^{+-}_1 - \tilde{\chi}^0_1 mass difference

Search for Low Scale Gravity Effects in e+e- Collisions at LEP

Recent theories propose that quantum gravity effects may be observable at LEP energies via gravitons that couple to Standard Model particles and propagate into extra spatial dimensions. The associated production of a graviton and a photon is searched for as well as the effects of virtual graviton exchange in the processes: e+e- -> gamma gamma, ZZ, WW, mu mu, tau tau, qq and ee No evidence for this new interaction is found in the data sample collected by the L3 detector at LEP at centre-of-mass energies up to 183 GeV. Limits close to 1 TeV on the scale of this new scenario of quantum gravity are set

Search for Branons at LEP

We search, in the context of extra-dimension scenarios, for the possible existence of brane fluctuations, called branons. Events with a single photon or a single Z-boson and missing energy and momentum collected with the L3 detector in e^+ e^- collisions at centre-of-mass energies sqrt{s}=189-209$ GeV are analysed. No excess over the Standard Model expectations is found and a lower limit at 95% confidence level of 103 GeV is derived for the mass of branons, for a scenario with small brane tensions. Alternatively, under the assumption of a light branon, brane tensions below 180 GeV are excluded

Search for Heavy Isosinglet Neutrino in e+e- Annihilation at LEP

We report on a search for the first generation heavy neutrino that is an isosinglet under the standard SU(2)_L gauge group. The data collected with the L3 detector at center-of-mass energies between 130 GeV and 208 GeV are used.The decay channel N_e --> eW is investigated and no evidence is found for a heavy neutrino, N_e, in a mass range between 80 GeV and 205 GeV. Upper limits on the mixing parameter between the heavy and light neutrino are derived

The use of Open Reading frame ESTs (ORESTES) for analysis of the honey bee transcriptome

BACKGROUND: The ongoing efforts to sequence the honey bee genome require additional initiatives to define its transcriptome. Towards this end, we employed the Open Reading frame ESTs (ORESTES) strategy to generate profiles for the life cycle of Apis mellifera workers. RESULTS: Of the 5,021 ORESTES, 35.2% matched with previously deposited Apis ESTs. The analysis of the remaining sequences defined a set of putative orthologs whose majority had their best-match hits with Anopheles and Drosophila genes. CAP3 assembly of the Apis ORESTES with the already existing 15,500 Apis ESTs generated 3,408 contigs. BLASTX comparison of these contigs with protein sets of organisms representing distinct phylogenetic clades revealed a total of 1,629 contigs that Apis mellifera shares with different taxa. Most (41%) represent genes that are in common to all taxa, another 21% are shared between metazoans (Bilateria), and 16% are shared only within the Insecta clade. A set of 23 putative genes presented a best match with human genes, many of which encode factors related to cell signaling/signal transduction. 1,779 contigs (52%) did not match any known sequence. Applying a correction factor deduced from a parallel analysis performed with Drosophila melanogaster ORESTES, we estimate that approximately half of these no-match ESTs contigs (22%) should represent Apis-specific genes. CONCLUSIONS: The versatile and cost-efficient ORESTES approach produced minilibraries for honey bee life cycle stages. Such information on central gene regions contributes to genome annotation and also lends itself to cross-transcriptome comparisons to reveal evolutionary trends in insect genomes

Historical Isolation versus Recent Long-Distance Connections between Europe and Africa in Bifid Toadflaxes (Linaria sect. Versicolores)

Background: Due to its complex, dynamic and well-known paleogeography, the Mediterranean region provides an ideal framework to study the colonization history of plant lineages. The genus Linaria has its diversity centre in the Mediterranean region, both in Europe and Africa. The last land connection between both continental plates occurred during the Messinian Salinity Crisis, in the late Miocene (5.96 to 5.33 Ma). Methodology/Principal Findings: We analyzed the colonization history of Linaria sect. Versicolores (bifid toadflaxes), which includes c. 22 species distributed across the Mediterranean, including Europe and Africa. Two cpDNA regions (rpl32-trnL UAG and trnK-matK) were sequenced from 66 samples of Linaria. We conducted phylogenetic, dating, biogeographic and phylogeographic analyses to reconstruct colonization patterns in space and time. Four major clades were found: two of them exclusively contain Iberian samples, while the other two include northern African samples together with some European samples. The bifid toadflaxes have been split in African and European clades since the late Miocene, and most lineage and speciation differentiation occurred during the Pliocene and Quaternary. We have strongly inferred four events of post-Messinian colonization following long-distance dispersal from northern Africa to the Iberian Peninsula, Sicily and Greece. Conclusions/Significance: The current distribution of Linaria sect. Versicolores lineages is explained by both ancien

Coalescent Simulations Reveal Hybridization and Incomplete Lineage Sorting in Mediterranean Linaria

We examined the phylogenetic history of Linaria with special emphasis on the Mediterranean sect. Supinae (44 species). We revealed extensive highly supported incongruence among two nuclear (ITS, AGT1) and two plastid regions (rpl32-trnLUAG, trnS-trnG). Coalescent simulations, a hybrid detection test and species tree inference in *BEAST revealed that incomplete lineage sorting and hybridization may both be responsible for the incongruent pattern observed. Additionally, we present a multilabelled *BEAST species tree as an alternative approach that allows the possibility of observing multiple placements in the species tree for the same taxa. That permitted the incorporation of processes such as hybridization within the tree while not violating the assumptions of the *BEAST model. This methodology is presented as a functional tool to disclose the evolutionary history of species complexes that have experienced both hybridization and incomplete lineage sorting. The drastic climatic events that have occurred in the Mediterranean since the late Miocene, including the Quaternary-type climatic oscillations, may have made both processes highly recurrent in the Mediterranean flora

Chromosome evolution in Cophomantini (Amphibia, Anura, Hylinae)

The hylid tribe Cophomantini is a diverse clade of Neotropical treefrogs composed of the genera Aplastodiscus, Boana, Bokermannohyla, Hyloscirtus, and Myersiohyla. The phylogenetic relationships of Cophomantini have been comprehensively reviewed in the literature, providing a suitable framework for the study of chromosome evolution. Employing different banding techniques, we studied the chromosomes of 25 species of Boana and 3 of Hyloscirtus; thus providing, for the first time, data for Hyloscirtus and for 15 species of Boana. Most species showed karyotypes with 2n = 2x = 24 chromosomes; some species of the B. albopunctata group have 2n = 2x = 22, and H. alytolylax has 2n = 2x = 20. Karyotypes are all bi-armed in most species presented, with the exception of H. larinopygion (FN = 46) and H. alytolylax (FN = 38), with karyotypes that have a single pair of small telocentric chromosomes. In most species of Boana, NORs are observed in a single pair of chromosomes, mostly in the small chromosomes, although in some species of the B. albopunctata, B. pulchella, and B. semilineata groups, this marker occurs on the larger pairs 8, 1, and 7, respectively. In Hyloscirtus, NOR position differs in the three studied species: H. alytolylax (4p), H. palmeri (4q), and H. larinopygion (1p). Heterochromatin is a variable marker that could provide valuable evidence, but it would be necesserary to understand the molecular composition of the C-bands that are observed in different species in order to test its putative homology. In H. alytolylax, a centromeric DAPI+ band was observed on one homologue of chromosome pair 2. The band was present in males but absent in females, providing evidence for an XX/XY sex determining system in this species. We review and discuss the importance of the different chromosome markers (NOR position, C-bands, and DAPI/CMA3 patterns) for their impact on the taxonomy and karyotype evolution in Cophomantini