Test Characteristics of Urinary Lipoarabinomannan and Predictors of Mortality among Hospitalized HIV-Infected Tuberculosis Suspects in Tanzania.

Tuberculosis is the most common cause of death among patients with HIV infection living in tuberculosis endemic countries, but many cases are not diagnosed pre-mortem. We assessed the test characteristics of urinary lipoarabinomannan (LAM) and predictors of mortality among HIV-associated tuberculosis suspects in Tanzania. We prospectively enrolled hospitalized HIV-infected patients in Dar es Salaam, with ≥2 weeks of cough or fever, or weight loss. Subjects gave 2 mLs of urine to test for LAM using a commercially available ELISA, ≥2 sputum specimens for concentrated AFB smear and solid media culture, and 40 mLs of blood for culture. Among 212 evaluable subjects, 143 (68%) were female; mean age was 36 years; and the median CD4 count 86 cells/mm(3). 69 subjects (33%) had culture confirmation of tuberculosis and 65 (31%) were LAM positive. For 69 cases of sputum or blood culture-confirmed tuberculosis, LAM sensitivity was 65% and specificity 86% compared to 36% and 98% for sputum smear. LAM test characteristics were not different in patients with bacteremia but showed higher sensitivity and lower specificity with decreasing CD4 cell count. Two month mortality was 64 (53%) of 121 with outcomes available. In multivariate analysis there was significant association of mortality with absence of anti-retroviral therapy (p = 0.004) and a trend toward association with a positive urine LAM (p = 0.16). Among culture-negative patients mortality was 9 (75%) of 12 in LAM positive patients and 27 (38%) of 71 in LAM negative patients (p = 0.02). Urine LAM is more sensitive than sputum smear and has utility for the rapid diagnosis of culture-confirmed tuberculosis in this high-risk population. Mortality data raise the possibility that urine LAM may also be a marker for culture-negative tuberculosis

Expansion of Human Airway Basal Stem Cells and Their Differentiation as 3D Tracheospheres

Although basal cells function as human airway epithelial stem cells, analysis of these cells is limited by in vitro culture techniques that permit only minimal cell growth and differentiation. Here, we report a protocol that dramatically increases the long-term expansion of primary human airway basal cells while maintaining their genomic stability using 3T3-J2 fibroblast coculture and ROCK inhibition. We also describe techniques for the differentiation and imaging of these expanded airway stem cells as three-dimensional tracheospheres containing basal, ciliated, and mucosecretory cells. These procedures allow investigation of the airway epithelium under more physiologically relevant conditions than those found in undifferentiated monolayer cultures. Together these methods represent a novel platform for improved airway stem cell growth and differentiation that is compatible with high-throughput, high-content translational lung research as well as human airway tissue engineering and clinical cellular therapy

Sustainability and Corporate Social Responsibility in the Perspective of Social Economy Entities: A Bibliometric Study

We start from the conceptual interconnection between Sustainability and Corporate Social Responsibility, which, although continuously subject to controversy, both within the scope of its definition and in its performance, advocate, as the ultimate goal, human development and of the society in general, promoting the interests of the Communities on a permanent, long-term basis and without compromising the options of the future generations. In this context, we cannot fail to draw a parallel with the entities that constitute the Social Economy Sector. The activities they carry out are of economic and social nature and must be pursued in the general interest of their members, users and beneficiaries, thus in the general interest of the Community. These institutions also reveal concerns about the sustainability in all the dimensions involved (economic, social and environmental), in which the organizational performance is particularly important, as it becomes imperative to guarantee their continuity, fostering and promoting their social action. We will, therefore, start by framing what is meant by Sustainability, Corporate Social Responsibility and Social Economy, with a particular focus on the current requirements of stakeholders regarding the socially responsible behaviour of the institutions as these, in turn, will entail the adoption of more comprehensive management tools, also more efficient and transparent concerning all dimensions (economic, financial and social). It is within this framework that a project called “TFA—TheoFrameAccountability—Theoretical framework for the promotion of accountability in the social economy sector: The IPSS case” emerges, being promoted by the University of Aveiro, with the participation of National Confederation of Solidarity Institutions (CNIS—acronym in Portuguese), and the Polytechnic Institutes of Coimbra and Porto. This project aims to promote the accountability of the social economy sector (economic, financial and social aspects), in the Private Social Solidarity Institutions (IPSS—acronym in Portuguese), assisting them not only in fulfilling their legal obligations, but also facilitating the reporting of results of activities carried out in a more effective manner and promoting transfer of knowledge (for the IPSS and also for the academic community), thus contributing to the development and sustainability of these institutions. Thus, we develop an exploratory and descriptive analysis, of a quantitative-qualitative nature, in which the procedures of data collection determine the result of the search strategy by the defined descriptors. For this purpose, the analysis will focus on the following variables: number of articles published per year; methodologies used; theories of support; identification by sector/area of activity; countries of origin; more representative institutions; authors who publish more and journals with the largest number of publications. The main results indicate a growing concern about sustainability and a growing publication in this area. This paper presents a bibliometric study to evaluate the main trends of current research on sustainability and on corporate social responsibility, thus contributing to the construction of the theoretical basis underlying the “TFA—TheoFrameAccountability” project.info:eu-repo/semantics/publishedVersio

Precise Analysis of Polymer Rotational Dynamics

Through the analysis of individual chain dynamics alongside the corresponding molecular structures under shear via nonequilibrium molecular dynamics simulations of C178H358 linear and short-chain branched polyethylene melts under shear flow, we observed that the conventional method based on the chain end-to-end vector (and/or the gyration tensor of chain) is susceptible to quantitatively inaccurate measurements and often misleading information in describing the rotational dynamics of polymers. Identifying the flaw as attributed to strong irregular Brownian fluctuations inherent to the chain ends associated with their large free volume and strong molecular collisions, we propose a simple, robust way based on the chain center-to-center vector connecting the two centers of mass of the bisected chain, which is shown to adequately describe polymer rotational dynamics without such shortcomings. We present further consideration that the proposed method can be useful in accurately measuring the overall chain structure and dynamics of polymeric materials with various molecular architectures, including branched and ring polymers.open

Physical activity to improve cognition in older adults: can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis

: EPHPP quality rating scores (DOCX 38 kb

Quantitative Evaluation of the Efficacy of Defence-in-Depth in Critical Infrastructures

This chapter reports on a model-based approach to assessing cyber-risks in a cyber-physical system (CPS), such as power-transmission systems. We demonstrate that quantitative cyber-risk assessment, despite its inherent difficulties, is feasible. In this regard: i) we give experimental evidence (using Monte-Carlo simulation) showing that the losses from a specific cyber-attack type can be established accurately using an abstract model of cyber-attacks – a model constructed without taking into account the details of the specific attack used in the study; ii) we establish the benefits from deploying defence-in-depth (DiD) against failures and cyber-attacks for two types of attackers: a) an attacker unaware of the nature of DiD, and b) an attacker who knows in detail the DiD they face in a particular deployment, and launches attacks sufficient to defeat DiD. This study provides some insight into the benefits of combining design-diversity – to harden some of the protection devices in a CPS – with periodic “proactive recovery” of protection devices. The results are discussed in the context of making evidence-based decisions about maximising the benefits from DiD in a particular CPS

Automatic control of the NMB level in general anaesthesia with a switching total system mass control strategy

This paper presents a model based switching control strategy to drive the neuromuscular blockade (NMB) level of patients undergoing general anesthesia to a predefined reference. A single-input single-output Wiener system with only two parameters is used to model the effect of two different muscle relaxants, atracurium and rocuronium, and a switching controller is designed based on a bank of total system mass control laws. Each of such laws is tuned for an individual model from a bank chosen to represent the behavior of the whole population. The control law to be applied at each instant corresponds to the model whose NMB response is closer to the patient's response. Moreover a scheme to improve the reference tracking quality based on the analysis of the patient's response, as well as, a comparison between the switching strategy and the Extended Kalman Kilter (EKF) technique are presented. The results are illustrated by means of several simulations, where switching shows to provide good results, both in theory and in practice, with a desirable reference tracking. The reference tracking improvement technique is able to produce a better reference tracking. Also, this technique showed a better performance than the (EKF). Based on these results, the switching control strategy with a bank of total system mass control laws proved to be robust enough to be used as an automatic control system for the NMB level