Continuum of care for HIV-positive women accessing programs to prevent parent-to-child transmission: Findings from India

This study examined the efforts of PPTCT programs in different cities in India to offer women a continuum of care, and shows that the programs have both strengths and shortcomings. The government launched a national treatment program that offers antiretroviral therapy (ART) to HIV-positive women, children below 15 years of age, and men. However, since the start-up of the ART program there have been concerns about limited access to and utilization of these services by women and children. To address these shortcomings, the PPTCT programs studied should strengthen their referral systems to public and private treatment and family planning services, better equip PPTCT providers to inform and counsel women about these topics, and engage NGOs in the community that have outreach services to maintain contact with women over time and link them and their families to a continuum of care

Exploring the barriers to accessing care and treatment for HIV-infected children in India: A diagnostic study

Each year 27 million births take place in India. A conservative estimate of HIV prevalence of 1 percent among antenatal women translates to about 80,000 HIV-infected children being born annually. The latest figures from the National AIDS Control Organisation show that there are about 5,600 documented HIV-positive children (0–14 years), but a very small number are receiving antiretroviral therapy. The Population Council and partners conducted a qualitative study in three high-prevalence states of India to explore the facilitators and barriers to accessing care for HIV-positive children and assessed the current level of adherence to ART among children receiving treatment. A cross-sectional study design was used. In-depth interviews were conducted with caregivers of HIV-positive children (\u3c12 years) and HIV-positive adolescents (12–16 years). A semistructured questionnaire with open-ended questions was used. Study participants were recruited from a convenience sample of community-based health facilities providing services for HIV-positive persons and positive networks in the three states. This brief focuses on findings from caregivers of HIV-infected children less than 12 years of age

Impacts of different ENSO flavors and tropical Pacific convection variability (ITCZ, SPCZ) on austral summer rainfall in South America, with a focus on Peru

El Niño in the eastern and central Pacific has different impacts on the rainfall of South America, and the atmospheric pathways through the South Pacific Convergence Zone (SPCZ) and Inter-Tropical Convergence Zone (ITCZ) are poorly understood. To address this, we performed linear regression analysis of E (eastern Pacific) and C (central Pacific) indices of sea surface temperature (SST), as well as precipitation indices for the SPCZ and ITCZ, with gridded precipitation and reanalysis data sets during the austral summer (December–February) for the 1980–2016 period. Positive C induces dry anomalies along the tropical Andes and northern South America (NSA), while wet anomalies prevail over southeastern South America (SESA). Moreover, it produces wet conditions in the northwestern Peruvian Amazon. In contrast, positive E enhances wet conditions along the coasts of Ecuador and northern Peru associated with the southward displacement of the eastern Pacific ITCZ and induces dry conditions in Altiplano, Amazon basin, and northeastern Brazil (NEB). Both El Niño Southern Oscillation (ENSO) indices are associated with weakened upper-level easterly flow over Peru, but it is more restricted to the central and southern Peruvian Andes with positive E. Both SPCZ indices, the zonal position of the SPCZ and its latitudinal displacement, suppress rainfall along western Peruvian Andes when are positive, but the latter also inhibits rainfall over the Bolivian Altiplano. They are also linked to upper-level westerly wind anomalies overall of Peru, but these anomalies do not extend as far south in the first. The southward displacement of the eastern Pacific ITCZ also induces wet anomalies in SESA while dry anomalies prevail over NEB, the western Amazon basin, and Bolivia. Oppositely, the southward displacement of the central Pacific ITCZ induces dry anomalies in NEB and along the northern coast of Peru; while wet anomalies occur mainly in eastern Brazil, Paraguay, and Bolivia through an enhancement of the low level jet

Long-Term Safety and Efficacy of Durable Polymer Cobalt-Chromium Everolimus-Eluting Stents in Patients at High Bleeding Risk: A Patient-Level Stratified Analysis From Four Postapproval Studies

BACKGROUND Long-term outcomes in patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention with a drug-eluting stent are unclear. Therefore, we aimed to evaluate long-term adverse events in HBR patients undergoing percutaneous coronary intervention with cobalt-chromium everolimus-eluting stent implantation. METHODS We analyzed stratified data from 4 all-comers postapproval registries. Patients with at least 1 of the following criteria were categorized as HBR: age ≥75 years, history of major bleeding (MB), history of stroke, chronic oral anticoagulant use, chronic kidney disease, anemia, or thrombocytopenia. Additionally, in a separate analysis, patients were categorized according to the recently published Academic Research Consortium HBR criteria. The Kaplan-Meier method was used for time-to-event analyses. Coronary thrombotic events (CTE) included myocardial infarction or definite/probable stent thrombosis. MB was defined according to the TIMI (Thrombolysis in Myocardial Infarction) or GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) scales. Impact of CTE and MB on subsequent risk of mortality was assessed using multivariable Cox regression with MB and CTE included as time-updated covariates. RESULTS Of the total 10 502 patients included, 3507 (33%) were identified as HBR. Compared with non-HBR patients, those at HBR had more comorbidities, higher lesion complexity, and a higher risk of 4-year mortality (Hazard Ratio [HR] 4.38 [95% CI, 3.76-5.11]). Results were qualitatively similar when using Academic Research Consortium criteria to define HBR. Risk of mortality was increased after CTE (HR 5.02 [95% CI, 3.93-6.41]), as well as after MB (HR 4.92 [95% CI, 3.82-6.35]). Of note, this effect was consistent across the spectrum of bleeding risk (P-interaction test 0.97 and 0.06, respectively). CONCLUSIONS Compared with the non-HBR population, HBR patients experienced worse 4-year outcomes after percutaneous coronary intervention with cobalt-chromium everolimus-eluting stent. Both CTE and MB had a significant impact on subsequent risk of mortality irrespective of bleeding risk

Recent developments in microbial oils production: a possible alternative to vegetable oils for biodiesel without competition with human food?

Since centuries vegetable oils are consumed as human food but it also finds applications in biodiesel production which is attracting more attention. But due to being in competition with food it could not be sustainable and leads the need to search for alternative. Nowdays microbes-derived oils (single cell oils) seem to be alternatives for biodiesel production due to their similar composition to that of vegetable oils. However, the cold flow properties of the biodiesel produced from microbial oils are unacceptable and have to be modified by an efficient transesterification. Glycerol which is by product of transesterification can be valorised into some more useful products so that it can also be utilised along with biodiesel to simplify the downstream processing. The review paper discusses about various potent microorganisms for biodiesel production, enzymes involved in the lipid accumulation, lipid quantification methods, catalysts used in transesterification (including enzymatic catalyst) and valorisation of glycerol