A situational picture of HIV/AIDS and injection drug use in Vinnitsya, Ukraine

BACKGROUND: New and explosive HIV epidemics are being witnessed in certain countries of Eastern Europe, including Ukraine, as well as a rapid and dramatic increase in the supply, use, and negative public health consequences of illicit drugs. A majority of registered HIV cases in Ukraine occur among injection drug users (IDUs), large numbers of whom report HIV risk behaviors such as needle sharing. The purpose of this study was to apply the World Health Organization's Rapid Assessment and Response on Injection Drug Use (IDU-RAR) guide to create a situational picture in the Vinnitsya Oblast, Ukraine, a region with very scarce information about the HIV/AIDS and injection drug use (IDU) epidemics. METHODS: The IDU-RAR uses a combination of qualitative data collection techniques commonly employed in social science and evaluation research to quickly depict the extent and nature of the given health problem and propose locally relevant recommendations for improvement. The investigators focused their assessment on the contextual factors, drug use, and intervention and policy components of the IDU-RAR. A combination of network and block sampling techniques was used. Data collection methods included direct observation, review of existing data, structured and unstructured interviews, and focus group discussions. Key informants and locations were visited until no new information was being generated. RESULTS: The number of registered HIV cases in Vinnitsya has increased from 3 (1987–1995) to 860 (1999–10/2004), 57 of whom have already died. Ten percent of annual admissions to the area's Regional Narcological Dispensary were for opiate disorders, and the number of registered IDUs rose by 20% from 1999 to 2000. The level of HIV/AIDS awareness is generally poor among the general population but high among high-risk populations. Both HIV/AIDS and injection drug use carry a strong stigma in the community, even among medical professionals. There was very little evidence of primary HIV/AIDS prevention efforts, and IDU prevention efforts focused on promotion of anti-drug messages in the schools. CONCLUSION: Given that Ukraine has sparse resources to be devoted to this problem, action recommendations should be prioritized, realistic, and initially targeted to persons in greatest need. The following action recommendations are prioritized by the following categories: First priority: Voluntary Counseling and Testing; Second Priority: Prevention and Education; and Third Priority: Harm Reduction and Treatment. They are provided in this sequence based on what response can realistically be implemented first with limited additional resources and can make the greatest immediate impact. The persons at greatest risk, HIV positive persons and IDUs, should be attended to first

Injection drug use and HIV/AIDS in China: Review of current situation, prevention and policy implications

Illicit drug abuse and HIV/AIDS have increased rapidly in the past 10 to 20 years in China. This paper reviews drug abuse in China, the HIV/AIDS epidemic and its association with injection drug use (IDU), and Chinese policies on illicit drug abuse and prevention of HIV/AIDS based on published literature and unpublished official data. As a major drug trans-shipment country with source drugs from the "Golden Triangle" and "Gold Crescent" areas in Asia, China has also become an increasingly important drug consuming market. About half of China's 1.14 million documented drug users inject, and many share needles. IDU has contributed to 42% of cumulatively reported HIV/AIDS cases thus far. Drug trafficking is illegal in China and can lead to the death penalty. The public security departments adopt "zero tolerance" approach to drug use, which conflict with harm reduction policies of the public health departments. Past experience in China suggests that cracking down on drug smuggling and prohibiting drug use alone can not prevent or solve all illicit drug related problems in the era of globalization. In recent years, the central government has outlined a series of pragmatic policies to encourage harm reduction programs; meanwhile, some local governments have not fully mobilized to deal with drug abuse and HIV/AIDS problems seriously. Strengthening government leadership at both central and local levels; scaling up methadone substitution and needle exchange programs; making HIV voluntary counseling and testing available and affordable to both urban and rural drug users; and increasing utilization of outreach and nongovernmental organizations are offered as additional strategies to help cope with China's HIV and drug abuse problem

Quantifying the impacts of ENSO and IOD on rain gauge and remotely sensed precipitation products over Australia

Large-scale ocean-atmospheric phenomena like the El Niño Southern Oscillation (ENSO) and Indian Ocean Dipole (IOD) have significant influence on Australia's precipitation variability. In this study, multi-linear regression (MLR) and complex empirical orthogonal function (CEOF) analyses were applied to isolate (i) the continental precipitation variations likely associated with ENSO and IOD, here referred to as 'ENSO/IOD mode', and (ii) the variability not associated with ENSO/IOD (the 'non-ENSO/IOD mode'). The first is of interest due to its dominant influence on inter-annual variability, while the second may reveal lower frequency variability or trends. Precipitation products used for this study included gridded rainfall estimates derived by interpolation of rain gauge data from the Australian Bureau of Meteorology (BoM), two satellite remote sensing products (CHIRP and TRMM TMPA version 7), and two weather forecast model re-analysis products (ERA-Interim and MERRA). The products covered the period 1981-2014 except TMPA (1998-2014). Statistical and frequency-based inter-comparisons were performed to evaluate the seasonal and long-term skills of various rainfall products against the BoM product. The results indicate that linear trends in rainfall during 1981-2014 were largely attributable to ENSO and IOD. Both intra-annual and seasonal rainfall changes associated with ENSO and IOD increased from 1991 to 2014. Among the continent's 13 major river basins, the greatest precipitation variations associated with ENSO/IOD were found over the Northern and North East Coast, while the smallest contributions were for Tasmania and the South West Coast basins. We also found that although the assessed products show comparable spatial variability of rainfall over Australia, systematic seasonal differences exist that were more pronounced during the ENSO and IOD events

Nitrogen Use and Carbon Sequestered by Corn Rotations in the Northern Corn Belt, U.S.

Diversified crop rotation may improve production efficiency, reduce fertilizer nitrogen (N) requirements for corn (Zea mays L.), and increase soil carbon (C) storage. Objectives were to determine effect of rotation and fertilizer N on soil C sequestration and N use. An experiment was started in 1990 on a Barnes clay loam (U.S. soil taxonomy: fine-loamy, mixed, superactive, frigid Calcic Hapludoll) near Brookings, SD. Tillage systems for corn–soybean (Glycine max [L.] Merr.) rotations were conventional tillage (CS) and ridge tillage (CSr). Rotations under conventional tillage were continuous corn (CC), and a 4-year rotation of corn–soybean–wheat (Triticum aestivum L.) companion-seeded with alfalfa (Medicago sativa L.)–alfalfa hay (CSWA). Additional treatments included plots of perennial warm season, cool season, and mixtures of warm and cool season grasses. N treatments for corn were corn fertilized for a grain yield of 8.5 Mg ha–1 (highN), of 5.3 Mg ha–1 (midN), and with no N fertilizer (noN). Total (1990–2000) corn grain yield was not different among rotations at 80.8 Mg ha–1 under highN. Corn yield differences among rotations increased with decreased fertilizer N. Total (1990–2000) corn yields with noN fertilizer were 69 Mg ha–1 under CSWA, 53 Mg ha–1 under CS, and 35 Mg ha–1 under CC. Total N attributed to rotations (noN treatments) was 0.68 Mg ha–1 under CSWA, 0.61 Mg ha–1 under CS, and 0.28 Mg ha–1 under CC. Plant carbon return depended on rotation and N. In the past 10 years, total C returned from above- ground biomass was 29.8 Mg ha–1 under CC with highN, and 12.8 Mg ha–1 under CSWA with noN. Soil C in the top 15 cm significantly increased (0.7 g kg–1) with perennial grass cover, remained unchanged under CSr, and decreased (1.7 g kg–1) under CC, CS, and CSWA. C to N ratio significantly narrowed (–0.75) with CSWA and widened (0.72) under grass. Diversified rotations have potential to increase N use efficiency and reduce fertilizer N input for corn. However, within a corn production system using conventional tillage and producing (averaged across rotation and N treatment) about 6.2-Mg ha–1 corn grain per year, we found no gain in soil C after 10 years regardless of rotation

The Resource Theory of Quantum States Out of Thermal Equilibrium

The ideas of thermodynamics have proved fruitful in the setting of quantum information theory, in particular the notion that when the allowed transformations of a system are restricted, certain states of the system become useful resources with which one can prepare previously inaccessible states. The theory of entanglement is perhaps the best-known and most well-understood resource theory in this sense. Here we return to the basic questions of thermodynamics using the formalism of resource theories developed in quantum information theory and show that the free energy of thermodynamics emerges naturally from the resource theory of energy-preserving transformations. Specifically, the free energy quantifies the amount of useful work which can be extracted from asymptotically-many copies of a quantum system when using only reversible energy-preserving transformations and a thermal bath at fixed temperature. The free energy also quantifies the rate at which resource states can be reversibly interconverted asymptotically, provided that a sublinear amount of coherent superposition over energy levels is available, a situation analogous to the sublinear amount of classical communication required for entanglement dilution.Comment: 4.5 pages main text, 12 pages appendix; v3: improvements to presentation of the main resul

HIV and hepatitis C virus infections among hanka injection drug users in central Ukraine: a cross-sectional survey

<p>Abstract</p> <p>Background</p> <p>Ukraine has experienced an increase in injection drug use since the 1990s. An increase in HIV and hepatitis C virus infections has followed, but not measures of prevalence and risk factors. The purposes of this study are to estimate the prevalence of HIV, HCV, and co-infection among injection drug users (IDUs) in central Ukraine and to describe risk factors for HIV and HCV.</p> <p>Methods</p> <p>A sample of 315 IDUs was recruited using snowball sampling for a structured risk interview and HIV/HCV testing (81.9% male, 42% single, average age 28.9 years [range = 18 to 55]).</p> <p>Results</p> <p>HIV and HCV antibodies were detected in 14.0% and 73.0%, respectively, and 12.1% were seropositive for both infections. The most commonly used drug was hanka, home-made from poppy straw and often mixed with other substances including dimedrol, diazepines, and hypnotics. The average period of injecting was 8.5 years; 62.5% reported past-year sharing needles or injection equipment, and 8.0% shared with a known HIV-positive person. More than half (51.1%) reported multiple sexual partners, 12.9% buying or selling sex, and 10.5% exchanging sex and drugs in the past year. Those who shared with HIV positive partners were 3.4 times more likely to be HIV positive than those who did not. Those who front- or back-loaded were 4 times more likely to be HCV positive than those who did not.</p> <p>Conclusion</p> <p>Harm reduction, addiction treatment and HIV prevention programs should address risk factors to stop further spread of both HIV and HCV among IDUs and to the general population in central Ukraine.</p

Insights into the Therapeutic Potential of Glucocorticoid Receptor Modulators for Neurodegenerative Diseases

Glucocorticoids are crucial for stress-coping, resilience, and adaptation. However, if the stress hormones become dysregulated, the vulnerability to stress-related diseases is enhanced. In this brief review, we discuss the role of glucocorticoids in the pathogenesis of neurodegenerative disorders in both human and animal models, and focus in particular on amyotrophic lateral sclerosis (ALS). For this purpose, we used the Wobbler animal model, which mimics much of the pathology of ALS including a dysfunctional hypothalamic–pituitary–adrenal axis. We discuss recent studies that demonstrated that the pathological cascade characteristic for motoneuron degeneration of ALS is mimicked in the genetically selected Wobbler mouse and can be attenuated by treatment with the selective glucocorticoid receptor antagonist (GRA) CORT113176. In long-term treatment (3 weeks) GRA attenuated progression of the behavioral, inflammatory, excitatory, and cell-death-signaling pathways while increasing the survival signal of serine–threonine kinase (pAkt). The action mechanism of the GRA may be either by interfering with GR deactivation or by restoring the balance between pro- and anti-inflammatory signaling pathways driven by the complementary mineralocorticoid receptor (MR)- and GR-mediated actions of corticosterone. Accordingly, GR antagonism may have clinical relevance for the treatment of neurodegenerative diseases.Fil: de Nicola, Alejandro Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Bioquímica Humana; ArgentinaFil: Meyer, Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Guennoun, Rachida. Inserm; Francia. Université Paris Sud; Francia. Université Paris Saclay; FranciaFil: Schumacher, Michael. Inserm; Francia. Université Paris Sud; Francia. Université Paris Saclay; FranciaFil: Hunt, Hazel. Corcepts Therapeutics; Estados UnidosFil: Belanoff, Joseph. Corcepts Therapeutics; Estados UnidosFil: de Kloet, E. Ronald. Leiden University. Leiden University Medical Center.; Países BajosFil: Gonzalez Deniselle, Maria Claudia. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Ciencias Fisiológicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentin

Failure to establish HIV care: characterizing the no show phenomenon

It is estimated that up to one-third of persons with known human immunodeficiency virus (HIV) infection in the United States are not engaged in care. We evaluated factors associated with patients\u27 failure to establish outpatient HIV care at our clinic and found that females, racial minorities, and patients lacking private health insurance were more likely to be no shows. At the clinic level, longer waiting time from the call to schedule a new patient visit to the appointment date was associated with failure to establish care. Because increased numbers of patients will be in need of outpatient HIV care as a result of recent Centers for Disease Control and Prevention guidelines advocating routine HIV testing, it is imperative that strategies to improve access are developed to overcome the no show phenomenon

The anaphylatoxins C3a and C5a are vasodilators in the canine coronary vasculature in vitro and in vivo

The effect of complement fragments on coronary blood flow in vivo and the contraction of coronary arteries in vitro was determined. In pentobarbital anesthetized dogs, intraarterial bolus injection of C3a and C5a, zymosan-activated serum and methylcholine in the coronary vascular bed caused transient and dose-dependent increases in coronary blood flow. Similar increases were obtained with 25 μg of C3a (104±13%, n =5) and 0.1 μg of methylcholine (102±4%, n =3). Smaller, increases in blood flow were elicited by 25 μg of C5a (41±18%, n =4) and 0.2 ml, of zymosan-activated serum (48±5%, n =4). None of these responses were associated, with significant changes in left ventricular contractile force measured with a strain gauge, arterial blood pressure, and heart rate. C3a dilated the coronary vascular bed in conscious dogs with an activity equal to or greater than that observed in anesthetized dogs. Isolated canine coronary arteries that were precontracted with serotonin relaxed in response to C3a, whether or not the endothelium was intact. Overall these data suggest that physiologically high doses of anaphylactic complement fragments vasodilate the canine coronary circulation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45056/1/11_2005_Article_BF01988727.pd