Progress in prevention of mother-to-child transmission of HIV infection in Ukraine: results from a birth cohort study

Background: Ukraine was the epicentre of the HIV epidemic in Eastern Europe, which has the most rapidly accelerating HIV epidemic world-wide today; national HIV prevalence is currently estimated at 1.6%. Our objective was to evaluate the uptake and effectiveness of interventions for prevention of mother-to-child transmission (PMTCT) over an eight year period within operational settings in Ukraine, within the context of an ongoing birth cohort study.Methods: The European Collaborative Study (ECS) is an ongoing birth cohort study in which HIV-infected pregnant women identified before or during pregnancy or at delivery were enrolled and their infants prospectively followed. Three centres in Ukraine started enrolling in 2000, with a further three joining in September 2006.Results: Of the 3356 women enrolled, 21% (689) reported current or past injecting drug use (IDU). Most women were diagnosed antenatally and of those, the proportion diagnosed in the first/second trimester increased from 47% in 2000/01 (83/178) to 73% (776/1060) in 2006/07 (p < 0.001); intrapartum diagnosis was associated with IDU (Adjusted odds ratio 4.38; 95% CI 3.19-6.02). The percentage of women not receiving any antiretroviral prophylaxis declined from 18% (36/205) in 2001 to 7% in 2007 (61/843) p < 0.001). Use of sdNVP alone substantially declined after 2003, with a concomitant increase in zidovudine prophylaxis. Median antenatal zidovudine prophylaxis duration increased from 24 to 72 days between 2000 and 2007. Elective caesarean section (CS) rates were relatively stable over time and 34% overall. Mother-to-child transmission (MTCT) rates decreased from 15.2% in 2001 (95% CI 10.2-21.4) to 7.0% in 2006 (95% CI 2.6-14.6). In adjusted analysis, MTCT risk was reduced by 43% with elective CS versus vaginal delivery and by 75% with zidovudine versus no prophylaxis.Conclusion: There have been substantial improvements in use of PMTCT interventions in Ukraine, including earlier diagnosis of HIV-infected pregnant women and increasing coverage with antiretroviral prophylaxis and the initial MTCT rate has more than halved. Future research should focus on hard-to-reach populations such as IDU and on missed opportunities for further reducing the MTCT rate

Machine learning techniques for MRI feature-based detection of frontotemporal lobar degeneration

Making a diagnosis of neurodegenerative diseases at an early stage is one of the most significant challenges of modern neuroscience. Although this family of diseases remains without a cure, the effectiveness of their medical treatment largely relies on the timing of their detection. For certain groups of diseases, such as Fronto-Temporal Dementia (FTD), trained professionals can effectively reach a correct diagnosis through the visual analysis of Magnetic Resonance Imaging, in its functional (fMRI) or raw (MRI) version. However, this operation is time-consuming and may be subject to personal interpretation. In this paper, we explore the performance of a group of machine learning algorithms to formulate a correct FTD diagnosis, in order to provide medical professionals with a supporting tool. The dataset consists of MRI data acquired on 30 subjects, and the experiments are carried out by investigating different fMRI techniques based on a Multi-Voxel Pattern Analysis (MVPA) approach. The results obtained show high accuracy in identifying FTD in elderly patients when Support Vector Machine and Random Forest techniques are used, with outcomes varying based on the fMRI methods

Nonlinear Two-Dimensional Green's Function in Smectics

The problem of the strain of smectics subjected to a force distributed over a line in the basal plane has been solved

Organization and management of clusters in Russia in the context of import substitution

The article covers the trends of the agribusiness development in Russia. It is shown that it is desirable to develop organizational-economic forms of entrepreneurship based on the cluster approach in the modern realities. The most famous agribusiness clusters in the world are explored. Regions of Russia that have achieved the most significant results in agribusiness clustering are mentioned. It is found that the establishment of agribusiness in Russia is defined by the political decision of regional authorities rather than based on research and development. An algorithm for establishing the agribusiness cluster is proposed, which includes four stages: methodological, analytical, organizational-economic and control. The key areas of state support for the development of agribusiness clusters in Russia are defined.peer-reviewe

Previous reproductive history and post-natal family planning among HIV-infected women in Ukraine

BACKGROUND: Ukraine has the highest antenatal HIV prevalence in Europe. The national prevention of mother-to-child transmission (MTCT) programme has reduced the MTCT rate, but less attention has been given to the prevention of unintended pregnancy among HIV-positive women. Our objectives were to describe the reproductive health, condom use and family planning (FP) practices of HIV-positive childbearing Ukrainian women and to identify factors associated with different methods of post-natal contraception. METHODS: HIV-infected childbearing women, diagnosed before or during pregnancy, were enrolled prospectively in a post-natal cohort study in four regional HIV/AIDS centres in Ukraine from December 2007. Logistic regression models were used to identify factors associated with post-natal FP practices. RESULTS: Data were available for 371 women enrolled by March 2009; 82% (n = 303) were married or cohabiting, 27% (97 of 363) reported a current HIV-negative sexual partner and 69% were diagnosed with HIV during their most recent pregnancy. Overall, 21% (75 of 349) of women were not using contraception post-natally (of whom 80% reported no current sexual activity), 50% (174 of 349) used condoms, 20% (74 of 349) relied solely/partially on coitus interruptus and 4% used hormonal methods or intrauterine device. Among married/cohabiting women, consistent use of condoms in the previous pregnancy [AOR 1.96 (95%CI 1.06–3.62)], having an HIV-positive partner [AOR 0.42 (0.20–0.87)], current sexual activity [AOR 4.53 (1.19–17.3)] and study site were significantly associated with post-natal condom use; 16% of those with HIV-negative partners did not use condoms. Risk factors for non-use of FP were lack of affordability [AOR 6.34 (1.73–23.2)] and inconsistent use of condoms in the previous pregnancy [AOR 7.25 (1.41–37.2)]. CONCLUSIONS: More than 40% of HIV-positive women in this population are at risk of unintended pregnancy and the one in six women in HIV-discordant couples not using barrier methods risk transmitting HIV to their partners. Our study results are limited by the observational nature of the data and the potential for both measured and unmeasured confounding

Associating ground magnetometer observations with current or voltage generators

A circuit analogy for magnetosphere‐ionosphere current systems has two extremes for drivers of ionospheric currents: ionospheric electric fields/voltages constant while current/conductivity vary—the “voltage generator”—and current constant while electric field/conductivity vary—the “current generator.” Statistical studies of ground magnetometer observations associated with dayside Transient High Latitude Current Systems (THLCS) driven by similar mechanisms find contradictory results using this paradigm: some studies associate THLCS with voltage generators, others with current generators. We argue that most of this contradiction arises from two assumptions used to interpret ground magnetometer observations: (1) measurements made at fixed position relative to the THLCS field‐aligned current and (2) negligible auroral precipitation contributions to ionospheric conductivity. We use observations and simulations to illustrate how these two assumptions substantially alter expectations for magnetic perturbations associated with either a current or a voltage generator. Our results demonstrate that before interpreting ground magnetometer observations of THLCS in the context of current/voltage generators, the location of a ground magnetometer station relative to the THLCS field‐aligned current and the location of any auroral zone conductivity enhancements need to be taken into account.Key PointsConductivity and location assumptions used to interpret ground magnetic perturbations yield conflicting resultsHigh‐latitude currents associated with voltage generators may instead be associated with current generators, and vice versaWithout better constraints on conductivity/station location relative to currents, conflicts will not be resolvedPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138366/1/jgra53632.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138366/2/jgra53632_am.pd