"Linkage to care" among people living with HIV - definition in the era of "universal test and treat" in a sub-Sahara African setting

BACKGROUND: Prompt linkage to human immunodeficiency virus (HIV) care after diagnosis is of utmost importance for individual health and reduction of HIV transmission. Different definitions for "linkage to care" have challenged comparisons as a public health marker. Its meaning in the era of "universal test and treat" has transformed in all settings, but is most relevant in sub-Sahara Africa, where the burden of new HIV infection is still highest. METHODS: For this narrative review on "linkage to care" definitions with a focus on sub-Saharan Africa, we searched PubMed/Medline between September and December 2020, restricted to the period 2000-2020 using Boolean operators: "HIV" AND ("linkage to care" OR "engagement in care") and screened for institutional definitions of "linkage to care". Additionally, as one example of a rural sub-Saharan African setting, we analysed linkage steps within the Chronic Diseases Clinic Ifakara (CDCI) and its associated Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) in rural Tanzania between 1 January 2017 and 31 March 2019. RESULTS: We analysed 81 articles that included "linkage to care" within different study settings and HIV organisations. Major differences in defining "linkage to care" exist, according to setting and location, patient populations and the timing of steps within the linkage process. We identified 16 different numerators and 10 denominators used to define linkage with time periods ranging from "same day as diagnosis" up to 12 months after diagnosis among 34 original articles from sub-Saharan Africa. At the CDCI, 1149/1671 (69%) newly diagnosed individuals were enrolled into care after diagnosis. Three months after enrolment into care, 94%, 86%, 85% and 71% of enrolled patients had a laboratory evaluation, a clinical evaluation, were initiated on treatment and had a first clinical follow-up visit after initiation of treatment, respectively. DUSCUSSION: To address the inconsistency in defining "linkage to care" and in order to guarantee the comparability of "linkage to care" in the sub-Saharan Africa region, we support the definition from the European region with some adaptions. We suggest a priority list of care indicators if more than one care indicator is available for successful "linkage to care" in the era of "universal test and treat" for sub-Sahara Africa

A Field Evaluation of the Efficacy of Milorganite as a Repellent for Non-Venomous Rat Snakes (Elaphe obsolete)

The objective of this study was to evaluate the efficacy of Milorganite® as a repellent for rat snakes. Milorganite® is the bio solids by-product left from the activated sludge process from the Milwaukee Metropolitan Sewer District. During 3, 7-day release periods, 5-6 mature rat snakes were placed within a 0.1ha plastic fence enclosure intended to impede escape. The enclosure contained natural and artificial hides and water. Snakes were fitted with an externally attached radio transmitter with location of each snake determined 3 times per day by radio telemetry and visual confirmation. During the first 2, 7-day period, with no Milorganite® treatment, snakes were contained within the enclosure for a similar (p\u3e0.05) duration of 9.1h±1.8 and 9.4h±1.8 respectively, before escaping. Prior to release of snakes in period 3, a total of 907.2g of Milorganite® was applied by hand in a 20cm width strip along the interior perimeter of the enclosure fence. During period 3, 6 snakes were maintained within the enclosure longer (p\u3c 0.005) compared to periods 1 and 2, with an average containment time of 23.5h/day±0.5. Total snake-hours that animals were maintained in the enclosure was higher (p\u3c0.005) during the Milorganite® treatment (164.0h±1.4) compared to non-treated period 1 (64.0h±1.8) or period 2 (66.0h±9.0). All snakes remained within the enclosure throughout the 7-day treatment period. One snake died on day 6, posttreatment from unknown causes. Results of this study suggest Milorganite® was effective as a repellent for the rat snake under these experimental conditions

44-jähriger Patient mit kulturnegativer, purulenter Perikarditis

Zusammenfassung: Wir berichten über einen Patienten mit purulenter Perikarditis und drohender Perikardtamponade, verursacht durch Neisseria meningitidis. Bei negativen Kulturen aus Blut und Perikardpunktat, wahrscheinlich bedingt durch die Vorbehandlung mit Antibiotika, konnten wir mittels Breitspektrumpolymerasekettenreaktion aus dem Perikardpunktat und einem Latexagglutinationstest aus Pleurapunktat Meningokokken der SerogruppeC nachweisen. Eine Meningokokkenperikarditis ohne Meningitis ist selten. Diagnostische Methoden auf nicht-kultureller Basis spielen bei Patienten, die bereits mit Antibiotika vorbehandelt sind, eine wichtige Roll

Normal values of blood pressure self-measurement in view of the 1999 World Health Organization-International Society of Hypertension guidelines

New guidelines for the management of hypertension have been published in 1999 by the World Health Organization (WHO) and the International Society of Hypertension (ISH). The WHO/ISH Committee has adopted in principle the definition and classification of hypertension provided by the JNC VI (1997). The new classification defines a blood pressure of 120/80 mm Hg as optimal and of 130/85 mm Hg as the limit between normal and high-normal blood pressure. It is unclear which self-measured home blood pressure values correspond to these office blood pressure limits. In this study we reevaluated data from our Dübendorf study to determine self-measured blood pressure values corresponding to optimal and normal office blood pressure using the percentiles of the (office and home) blood pressure distributions of 503 individuals (age, 20 to 90 years; mean age, 46.5 years; 265 men, 238 women). Self-measured blood pressure values corresponding to office values of 130/85 mm Hg and 120/80 mm Hg were 124.1/79.9 mm Hg and 114.3/75.1 mm Hg. Thus, we propose 125/80 mm Hg as a home blood pressure corresponding to an office blood pressure of 130/85 mm Hg (WHO 1999: normal) and 115/75 mm Hg corresponding to 120/80 mm Hg (optimal). Am J Hypertens 2000;13:940-943 © 2000 American Journal of Hypertension, Lt

Interval Training in Sports Medicine: Current Thoughts on an Old Idea

In light of the global physical inactivity pandemic, the increasing prevalence of non-committable diseases, and mounting healthcare costs, effective and feasible prevention and treatment approaches are urgently needed [...]

Structural and magnetic properties of an InGaAs/Fe3_3Si superlattice in cylindrical geometry

The structure and the magnetic properties of an InGaAs/Fe3Si superlattice in a cylindrical geometry are investigated by electron microscopy techniques, x-ray diffraction and magnetometry. To form a radial superlattice, a pseudomorphic InGaAs/Fe3As bilayer has been released from its substrate self-forming into a rolled-up microtube. Oxide-free interfaces as well as areas of crystalline bonding are observed and an overall lattice mismatch between succeeding layers is determined. The cylindrical symmetry of the final radial superlattice shows a significant effect on the magnetization behavior of the rolled-up layers

Comparison of a 2-Layer Electric Fence and a Single Strand Electric Fence in Mitigating Browsing of Impatiens by White-Tailed Deer

The objective of this study was to evaluate two electric fence configurations in minimizing damage to impatiens (Impatiens walleriana) by white-tailed deer (Odocoileus virginianus). Each of 3 sites consisted of 3 plots (3mx3m), containing 16, evenly spaced impatiens planted on the perimeter of each plot. Plots within each site had a control, single strand and 2-layered electric fence. Control plots had no fencing. Single strand plots had one electrified wire attached to posts at 40 cm height, surrounding the plot. Two-layered electric fence had energized wire attached to posts at 25 cm and 60 cm height, on the perimeter of the plot. A second, single electrified wire was attached to posts at 25 cm height, 1 m to the exterior of the two strand fence. Eight plants within each plot was photographed weekly for 3-weeks. The percentage of total pixels containing plant material in each photo was used to determine changes in plant growth. The percentage of pixels containing impatiens plants was lower (

Field Evaluation of Two External Attachment Location of Radio Transmitters on Non-Venomous Rat Snakes (elaphe obsolete)

The objective of this study was to determine the effectiveness of external attachment of radio transmitters at one of two locations on mature rat snakes (Elaphe obsolete). Transmitters were attached to mature snakes (n = 10; 136.7cm ± 6.4) on either the ventral surface (n = 5) or dorsal-lateral surface of the rib cage (n = 5), approximately 25cm cranially to the cloaca. Transmitters (18mm × 8mm × 2mm) were attached by one drop of acrylamide gel glue to the adhering side of camouflage duct tape (20cm × 30mm), a single drop of glue on the exposed side of the transmitter, and secured by wrapping the tape to the snake’s body with the transmitter in the appropriate location. A second piece of duct tape (20cm × 40mm) overlapped and secured the first piece of tape with the transmitter. Snakes were placed in a 0.1ha plastic fence enclosure, (128.5cm ± 0.5 height, and 17.1° ± 0.5 inward slope) in an unimproved pasture with numerous hides, water and food. Snakes (n = 4) shed their skin and the transmitter, within 6- 17d post-attachment (11.7d ± 2.4). Snakes (n = 4) escaping the enclosure and not located, ranged from 1- 21d post-attachment, (12.3d ± 4.7). There was no difference (p \u3e 0.05) in functional days snakes were located by radio telemetry due to attachment site or sex. Transmitter reception distance was typically \u3c 50m and often problematic. Results of this study suggest that the location of external attachment of transmitters had no influence on duration of effectiveness. However, shedding and limited telemetry range under these conditions should be considered to determine if the methodology is appropriate for the desired objectives

NB SPUTTER COATING ON QWR IN ANU

ABSTRACT Nb sputtered QWRs are to be used for the future extension of the Linac. The magnetron sputtering system and its operational performance are described. A magnetron discharge in argon is used for sputtering niobium and in helium for cleaning of the resonator. The cathode comprises two cylindrical and one ring element. The I-V characteristics of the sputtering in argon are given. The superconducting film is deposited with a uniform film thickness and coverage of the resonator. The distribution of the deposition rate f r o m different cathode-resonator geometry and film thickness profiles are discussed. The switching of the cylindrical sputtering cathode from external to internal regions of the cathode, is described. A sputtering procedure, t e s t depositions on ceramic samples and sputtering on the QWR for Time-Energy Lens, will be outlined. The composition of impurities stemming from t h e sputtering process, will be discussed. . I n t r o d u c t i o n The ANU accelerator system, comprising the 14UD and Linac, continues t o evolve toward a competent integrated research facility. The Linac successfully passed important milestones in 1996, including the f i r s t nuclear physics experiment performed on 5 June, and its o f f i c i a l inauguration on 11 July. Good progress has been made in the conditioning of the Pb plated, split loop resonators. Combinations of pulsed RF power conditioning and helium conditioning have enabled all resonators to operate near and above 2 MV/m