HIV status disclosure and ARV adherence among patients attending ...

African Journals Online (AJOL)

HIV status disclosure and ARV adherence among patients attending Jomo Kenyatta University comprehensive care clinic. ... Failure to daily intake of Anti Retrovirals (ARV) not only prevents treatment failure but may also lead to viral development of resistance to the drugs. The fact that HIV is mainly sexually transmitted ...

AR-v7 protein expression is regulated by protein kinase and phosphatase

Science.gov (United States)

Li, Yinan; Xie, Ning; Gleave, Martin E.; Rennie, Paul S.; Dong, Xuesen

2015-01-01

Failure of androgen-targeted therapy and progression of castration-resistant prostate cancer (CRPC) are often attributed to sustained expression of the androgen receptor (AR) and its major splice variant, AR-v7. Although the new generation of anti-androgens such as enzalutamide effectively inhibits AR activity, accumulating pre-clinical and clinical evidence indicates that AR-v7 remains constitutively active in driving CRPC progression. However, molecular mechanisms which control AR-v7 protein expression remain unclear. We apply multiple prostate cancer cell models to demonstrate that enzalutamide induces differential activation of protein phosphatase-1 (PP-1) and Akt kinase depending on the gene context of cancer cells. The balance between PP-1 and Akt activation governs AR phosphorylation status and activation of the Mdm2 ubiquitin ligase. Mdm2 recognizes phosphorylated serine 213 of AR-v7, and induces AR-v7 ubiquitination and protein degradation. These findings highlight the decisive roles of PP-1 and Akt for AR-v7 protein expression and activities when AR is functionally blocked. PMID:26378044

Research on Fairing design and CFD Analysis of Submarine Pipeline Inspection ARV

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Jin Xiaojian

2017-01-01

Full Text Available Along with the fast development of the ocean exploitation, the cost-effective requirement of autonomous & remotely operated vehicle (ARV, which can perform more complicated missions such as the oil exploitation and the inspection of the submarine pipeline is more urgent. The submarine pipeline inspection ARV can help us better understand, protect and efficiently utilize them for human welfare. Fairing design of a new detection ARV are introduced in this paper. In order to select an appropriate thruster that will achieve the required speed of the ARV, the ANSYS-CFX tools are used to predicted the drag force. The CFD results reveal the distribution of velocity and pressure values of the ARV. In order to verify the CFD modeling process, a towed body was developed and analyzed, compared against the corresponding physical test data.

Promosi Kesehatan Nola Pender Berpengaruh Terhadap Pengetahuan dan Kepatuhan ODHA Minum ARV

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Tuti Asrianti Utami

2017-05-01

Full Text Available The success rate of ARV therapy depends on the adherence of HIV-AIDS patients in ARV treatment. The purpose of this study was to analyze the effect of NolaPender health promotion to improve the knowledge and adherence of PLWHA (People living with HIV-AIDS with ARV in SintCarolus Health Service (SCHS and Persahabatan General Hospital (PGH. This study used a Pre-Post test Quasi Eksperimantal Non Equivalent Control Group and a total sample of 90 respondents were recruited through the use of consecutive sampling with inclusion criteria where 45 respondents served as intervention group in SCHS and the remaining as control group in PGH from May-June 2016. The result showed most respondents were in the late adulthood stage (36-55 years old, male, having advanced education, working, exposed to counseling service, having family support as well as peer group support, easy in reaching health service and with health insurance. NolaPender health promotion increased the knowledge of ARV (mean score pre intervention was 5.31 to post intervention 7.04, and improving the adherence of taking ARV from moderate to good adherence as many as 51.1%. There was an effect of Nola Pender health promotion using booklet to respondents’ knowledge (p-value=0.000 from 13.3% to 91.1% and also effect of knowledge improvement of ARV to the adherence of taking ARV, with the support from peer group from 30.2% to 87.2%. The study recommends to continue this program of Nola Pender health promotion for PLWHA taking ARV in a structured and well planned system.

knowledge and attitudes towards the use of arvs among adults

African Journals Online (AJOL)

To assess knowledge and attitudes towards the use of ARV drugs among adults in Dodoma urban district ... male and female respectively interviewed were aware of ARVs. Also ... Sub-Saharan Africa is the most severely affected ... Tanzania, it has been estimated that more than ... support unique to those who fall sick and.

Pengabaian Distinction Principle dalam Situasi Blokade oleh Israel di Jalur Gaza

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Erwin Erwin

2013-12-01

Full Text Available Abstrak      Konflik bersenjata (perang telah ada dan terjadi ribuan tahun yang lalu walaupun berbeda situasi dan derajat konfliknya dengan konflik bersenjata (perang pada masa modern seperti sekarang. Salah satu konflik yang terjadi dalam sejarah modern peradaban manusia adalah konflik Israel-Palestina. Dalam catatan sejarah peradaban manusia, konflik Israel-Palestina merupakan salah satu konflik terpanjang di dunia, karena sampai saat inipun masih terjadi. Terdapat banyak upaya perdamaian dan perjanjian terus dilakukan berbagai pihak untuk merintis dan mencapai kesepakatan perdamaian, akan tetapi konflik tetap terus terjadi. Adapun peristiwa yang terjadi sebagai bagian dari konflik Israel-Palestina adalah terjadinya blokade atas Gaza pada bulan Juli tahun 2007 oleh Israel. Blokade Israel di Gaza telah mengabaikan prinsip pembedaan (distinction combatan dan civilian (penduduk sipil. Dengan alasan apapun tindakan blokade Israel telah melanggar hukum internasional pada umumnya dan Hukum Humaniter Internasional (HHI pada khususnya.Kata Kunci : Blokade, Gaza, Distinction Principle

Social arv og ulighed

DEFF Research Database (Denmark)

Jensen, Bente

2017-01-01

Artiklen søger at komme tættere på spørgsmål om hvordan dagtilbud kan gøre en forskel for social udsatte børn ved for det første at indkredse forskning om dagtilbuds betydning set i relation til en social arv- og ulighedsproblematik. For det andet belyses eksempler fra dansk interventionsforskning...

IDRC in the West Bank and Gaza

International Development Research Centre (IDRC) Digital Library (Canada)

By examining issues such as household dynamics, access to justice, the right to work, education, health, political participation, and migration, researchers are identifying ways for policymakers to enhance women's rights. □ Transitional justice, lasting peace. Funding for West Bank and Gaza: $225,000. Duration: 2008–2011.

Patent Pooling for Promoting Access to Antiretroviral Drugs (ARVs) - A Strategic Option for India.

Science.gov (United States)

Satyanarayana, Kanikaram; Srivastava, Sadhana

2010-01-19

The current HIV/AIDS scenario in India is quite grim with an estimated 2.4 million people living with HIV/AIDS (PLHA) in 2008, just behind South Africa and Nigeria. The anti-retroviral drugs (ARVs) remain the main stay of global HIV/AIDS treatment. Over 30 ARVs (single and FDCs) available under six categories viz., NRTIs (nucleoside reverse transcriptase inhibitors), NNRTIs (non-nucleoside reverse transcriptase inhibitors), Protease inhibitors, the new Fusion inhibitors, Entry inhibitors-CCR5 co-receptor antagonists and HIV integrase strand transfer inhibitors. The major originator companies for these ARVs are: Abbott, Boehringer Ingelheim (BI), Bristol-Myers Squibb (BMS), Gilead, GlaxoSmithKline (GSK), Merck, Pfizer, Roche, and Tibotec. Beginning with zidovidine in 1987, all the drugs are available in the developed countries. In India, about 30 ARVs are available as generics manufactured by Aurobindo, Hyderabad, Andhra Pradesh; Cipla Limited, Goa; Emcure Pharmaceuticals, Pune, Maharashtra; Hetero Drugs, Hyderabad, Andhra Pradesh; Macleods Pharmaceuticals, Daman; Matrix Laboratories, Nashik, Maharashtra; Ranbaxy, Sirmour, Himachal Pradesh; and Strides Arcolab, Bangalore, Karnataka. The National AIDS Control Organization (NACO) set up in 1992 by the Govt. of India provides free ARVs to HIV positive patients in India since 2004. The drugs available in India include both single drugs and FDCs covering both first line and second line ARVs. Even while there are claims of stabilization of the disease load, there is still huge gap of those who require ARVs as only about 150,000 PLHA receive the ARVs from the Govt. and other sources. Access to ARVs therefore is still a cause of serious concern ever since India became fully Trade Related Aspects of Intellectual Property Rights (TRIPS)-complaint in 2005. Therefore, the Indian pharmaceutical companies cannot make generics for those for drugs introduced post-2005 due to product patent regime. Other concerns include heat stable

Educational models and concept of childhood in the Gaza Strip

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Arianna Taddei

2010-07-01

Full Text Available In 2008, R.E.C. (Remedial Education Centre, Gaza, Palestine was carrying out the project “Promotion of the democratic process and active participation among young population in the Gaza Strip”, approved by the Europe Initiative for democracy and Human Rights, and financed by the European Union. The project included a research activity, “Educational models and concept of childhood in the Gaza Strip”. The research is an idea coming from the long-term collaboration, started in 2002, between EducAid (Italian Ngo, Rimini, Italy and R.E.C. in the educational work with the vulnerable children in the Gaza Strip.Teachers, educators and parents play a fundamental role in the education of children and adolescents; therefore families, associations and schools should be places where children become aware of their rights as human beings, in order to become, one day, active citizens of a society that themselves can improve. It’s of fundamental importance the policy that institutions carry out (supporting families, schools and associations, because it guarantees a functional education system. We interfaced with the different faces of formal and informal education, and it was impossible not to have the sensation of being inside a big prison, not too big, if we think its size compared to one and a half million inhabitants, between a closed tall and gray wall, a sea hardly accessible due to embargo, and Erez, the check point of transit for Israel. No gas, no fuel, no electricity, yet children continue to go to school, the roads are crowded by pedestrians who are waiting for a taxi for hours under the sun, wondering if they can go to work. The potential of education and schooling represent non-violent weapons to defend peace, promote change, make children aware of their rights, begin to live their citizenship at school, at home, in the associations. Through the testimonies we realized how much these valuable potentials are in danger in the Gaza Strip, as

Promosi Kesehatan Nola Pender Berpengaruh Terhadap Pengetahuan dan Kepatuhan ODHA Minum ARV

OpenAIRE

Tuti Asrianti Utami

2017-01-01

The success rate of ARV therapy depends on the adherence of HIV-AIDS patients in ARV treatment. The purpose of this study was to analyze the effect of NolaPender health promotion to improve the knowledge and adherence of PLWHA (People living with HIV-AIDS) with ARV in SintCarolus Health Service (SCHS) and Persahabatan General Hospital (PGH). This study used a Pre-Post test Quasi Eksperimantal Non Equivalent Control Group and a total sample of 90 respondents were recruited through the use of c...

DBC1 promotes castration-resistant prostate cancer by positively regulating DNA binding and stability of AR-V7.

Science.gov (United States)

Moon, Sue Jin; Jeong, Byong Chang; Kim, Hwa Jin; Lim, Joung Eun; Kwon, Ghee Young; Kim, Jeong Hoon

2018-03-01

Constitutively active AR-V7, one of the major androgen receptor (AR) splice variants lacking the ligand-binding domain, plays a key role in the development of castration-resistant prostate cancer (CRPC) and anti-androgen resistance. However, our understanding of the regulatory mechanisms of AR-V7-driven transcription is limited. Here we report DBC1 as a key regulator of AR-V7 transcriptional activity and stability in CRPC cells. DBC1 functions as a coactivator for AR-V7 and is required for the expression of AR-V7 target genes including CDH2, a mesenchymal marker linked to CRPC progression. DBC1 is required for recruitment of AR-V7 to its target enhancers and for long-range chromatin looping between the CDH2 enhancer and promoter. Mechanistically, DBC1 enhances DNA-binding activity of AR-V7 by direct interaction and inhibits CHIP E3 ligase-mediated ubiquitination and degradation of AR-V7 by competing with CHIP for AR-V7 binding, thereby stabilizing and activating AR-V7. Importantly, DBC1 depletion suppresses the tumorigenic and metastatic properties of CRPC cells. Our results firmly establish DBC1 as a critical AR-V7 coactivator that plays a key role in the regulation of DNA binding and stability of AR-V7 and has an important physiological role in CRPC progression.

Performance comparison of two androgen receptor splice variant 7 (AR-V7) detection methods.

Science.gov (United States)

Bernemann, Christof; Steinestel, Julie; Humberg, Verena; Bögemann, Martin; Schrader, Andres Jan; Lennerz, Jochen K

2018-01-23

To compare the performance of two established androgen receptor splice variant 7 (AR-V7) mRNA detection systems, as paradoxical responses to next-generation androgen-deprivation therapy in AR-V7 mRNA-positive circulating tumour cells (CTC) of patients with castration-resistant prostate cancer (CRPC) could be related to false-positive classification using detection systems with different sensitivities. We compared the performance of two established mRNA-based AR-V7 detection technologies using either SYBR Green or TaqMan chemistries. We assessed in vitro performance using eight genitourinary cancer cell lines and serial dilutions in three AR-V7-positive prostate cancer cell lines, as well as in 32 blood samples from patients with CRPC. Both assays performed identically in the cell lines and serial dilutions showed identical diagnostic thresholds. Performance comparison in 32 clinical patient samples showed perfect concordance between the assays. In particular, both assays determined AR-V7 mRNA-positive CTCs in three patients with unexpected responses to next-generation anti-androgen therapy. Thus, technical differences between the assays can be excluded as the underlying reason for the unexpected responses to next-generation anti-androgen therapy in a subset of AR-V7 patients. Irrespective of the method used, patients with AR-V7 mRNA-positive CRPC should not be systematically precluded from an otherwise safe treatment option. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

Influence of the method of optimizing adjustments of ARV-SD on attainable degree of system stability. Vliyaniye metoda optimizatsii nastroyek ARV-SD na dostizhimuyu stepen ustoychivosti sistemy

Energy Technology Data Exchange (ETDEWEB)

Gruzdev, I.A.; Trudospekova, G.Kh.

1983-01-01

An examination is made of the efficiency of the methods of successive and simultaneous optimization of adjustments of ARV-SD (ARV of strong action) of several PP. It is shown that with the use of the method of simultaneous optimization for an idealized model of complex EPS, it is possible to attain absolute controllability of the degree of stability.

Vulnerable infected populations and street markets for ARVs: Potential implications for PrEP rollout in the USA.

Science.gov (United States)

Kurtz, Steven P; Buttram, Mance E; Surratt, Hilary L

2014-04-01

Widespread diversion of antiretroviral (ARV) medications to illicit markets has recently been documented among indigent patients in South Florida. The recent approval of ARVs for pre-exposure prophylaxis (PrEP) has the potential to broaden these illicit markets, as high-risk individuals seek ARVs without a prescription or medical supervision. Nonadherence among diverters and unsupervised use of ARVs for treatment or PrEP increase risks of treatment failure, drug resistance, and disease transmission. We report the scope of ARV diversion among substance-using men who have sex with men in South Florida. Structured interviews (N = 515) queried demographics, HIV status, mental distress, substance dependence, and sexual risks. HIV-positive participants answered questions about medical care, treatment, and ARV adherence and diversion. Median age was 39. Of 46.4% who were HIV-positive, 79.1% were prescribed ARVs. Of these, 27% reported selling/trading ARVs. Reasons for diversion were sharing/trading with friends, sale/trade for money/drugs, and sale/trade of unused medications. ARV diverters, compared to nondiverters, were more likely to be substance dependent (74.5% vs. 58.7%, p = 0.046) and have traded sex for money/drugs (60.8% vs. 32.6%, p increased risks of treatment failure, disease transmission, and PrEP failure should be carefully considered in developing policy and behavioral supports to scaling up treatment as prevention and PrEP.

Oral manifestations of anemia in HIV/AIDS patients without ARV treatment

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Wahyu Hidayat

2017-03-01

Full Text Available Abstract Introduction: Acquired immunodeficiency syndrome (AIDS is  a set of symptoms caused by decreases of the immune system that was infected by human immunodeficiency virus (HIV. Blood disorders often found in patient with HIV and associated with HIV infection. Mostly found disorders is anemia of chronic disease. The prevalence of anemia in HIV/AIDS patients reaches 70%. Oral manifestations of anemia are atrophy of the papillae on tongue, glossodynia, pallor, angular cheilitis, glossitis, aphthous ulcers/erosive lesions, candidiasis, and geographic tongue. There are many publications that uses anemia as indicator to determine the prognosis of HIV infection, thus the description of oral manifestation of anemia in the non-ARV HIV/AIDS patients is a necessity. The purpose of this study was to describe the oral manifestation of anemia in the non-ARV HIV/AIDS patients. Methods: The methods used were purposive random sampling. Samples were new HIV/AIDS patients who have not got antiretroviral (ARV treatment. The study included 40 patients in Teratai Clinic Hasan Sadikin Hospital Bandung. Results: Oral manifestations of anemia were found amongst non-ARV HIV/AIDS patients, which were candidiasis in  37 patients, glossodynia in 28 patients, glossitis in 10 patients, and angular cheilitis in 1 patient. Conclusion: From the study found that oral manifestations of anemia that found in non-ARV HIV/AIDS patients were candidiasis, glossodynia, glossitis and angular cheilitis. HIV/AIDS patients with anemia needed to treat more intensive for better prognosis and quality of life. Keywords: Anemia, HIV/AIDS, Candidiasis, Glossitis, Glossodynia

Iisrael lõdvendab Gaza maablokaadi / Hendrik Vosman, Jürgen Tamme

Index Scriptorium Estoniae

Vosman, Hendrik

2010-01-01

Israeli valitsus vähendas piiranguid ja lubab nüüd toiduaineid, mänguasju, kirjatarbeid, madratseid ja rätikuid Gaza sektorisse tarnida. Hamas nimetas blokaadi leevendamise otsust tühiseks meediapropagandaks

The Rh allele frequencies in Gaza city in Palestine

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Skaik Younis

2011-01-01

Full Text Available Background: The Rh blood group system is the second most clinically significant blood group system. It includes 49 antigens, but only five (D, C, E, c and e are the most routinely identified due to their unique relation to hemolytic disease of the newborn (HDN and transfusion reactions. Frequency of the Rh alleles showed variation, with regard to race and ethnic. Objectives: The purpose of the study was to document the Rh alleles′ frequencies amongst males (M and females (F in Gaza city in Palestine. Materials and Methods: Two hundred and thirty-two blood samples (110 M and 122 F were tested against monoclonal IgM anti-C,anti-c, anti-E, anti-e and a blend of monoclonal/polyclonal IgM/IgG anti-D. The expected Rh phenotypes were calculated using gene counting method. Results: The most frequent Rh antigen in the total sample was e, while the least frequent was E.The order of the combined Rh allele frequencies in both M and F was CDe > cDe > cde > CdE > cDE > Cde > CDE. A significant difference was reported between M and F regarding the phenotypic frequencies (P < 0.05. However, no significance (P > 0.05 was reported with reference to the observed and expected Rh phenotypic frequencies in either M or F students. Conclusion: It was concluded that the Rh antigens, alleles and phenotypes in Gaza city have unique frequencies, which may be of importance to the Blood Transfusion Center in Gaza city and anthropology.

Loss of Subcellular Lipid Transport Due to ARV1 Deficiency Disrupts Organelle Homeostasis and Activates the Unfolded Protein Response*

Science.gov (United States)

Shechtman, Caryn F.; Henneberry, Annette L.; Seimon, Tracie A.; Tinkelenberg, Arthur H.; Wilcox, Lisa J.; Lee, Eunjee; Fazlollahi, Mina; Munkacsi, Andrew B.; Bussemaker, Harmen J.; Tabas, Ira; Sturley, Stephen L.

2011-01-01

The ARV1-encoded protein mediates sterol transport from the endoplasmic reticulum (ER) to the plasma membrane. Yeast ARV1 mutants accumulate multiple lipids in the ER and are sensitive to pharmacological modulators of both sterol and sphingolipid metabolism. Using fluorescent and electron microscopy, we demonstrate sterol accumulation, subcellular membrane expansion, elevated lipid droplet formation, and vacuolar fragmentation in ARV1 mutants. Motif-based regression analysis of ARV1 deletion transcription profiles indicates activation of Hac1p, an integral component of the unfolded protein response (UPR). Accordingly, we show constitutive splicing of HAC1 transcripts, induction of a UPR reporter, and elevated expression of UPR targets in ARV1 mutants. IRE1, encoding the unfolded protein sensor in the ER lumen, exhibits a lethal genetic interaction with ARV1, indicating a viability requirement for the UPR in cells lacking ARV1. Surprisingly, ARV1 mutants expressing a variant of Ire1p defective in sensing unfolded proteins are viable. Moreover, these strains also exhibit constitutive HAC1 splicing that interacts with DTT-mediated perturbation of protein folding. These data suggest that a component of UPR induction in arv1Δ strains is distinct from protein misfolding. Decreased ARV1 expression in murine macrophages also results in UPR induction, particularly up-regulation of activating transcription factor-4, CHOP (C/EBP homologous protein), and apoptosis. Cholesterol loading or inhibition of cholesterol esterification further elevated CHOP expression in ARV1 knockdown cells. Thus, loss or down-regulation of ARV1 disturbs membrane and lipid homeostasis, resulting in a disruption of ER integrity, one consequence of which is induction of the UPR. PMID:21266578

Community attitudes toward rationing ARVs: a qualitative study of justice and equity.

Science.gov (United States)

Rennie, Stuart

2006-12-01

Medical rationing of anti-retroviral therapies (ARVs) may conflict with the right to health, but rationing is nevertheless a reality in developing countries. In this article, which is based on a poster presentation at the conference, Stuart Rennie presents the preliminary findings of a study on community attitudes towards rationing ARVs in the Democratic Republic of Congo (DRC).

Sõjaroim reaalajas : Iisrael kasutab Gazas valge fosfori pomme / Christopher Bollyn

Index Scriptorium Estoniae

Bollyn, Christopher

2009-01-01

Ajalehe The Times väitel kasutab Iisrael rünnakutes Gaza sektorile valge fosfori pomme, mis on Genfi konventsiooniga keelatud. Vt. samas: Genfi konventsioon ; Fosforitükid põlevad kehas luudeni välja

Arved Viirlaid teises kaanonis / Jüri Talvet

Index Scriptorium Estoniae

Talvet, Jüri, 1945-

2002-01-01

Arved Viirlaid 80. Ka tema juubeliks ilmunud ingliskeelsest luulekogust "Selected poems" (tlk. Taimi Ene Moks ja R. W. Stedingh). Ilmunud ka kogumikus: Talvet, Jüri. Tõrjumatu äär. Tartu : Ilmamaa, 2005, lk. 417-420, pealk.: Teises Kaanonis: Viirlaiu luule inglise keeles

Impact of war, religiosity and ideology on PTSD and psychiatric disorders in adolescents from Gaza Strip and South Lebanon.

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Khamis, Vivian

2012-06-01

This study investigated the extent to which differences in the types of war trauma, economic pressure, religiosity and ideology accounted for variation in PTSD and psychiatric disorders among adolescents from Gaza Strip and South Lebanon. Participants were 600 adolescents aged 12-16 years. They were selected from the public school system in the highly war exposed areas. Questionnaires were administered in an interview format with adolescents at school by two trained psychologists. Results indicated that the various types of trauma had differential effects on the psychological status of adolescents in both countries. Economic pressure was more predictive of PTSD and psychological distress in adolescents from Gaza. Differences in religiosity and ideology did not account for similar variation in stress response among adolescents from Gaza and South Lebanon. While higher levels of religiosity evidenced the greatest levels of depression and anxiety in adolescents from Gaza, religiosity had an attenuated effect on adolescents from South Lebanon. Ideology was negatively associated with depression and anxiety in Gaza strip adolescents, whereas it did not play a role for adolescents from South Lebanon. The clinical and research implications of these conclusions are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Epidemiology and Outcomes of Hospitalized Burn Patients in Gaza ...

African Journals Online (AJOL)

BACKGROUNG: Burns are serious health problems and leading causes of mortality and morbidity in the Eastern Mediterranean Region. This study aimed to overview the epidemiological profile and to present outcomes among hospitalized burn patients in AL Alamy burn center in Gaza. METHODS: This was a ...

Sustainability of ARV provision in developing countries: challenging a framework based on program history

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Thiago Botelho Azeredo

Full Text Available Abstract The provision of ARVs is central to HIV/AIDS programs, because of its impact on the course of the disease and on quality of life. Although first-line treatments costs have declined, treatment-associated expenses are steeper each year. Sustainability is therefore an important variable for the success of treatment programs. A conceptual framework on sustainability of ARV provision was developed, followed by data collection instruments. The pilot study was undertaken in Brazil. Bolivia, Peru and Mozambique, were visited. Key informants were identified and interviewed. Investigation of sustainability related to ARV provision involved implementation and routinization events of provision schemes. Evidence of greater sustainability potential was observed in Peru, where provision is implemented and routinized by the National HIV/AIDS program and expenditures met by the government. In Mozambique, provision is dependent on donations and external aid, but the country displays a great effort to incorporate ARV provision and care in routine healthcare activities. Bolivia, in addition to external dependence on financing and management of drug supply, presents problems regarding implementation and routinization. The conceptual framework was useful in recognizing events that influence sustainable ARV provision in these countries.

A reflective learning report about the implementation and impacts of Psychological First Aid (PFA) in Gaza.

Science.gov (United States)

Schafer, Alison; Snider, Leslie; Sammour, Rania

2016-01-01

Psychological First Aid (PFA) is the recommended immediate psychosocial response during crises. As PFA is now widely implemented in crises worldwide, there are increasing calls to evaluate its effectiveness. World Vision used PFA as a fundamental component of their emergency response following the 2014 conflict in Gaza. Anecdotal reports from Gaza suggest a range of benefits for those who received PFA. Though not intending to undertake rigorous research, World Vision explored learnings about PFA in Gaza through Focus Group Discussions with PFA providers, Gazan women, men and children and a Key Informant Interview with a PFA trainer. The qualitative analyses aimed to determine if PFA helped individuals to feel safe, calm, connected to social supports, hopeful and efficacious - factors suggested by the disaster literature to promote coping and recovery (Hobfoll et al., 2007). Results show positive psychosocial benefits for children, women and men receiving PFA, confirming that PFA contributed to: safety, reduced distress, ability to engage in calming practices and to support each other, and a greater sense of control and hopefulness irrespective of their adverse circumstances. The data shows that PFA formed an important part of a continuum of care to meet psychosocial needs in Gaza and served as a gateway for addressing additional psychosocial support needs. A "whole-of-family" approach to PFA showed particularly strong impacts and strengthened relationships. Of note, the findings from World Vision's implementation of PFA in Gaza suggests that future PFA research go beyond a narrow focus on clinical outcomes, to a wider examination of psychosocial, familial and community-based outcomes.

Designing ARVs Patent Pool Up to Trade & Policy Evolutionary Dynamics.

Science.gov (United States)

Dionisio, Daniele; Racalbuto, Vincenzo; Messeri, Daniela

2010-01-19

Patent pools for second and third-line Fixed Dose Combination (FDC) antiretroviral drugs (ARVs) should not be delayed as they are instrumental to urgent public health needs in the under-served markets.Nonetheless, multinational originator companies still seem to perceive patent pooling for ARVs as a minefield that would offer the generic competitors lots of deeply exploitable opportunities, to the detriment of patent owner's rights.This paper analyses the brand industry concerns, while looking for a strategy up to a really equitable and free world market, without any discrimination between end-users in wealthy and resource-limited countries.This strategy would urge partnerships between originator companies first to make newer FDC ARVs quickly available and allow patent pool agreements with generic counterparts to be negotiated straight afterwards.The patent pool strategy highlighted in this paper would assert the primacy of health over for-profit policies, while aligning with the 61(st) WHO's Assembly recommendations and G7, G8 and World Trade Organisation's warnings and pledges against trade protectionism.

The ARV roll out and the disability grant: a South African dilemma?

Science.gov (United States)

de Paoli, Marina Manuela; Mills, Elizabeth Anne; Grønningsaeter, Arne Backer

2012-02-16

Prior to the antiretroviral (ARV) drug roll out in 2004, people living with HIV (PLHIV) in South Africa received disability grants when they were defined as "AIDS-sick". In the absence of available and effective medication, a diagnosis of AIDS portended disability. The disability grant is a critical component of South Africa's social security system, and plays an important role in addressing poverty among PLHIV. Given the prevalence of unemployment and poverty, disability grants ensure access to essential resources, like food, for PLHIV. Following the ARV roll out in South Africa, PLHIV experienced improved health that, in turn, affected their grant eligibility. Our aim is to explore whether PLHIV reduced or stopped treatment to remain eligible for the disability grant from the perspectives of both PLHIV and their doctors. A mixed-methods design with concurrent triangulation was applied. We conducted: (1) in-depth semi-structured interviews with 29 PLHIV; (2) in-depth semi-structured interviews with eight medical doctors working in the public sector throughout the Cape Peninsula; (3) three focus group discussions with programme managers, stakeholders and community workers; and (4) a panel survey of 216 PLHIV receiving ARVs. Unemployment and poverty were the primary concerns for PLHIV and the disability grant was viewed as a temporary way out of this vicious cycle. Although loss of the disability grant significantly affected the well-being of PLHIV, they did not discontinue ARVs. However, in a number of subtle ways, PLHIV "tipped the scales" to lower the CD4 count without stopping ARVs completely. Grant criteria were deemed ad hoc, and doctors struggled to balance economic and physical welfare when assessing eligibility. It is crucial to provide sustainable economic support in conjunction with ARVs in order to make "positive living" a reality for PLHIV. A chronic illness grant, a basic income grant or an unemployment grant could provide viable alternatives when the

Severe extremity amputations in surviving Palestinian civilians caused by explosives fired from drones during the Gaza War.

Science.gov (United States)

Heszlein-Lossius, Hanne; Al-Borno, Yahya; Shaqoura, Samar; Skaik, Nashwa; Giil, Lasse Melvær; Gilbert, Mads

2018-02-21

During four separate Israeli military attacks on Gaza (2006, 2009, 2012, and 2014), about 4000 Palestinians were killed and more than 17 000 injured (412 killed and 1264 injured in 2006; 1383 killed and more than 5300 injured in 2009; 130 killed and 1399 injured in 2012; and 2251 killed and 11 231 injured in 2014). An unknown number of people had traumatic amputations of one or more extremities. Use of unmanned Israeli drones for surveillance and armed attacks on Gaza was evident, but exact figures on numbers of drone strikes on Gaza are not available. The aim of this study was to explore the medical consequences of strikes on Gaza with different weapons, including drones. We studied a cohort of civilians in the Gaza Strip who had one of more traumatic limb amputation during the Israeli military attacks between 2006 and 2016. The study was done at The Artificial Limb and Polio Center (ALPC) in the Gaza Strip where most patients are treated and trained after amputation. We used standardised forms and validated instruments to record date and mechanism of injury, self-assessed health, socioeconomic status, anatomical location and length of amputation, comorbidity, and the results of a detailed clinical examination. The studied cohort consisted of 254 Paletinian civilians (234 [92%] men, 20 [8%] women, and 43 [17%] children aged 18 years and younger) with traumatic amputations caused by different weapons. 216 (85%) people had amputations proximal to wrist or ankle, 131 (52%) patients had more than one major amputation or an amputation above the knee, or both, and 136 (54%) people were injured in attacks with Israeli drones, including eight (40%) of the women. The most severe amputations were caused by drone attacks (p=0·0001). Extremity injuries after drone attacks led to immediate amputation more often than with other weapons (p=0·014). Patients injured during cease-fire periods were younger than patients injured during periods of declared Israeli military

Equity in access to ARV drugs in Malawi

African Journals Online (AJOL)

2007-05-01

May 1, 2007 ... included):'We found that financial resources are not regarded as .... The dangers implied in this statement are obvious. ..... Mwansambo, A., & Chizimba, R. (2004) Consolidated report on equity in access to ARVs. Lilongwe:.

[The impact of the androgen receptor splice variant AR-V7 on the prognosis and treatment of advanced prostate cancer].

Science.gov (United States)

Thelen, P; Taubert, H; Duensing, S; Kristiansen, G; Merseburger, A S; Cronauer, M V

2018-01-25

A recently discovered mechanism enabling prostate cancer cells to escape the effects of endocrine therapies consists in the synthesis of C-terminally truncated, constitutively active androgen receptor (AR) splice variants (AR-V). Devoid of a functional C-terminal hormone/ligand binding domain, various AR-Vs are insensitive to therapies targeting the androgen/AR signalling axis. Preliminary studies suggest that AR-V7, the most common AR-V, is a promising predictive tumour marker and a relevant selection marker for the treatment of advanced prostate cancer. This review critically outlines recent advances in AR-V7 diagnostics and presents an overview of current AR-V7 targeted therapies. © Georg Thieme Verlag KG Stuttgart · New York.

The Sources of Some of the Anthropological and Cosmological Ideas of Sulayman of Gaza

Directory of Open Access Journals (Sweden)

Davydenkov Oleg

2016-06-01

Full Text Available The article provides a brief overview ofSulayman, bishop of Gaza, an Arab-Christian Orthodox author of 10-11th centuries, and his theological and philosophical writings. Exploring the question of the sources of Sulayman’s ideas associated with the doctrine of man as a microcosm and his representation of the cross as a principle that underlies the created world and human nature, the author comes to the conclusion that most of these ideas are contained in the Greek patristic literature (the Great Cappadocians, St John of Damascus with which Sulayman as a person sufficiently educated and having command of the Greek language was likely familiar. Thus, contrary to the opinion of some modern scholars who believe that these anthropological and cosmological ideas were borrowed by the bishop of Gaza from contemporary Muslim (Ismaili esoteric literature, the author concludes that the presence of these ideas in the writings of Sulayman of Gaza suggests a good acquaintance with the Greek patristic tradition rather than his openness to borrowing from non-Christian sources.

Challenges confronting health care workers in government's ARV ...

African Journals Online (AJOL)

Challenges confronting health care workers in government's ARV rollout: rights and responsibilities. ... Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad ... Unless the rights of HCWs are recognised and their needs adequately addressed, the best laid plans of government will be at risk.

Histone demethylase JMJD1A promotes alternative splicing of AR variant 7 (AR-V7) in prostate cancer cells.

Science.gov (United States)

Fan, Lingling; Zhang, Fengbo; Xu, Songhui; Cui, Xiaolu; Hussain, Arif; Fazli, Ladan; Gleave, Martin; Dong, Xuesen; Qi, Jianfei

2018-05-15

Formation of the androgen receptor splicing variant 7 (AR-V7) is one of the major mechanisms by which resistance of prostate cancer to androgen deprivation therapy occurs. The histone demethylase JMJD1A (Jumonji domain containing 1A) functions as a key coactivator for AR by epigenetic regulation of H3K9 methylation marks. Here, we describe a role for JMJD1A in AR-V7 expression. While JMJD1A knockdown had no effect on full-length AR (AR-FL), it reduced AR-V7 levels in prostate cancer cells. Reexpression of AR-V7 in the JMJD1A-knockdown cells elevated expression of select AR targets and partially rescued prostate cancer cell growth in vitro and in vivo. The AR-V7 protein level correlated positively with JMJD1A in a subset of human prostate cancer specimens. Mechanistically, we found that JMJD1A promoted alternative splicing of AR-V7 through heterogeneous nuclear ribonucleoprotein F (HNRNPF), a splicing factor known to regulate exon inclusion. Knockdown of JMJD1A or HNRNPF inhibited splicing of AR-V7, but not AR-FL, in a minigene reporter assay. JMJD1A was found to interact with and promote the recruitment of HNRNPF to a cryptic exon 3b on AR pre-mRNA for the generation of AR-V7. Taken together, the role of JMJD1A in AR-FL coactivation and AR-V7 alternative splicing highlights JMJD1A as a potentially promising target for prostate cancer therapy.

The war in Gaza: A humanitarian crisis

Directory of Open Access Journals (Sweden)

Mahomed Sathar

2014-11-01

Full Text Available Justice, sovereignty and self-determination for all human beings are fundamental foundations for healthcare and human rights. In any civilised society, the balance between medical ethics and human rights is critical for the delivery of healthcare. War is a deeply ethical issue. Combatants, whose violations of international conventions, laws and codes of ethics during war and political conflict are detrimental to civilian non-combatants, including healthcare workers, commit crimes against humanity. The war in Gaza is a humanitarian crisis.

West Bank and Gaza : Country Procurement Issues Paper

OpenAIRE

World Bank

2008-01-01

The main aim of the CPIP is to assess the current state of pubic procurement in West Bank and Gaza in the form of a ''snap shot'' and accordingly, to provide a partial assessment, broadly along the lines of the OPCS paper that would address the following objectives. First, to assess the latest progress with regard to the procurement reform recommended by the 2004 CPAR and the commitment of...

Prediction of dissolved oxygen in the Mediterranean Sea along Gaza, Palestine - an artificial neural network approach.

Science.gov (United States)

Zaqoot, Hossam Adel; Ansari, Abdul Khalique; Unar, Mukhtiar Ali; Khan, Shaukat Hyat

2009-01-01

Artificial Neural Networks (ANNs) are flexible tools which are being used increasingly to predict and forecast water resources variables. The human activities in areas surrounding enclosed and semi-enclosed seas such as the Mediterranean Sea always produce in the long term a strong environmental impact in the form of coastal and marine degradation. The presence of dissolved oxygen is essential for the survival of most organisms in the water bodies. This paper is concerned with the use of ANNs - Multilayer Perceptron (MLP) and Radial Basis Function neural networks for predicting the next fortnight's dissolved oxygen concentrations in the Mediterranean Sea water along Gaza. MLP and Radial Basis Function (RBF) neural networks are trained and developed with reference to five important oceanographic variables including water temperature, wind velocity, turbidity, pH and conductivity. These variables are considered as inputs of the network. The data sets used in this study consist of four years and collected from nine locations along Gaza coast. The network performance has been tested with different data sets and the results show satisfactory performance. Prediction results prove that neural network approach has good adaptability and extensive applicability for modelling the dissolved oxygen in the Mediterranean Sea along Gaza. We hope that the established model will help in assisting the local authorities in developing plans and policies to reduce the pollution along Gaza coastal waters to acceptable levels.

Nuclear-specific AR-V7 Protein Localization is Necessary to Guide Treatment Selection in Metastatic Castration-resistant Prostate Cancer.

Science.gov (United States)

Scher, Howard I; Graf, Ryon P; Schreiber, Nicole A; McLaughlin, Brigit; Lu, David; Louw, Jessica; Danila, Daniel C; Dugan, Lyndsey; Johnson, Ann; Heller, Glenn; Fleisher, Martin; Dittamore, Ryan

2017-06-01

Circulating tumor cells (CTCs) expressing AR-V7 protein localized to the nucleus (nuclear-specific) identify metastatic castration-resistant prostate cancer (mCRPC) patients with improved overall survival (OS) on taxane therapy relative to the androgen receptor signaling inhibitors (ARSi) abiraterone acetate, enzalutamide, and apalutamide. To evaluate if expanding the positivity criteria to include both nuclear and cytoplasmic AR-V7 localization ("nuclear-agnostic") identifies more patients who would benefit from a taxane over an ARSi. The study used a cross-sectional cohort. Between December 2012 and March 2015, 193 pretherapy blood samples, 191 of which were evaluable, were collected and processed from 161 unique mCRPC patients before starting a new line of systemic therapy for disease progression at the Memorial Sloan Kettering Cancer Center. The association between two AR-V7 scoring criteria, post-therapy prostate-specific antigen (PSA) change (PTPC) and OS following ARSi or taxane treatment, was explored. One criterion required nuclear-specific AR-V7 localization, and the other required an AR-V7 signal but was agnostic to protein localization in CTCs. Correlation of AR-V7 status to PTPC and OS was investigated. Relationships with survival were analyzed using multivariable Cox regression and log-rank analyses. A total of 34 (18%) samples were AR-V7-positive using nuclear-specific criteria, and 56 (29%) were AR-V7-positive using nuclear-agnostic criteria. Following ARSi treatment, none of the 16 nuclear-specific AR-V7-positive samples and six of the 32 (19%) nuclear-agnostic AR-V7-positive samples had ≥50% PTPC at 12 weeks. The strongest baseline factor influencing OS was the interaction between the presence of nuclear-specific AR-V7-positive CTCs and treatment with a taxane (hazard ratio 0.24, 95% confidence interval 0.078-0.79; p=0.019). This interaction was not significant when nuclear-agnostic criteria were used. To reliably inform treatment selection

Possible health effects of liquefied petroleum gas on workers at filling and distribution stations of Gaza governorates.

Science.gov (United States)

Sirdah, M M; Al Laham, N A; El Madhoun, R A

2013-03-01

Liquefied petroleum gas (LPG) is widely used in the Gaza Strip for domestic purposes, in agriculture and industry and, illegally, in cars. This study aimed to identify possible health effects on workers exposed to LPG in Gaza governorates. Data were collected by a questionnaire interview, and haematological and biochemical analyses of venous blood samples were made from 30 workers at filling and distribution stations and 30 apparently healthy controls. Statistically significant differences were found in all self-reported health-related complaints among LPG workers versus controls. LPG workers had significantly higher values of red blood cell counts, haemoglobin, haematocrit mean corpuscular haemoglobin and platelet counts. They also had significantly higher values of kidney function tests (urea, creatinine and uric acid) and liver function enzyme activities (aspartate aminotransferase and alanine aminotransferase). LPG workers at Gaza Strip petroleum stations are at higher risk for health-related symptoms and clinical abnormalities.

Androgen receptor and its splice variant, AR-V7, differentially regulate FOXA1 sensitive genes in LNCaP prostate cancer cells.

Science.gov (United States)

Krause, William C; Shafi, Ayesha A; Nakka, Manjula; Weigel, Nancy L

2014-09-01

Prostate cancer (PCa) is an androgen-dependent disease, and tumors that are resistant to androgen ablation therapy often remain androgen receptor (AR) dependent. Among the contributors to castration-resistant PCa are AR splice variants that lack the ligand-binding domain (LBD). Instead, they have small amounts of unique sequence derived from cryptic exons or from out of frame translation. The AR-V7 (or AR3) variant is constitutively active and is expressed under conditions consistent with CRPC. AR-V7 is reported to regulate a transcriptional program that is similar but not identical to that of AR. However, it is unknown whether these differences are due to the unique sequence in AR-V7, or simply to loss of the LBD. To examine transcriptional regulation by AR-V7, we have used lentiviruses encoding AR-V7 (amino acids 1-627 of AR with the 16 amino acids unique to the variant) to prepare a derivative of the androgen-dependent LNCaP cells with inducible expression of AR-V7. An additional cell line was generated with regulated expression of AR-NTD (amino acids 1-660 of AR); this mutant lacks the LBD but does not have the AR-V7 specific sequence. We find that AR and AR-V7 have distinct activities on target genes that are co-regulated by FOXA1. Transcripts regulated by AR-V7 were similarly regulated by AR-NTD, indicating that loss of the LBD is sufficient for the observed differences. Differential regulation of target genes correlates with preferential recruitment of AR or AR-V7 to specific cis-regulatory DNA sequences providing an explanation for some of the observed differences in target gene regulation. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Impact of HIV/AIDS and ARV Treatment on Worker Absenteeism: Implications for African Firms

Science.gov (United States)

Habyarimana, James; Mbakile, Bekezela; Pop-Eleches, Cristian

2010-01-01

We characterize medium and long-run labor market impacts of HIV/AIDS and ARV treatment using unique panel data of worker absenteeism and information from an AIDS treatment program at a large mining firm in Botswana. We present robust evidence of an inverse-V shaped pattern in worker absenteeism around the time of ARV treatment inception.…

L´Ekphrasis Eikonos de Procope de Gaza en tant que reflet de la société de l´Antiquité tardive

Czech Academy of Sciences Publication Activity Database

Drbal, Vlastimil

2011-01-01

Roč. 69, č. 3 (2011), s. 106-122 ISSN 0007-7712 Grant - others:AV ČR (CZ)(CZ) M300920901 Program:M Institutional research plan: CEZ:AV0Z90920516 Keywords : ekphrasis * Late Antiquity * Gaza * Procopius of Gaza Subject RIV: AB - History

Exposure to war traumatic experiences, post-traumatic stress disorder and post-traumatic growth among nurses in Gaza.

Science.gov (United States)

Shamia, N A; Thabet, A A M; Vostanis, P

2015-12-01

What is known on the subject? This study builds on existing research on war-related factors that may affect health-care staff by particularly focusing on trauma exposure in both professional and everyday life, as well as on correlates of later positive psychological changes. What this paper adds to existing knowledge? It shows that one in five nursing staff working in Gaza experienced post-traumatic stress symptoms within the clinical range, 2 years after an incursion on Gaza and after being exposed to substantial trauma during this period. Participants appeared to develop a variety of post-traumatic growth responses following trauma exposure. Although nurses experienced traumatic events both as civilians and in their health-care capacity, personal exposure was strongly associated with PTSD symptoms. What are the implications for practice? Support to nursing and other health-care professionals in war situations should entail different levels, remain available well after an acute conflict, and take into consideration both personal and practice-related traumatic events. Mental health nursing practitioners can play a pivotal role in this. To establish the association between war traumatic experiences, post-traumatic stress disorder (PTSD) symptoms and post-traumatic growth among nurses in the Gaza Strip, 2 years after an incursion on Gaza, and during a period of ongoing trauma exposure. This study builds on existing evidence by considering exposure to personal and work-related traumatic events, and on factors associated with later positive psychological adaptation. The sample consisted of 274 randomly selected nurses in Gaza who completed the Gaza Traumatic Events Checklist, PTSD Checklist, and Posttraumatic Growth Inventory. Of the nurses, 19.7% reported full PTSD. There was a significant relationship between traumatic events and PTSD scores; as well as between community-related traumatic events and post-traumatic growth. Participants reported a range of traumatic

Dual Therapy Treatment Strategies for the Management of Patients Infected with HIV: A Systematic Review of Current Evidence in ARV-Naive or ARV-Experienced, Virologically Suppressed Patients.

Science.gov (United States)

Baril, Jean-Guy; Angel, Jonathan B; Gill, M John; Gathe, Joseph; Cahn, Pedro; van Wyk, Jean; Walmsley, Sharon

2016-01-01

We reviewed the current literature regarding antiretroviral (ARV)-sparing therapy strategies to determine whether these novel regimens can be considered appropriate alternatives to standard regimens for the initial treatment of ARV-naive patients or as switch therapy for those patients with virologically suppressed HIV infection. A search for studies related to HIV dual therapy published from January 2000 through April 2014 was performed using Biosis, Derwent Drug File, Embase, International Pharmaceutical Abstracts, Medline, Pascal, SciSearch, and TOXNET databases; seven major trial registries, and the abstracts of major conferences. Using predetermined criteria for inclusion, an expert review committee critically reviewed and qualitatively evaluated all identified trials for efficacy and safety results and potential limitations. Sixteen studies of dual therapy regimens were critiqued for the ARV-naive population. Studies of a protease inhibitor/ritonavir in combination with the integrase inhibitor raltegravir or the nucleoside reverse transcriptase inhibitor lamivudine provided the most definitive evidence supporting a role for dual therapy. In particular, lopinavir/ritonavir or darunavir/ritonavir combined with raltegravir and lopinavir/ritonavir combined with lamivudine demonstrated noninferiority to standard of care triple therapy after 48 weeks of treatment. Thirteen trials were critiqued in ARV-experienced, virologically suppressed patients. The virologic efficacy outcomes were mixed. Although overall data regarding toxicity are limited, when compared with standard triple therapy, certain dual therapy regimens may offer advantages in renal function, bone mineral density, and limb fat changes; however, some dual combinations may elevate lipid or bilirubin levels. The potential benefits of dual therapy regimens include reduced toxicity, improved tolerability and adherence, and reduced cost. Although the data reviewed here provide valuable insights into the

Application of ann for predicting water quality parameters in the mediterranean sea along gaza-palestine

International Nuclear Information System (INIS)

Zaqoot, H.A.; Unar, M.A.

2008-01-01

Seawater pollution problems are gaining interest world wide because of their health impacts and other environmental issues. Intense human activities in areas surrounding enclosed and semi-enclosed seas such as the Mediterranean Sea always produce in the long term a strong environmental impact in the form of coastal and marine degradation. This paper is concerned with the use of ANNs (Artificial Neural Networks) MLP ( Multilayer Perceptron) model for the prediction of pH and EC (Electrical Conductivity) in water quality parameters along Gaza city coast. MLP neural networks are trained and developed with reference to three major oceanographic parameters (water temperature, wind speed and turbidity) to predict the values of pH and EC; these parameters are considered as inputs of the neural network. The data collected comprised of four years and collected from nine locations along Gaza coastline. Results show that the model has high capability and accuracy in predicting both parameters. The network performance has been validated with different data sets and the results show satisfactory performance. Results of the developed model have been compared with multiple regression statistical models and found that MLP predictions are slightly better than the conventional methods. Prediction results prove that the proposed approach is suitable for modeling the water quality in the Mediterranean Sea along Gaza. (author)

In Situ Detection and Quantification of AR-V7, AR-FL, PSA, and KRAS Point Mutations in Circulating Tumor Cells.

Science.gov (United States)

El-Heliebi, Amin; Hille, Claudia; Laxman, Navya; Svedlund, Jessica; Haudum, Christoph; Ercan, Erkan; Kroneis, Thomas; Chen, Shukun; Smolle, Maria; Rossmann, Christopher; Krzywkowski, Tomasz; Ahlford, Annika; Darai, Evangelia; von Amsberg, Gunhild; Alsdorf, Winfried; König, Frank; Löhr, Matthias; de Kruijff, Inge; Riethdorf, Sabine; Gorges, Tobias M; Pantel, Klaus; Bauernhofer, Thomas; Nilsson, Mats; Sedlmayr, Peter

2018-03-01

Liquid biopsies can be used in castration-resistant prostate cancer (CRPC) to detect androgen receptor splice variant 7 (AR-V7), a splicing product of the androgen receptor. Patients with AR-V7-positive circulating tumor cells (CTCs) have greater benefit of taxane chemotherapy compared with novel hormonal therapies, indicating a treatment-selection biomarker. Likewise, in those with pancreatic cancer (PaCa), KRAS mutations act as prognostic biomarkers. Thus, there is an urgent need for technology investigating the expression and mutation status of CTCs. Here, we report an approach that adds AR-V7 or KRAS status to CTC enumeration, compatible with multiple CTC-isolation platforms. We studied 3 independent CTC-isolation devices (CellCollector, Parsortix, CellSearch) for the evaluation of AR-V7 or KRAS status of CTCs with in situ padlock probe technology. Padlock probes allow highly specific detection and visualization of transcripts on a cellular level. We applied padlock probes for detecting AR-V7, androgen receptor full length (AR-FL), and prostate-specific antigen (PSA) in CRPC and KRAS wild-type (wt) and mutant (mut) transcripts in PaCa in CTCs from 46 patients. In situ analysis showed that 71% (22 of 31) of CRPC patients had detectable AR-V7 expression ranging from low to high expression [1-76 rolling circle products (RCPs)/CTC]. In PaCa patients, 40% (6 of 15) had KRAS mut expressing CTCs with 1 to 8 RCPs/CTC. In situ padlock probe analysis revealed CTCs with no detectable cytokeratin expression but positivity for AR-V7 or KRAS mut transcripts. Padlock probe technology enables quantification of AR-V7, AR-FL, PSA, and KRAS mut/wt transcripts in CTCs. The technology is easily applicable in routine laboratories and compatible with multiple CTC-isolation devices. © 2017 American Association for Clinical Chemistry.

Detection of AR-V7 mRNA in whole blood may not predict the effectiveness of novel endocrine drugs for castration-resistant prostate cancer.

Science.gov (United States)

Takeuchi, Takumi; Okuno, Yumiko; Hattori-Kato, Mami; Zaitsu, Masayoshi; Mikami, Koji

2016-01-01

A splice variant of androgen receptor (AR), AR-V7, lacks in androgen-binding portion and leads to aggressive cancer characteristics. Reverse transcription-polymerase chain reactions (PCRs) and subsequent nested PCRs for the amplification of AR-V7 and prostate-specific antigen (PSA) transcripts were done for whole blood of patients with prostate cancer and male controls. With primary reverse transcription PCRs, AR-V7 and PSA were detected in 4.5% and 4.7% of prostate cancer, respectively. With nested PCRs, AR-V7 messenger RNA (mRNA) was positive in 43.8% of castration-sensitive prostate cancer and 48.1% of castration-resistant prostate cancer (CRPC), while PSA mRNA was positive in 6.3% of castration-sensitive prostate cancer and 18.5% of CRPC. Whole-blood samples of controls showed AR-V7 mRNA expression by nested PCR. Based on multivariate analysis, expression of AR-V7 mRNA in whole blood was not significantly correlated with clinical parameters and PSA mRNA in blood, while univariate analysis showed a correlation between AR-V7 mRNA and metastasis at initial diagnosis. Detection of AR-V7 mRNA did not predict the reduction of serum PSA in patients with CRPC following abiraterone and enzalutamide administration. In conclusion, AR-V7 mRNA expression in normal hematopoietic cells may have annihilated the manifestation of aggressiveness of prostate cancer and the prediction of the effectiveness of abiraterone and enzalutamide by the assessment of AR-V7 mRNA in blood.

Novel Junction-specific and Quantifiable In Situ Detection of AR-V7 and its Clinical Correlates in Metastatic Castration-resistant Prostate Cancer.

Science.gov (United States)

Zhu, Yezi; Sharp, Adam; Anderson, Courtney M; Silberstein, John L; Taylor, Maritza; Lu, Changxue; Zhao, Pei; De Marzo, Angelo M; Antonarakis, Emmanuel S; Wang, Mindy; Wu, Xingyong; Luo, Yuling; Su, Nan; Nava Rodrigues, Daniel; Figueiredo, Ines; Welti, Jonathan; Park, Emily; Ma, Xiao-Jun; Coleman, Ilsa; Morrissey, Colm; Plymate, Stephen R; Nelson, Peter S; de Bono, Johann S; Luo, Jun

2018-05-01

Androgen receptor splice variant 7 (AR-V7) has been implicated in resistance to abiraterone and enzalutamide treatment in men with metastatic castration-resistant prostate cancer (mCRPC). Tissue- or cell-based in situ detection of AR-V7, however, has been limited by lack of specificity. To address current limitations in precision measurement of AR-V7 by developing a novel junction-specific AR-V7 RNA in situ hybridization (RISH) assay compatible with automated quantification. We designed a RISH method to visualize single splice junctions in cells and tissue. Using the validated assay for junction-specific detection of the full-length AR (AR-FL) and AR-V7, we generated quantitative data, blinded to clinical data, for 63 prostate tumor biopsies. We evaluated clinical correlates of AR-FL/AR-V7 measurements, including association with prostate-specific antigen progression-free survival (PSA-PFS) and clinical and radiographic progression-free survival (PFS), in a subset of patients starting treatment with abiraterone or enzalutamide following biopsy. Quantitative AR-FL/AR-V7 data were generated from 56 of the 63 (88.9%) biopsy specimens examined, of which 44 were mCRPC biopsies. Positive AR-V7 signals were detected in 34.1% (15/44) mCRPC specimens, all of which also co-expressed AR-FL. The median AR-V7/AR-FL ratio was 11.9% (range 2.7-30.3%). Positive detection of AR-V7 was correlated with indicators of high disease burden at baseline. Among the 25 CRPC biopsies collected before treatment with abiraterone or enzalutamide, positive AR-V7 detection, but not higher AR-FL, was significantly associated with shorter PSA-PFS (hazard ratio 2.789, 95% confidence interval 1.12-6.95; p=0.0081). We report for the first time a RISH method for highly specific and quantifiable detection of splice junctions, allowing further characterization of AR-V7 and its clinical significance. Higher AR-V7 levels detected and quantified using a novel method were associated with poorer response to

Sand dunes of the Gaza Strip (southwestern Palestine: morphology, textural characteristics and associated environmental impacts

Directory of Open Access Journals (Sweden)

Khalid Fathi Ubeid

2014-07-01

Full Text Available Sand dunes are wide spread in the Gaza Strip and are present in its northern, central and southern regions. Thirty sand samples were collected at seven locations along the middle region of the Strip. The coordinates for each sampling site were positioned using GPS and processed with ArcGIS software. Mechanical and chemical properties were examined to determine the textural characteristics and carbonate contents of the dune sands. The mean grain size is fine to medium, and the sands range from moderate- to well-sorting. The skewness is fine to very fine, and the kurtosis ranges from mesokurtic to very leptokurtic. Additionally, the results show that the carbonate content ranges from 1.5% to 5%. The high permeability, good porosity, and low carbonate content of the sand dunes in the Gaza Strip have led to more groundwater pollution via leachates percolating from the solid waste landfills and basins from wastewater treatments constructed above the sand dunes. Sand quarries have also changed the natural landscape of the Gaza Strip. These quarries were excavated randomly, used for a short period and then disused. This random and unregulated excavation has led to the destruction of natural habitats for flora and fauna.   Resumen Las dunas de arena se extienden ampliamente en la Franja de Gaza y hacen presencia en las regiones del norte, centro y sur. Para este trabajo se recolectaron treinta muestras de arena en siete puntos a lo largo de la región media de la Franja. Las coordenadas de cada muestra se marcaron con el GPS y se procesaron con el programa ArcGIS. Se examinaron las propiedades químicas y mecánicas para determinar las características de textura y los contenidos de carbonato de las dunas de arena. El tamaño del grano está entre fino y medio y las arenas oscilan entre moderadas y bien definidas. La asimetría estadística va desde fina hasta muy fina y la variedad de la curtosis se ubica entre mesocúrtica y muy leptoc

Dual Therapy Treatment Strategies for the Management of Patients Infected with HIV: A Systematic Review of Current Evidence in ARV-Naive or ARV-Experienced, Virologically Suppressed Patients.

Directory of Open Access Journals (Sweden)

Jean-Guy Baril

Full Text Available We reviewed the current literature regarding antiretroviral (ARV-sparing therapy strategies to determine whether these novel regimens can be considered appropriate alternatives to standard regimens for the initial treatment of ARV-naive patients or as switch therapy for those patients with virologically suppressed HIV infection.A search for studies related to HIV dual therapy published from January 2000 through April 2014 was performed using Biosis, Derwent Drug File, Embase, International Pharmaceutical Abstracts, Medline, Pascal, SciSearch, and TOXNET databases; seven major trial registries, and the abstracts of major conferences. Using predetermined criteria for inclusion, an expert review committee critically reviewed and qualitatively evaluated all identified trials for efficacy and safety results and potential limitations.Sixteen studies of dual therapy regimens were critiqued for the ARV-naive population. Studies of a protease inhibitor/ritonavir in combination with the integrase inhibitor raltegravir or the nucleoside reverse transcriptase inhibitor lamivudine provided the most definitive evidence supporting a role for dual therapy. In particular, lopinavir/ritonavir or darunavir/ritonavir combined with raltegravir and lopinavir/ritonavir combined with lamivudine demonstrated noninferiority to standard of care triple therapy after 48 weeks of treatment. Thirteen trials were critiqued in ARV-experienced, virologically suppressed patients. The virologic efficacy outcomes were mixed. Although overall data regarding toxicity are limited, when compared with standard triple therapy, certain dual therapy regimens may offer advantages in renal function, bone mineral density, and limb fat changes; however, some dual combinations may elevate lipid or bilirubin levels.The potential benefits of dual therapy regimens include reduced toxicity, improved tolerability and adherence, and reduced cost. Although the data reviewed here provide valuable

Exploring water and food security: the water footprint of domestic food production in the Gaza Strip

Science.gov (United States)

Recanati, Francesca; Castelletti, Andrea; Dotelli, Giovanni; Melià, Paco

2016-04-01

Water scarcity and food security are major issues in the Gaza Strip. This area is characterized by one of the highest densities in the world and it is affected by both severe scarcity of water resources and limited trading possibilities.Given this context, the enhancement of domestic food production is considered a fundamental strategy in achieving food security in the area. For this reason, rural people play a crucial role in implementing sustainable strategies for enhancing the domestic food production while preserving water resources. In order to investigate the effectiveness of existing agricultural scenarios in achieving food security in a sustainable manner, we propose a framework to assess food production systems in terms of their contribution to the nutritional and economic conditions of rural households and their impact on water resources. In particular, the latter has been carried out through the water footprint indicator proposed by the Water Footprint Network. The case study analyzed is a sample farm located in the Gaza Strip, whose food production is based on horticulture, animal husbandry and aquaculture. The study is articulated into two main parts: first, we compare alternative scenarios of vegetal and animal food production in terms of food supply, water consumption and economic income at the household scale; then, we extend the analysis to evaluate the potential contribution of domestic food production to the food security in the whole Gaza Strip, focusing on the nutritional dimension, and providing a preliminary assessment of the environmental and economic sustainability. In particular, we evaluate water appropriation for domestic food production and compare it with the availability of water resources in the region. The outcomes highlight that the domestic food production can potentially satisfy both a basic diet and economic income for rural household, but the related appropriation of freshwater results unsustainable with respect to the fresh

Tööõnnetuste arv Ida-Virus väheneb / Erika Prave

Index Scriptorium Estoniae

Prave, Erika, 1970-

2004-01-01

Ilmunud ka: Severnoje Poberezhje, 7. dets. 2004, lk. 3. Tööinspektsiooni viimase üheksa aasta statistikast järeldub, et tööõnnetuste arv on Ida-Virumaal aastatega vähenenud peaaegu poole võrra

Microbial water quality of coastal recreational water in the Gaza Strip, Palestine

Directory of Open Access Journals (Sweden)

MAZEN T. ABUALTAYEF

2014-05-01

Full Text Available Abualtayef MT, Abd Rabou AN, Abu Foul AA, Ghabayen SM, Elsinwar HM. 2014. Microbial water quality of coastal recreational water in the Gaza Strip, Palestine. Nusantara Bioscience 6: 26-32. Wastewater disposal into the Mediterranean coast of the Gaza Strip has many negative effects, whether on the environment or on human health, thus microbiological analysis of seawater samples was carried out. The microbial analysis was confined on two types of fecal indicators (fecal coliform and fecal streptococci, in addition to a single type of bacteria (pseudomonas. This study was conducted between the beginning of July 2012 to the mid of October 2012 over an area extended from the proposed Khan Younis fishing port to Gaza fishing port, with a length of about 23 km. The study area was divided into five zones. The samples were collected in two rounds: the first round included 75 samples that collected along the study area during the summer season. The second round included 19 samples that collected in the autumn season to compare it with their counterparts that have been collected in the summer season. Laboratory analysis showed the presence of contamination in many of these samples. The results also showed that the pollution was concentrated in and surrounding the mouths of wastewater outfalls. Depending on the microbial analyses, which have been collected in the first round, the fecal coliform appeared in 61% of the samples, while fecal streptococci appeared in all samples and pseudomonas appeared in 33% of the samples. The pollutants were widespread along the study area, which are the result mainly from wastewater discharge into the sea. A risk analysis was done for season variations using the second moment method; in general, it was found that risk in both seasons was high especially in summer.

Gaza ceasefire crumbles while West embarks on a new round of hand-wringing

DEFF Research Database (Denmark)

Pace, Michelle

2014-01-01

Tragically, the 72-hour ceasefire brokered between the Israeli Defence Force and Hamas collapsed within two hours – just as shops in Gaza were opening and the fishing fleet setting out to sea for the first time in days. It’s unclear how the truce was broken, and both sides are flinging blame...

Overexpression of nuclear AR-V7 protein in primary prostate cancer is an independent negative prognostic marker in men with high-risk disease receiving adjuvant therapy.

Science.gov (United States)

Chen, Xin; Bernemann, Christof; Tolkach, Yuri; Heller, Martina; Nientiedt, Cathleen; Falkenstein, Michael; Herpel, Esther; Jenzer, Maximilian; Grüllich, Carsten; Jäger, Dirk; Sültmann, Holger; Duensing, Anette; Perner, Sven; Cronauer, Marcus V; Stephan, Carsten; Debus, Jürgen; Schrader, Andres Jan; Kristiansen, Glen; Hohenfellner, Markus; Duensing, Stefan

2018-04-01

Overexpression of the androgen receptor (AR) splice variant 7 (AR-V7) has recently been reported to be associated with resistance to antihormonal therapy. Herein, we address the question whether tumor cells with AR-V7 expression can be detected at the time of radical prostatectomy, that is, before long-term hormonal manipulation and castration resistance, and what the potential prognostic impact on the biochemical recurrence (BCR)-free survival may be. An anti-AR-V7 antibody was first validated in a training set of prostate cancer specimens by a comparison of AR-V7 protein to AR-V7 mRNA expression. We then analyzed nuclear AR-V7 protein expression in the primary tumors and lymph node metastases from 163 predominantly high-risk patients (cohort I) as well as the primary tumors from patients of a second, consecutive patient cohort (n = 238, cohort II) not selected for any clinicopathological features. Staining results were correlated to patient characteristics and BCR-free patient survival. High nuclear AR-V7 protein expression was detected in approximately 30%-40% of patients in cohort I and II at the time of radical prostatectomy. High baseline expression of nuclear AR-V7 protein was associated with an unfavorable BCR-free survival in the high-risk patient cohort I but not in the unselected consecutive cohort II. Remarkably, AR-V7 was an independent negative prognostic factor in high-risk prostate cancer patients of cohort I who were selected to receive adjuvant treatment. Prostate cancer cells with high nuclear AR-V7 protein expression can be detected in a substantial proportion of tumors at the time of radical prostatectomy. The presence of AR-V7-positive tumor cells is associated with an unfavorable prognosis for BCR-free survival in a high-risk patient cohort including a subgroup of patients selected to receive adjuvant therapy, in which AR-V7 was an independent negative prognosticator. Overexpression of nuclear AR-V7 protein hence identifies a subset of tumors

Tööpuudus hiilib kikivarvul Võrumaale / Arved Breidaks

Index Scriptorium Estoniae

Breidaks, Arved, 1975-

2008-01-01

Võrumaal on töötute arv eelmise aastaga võrreldes tõusma hakanud: mullu suvel maakonnas registreeritud 3,9%-line töötuse määr asendus tänavu juuli lõpus 5,4%-lise töötusega. Lisa: Töötus Võrumaal. Vt. samas: Kuidas iseloomustate olukorda Võrumaa tööjõuturul? Vastavad Martin Arula (AS Toftan), Kaido Mäesalu (AS Suwem), Meelis Munski (AS Semuehitus), Indrek Klampe (OÜ Selista Ehitus), Andres Visanpuu (Võru TÜ)

Melatonin Inhibits Androgen Receptor Splice Variant-7 (AR-V7)-Induced Nuclear Factor-Kappa B (NF-κB) Activation and NF-κB Activator-Induced AR-V7 Expression in Prostate Cancer Cells: Potential Implications for the Use of Melatonin in Castration-Resistant Prostate Cancer (CRPC) Therapy.

Science.gov (United States)

Liu, Vincent Wing Sun; Yau, Wing Lung; Tam, Chun Wai; Yao, Kwok-Ming; Shiu, Stephen Yuen Wing

2017-05-31

A major current challenge in the treatment of advanced prostate cancer, which can be initially controlled by medical or surgical castration, is the development of effective, safe, and affordable therapies against progression of the disease to the stage of castration resistance. Here, we showed that in LNCaP and 22Rv1 prostate cancer cells transiently overexpressing androgen receptor splice variant-7 (AR-V7), nuclear factor-kappa B (NF-κB) was activated and could result in up-regulated interleukin ( IL ) -6 gene expression, indicating a positive interaction between AR-V7 expression and activated NF-κB/IL-6 signaling in castration-resistant prostate cancer (CRPC) pathogenesis. Importantly, both AR-V7-induced NF-κB activation and IL-6 gene transcription in LNCaP and 22Rv1 cells could be inhibited by melatonin. Furthermore, stimulation of AR-V7 mRNA expression in LNCaP cells by betulinic acid, a pharmacological NF-κB activator, was reduced by melatonin treatment. Our data support the presence of bi-directional positive interactions between AR-V7 expression and NF-κB activation in CRPC pathogenesis. Of note, melatonin, by inhibiting NF-κB activation via the previously-reported MT₁ receptor-mediated antiproliferative pathway, can disrupt these bi-directional positive interactions between AR-V7 and NF-κB and thereby delay the development of castration resistance in advanced prostate cancer. Apparently, this therapeutic potential of melatonin in advanced prostate cancer/CRPC management is worth translation in the clinic via combined androgen depletion and melatonin repletion.

Melatonin Inhibits Androgen Receptor Splice Variant-7 (AR-V7-Induced Nuclear Factor-Kappa B (NF-κB Activation and NF-κB Activator-Induced AR-V7 Expression in Prostate Cancer Cells: Potential Implications for the Use of Melatonin in Castration-Resistant Prostate Cancer (CRPC Therapy

Directory of Open Access Journals (Sweden)

Vincent Wing Sun Liu

2017-05-01

Full Text Available A major current challenge in the treatment of advanced prostate cancer, which can be initially controlled by medical or surgical castration, is the development of effective, safe, and affordable therapies against progression of the disease to the stage of castration resistance. Here, we showed that in LNCaP and 22Rv1 prostate cancer cells transiently overexpressing androgen receptor splice variant-7 (AR-V7, nuclear factor-kappa B (NF-κB was activated and could result in up-regulated interleukin (IL-6 gene expression, indicating a positive interaction between AR-V7 expression and activated NF-κB/IL-6 signaling in castration-resistant prostate cancer (CRPC pathogenesis. Importantly, both AR-V7-induced NF-κB activation and IL-6 gene transcription in LNCaP and 22Rv1 cells could be inhibited by melatonin. Furthermore, stimulation of AR-V7 mRNA expression in LNCaP cells by betulinic acid, a pharmacological NF-κB activator, was reduced by melatonin treatment. Our data support the presence of bi-directional positive interactions between AR-V7 expression and NF-κB activation in CRPC pathogenesis. Of note, melatonin, by inhibiting NF-κB activation via the previously-reported MT1 receptor-mediated antiproliferative pathway, can disrupt these bi-directional positive interactions between AR-V7 and NF-κB and thereby delay the development of castration resistance in advanced prostate cancer. Apparently, this therapeutic potential of melatonin in advanced prostate cancer/CRPC management is worth translation in the clinic via combined androgen depletion and melatonin repletion.

Assessing food security in water scarce regions by Life Cycle Analysis: a case study in the Gaza strip

Science.gov (United States)

Recanati, Francesca; Castelletti, Andrea; Melià, Paco; Dotelli, Giovanni

2013-04-01

Food security is a major issue in Palestine for both political and physical reasons, with direct effects on the local population living conditions: the nutritional level of people in Gaza is classified by FAO as "insecure". As most of the protein supply comes from irrigated agricultural production and aquaculture, freshwater availability is a limiting factor to food security, and the primary reason for frequent conflicts among food production processes (e.g. aquaculture, land livestock or different types of crops). In this study we use Life Cycle Analysis to assess the environmental impacts associated to all the stages of water-based protein production (from agriculture and aquaculture) in the Gaza strip under different agricultural scenarios and hydroclimatic variability. As reported in several recent studies, LCA seems to be an appropriate methodology to analyze agricultural systems and assess associated food security in different socio-economic contexts. However, we argue that the inherently linear and static nature of LCA might prove inadequate to tackle with the complex interaction between water cycle variability and the food production system in water-scarce regions of underdeveloped countries. Lack of sufficient and reliable data to characterize the water cycle is a further source of uncertainty affecting the robustness of the analysis. We investigate pros and cons of LCA and LCA-based option planning in an average size farm in Gaza strip, where farming and aquaculture are family-based and integrated by reuse of fish breeding water for irrigation. Different technological solutions (drip irrigation system, greenhouses etc.) are evaluated to improve protein supply and reduce the pressure on freshwater, particularly during droughts. But this use of technology represent also a contribution in increasing sustainability in agricultural processes, and therefore in economy, of Gaza Strip (reduction in chemical fertilizers and pesticides etc.).

Preliminary survey of natural background radiation in the Gaza Strip in Palestine

International Nuclear Information System (INIS)

Yassin, S.S.; Steck, D.J.

2002-01-01

A preliminary survey of indoor radon, outdoor radon and surface alpha activity on glass in northern Gaza found that the average value indoors was 34 Bq m -3 , 18 Bq m -3 outdoors, and 13 Bq m -2 on glass. Good correlation was found between the retrospectively reconstructed radon exposure from implanted activity and the estimate based on contemporary radon gas concentration and age. (orig.)

Püsiühenduste arv kasvas aastaga poole võrra / Tõnu Vare

Index Scriptorium Estoniae

Vare, Tõnu, 1947-

2005-01-01

Uuringufirma Point Topic andmetel oli 30. septembri 2004. a. seisuga Interneti püsiühenduste arv maailmas 136,4 miljonit. Diagrammid: Püsiühendustega leibkondade osakaal (%) Euroopas; 512 Kb/s allalaadimiskiirusega püsiühenduse kuutasu (eurodes)

A novel rudivirus, ARV1, of the hyperthermophilic archaeal genus Acidianus

DEFF Research Database (Denmark)

Vestergaard, Gisle Alberg; Häring, Monika; Peng, Xu

2005-01-01

Virus ARV1, the first member of the family Rudiviridae infecting hyperthermophilic archaea of the genus Acidianus, was isolated from a hot spring in Pozzuoli, Italy. The rod-shaped virions, 610 +/- 50 nm long and 22 +/- 3 nm wide, are non-enveloped and carry a helical nucleoprotein core, with thr...

Assessment by Employers of Newly Graduated Civil Engineers from the Islamic University of Gaza

Science.gov (United States)

Enshassi, Adnan; Hassouna, Ahmed

2005-01-01

The evaluation process is very important to identify and recognize the strengths and the weaknesses of graduated students. The purpose of this paper is to evaluate the performance of the newly graduated civil engineers from the Islamic University of Gaza in Palestine. The methodology was based on questionnaires and informal interview. The…

AR-V7 in Peripheral Whole Blood of Patients with Castration-resistant Prostate Cancer: Association with Treatment-specific Outcome Under Abiraterone and Enzalutamide.

Science.gov (United States)

Seitz, Anna Katharina; Thoene, Silvia; Bietenbeck, Andreas; Nawroth, Roman; Tauber, Robert; Thalgott, Mark; Schmid, Sebastian; Secci, Ramona; Retz, Margitta; Gschwend, Jürgen E; Ruland, Jürgen; Winter, Christof; Heck, Matthias M

2017-11-01

It has been demonstrated that androgen receptor splice variant 7 (AR-V7) expression in circulating tumor cells (CTCs) predicts poor treatment response in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone or enzalutamide. To develop a practical and robust liquid profiling approach for direct quantification of AR-V7 in peripheral whole blood without the need for CTC capture and to determine its potential for predicting treatment response in mCRPC patients. Whole blood samples from a prospective biorepository of 85 mCRPC patients before treatment initiation with abiraterone (n=56) or enzalutamide (n=29) were analyzed via droplet digital polymerase chain reaction. The association of AR-V7 status with prostate-specific antigen (PSA) response defined by PSA decline ≥50% and with PSA-progression-free survival (PSA-PFS), clinical PFS, and overall survival (OS) was assessed. High AR-V7 expression levels in whole blood were detectable in 18% (15/85) of patients. No patient with high AR-V7 expression achieved a PSA response, and AR-V7 status was an independent predictor of PSA response in multivariable logistic regression analysis (p=0.03). High AR-V7 expression was associated with shorter PSA-PFS (median 2.4 vs 3.7 mo; pAR-V7 expression remained an independent predictor of shorter PSA-PFS (hazard ratio [HR] 7.0, 95% confidence interval [CI] 2.3-20.7; pAR-V7 mRNA levels in whole blood is a simple and promising approach to predict poor treatment outcome in mCRPC patients receiving abiraterone or enzalutamide. We established a method for determining AR-V7 status in whole blood. This test predicted treatment resistance in patients with metastatic castration-resistant prostate cancer undergoing treatment with abiraterone or enzalutamide. Prospective validation is needed before application to clinical practice. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Perception of Contracting parties on Construction Safety in the Gaza Strip, Palestine

International Nuclear Information System (INIS)

Enhassi, Adnan Ali; Hassouna, Ahmed Mohamed; Mayer, P.E.; Choudhary, R.M.

2007-01-01

The construction industry is one of the most hazardous industries in developing countries. Understanding the safety climate or culture of a workplace, the perceptions and attitudes of workforce are important factors in assessing safety needs. The construction industry in Palestine, by its inherent nature, is susceptible to potentially dangerous conditions that affect the safety of all personnel working in construction projects. This paper reports, based on a questionnaire survey, the perception of owners, consultants and contractors towards safety in the Gaza Strip. The results showed that, most of the participants in the survey had accidents in their construction projects. The findings indicated that, main causes of fatalities and injuries are falling from heights, dropped objects and materials and being caught under excavations. Carelessness of workers, lack of safety knowledge and lack of safety training are the main three reasons that contributed to the increase rate of accidents among construction workers in the Gaza Strip. Therefore, contactors should prepare safety training programs which help personnel to carry out various accidents preventive activities effectively. Training material should discuss the cost of accidents, the influence of good safety performance and should stress the safety objectives of the company, the relevant laws and legislation and contractual relationships with clients regarding safety matters. (author)

Iron deficiency anemia among kindergarten children living in the marginalized areas of Gaza Strip, Palestine

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Mahmoud Mohammed Sirdah

2014-04-01

Full Text Available Background: iron deficiency anemia is the most common type of nutritional anemia; it has been recognized as an important health problem in Palestine. This study was conducted to estimate the prevalence and to identify possible risk factors of iron deficiency anemia among kindergarten children living in the marginalized areas of the Gaza Strip and to evaluate the effectiveness of supplementing oral iron formula in the anemic children. Methods: the study included 735 (384 male and 351 female kindergarten children. Data was collected by questionnaire interviews, anthropometric measurements, and complete blood count analysis. All iron deficient anemic children were treated using an oral iron formula (50 mg ferrous carbonate + 100 mg vitamin C /5 mL and the complete blood count was reassessed after three months. A univariate analysis and a multiple logistic regression model were constructed; crude and adjusted odds ratios (OR, and 95% confidence intervals (95% CI were calculated. Results: the overall prevalence of iron deficiency anemia was 33.5% with no significant differences between boys and girls. Significantly different prevalences of iron deficiency anemia were reported between different governorates of the Gaza Strip. Governorate, low education level of the parents and smoking are significant risk factors for children developing anemia. Significantly lower complete blood count parameters, except for WBC, were reported in anemic children. The oral iron treatment significantly improved hemoglobin concentrations, and normalized the iron deficiency marker. Conclusions: iron deficiency anemia is a serious health problem among children living in the marginalized areas of the Gaza Strip, which justifies the necessity for national intervention programs to improve the health status for the less fortunate development areas.

Sources of Human Insecurity in Post-War Situations: The Case of Gaza

OpenAIRE

Ziadni, Maisa; Hammoudeh, Weeam; Rmeileh, Niveen M.E. Abu; Hogan, Dennis; Shannon, Harry; Giacaman, Rita

2011-01-01

This paper explores classical and war-related factors associated with human insecurity reports in the Gaza Strip following the winter 2008–09 Israeli attack. A cross-sectional survey was conducted six months after the Israeli attack with adults from 3017 households. Results demonstrate that persons with greater human capital and socioeconomic resources were somewhat protected from human insecurity associated with the attack and siege. Results also underscore the significance of including both...

Effect of Antiretroviral Drug (arved) on the Kidney in Albino Rat ...

African Journals Online (AJOL)

African studies on effect of antiretroviral drugs on the kidney are limited resulting to scanty information on the safety of these drugs. This study was therefore designed to evaluate the effects of antiretroviral drugs arved®, on creatinine, urea, potassium and sodium ions as well as histological effect on the kidney. A total of fifty ...

Factores que influyen en la decisión de licitar o no licitar en la Franja de Gaza - perspectivas de los contratistas Factors affecting bid/no bid decision in the Gaza Strip -contractors' perspectives

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Adnan Enshassi

2011-01-01

Full Text Available La decisión de licitar o no licitar un determinado proyecto es crucial para la sobrevivencia de los contratistas. El objetivo de este artículo es identificar y clasificar los factores que determinan la decisión de licitar o no licitar, de acuerdo a su importancia relativa desde la perspectiva de contratistas locales que operan en la Franja de Gaza, Palestina. Se identificaron un total de setenta y ocho factores, por medio de una revisión exhaustiva de la literatura, para evaluar los factores más importantes que afectan las decisiones de los contratistas por licitar no licitar en la Franja de Gaza. Se desarrolló una medición dentro de una muestra compuesta por setenta y tres contratistas clasificados bajo la categoría construcción, y sesenta y cinco de ellos respondieron a una razón de 89%. Los resultados ilustran que la reputación de los clientes, la capacidad financiera de éstos, el potencial financiero del proyecto y la disponibilidad constructiva de materias primas en los mercados locales, así como la estabilidad de la industria de la construcción, fueron los principales factores críticos que influyen en las decisiones de licitar o no licitar. Este estudio sugiere que los contratistas y clientes debieran mejorar sus sistemas financieros y aptitudes para poder mantenerse dentro del negocio.To bid or not to bid for a certain project is considered to be a crucial decision for contractors' survival. The objective of this paper is to identify and rank the factors that affect the bid/no bid decision according to their relative importance from the perspective of the local contractors operating in the Gaza Strip, Palestine. A total of seventy-eight factors were identified through a comprehensive literature review to evaluate the most important factors that affect the contractors' decisions to bid or not in the Gaza strip. A survey was conducted on a sample of seventy three contractors classified under the building category, and sixty

Representations of victimization and responsibility during the Second Intifada and the Gaza War in German quality newspapers

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Felix Gaisbauer

2012-10-01

Full Text Available The German press has often been accused of fanning, through one-sided reportage (bias on the Israeli-Palestinian conflict, not only anti-Israeli, but also anti-Semitic attitudes in their readers. A content analytic study by Maurer and Kempf (2011 of a representative sample of the reportage on the second Intifada and the Gaza war does not support these claims. The study concentrated above all on escalation vs. de-escalation-oriented representations of the conflict parties. Using the same text material (N = 396 newspaper articles, the present study has the aim of determining the representation (framing of Israeli and Palestinian victims, as well as the representation of responsibility for this victimization in German quality newspapers. By means of Latent Class Analysis, consistent patterns of style characteristics are identified that emphasize or suppress the aspects of victimization and responsibility. These media frames are then studied in regard to their partisanship (bias and tendency over time (second Intifada vs. Gaza war. It was found that from the second Intifada to the Gaza war the media frames increasingly show a pro-Palestinian bias, while the pro-Israeli bias in the reportage becomes weaker. In part, this is counterbalanced in that frames that try for balance with a pro-Israeli tendency emphasize Israeli civilian victims. Thereby all the newspapers studied display the here identified forms of bias to the same degree, so that it is not the press „in itself“ that can be judged to be biased, but rather the individual articles in all the newspapers take clear positions.

Iisrael lubab nädalaid kestvat sõda, et pühkida Hamas Gazas võimult / Kaivo Kopli

Index Scriptorium Estoniae

Kopli, Kaivo

2008-01-01

Iisrael vastas Hamasi rünnakutele väidetavalt tugevaima pommitamisega Gaza sektoris 1967. a. sõjast saadik, selle üheks põhjuseks peavad vaatlejad Iisraeli sisepoliitilist olukorda. Vt. samas: Hamas ei taha siiani leppida Iisraeli riigi olemasoluga

Adherence to ARV medication in Romanian young adults: self-reported behaviour and psychological barriers

NARCIS (Netherlands)

Dima, A.L.; Schweitzer, A.M.; Diaconiţă, R.; Remor, E.; Wanless, R.S.

2013-01-01

Adherence to antiretroviral (ARV) treatment during adolescence and young adulthood is a significant clinical issue for the current management of the HIV/AIDS epidemic in Romania. Understanding patients' own perceptions of their adherence behaviours and related psychological barriers is instrumental

CX4945 suppresses the growth of castration-resistant prostate cancer cells by reducing AR-V7 expression.

Science.gov (United States)

Deng, Chuangzhong; Chen, Jieping; Guo, Shengjie; Wang, Yanjun; Zhou, Qianghua; Li, Zaishang; Yang, Xingping; Yu, Xingsu; Zhang, Zhenfeng; Zhou, Fangjian; Han, Hui; Yao, Kai

2017-08-01

The aberrant expression of casein kinase 2 (CK2) has been reported to be involved in the tumorigenesis and progression of prostate cancer. The inhibition of CK2 activity represses androgen-dependent prostate cancer cells by attenuating the androgen receptor (AR) signaling pathway. In this study, we examined the effect of CK2 inhibition in castration-resistant prostate cancer (CRPC) cells, in which AR variants (ARVs) play a predominant role. A newly synthetic CK2 selective inhibitor CX4945 was utilized to study the effect of CK2 inhibition in CRPC cells by CCK8 assay and colony formation assay. Protein and mRNA levels of full-length AR (AR-FL) and AR-V7 were determined by qPCR and western blot, respectively. The nuclear translocation of p50 and p65 was assessed to reflect the activity of the NF-κB pathway. CX4945 reduced the proliferation of CRPC cells in a dose-dependent and time-dependent manner. AR-V7 rather than AR-FL was downregulated by CX4945 in both the mRNA and protein level. Furthermore, CX4945 could restore the sensitivity of CRPC cells to bicalutamide. The analysis of possible mechanisms demonstrated that the inhibition of CK2 diminished the phosphorylation of p65 at ser529 and thus attenuated the activity of the NF-κB pathway. The inhibition of CK2 by CX4945 can repress the viability of CRPC cells and restore their sensitivity to anti-androgen therapy by suppressing AR-V7. This finding presents a potential option for the treatment of prostate cancer, especially CRPC.

The detection of phosphorus in the tissue of bomb victims in Gaza.

Science.gov (United States)

Thomsen, Jørgen L; Worm-Leonhard, Martin

2010-01-01

One of the authors went on a fact finding mission to Gaza immediately after the termination of the Israeli invasion. One of the allegations towards the invading Israeli army was the use of phosphorus bombs. The author was able to take samples of tissue from burn victims. Attempts were made to demonstrate the presence of phosphorus in the burn wounds. Using histology and Raman spectroscopy it was found with a high degree of probability that phosphorus was present, although it was not proven with absolute certainty.

Sociodemographic correlates of food habits among school adolescents (12–15 year in north Gaza Strip

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Shi Zumin

2009-06-01

Full Text Available Abstract Background There is little information about meal patterns and food consumption of adolescents in Palestine. The objective of this study was to describe the association between sociodemographic factors and food intake, and meal patterns among Palestinian school adolescents (12–15 year in North Gaza Strip. Methods A cross-sectional study was conducted in 2002 comprising 944 subjects in 10 schools in Gaza city, Jabalia village and Jabalia refugee camp. Self-administered questionnaires were filled in by students and parents to obtain data on frequency of meals, food intake and sociodemographic characteristics. Results High household socioeconomic status (SES was associated with the increased number of meals and the increased intakes of many nutritious foods such as; animal food items, fruits and vegetables and dairy foods. The percentage of adolescents having breakfast daily of high and low SES was 74.5% vs 55% in boys and 65.6% vs 45% in girls. The percentage of girls with refugee status who had lunch was higher (90.2% compared to the local citizen girls (83.9%, (p = 0.03. Girls were less likely to skip daily lunch (OR = 0.55, 95% CI = 0.36–0.87, p = 0.01 compared to boys. Risk of skipping lunch was three times higher among adolescents living in the village compared to Gaza well-off area (OR = 3.3, 95% CI = 1.72–6.31, p Conclusion Meal skipping is common, particularly among those of low SES and the intakes of many nutritious foods such as animal food items, fruits and vegetables and dairy foods seem to be low among adolescents of low SES. The results of this study could be used as an important base-line for future monitoring of the nutritional situation of adolescents.

Prevalence and predictors of traditional medicine utilization among persons living with AIDS (PLWA) on antiretroviral (ARV) and prophylaxis treatment in both rural and urban areas in South Africa.

Science.gov (United States)

Hughes, G D; Puoane, T R; Clark, B L; Wondwossen, T L; Johnson, Q; Folk, W

2012-01-01

Previous studies have reported that majority of antiretroviral (ARV) treatment-naïve patients use traditional medicine (TM). Given that TM use is ubiquitous in South Africa especially for chronic conditions, there is a potential for ARV non-adherence and serious drug interactions among patients with HIV/AIDs who use TM. The motivating factors for TM use in HIV/AIDS patients on ARV and prophylaxis treatment have not been well defined in South Africa. This study aimed to investigate the prevalence, facilitators, predictors, and types of TM used among persons living with HIV/AIDS on antiretroviral treatment. The study was a cross-sectional survey which involved 100 participants enrolled at ARV clinics in two South African provinces. Univariate and bivariate analyses were performed to assess the relationships between variables and potential predictors of TM. Sixteen percent of participants on ARV reported TM use. Seventy-nine percent used TM prior to a diagnosis of HIV. Participants were more likely to use TM if they were from a rural province, female, older, unmarried, employed, had limited education, or were HIV-positive for less than five years. TM users reported utilizing herbal or medicinal mixtures that were claimed to heal all conditions. This study provides insights into the treatment modalities selected by patients with HIV/AIDS in South Africa who are receiving ARV. This study revealed that less than 20% of participants co-used TM and ARV. However, close to 80% of participants utilize TM before contracting HIV, which is in keeping with approximate estimates by the WHO.

Increasing Neonatal Mortality among Palestine Refugees in the Gaza Strip

Science.gov (United States)

van den Berg, Maartje M.; Madi, Haifa H.; Khader, Ali; Hababeh, Majed; Zeidan, Wafa’a; Wesley, Hannah; Abd El-Kader, Mariam; Maqadma, Mohamed; Seita, Akihiro

2015-01-01

Background The United Nations Relief and Works Agency for Palestine refugees in the Near East (UNRWA) has periodically estimated infant mortality rates among Palestine refugees in Gaza. These surveys have recorded a decline from 127 per 1000 live births in 1960 to 20.2 in 2008. Methods We used the same preceding-birth technique as in previous surveys. All multiparous mothers who came to the 22 UNRWA health centres to register their last-born child for immunization were asked if their preceding child was alive or dead. We based our target sample size on the infant mortality rate in 2008 and included 3128 mothers from August until October 2013. We used multiple logistic regression analyses to identify predictors of infant mortality. Findings Infant mortality in 2013 was 22.4 per 1000 live births compared with 20.2 in 2008 (p = 0.61), and this change reflected a statistically significant increase in neonatal mortality (from 12.0 to 20.3 per 1000 live births, p = 0.01). The main causes of the 65 infant deaths were preterm birth (n = 25, 39%), congenital anomalies (n = 19, 29%), and infections (n = 12, 19%). Risk factors for infant death were preterm birth (OR 9.88, 3.98–24.85), consanguinity (2.41, 1.35–4.30) and high-risk pregnancies (3.09, 1.46–6.53). Conclusion For the first time in five decades, mortality rates have increased among Palestine refugee newborns in Gaza. The possible causes of this trend may include inadequate neonatal care. We will estimate infant and neonatal mortality rates again in 2015 to see if this trend continues and, if so, to assess how it can be reversed. PMID:26241479

"It's important to take your medication everyday okay?" An evaluation of counselling by lay counsellors for ARV adherence support in the Western Cape, South Africa.

Science.gov (United States)

Dewing, S; Mathews, C; Schaay, N; Cloete, A; Louw, J; Simbayi, L

2013-01-01

There is growing interest in standard care programmes for antiretroviral (ARV) adherence support. In South Africa, individual counselling following ARV initiation is a main strategy for supporting adherence in the public sector. Egan's client-centred "Skilled Helper" counselling model is the predominant model used in HIV counselling in this context. This study evaluated counselling delivered by lay ARV adherence counsellors in Cape Town in terms of adherence to Egan's model. Thirty-eight transcripts of counselling sessions with non-adherent patients were analysed based on the methods of content analysis. These sessions were conducted by 30 counsellors. Generally counsellors' practice adhered neither to Egan's model nor a client-centred approach. Inconsistent with evidence-based approaches to counselling for ARV adherence support, counsellors mainly used information-giving and advice as strategies for addressing clients' non-adherence. Recommendations for improving practice are made. The question as to how appropriate strategies from developed countries are for this setting is also raised.

The effects of the Israeli siege on health provision in the Gaza Strip: a qualitative and theoretical analysis.

Science.gov (United States)

Smith, Ron J

2018-02-21

Siege, a process of political domination aimed at isolating an entire population, is a unique threat to health-care provision. The aim of this study was to qualitatively examine the effects of the Israeli siege on the practices and systems that underlie health in the Gaza Strip. Data were from participant observation between 2009 and 2017, including 20 interviews with doctors and health administrators in non-governmental organisations (NGO), government, and UN sectors. All participants were provided with a description of the study and provided written consent to participate. The study was approved through the Human Subjects Review process at Bucknell University and the University of Washington. The data were analysed using a critical political economic framework, based on the concepts of primitive accumulation, accumulation by dispossession, surplus populations, and de-development. These analytical frames are further developed to interpret neoliberal trends in health-care systems organising and financing as they apply in the distorted social and economic context of siege. The elimination of political sovereignty through the twin processes of occupation and siege are the primary impediments to the successful promotion of public health in the Gaza Strip. Findings indicate that siege impinges on effective health-care provision by withholding materials and resources and undermining the health care at a systems level. These strains pose considerable threats to health care, within the ministry of health and among other entities in the Gaza Strip that deliver care. Gazan society is divested of the underpinnings necessary for a well functioning sovereign health-care infrastructure. Instead of a self-governing, independent system, this analysis reveals a system that is comprised of captive clients who are entirely dependent on Israel, international bodies, and the aid industry for goods and services, with no means of independent development. The siege represents a

A survey on the knowledge and attitudes among the students of Al-Azhar University to HIV/AIDS, the Gaza Strip-Palestine

Directory of Open Access Journals (Sweden)

Basil Jabber Kanoa

2015-12-01

Full Text Available Objective: The study assessed the knowledge and attitudes of students’ at a university in Gaza regarding HIV/AIDS and identified differences in knowledge about HIV, and attitudes by gender, locality, and social and economic status. Methods: This descriptive study targeted 492 students of Al-Azhar University-Gaza. The participants completed self-administered questionnaires that included the following dimensions: socio-demographic, measurements of student's knowledge level and measurement of student's attitudes towards HIV/AIDS. Results: Findings showed moderate level of knowledge regarding HIV/AIDS although there was a very low of perception regarding the acceptance and sharing of HIV/AIDS persons. It means that only one third of the study respondents are willingness to be in close touch with people living with HIV or even communication with them, and less than fifty percent thought that it is their right to be engaged in a public or governmental job, stigma and discriminatory attitudes toward HIV/AIDS persons is high only 48% of the students thought it right to employ people living with HIV (PLHIV and 35.5% refused to work in the same place with PLHIV. Conclusion: This study indicates the need for improving the level of knowledge as well as promoting the students' towards positive attitude.Key words: AIDS, Knowledge, attitude, students, HIV, Gaza

In depth analysis of risk factors for coeliac disease amongst children under 18 years Old in the Gaza strip. A cross sectional study

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Al-Raee Mohammad B

2012-11-01

Full Text Available Abstract Coeliac disease is an important clinical disorder affecting the human gastrointestinal tract leading to multiple signs and symptoms in different body organs. This disease was the subject of a cross sectional descriptive-analytic study conducted in the Gaza Strip during 2010. Objectives were oriented to identify and verify several variables and attributes affecting the prognosis of coeliac disease in the patients. Ninety five children out of 113 patients were arranged into two groups according to age from 2 to 11 years and from 12 to 18 years old. Results showed the poor interest of health professionals regarding coeliac disease in the Gaza Strip. The mean age of study population was 5.47 years for males and 8.93 years for females. The lifestyle of coeliac patients was directly proportional with better nutritional indictors. Poor recognition of the emblem illustrating gluten in foods implicates effective health awareness or promotion. The more knowledgeable patients or mothers (P = 0.036 were the more compliant. The compliance to giving gluten free foods outside home was statistically significant (P = 0.037. Similarly, cautious approach when buying foods or detergents (P = 0.011. According to BMI 74.4%, 23.4% and 3.2% of all patients were normal, underweight and overweight respectively. Albumin blood level was normal in 32.6% and low in 67.4%. Meanwhile, blood calcium level was normal in 76.8%, low in 21.1% and high in 2.1% of all patients. Conclusion: The study showed that recreation and social activities for coeliac patients are substantially missing in the Gaza Strip. Moreover, the study proved that AEI is a reliable centre for care of coeliac disease patients and conducting relevant studies. Recommendation: There is a need for thorough and continuous community and institutional mobilization regarding coeliac disease in the Gaza Strip and in Palestine.

ONC201 Targets AR and AR-V7 Signaling, Reduces PSA, and Synergizes with Everolimus in Prostate Cancer.

Science.gov (United States)

Lev, Avital; Lulla, Amriti R; Ross, Brian C; Ralff, Marie D; Makhov, Petr B; Dicker, David T; El-Deiry, Wafik S

2018-05-01

Androgen receptor (AR) signaling plays a key role in prostate cancer progression, and androgen deprivation therapy (ADT) is a mainstay clinical treatment regimen for patients with advanced disease. Unfortunately, most prostate cancers eventually become androgen-independent and resistant to ADT with patients progressing to metastatic castration-resistant prostate cancer (mCRPC). Constitutively activated AR variants (AR-V) have emerged as mediators of resistance to AR-targeted therapy and the progression of mCRPC, and they represent an important therapeutic target. Out of at least 15 AR-Vs described thus far, AR-V7 is the most abundant, and its expression correlates with ADT resistance. ONC201/TIC10 is the founding member of the imipridone class of small molecules and has shown anticancer activity in a broad range of tumor types. ONC201 is currently being tested in phase I/II clinical trials for advanced solid tumors, including mCRPC, and hematologic malignancies. There has been promising activity observed in patients in early clinical testing. This study demonstrates preclinical single-agent efficacy of ONC201 using in vitro and in vivo models of prostate cancer. ONC201 has potent antiproliferative and proapoptotic effects in both castration-resistant and -sensitive prostate cancer cells. Furthermore, the data demonstrate that ONC201 downregulates the expression of key drivers of prostate cancer such as AR-V7 and downstream target genes including the clinically used biomarker PSA (KLK3). Finally, the data also provide a preclinical rationale for combination of ONC201 with approved therapeutics for prostate cancer such as enzalutamide, everolimus (mTOR inhibitor), or docetaxel. Implications: The preclinical efficacy of ONC201 as a single agent or in combination, in hormone-sensitive or castration-resistant prostate cancer, suggests the potential for immediate clinical translation. Mol Cancer Res; 16(5); 754-66. ©2018 AACR . ©2018 American Association for Cancer

Managing water and salinity with desalination, conveyance, conservation, waste-water treatment and reuse to counteract climate variability in Gaza

Science.gov (United States)

Rosenberg, D. E.; Aljuaidi, A. E.; Kaluarachchi, J. J.

2009-12-01

We include demands for water of different salinity concentrations as input parameters and decision variables in a regional hydro-economic optimization model. This specification includes separate demand functions for saline water. We then use stochastic non-linear programming to jointly identify the benefit maximizing set of infrastructure expansions, operational allocations, and use of different water quality types under climate variability. We present a detailed application for the Gaza Strip. The application considers building desalination and waste-water treatment plants and conveyance pipelines, initiating water conservation and leak reduction programs, plus allocating and transferring water of different qualities among agricultural, industrial, and urban sectors and among districts. Results show how to integrate a mix of supply enhancement, conservation, water quality improvement, and water quality management actions into a portfolio that can economically and efficiently respond to changes and uncertainties in surface and groundwater availability due to climate variability. We also show how to put drawn-down and saline Gaza aquifer water to more sustainable and economical use.

Prevalence and Associated Factors for Dual Form of Malnutrition in Mother-Child Pairs at the Same Household in the Gaza Strip-Palestine.

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Rima Rafiq El Kishawi

Full Text Available In many developing countries nutritional, and epidemiological transitions are emerging into continuing undernutrition and escalating overnutrition, giving rise to the double burden of the malnutrition phenomenon.This study aims to determine the prevalence of the dual form of malnutrition (overweight mother/underweight child in the same household and its associated factors in the Gaza Strip.A total of 357 mother-child pairs from the same households were surveyed from three different geographical locations in the Gaza Strip, namely, El Remal urban area, Jabalia refugee camp, and Al Qarara rural area. The height and weight of mothers aged 18-50 years were measured, and their body mass index (BMI was computed. The mothers were categorized according to the criterion of the World Health Organization (WHO for BMI as overweight if they have a BMI ≥ 25 kg/m2. Anthropometric indices were measured for children aged two to five years to classify the underweight children Z-score <-1.The results showed the prevalence of the dual form of malnutrition in the Gaza Strip was 15.7%, and its associated factors were child's birth order (ORadj, 1.50, 95% CL, 1.22, 1.82; p = <0.001, father's educational (low or medium levels (ORadj, 3.19, 95% CL, 1.07, 9.5; p = 0. 036, or (ORadj, 3.4, 95% CL, 1.12, 10.37; p = 0. 031, high scores of mothers' nutrition knowledge (ORadj, 1.23, 95% CL, 1.01, 1.52; p = 0. 048, and low monthly income (ORadj, 0.28, 95% CL, 0.09, 0.88; p = 0. 030.The results from this study showed the dual form of malnutrition in the same household was prevalent in the Gaza Strip. This is a public health issue that must be understood and addressed and policy makers must implement an appropriate nutrition action plan to control dual form of malnutrition based on the underlying specific risk factors in the study population. In addition, interventions are needed to help individuals to translate their nutrition knowledge into healthy dietary behaviors.

Supply chain solutions to improve the distribution of antiretroviral drugs (ARVs to clinics in rural areas: A case study of the QwaQwa district

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Mamolise Mokheseng

2017-10-01

Full Text Available This article serves as a case study based on research that was performed in the QwaQwa district in the Free State Province where the distribution of ARVs to the regional Manapo hospital, as well as between the hospital and its peripheral clinics, was interrupted and inconsistent due to problems in the supply chain. An unreliable and interrupted ARV supply chain creates the risk of virus reactivation and eventual patient mortality. The objectives of the study were to explore the problems experienced with the ARV distribution practices at the Manapo hospital, and to recommend ways in which the distribution of ARVs can be improved so that patients can receive an uninterrupted supply. The nature of the topic researched dictated the use of mainly the quantitative research method. The main problems identified include: Wrong and no uniform practice of ordering stock by the hospital and the clinics; lack of reliable, structured transportation from the depot to the hospital; as well as poor inventory management and poor overall communication. Recommendations to address the problems include: Implementing a supply chain planning and design process; improving inventory management and warehousing practices; implementing more effective and reliable distribution and transportation processes; as well as improving supply chain coordination and overall communication.

Profil Lipodistrofi dan Dislipidemia pada Pasien Prepubertas dengan HIV yang Mendapat Terapi ARV di Rumah Sakit Cipto Mangunkusumo

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Yessi Yuniarti

2016-11-01

Kesimpulan. Prevalensi lipodistrofi dan dislipidemia cukup tinggi pada pasien prepubertas dengan HIV yang mendapatkan terapi ARV. Mayoritas subyek yang mengalami lipodistrofi memiliki massa lemak tubuh, TLK triceps dan subscapular yang normal.

A functional, genome-wide evaluation of liposensitive yeast identifies the "ARE2 required for viability" (ARV1) gene product as a major component of eukaryotic fatty acid resistance.

Science.gov (United States)

Ruggles, Kelly V; Garbarino, Jeanne; Liu, Ying; Moon, James; Schneider, Kerry; Henneberry, Annette; Billheimer, Jeff; Millar, John S; Marchadier, Dawn; Valasek, Mark A; Joblin-Mills, Aidan; Gulati, Sonia; Munkacsi, Andrew B; Repa, Joyce J; Rader, Dan; Sturley, Stephen L

2014-02-14

The toxic subcellular accumulation of lipids predisposes several human metabolic syndromes, including obesity, type 2 diabetes, and some forms of neurodegeneration. To identify pathways that prevent lipid-induced cell death, we performed a genome-wide fatty acid sensitivity screen in Saccharomyces cerevisiae. We identified 167 yeast mutants as sensitive to 0.5 mm palmitoleate, 45% of which define pathways that were conserved in humans. 63 lesions also impacted the status of the lipid droplet; however, this was not correlated to the degree of fatty acid sensitivity. The most liposensitive yeast strain arose due to deletion of the "ARE2 required for viability" (ARV1) gene, encoding an evolutionarily conserved, potential lipid transporter that localizes to the endoplasmic reticulum membrane. Down-regulation of mammalian ARV1 in MIN6 pancreatic β-cells or HEK293 cells resulted in decreased neutral lipid synthesis, increased fatty acid sensitivity, and lipoapoptosis. Conversely, elevated expression of human ARV1 in HEK293 cells or mouse liver significantly increased triglyceride mass and lipid droplet number. The ARV1-induced hepatic triglyceride accumulation was accompanied by up-regulation of DGAT1, a triglyceride synthesis gene, and the fatty acid transporter, CD36. Furthermore, ARV1 was identified as a transcriptional of the protein peroxisome proliferator-activated receptor α (PPARα), a key regulator of lipid homeostasis whose transcriptional targets include DGAT1 and CD36. These results implicate ARV1 as a protective factor in lipotoxic diseases due to modulation of fatty acid metabolism. In conclusion, a lipotoxicity-based genetic screen in a model microorganism has identified 75 human genes that may play key roles in neutral lipid metabolism and disease.

Socioeconomic status and chronic disease in Palestinians living in and outside refugee camps in the West Bank and the Gaza Strip

DEFF Research Database (Denmark)

Jonassen, Marie; Shaheen, Amira; Duraidi, Mohammed

2018-01-01

differed between Palestinians living in and outside refugee camps. Methods: The study was based on representative samples of Palestinians living in the occupied Palestinian territory (West Bank and Gaza Strip), aged 25 years and older, collected by the Palestinian Central Bureau of Statistics in 2006...

AR-V7 in circulating tumor cells cluster as a predictive biomarker of abiraterone acetate and enzalutamide treatment in castration-resistant prostate cancer patients.

Science.gov (United States)

Okegawa, Takatsugu; Ninomiya, Naoki; Masuda, Kazuki; Nakamura, Yu; Tambo, Mitsuhiro; Nutahara, Kikuo

2018-06-01

We examined whether androgen receptor splice variant 7 (AR-V7) in circulating tumor cell(CTC)clusters can be used to predict survival in patients with bone metastatic castration resistant-prostate cancer (mCRPC) treated with abiraterone or enzalutamide. We retrospectively enrolled 98 patients with CRPC on abiraterone or enzalutamide, and investigated the prognostic value of CTC cluster detection (+ v -) and AR-V7 detection (+ v -) using a CTC cluster detection - based AR-V7 mRNA assay. We examined ≤50% prostate-specific antigen (PSA) responses, PSA progression-free survival (PSA-PFS), clinical and radiological progression-free survival (radiologic PSF), and overall survival (OS). We then assessed whether AR-V7 expression in CTC clusters identified after On-chip multi-imaging flow cytometry was related to disease progression and survival after first-line systemic therapy. All abiraterone-treated or enzalutamide-treated patients received prior docetaxel. The median follow-up was 20.7 (range: 3.0-37.0) months in the abiraterone and enzalutamide cohorts, respectively. Forty-nine of the 98 men (50.0%) were CTC cluster (-), 23 of the 98 men (23.5%) were CTC cluster(+)/AR-V7(-), and 26 of the 98 men (26.5%) were CTC cluster(+)/AR-V7(+). CTC cluster(+)/AR-V7(+) patients were more likely to have EOD ≥3 at diagnosis (P = 0.003), pain (P = 0.023), higher alkaline phosphatase levels (P cluster(+), CTC cluster(+)/AR-V7(-), and ALP >UNL were independently associated with a poor PSA-PFS, radiographic PFS, and OS in abiraterone-treated patients and enzalutamide-treated patients. The CTC clusters and AR-V7-positive CTC clusters detected were important for assessing the response to abiraterone or enzalutamide therapy and for predicting disease outcome. © 2018 Wiley Periodicals, Inc.

A Functional, Genome-wide Evaluation of Liposensitive Yeast Identifies the “ARE2 Required for Viability” (ARV1) Gene Product as a Major Component of Eukaryotic Fatty Acid Resistance*

Science.gov (United States)

Ruggles, Kelly V.; Garbarino, Jeanne; Liu, Ying; Moon, James; Schneider, Kerry; Henneberry, Annette; Billheimer, Jeff; Millar, John S.; Marchadier, Dawn; Valasek, Mark A.; Joblin-Mills, Aidan; Gulati, Sonia; Munkacsi, Andrew B.; Repa, Joyce J.; Rader, Dan; Sturley, Stephen L.

2014-01-01

The toxic subcellular accumulation of lipids predisposes several human metabolic syndromes, including obesity, type 2 diabetes, and some forms of neurodegeneration. To identify pathways that prevent lipid-induced cell death, we performed a genome-wide fatty acid sensitivity screen in Saccharomyces cerevisiae. We identified 167 yeast mutants as sensitive to 0.5 mm palmitoleate, 45% of which define pathways that were conserved in humans. 63 lesions also impacted the status of the lipid droplet; however, this was not correlated to the degree of fatty acid sensitivity. The most liposensitive yeast strain arose due to deletion of the “ARE2 required for viability” (ARV1) gene, encoding an evolutionarily conserved, potential lipid transporter that localizes to the endoplasmic reticulum membrane. Down-regulation of mammalian ARV1 in MIN6 pancreatic β-cells or HEK293 cells resulted in decreased neutral lipid synthesis, increased fatty acid sensitivity, and lipoapoptosis. Conversely, elevated expression of human ARV1 in HEK293 cells or mouse liver significantly increased triglyceride mass and lipid droplet number. The ARV1-induced hepatic triglyceride accumulation was accompanied by up-regulation of DGAT1, a triglyceride synthesis gene, and the fatty acid transporter, CD36. Furthermore, ARV1 was identified as a transcriptional of the protein peroxisome proliferator-activated receptor α (PPARα), a key regulator of lipid homeostasis whose transcriptional targets include DGAT1 and CD36. These results implicate ARV1 as a protective factor in lipotoxic diseases due to modulation of fatty acid metabolism. In conclusion, a lipotoxicity-based genetic screen in a model microorganism has identified 75 human genes that may play key roles in neutral lipid metabolism and disease. PMID:24273168

Planning in the Face of Power : Experiencing Power Dimensions in a Visioning Process in the West Bank and the Gaza Strip

NARCIS (Netherlands)

Gugerell, Katharina; Netsch, Stefan

2017-01-01

This article reflects on dimensions of power that occurred in visioning workshops with different stakeholder in the West Bank and in the Gaza Strip. The overall argument developed in the article is that the visioning process—especially signs of spatial and institutional dimensions of power—occurred

Supply chain solutions to improve the distribution of antiretroviral drugs (ARVs) to clinics in rural areas: A case study of the QwaQwa district

OpenAIRE

Mokheseng, Mamolise; Horn, Gideon S.; Klopper, Aileen G.

2017-01-01

This article serves as a case study based on research that was performed in the QwaQwa district in the Free State Province where the distribution of ARVs to the regional Manapo hospital, as well as between the hospital and its peripheral clinics, was interrupted and inconsistent due to problems in the supply chain. An unreliable and interrupted ARV supply chain creates the risk of virus reactivation and eventual patient mortality. The objectives of the study were to explore the problems e...

Biomarkers and biometric measures of adherence to use of ARV-based vaginal rings.

Science.gov (United States)

Stalter, Randy M; Moench, Thomas R; MacQueen, Kathleen M; Tolley, Elizabeth E; Owen, Derek H

2016-01-01

Poor adherence to product use has been observed in recent trials of antiretroviral (ARV)-based oral and vaginal gel HIV prevention products, resulting in an inability to determine product efficacy. The delivery of microbicides through vaginal rings is widely perceived as a way to achieve better adherence but vaginal rings do not eliminate the adherence challenges exhibited in clinical trials. Improved objective measures of adherence are needed as new ARV-based vaginal ring products enter the clinical trial stage. To identify technologies that have potential future application for vaginal ring adherence measurement, a comprehensive literature search was conducted that covered a number of biomedical and public health databases, including PubMed, Embase, POPLINE and the Web of Science. Published patents and patent applications were also searched. Technical experts were also consulted to gather more information and help evaluate identified technologies. Approaches were evaluated as to feasibility of development and clinical trial implementation, cost and technical strength. Numerous approaches were identified through our landscape analysis and classified as either point measures or cumulative measures of vaginal ring adherence. Point measurements are those that give a measure of adherence at a particular point in time. Cumulative measures attempt to measure ring adherence over a period of time. Approaches that require modifications to an existing ring product are at a significant disadvantage, as this will likely introduce additional regulatory barriers to the development process and increase manufacturing costs. From the point of view of clinical trial implementation, desirable attributes would be high acceptance by trial participants, and little or no additional time or training requirements on the part of participants or clinic staff. We have identified four promising approaches as being high priority for further development based on the following measurements

Quality of life, primary traumatisation, and positive and negative affects in primary school students in the Gaza Strip.

Science.gov (United States)

Veronese, Guido; Pepe, Alessandro; Almurnak, Feda; Jaradah, Alaa; Hamdouna, Husam

2018-02-21

Many researchers have reported that exposure to war and ongoing political violence increases mental health problems in children. Results of studies have also shown a high prevalence (58-80%) of post-traumatic stress disorder in war-affected children living in the occupied Palestinian territory. The aim of this study was to estimate the direct and indirect effects of perceived life satisfaction on the consequences of children's exposure to trauma and the balance of positive and negative affect. Palestinian children were recruited from primary schools in four refugee camps in the Gaza Strip (Bureij, Gaza Beach Camp, Jabalia, Rafah). All children had been involved in or witnessed one or more episodes of violence involving other people in the 2 months prior to the study (the 2012 Gaza War). We used the Multidimensional Students Life Satisfaction Scale (peers, self, living environment, school, family), the Positive and Negative Affect Scale for Children, and the revised Children Impact of Events scale (intrusion and avoidance symptoms) to test (through structural equation modelling) the moderation effect of life satisfaction on war trauma via positive emotions. 1276 Palestinian children were enrolled in this study. The model tested with structural equation modelling was robust. Children's life satisfaction influenced both the intrusion (β=-0·48; p=0.003) and avoidance (β=-11; p=0·021) effects of primary traumatisation. The consequences of primary traumatisation by intrusion (β=0·34; p=0·008) and avoidance (β=0·27; p=0.011) contributed to increasing negative affect. Finally, perceived life satisfaction had direct effects on affective experience, specifically increasing positive affect and diminishing negative affect. Perceived quality of life in children has a role in controlling war-related traumas. Life satisfaction contributes both directly and indirectly to change affectivity. When children perceive themselves to be highly satisfied with their home and

ARV Re-Entry Module Aerodynmics And Aerothermodynamics

Science.gov (United States)

Scheer, Heloise; Tran, Philippe; Berthe, Philippe

2011-05-01

Astrium-ST is the prime contractor of ARV phase A and is especially in charge of designing the Reentry Module (RM). The RM aeroshape has been defined following a trade-off. High level system requirements were derived with particular attention paid on minimum lift-over-drag ratio, trim incidence, centre-of-gravity lateral off-set and box size, volumetric efficiency, attitude at parachute deployment, flight heritage and aeroheating. Since moderate cross-range and thus L/D ratio were required, the aeroshape trade-off has been performed among blunt capsule candidates. Two front- shield families were considered: spherical (Apollo/ARD/Soyuz type) and sphero-conical (CTV type) segment front-shield. The rear-cone angle was set to 20° for internal pressurized volume and accommodation purposes. Figures of merit were assessed and a spherical front- shield of ARD type with a 20° rear-cone section was selected and proposed for further investigations. Maximum benefits will be taken from ARD flight heritage. CFD and WTT campaigns plans will be presented including preliminary results.

ICC jurisdiction over acts committed in the Gaza Strip : Article 12(3) of the ICC Statute and non-state entities / Yaël Ronen

Index Scriptorium Estoniae

Ronen, Yaël

2010-01-01

Rahvusvahelise Kriminaalkohtu jurisdiktsioonist, mis on riigikeskne. Palestiina poolt vastu võetud ja kohtule esitatud deklaratsioonist, mille järgi peaks kohus võtma arvesse ka Gazas toime pandud õigurikkumisi sõltumata sellest, et Palestiinat pole riigina tunnustatud

Price Reversal Pattern of ARV Drugs: A Transaction-Cost Approach Digression

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Frank LORNE

2015-05-01

Full Text Available A price reversal pattern of ARV drugs was noted across lower and middle income countries in that the lower-income countries have higher prices relative to higher-income countries based on a 2008-2009 Summary Report by World Health Organization. The transaction costs affecting AVR drug pricing can be broadly classified into two kinds: One between the final users and the opinion/knowledge experts, and the other between the opinion/knowledge experts and the manufacturers. Economist’s version of price discrimination needs to be modified by including transaction costs. Transaction costs also point to institution creditability factors that will affect NGO procurement.

Kirik keset küla : Viimsi Püha Jaakobi kirik = Community and Congregation : St. Jacob's Church in Viimsi / Triin Ojari

Index Scriptorium Estoniae

Ojari, Triin, 1974-

2008-01-01

Luterlik pühakoda on ühtlasi kõigi merel hukkunute mälestuskirik ja pääsenute tänukirik. Maja ette on paigutatud graniitplaat parvlaeval Estonia hukkunute nimedega. Saal toimib ka galeriipinnana. Autor Martin Aunin, kaasautor Erkki Ristoja. Konstruktor Kristjan Kaares. Interjööri valgustid: Tarmo Luisk. Projekt: 1998, valmis: 2007. Asendi- ja I korruse plaan, 3 värv. välis- ja 2 sisevaadet

Analysis of Multi Temporal Satellite Imagery for Total Suspended Sediments in a Wave-Active Coastal Area-Gaza Strip Coastal Water, Palestine

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Midyan D.I. Aldabash

2016-03-01

Full Text Available Sediment load materials is one of the key factors that determine the surface water quality, both of oceanic and river water, and it specifies water optical properties. Thus it provides a background for a plenty of applications and projects in the water and oceanography community. Landsat detects and classifies reflected solar energy from bodies on the earth's surface. Suspended sediments existing in water column have an optical influences. So that, Landsat images could detect suspended sediments concentration in such a water surface. In this study we have three main objectives to be achieved as; TSS Concentration maps generation in the Gaza Strip coastal zone, achieving analysis processes on TSS trend itself and TSS related coastal phenomenon, and investigation of the ability of Landsat images to detect TSS comprehensively in a wavy coastal zone. For this purpose two landsat TM5 images acquired in 1999 and 2010, one Landsat TM7 images acquired in 2003, and 2 Landsat Oli 8 images acquired in 2014 and 2015 were used for TSS mapping. In addition, 64 TSS in-situ tested samples were also to calculate a correlation equation between Digital Numbers - DN in each image pixels and TSS values in the ground data. All image analysis and remote sensing steps have been done in this study using Integrated Land and Water Information System - ILWIS software version ILWIS academic 3.3. Green and Red bands in all used Landsat images contained the highest linear correlation factors -R- for the images acquired in 1999, 2003, 2010, 2014, and 2015. Resulted correlation factors were higher by reducing time difference between acquisition time and sampling time. Generated maps showed that circulation in Gaza coastal area are counterclockwise, and it brings the sediments from Nile River Delta toward Gaza Strip.

Análisis de Minimización de Costo e Impacto Presupuestario del Tratamiento ARV con Abacavir/Lamivudina para el VIH/SIDA en México.

Science.gov (United States)

Rely, Kely; Martínez Valverde, Silvia; Salinas Escudero, Guillermo

2013-12-01

In Mexico, health authorities have raised reach the total of people living with HIV/ AIDS who need treatment have access to it, with the proper use of the best ARV therapies. Evaluate health spending would mean the management of patients with HIV/AIDS with the first-line therapy of abacavir/lamivudine with respect to tenofovir/emtricitabine and lamivudine-zidovudine. A literature review was conducted to seek evidence from clinical studies that demonstrated similar efficacy of ARV treatment between abacavir-lamivudine medications compared with other options. To calculate the incremental cost between these treatments, there was a Budget Impact Analysis and a pharmacoeconomic model was constructed to estimate the economic benefits by increasing its market share. Increased market penetration of abacavir/lamivudine represent a save of $ 44.8 million for the National Health System in Mexico during the years 2012-2017, without compromising the quality and effectiveness of treatment. Furthermore, this increase in market share with abacavir-lamivudine, the National Health System could get an additional benefit to deal on average 5.197 with HIV patients by 5 years with ARV therapies in Mexico. The use of abacavir/lamivudine in ARV treatment of patients with HIV/AIDS is a cost saving for the Mexican health System, which leads to a potential reduction in resources of US$44.8 million in treatment costs in the five projected years. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Resilience and distress: Israelis respond to the disengagement from Gaza and the second Lebanese war.

Science.gov (United States)

Ben-Zur, Hasida; Gilbar, Ora

2011-10-01

Resilience and distress in Israeli society were assessed at three points in time: before and after the Israeli disengagement from Gaza, and after the second Lebanese war. A random sample of 366 Israelis was assessed for nation-related anxiety and hostility, personal resources and post-traumatic symptoms. The lowest levels of anxiety were observed at the second time point, after the disengagement. Respondents with high-resilience profiles showed lower levels of post-traumatic symptoms and higher levels of personal resources. The findings underscore Israelis' resilience and the importance of personal resources in ongoing nationally stressful situations.

The city as a battlespace: from Gaza to Rio de Janeiro

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Márcio José Mendonça

2018-03-01

Full Text Available This study sees the city not only as the primary venue of the capitalism, but as a stage of future wars, as it is observed that the city has been taken and thought as a battlespace in contemporary wars. We are considering that the city has been used by insurgent groups such as terrorists, insurgents and drug traffickers, who hide and use the physical infrastructure of the city in fighting regular armies as a way to reduce military power disparities. Because of this, his life in the city has been affected by conflicts in urban terrain, that aim to not only destroy the enemy, but to destroy its survival space, denying the city. This destruction of the urban space as part of a war strategy, is first analyzed in Gaza, and then to question the extent to which this occurs in the city of Rio de Janeiro.

Health journalism in the service of power: 'moral complacency' and the Hebrew media in the Gaza-Israel conflict.

Science.gov (United States)

Birenbaum-Carmeli, Daphna

2014-05-01

The power of health news as a vehicle in the production of meaning in the service of power is the core of this article. Tracking the media coverage of a medical service, it shows how a routine practice can be invoked at a time of armed conflict so as to enhance a benevolent state image. The case at hand is the medical treatment of Gaza children in Israeli hospitals. A series of Internet searches revealed a group of publications on the subject in the Hebrew media, during and shortly after Israel's assault on Gaza in the winter of 2008-2009. In the press articles the treatments were invariably constituted as the epitome of Israel's compassion towards the enemy's children. This image relied, however, on a simultaneous silencing of other aspects of these treatments, which would have challenged this image. The monolithic depictions give rise to the notion of reversed moral panic or 'moral complacency', wherein the media amplifies a little-known social phenomenon into an epitome of societal values and charges it with significance on a national scale. The article ends with considering some features that possibly render health news an especially convenient domain for state-supportive media presentations. © 2014 The Author. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Obstacles of Search Engines Used by Graduate Students at The Faculty of Education, The Islamic University in Gaza

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Fayez Kamal Shaladan

2018-03-01

Full Text Available This study aimed to identify obstacles of search engines used by graduate students at the Faculty of Education, the Islamic University in Gaza, and to overcome them. The researchers utilized the analytical descriptive approach to achieve the goal of the study. They used the interview tool and designed a questionnaire to collect data for the study. The sample of the study was (164 male and female postgraduate students enrolled in the College of Education. The study results were as follows: The degree of obstacles to the use of search engines among postgraduate students at the Faculty of Education at the Islamic University in Gaza was high with a percentage of (%71.05.There were no statistically significant differences between the averages of the study sample for the obstacles of the use of the search engines among the postgraduate students in the Faculty of Education, the Islamic University due to the gender and academic variables, the cumulative average. An exception to this was the third theme which was personal constraints which had differences in favor of students whose cumulative rates were less than (%85. The study concluded with these recommendations: The university should subscribe to various search engines revise admission terms and conditions for postgraduate studies whereby English and computer courses can be included. Keywords: Search engines, Students, Postgraduate studies, Islamic University.

Investigating the Relationship Between Drone Warfare and Civilian Casualties in Gaza

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Dr. Ann Rogers

2014-12-01

Full Text Available Unmanned aerial vehicles (UAVs, better known as drones, are increasingly touted as ‘humanitarian’ weapons that contribute positively to fighting just wars and saving innocent lives. At the same time, civilian casualties have become the most visible and criticized aspect of drone warfare. It is argued here that drones contribute to civilian casualties not in spite of, but because of, their unique attributes. They greatly extend war across time and space, pulling more potential threats and targets into play over long periods, and because they are low-risk and highly accurate, they are more likely to be used. The assumption that drones save lives obscures a new turn in strategic thinking that sees states such as Israel and the US rely on large numbers of small, highly discriminating attacks applied over time to achieve their objectives. This examination of Israel’s 2014 war in Gaza argues that civilian casualties are not an unexpected or unintended consequence of drone warfare, but an entirely predictable outcome.

The Impact of the Dimensions of the Administrative Decision Support Systems on the Re-engineering of the Systems of the Palestinian universities in Gaza Strip from the Employees’ Perspective

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Mazen Jehad I. Al Shobaki

2017-08-01

Full Text Available This study aimed to identify the impact of the dimensions of the administrative decision support systems on the re-engineering of the systems of the Palestinian universities in Gaza Strip from the standpoint of employees. A descriptive approach was used through which a questionnaire was developed and distributed to a stratified random sample. (500 questionnaires were distributed and (449 were returned, with (89.8% response rate. The study revealed these results: There was an effect for the potentials (physical, human, technical, and organizational design available for the decision support systems and re-engineering of the systems in the Palestinian higher education institutions in Gaza Strip.There were significant differences between the assessment means of the study sample about the impact of decision support systems to re-engineer the systems in the Palestinian higher education institutions in Gaza Strip due to the gender variable in favor of males. There also differences due to the name of the university variable in favor of the Islamic University, Al Azhar University, Al Aqsa University, respectively. It was recommended that Palestinian higher education institutions which intend to start re-engineering the systems should be encouraged immediately start the process. These institutions should also develop the infrastructure of the decisions support systems when re-engineering their operations. Keywords: Decision support systems, Re-engineering, Palestinian higher education institutions.

The association between ARV and TB drug resistance on TB treatment outcome among Kazakh TB/HIV patients.

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Mishkin, Kathryn; Alaei, Kamiar; Alikeyeva, Elmira; Paynter, Christopher; Aringazina, Altyn; Alaei, Arash

2018-02-26

TB drug resistance poses a serious threat to the public health of Kazakhstan. This paper presents findings related to TB treatment outcome and drug resistant status among people coinfected with HIV and TB in Kazakhstan. Cohort study using data were provided by the Kazakhstan Ministry of Health's National Tuberculosis Program for 2014 and 2015. Chi-square and logistical regression were performed to understand factors associated with drug resistant TB status and TB treatment outcome. In bivariate analysis, drug resistant status was significantly associated with year of TB diagnosis (p=0.001) viral load (p=0.03). TB treatment outcome was significantly associated with age at diagnosis (p=01), ARV treatment (p <0.0001), and TB drug resistant status (p=0.02). In adjusted analysis, drug resistance was associated with increased odds of successful completion of treatment with successful result compared to treatment failure (OR 6.94, 95% CI: 1.39-34.44) CONCLUSIONS: Our results suggest that being drug resistant is associated with higher odds of completing treatment with successful outcome, even when controlling for receipt of ARV therapy. Copyright © 2018. Published by Elsevier Ltd.

Microbial contamination of the drinking water distribution system and its impact on human health in Khan Yunis Governorate, Gaza Strip: seven years of monitoring (2000-2006).

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Abu Amr, S S; Yassin, M M

2008-11-01

To assess total and faecal coliform contamination in water wells and distribution networks over the past 7 years, and their association with human health in Khan Yunis Governorate, Gaza Strip. Historical data and interview questionnaire. Data were obtained from the Palestinian Ministry of Health on total and faecal coliform contamination in water wells and distribution networks, and on the incidence of water-related diseases in Khan Yunis Governorate. An interview questionnaire was conducted with 210 residents of Khan Yunis Governorate. Total and faecal coliform contamination exceeded the World Health Organization's limit for water wells and networks. However, the contamination percentages were higher in networks than in wells. Diarrhoeal diseases were strongly correlated with faecal coliform contamination in water networks (r=0.98). This is consistent with the finding that diarrhoeal diseases were the most common self-reported diseases among the interviewees. Such diseases were more prevalent among subjects who drank municipal water than subjects who drank desalinated or home-filtered water (odds ratio=2.03). Intermittent water supply, insufficient chlorination and sewage flooding seem to be associated with self-reported diseases. Residents in the Gaza Strip have a good level of knowledge about drinking water contamination, and this is reflected in good practice. Water quality has deteriorated in the Gaza Strip, and this may contribute to the prevalence of water-related diseases. Self-reported diseases among interviewees in Khan Yunis Governorate were associated with source of drinking water, intermittent water supply, insufficient chlorination, sewage flooding and age of water networks.

Demonstration of the Effectiveness of Augmented Reality Telesurgery in Complex Hand Reconstruction in Gaza

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Luck, Joshua; Billingsley, Michael L.; Heyes, Richard; Smith, Oliver J.; Mosahebi, Afshin; Khoussa, Abu; Abu-Sittah, Ghassan; Hachach-Haram, Nadine

2018-01-01

Summary: Augmented reality (AR) is defined as “a technology that superimposes a computer-generated image on a user’s view of the real world, thus providing a composite view.”1 This case report describes how emerging AR telesurgery technologies may be used to facilitate international surgeon–surgeon collaboration and training. Here, we illustrate how a remote surgeon in Beirut, Lebanon, was able to offer assistance to a surgeon in Gaza, Palestine, during a complex hand reconstruction case following a bomb-blast injury in an 18-year-old male. We discuss the implications of AR technology on the future of global surgery and how it may be used to reduce structural inequities in access to safe surgical care. PMID:29707463

Demonstration of the Effectiveness of Augmented Reality Telesurgery in Complex Hand Reconstruction in Gaza

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Max J. Greenfield, BSc

2018-03-01

Full Text Available Summary:. Augmented reality (AR is defined as “a technology that superimposes a computer-generated image on a user’s view of the real world, thus providing a composite view.”1 This case report describes how emerging AR telesurgery technologies may be used to facilitate international surgeon–surgeon collaboration and training. Here, we illustrate how a remote surgeon in Beirut, Lebanon, was able to offer assistance to a surgeon in Gaza, Palestine, during a complex hand reconstruction case following a bomb-blast injury in an 18-year-old male. We discuss the implications of AR technology on the future of global surgery and how it may be used to reduce structural inequities in access to safe surgical care.

Health-related quality of life of Palestinian preschoolers in the Gaza Strip: a cross-sectional study

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Smith Maureen

2011-04-01

Full Text Available Abstract Background Research on children's responses to wartime trauma has mostly addressed Post-Traumatic Stress Disorder (PTSD. However, PTSD is only one aspect of a complex set of responses. This study proposes to expand knowledge of well-being in children exposed to political violence through widening the conceptualization of well-being beyond PTSD, morbidity, and mortality by measuring health-related quality of life (HRQOL and its facets, physical health, and psychosocial health. Methods In 2007, we used a cross-sectional random sample of kindergartens to examine factors associated with HRQOL, as measured by the PedsQL 4.0, in 350 preschoolers in the Gaza Strip, Palestine, where political violence and deprivation are widespread. Results About 65% of the mothers reported severely impaired psychosocial and emotional functioning in their children. Preschoolers had lower HRQOL than the US reference sample and samples of children in other low income countries with large effect size. HRQOL was comparable to those of US children with several chronic diseases. Factors associated with lower HRQOL were older child age, male gender, and more exposures to traumatic events. Factors associated with HRQOL subscales were for lower psychosocial health: older child age, history of food, water, and electricity deprivation during incursion, and witnessing assassination of people by rockets. For lower physical health: older child age, history of food, water, and electricity deprivation during incursion, and having heard of a killing of a friend by soldiers. Conclusions HRQOL, including psychosocial health and emotional functioning is often severely impaired among preschoolers in the Gaza Strip. Exposure to both violent and non-violent negative events was associated with HRQOL in preschoolers.

Assessment of health-care waste management in a humanitarian crisis: A case study of the Gaza Strip.

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Caniato, Marco; Tudor, Terry Louis; Vaccari, Mentore

2016-12-01

Health-care waste management requires technical, financial and human resources, and it is a challenge for low- and middle income countries, while it is often neglected in protracted crisis or emergency situations. Indeed, when health, safety, security or wellbeing of a community is threatened, solid waste management usually receives limited attention. Using the Gaza Strip as the case study region, this manuscript reports on health-care waste management within the context of a humanitarian crisis. The study employed a range of methods including content analyses of policies and legislation, audits of waste arisings, field visits, stakeholder interviews and evaluation of treatment systems. The study estimated a production from clinics and hospitals of 683kg/day of hazardous waste in the Gaza Strip, while the total health-care waste production was 3357 kg/day. A number of challenges was identified including lack of clear definitions and regulations, limited accurate data on which to base decisions and strategies and poor coordination amongst key stakeholders. Hazardous and non-hazardous waste was partially segregated and treatment facilities hardly used, and 75% of the hazardous waste was left untreated. Recommendations for mitigating these challenges posed to patients, staff and the community in general are suggested. The outputs are particularly useful to support decision makers, and re-organize the system according to reliable data and sound assumptions. The methodology can be replicated in other humanitarian settings, also to other waste flows, and other sectors of environmental sanitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Multimodal actions of the phytochemical sulforaphane suppress both AR and AR-V7 in 22Rv1 cells: Advocating a potent pharmaceutical combination against castration-resistant prostate cancer.

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Khurana, Namrata; Kim, Hogyoung; Chandra, Partha K; Talwar, Sudha; Sharma, Pankaj; Abdel-Mageed, Asim B; Sikka, Suresh C; Mondal, Debasis

2017-11-01

Prostate cancer (PCa) cells expressing full-length androgen receptor (AR-FL) are susceptible to androgen deprivation therapy (ADT). However, outgrowth of castration-resistant prostate cancer (CRPC) can occur due to the expression of constitutively active (ligand-independent) AR splice variants, particularly AR-V7. We previously demonstrated that sulforaphane (SFN), an isothiocyanate phytochemical, can decrease AR-FL levels in the PCa cell lines, LNCaP and C4-2B. Here, we examined the efficacy of SFN in targeting both AR-FL and AR-V7 in the CRPC cell line, CWR22Rv1 (22Rv1). MTT cell viability, wound-heal assay, and colony forming unit (CFU) measurements revealed that 22Rv1 cells are resistant to the anti-androgen, enzalutamide (ENZ). However, co-exposure to SFN sensitized these cells to the potent anticancer effects of ENZ (PAR-FL and AR-V7 levels, and immunofluorescence microscopy (IFM) depicted decreased AR in both cytoplasm and nucleus with SFN treatment. SFN increased both ubiquitination and proteasomal activity in 22Rv1 cells. Studies using a protein synthesis inhibitor (cycloheximide) or a proteasomal inhibitor (MG132) indicated that SFN increases both ubiquitin-mediated aggregation and subsequent proteasomal-degradation of AR proteins. Previous studies reported that SFN inhibits the chaperone activity of heat-shock protein 90 (Hsp90) and induces the nuclear factor erythroid-2-like 2 (Nrf2) transcription factor. Therefore, we investigated whether the Hsp90 inhibitor, ganetespib (G) or the Nrf2 activator, bardoxolone methyl (BM) can similarly suppress AR levels in 22Rv1 cells. Low doses of G and BM, alone or in combination, decreased both AR-FL and AR-V7 levels, and combined exposure to G+BM sensitized 22Rv1 cells to ENZ. Therefore, adjunct treatment with the phytochemical SFN or a safe pharmaceutical combination of G+BM may be effective against CRPC cells, especially those expressing AR-V7.

Prevalence and Associated Factors for Dual Form of Malnutrition in Mother-Child Pairs at the Same Household in the Gaza Strip-Palestine.

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El Kishawi, Rima Rafiq; Soo, Kah Leng; Abed, Yehia Awad; Wan Muda, Wan Abdul Manan

2016-01-01

In many developing countries nutritional, and epidemiological transitions are emerging into continuing undernutrition and escalating overnutrition, giving rise to the double burden of the malnutrition phenomenon. This study aims to determine the prevalence of the dual form of malnutrition (overweight mother/underweight child) in the same household and its associated factors in the Gaza Strip. A total of 357 mother-child pairs from the same households were surveyed from three different geographical locations in the Gaza Strip, namely, El Remal urban area, Jabalia refugee camp, and Al Qarara rural area. The height and weight of mothers aged 18-50 years were measured, and their body mass index (BMI) was computed. The mothers were categorized according to the criterion of the World Health Organization (WHO) for BMI as overweight if they have a BMI ≥ 25 kg/m2. Anthropometric indices were measured for children aged two to five years to classify the underweight children Z-score child's birth order (ORadj, 1.50, 95% CL, 1.22, 1.82; p = <0.001), father's educational (low or medium) levels (ORadj, 3.19, 95% CL, 1.07, 9.5; p = 0. 036), or (ORadj, 3.4, 95% CL, 1.12, 10.37; p = 0. 031), high scores of mothers' nutrition knowledge (ORadj, 1.23, 95% CL, 1.01, 1.52; p = 0. 048), and low monthly income (ORadj, 0.28, 95% CL, 0.09, 0.88; p = 0. 030). The results from this study showed the dual form of malnutrition in the same household was prevalent in the Gaza Strip. This is a public health issue that must be understood and addressed and policy makers must implement an appropriate nutrition action plan to control dual form of malnutrition based on the underlying specific risk factors in the study population. In addition, interventions are needed to help individuals to translate their nutrition knowledge into healthy dietary behaviors.

Profiles of refugee and non-refugee Palestinians from the West Bank and Gaza.

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Al-qudsi, S S

2000-01-01

Relying on demographic and labor surveys which the Palestinian Central Bureau of Statistics collected in 1995, this article investigates the profile of West Bank and Gaza refugees. Refugees are better educated and have higher fertility than non-refugee Palestinians, but the difference is small. However, they have a significantly lower participation rate, a higher unemployment rate and a higher incidence of arrests and work stoppage than the corresponding rates among non-refugee Palestinians. A smaller proportion of Palestinians commute to work into the Israeli labor market and refugees earn lower wages than nonrefugees. Returns to investment in education are small for both groups. High fertility among refugees imposes a future challenge for policy makers in terms of resources required for the provision of appropriate education and health facilities. Employing future labor market entrants is another serious policy challenge.

Hybrid Underwater Vehicle: ARV Design and Development

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Zhigang DENG

2014-02-01

Full Text Available The development of SMU-I, a new autonomous & remotely-operated vehicle (ARV is described. Since it has both the characteristics of autonomous underwater vehicle (AUV and remote operated underwater vehicle (ROV, it is able to achieve precision fix station operation and manual timely intervention. In the paper the initial design of basic components, such as vehicle, propulsion, batteries etc. and the control design of motion are introduced and analyzed. ROV’s conventional cable is replaced by a fiber optic cable, which makes it available for high-bandwidth real-time video, data telemetry and high-quality teleoperation. Furthermore, with the aid of the manual real-time remote operation and ranging sonar, it also resolves the AUV’s conflicting issue, which can absolutely adapt the actual complex sea environment and satisfy the unknown mission need. The whole battery system is designed as two-battery banks, whose voltages and temperatures are monitored through CAN (controller area network bus to avoid battery fire and explosion. A fuzzy-PID controller is designed for its motion control, including depth control and direction control. The controller synthesizes the advantage of fuzzy control and PID control, utilizes the fuzzy rules to on-line tune the parameters of PID controller, and achieves a better control effect. Experiment results demonstrate to show the effectiveness of the test-bed.

Theoretical evaluation of electromagnetic emissions from GSM900 mobile telephony base stations in the West Bank and Gaza Strip-Palestine

International Nuclear Information System (INIS)

Lahham, Adnan; Abu Alkbash, Jehad; ALMasri, Hussien

2017-01-01

Theoretical assessments of power density in far-field conditions were used to evaluate the levels of environmental electromagnetic frequencies from selected GSM900 macrocell base stations in the West Bank and Gaza Strip. Assessments were based on calculating the power densities using commercially available software (RF-Map from Telstra Research Laboratories-Australia). Calculations were carried out for single base stations with multi-antenna systems and also for multiple base stations with multi-antenna systems at 1.7 m above the ground level. More than 100 power density levels were calculated at different locations around the investigated base stations. These locations include areas accessible to the general public (schools, parks, residential areas, streets and areas around kindergartens). The maximum calculated electromagnetic emission level resulted from a single site was 0.413 μW cm -2 and found at Hizma town near Jerusalem. Average maximum power density from all single sites was 0.16 μW cm -2 . The results of all calculated power density levels in 100 locations distributed over the West Bank and Gaza were nearly normally distributed with a peak value of ∼0.01% of the International Commission on Non-Ionizing Radiation Protection's limit recommended for general public. Comparison between calculated and experimentally measured value of maximum power density from a base station showed that calculations overestimate the actual measured power density by ∼27%. (authors)

FCJ-200 When Memes Go to War: Viral Propaganda in the 2014 Gaza-Israel Conflict

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Chris Rodley

2016-03-01

Full Text Available During the Gaza-Israel conflict of July-August 2014, a large volume of creative, multimodal digital content aimed at influencing public opinion was disseminated on social media by belligerents and their supporters. This paper highlights two related features of this ‘viral agitprop’: the use of a diverse range of novel, hypermediated forms to represent a limited set of messages, and thematisation of the act of mediation itself. I argue that these practices are a response to the challenges of communicating with multiple publics within data streams that are crowded, competitive and fast-moving. I suggest this content represents a distinctive new Internet genre which problematises accounts of the relationship between war and media by Friedrich Kittler and Jean Baudrillard.

Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs.

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Zulu, Rodah M; Byrne, Nuala M; Munthali, Grace K; Chipeta, James; Handema, Ray; Musonda, Mofu; Hills, Andrew P

2011-09-21

Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV) treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS) is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA) beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW) and derive fat-free mass (FFM) and fat mass (FM). This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI), body composition, CD4, viral load and micronutrient status. This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Pan African Clinical Trial Registry PACTR201108000303396.

Theoretical Evaluation of Electromagnetic Emissions from GSM900 Mobile Telephony Base Stations in the West Bank and Gaza Strip-Palestine.

Science.gov (United States)

Lahham, Adnan; Alkbash, Jehad Abu; ALMasri, Hussien

2017-04-20

Theoretical assessments of power density in far-field conditions were used to evaluate the levels of environmental electromagnetic frequencies from selected GSM900 macrocell base stations in the West Bank and Gaza Strip. Assessments were based on calculating the power densities using commercially available software (RF-Map from Telstra Research Laboratories-Australia). Calculations were carried out for single base stations with multiantenna systems and also for multiple base stations with multiantenna systems at 1.7 m above the ground level. More than 100 power density levels were calculated at different locations around the investigated base stations. These locations include areas accessible to the general public (schools, parks, residential areas, streets and areas around kindergartens). The maximum calculated electromagnetic emission level resulted from a single site was 0.413 μW cm-2 and found at Hizma town near Jerusalem. Average maximum power density from all single sites was 0.16 μW cm-2. The results of all calculated power density levels in 100 locations distributed over the West Bank and Gaza were nearly normally distributed with a peak value of ~0.01% of the International Commission on Non-Ionizing Radiation Protection's limit recommended for general public. Comparison between calculated and experimentally measured value of maximum power density from a base station showed that calculations overestimate the actual measured power density by ~27%. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Assessing the impact of a food supplement on the nutritional status and body composition of HIV-infected Zambian women on ARVs

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Musonda Mofu

2011-09-01

Full Text Available Abstract Background Zambia is a sub-Saharan country with one of the highest prevalence rates of HIV, currently estimated at 14%. Poor nutritional status due to both protein-energy and micronutrient malnutrition has worsened this situation. In an attempt to address this combined problem, the government has instigated a number of strategies, including the provision of antiretroviral (ARV treatment coupled with the promotion of good nutrition. High-energy protein supplement (HEPS is particularly promoted; however, the impact of this food supplement on the nutritional status of people living with HIV/AIDS (PLHA beyond weight gain has not been assessed. Techniques for the assessment of nutritional status utilising objective measures of body composition are not commonly available in Zambia. The aim of this study is therefore to assess the impact of a food supplement on nutritional status using a comprehensive anthropometric protocol including measures of skinfold thickness and circumferences, plus the criterion deuterium dilution technique to assess total body water (TBW and derive fat-free mass (FFM and fat mass (FM. Methods/Design This community-based controlled and longitudinal study aims to recruit 200 HIV-infected females commencing ARV treatment at two clinics in Lusaka, Zambia. Data will be collected at four time points: baseline, 4-month, 8-month and 12-month follow-up visits. Outcome measures to be assessed include body height and weight, body mass index (BMI, body composition, CD4, viral load and micronutrient status. Discussion This protocol describes a study that will provide a longitudinal assessment of the impact of a food supplement on the nutritional status of HIV-infected females initiating ARVs using a range of anthropometric and body composition assessment techniques. Trial Registration Pan African Clinical Trial Registry PACTR201108000303396.

The relationships between family functioning and attachment orientations to post-traumatic stress symptoms among young adults who were evacuated from Gaza Strip settlements as adolescents.

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Zerach, Gadi; Tam, Elkanor

2016-01-01

This study examined post-traumatic stress disorder (PTSD) symptoms among young adults that were evicted from their residences in Gaza settlements ("Gush Katif") as adolescents and actively participated in the resistance events. Furthermore, we examined the moderating role of exposure to forced relocation on the association between attachment orientations and family functioning and PTSD symptoms. We conducted a correlative, cross-sectional study in 2013. Participants were Israeli evicted residents (ER group; N = 102), comparison groups of evicted nonresidents (ENR group; N = 27), and nonevicted nonresidents (NENR group; N = 53). All participants completed a battery of self-reported questionnaires. The ER group reported a higher number of PTSD symptoms as compared to the comparison groups. However, ER participants did not differ from ENR and NENR participants in their perception of family functioning. Importantly, the group (ER vs. NENR) moderated the association between attachment-anxiety and PTSD symptoms and between family adaptability and PTSD symptoms. Nine years after the forced relocation from Gaza settlements, young adults that were evicted from their residences as adolescents suffer from PTSD symptoms that are more related to the relocation itself than the stress entailed in the resistance events.

Trends in Decline of Antiretroviral Resistance among ARV-Experienced Patients in the HIV Outpatient Study: 1999–2008

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Kate Buchacz

2012-01-01

Full Text Available Background. Little is known about temporal trends in frequencies of clinically relevant ARV resistance mutations in HIV strains from U.S. patients undergoing genotypic testing (GT in routine HIV care. Methods. We analyzed cumulative frequency of HIV resistance among patients in the HIV Outpatient Study (HOPS who, during 1999–2008 and while prescribed antiretrovirals, underwent GT with plasma HIV RNA >1,000 copies/mL. Exposure ≥4 months to each of three major antiretroviral classes (NRTI, NNRTI and PI was defined as triple-class exposure (TCE. Results. 906 patients contributed 1,570 GT results. The annual frequency of any major resistance mutations decreased during 1999–2008 (88% to 79%, P=0.05. Resistance to PIs decreased among PI-exposed patients (71% to 46%, P=0.010 as exposure to ritonavir-boosted PIs increased (6% to 81%, P<0.001. Non-significant declines were observed in resistance to NRTIs among NRTI-exposed (82% to 67%, and triple-class-resistance among TCE patients (66% to 41%, but not to NNRTIs among NNRTI-exposed. Conclusions. HIV resistance was common but declined in HIV isolates from subgroups of ARV-experienced HOPS patients during 1999–2008. Resistance to PIs among PI-exposed patients decreased, possibly due to increased representation of patients whose only PI exposures were to boosted PIs.

Assessing the impacts of climate change in Mediterranean catchments under conditions of data scarcity - The Gaza case study

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Gampe, David; Ludwig, Ralf

2013-04-01

According to current climate projections, Mediterranean countries are at high risk for an even pronounced susceptibility to changes in the hydrological budget and extremes. While there is scientific consensus that climate induced changes on the hydrology of Mediterranean regions are presently occurring and are projected to amplify in the future, very little knowledge is available about the quantification of these changes, which is hampered by a lack of suitable and cost effective hydrological monitoring and modeling systems. The European FP7-project CLIMB is aiming to analyze climate induced changes on the hydrology of the Mediterranean Basins by investigating seven test sites located in the countries Italy, France, Turkey, Tunisia, Gaza and Egypt. CLIMB employs a combination of novel geophysical field monitoring concepts, remote sensing techniques and integrated hydrologic modeling to improve process descriptions and understanding and to quantify existing uncertainties in climate change impact analysis. One of those seven sites is the Gaza Strip, located in the Eastern Mediterranean and part of the Palestinian Autonomous Area, covers an area of 365km² with a length of 35km and 6 to 12km in width. Elevation ranges from sea level up to 104m in the East of the test site. Mean annual precipitation varies from 235mm in the South to 420mm in the North of the area. The inter annual variability of rainfall and the rapid population growth in an highly agricultural used area represent the major challenges in this area. The physically based Water Simulation Model WaSiM Vers. 2 (Schulla & Jasper (1999)) is setup to model current and projected future hydrological conditions. The availability of measured meteorological and hydrological data is poor as common to many Mediterranean catchments. The lack of available measured input data hampers the calibration of the model setup and the validation of model outputs. WaSiM was driven with meteorological forcing taken from 4

MORBILI PADA ANAK DALAM PENGOBATAN ANTI RETRO VIRAL (ARV

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Surya Dipta Nugraha

2016-03-01

Full Text Available MEASLES IN CHILDREN WITH ANTI RETRO VIRAL (ARV ON TREATMENT ABSTRACT Introduction: Morbili is an acute viral infectious disease caused by a virus transmitted morbili. Morbili is a contagious acute viral infectious disease that is characterized by three stages: catarrhal stage, eruption stage and convalence stage. Another name morbili is measles, measles, or rubeola. Morbili caused by a virus that is classified as Family paramyxovirus, the virus genus morbili contained in nasopharyngeal secretions and blood during the prodromal period until 24 hours after the onset of spots. Case: Patient male, 6 years old, Hindu, Balinese tribe, came with complaints of febris since 5 days ago. Febris is not measured with a thermometer. The heat is felt up and down, getting better with medicine. Complaints red spots felt since 1 day ago. Originally discovered red spots appear in the neck area and then to the face and chest. The incidence of rash accompanied by itching and heat. This complaint is accompanied with nosebleeds 1 day ago, cough with sputum since 5 days ago and the red eye from one day ago. Patients feel the first time such complaints. Having a history of antiretroviral use regularly since 1.5 years old. Keywords: rash, morbili, HIV, antiretroviral drugs.

The Quality of Banking Services in Light of the Financial Transformations and Their Impact on the Marketing Performance of the Banks in Gaza Strip

OpenAIRE

Al Hila , Amal ,; Alhelou , Eitedal ,; Al Shobaki , Mazen ,; Abu Naser , Samy S

2017-01-01

International audience; This study aimed to investigate the effect on the quality of banking services marketing performance of banks operating in the Gaza Strip in light of the financial transitions from the perspective of employees, and the disclosure of the relationship between the quality of banking services and marketing performance from the perspective of employees and customers. The researcher used descriptive and analytical approach, and the study population of employees and customers ...

The Legal Implication of Palestine's Ad Hoc Declaration and Accession to the ICC's Jurisdiction Based on the Rome Statute 1998 (Case Study of Israeli Attacks on Gaza Strip from January 2009 to December 2014

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Nabilla Utami Dhiya Rahmani

2016-12-01

Full Text Available Abstract The conflict between Israel and Palestine on Gaza Strip has caused not only military casualties but also civilian casualties which are protected by the international law. The protection of civilians in armed conflict is basically set in the Geneva Convention of 1949 which has been ratified by Israel and Palestine, in which violations of its provisions constitute war crimes. This paper discusses the mechanism of the International Criminal Court based on the Rome Statute 1998 in enforcing the law against war crimes on Gaza Strip. Articles 13 and 15 of Rome Statute 1998 provide jurisdiction for the settlement of an international criminal case. Palestine has made several attempts in accepting the jurisdiction of the ICC in 2009 and 2015, namely through their declaration and accession which further gave legal implication on the implementation of the international law. Based on these studies, this paper will further discuss the legal implication of the Palestine's declaration in 2009 and 2015, as well as its accession in 2015. Abstrak Konflik yang telah terjadi bertahun-tahun antara Israel dan Palestina di jalur Gaza telah memakan tidak hanya korban militer namun juga korban sipil yang dilindungi oleh hukum internasional. Perlindungan terhadap penduduk sipil dalam konflik bersenjata pada dasarnya diatur dalam Konvensi Jenewa IV tahun 1949 yang telah diratifikasi oleh Israel dan Palestina di mana pelanggaran terhadap ketentuannya merupakan kejahatan perang. Penulis dalam tulisan ini membahas mengenai mekanisme International Criminal Court berdasarkan Statuta Roma 1998 dalam menegakkan hukum terhadap kejahatan perang di jalur Gaza. Berdasarkan Statuta Roma 1998 Pasal 13 dan 15, ICC memiliki yurisdiksi atas penyelesaian suatu kasus pidana internasional yang diajukan negara anggota, rekomendasi Dewan Keamanan PBB, investigasi mandiri yang dilakukan oleh jaksa Mahkamah Pidana Internasional, atau deklarasi ad hoc yang dilakukan bagi negara bukan

Short and longer-term psychological consequences of Operation Cast Lead: documentation from a mental health program in the Gaza Strip

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Llosa Augusto E

2012-10-01

Full Text Available Abstract Background There is growing recognition of the psychological impact of adversity associated with armed conflict on exposed civilian populations. Yet there is a paucity of evidence on the value of mental health programs in these contexts, and of the chronology of psychological sequelae, especially in prolonged conflicts with repeated cycles of extreme violence. Here, we describe changes in the psychological profile of new patients in a mental health program after the military offensive Cast Lead, in the context of the prolonged armed conflict involving the Gaza Strip. Methods This study analyses routinely collected program data from a Médecins Sans Frontières mental health program in the Gaza Strip spanning 2007–2011. Data consist of socio-demographic as well as clinical baseline and follow-up data on new patients entering the program. Comparisons were made through Chi square and Fisher’s exact tests, univariate and multivariate logistic and linear regression. Results PTSD, depression and other anxiety disorders were the most frequent psychopathologies, with 21% having multiple diagnoses. With a median of nine sessions, clinical improvement was recorded for 83% (1122/1357, and more common for those with separation anxiety, acute and posttraumatic disorders as principal diagnosis (855/1005, compared to depression (141/183, p Conclusion Evolving changes in patient volume, diagnoses and recall period to triggering events suggest a lengthy and durable effect of an intensified exposure to violence in a context of prolonged conflict. Our findings suggest that mental health related humanitarian relief in protracted conflicts might need to prepare for an increase in patients with changing profiles over an extended period following an acute flare-up in violence.

"We must cooperate with one another against the Enemy": Agency and activism in school-aged children as protective factors against ongoing war trauma and political violence in the Gaza Strip.

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Veronese, Guido; Pepe, Alessandro; Jaradah, Alaa; Murannak, Feda; Hamdouna, Housam

2017-08-01

This exploratory qualitative study investigated self-perceived risk and protection factors that may reinforce the ability of children living in refugee camps on the Gaza Strip to adjust to a traumatic and risky life context characterized by loss and dispossession. The sample comprised 200 Palestinian children recruited at primary schools in four refugee camps in the Gaza Strip following the Israeli military operation "Pillar of Defence" in 2012. Thematic content analysis was applied to written materials and narratives produced by the children. Environment, friends, emotions, family, play, self, sociality, health, school, and spirituality were the dimensions that emerged from the narrative texts. Palestinian children's psychological adaptability and ability to reposition themselves along the continuum between ease and disease is underpinned by constant political agency and activism - a dimension that guides sense-making activities in a traumatizing environment marked by continuous uncertainty, loss and bereavement. We therefore recommend a politically-informed focus, both when assessing children and when designing intervention for them in contexts of chronic political violence and war. Copyright © 2017 Elsevier Ltd. All rights reserved.

Modeling HIV vaccines in Brazil: assessing the impact of a future HIV vaccine on reducing new infections, mortality and number of people receiving ARV.

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Maria Goretti P Fonseca

2010-07-01

Full Text Available The AIDS epidemic in Brazil remains concentrated in populations with high vulnerability to HIV infection, and the development of an HIV vaccine could make an important contribution to prevention. This study modeled the HIV epidemic and estimated the potential impact of an HIV vaccine on the number of new infections, deaths due to AIDS and the number of people receiving ARV treatment, under various scenarios.The historical HIV prevalence was modeled using Spectrum and projections were made from 2010 to 2050 to study the impact of an HIV vaccine with 40% to 70% efficacy, and 80% coverage of adult population, specific groups such as MSM, IDU, commercial sex workers and their partners, and 15 year olds. The possibility of disinhibition after vaccination, neglecting medium- and high-risk groups, and a disease-modifying vaccine were also considered. The number of new infections and deaths were reduced by 73% and 30%, respectively, by 2050, when 80% of adult population aged 15-49 was vaccinated with a 40% efficacy vaccine. Vaccinating medium- and high-risk groups reduced new infections by 52% and deaths by 21%. A vaccine with 70% efficacy produced a great decline in new infections and deaths. Neglecting medium- and high-risk population groups as well as disinhibition of vaccinated population reduced the impact or even increased the number of new infections. Disease-modifying vaccine also contributed to reducing AIDS deaths, the need for ART and new HIV infections.Even in a country with a concentrated epidemic and high levels of ARV coverage, such as Brazil, moderate efficacy vaccines as part of a comprehensive package of treatment and prevention could have a major impact on preventing new HIV infections and AIDS deaths, as well as reducing the number of people on ARV. Targeted vaccination strategies may be highly effective and cost-beneficial.

Fotografia, imaginário e os lugares do Outro: um passeio por imagens do ataque israelense à Faixa de Gaza

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Alberto Carlos Augusto Klein

2012-09-01

Full Text Available Este trabalho apresenta a análise da cobertura imagética do maior ataque israelense à faixa de Gaza nas capas da Folha de S. Paulo entre dezembro de 2008 e fevereiro de 2009. A partir dos esquemas de representação escolhidos na edição fotográfica do jornal, atenta para a caracterização dos lados envolvidos utilizando como subsídio os conceitos de teóricos da imagem, além das noções de estereótipo e arquétipo, para compreender de que modo se elabora a construção da Alteridade na oposição Ocidente versus Oriente.

Popkontsert terroriohvrite toetuseks

Index Scriptorium Estoniae

2001-01-01

Muusikakanal VH1, Cablevision ja Miramix Film korraldavad 20.oktoobril televisioonis otse ülekantava kontserdi Madison Square Gardenis New Yorgi terroriaktis hukkunute mälestuseks ja kannatada saanute toetuseks

Ekspertiis : ohvrid uppusid / Kristjan Roos

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Roos, Kristjan, 1978-

2005-01-01

Kopteriõnnetuses hukkunute surma põhjustas kohtuekspertiisi esialgsetel andmetel uppumine. Kopteriõnnetuse uurimiskomisjoni esimehe Tõnu Aderi, lennuameti asejuhi Rein Porro kommentaare. Vt. samas: Mirjam Roosioja. Ohvrid olid kindlustatud 2 000 000 kroonile

Risk factors for DSM 5 PTSD symptoms in Israeli civilians during the Gaza war.

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Gil, Sharon; Weinberg, Michael; Or-Chen, Keren; Harel, Hila

2015-04-01

In light of the current modifications presented in the diagnostic criteria of posttraumatic stress disorder (PTSD) in the DSM 5, this study aimed at revalidating well-known PTSD risk factors, including gender, peritraumatic dissociation, social support, level of threat, and trait tendency for forgiveness. Five hundred and one Israeli civilians were assessed during real-time exposure to missile and rocket fire at the eruption of the Gaza war. Assessments took place approximately one to 2 weeks after the beginning of this military operation, relying on web administration of the study, which allowed simultaneous data collection from respondents in the three regions in Israel that were under attack. A structural equation model design revealed that higher levels of forgiveness toward situations were associated with fewer PTSD symptoms, whereas peritraumatic dissociation and high levels of objective and subjective threat were positively associated with PTSD symptoms. Additionally, females were at higher risk for PTSD symptoms than males. The findings of this study provide further evidence for the importance of directing preventive attention to those vulnerable to the development of elevated levels of PTSD symptoms. Theoretical and clinical implications of the findings are discussed.

Nutritional status of Palestinian preschoolers in the Gaza Strip: a cross-sectional study

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Massad Salwa G

2012-01-01

Full Text Available Abstract Background The authors examined factors associated with nutritional resilience/vulnerability among preschoolers in the Gaza Strip in 2007, where political violence and deprivation are widespread. Methods This cross-sectional study was carried out in 2007 using random sampling of kindergartens in order to select 350 preschoolers. Binary logistic regression was used to compare resilient (adequate nutrition and vulnerable (stunted groups with those with moderate nutrition. Results Approximately 37% of the subjects demonstrated nutritional resilience and 15% were vulnerable. Factors associated with nutritional resilience were child younger age, normal birth weight, actively hand- or spoon-feeding when the child was below two years, and residential stability in the past two years. The only factor associated with nutritional vulnerability was lower total score on the mother's General Health Questionnaire, which we interpret as a marker of maternal mental health. Conclusions Children with low-birth weight and older children had worse nutritional resiliency outcomes. Further, poorer outcomes for children were associated with lower maternal mental health status, as well as increased family residential instability. Our results add to the large literature on the pervasive effects of violence and instability on children and underscore the need for resources for early intervention and for the urgent resolution of the Palestinian and other armed conflicts.

Nutritional status of Palestinian preschoolers in the Gaza Strip: a cross-sectional study.

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Massad, Salwa G; Nieto, F J; Palta, Mari; Smith, Maureen; Clark, Roseanne; Thabet, Abdel-Aziz

2012-01-11

The authors examined factors associated with nutritional resilience/vulnerability among preschoolers in the Gaza Strip in 2007, where political violence and deprivation are widespread. This cross-sectional study was carried out in 2007 using random sampling of kindergartens in order to select 350 preschoolers. Binary logistic regression was used to compare resilient (adequate nutrition) and vulnerable (stunted) groups with those with moderate nutrition. Approximately 37% of the subjects demonstrated nutritional resilience and 15% were vulnerable. Factors associated with nutritional resilience were child younger age, normal birth weight, actively hand- or spoon-feeding when the child was below two years, and residential stability in the past two years. The only factor associated with nutritional vulnerability was lower total score on the mother's General Health Questionnaire, which we interpret as a marker of maternal mental health. Children with low-birth weight and older children had worse nutritional resiliency outcomes. Further, poorer outcomes for children were associated with lower maternal mental health status, as well as increased family residential instability. Our results add to the large literature on the pervasive effects of violence and instability on children and underscore the need for resources for early intervention and for the urgent resolution of the Palestinian and other armed conflicts. © 2012 Massad et al; licensee BioMed Central Ltd.

15 aasta pärast tapab liiklus enam kui aids / Küllike Rooväli

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Rooväli, Küllike, 1969-

2004-01-01

Maailma Terviseorganisatsiooni (WHO) ennustusel on liiklusõnnetustes hukkumine 15 aasta pärast maailmas kolme kõige sagedasema surmapõhjuse hulgas. Eesti on avariides hukkunute arvult maailmas esirinnas. Lisa: Surma põhjused maailmas

The Napoleon Graves / Michael Tarm

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Tarm, Michael

2002-01-01

Vilniuse lähedal leiti 1812. a. Isamaasõjas hukkunud prantsuse sõdurite matmispaik. Säilmete antropoloogilised uuringud võimaldavad kindlaks määrata hukkunute vanuse, soo ja tõenäolise surma põhjuse

Hollywood lõikab filmidest purunenud torne välja / Malle Pajula

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Pajula, Malle, 1971-

2001-01-01

Seoses 11. septembri terrorirünnakuga lõigatakse ekraanile tulevatest filmidest välja lõike, mis kujutavad tänaseks kokku varisenud Kaubanduskeskuse torne ning hoitakse kinni esilinastusi, mis võiksid olla liiga valusad hukkunute omastele

Urozhentsõ Estonii, pogibshije v Afganskoi voine / Küllo Arjakas

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Arjakas, Küllo, 1959-

2006-01-01

Afganistani sõja lõpust on möödunud 17 aastat, Eesti NSV sõjakomissariaatide kaudu osales sõjas teadaolevalt 1652 sõjaväelast. Autor ootab täpsustavaid andmeid osalejate, hukkunute ja teadmata kadunute kohta

Suvemuusika : Oramo ja Kaljuste / Igor Garshnek

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Garšnek, Igor, 1958-

1999-01-01

25. augustil Estonia kontserdisaalis toimunud Birmingami SO kontserdist. Kavas G. Benjamini "Sudden Times", Sibeliuse Viiulikontsert ja Brahmsi 2. sümfoonia. 26. augustil Tallinnas endise tselluloosivabriku katlamajas toimunud kontserdist ja videosalvestusest, kus kanti ette Mozarti "Reekviem" Kosovos hukkunute mälestuseks

Birinci Dünya Savaşı’nda Gazze Muharebeleri / The Battles of Gaza in World War I

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Sami Ağaoğlu

2017-04-01

Full Text Available Abstract According to Germany’s demand, Ottoman Empire opened Canal Front which is one of the most important front lines of WWI to pass the Suez Canal and attack Egypt. There were two massive attacks between Ottoman and British. The first clash occured in 1915 and second took place in 1916. Result of Ottoman forces struggle with the British troops, Ottoman Empire were defeated but then Ottoman Empire counter attacked. They tried to prevent British attacks in the campaigns of Sinai and Palestine. The paper deals with the First and the Second Battle of Gaza that repelled English forces, the third Gaza Battle and its result, Yildirim Army Group (or Thunderbolt Army Group of the Ottoman Empire that was formed in order to prevent advance of attackers and siege and fall of Jerusalem. Therefore, subsequent failures of the campaign and retreating to the Anatolia started. The research paper was based on archival documents, primary&secondary sources and memoirs. Öz Osmanlı Devleti, Birinci Dünya Savaşı’nın önemli cephelerinden olan Kanal cephesini Almanların isteği doğrultusunda Süveyş kanalının geçmek ve Mısır’a taarruz etmek amacıyla açmıştı. Osmanlı Ordusunun I. Kanal Seferi ve II. Kanal Seferi başarısız olunca, karşı saldırıya geçen İngiliz birlikleri Sina ve Filistin cephesinde, Gazze muharebeleri ile durdurulmaya çalışılmıştır. Araştırmamızda, İngiliz birliklerinin püskürtüldüğü I. ve II. Gazze muharebeleri, Birüssebi ve Gazze’nin elden çıktığı III. Gazze muharebesi, Osmanlı Devleti’nin bu yenilgiyi durdurabilmek için kurduğu Yıldırım Orduları Gurup Komutanlığı ve Kudüs’ün elden çıkışı ele alınmıştır. Böylelikle birbiri ardına gelen yenilgiler zinciri ile Osmanlı Ordularının Anadolu’ya çekilişi arşiv belgeleri, birinci elden kaynaklar ve hatıratlardan yararlanılarak işlenmiştir.

Application of Project Time Management Tools and Techniques to the Construction Industry in the Gaza Strip

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Nabil Sawalhi

2012-11-01

Full Text Available The objective of this paper is to investigate the level of applying theproject time management tools and techniques by public ownersand construction contractors in the Gaza Strip. This study hasbeen conducted by means of a survey questionnaire. Seventythreequestionnaires were distributed to target constructioncontractors and twenty-five questionnaires to public owners. Sixtycompleted questionnaires from contractors and twenty-threequestionnaires from public owners were received and analysed.The survey results indicated that contemporary project timemanagement tools and techniques are not widely used amonglocal contractors and owners. Lack of subcontractor’s knowledgeand awareness of the importance of project time managementtools and techniques are still major obstacles toward the efficientutilisation of such tools. This study recommended that there is anurgent need to establish a professional industry body such as anInstitute of Building to review and evaluate existing local projectmanagement practices. This professional body may be establishedby the government through the Ministry of Housing and PublicWorks or by the local university in cooperation with a similarinternational professional industry body. Current training effortshould be tailored to encourage owners and contractors to usework breakdown structures, resource optimisation, and networkscheduling.

An integrated study of spatial multicriteria analysis and mathematical modelling for managed aquifer recharge site suitability mapping and site ranking at Northern Gaza coastal aquifer.

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Rahman, Mohammad Azizur; Rusteberg, Bernd; Uddin, Mohammad Salah; Lutz, Annegret; Saada, Muath Abu; Sauter, Martin

2013-07-30

This paper describes an integrated approach of site suitability mapping and ranking of the most suitable sites, for the implementation of Managed Aquifer Recharge (MAR) projects, using spatial multicriteria decision analysis (SMCDA) techniques and mathematical modelling. The SMCDA procedure contains constraint mapping, site suitability analysis with criteria standardization and weighting, criteria overlay by analytical hierarchy process (AHP) combined with weighted linear combination (WLC) and ordered weighted averaging (OWA), and sensitivity analysis. The hydrogeological impacts of the selected most suitable sites were quantified by using groundwater flow and transport modelling techniques. Finally, ranking of the selected sites was done with the WLC method. The integrated approach is demonstrated by a case study in the coastal aquifer of North Gaza. Constraint mapping shows that 50% of the total study area is suitable for MAR implementation. About 25% of the total area is "very good" and 25% percent is "good" for MAR, according to the site suitability analysis. Six locations were selected and ranked against six representative decision criteria. Long term (year 2003 to year 2040) groundwater flow and transport simulations were performed to quantify the selected criteria under MAR project operation conditions at the selected sites. Finally, the suitability mapping and hydrogeological investigation recommends that the location of the existing infiltration ponds, constructed near the planned North Gaza Wastewater Treatment Plant (NGWWTP) is most suitable for MAR project implementation. This paper concludes that mathematical modelling should be combined with the SMCDA technique in order to select the best location for MAR project implementation. Besides MAR project implementation, the generalised approach can be applicable for any other water resources development project that deals with site selection and implementation. Copyright © 2013 Elsevier Ltd. All rights

Gender difference and characteristics attributed to coronary artery disease in Gaza-Palestine.

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Jamee, Amal; Abed, Yehia; Jalambo, Marwan O

2013-05-26

Traditionally coronary artery disease (CAD) has been considered as disease affecting men, and for long time women were not included in researches programme. In both sexes, coronary heart disease risk increases with age. Extensive clinical and statistical studies have identified serial factors that increase the risk of coronary heart disease, some of them can be modified, and some cannot. This study was performed to analyze the extent to which cardiovascular risk factors can explain the gender difference in coronary heart disease. The study design is a cross sectional study based on 155 cardiac patients admitted to cardiology department in Al-shifa hospital Gaza. The following cardiac risk factors were determined from the patient's records, smoking, diabetes, high blood pressure, Dyslipedemia and presence of family history of coronary artery disease. Catheterization results review were done. Statistical Package for Social Science version 17 was used for data entry and analysis. Frequency and cross tabulation were done to explore the relationship between the study variables. Chi-square test was used for testing statistical and P-value less than 0.05 were considered as significant. Most of risk factors were more favorable in females and increase with age. Myocardial infarction in male compared with female was 2 times higher, and chronic angina pain is common in female than male respectively 71.4% and 46.7%. Around 77% of female have two vessels disease and more. No great differences in number of diseased vessels among patients with myocardial infarction or chronic stable angina. Patients with low EF <50% have higher chance of affected vessels (82.9%). CAD stay the major problem in male and female, certain patient's characteristics and clinical conditions may place female at higher risk of coronary artery disease development or progression. This article addresses emerging knowledge regarding gender differences in CAD risk factors and responsiveness to risk reduction

ARV robotic technologies (ART): a risk reduction effort for future unmanned systems

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Jaster, Jeffrey F.

2006-05-01

The Army's ARV (Armed Robotic Vehicle) Robotic Technologies (ART) program is working on the development of various technological thrusts for use in the robotic forces of the future. The ART program will develop, integrate and demonstrate the technology required to advance the maneuver technologies (i.e., perception, mobility, tactical behaviors) and increase the survivability of unmanned platforms for the future force while focusing on reducing the soldiers' burden by providing an increase in vehicle autonomy coinciding with a decrease in the total number user interventions required to control the unmanned assets. This program will advance the state of the art in perception technologies to provide the unmanned platform an increasingly accurate view of the terrain that surrounds it; while developing tactical/mission behavior technologies to provide the Unmanned Ground Vehicle (UGV) the capability to maneuver tactically, in conjunction with the manned systems in an autonomous mode. The ART testbed will be integrated with the advanced technology software and associated hardware developed under this effort, and incorporate appropriate mission modules (e.g. RSTA sensors, MILES, etc.) to support Warfighter experiments and evaluations (virtual and field) in a military significant environment (open/rolling and complex/urban terrain). The outcome of these experiments as well as other lessons learned through out the program life cycle will be used to reduce the current risks that are identified for the future UGV systems that will be developed under the Future Combat Systems (FCS) program, including the early integration of an FCS-like autonomous navigation system onto a tracked skid steer platform.

Factors affecting adherence to short-course ARV prophylaxis for preventing mother-to-child transmission of HIV in sub-Saharan Africa: a review and lessons for future elimination.

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Colombini, Manuela; Stöckl, Heidi; Watts, Charlotte; Zimmerman, Cathy; Agamasu, Enyonam; Mayhew, Susannah H

2014-01-01

Despite the biomedical potential to eliminate vertical HIV transmission, drug adherence to short regimens is often sub-optimal. To inform future programmes, we reviewed evidence on the factors influencing maternal and infant drug adherence to preventing MTCT drug regimens at delivery in sub-Saharan Africa. A literature review yielding 14 studies on adherence to drug regimes among HIV-positive pregnant women and mothers in sub-Saharan Africa was conducted. Rates of maternal adherence to preventive drug regimens at time of delivery varied widely across sites between 35 and 93.5%. Factors most commonly associated with low adherence to antiretroviral therapy (ARV) prophylaxis for preventing MTCT at the health system level include giving birth at home, quality and timing of HIV testing and counselling, and late distribution of nevirapine (NVP). Socio-demographic and demand-side factors include fear of stigma, lack of male involvement, fear of partner's reaction to disclosure, few antenatal (ANC) visits, young age and lack of education. With the implementation of the newly published WHO guidelines recommending triple-drug ARV regimen during pregnancy and breastfeeding for all women with HIV, it is important that women are able to adhere to recommended drug regimens. Service improvements should include clear and timely communication with women about the benefits of combined regimens and greater emphasis on patient confidentiality. Efforts must be made to help women overcome barriers that reduce adherence, such as financial logistical challenges, social stigma and women's fear of violence.

Maternal pre- and postnatal mental health and infant development in war conditions: The Gaza Infant Study.

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Punamäki, Raija-Leena; Diab, Safwat Y; Isosävi, Sanna; Kuittinen, Saija; Qouta, Samir R

2018-03-01

Women and their infants need special protection in war context, as traumatic events can risk maternal mental and obstetric health and compromise infant development. This prospective study examined, first, how exposure to war trauma is associated with maternal mental health in pregnancy and postpartum, obstetric and newborn health, and infant development. Second, it tested the role of maternal mental health and obstetric risks in mediating between war trauma and infant development. Palestinian women (N = 511) from the Gaza strip participated during pregnancy (T1) and at 4 (T2) and 12 (T3) months postpartum. They reported PTSD, depressive, anxiety, and dissociative symptoms, as well as pregnancy complications, newborn health risks such as prematurity, and infant sensorimotor and language development. First, exposure to war trauma was associated with high levels of maternal mental health and complications at pregnancy, and with increased postpartum mental health symptoms, but exposure was not directly associated with newborn health risks or problems in infant development. Second, maternal mental health both in pregnancy and postpartum, but not pregnancy complications or newborn health, mediated the negative impact of war trauma on infant sensorimotor and language development at 12 months. Interventions to protect early child development in war conditions should be tailored to support maternal mental health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Obstacles to the Application of Administrative Process Engineering in Gaza Universities from the Faculty Members’ Perspective

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Mahmoud A.R. Assaf

2017-08-01

Full Text Available The study aimed to identify the faculty members’ levels of assessment at Palestinian universities of the obstacles to the application of engineering of administrative processes ; and to find out whether there were statistically significant differences at the level of significance (α≤0.05 between the mean scores of assessment attributable to the variables: (college, academic rank, years of service. To achieve this, the researcher followed the descriptive method by using a questionnaire consisting of 36 items distributed into 4 areas: (technical, human, financial, administrative. The sample consisted of (95 faculty members from two universities (Al-Azhar and Islamia. The study revealed that the total degree of the respondents’ assessment of the obstacles to the application of engineering of administrative processes was (73.4%. The order of obstacles was as follows: i financial, ii human, iii administrative and iv technical obstacles. Further, there were no statistically significant differences at the level of significance (α≤0.05 between the mean scores of respondents’ assessment of the obstacles to the application of this method at the Palestinian universities that were attributed to these variables: (college, academic rank, years of service.The study recommended the need for allocating of adequate financial budgets, and the creation of a special unit in each university to be responsible for providing training on the concepts of reengineering administrative processes and linking them to quality and continuous improvement. Keywords: Administrative process engineering, Gaza governorates , Faculty members.

A contrução do canal de Suez e a formação do conflito: a força de paz brasileira na Faixa de Gaza

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Francisca Carla Santos Ferrer

2006-04-01

Full Text Available Apesar de ocorrerem ainda inúmeros conflitos, após 1945 as nações uniram-se em busca de paz. A ONU passou a intervir em conflitos armados sempre que achasse necessário para a manutenção da paz. Entretanto, o imperialismo havia deixado suas marcas em diversos países da África, que após a Segunda Guerra Mundial se lançaram na luta por independência. Este foi o caso de Suez. No presente artigo apresentamos nossa análise sobre a formação do conflito árabe-israelense na Faixa de Gaza e da efetiva participação brasileira, como força de paz enviada pela ONU, na Guerra dos Seis Dias.

One flag, two rallies: Mechanisms of public opinion in Israel during the 2014 Gaza war.

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Feinstein, Yuval

2018-01-01

In Israel, public reaction to the 2014 Gaza war included massive support for the military operation and a sharp increase in the popularity of Prime Minister Netanyahu. To understand what caused these "rally-round-the-flag" (RRTF) effects, panel data were collected from a representative sample of the Jewish majority in Israel during and after the war. The article integrate empirical and theoretical arguments from public opinion studies, and from social and political psychology, to contextualize and guide the analysis. The results reveal that perceived threat to collective security produced two simultaneous rally outcomes through distinct processes: First, increased identification with the ethno-national Jewish group led to a rally behind Israel's prime minister. Second, anger toward Hamas and sentiment of national superiority, which was activated by increased ethno-national identification, produced a rally behind the military operation. In addition to explaining its specific empirical case, this study makes three broader contributions. First, it extends the investigation of the RRTF phenomenon in wartime beyond the popularity of the head of the state (the focus of most previous studies) by also examining levels of support for the use of military power. Second, it reveals some of the mechanisms through which distinct elements of popular nationalism mediate the relationship between war events and heterogeneous rally effects. Third, this study shows that the mechanisms that have been detected in studies of individual attitudes and behavior in small groups under conditions of perceived threat or competition can help explain the behavior of these individuals as members of larger, imagined national communities during war. Copyright © 2017 Elsevier Inc. All rights reserved.

Novel galeterone analogs act independently of AR and AR-V7 for the activation of the unfolded protein response and induction of apoptosis in the CWR22Rv1 prostate cancer cell model.

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McCarty, David J; Huang, Weiliang; Kane, Maureen A; Purushottamachar, Puranik; Gediya, Lalji K; Njar, Vincent C O

2017-10-24

The androgen receptor (AR) has long been the primary target for the treatment of prostate cancer (PC). Despite continuous efforts to block AR activity through ligand depletion, AR antagonism, AR depletion and combinations thereof, advanced PC tumors remain resilient. Herein, we evaluate two galeterone analogs, VNPT-178 and VNLG-74A, in PC cell models of diverse androgen and AR dependence attempting to delineate their mechanisms of action and potential clinical utility. Employing basic biochemical techniques, we determined that both analogs have improved antiproliferative and anti-AR activities compared to FDA-approved abiraterone and enzalutamide. However, induction of apoptosis in these models is independent of the AR and its truncated variant, AR-V7, and instead likely results from sustained endoplasmic reticulum stress and deregulated calcium homeostasis. Using in silico molecular docking, we predict VNPT-178 and VNLG-74A bind the ATPase domain of BiP/Grp78 and Hsp70-1A with greater affinity than the AR. Disruption of 70 kDa heat shock protein function may be the underlying mechanism of action for these galeterone analogs. Therefore, despite simultaneously antagonizing AR activity, AR and/or AR-V7 expression alone may inadequately predict a patient's response to treatment with VNPT-178 or VNLG-74A. Future studies evaluating the context-specific limitations of these compounds may provide clarity for their clinical application.

Urban planning and interactions with atmospheric pollution in Arve valley

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Langlois de Septenville, William; Cossart, Étienne

2017-04-01

Atmospheric pollution is a major concern of urbanised areas and territory managers have to conduct efficient policies to decrease population exposure and vulnerability. Even if pollution peaks are subject to an important mediatisation and to a large part of preventive actions, background pollution remains responsible of the largest sanitary effects. They depend on (1) the concentration and the duration of the exposure and (2) to the kind of pollutants considered. Many sources of pollutants can be identified in urban areas as heating, industry or traffic; and each of them generates specific particles. Currently, the major part of pollution risk studies focuses on modelling particle emissions and their dissemination in the environment. These kinds of studies highlight the hazard intensity and its spatiality, commonly named the hazard exposure. Another part of risk studies, less frequent, considers the vulnerability. Vulnerability is a complex concept that involves a wide range of scales and objects ranging from biophysical parameters to social characteristics. They notably concern accessibility to information, knowledge and perceptions about the risk. The Arve valley (south-east of France) is subject to heavy pollution concentrations. High levels recording in this area have imposed the implementation of an Atmosphere Protection Plan. This type of plan is triggered if a peak occurs and enforces provisional binding measures for polluters, such as highway speed limitation for traffic emissions. These measures are only focused on emissions and have no effect for reducing vulnerability and exposition, for a long- and short-term time scales. An opportunity to ensure this objective is to consider how local urban morphologies can combine exposition and vulnerability situations. Indeed, cities have been planned without taking into account atmospheric pollution and morphologies. This context may conduct to the increase in both of these two risk components and producing

Integrating an artificial intelligence approach with k-means clustering to model groundwater salinity: the case of Gaza coastal aquifer (Palestine)

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Alagha, Jawad S.; Seyam, Mohammed; Md Said, Md Azlin; Mogheir, Yunes

2017-12-01

Artificial intelligence (AI) techniques have increasingly become efficient alternative modeling tools in the water resources field, particularly when the modeled process is influenced by complex and interrelated variables. In this study, two AI techniques—artificial neural networks (ANNs) and support vector machine (SVM)—were employed to achieve deeper understanding of the salinization process (represented by chloride concentration) in complex coastal aquifers influenced by various salinity sources. Both models were trained using 11 years of groundwater quality data from 22 municipal wells in Khan Younis Governorate, Gaza, Palestine. Both techniques showed satisfactory prediction performance, where the mean absolute percentage error (MAPE) and correlation coefficient ( R) for the test data set were, respectively, about 4.5 and 99.8% for the ANNs model, and 4.6 and 99.7% for SVM model. The performances of the developed models were further noticeably improved through preprocessing the wells data set using a k-means clustering method, then conducting AI techniques separately for each cluster. The developed models with clustered data were associated with higher performance, easiness and simplicity. They can be employed as an analytical tool to investigate the influence of input variables on coastal aquifer salinity, which is of great importance for understanding salinization processes, leading to more effective water-resources-related planning and decision making.

Iraak sihikul : veriste rusude kohal kerkib teistsugune riik / Heiki Suurkask

Index Scriptorium Estoniae

Suurkask, Heiki, 1972-

2006-01-01

Iraagis kujunenud olukorrast. Autori väitel ei usu enam peaaegu keegi võimalusse purustada mässulisi Iraagis sõjalise jõuga, vastupanuvõitlus USA okupatsiooni vastu on laienenud kahe kogukonna vaheliseks verevalamiseks. Hukkunute arvust. Vt. samas: Shiiitide sõjakas juht al-Sadri suurendab Iraagis oma võimu; Rahukolle Kurdistan ei rutta iseseisvuma. Lisad: Sunniitide vägivaldne kolmnurk; Iraagi naabrid kaitsevad kiivalt oma huve

Kohtumisel Bushiga tuleks tõstatada ka Estonia huku teema / Allar Viivik

Index Scriptorium Estoniae

Viivik, Allar

2006-01-01

Parvlaeval Estonia hukkunute omaste ühendused avaldasid oma pöördumises Toomas Hendrik Ilvesele soovi, et president arutaks kohtumisel USA presidendi George W. Bushiga USA julgeolekuagentuuri NSA käsutuses olevate laevahukku puudutavate salastatud dokumentide üleandmist Eestile. Pöördumisele on alla kirjutanud Estonia Litigation Associationi esimees Helje Kaskel ja Estonia Hukupõhjuste Väljaselgitamise Mittetulundusühingu (EHVM) juht Ülo Veide

How to assess solid waste management in armed conflicts? A new methodology applied to the Gaza Strip, Palestine.

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Caniato, Marco; Vaccari, Mentore

2014-09-01

We have developed a new methodology for assessing solid waste management in a situation of armed conflict. This methodology is composed of six phases with specific activities, and suggested methods and tools. The collection, haulage, and disposal of waste in low- and middle-income countries is so complicated and expensive task for municipalities, owing to several challenges involved, that some waste is left in illegal dumps. Armed conflicts bring further constraints, such as instability, the sudden increase in violence, and difficulty in supplying equipment and spare parts: planning is very difficult and several projects aimed at improving the situation have failed. The methodology was validated in the Gaza Strip, where the geopolitical situation heavily affects natural resources. We collected information in a holistic way, crosschecked, and discussed it with local experts, practitioners, and authorities. We estimated that in 2011 only 1300 tonne day(-1) were transported to the three disposal sites, out of a production exceeding 1700. Recycling was very limited, while the composting capacity was 3.5 tonnes day(-1), but increasing. We carefully assessed system elements and their interaction. We identified the challenges, and developed possible solutions to increase system effectiveness and robustness. The case study demonstrated that our methodology is flexible and adaptable to the context, thus it could be applied in other areas to improve the humanitarian response in similar situations. © The Author(s) 2014.

Compliance with the national palestinian infection prevention and control protocol at governmental paediatric hospitals in gaza governorates.

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Eljedi, Ashraf; Dalo, Shareef

2014-08-01

Nosocomial infections are a significant burden for both patients and the healthcare system. For this reason, infection prevention and control (IPC) practices are extremely important. The Palestinian Ministry of Health adopted the national IPC Protocol in 2004. This study aimed to assess the compliance of healthcare providers (HCPs) with the Protocol in three governmental paediatric hospitals in Gaza governorates. This descriptive cross-sectional study was conducted from February to November 2010. Data were collected from a sample of doctors, nurses and physiotherapists (N = 334) using a self-administered questionnaire and observation checklists to record HCP practices and assess the hospital environment. The response rate was 92%. The most important reasons for non-compliance with the IPC Protocol were the absence of an education programme (61.5%), lack of knowledge (52.4%) and the scarcity of required supplies (46.9%). Only 2.3% of respondents had a copy of the IPC Protocol, while 65.8% did not know of its existence. Only 16.9% had participated in training sessions regarding general IPC practices. The observation checklist regarding HCP practices revealed low levels of compliance in hand washing (45.9%), wearing gloves (40.7%) and using antiseptics/disinfectants (49.16%). The health facilities checklist indicated that there was a lack of certain essential equipment and materials, such as covered waste containers and heavy-duty gloves. Due to the lack of HPC knowledge, the authors recommend that the IPC Protocol be made available in all hospitals. In addition, a qualified team should implement intensive IPC education and training programmes and facilities should provide the required equipment and materials.

Can people remain engaged and vigorous in the face of trauma? Palestinians in the West Bank and Gaza.

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Hobfoll, Stevan E; Johnson, Robert J; Canetti, Daphna; Palmieri, Patrick A; Hall, Brian J; Lavi, Iris; Galea, Sandro

2012-01-01

This is the first study to investigate how actively engaged and vigorous people remain in their life tasks in the midst of chronic exposure to significant traumatic events. We sought to identify risk and protective factors for engagement within the context of ongoing exposure to political violence and social upheaval. We randomly identified and interviewed 1,196 adult residents of the West Bank and Gaza during a period of violent conflict on 3 occasions: (1) September-October 2007, (2) April-May 2008, and (3) October-November 2008. Participants were asked about their exposure to political violence, symptoms of depression, and posttraumatic stress (PTS) symptoms, their level of social support, psychosocial resource loss, and positive engagement in life tasks. Path modeling revealed that trauma exposure indirectly affected engagement through its impact on resource loss and PTS and depression symptoms. PTS symptoms at Wave 2 were modestly related to greater engagement at Wave 3, and depression symptoms did not independently predict engagement at Wave 3. Psychosocial resource loss at Wave 1 and Wave 2 was the best overall predictor of engagement at Wave 3, through its direct and indirect effects via PTS symptoms. Greater engagement was also predicted by greater social support, being more educated, being younger, and being more religious. The relative independence of psychological distress and engagement was noted as a critical finding supporting a key tenet of positive psychology. The relationship of resource loss and social support with engagement suggests that bolstering psychosocial resources may offer a route for primary and secondary prevention amidst chronic traumatic conditions. © 2012 Guilford Publications, Inc.

Quality of life, human insecurity, and distress among Palestinians in the Gaza Strip before and after the Winter 2008-2009 Israeli war.

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Hammoudeh, Weeam; Hogan, Dennis; Giacaman, Rita

2013-11-01

This study investigates changes in the quality of life (QoL) of Gaza Palestinians before and after the Israeli winter 2008-2009 war using the World Health Organization's WHOQOL-Bref; the extent to which this instrument adequately measures changing situations; and its responsiveness to locally developed human insecurity and distress measures appropriate for context. Ordinary least squares regression analysis was performed to detect how demographic and socioeconomic variables usually associated with QoL were associated with human insecurity and distress. We estimated the usual baseline model for the three QoL domains, and a second set of models including these standard variables and human insecurity and distress to assess how personal exposure to political violence affects QoL. No difference between the quality of life scores in 2005 and 2009 was found, with results suggesting lack of sensitivity of WHOQOL-Bref in capturing changes resulting from intensification of preexisting political violence. Results show that human insecurity and individual distress significantly increased in 2009 compared to 2005. Results indicate that a political domain may provide further understanding of and possibly increase the sensitivity of the instrument to detect changes in the Qol of Palestinians and possibly other populations experiencing intensified political violence.

Preferences for ARV-based HIV prevention methods among men and women, adolescent girls and female sex workers in Gauteng Province, South Africa: a protocol for a discrete choice experiment.

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Quaife, Matthew; Eakle, Robyn; Cabrera, Maria; Vickerman, Peter; Tsepe, Motlalepule; Cianci, Fiona; Delany-Moretlwe, Sinead; Terris-Prestholt, Fern

2016-06-27

For the past few decades, condoms have been the main method of HIV prevention. Recent advances in antiretroviral (ARV)-based prevention products have substantially changed the prevention landscape, yet little is known about how popular these products will be among potential users, or whether new methods might be used in conjunction with, or instead of, condoms. This study will use a discrete choice experiment (DCE) to (1) explore potential users' preferences regarding HIV prevention products, (2) quantify the importance of product attributes and (3) predict the uptake of products to inform estimates of their potential impact on the HIV epidemic in South Africa. We consider preferences for oral pre-exposure prophylaxis; a vaginal microbicide gel; a long-acting vaginal ring; a SILCS diaphragm used in concert with gel; and a long-acting ARV-based injectable. This study will gather data from 4 populations: 200 women, 200 men, 200 adolescent girls (aged 16-17 years) and 200 female sex workers. The DCE attributes and design will be developed through a literature review, supplemented by a thematic analysis of qualitative focus group discussions. Extensive piloting will be carried out in each population through semistructured interviews. The final survey will be conducted using computer tablets via a household sample (for women, men and adolescents) and respondent-driven sampling (for female sex workers), and DCE data analysed using a range of multinomial logit models. This study has been approved by the University of the Witwatersrand Human Research Ethics Committee and the Research Ethics Committee at the London School of Hygiene and Tropical Medicine. Findings will be presented to international conferences and peer-reviewed journals. Meetings will be held with opinion leaders in South Africa, while results will be disseminated to participants in Ekurhuleni through a public meeting or newsletter. Published by the BMJ Publishing Group Limited. For permission to use (where

The Demand for Antiretroviral Drugs in the Illicit Marketplace: Implications for HIV Disease Management Among Vulnerable Populations.

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Tsuyuki, Kiyomi; Surratt, Hilary L; Levi-Minzi, Maria A; O'Grady, Catherine L; Kurtz, Steven P

2015-05-01

The diversion of antiretroviral medications (ARVs) has implications for the integrity and success of HIV care, however little is known about the ARV illicit market. This paper aimed to identify the motivations for buying illicit ARVs and to describe market dynamics. Semi-structured interviews (n = 44) were conducted with substance-involved individuals living with HIV who have a history of purchasing ARVs on the street. Grounded theory was used to code and analyze interviews. Motivations for buying ARVs on the illicit market were: to repurchase ARVs after having diverted them for money or drugs; having limited access or low quality health care; to replace lost or ruined ARVs; and to buy a back-up stock of ARVs. This study identified various structural barriers to HIV treatment and ARV adherence that incentivized ARV diversion. Findings highlight the need to improve patient-provider relationships, ensure continuity of care, and integrate services to engage and retain high-needs populations.

Homocysteine and vitamin B 12 status and iron deficiency anemia in female university students from Gaza Strip, Palestine

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Mahmoud Mohammed Sirdah

2014-06-01

Full Text Available OBJECTIVE: Nutritional deficiencies are very significant to the overall health of humans at all ages and for both genders, yet in infants, children and women of childbearing age these deficiencies can seriously affect growth and development. The present work is aimed to assess homocysteine and vitamin B12 status in females with iron deficiency anemia from the Gaza Strip.METHODS: Venous blood samples were randomly collected from 240 female university students (18-22 years old and parameters of the complete blood count, serum ferritin, homocysteine and vitamin B12 were measured. Statistical analysis included the t-test and analysis of variance (ANOVA using the IBM SPSS software (version 18. Statistical significance was set for p-values <0.05.RESULTS: The results revealed that 20.4% of the students have iron deficiency anemia. The mean serum vitamin B12 level in females with iron deficiency anemia (212.9 ± 62.8 pg/mL was significantly lower than in normal controls (286.9 ± 57.1 pg/mL and subjects with microcytic anemia and normal ferritin (256.7 ± 71.1 pg/mL. Significantly higher serum homocysteine levels were reported in the iron deficiency anemia group (27.0 ± 4.6 µmol/L compared to normal controls (15.5 ± 2.9 µmol/L and in subjects with microcytic anemia and normal ferritin (18.1 ± 2.7 µmol/L. Statistically significant negative correlations were reported for serum homocysteine with serum ferritin, vitamin B12, hemoglobin, and hematocrit levels.CONCLUSION: Important associations were found between serum homocysteine and markers of iron deficiency. Monitoring homocysteine levels might be essential to understand the development of different clinical conditions including anemia. It seems necessary to conduct prospective trials to determine whether treating anemia ameliorates homocysteine levels.

Impact Assessment and Multicriteria Decision Analysis of Alternative Managed Aquifer Recharge Strategies Based on Treated Wastewater in Northern Gaza

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Mohammad Azizur Rahman

2014-12-01

Full Text Available For better planning of a managed aquifer recharge (MAR project, the most promising strategies should analyze the environmental impact, socio-economic efficiency, and their contribution to the existing or future water resource conditions in the region. The challenge of such studies is to combine and quantify a wide range of criteria from the environment and society. This necessity leads to an integrated concept and analysis. This paper outlines an integrated approach considering environmental, health, social and economic aspects to support in the decision-making process to implement a managed aquifer recharge project as a potential response to water resource problems. In order to demonstrate the approach in detail, this paper analysed several water resources management strategies based on MAR implementation, by using treated wastewater in the Northern Gaza Strip and the potential impacts of the strategies on groundwater resources, agriculture, environment, health, economy and society. Based on the Palestinian water policy (Year 2005–2025 on wastewater reuse, three MAR strategies were developed in close cooperation with the local decision makers. The strategies were compared with a base line strategy referred to as the so-called “Do Nothing Approach”. The results of the study show that MAR project implementation with treated wastewater at a maximum rate, considered together with sustainable development of groundwater, is the best and most robust strategy amongst those analyzed. The analysis shows the defined MAR strategies contribute to water resources development and environmental protection or improvement including an existing eutrophic lake. The integrated approach used in this paper may be applicable not only to MAR project implementation but also to other water resources and environmental development projects.

A cross sectional study of the relationship between the exposure of pregnant women to military attacks in 2014 in Gaza and the load of heavy metal contaminants in the hair of mothers and newborns.

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Manduca, Paola; Diab, Safwat Y; Qouta, Samir R; Albarqouni, Nabil Ma; Punamaki, Raiija-Leena

2017-08-02

Metal contamination of humans in war areas has rarely been investigated. Weaponry's heavy metals become environmentally stable war remnants and accumulate in living things. They also pose health risks in terms of prenatal intake, with potential long term risks for reproductive and children's health. We studied the contribution of military attacks to the load of 23 metals in the hair of Palestinian women in the Gaza Strip, who were pregnant at the time of the military attacks in 2014, and their newborns. We compared the metal load in the mothers with values for adult hair from outside the war area (RHS) as the reference. We investigated heavy metals trans-passing in utero, and assessed if the heavy metal intake could derive from sources unrelated to the war. Cross sectional study. Cross sectional convenience sample of 502 mothers delivering in the Gaza Strip and their newborns. Measure of the load of heavy metals in mother and newborn hair by inductively coupled plasma-mass spectrometry (ICP-MS). Comparison of metal loads with the reference RHS, between groups with different exposures to attacks and house/agriculture chemicals, and between mothers and newborns. Data for birth registry and for exposures to war and other known risk factors were obtained at interview with the mothers. Photographic documentation of damage from military attacks was obtained. The whole cross sectional convenience sample had a significantly higher load of heavy metals than the reference RHS. Women exposed to military attacks had a significantly higher load of heavy metals than those not exposed; the load in newborns correlated positively with the mothers' load. No significant difference was found between users/non-users of house/agriculture chemicals. No other known confounder was identified. High heavy metal loads in mothers, reflected in those of their newborns, were associated with exposure to military attacks, posing a risk of immediate and long term negative outcomes for pregnancy and

Conflict between Israel and Hamas

Science.gov (United States)

2015-06-12

this plan, war erupted, leading to the free -for-all Arab land grab. The Egyptians usurped Gaza. The Jordanians occupied the West Bank. Then Israel took...102 Yaacov Amidror, “Line in the Sand ,” The BESA Center, February 2, 2015, accessed March 12, 2015, http://besacenter.org/?s=Line+in+the+ Sand . 69...Laub and Fares Akram, “Hamas Consolidates Its Grip on Gaza as Reconstruction Stalls Gaza City,” ABC News, accessed April 28, 2015, http

Do national drug policies influence antiretroviral drug prices? Evidence from the Southern African Development community.

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Liu, Yao; Galárraga, Omar

2017-03-01

The efficacy of low- and middle-income countries’ (LMIC) national drug policies in managing antiretroviral (ARV) pharmaceutical prices is not well understood. Though ARV drug prices have been declining in LMIC over the past decade, little research has been done on the role of their national drug policies. This study aims to (i) analyse global ARV prices from 2004 to 2013 and (ii) examine the relationship of national drug policies to ARV prices. Analysis of ARV drug prices utilized data from the Global Price Reporting Mechanism from the World Health Organization (WHO). Ten of the most common ARV drugs (first-line and second-line) were selected. National drug policies were also assessed for 12 countries in the South African Development Community (SADC), which self-reported their policies through WHO surveys. The best predictor of ARV drug price was generic status—the generic versions of 8 out of 10 ARV drugs were priced lower than branded versions. However, other factors such as transaction volume, HIV prevalence, national drug policies and PEPFAR/CHAI involvement were either not associated with ARV drug price or were not consistent predictors of price across different ARV drugs. In the context of emerging international trade agreements, which aim to strengthen patent protections internationally and potentially delay the sale of generic drugs in LMIC, this study shines a spotlight on the importance of generic drugs in controlling ARV prices. Further research is needed to understand the impact of national drug policies on ARV prices.

Antiretroviral Drug Use in a Cross-Sectional Population Survey in Africa: NIMH Project Accept (HPTN 043).

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Fogel, Jessica M; Clarke, William; Kulich, Michal; Piwowar-Manning, Estelle; Breaud, Autumn; Olson, Matthew T; Marzinke, Mark A; Laeyendecker, Oliver; Fiamma, Agnès; Donnell, Deborah; Mbwambo, Jessie K K; Richter, Linda; Gray, Glenda; Sweat, Michael; Coates, Thomas J; Eshleman, Susan H

2017-02-01

Antiretroviral (ARV) drug treatment benefits the treated individual and can prevent HIV transmission. We assessed ARV drug use in a community-randomized trial that evaluated the impact of behavioral interventions on HIV incidence. Samples were collected in a cross-sectional survey after a 3-year intervention period. ARV drug testing was performed using samples from HIV-infected adults at 4 study sites (Zimbabwe; Tanzania; KwaZulu-Natal and Soweto, South Africa; survey period 2009-2011) using an assay that detects 20 ARV drugs (6 nucleoside/nucleotide reverse transcriptase inhibitors, 3 nonnucleoside reverse transcriptase inhibitors, and 9 protease inhibitors; maraviroc; raltegravir). ARV drugs were detected in 2011 (27.4%) of 7347 samples; 88.1% had 1 nonnucleoside reverse transcriptase inhibitors ± 1-2 nucleoside/nucleotide reverse transcriptase inhibitors. ARV drug detection was associated with sex (women>men), pregnancy, older age (>24 years), and study site (P < 0.0001 for all 4 variables). ARV drugs were also more frequently detected in adults who were widowed (P = 0.006) or unemployed (P = 0.02). ARV drug use was more frequent in intervention versus control communities early in the survey (P = 0.01), with a significant increase in control (P = 0.004) but not in intervention communities during the survey period. In KwaZulu-Natal, a 1% increase in ARV drug use was associated with a 0.14% absolute decrease in HIV incidence (P = 0.018). This study used an objective, biomedical approach to assess ARV drug use on a population level. This analysis identified factors associated with ARV drug use and provided information on ARV drug use over time. ARV drug use was associated with lower HIV incidence at 1 study site.

The effect of prolonged exposure to war-related stress among hospital personnel with different affect types: lessons from the Second Lebanon War and the Gaza "Cast Lead" operation.

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Palgi, Yuval; Ben-Ezra, Menachem; Shrira, Amit

2012-01-01

Two studies examined peritraumatic symptoms due to war-related stress among hospital personnel with different affect types. In Study 1, we examined 80 Israeli hospital personnel during the period they were exposed to frequent missile attacks in the Second Lebanon War. In Study 2, we examined 67 and 74 Israeli hospital personnel during the time they were exposed and were not exposed, respectively, to missile attacks in the Gaza "Cast Lead" operation. In both studies, hospital personnel completed measures of posttraumatic stress disorder symptoms as well as of positive- and negative-affect items (PA and NA, respectively). Exposed personnel with a positive congruent (high PA and low NA) or a deflated incongruent (low PA and low NA) affective types had a lower level of peritraumatic symptoms compared to those with a negative congruent (low PA and high NA) or an inflated incongruent (high PA and NA) affective types. Study 2 further showed that among non-exposed personnel, only personnel with a negative congruent affective type had a higher level of peritraumatic symptoms compared to personnel with other affective types. Clinical implications and required future studies are discussed.

Antiretroviral Drug Use in a Cohort of HIV-Uninfected Women in the United States: HIV Prevention Trials Network 064.

Directory of Open Access Journals (Sweden)

Iris Chen

Full Text Available Antiretroviral (ARV drug use was analyzed in HIV-uninfected women in an observational cohort study conducted in 10 urban and periurban communities in the United States with high rates of poverty and HIV infection. Plasma samples collected in 2009-2010 were tested for the presence of 16 ARV drugs. ARV drugs were detected in samples from 39 (2% of 1,806 participants: 27/181 (15% in Baltimore, MD and 12/179 (7% in Bronx, NY. The ARV drugs detected included different combinations of non-nucleoside reverse transcriptase inhibitors and protease inhibitors (1-4 drugs/sample. These data were analyzed in the context of self-reported data on ARV drug use. None of the 39 women who had ARV drugs detected reported ARV drug use at any study visit. Further research is needed to evaluate ARV drug use by HIV-uninfected individuals.

Juudi sõduri aitas vabadusse sakslaste "härra Hezbollah" / Kadri Veermäe

Index Scriptorium Estoniae

Veermäe, Kadri

2011-01-01

Iisrael sõlmis Gaza sektorit kontrolliva rühmitusega Hamas leppe, mille raames Iisrael vabastab 1000 Palestiina vangi kui Hamas vabastab 2006. aastal Gaza mässuliste poolt vangistatud Gilad Shaliti. Noore miinipilduri pikaajaline vangistus

Global strategies to reduce the price of antiretroviral medicines: evidence from transactional databases.

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Waning, Brenda; Kaplan, Warren; King, Alexis C; Lawrence, Danielle A; Leufkens, Hubert G; Fox, Matthew P

2009-07-01

To estimate the impact of global strategies, such as pooled procurement arrangements, third-party price negotiation and differential pricing, on reducing the price of antiretrovirals (ARVs), which currently hinders universal access to HIV/AIDS treatment. We estimated the impact of global strategies to reduce ARV prices using data on 7253 procurement transactions (July 2002-October 2007) from databases hosted by WHO and the Global Fund to Fight AIDS, Tuberculosis and Malaria. For 19 of 24 ARV dosage forms, we detected no association between price and volume purchased. For the other five ARVs, high-volume purchases were 4-21% less expensive than medium- or low-volume purchases. Nine of 13 generic ARVs were priced 6-36% lower when purchased under the Clinton Foundation HIV/AIDS Initiative (CHAI). Fifteen of 18 branded ARVs were priced 23-498% higher for differentially priced purchases compared with non-CHAI generic purchases. However, two branded, differentially priced ARVs were priced 63% and 73% lower, respectively, than generic non-CHAI equivalents. Large purchase volumes did not necessarily result in lower ARV prices. Although current plans for pooled procurement will further increase purchase volumes, savings are uncertain and should be balanced against programmatic costs. Third-party negotiation by CHAI resulted in lower generic ARV prices. Generics were less expensive than differentially priced branded ARVs, except where little generic competition exists. Alternative strategies for reducing ARV prices, such as streamlining financial management systems, improving demand forecasting and removing barriers to generics, should be explored.

Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip.

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Caniato, M; Tudor, T; Vaccari, M

2015-01-01

The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology, which involved a large number of stakeholders. Such an approach served to raise interest and awareness at different levels (public authorities, health providers, supporting actors, others), stimulate the discussion about the adoption of specific policies, and identify the effective way forward. Copyright © 2014 Elsevier Ltd. All rights reserved.

Iisraeli blokaadist nördinud gazalased tungisid Egiptusesse / Hendrik Vosman

Index Scriptorium Estoniae

Vosman, Hendrik

2008-01-01

Iisrael lõpetas piiriületuse Gazaga karistuseks äärmusliku Hamasi rühmituse kontrollitud piirkonnast Iisraeli vastu suunatud raketi- ja suurtükitulele, mistõttu murdsid kümned tuhanded Gaza elanikud Egiptusesse. Kaart: Gaza maakitsus. Lisa: Kahe riigi vahel

Iisraeli väeüksused tungisid Gazasse palestiinlaste aladele / Liise Lehtsalu

Index Scriptorium Estoniae

Lehtsalu, Liise

2006-01-01

Iisraeli vägede rünnakust Gaza palestiinlaste aladele eesmärgiga vabastada Palestiina äärmusrühmituse poolt röövitud Iisraeli sõdur. Sissetungi ajendiks oli Palestiina rühmituste rünnak Iisraeli piiripunktile Gaza lõunaosas

A lifeline to treatment: the role of Indian generic manufacturers in supplying antiretroviral medicines to developing countries.

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Waning, Brenda; Diedrichsen, Ellen; Moon, Suerie

2010-09-14

Indian manufacturers of generic antiretroviral (ARV) medicines facilitated the rapid scale up of HIV/AIDS treatment in developing countries though provision of low-priced, quality-assured medicines. The legal framework in India that facilitated such production, however, is changing with implementation of the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights, and intellectual property measures being discussed in regional and bilateral free trade agreement negotiations. Reliable quantitative estimates of the Indian role in generic global ARV supply are needed to understand potential impacts of such measures on HIV/AIDS treatment in developing countries. We utilized transactional data containing 17,646 donor-funded purchases of ARV tablets made by 115 low- and middle-income countries from 2003 to 2008 to measure market share, purchase trends and prices of Indian-produced generic ARVs compared with those of non-Indian generic and brand ARVs. Indian generic manufacturers dominate the ARV market, accounting for more than 80% of annual purchase volumes. Among paediatric ARV and adult nucleoside and non-nucleoside reverse transcriptase inhibitor markets, Indian-produced generics accounted for 91% and 89% of 2008 global purchase volumes, respectively. From 2003 to 2008, the number of Indian generic manufactures supplying ARVs increased from four to 10 while the number of Indian-manufactured generic products increased from 14 to 53. Ninety-six of 100 countries purchased Indian generic ARVs in 2008, including high HIV-burden sub-Saharan African countries. Indian-produced generic ARVs used in first-line regimens were consistently and considerably less expensive than non-Indian generic and innovator ARVs. Key ARVs newly recommended by the World Health Organization are three to four times more expensive than older regimens. Indian generic producers supply the majority of ARVs in developing countries. Future scale up using newly

Pemaknaan Obat Antiretroviral bagi Sekelompok Orang dengan HIV–AIDS di Kota Bandung, Cimahi, Denpasar dan Kabupaten Badung (The Meaning of Antiretroviral for People Living with HIV–AIDS in Bandung, Cimahi, Denpasar, and Badung Districts

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Rini Sasanti Handayani

2014-04-01

Full Text Available Background: Antiretroviral (ARV is the drug to reduce varemia and enhances CD4+ level. ARV cannot cure HIVAIDSbut it increases the life expectancy of people living with HIV-AIDS (PLHA. ARV is a lifetime treatment that needs ahigh adherence. The meaning of ARV which vulnerable to low adherence is related to stigma and discrimination. It is alsorelated to the changing of life pattern in which taking ARV is considered as a burden. This research suggests the needto include the meaning of ARV for a successful therapy. Because using ARV for a long time can make PLHAs feel boringand sometimes they drop out the treatment. Method: The research was conducted in Bandung, Cimahi, Denpasar andBadung districts in 2011. The subjects were 17 PLHAs consist of 9 females and 8 males, aged 20-42 years. Data werecollected by doing in depth interview which then analyzed with content analysis method. Results: The meanings of ARVwhich give positive impact on adherence including the function of ARV that not merely as medical stuff but also have thefunction related to psychological or spiritual meaning (miracle; the changing on life pattern (consider as a habit; and thehope for life (the second chance Recommendations: The study recommends to include the meaning of ARV related to the function on spiritual/psychological matter, the changing on life pattern and the hope for life other than just give councellingon medical function of ARVs and handling side effects.

Shared War reality effects on the professional quality of life of mental health professionals.

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Pruginin, Itay; Segal-Engelchin, Dorit; Isralowitz, Richard; Reznik, Alexander

2016-01-01

To date, studies on the outcomes of a shared war reality among mental health professionals (MHPs) in southern Israel have focused only on those residing and working in Otef Gaza. The aim of this study is to determine the impact of different exposure levels to shared trauma on the professional quality of life of MHPs in southern Israel. This study compares the level of secondary traumatic stress, burnout, and compassion satisfaction of social workers from Otef Gaza to social workers living and working in the Beer-Sheva area who experience occasional missile attacks. The Professional Quality of Life Scale was used to examine the level of secondary traumatic stress, burnout, and compassion satisfaction of 125 social workers living and working in the Negev: 72 from Beer-Sheva and 53 from the regional councils of Otef Gaza. No statistically significant differences were found in the three professional quality of life variables between the Otef-Gaza and Beer-Sheva groups. The lack of secondary traumatic stress and burnout differences between the study groups, despite the chronic exposure to terror attacks among the Otef Gaza social workers, may be explained by the strong sense of belonging and support evidenced by many Otef Gaza residents as well as by the comprehensive trauma training MHPs receive for work in the region. The results of this study are important for health policy geared to trauma prevention efforts, moderating the effects of work under shared war reality, and promoting the professional quality of life of MHPs in conflict areas.

Designing equitable antiretroviral allocation strategies in resource-constrained countries.

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David P Wilson

2005-02-01

Full Text Available Recently, a global commitment has been made to expand access to antiretrovirals (ARVs in the developing world. However, in many resource-constrained countries the number of individuals infected with HIV in need of treatment will far exceed the supply of ARVs, and only a limited number of health-care facilities (HCFs will be available for ARV distribution. Deciding how to allocate the limited supply of ARVs among HCFs will be extremely difficult. Resource allocation decisions can be made on the basis of many epidemiological, ethical, or preferential treatment priority criteria.Here we use operations research techniques, and we show how to determine the optimal strategy for allocating ARVs among HCFs in order to satisfy the equitable criterion that each individual infected with HIV has an equal chance of receiving ARVs. We present a novel spatial mathematical model that includes heterogeneity in treatment accessibility. We show how to use our theoretical framework, in conjunction with an equity objective function, to determine an optimal equitable allocation strategy (OEAS for ARVs in resource-constrained regions. Our equity objective function enables us to apply the egalitarian principle of equity with respect to access to health care. We use data from the detailed ARV rollout plan designed by the government of South Africa to determine an OEAS for the province of KwaZulu-Natal. We determine the OEAS for KwaZulu-Natal, and we then compare this OEAS with two other ARV allocation strategies: (i allocating ARVs only to Durban (the largest urban city in KwaZulu-Natal province and (ii allocating ARVs equally to all available HCFs. In addition, we compare the OEAS to the current allocation plan of the South African government (which is based upon allocating ARVs to 17 HCFs. We show that our OEAS significantly improves equity in treatment accessibility in comparison with these three ARV allocation strategies. We also quantify how the size of the

Sõjaraport õõnestab ÜRO usaldusväärsust / Jürgen Tamme

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Tamme, Jürgen

2011-01-01

ÜRO Gaza sõda puudutavas raportis kritiseeritakse nii Iisraeli kui ka Palestiina islamistlikku äärmusrühmitust Hamas. ÜRO inimõiguste uurija Richard Goldstone leiab, et raport on siiski puudulik, kuna praegu omab ÜRO juba rohkem infot Gaza sõja kohta

Отчёт о войне в Газе подрывает доверие к ООН

Index Scriptorium Estoniae

2011-01-01

ÜRO Gaza sõda puudutavas raportis kritiseeritakse nii Iisraeli kui ka Palestiina islamistlikku äärmusrühmitust Hamas. ÜRO inimõiguste uurija Richard Goldstone leiab, et raport on siiski puudulik, kuna praegu omab ÜRO juba rohkem infot Gaza sõja kohta

Analytical Validation and Clinical Qualification of a New Immunohistochemical Assay for Androgen Receptor Splice Variant-7 Protein Expression in Metastatic Castration-resistant Prostate Cancer.

Science.gov (United States)

Welti, Jonathan; Rodrigues, Daniel Nava; Sharp, Adam; Sun, Shihua; Lorente, David; Riisnaes, Ruth; Figueiredo, Ines; Zafeiriou, Zafeiris; Rescigno, Pasquale; de Bono, Johann S; Plymate, Stephen R

2016-10-01

The androgen receptor splice variant-7 (AR-V7) has been implicated in the development of castration-resistant prostate cancer (CRPC) and resistance to abiraterone and enzalutamide. To develop a validated assay for detection of AR-V7 protein in tumour tissue and determine its expression and clinical significance as patients progress from hormone-sensitive prostate cancer (HSPC) to CRPC. Following monoclonal antibody generation and validation, we retrospectively identified patients who had HSPC and CRPC tissue available for AR-V7 immunohistochemical (IHC) analysis. Nuclear AR-V7 expression was determined using IHC H score (HS) data. The change in nuclear AR-V7 expression from HSPC to CRPC and the association between nuclear AR-V7 expression and overall survival (OS) was determined. Nuclear AR-V7 expression was significantly lower in HSPC (median HS 50, interquartile range [IQR] 17.5-90) compared to CRPC (HS 135, IQR 80-157.5; pprostate cancer. A higher level of AR-V7 identifies a group of patients who respond less well to certain prostate cancer treatments and live for a shorter period of time. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

HEALTH BELIEF MODEL DAN KAITANNYA DENGAN KETIDAKPATUHAN TERAPI ANTIRETEROVIRAL PADA ORANG DENGAN HIV/AIDS

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Abdul Kharis Sisyahid

2017-01-01

Full Text Available Antiretroviral (ARV therapy for people living with HIV/AIDS (PLHIV may reduce mortality and improve the quality of life among them. Non-adherence of HIV/AIDS patients in ARV therapy may lead to cease of therapy, increase risk of death, complicate evaluation of ARV services, and increase the risk of ARV resistance if they wish to start over. This study aimed to determine the factors that cause non-adherence to ARV therapy among PLHIV in Pemalang Regency. The research used qualitative method with case study approach. Data collection was conducted through in-depth interviews, observations, and documentation to 6 HIV/ AIDS patients who were listed as non-adherence patient in ARV therapy. Data analysis was done descriptively with triangulation method and data analysis. Results revealed that the factors that cause non-adherence to ARV therapy among PLHIV were lack of vulnerability perception to illness in the future, lack of illness perception among informants about the severity of illness, lack of benefit perception perceived by most informants, and barrier perception of side effects, lack of facilities to access ARV, and pudency that their HIV-positive status was known by others.

ANALYSIS OF UNEMPLOYMENT CHALLENGES IN PALESTINE BETWEEN 2000 AND 2015

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Ahmed SALAMA

2017-12-01

Full Text Available This paper discusses the challenges of unemployment in Palestine between 2000 and 2015. The study aims to understand the trends and sources of unemployment in Palestine. Using the Palestinian Central Bureau of Statistics (PCBS data, trend analysis was used to understand the trends of unemployment in both parts of Palestine (West Bank and Gaza Strip between 2000 and 2015. The Results showed that there is a downward trend in the unemployment rate in West Bank and an upward trend appears on the unemployment rate in Gaza Strip. The constraints during the second Intifada and the Siege on Gaza Strip are the main factors that affected on unemployment between 2000 and 2015. The economic growth difference in both parts of Palestine (West Bank and Gaza Strip can be one of the reasons that affecting on unemployment besides the other reasons. Some solutions are introduced for unemployment challenge in Palestine beside the solution of lack of independence issue.

Quantification de la Charge Virale et tests de résistance du VIH-1 aux ARV à partir d’échantillons DBS (Dried Blood Spots chez des patients Guinéens sous traitement antirétroviral

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Nestor Bangoura

2015-06-01

Full Text Available Problématique: Comme dans plusieurs pays du Sud, le suivi virologique des patients sous traitement antirétroviral (TARV en Guinée est timide voire inexistant dans certaines localités. Le but de cette étude était d’évaluer la faisabilité technique et logistique de l’utilisation des DBS dans les tests de charge virale (CV et de génotypage. Méthode: De septembre à octobre 2010, les DBS ont été préparés à partir de prélèvements sanguins de patients adultes sous TARV. Le délai d’envoi des échantillons au laboratoire de référence était de 30 jours maximum après le prélèvement et se faisait à température ambiante. La CV a été quantifiée et les échantillons de patients en échec virologique (CV ≥ 3 log10 copies/mL ont été génotypés selon le protocole de l’ANRS. L’algorithme de Stanford version 6.0.8 a été utilisé pour l’analyse et l’interprétation des mutations de résistance. Résultats: Parmi les 136 patients inclus, 129 et 7 étaient respectivement sous première et deuxième ligne de traitement avec une médiane de suivi de 35 mois [IQR: 6-108]. L’échec virologique a été noté chez 33 patients. Parmi eux, 84.8% (n = 28/33 ont bénéficié d’ungénotypage. Le taux de résistance global était de 14% (n = 19/136. Le CRF02_AG était le sous type viral le plus prévalent (82%; n = 23. Conclusion: En plus de montrer la faisabilité technique et logistique des tests de CV et de génotypage à partir des DBS, ces résultats montrent l’intérêt de leurs utilisations dans le suivi virologique des patients sous TARV. Cette étude a permis également de documenter l’échec virologique, la résistance aux ARV et la diversité génétique du VIH-1 en Guinée. Mots clés: VIH-1, Résistance aux ARV, DBS (Dried Blood Spots, Guinée Conakry, Génotypage,Charge Virale.   Quantification of Viral load and resistance tests of HIV-1 to ARVs from dried blood spotssamples in Guinean patients undergoing

Mobile phone use for a social strategy to improve antiretroviral refill experience at a low-resource HIV clinic: patient responses from Nigeria.

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Adetunji, Adedotun A; Muyibi, Sufiyan A; Imhansoloeva, Martins; Ibraheem, Olusola M; Sunmola, Adegbenga; Kolawole, Olubunmi O; Akinrinsola, Oluwasina O; Ojo-Osagie, James O; Mosuro, Olusola A; Abiolu, Josephine O; Irabor, Achiaka E; Okonkwo, Prosper; Adewole, Isaac F; Taiwo, Babafemi O

2017-05-01

In sub-Saharan African areas where antiretroviral (ARV) drugs are not available through community pharmacies, clinic-based pharmacies are often the primary source of ARV drug refills. Social pressure is mounting on treatment providers to adjust ARV refill services towards user-friendly approaches which prioritize patients' convenience and engage their resourcefulness. By this demand, patients may be signalling dissatisfaction with the current provider-led model of monthly visits to facility-based pharmacies for ARV refill. Mobile phones are increasingly popular in sub-Saharan Africa, and have been used to support ARV treatment goals in this setting. A patient-centred response to on-going social pressure requires treatment providers to view ARV refill activities through the eyes of patients who are negotiating the challenges of day-to-day life while contemplating their next refill appointment. Using focus groups of five categories of adult patients receiving combination ARV therapy, we conducted this cross-sectional qualitative study to provide insight into modifiable gaps between patients' expectations and experiences of the use of mobile phones in facility-based ARV refill service at a public HIV clinic in Nigeria. A notable finding was patients' preference for harnessing informal social support (through intermediaries with mobile phones) to maintain adherence to ARV refill appointments when they could not present in person. This evolving social support strategy also has the potential to enhance defaulter tracking. Our study findings may inform the development of ARV refill strategies and the design of future qualitative studies on client-provider communication by mobile phones in under-resourced HIV treatment programmes.

Concurrent use of Antiretroviral and African traditional medicines amongst people living with HIV/AIDS (PLWA) in the eThekwini Metropolitan area of KwaZulu Natal.

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Mncengeli, Sibanda; Manimbulu, Nlooto M; Panjasaram, Naidoo

2016-12-01

People living with HIV/AIDS (PLWA) often use African Traditional Medicines (ATM) either alone or in combination with Western medicines including Antiretrovirals (ARV). To explore the prevalence of concurrent Antiretrovirals (ARV) and African Traditional medicines (ATM) use and determine the effects of any concurrent use on the CD4+ Lymphocyte count and Viral Load (VL) of PLWA in the eThekwini Metropolitan area. A descriptive and exploratory study was carried out on 360 patients. Information was gathered on patients socioeconomic characteristics, ATM usage, outcome measures of HIV disease progression (CD4+ Count, VL). The data was analysed using descriptive statistics, univariate and multivariate analyses. 4.98% (14/281) of the patients used ATM and ARV concurrently during the study period. Over 65% (185/281) reported ATM use before diagnosis with HIV whilst 77.6% (218/281) reported previous ATM use after their HIV diagnosis but before initiation with ARV. Place of residence (p=0.004), age (p<0.001) and education level (P=0.041) were found to be significantly and positively correlated with ATM use. There were no statistically significant changes in mean plasma CD4+ Count and inconclusive effects on VL during the period of the study in the group taking ARV alone when compared with the group using ARV and ATM concomitantly. Concurrent ARV and ATM use is quite low (4.98%) when compared to ATM use before HIV diagnosis and after HIV diagnosis but before initiation with ARV. This may point to efficient pre-counselling efforts before ARV initiation by health care professionals. This study also demonstrated that there were no significant differences in the CD4+ and inconclusive effects on VL, between patients taking both ARV and ATM concomitantly and those using ARV alone.

Factors influencing global antiretroviral procurement prices.

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Wirtz, Veronika J; Forsythe, Steven; Valencia-Mendoza, Atanacio; Bautista-Arredondo, Sergio

2009-11-18

Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs. An ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs. Three key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief. One of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful tool to achieve this.

Targeting AR Variant-Coactivator Interactions to Exploit Prostate Cancer Vulnerabilities.

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Magani, Fiorella; Peacock, Stephanie O; Rice, Meghan A; Martinez, Maria J; Greene, Ann M; Magani, Pablo S; Lyles, Rolando; Weitz, Jonathan R; Burnstein, Kerry L

2017-11-01

Castration-resistant prostate cancer (CRPC) progresses rapidly and is incurable. Constitutively active androgen receptor splice variants (AR-Vs) represent a well-established mechanism of therapeutic resistance and disease progression. These variants lack the AR ligand-binding domain and, as such, are not inhibited by androgen deprivation therapy (ADT), which is the standard systemic approach for advanced prostate cancer. Signaling by AR-Vs, including the clinically relevant AR-V7, is augmented by Vav3, an established AR coactivator in CRPC. Using mutational and biochemical studies, we demonstrated that the Vav3 Diffuse B-cell lymphoma homology (DH) domain interacted with the N-terminal region of AR-V7 (and full length AR). Expression of the Vav3 DH domain disrupted Vav3 interaction with and enhancement of AR-V7 activity. The Vav3 DH domain also disrupted AR-V7 interaction with other AR coactivators: Src1 and Vav2, which are overexpressed in PC. This Vav3 domain was used in proof-of-concept studies to evaluate the effects of disrupting the interaction between AR-V7 and its coactivators on CRPC cells. This disruption decreased CRPC cell proliferation and anchorage-independent growth, caused increased apoptosis, decreased migration, and resulted in the acquisition of morphological changes associated with a less aggressive phenotype. While disrupting the interaction between FL-AR and its coactivators decreased N-C terminal interaction, disrupting the interaction of AR-V7 with its coactivators decreased AR-V7 nuclear levels. Implications: This study demonstrates the potential therapeutic utility of inhibiting constitutively active AR-V signaling by disrupting coactivator binding. Such an approach is significant, as AR-Vs are emerging as important drivers of CRPC that are particularly recalcitrant to current therapies. Mol Cancer Res; 15(11); 1469-80. ©2017 AACR . ©2017 American Association for Cancer Research.

Presence of Apis Rhabdovirus-1 in Populations of Pollinators and Their Parasites from Two Continents.

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Levin, Sofia; Galbraith, David; Sela, Noa; Erez, Tal; Grozinger, Christina M; Chejanovsky, Nor

2017-01-01

The viral ecology of bee communities is complex, where viruses are readily shared among co-foraging bee species. Additionally, in honey bees ( Apis mellifera ), many viruses are transmitted - and their impacts exacerbated - by the parasitic Varroa destructor mite. Thus far, the viruses found to be shared across bee species and transmitted by V. destructor mites are positive-sense single-stranded RNA viruses. Recently, a negative-sense RNA enveloped virus, Apis rhabdovirus-1 (ARV-1), was found in A. mellifera honey bees in Africa, Europe, and islands in the Pacific. Here, we describe the identification - using a metagenomics approach - of ARV-1 in two bee species ( A. mellifera and Bombus impatiens ) and in V. destructor mites from populations collected in the United States and Israel. We confirmed the presence of ARV-1 in pools of A. mellifera , B. impatiens , and V. destructor from Israeli and U.S. populations by RT-PCR and found that it can reach high titers in individual honey bees and mites (10 7 -10 8 viral genomic copies per individual). To estimate the prevalence of ARV-1 in honey bee populations, we screened 104 honey bee colonies across Israel, with 21 testing ARV-1-positive. Tagged-primer-mediated RT-PCR analysis detected the presence of the positive-sense ARV-1 RNA in A. mellifera and V. destructor , indicating that ARV-1 replicates in both hosts. This is the first report of the presence of ARV-1 in B. impatiens and of the replication of a rhabdovirus in A. mellifera and V. destructor . Our data suggest that Varroa mites could act as an ARV-1 vector; however, the presence of ARV-1 in B. impatiens (which are not parasitized by Varroa ) suggests that it may not require the mite for transmission and ARV-1 may be shared among co-foraging bee species. Given that ARV-1 is found in non-Apis bee species, and because "ARV" is used for the Adelaide River virus, we propose that this virus should be called bee rhabdovirus 1 and abbreviated BRV-1. These results

What kind of state deserves to exist?

NARCIS (Netherlands)

Reinhart, T.

2004-01-01

Amidst the political storm in Israel regarding the "Gaza disengagement" plan, only one really meaningful fact emerges: Sharon received Bush's approval to proceed with his plan for the wall in the West Bank. With regard to the Gaza strip, the disengagement plan published in the Israeli papers on

Far East Asia | Page 76 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Far East Asia. Extrême-Orient. Read more about Renforcement d'un cadre favorable à l'entrepreneuriat en Cisjordanie et à Gaza. Language French. Read more about Enhancing the Framework for Entrepreneurship in the West Bank and Gaza. Language English. Read more about Mekong Economic Research Network ...

Treatment seeking for posttraumatic stress in Israel Defense Forces veterans deployed in the Second Lebanon War (2006) and "Operation Cast Lead" in the Gaza Strip (2009): a comparative study.

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Levi, Ofir; Lubin, Gadi

2018-05-01

The goal of the study was to determine the long-term prevalence of combat-related treatment seeking and posttraumatic stress disorder (PTSD) in Israel's veterans deployed to the Second Lebanon War (2006) and "Operation Cast Lead" in the Gaza Strip (2009). The prevalence of treatment seeking and DSM-IV-TR diagnoses among Israel Defense Force (IDF) veterans was assessed using seven and five year's surveillance and records. The whereabouts and combat exposure of veterans during the war was determined based on the IDF's Operations Directorate records. Overall prevalence of treatment seeking was 1.32% and 0.38% in the Second Lebanon War and "Operation Cast Lead", respectively. The prevalence of treatment-seeking veterans from the Second Lebanon War and in "Operation Cast Lead" was significantly higher in soldiers deployed to high combat-exposure zones (2.19% and 3.1%, respectively), relative to low combat-exposure zones (0.24% and 0.06%, respectively), and relative to soldiers deployed elsewhere (0.26% and 0.02%, respectively). PTSD prevalence was similar among treatment-seeking veterans deployed in high combat-exposure zones in both combats. There is a gap of anywhere between 3% and 11% between treatment seeking by IDF veterans following war deployment and the actual prevalence of PTSD in this soldier population.

The occurrence of Orthoreovirus, Rotavirus and chicken anemia virus in chickens of the poultry industry in Minas Gerais, Brazil

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R.L. Rios

2012-12-01

Full Text Available Fifty-four fecal samples taken from broiler chickens from 1 to 45 days of age, and of pullets from 10 to 13 weeks of age, original from eight different poultry regions in the state of Minas Gerais, Brazil, were collected from March 2008 to January 2010 for avian Orthoreovirus (ARV and avian Rotavirus (AvRV analyses. For the assay of ARV, RNA was immediately extracted (Trizolâ and transcribed into cDNA for assaying in a nested-PCR with ARV-specific primers. For AvRV, polyacrylamide gel electrophoresis (PAGE was performed with RNA extracts obtained by phenol-chloroform extraction. CAV was additionally investigated through a nested-PCR of thymus and spleen. Results found 5.55% positive for ARV and 9.25% for AvRV. Also, CAV and ARV genomes were detected in co-infection, in a highly prostrated and claudicating chicken flock. No ARV or AvRV infections were detected in pullets. Material of a clinically affected flock was inoculated into SPF embryos, resulting in embryonic hemorrhage, whitish foci in the chorio-allantoic membrane and death. Sequencing of ARV amplicons and isolate cDNA grouped local strains with the ARV S1133 strain, historically used in live vaccines, suggesting the continued circulation of this vaccine virus strain in intensive poultry regions. Detection rates for ARV and AvRV, as well as the presence of CAV, were additionally indicative of failing biosecurity strategies for the intensive poultry regions examined.

Clinical manifestations and treatment outcomes in HIV-1-infected children receiving antiretroviral therapy in Karachi, Pakistan.

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Mir, Fatima; Qamar, Farah Naz; Baig-Ansari, Naila; Abro, Azra Ghayas; Abbas, Syed Qamar; Kazi, Mohammed Ahmed; Rizvi, Arjumand; Zaidi, Anita Kaniz Mehdi

2014-04-15

The impact of antiretroviral (ARV) therapy on immunological and growth parameters in HIV-positive children in Pakistan has not been reported to date. A retrospective chart review of children diagnosed with HIV at the Sindh AIDS Control Proigramme (SACP) and registered at the Aga Khan University, Karachi, between January 2005 and 2013 was conducted, evaluating clinical and laboratory profiles of HIV+ ARV+ children for ARV impact (serial height and weight CD4 and viral counts). Twenty-four children were diagnosed and registered as HIV positive over five years, and 20 were started on ARV. Six were excluded from analysis (ARV duration treatment failure at a median duration of 25 weeks (IQR 18-32) on ARV and underwent resistance genotyping. All nine had NNRTI resistance, two had high-grade NRTI resistance (≥ 4 thymidine analog mutations). Median age at start of ARV was 71.5 weeks (IQR 37.5-119). Median baseline weight for age (WAZ) and height for age (HAZ) z-scores changed from -1.94 to 1.69 and -1.99 to -1.59, respectively, after six months of therapy. Median CD4 percentage and viral load at baseline changed from 13.8 to 17.8, while viral load changed from 285 × 104 copies to zero at six months. ARV improved absolute CD4 and viral counts. Weight and height did not  improve significantly, highlighting the need for aggressive nutritional rehabilitation. Early development of ARV resistance in these children requires formal assessment.

Time to viral load suppression in antiretroviral-naive and -experienced HIV-infected pregnant women on highly active antiretroviral therapy: implications for pregnant women presenting late in gestation.

Science.gov (United States)

Aziz, N; Sokoloff, A; Kornak, J; Leva, N V; Mendiola, M L; Levison, J; Feakins, C; Shannon, M; Cohan, D

2013-11-01

To compare time to achieve viral load HIV-infected antiretroviral (ARV) -naive versus ARV-experienced pregnant women on highly active antiretroviral therapy (HAART). Retrospective cohort study. Three university medical centers, USA. HIV-infected pregnant women initiated or restarted on HAART during pregnancy. We calculated time to viral load HIV-infected pregnant women on HAART who reported at least 50% adherence, stratifying based on previous ARV exposure history. Time to HIV viral load HIV-infected pregnant women, comprising 76 ARV-naive and 62 ARV-experienced. Ninety-three percent of ARV-naive women achieved a viral load HIV log10 viral load was associated with a later time of achieving viral load HIV log10 viral load was associated with a longer time of achieving viral load Pregnant women with ≥50% adherence, whether ARV-naive or ARV-experienced, on average achieve a viral load HIV log10 viral load were all statistically significant predictors of earlier time to achieve viral load <400 copies/ml and <1000 copies/ml. Increased CD4 count was statistically significant as a predictor of earlier time to achieve viral load <1000 copies/ml. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

Kümnendik Euroopa pankadest kadunud / Lembo Tanning

Index Scriptorium Estoniae

Tanning, Lembo

2000-01-01

EL-15-riikides on pankade arv ajavahemikus 1994 kuni 1997 vähenenud 10%, kuid samal ajal on krediidiinstitutsioonide kohalike allüksuste arv kasvanud 8% ja teenistujate arv jäänud suhteliselt muutumatuks. Tabel: ülevaade Eesti pangandusmaastikust

The PHACS SMARTT Study: Assessment of the Safety of In Utero Exposure to Antiretroviral Drugs

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Russell Barrett Van Dyke

2016-05-01

Full Text Available The Surveillance Monitoring for ART Toxicities (SMARTT cohort of the Pediatric HIV/AIDS Cohort Study (PHACS includes over 3500 HIV-exposed but uninfected (HEU infants and children at 22 sites in the U.S. including Puerto Rico. The goal of the study is to determine the safety of in utero exposure to antiretrovirals (ARV and to estimate the incidence of adverse events. Domains being assessed include metabolic, growth and development, cardiac, neurological, neurodevelopmental, behavior, language, and hearing. SMARTT employs an innovative trigger-based design as an efficient means to identify and evaluate adverse events. Participants who met a predefined clinical or laboratory threshold (trigger undergo additional evaluations to define their case status. After adjusting for birth cohort and other factors, there was no significant increase in the likelihood of meeting overall case status (case in any domain with exposure to combination ARVs (cARV, any ARV class, or any specific ARV. However, several individual ARVs were significantly associated with case status in individual domains, including zidovudine for a metabolic case, first trimester stavudine for a language case, and didanosine plus stavudine for a neurodevelopmental case. We found an increased rate of preterm birth with first trimester exposure to protease inhibitor-based cARV. Although there was no overall increase in congenital anomalies with first trimester cARV, a significant increase was seen with exposure to atazanavir, ritonavir, and didanosine plus stavudine. Tenofovir exposure was associated with significantly lower mean whole-body bone mineral content in the newborn period and a lower length and head circumference at 1 year of age. With neurodevelopmental testing at 1 year of age, specific ARVs (atazanavir, ritonavir-boosted lopinavir, nelfinavir, and tenofovir were associated with lower performance, although all groups were within the normal range. No ARVs or classes were

Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip

International Nuclear Information System (INIS)

Caniato, M.; Tudor, T.; Vaccari, M.

2015-01-01

Highlights: • We systematically review scientific literature about health-care waste management. • We identify and discuss gaps, trends, efforts, and key-factors. • We suggest areas for improvement and best practices reported in literature. • We include recommendations for policy makers, practitioners and researchers. • We promote a holistic and harmonized approach to health-care waste management. - Abstract: The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology

Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip

Energy Technology Data Exchange (ETDEWEB)

Caniato, M., E-mail: marcocaniato@gmail.com [Research Centre on Appropriate Technologies for Environmental Management in Developing Countries (CeTAmb), University of Brescia, Brescia (Italy); Tudor, T. [Centre for Sustainable Waste Management, School of Science and Technology, University of Northampton, Northampton (United Kingdom); Vaccari, M. [Research Centre on Appropriate Technologies for Environmental Management in Developing Countries (CeTAmb), University of Brescia, Brescia (Italy)

2015-01-15

Highlights: • We systematically review scientific literature about health-care waste management. • We identify and discuss gaps, trends, efforts, and key-factors. • We suggest areas for improvement and best practices reported in literature. • We include recommendations for policy makers, practitioners and researchers. • We promote a holistic and harmonized approach to health-care waste management. - Abstract: The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology

Individual and contextual factors of influence on adherence to antiretrovirals among people attending public clinics in Rio de Janeiro, Brazil

Science.gov (United States)

2013-01-01

Background There are inconsistencies in the determinants of adherence to antiretrovirals (ARVs) across settings as well as a lack of studies that take into consideration factors beyond the individual level. This makes it necessary to examine factors holistically in multiple settings and populations while taking into consideration the particularities of each context, in order to understand the patterns of ARV adherence. This research explored ARV adherence and individual, relational and environmental-structural factors. Methods A cross-sectional survey was conducted from August 2008 through July 2009 among participants currently on ARVs recruited from 6 public health clinics, selected to maximize diversity in terms of caseload and location, representing the range of clinics within Rio de Janeiro city, Brazil. Multivariate logistic regression analysis was used to assess the association between our multilevel factors with ARV adherence among participants with complete cases (n = 632). Results Eighty-four percent of respondents reported adherence to all of their ARV doses in the last 4 days. Of the socio-demographic variables, those who had one child were positively associated with adherence (AOR 2.29 CI [1.33-3.94]). On the relational level, those with high social support (AOR 2.85 CI [1.50-5.41]) were positively associated with adherence to ARVs. On the environmental-structural level, we found gender was significant with women negatively associated with adherence to ARVs (AOR 0.58 CI [0.38-0.88]) while those with a high asset index (AOR 2.47 CI [1.79-3.40]) were positively associated with adherence to ARVs. Conclusions This research highlights the importance of examining the multiple levels of influence on ARV adherence. Intervention research in lower and middle-income settings should address and evaluate the impact of attending to both gender and economic inequalities to improve ARV adherence, as well as relational areas such as the provision of social support. PMID

Comprehensive Profiling of the Androgen Receptor in Liquid Biopsies from Castration-resistant Prostate Cancer Reveals Novel Intra-AR Structural Variation and Splice Variant Expression Patterns.

Science.gov (United States)

De Laere, Bram; van Dam, Pieter-Jan; Whitington, Tom; Mayrhofer, Markus; Diaz, Emanuela Henao; Van den Eynden, Gert; Vandebroek, Jean; Del-Favero, Jurgen; Van Laere, Steven; Dirix, Luc; Grönberg, Henrik; Lindberg, Johan

2017-08-01

Expression of the androgen receptor splice variant 7 (AR-V7) is associated with poor response to second-line endocrine therapy in castration-resistant prostate cancer (CRPC). However, a large fraction of nonresponding patients are AR-V7-negative. To investigate if a comprehensive liquid biopsy-based AR profile may improve patient stratification in the context of second-line endocrine therapy. Peripheral blood was collected from patients with CRPC (n=30) before initiation of a new line of systemic therapy. We performed profiling of circulating tumour DNA via low-pass whole-genome sequencing and targeted sequencing of the entire AR gene, including introns. Targeted RNA sequencing was performed on enriched circulating tumour cell fractions to assess the expression levels of seven AR splice variants (ARVs). Somatic AR variations, including copy-number alterations, structural variations, and point mutations, were combined with ARV expression patterns and correlated to clinicopathologic parameters. Collectively, any AR perturbation, including ARV, was detected in 25/30 patients. Surprisingly, intra-AR structural variation was present in 15/30 patients, of whom 14 expressed ARVs. The majority of ARV-positive patients expressed multiple ARVs, with AR-V3 the most abundantly expressed. The presence of any ARV was associated with progression-free survival after second-line endocrine treatment (hazard ratio 4.53, 95% confidence interval 1.424-14.41; p=0.0105). Six out of 17 poor responders were AR-V7-negative, but four carried other AR perturbations. Comprehensive AR profiling, which is feasible using liquid biopsies, is necessary to increase our understanding of the mechanisms underpinning resistance to endocrine treatment. Alterations in the androgen receptor are associated with endocrine treatment outcomes. This study demonstrates that it is possible to identify different types of alterations via simple blood draws. Follow-up studies are needed to determine the effect of

Anthropogenic desertification by high-albedo pollution Observations and modeling

Science.gov (United States)

Otterman, J.; Rosenberg, N. W.; Rosenberg, E.

1974-01-01

ERTS-1 MSS albedo data of Western Negev, Sinai and the Gaza strip are presented. A sharp contrast in albedo exists across the Negev-Sinai and Negev-Gaza strip borders. Anthropogenic desertification has occurred on the Arab side due to overgrazing and Bedouin agriculture, whereas natural vegetation grows much more abundantly on the Israeli side.

Estimation of muscle fatigue by ratio of mean frequency to average rectified value from surface electromyography.

Science.gov (United States)

Fernando, Jeffry Bonar; Yoshioka, Mototaka; Ozawa, Jun

2016-08-01

A new method to estimate muscle fatigue quantitatively from surface electromyography (EMG) is proposed. The ratio of mean frequency (MNF) to average rectified value (ARV) is used as the index of muscle fatigue, and muscle fatigue is detected when MNF/ARV falls below a pre-determined or pre-calculated baseline. MNF/ARV gives larger distinction between fatigued muscle and non-fatigued muscle. Experiment results show the effectiveness of our method in estimating muscle fatigue more correctly compared to conventional methods. An early evaluation based on the initial value of MNF/ARV and the subjective time when the subjects start feeling the fatigue also indicates the possibility of calculating baseline from the initial value of MNF/ARV.

A system of prisons

NARCIS (Netherlands)

Reinhart, T.

2005-01-01

The prevailing sentiment in the Western media is that a new era has started in the Middle East .The magic that transformed Sharon’s image into a hero of peace was his pullout from Gaza. In fact, however, as important as the evacuation of the Gaza settlements is, it is far from signaling the end of

Head lice infestation in school children of a low socio- economy ...

African Journals Online (AJOL)

STORAGESEVER

2008-07-04

Jul 4, 2008 ... In the old Gaza city and the rural village Jabalia within the Gaza Governorate the rate of infestation with lice was 14.1% in the primary school girls. (Al-Shawa, 2006). In a high socio-economy area in Izmir,. Turkey, 4.2% of the studied population of the secondary and elementary school children were infested ...

The Biological and Clinical Significance of Androgen Receptor Variants

Science.gov (United States)

2014-04-01

of AR-V7 in low- grade PCa might be associated with development of high-grade Pea . Aim 3 was to evaluate the role of AR-V7 in mediating primary... protein expression of AR-V7 in CRPC vs. hormone nai’ve prostate cancer (PCa).2 In addition, AR-V7 mRNA expression in bone metastases of men with CRPC...ISH method is compatible with IHC to enable the detection of RNA and protein markers in the same tissue section for colocalization and functional

Proper Sterol Distribution Is Required for Candida albicans Hyphal Formation and Virulence

OpenAIRE

McCourt, Paula; Liu, Hsing-Yin; Parker, Josie E.; Gallo-Ebert, Christina; Donigan, Melissa; Bata, Adam; Giordano, Caroline; Kelly, Steven L.; Nickels, Joseph T.

2016-01-01

Candida albicans is an opportunistic fungus responsible for the majority of systemic fungal infections. Multiple factors contribute to C. albicans pathogenicity. C. albicans strains lacking CaArv1 are avirulent. Arv1 has a conserved Arv1 homology domain (AHD) that has a zinc-binding domain containing two cysteine clusters. Here, we explored the role of the CaAHD and zinc-binding motif in CaArv1-dependent virulence. Overall, we found that the CaAHD was necessary but not sufficient for cells to...

Economic evaluation of weekends-off antiretroviral therapy for young people in 11 countries.

Science.gov (United States)

Tierrablanca, Luis Enrique; Ochalek, Jessica; Ford, Deborah; Babiker, Ab; Gibb, Diana; Butler, Karina; Turkova, Anna; Griffin, Susan; Revill, Paul

2018-02-01

To analyze the cost effectiveness of short-cycle therapy (SCT), where patients take antiretroviral (ARV) drugs 5 consecutive days a week and have 2 days off, as an alternative to continuous ARV therapy for young people infected with human immunodeficiency virus (HIV) and taking efavirenz-based first-line ARV drugs. We conduct a hierarchical cost-effectiveness analysis based on data on clinical outcomes and resource use from the BREATHER trial. BREATHER is a randomized trial investigating the effectiveness of SCT and continuous therapy in 199 participants aged 8 to 24 years and taking efavirenz-based first-line ARV drugs in 11 countries worldwide. Alongside nationally representative unit costs/prices, these data were used to estimate costs and quality adjusted life years (QALYs). An incremental cost-effectiveness comparison was performed using a multilevel bivariate regression approach for total costs and QALYs. Further analyses explored cost-effectiveness in low- and middle-income countries with access to low-cost generic ARV drugs and high-income countries purchasing branded ARV drugs, respectively. At 48 weeks, SCT offered significant total cost savings over continuous therapy of US dollar (USD) 41 per patient in countries using generic drugs and USD 4346 per patient in countries using branded ARV drugs, while accruing nonsignificant total health benefits of 0.008 and 0.009 QALYs, respectively. Cost-effectiveness estimates were similar across settings with access to generic ARV drugs but showed significant variation among high-income countries where branded ARV drugs are purchased. SCT is a cost-effective treatment alternative to continuous therapy for young people infected with HIV in countries where viral load monitoring is available.

Presence of Apis Rhabdovirus-1 in Populations of Pollinators and Their Parasites from Two Continents

Directory of Open Access Journals (Sweden)

Sofia Levin

2017-12-01

Full Text Available The viral ecology of bee communities is complex, where viruses are readily shared among co-foraging bee species. Additionally, in honey bees (Apis mellifera, many viruses are transmitted – and their impacts exacerbated – by the parasitic Varroa destructor mite. Thus far, the viruses found to be shared across bee species and transmitted by V. destructor mites are positive-sense single-stranded RNA viruses. Recently, a negative-sense RNA enveloped virus, Apis rhabdovirus-1 (ARV-1, was found in A. mellifera honey bees in Africa, Europe, and islands in the Pacific. Here, we describe the identification – using a metagenomics approach – of ARV-1 in two bee species (A. mellifera and Bombus impatiens and in V. destructor mites from populations collected in the United States and Israel. We confirmed the presence of ARV-1 in pools of A. mellifera, B. impatiens, and V. destructor from Israeli and U.S. populations by RT-PCR and found that it can reach high titers in individual honey bees and mites (107–108 viral genomic copies per individual. To estimate the prevalence of ARV-1 in honey bee populations, we screened 104 honey bee colonies across Israel, with 21 testing ARV-1-positive. Tagged-primer-mediated RT-PCR analysis detected the presence of the positive-sense ARV-1 RNA in A. mellifera and V. destructor, indicating that ARV-1 replicates in both hosts. This is the first report of the presence of ARV-1 in B. impatiens and of the replication of a rhabdovirus in A. mellifera and V. destructor. Our data suggest that Varroa mites could act as an ARV-1 vector; however, the presence of ARV-1 in B. impatiens (which are not parasitized by Varroa suggests that it may not require the mite for transmission and ARV-1 may be shared among co-foraging bee species. Given that ARV-1 is found in non-Apis bee species, and because “ARV” is used for the Adelaide River virus, we propose that this virus should be called bee rhabdovirus 1 and abbreviated BRV-1

Antiretroviral drug resistance: A guide for the southern African clinician

African Journals Online (AJOL)

Both private and public sector see a bewildering clinical array of patients taking failing antiretroviral (ARV) regimens. We intend this article to provide a practical guide to help clinicians understand and manage ARV drug resistance in an African context. ARV resistance is a rapidly evolving field, requiring expertise in dealing ...

Euroopa panganduse arengusuunad / Lembo Tanning

Index Scriptorium Estoniae

Tanning, Lembo

2000-01-01

Euroopa Liidu liikmesriikides on pankade arv ajavahemikus 1994-1997 10% võrra vähenenud, kuid samaaegselt on krediidiinstitutsioonide kohalike allüksuste arv 8% võrra kasvanud ja teenistujate arv suhteliselt muutumatuks jäänud. Tabel: Ülevaade Euroopa Majandusruumi finantsinstitutsioonide arvust, filiaalidest ja töötajatest

Improving access to antiretrovirals in rural South Africa – a call to ...

African Journals Online (AJOL)

Improving access to antiretrovirals in rural South Africa – a call to action. South Africa (SA) already has the world's biggest antiretroviral (ARV) programme. With the introduction of extended criteria for initiating ARVs, the National Department of Health (NDoH) wishes to increase the number of people on ARVs by around.

Acceptability and confidence in antiretroviral generics of physicians and HIV-infected patients in France.

Science.gov (United States)

Allavena, Clotilde; Jacomet, Christine; Pereira, Bruno; Morand-Joubert, Laurence; Bagheri, Haleh; Cotte, Laurent; Garaffo, Rodolphe; Gerbaud, Laurent; Dellamonica, Pierre

2014-01-01

Switching brand name medications to generics is recommended in France in the interest of cost effectiveness but patients and physicians are sometimes not convinced that switching is appropriate. Some antiretroviral (ARV) generics (ZDV, 3TC, NVP) have been marketed in France since 2013. A multicentric cross-sectional survey was performed in September 2013 to evaluate the perception of generics overall and ARV generics in physicians and HIV-infected patients and factors associated to their acceptability. Adult HIV outpatients were asked to complete a self-questionnaire on their perception of generics. Physicians completed a questionnaire on the acceptability of generics and ARV generics. Socio-demographic data, medical history and HIV history were collected. 116 physicians in 33 clinics (68% in University Hospital) included 556 patients (France-native 77%, active employment 59%, covered by social Insurance 100%, homosexual/bisexual contamination 47%, median HIV duration 13 years, hepatitis coinfection 16%, on ARV therapy 95%). Overall, patients accepted and had confidence in generics in 76% and 55% of the cases, respectively. Switching ARVs for generics was accepted by 44% of the patients but only by 17% if the pill burden was going to increase. 75% of the physicians would prescribe generics, but this decreased to only 26% if the combo had to be broken. The main reasons for non-prescription of generics were previous brand name ARV-induced side effects (35%), refusal of generics overall (37%), lack of understanding of generics (26%), risk of non-observance of treatment (44%), anxiety (47%) and depressive symptoms (25%). In multivariate analysis, factors associated with the acceptability of ARV generics in patients were the use of generics overall (p<0.001) and in physicians, the absence of concern regarding the drug efficacy (p<0.001) and being aware that the patient would accept generics overall (p=0.03) and ARV generics (p=0.04). No factors related to

Antiretroviral procurement and supply chain management.

Science.gov (United States)

Ripin, David J; Jamieson, David; Meyers, Amy; Warty, Umesh; Dain, Mary; Khamsi, Cyril

2014-01-01

Procurement, the country-level process of ordering antiretrovirals (ARVs), and supply chain management, the mechanism by which they are delivered to health-care facilities, are critical processes required to move ARVs from manufacturers to patients. To provide a glimpse into the ARV procurement and supply chain, the following pages provide an overview of the primary stakeholders, principal operating models, and policies and regulations involved in ARV procurement. Also presented are key challenges that need to be addressed to ensure that the supply chain is not a barrier to the goal of universal coverage. This article will cover the steps necessary to order and distribute ARVs, including different models of delivery, key stakeholders involved, strategic considerations that vary depending on context and policies affecting them. The single drug examples given illustrate the complications inherent in fragmented supply and demand-driven models of procurement and supply chain management, and suggest tools for navigating these hurdles that will ultimately result in more secure and reliable ARV provision. Understanding the dynamics of ARV supply chain is important for the global health community, both to ensure full and efficient treatment of persons living with HIV as well as to inform the supply chain decisions for other public health products.

Lack of pre-antiretroviral care and competition from traditional ...

African Journals Online (AJOL)

Lack of family support tripled the risk of initiating ART very late (AOR 3.3, 95% CI: 1.6-6.6). Conclusion: Policy makers should prevent ARV stock-outs though effective ARV procurement and supply chain management. New HIV clients should seek pre-ARV care for routine monitoring and determination of ART eligibility.

Intergenerational patterns of family violence related to alcohol abuse: a genogram-based study

Directory of Open Access Journals (Sweden)

Cláudia Silveira Tondowski

2014-12-01

Full Text Available The objective of this study was to analyze intergenerational patterns of alcohol related violence (ARV. An intentional sample comprising 42 family members was selected according to a set of criteria, including history of ARV. A genogram based on anonymous semi-structured taped interviews was created. The Content Analysis pointed to different patterns of repetition of intergenerational ARV. The most recurrent ones were those of lineal consanguinity (father/son and through marriage. We observed similarities over the generations of each family as regards the pattern of alcohol consumption; the type of violence; the family reaction and the family life cycle in which ARV was intensified. Our results confirm the intergenerational reproduction of ARV. In conclusion, it is important to create intervention strategies to prevent intergenerational repetition of this association of behaviors.

Androgen receptor variant-7: an important predictive biomarker in castrate resistant prostate cancer

Directory of Open Access Journals (Sweden)

Oliver Sartor

2015-06-01

Full Text Available The recent manuscript in New England Journal of Medicine by Antonarakis et al. [1] has important clinical implications. This study evaluates mRNA expression of a particular androgen receptor splice variant-7 (AR-V7, in circulating tumor cells (CTCs from metastatic castrate-resistant prostate cancer (mCRPC patients receiving enzalutamide or abiraterone. The findings were striking, none of the 18 patients with detectable AR-V7 in CTCs had prostate-specific antigen (PSA responses. Further, the median time to PSA progression after enzalutamide or abiraterone treatment was only 1.3-1.4 months in AR-V7-positive patients as compared to 5.3-6.1 months in AR-V7 negative patients. AR-V7 in CTCs was also associated with shorter survival.

Antiretroviral drug supply challenges in the era of scaling up ART in Malawi.

Science.gov (United States)

Schouten, Erik J; Jahn, Andreas; Ben-Smith, Anne; Makombe, Simon D; Harries, Anthony D; Aboagye-Nyame, Francis; Chimbwandira, Frank

2011-07-06

The number of people receiving antiretroviral treatment (ART) has increased considerably in recent years and is expected to continue to grow in the coming years. A major challenge is to maintain uninterrupted supplies of antiretroviral (ARV) drugs and prevent stock outs. This article discusses issues around the management of ARVs and prevention of stock outs in Malawi, a low-income country with a high HIV/AIDS burden, and a weak procurement and supply chain management system. This system for ARVs, paid for by the Global Fund to Fight AIDS, Tuberculosis and Malaria, and bypassing the government Central Medical Stores, is in place, using the United Nations Children's Fund's (UNICEF's) procurement services. The system, managed by a handful of people who spend limited time on supply management, is characterized by a centrally coordinated quantification based on verified data from all national ART clinics, parallel procurement through UNICEF, and direct distribution to ART clinics. The model worked well in the first years of the ART programme with a single first-line ARV regimen, but with more regimens becoming available (e.g., alternative first-line, second-line and paediatric regimens), it has become more difficult to administer. Managing supplies through a parallel system has the advantage that weaknesses in the national system have limited influence on the ARV procurement and supply chain management system. However, as the current system operates without a central warehouse and national buffer stock capacity, it diminishes the ability to prevent ARV stock outs. The process of ordering ARVs, from the time that estimates are made to the arrival of supplies in health facilities, takes approximately one year. Addressing the challenges involved in maintaining ARVs through an efficient procurement and supply chain management system that prevents ARV stock outs through the establishment of a dedicated procurement team, a central warehouse and/or national buffer stock is a

Lehmad taanduvad lammaste ees

Index Scriptorium Estoniae

2008-01-01

PRIA põllumajandusloomade registri andmetel vähenes ajavahemikul 2002. a. lõpust kuni 2007. a. lõpuni veiste arv Eestis 21 687 looma võrra, veisepidajate arv on 6 aastaga vähenenud 52,56%. Lammaste arv suurenes aga ajavahemikul 2000. a. lõpust 2007. a. lõpuni 3,4 korda. Tabel: Veiste hulk väheneb

Las personas que viven con VIH/SIDA y su vínculo con los antirretrovirales provistos por el Programa Nacional en Argentina People living with HIV/AIDS and their link with the antiretrovirals provided by the National Programme in Argentina

Directory of Open Access Journals (Sweden)

Marisel Andrea Colautti

2012-05-01

Full Text Available El Estado argentino se compromete, mediante la Ley Nacional de SIDA, a suministrar gratuitamente los ARV. Reconociendo la complejidad que envuelve el proceso de gestión de ARV desde Programa Nacional y dando por sentado que las PVVS son el fin último del mismo, se piensa que es fundamental indagar en sus opiniones. El objetivo es explorar el suministro de ARV desde la perspectiva de las PVVS, en un hospital público de Rosario, respecto a: 1 valoración del Programa y de la información recibida, 2 tiempos de espera, 3 la provisión en relación con la disponibilidad de ARV para sostener el tratamiento. Estudio de abordaje cualitativo, con entrevistas durante enero y febrero de 2007, se realizan en presencia de una psicóloga. Se definen criterios de selección de los entrevistados y ejes para las entrevistas. Las PVVS entrevistadas son 15 y opinan con autoridad respecto al Programa, señalando problemas en el suministro de ARV. Reconocen dificultades del sostenimiento en el tiempo en la toma de ARV y sus consecuencias en relación a la muerte y a la calidad de vida. El Programa se caracteriza por convivencia de rasgos que responden a políticas garantizadas por el Estado y a programas que responden a la emergencia. Aparece la necesidad de repensar el Programa como política de salud genuina, considerando a los ARV como medicamentos esenciales.In accordance with the National AIDS Law, the Argentinian State is committed to supply antiretroviral medication (ARV free of charge. Due to the complexity of the National ARV Program management process, and the fact that people with HIV/AIDS (PLHA are the beneficiaries of the Program, it is considered relevant to ascertain their opinion. The aim of this work is to examine the supply of ARV by the National HIV/AIDS Program, from the perspective of PLHA, in a public hospital of the city of Rosario, in relation to: 1 value of the Program and the information received from it; 2 waiting times; 3 availability

CLOSE RANGE PHOTOGRAMMETRY APPLIED TO THE DOCUMENTATION OF AN ARCHAEOLOGICAL SITE IN GAZA STRIP, PALESTINE

Directory of Open Access Journals (Sweden)

E. Alby

2013-07-01

Full Text Available In a geopolitical very complex context as the Gaza Strip it has to be dealt with an enhancement of an archaeological site. This site is the monastery of St. Hilarion. To enable a cultural appropriation of a place with several identified phases of occupation must undertake extensive archaeological excavation. Excavate in this geographical area is to implement emergency excavations, so the aim of such a project can be questioned for each mission. Real estate pressure is also a motivating setting the documentation because the large population density does not allow systematic studies of underground before construction projects. This is also during the construction of a road that the site was discovered. Site dimensions are 150 m by 80 m. It is located on a sand dune, 300 m from the sea. To implement the survey, four different levels of detail have been defined for terrestrial photogrammetry. The first level elements are similar to objects, capitals, fragment of columns, tiles for example. Modeling of small objects requires the acquisition of very dense point clouds (density: 1 point / 1 mm on average. The object must then be a maximum area of the sensor of the camera, while retaining in the field of view a reference pattern for the scaling of the point cloud generated. The pictures are taken at a short distance from the object, using the images at full resolution. The main obstacle to the modeling of objects is the presence of noise partly due to the studied materials (sand, smooth rock, which do not favor the detection of points of interest quality. Pretreatments of the cloud will be achieved meticulously since the ouster of points on a surface of a small object results in the formation of a hole with a lack of information, useful to resulting mesh. Level 2 focuses on the stratigraphic units such as mosaics. The monastery of St. Hilarion identifies thirteen floors of which has been documented years ago by silver photographs, scanned later

Arc in a Gas Flowing Through a Magnetic Field; Duga v potoke gaza pri nalichii magnitnogo polya

Energy Technology Data Exchange (ETDEWEB)

Baranov, V. Ju.; Vasil' eva, I. A.; Ul' janov, K. N. [Vsesojuznyj Jelektrotehnicheskij Institut Im.V.I. Lenina, Moskva, SSSR (Russian Federation)

1966-10-15

' provodit' issledovanija v spektral'no chistom argone. Davlenie menjalos' v diapazone 1-M00mm.rt.st., skorosti potoka V{sub 0} Less-Than-Or-Equal-To 10{sup 4} sm/sek. Magnitnoe pole v usko - ritele (B{sub 1}) i oblasti issleduemoj dugi (B{sub 2}) menjalis' ot 0 do 7*10{sup 3} je. Provodilis' zondovye i spektral'n{sub e} izmerenija raspredelenij v prostranstve koncentracii jelektronov pe i temperatury jelektronov T{sub e}. Temperatura gaza T{sub g} izmerjalas' metodom nakalivaemoj niti, skorost' potoka - pri pomoshhi trubok Pito. Jeksperimenty provodilis' kak v tormozjashhem, tak i v uskorjajushhem magnitnom pole. (author)

Pharmacokinetic, Pharmacogenetic, and Other Factors Influencing CNS Penetration of Antiretrovirals

Directory of Open Access Journals (Sweden)

Jacinta Nwamaka Nwogu

2016-01-01

Full Text Available Neurological complications associated with the human immunodeficiency virus (HIV are a matter of great concern. While antiretroviral (ARV drugs are the cornerstone of HIV treatment and typically produce neurological benefit, some ARV drugs have limited CNS penetration while others have been associated with neurotoxicity. CNS penetration is a function of several factors including sieving role of blood-brain and blood-CSF barriers and activity of innate drug transporters. Other factors are related to pharmacokinetics and pharmacogenetics of the specific ARV agent or mediated by drug interactions, local inflammation, and blood flow. In this review, we provide an overview of the various factors influencing CNS penetration of ARV drugs with an emphasis on those commonly used in sub-Saharan Africa. We also summarize some key associations between ARV drug penetration, CNS efficacy, and neurotoxicity.

Loomakasvatus esimesel poolaastal / Matti Piirsalu

Index Scriptorium Estoniae

Piirsalu, Matti, 1947-

2007-01-01

2007. aasta I poolaasta põllumajandussaaduste tootmise statistika. Tabelid: Loomade ja lindude arv 2006. ja 2007. a. seisuga 30. juuni; Loomade arv maakondade lõikes seisuga 30. juuni 2007 (PRIA andmeil); Põhiliste loomakasvatussaaduste tootmine 2006. ja 2007. a. I poolaastal; Veisekarjade suurus seisuga 30. juuni 2007 (PRIA andmeil); Veiste arv seisuga 30. juuni 2007 (PRIA andmeil); Prognoositav lihatoodang I poolaastal tapamassis

Avian reovirus L2 genome segment sequences and predicted structure/function of the encoded RNA-dependent RNA polymerase protein

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Xu Wanhong

2008-12-01

Full Text Available Abstract Background The orthoreoviruses are infectious agents that possess a genome comprised of 10 double-stranded RNA segments encased in two concentric protein capsids. Like virtually all RNA viruses, an RNA-dependent RNA polymerase (RdRp enzyme is required for viral propagation. RdRp sequences have been determined for the prototype mammalian orthoreoviruses and for several other closely-related reoviruses, including aquareoviruses, but have not yet been reported for any avian orthoreoviruses. Results We determined the L2 genome segment nucleotide sequences, which encode the RdRp proteins, of two different avian reoviruses, strains ARV138 and ARV176 in order to define conserved and variable regions within reovirus RdRp proteins and to better delineate structure/function of this important enzyme. The ARV138 L2 genome segment was 3829 base pairs long, whereas the ARV176 L2 segment was 3830 nucleotides long. Both segments were predicted to encode λB RdRp proteins 1259 amino acids in length. Alignments of these newly-determined ARV genome segments, and their corresponding proteins, were performed with all currently available homologous mammalian reovirus (MRV and aquareovirus (AqRV genome segment and protein sequences. There was ~55% amino acid identity between ARV λB and MRV λ3 proteins, making the RdRp protein the most highly conserved of currently known orthoreovirus proteins, and there was ~28% identity between ARV λB and homologous MRV and AqRV RdRp proteins. Predictive structure/function mapping of identical and conserved residues within the known MRV λ3 atomic structure indicated most identical amino acids and conservative substitutions were located near and within predicted catalytic domains and lining RdRp channels, whereas non-identical amino acids were generally located on the molecule's surfaces. Conclusion The ARV λB and MRV λ3 proteins showed the highest ARV:MRV identity values (~55% amongst all currently known ARV and MRV

Preliminary evidence of HIV seroconversion among HIV-negative men who have sex with men taking non-prescribed antiretroviral medication for HIV prevention in Miami, Florida, USA.

Science.gov (United States)

Buttram, Mance E; Kurtz, Steven P

2017-04-01

Background Limited information suggests that men who have sex with men (MSM) are informally obtaining antiretroviral medication (ARVs) and using them for HIV pre-exposure prophylaxis (PrEP). Data are drawn from an on-going study examining the use of non-prescribed ARVs for PrEP. To date, 24 qualitative interviews have been conducted with HIV-negative, substance-using MSM living in Miami, Florida, USA. Data are presented from two participants who reported HIV seroconversion while using non-prescribed ARVs for PrEP. Preliminary data indicate that some young MSM: (i) lack awareness of and accurate information about the efficacious use of PrEP; (ii) obtain non-prescribed ARVs from HIV-positive sex partners and use these medications for PrEP in a way that does not provide adequate protection against HIV infection or cohere with established guidelines; and (iii) engage in multiple HIV transmission risk behaviours, including condomless anal sex and injection drug use. The informal, non-prescribed and non-medically supervised use of ARVs for HIV prevention has the potential to undermine the protective benefits of PrEP and leave men unprotected against HIV transmission and at risk for ARV resistance.

Affordability of adult HIV/AIDS treatment in developing countries: modelling price determinants for a better insight of the market functioning.

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Sagaon-Teyssier, Luis; Singh, Sauman; Dongmo-Nguimfack, Boniface; Moatti, Jean-Paul

2016-01-01

This study aims to provide a landscape of the global antiretroviral (ARV) market by analyzing the transactional data on donor-funded ARV procurement between 2003 and 2015, and the ARV price determinants. The data were obtained from the Global Price Reporting Mechanism (GPRM) managed by the AIDS Medicines and Diagnostics Service of the WHO, and it consists of information that covers approximately 80% of the total donor-funded adult ARV transactions procurement. ExWorks prices and procured quantities were standardized according to the guidelines in terms of yearly doses. Descriptive statistics on quantities and prices show the main trends of the ARV market. Ordinary least squares estimation was carried out for the whole sample, then stratified according to the type of supplier (originator and generic) and controlled for time and geographical fixed-effects. Given that analyses were carried out on a public dataset on ARV transactional prices from the GPRM, ethics are respected and consent was not necessary. Originator medicines are on average the least expensive in the sub-Saharan Africa region, where at the same time, generic medicines are on average the most expensive. By contrast, originator medicines are the most expensive in Europe and Central Asia, and generic medicines are the least expensive. In fact, the data suggest mixed strategies by ARV suppliers to exploit opportunities for profit maximization and to adapt to the specific conditions of market competition in each region. Our results also suggest that the expiration of patents is not sufficient to boost additional developments in generic competition (at least in the ARV market) and that formal or informal agreements between generic firms may de facto slow down or even reverse long-term trends towards price decreases. Our findings provide an improved understanding of the ARV market that can help countries strengthen policy measures to increase their bargaining power in price negotiations and the use of TRIPS

Proteomics analysis of the DF-1 chicken fibroblasts infected with avian reovirus strain S1133.

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Wen-Ting Chen

Full Text Available BACKGROUND: Avian reovirus (ARV is a member of the Orthoreovirus genus in the Reoviridae family. It is the etiological agent of several diseases, among which viral arthritis and malabsorption syndrome are the most commercially important, causing considerable economic losses in the poultry industry. Although a small but increasing number of reports have characterized some aspects of ARV infection, global changes in protein expression in ARV-infected host cells have not been examined. The current study used a proteomics approach to obtain a comprehensive view of changes in protein levels in host cells upon infection by ARV. METHODOLOGY AND PRINCIPAL FINDINGS: The proteomics profiles of DF-1 chicken fibroblast cells infected with ARV strain S1133 were analyzed by two-dimensional differential-image gel electrophoresis. The majority of protein expression changes (≥ 1.5 fold, p<0.05 occurred at 72 h post-infection. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry identified 51 proteins with differential expression levels, including 25 that were upregulated during ARV infection and 26 that were downregulated. These proteins were divided into eight groups according to biological function: signal transduction, stress response, RNA processing, the ubiquitin-proteasome pathway, lipid metabolism, carbohydrate metabolism, energy metabolism, and cytoskeleton organization. They were further examined by immunoblotting to validate the observed alterations in protein expression. CONCLUSION/SIGNIFICANCE: This is the first report of a time-course proteomic analysis of ARV-infected host cells. Notably, all identified proteins involved in signal transduction, RNA processing, and the ubiquitin-proteasome pathway were downregulated in infected cells, whereas proteins involved in DNA synthesis, apoptosis, and energy production pathways were upregulated. In addition, other differentially expressed proteins were linked with the cytoskeleton

Role of Androgen Receptor Variants in Prostate Cancer: Report from the 2017 Mission Androgen Receptor Variants Meeting.

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Luo, Jun; Attard, Gerhardt; Balk, Steven P; Bevan, Charlotte; Burnstein, Kerry; Cato, Laura; Cherkasov, Artem; De Bono, Johann S; Dong, Yan; Gao, Allen C; Gleave, Martin; Heemers, Hannelore; Kanayama, Mayuko; Kittler, Ralf; Lang, Joshua M; Lee, Richard J; Logothetis, Christopher J; Matusik, Robert; Plymate, Stephen; Sawyers, Charles L; Selth, Luke A; Soule, Howard; Tilley, Wayne; Weigel, Nancy L; Zoubeidi, Amina; Dehm, Scott M; Raj, Ganesh V

2018-05-01

Although a number of studies have demonstrated the importance of constitutively active androgen receptor variants (AR-Vs) in prostate cancer, questions still remain about the precise role of AR-Vs in the progression of castration-resistant prostate cancer (CRPC). Key stakeholders and opinion leaders in prostate cancer convened on May 11, 2017 in Boston to establish the current state of the field of AR-Vs. The meeting "Mission Androgen Receptor Variants" was the second of its kind sponsored by the Prostate Cancer Foundation (PCF). This invitation-only event was attended by international leaders in the field and representatives from sponsoring organizations (PCF and industry sponsors). Eighteen faculty members gave short presentations, which were followed by in-depth discussions. Discussions focused on three thematic topics: (1) potential of AR-Vs as biomarkers of therapeutic resistance; (2) role of AR-Vs as functionally active CRPC progression drivers; and (3) utility of AR-Vs as therapeutic targets in CRPC. The three meeting organizers synthesized this meeting report, which is intended to summarize major data discussed at the meeting and identify key questions as well as strategies for addressing these questions. There was a critical consensus that further study of the AR-Vs is an important research focus in CRPC. Contrasting views and emphasis, each supported by data, were presented at the meeting, discussed among the participants, and synthesized in this report. This article highlights the state of knowledge and outlines the most pressing questions that need to be addressed to advance the AR-V field. Although further investigation is needed to delineate the role of androgen receptor (AR) variants in metastatic castration-resistant prostate cancer, advances in measurement science have enabled development of blood-based tests for treatment selection. Detection of AR variants (eg, AR-V7) identified a patient population with poor outcomes to existing AR

Jejak Pemikiran Al-Gazali dalam Tradisi Pendidikan Pesantren

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A Washil

2016-06-01

Full Text Available Pesantren (Islamic boarding school tradition can not be separated from the influence of Abu> Ha>mid al-Gaza>li>. This thought became the foundation to see the traces left by this hujjatul Isla>m in pesantren’s scientific tradition; what have became tradition, and what have changed and developed  in the tradition itself. This study shows that the thought of al-Gaza>li> influence several aspects (1 ontology about the nature and origin of science, it’s quality and position, which is linked to the learning process, (2 classification of science that is read sub-ordinatively, classificatively, even dichotomous, (3 the orientation and development of science in the education process that oriented to the hereafter life and worldly benefit. But in education process, every pesantren has their own interpretation. It is caused by differences in readings and adjustments to local circumstances. Therefore the thought of al-Gaza>li> is not always intact in education process. Most actually showed irregularities. It is caused by the dynamics of the social history, cultural and political of Indonesian. Readings and interpretation of al-Gaza>li> thought in pesantren tradition is also dynamic, in the sense of showing the progress from period to period.

Open Communication and Discussion Facilitate Reconciliation: The Maimonides Approach to Publication of Manduca’s Letter in The Lancet

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Shraga Blazer

2015-01-01

Full Text Available [Extract] Dear Friends and Colleagues, In August of 2014, Manduca P et al. published “An open letter for the people in Gaza” in The Lancet. This letter was the response of those authors to their perspective of what was happening in Gaza during the summer-long conflict between Israel and Gaza. Israel was finally responding to years of bombardment from Gaza into civilian areas in the south of Israel. Two of the authors of the letters were known anti-Semites, and held connections with David Duke, a former Ku Klux Klan Grand Wizard in Louisiana and advocate of Nazism. Both these authors expressed sympathy and support for Duke’s rabidly anti-Jewish positions. In their letter they accused Israel’s medical community of complicity in committing terrible atrocities and even implied that chemical warfare was being used by Israel. ...

Impact of the trade-related aspects of intellectual property rights (TRIPS) agreement on India as a supplier of generic antiretrovirals.

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Babovic, Sonja; Wasan, Kishor M

2011-03-01

This is a commentary on how the trade-related aspects of intellectual property rights (TRIPS) agreement has impacted India as a supplier of generic antiretrovirals (ARVs). We provide a systematic review of the issues related to the TRIPS agreement that affects India. This includes discussion around (a) the legal landscape underpinning India as a supplier of generic ARVs; (b) supply of second-line ARVs; and (c) the future of generic drug production in India. The proclamation into force of TRIPS-compliant intellectual property law in India is likely to affect its position as a supplier of affordable ARVs, especially drugs brought to market after 2005. Currently, mechanisms exist for the generic production of almost all ARVs in India, including second-line drugs; however, the manufacture of these drugs by generic pharmaceutical companies may require additional market incentives. Compulsory licensing may emerge as an additional mechanism by which India can provide affordable versions of patented drugs to Least Developed Countries (LDCs). Copyright © 2010 Wiley-Liss, Inc.

Iran and Saudi Arabia: Potential for Conflict or Uneasy Peace?

Science.gov (United States)

2009-12-11

discriminated against nearly as much as non-Muslims. Because of this the proverbial glass ceiling prevents the Shia from attaining status among the Sunni...to winning Gaza.” 97 This Iranian policy reached not only into Gaza, but also Lebanon , their role would play a part in the contest for influence...101 In effect the Iranians had turned southern Lebanon into a proxy state. Challenges to Saudi Religious Authority The Iranians, by the very

Telefon on kaotaja / Tõnu Vare

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Vare, Tõnu, 1947-

2003-01-01

Computer Industry Alamac Inc ennustuse kohaselt suureneb Interneti kasutajate arv maailmas 2005. aastaks ligi miljardini ehk täpsemalt 945 miljoni inimeseni. Diagramm: Interneti kasutajate arv maailmas (miljonites)

A MultiFactorial Risk Score to weigh toxicities and co-morbidities relative to costs of antiretrovirals in a cohort of HIV-infected patients

OpenAIRE

M Tontodonati; F Sozio; F Vadini; E Polilli; T Ursini; G Calella; P Di Stefano; E Mazzotta; A Costantini; C D'Amario; G Parruti

2012-01-01

Purpose of the study: Considering costs of antiretrovirals (ARVs) for HIV patients is increasingly needed. A simple and comprehensive tool weighing comorbidities and ARV-related toxicities could be useful to judge the appropriateness of use of more expensive drugs. We conceived a MultiFactorial Risk Score (MFRS) to evaluate the appropriateness of ARVs prescription relative to their costs. Methods: HIV patients were consecutively enrolled in 2010-2011. We considered socio-demographic character...

Novel BET protein proteolysis-targeting chimera exerts superior lethal activity than bromodomain inhibitor (BETi) against post-myeloproliferative neoplasm secondary (s) AML cells.

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Saenz, D T; Fiskus, W; Qian, Y; Manshouri, T; Rajapakshe, K; Raina, K; Coleman, K G; Crew, A P; Shen, A; Mill, C P; Sun, B; Qiu, P; Kadia, T M; Pemmaraju, N; DiNardo, C; Kim, M-S; Nowak, A J; Coarfa, C; Crews, C M; Verstovsek, S; Bhalla, K N

2017-09-01

The PROTAC (proteolysis-targeting chimera) ARV-825 recruits bromodomain and extraterminal (BET) proteins to the E3 ubiquitin ligase cereblon, leading to degradation of BET proteins, including BRD4. Although the BET-protein inhibitor (BETi) OTX015 caused accumulation of BRD4, treatment with equimolar concentrations of ARV-825 caused sustained and profound depletion (>90%) of BRD4 and induced significantly more apoptosis in cultured and patient-derived (PD) CD34+ post-MPN sAML cells, while relatively sparing the CD34+ normal hematopoietic progenitor cells. RNA-Seq, Reverse Phase Protein Array and mass cytometry 'CyTOF' analyses demonstrated that ARV-825 caused greater perturbations in messenger RNA (mRNA) and protein expressions than OTX015 in sAML cells. Specifically, compared with OTX015, ARV-825 treatment caused more robust and sustained depletion of c-Myc, CDK4/6, JAK2, p-STAT3/5, PIM1 and Bcl-xL, while increasing the levels of p21 and p27. Compared with OTX015, PROTAC ARV-771 treatment caused greater reduction in leukemia burden and further improved survival of NSG mice engrafted with luciferase-expressing HEL92.1.7 cells. Co-treatment with ARV-825 and JAK inhibitor ruxolitinib was synergistically lethal against established and PD CD34+ sAML cells. Notably, ARV-825 induced high levels of apoptosis in the in vitro generated ruxolitinib-persister or ruxolitinib-resistant sAML cells. These findings strongly support the in vivo testing of the BRD4-PROTAC based combinations against post-MPN sAML.

Factors contributing to antiretroviral drug adherence among adults living with HIV or AIDS in a Kenyan rural community.

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Kioko, Mary T; Pertet, Anne M

2017-07-31

Antiretroviral (ARV) adherence of ≥ 95% is recommended for suppressing HIV. However, studies have shown that the ≥ 95% recommended level is rarely achieved. This cross-sectional community-based study sought to assess factors contributing to ARV drug adherence among adults living with HIV or AIDS. The study was conducted in a rural community in Machakos County, Kenya. The questions used for the study were adapted from the Patient Medicine Adherence Questionnaire (PMAQ), a tool grounded in the Health Belief Model. Adherence to ARV was measured using self-reports and pill counts. The perception social support was measured with a 5-point Likert scale, whereas the type and the number of side effects experienced were recorded using 'yes' and 'no' questions. We used the chi-square test to test associations and binary logistic regression to assess factors explaining dose adherence to ARV. The levels of adherence of 86% using self-reports were significantly higher (p < 0.001) than the pill count of 58.6%. The immediate family was rated high in providing social support (3.7 ± 0.6) followed by social support groups (3.1 ± 0.8). A binary logistic regression analysis was conducted to predict ARV adherence (adherent, non-adherent) using social support, side effects and marital status as explanatory variables. The Wald criterion demonstrated that marital status (p = 0.019) and burden of side effects (p ≤ 0.001) made a significant contribution to the prediction of ARV adherence. The burden of side effects and being a divorcee are primary predictors of ARV adherence.

Gambaran Fungsi Kognitif HIV Anak yang Telah Memperoleh Terapi Antiretrovirus

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Herlina Herlina

2016-11-01

Full Text Available Latar belakang. Pasien HIV anak berisiko tinggi mengalami gangguan neurokognitif akibat keterlibatan sistem saraf pusat (SSP. Pemberian antiretrovirus (ARV menurunkan viral load di SSP sehingga mencegah penurunan fungsi kognitif. Tujuan. Memberikan gambaran fungsi kognitif pasien HIV anak dalam terapi ARV. Metode. Studi potong lintang dilakukan terhadap pasien HIV anak berusia 5-15 tahun. Penilaian kognitif dilakukan dengan instrumen Wechsler intelligence scale for children IV (WISC IV dilanjutkan dengan pemeriksaan elektroensefalografi untuk membuktikan kerusakan akibat keterlibatan SSP pada infeksi HIV. Hasil. Sembilan puluh pasien HIV anak (median usia 9 tahun telah memperoleh ARV selama  1-124 bulan dengan median 69 bulan. Hasil rerata verbal, performance, dan full-scale IQ (FSIQ berturut-turut adalah 88,66 (SB 15,69, 85,30 (SB 15,35, dan 85,73 (SB 15,61. Dua puluh tiga (25,6% subjek memiliki verbal IQ abnormal, 34 (37,8% performance scale abnormal, dan 32 (35,6% FSIQ abnormal. Hasil EEG abnormal didapatkan pada 22 subjek (22,4% dan tidak memiliki hubungan dengan stadium klinis, usia dan lama pemberian ARV, serta viral load. Stadium HIV menunjukkan hubungan bermakna dengan komponen verbal scale IQ dan FSIQ (p=0,042 dan p=0,044. Hasil IQ tidak memiliki hubungan dengan usia pemberian ARV, lama pemberian ARV, dan viral load. Kesimpulan. Pasien HIV anak yang telah mendapat terapi ARV selama 1-124 bulan memiliki rerata IQ abnormal pada verbal, performance, dan FSIQ meskipun jika dinyatakan dalam bentuk kategori, lebih dari 50% subjek memiliki IQ normal pada ketiga skala WISC.

Influence of organizational culture on provider adherence to the diabetic clinical practice guideline: using the competing values framework in Palestinian Primary Healthcare Centers

OpenAIRE

Radwan,Mahmoud; Akbari Sari,Ali; Rashidian,Arash; Takian,Amirhossein; Abou-Dagga,Sanaa; Elsous,Aymen

2017-01-01

Mahmoud Radwan,1 Ali Akbari Sari,1 Arash Rashidian,1 Amirhossein Takian,1 Sanaa Abou-Dagga,2 Aymen Elsous1 1Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Research Affairs and Graduates Studies, Islamic University of Gaza, Gaza Strip, Palestine Background: Diabetes mellitus (DM) is a serious chronic disease and an important public health issue. This study aimed to identify the pr...

Eesti maksusüsteem liitumisel Euroopa Liiduga / Olev Raju

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Raju, Olev, 1948-

2004-01-01

Ülevaade Eesti maksusüsteemi kujunemisest ja makromajanduslikust toimest alates 1993. aastast. Tabelid: Eesti majanduse arengut iseloomustavaid arve 1998-2003; Ettevõtte tulumaksu iseloomustavaid arve Ida-Euroopa maades (2002)

HIV Genetic Diversity and Drug Resistance

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Santos, André F.; Soares, Marcelo A.

2010-01-01

Most of the current knowledge on antiretroviral (ARV) drug development and resistance is based on the study of subtype B of HIV-1, which only accounts for 10% of the worldwide HIV infections. Cumulative evidence has emerged that different HIV types, groups and subtypes harbor distinct biological properties, including the response and susceptibility to ARV. Recent laboratory and clinical data highlighting such disparities are summarized in this review. Variations in drug susceptibility, in the emergence and selection of specific drug resistance mutations, in viral replicative capacity and in the dynamics of resistance acquisition under ARV selective pressure are discussed. Clinical responses to ARV therapy and associated confounding factors are also analyzed in the context of infections by distinct HIV genetic variants. PMID:21994646

The global pediatric antiretroviral market: analyses of product availability and utilization reveal challenges for development of pediatric formulations and HIV/AIDS treatment in children.

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Waning, Brenda; Diedrichsen, Ellen; Jambert, Elodie; Bärnighausen, Till; Li, Yun; Pouw, Mieke; Moon, Suerie

2010-10-17

Important advances in the development and production of quality-certified pediatric antiretroviral (ARV) formulations have recently been made despite significant market disincentives for manufacturers. This progress resulted from lobbying and innovative interventions from HIV/AIDS activists, civil society organizations, and international organizations. Research on uptake and dispersion of these improved products across countries and international organizations has not been conducted but is needed to inform next steps towards improving child health. We used information from the World Health Organization Prequalification Programme and the United States Food and Drug Administration to describe trends in quality-certification of pediatric formulations and used 7,989 donor-funded, pediatric ARV purchase transactions from 2002-2009 to measure uptake and dispersion of new pediatric ARV formulations across countries and programs. Prices for new pediatric ARV formulations were compared to alternative dosage forms. Fewer ARV options exist for HIV/AIDS treatment in children than adults. Before 2005, most pediatric ARVs were produced by innovator companies in single-component solid and liquid forms. Five 2-in1 and four 3-in-1 generic pediatric fixed-dose combinations (FDCs) in solid and dispersible forms have been quality-certified since 2005. Most (67%) of these were produced by one quality-certified manufacturer. Uptake of new pediatric FDCs outside of UNITAID is low. UNITAID accounted for 97-100% of 2008-2009 market volume. In total, 33 and 34 countries reported solid or dispersible FDC purchases in 2008 and 2009, respectively, but most purchases were made through UNITAID. Only three Global Fund country recipients reported purchase of these FDCs in 2008. Prices for pediatric FDCs were considerably lower than liquids but typically higher than half of an adult FDC. Pediatric ARV markets are more fragile than adult markets. Ensuring a long-term supply of quality, well

Avian reovirus S1133-induced apoptosis is associated with Bip/GRP79-mediated Bim translocation to the endoplasmic reticulum.

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Lin, Ping-Yuan; Liu, Hung-Jen; Chang, Ching-Dong; Chen, Yo-Chia; Chang, Chi-I; Shih, Wen-Ling

2015-04-01

In this study the mechanism of avian reovirus (ARV) S1133-induced pathogenesis was investigated, with a focus on the contribution of ER stress to apoptosis. Our results showed that upregulation of the ER stress response protein, as well as caspase-3 activation, occurred in ARV S1133-infected cultured cells and in SPF White Leghorn chicks organs. Upon infection, Bim was translocated specifically to the ER, but not mitochondria, in the middle to late infectious stages. In addition, ARV S1133 induced JNK phosphorylation and promoted JNK-Bim complex formation, which correlated with the Bim translocation and apoptosis induction that was observed at the same time point. Knockdown of BiP/GRP78 by siRNA and inhibition of BiP/GRP78 using EGCG both abolished the formation of the JNK-Bim complex, caspase-3 activation, and subsequent apoptosis induction by ARV S1133 efficiently. These results suggest that BiP/GRP78 played critical roles and works upstream of JNK-Bim in response to the ARV S1133-mediated apoptosis process.

Pre-exposure prophylaxis and antiretroviral resistance: HIV prevention at a cost?

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Hurt, Christopher B; Eron, Joseph J; Cohen, Myron S

2011-12-01

Pre-exposure prophylaxis (PrEP), the use of antiretrovirals (ARVs) by human immunodeficiency virus (HIV)-uninfected individuals to prevent acquisition of the virus during high-risk sexual encounters, enjoyed its first 2 major successes with the Centre for the AIDS Programme of Research in South Africa (CAPRISA) 004 and the Pre-Exposure Prophylaxis Initiative (iPrEx). These successes were buoyed by additional positive results from the TDF2 and Partners PrEP trials. Although no seroconverters in either arm of CAPRISA developed resistance to tenofovir, 2 participants in iPrEx with undetected, seronegative acute HIV infection were randomized to receive daily oral tenofovir-emtricitabine and resistance to emtricitabine was later discovered in both men. A similar case in the TDF2 study resulted in resistance to both ARVs. These cases prompted us to examine existing literature on the nature of resistance mutations elicited by ARVs used for PrEP. Here, we discuss the impact of signature mutations selected by PrEP, how rapidly these emerge with daily ARV exposure, and the individual-level and public health consequences of ARV resistance.

Antiretroviral purchasing and prescription practices in Mexico: constraints, challenges and opportunities.

Science.gov (United States)

Chaumont, Claire; Bautista-Arredondo, Sergio; Calva, Juan José; Bahena-González, Roberto Isaac; Sánchez-Juárez, Gerda Hitz; González de Araujo-Muriel, Arturo; Magis-Rodríguez, Carlos; Hernández-Ávila, Mauricio

2015-01-01

This study examines the antiretroviral (ARV) market characteristics for drugs procured and prescribed to Mexico's Social Protection System in Health beneficiaries between 2008 and 2013, and compares them with international data. Procurement information from the National Center for the Prevention and the Control of HIV/AIDS was analyzed to estimate volumes and prices of key ARV. Annual costs were compared with data from the World Health Organization's Global Price Reporting Mechanism for similar countries. Finally, regimens reported in the ARV Drug Management, Logistics and Surveillance System database were reviewed to identify prescription trends and model ARV expenditures until 2018. Results show that the first-line ARV market is concentrated among a small number of patented treatments, in which prescription is clinically adequate, but which prices are higher than those paid by similar countries. The current set of legal and structural options available to policy makers to bring prices down is extremely limited. Different negotiation policies were not successful to decrease ARV high prices in the public health market. The closed list approach had a good impact on prescription quality but was ineffective in reducing prices. The Coordinating Commission for Negotiating the Price of Medicines and other Health Supplies also failed to obtain adequate prices. To maximize purchase efficiency, policy makers should focus on finding long-term legal and political safeguards to counter the high prices imposed by pharmaceutical companies.

Comparative costs of inpatient care for HIV-infected and uninfected children and adults in Soweto, South Africa.

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Thomas, Leena S; Manning, Arthur; Holmes, Charles B; Naidoo, Shan; van der Linde, Frans; Gray, Glenda E; Martinson, Neil A

2007-12-01

HIV/AIDS creates a massive burden of care for health systems. A better understanding of the impact of HIV infection on health care utilization and costs may enable better use of limited resources. We compared public sector inpatient costs of HIV-infected versus uninfected adults and children at a large hospital in Soweto, South Africa. Daily hotel costs estimated from hospital financial data and total patient visits were combined with utilization, abstracted from patients' charts, and costed using government price lists to estimate total inpatient costs. A total of 1185 eligible records were included over a 6-week period in 2005. Eight hundred twelve were from HIV-infected patients, and of these, 77 were on antiretroviral (ARV) therapy. The mean length of stay (LOS) and mean drug and intravenous fluid utilization of HIV-infected adults not on ARVs was greater than those of uninfected adults, resulting in a $200 higher total average admission cost. Patients on ARVs had longer LOS and incurred a total average admission cost of $750 more than HIV-infected adults not on ARVs. Inpatient costs were greater for this selected group of HIV-infected adults, and even higher for the small proportion of individuals receiving ARVs. Budget allocations should incorporate case mix by HIV and ARV status as a key determinant of hospital expenditure.

HIV Drug Resistance-Associated Mutations in Antiretroviral Naïve HIV-1-Infected Latin American Children

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Luis E. Soto-Ramirez

2010-01-01

Full Text Available Our goal was to describe the presence of HIV drug resistance among HIV-1-infected, antiretroviral (ARV naïve children and adolescents in Latin America and to examine resistance in these children in relation to drug exposure in the mother. Genotyping was performed on plasma samples obtained at baseline from HIV-1-infected participants in a prospective cohort study in Brazil, Argentina, and Mexico (NISDI Pediatric Study. Of 713 HIV-infected children enrolled, 69 were ARV naïve and eligible for the analysis. At enrollment, mean age was 7.3 years; 81.2% were infected with HIV perinatally. Drug resistance mutations (DRMs were detected in 6 (8.7%; 95% confidence interval 3.1–18.2% ARV-naïve subjects; none of the mothers of these 6 received ARVs during their pregnancies and none of the children received ARV prophylaxis. Reverse transcriptase mutations K70R and K70E were detected in 3 and 2 subjects, respectively; protease mutation I50 V was detected in 1 subject. Three of the 6 children with DRMs initiated ARV therapy during followup, with a good response in 2. The overall rate of primary drug resistance in this pediatric HIV-infected population was low, and no subjects had more than 1 DRM. Mutations associated with resistance to nucleoside reverse transcriptase inhibitors were the most prevalent.

Evaluación de los impactos medioambientales de los proyectos de construcción

OpenAIRE

Adnan Enshassi; Bernd Kochendoerfer; Ehsan Rizq

2014-01-01

El sector de la construcción es considerado mundialmente como una de las principales fuentes de contaminación medioambiental, pues produce enormes efectos negativos en el medioambiente ya sea directa o indirectamente. La Franja de Gaza está experimentando un aumento de los proyectos de construcción, incrementando la presión sobre el ecosistema al introducir y generar diversos contaminantes. Los ecosistemas de la Franja de Gaza se están debilitando y deteriorando debido a sus limitados recurso...

Vene turist tooks raha meeleldi Eestisse / Aivar Reinap, Helve Laasik

Index Scriptorium Estoniae

Reinap, Aivar, 1968-

2000-01-01

Keerulised viisatingimused peletavad Vene turiste Eestist eemale. Tabelid: Eestit külastanud turistide arv, s.h. Soome ja Vene turistide arv, venelaste reisisihid. Kommenteerivad: J. Ligi, Y. Vanhanen, H. Tiido. Parlamendisaadik (J. Ligi)

The contribution of family planning towards the prevention of vertical HIV transmission in Uganda.

Directory of Open Access Journals (Sweden)

Wolfgang Hladik

Full Text Available BACKGROUND: Uganda has one of the highest total fertility rates (TFR worldwide. We compared the effects of antiretroviral (ARV prophylaxis for the prevention of mother-to-child HIV transmission (PMTCT to that of existing family planning (FP use and estimated the burden of pediatric HIV disease due to unwanted fertility. METHODOLOGY/PRINCIPAL FINDINGS: Using the demographic software Spectrum, a baseline mathematical projection to estimate the current pediatric HIV burden in Uganda was compared to three hypothetical projections: 1 without ARV-PMTCT (to estimate the effect of ARV-PMTCT, 2 without contraception (effect of existing FP use, 3 without unwanted fertility (effect of unmet FP needs. Key input parameters included HIV prevalence, ARV-PMTCT uptake, MTCT probabilities, and TFR. We estimate that in 2007, an estimated 25,000 vertical infections and 17,000 pediatric AIDS deaths occurred (baseline projection. Existing ARV-PMTCT likely averted 8.1% of infections and 8.5% of deaths. FP use likely averted 19.7% of infections and 13.1% of deaths. Unwanted fertility accounted for 21.3% of infections and 13.4% of deaths. During 2008-2012, an estimated 131,000 vertical infections and 71,000 pediatric AIDS deaths will occur. The projected scale up of ARV-PMTCT (from 39%-57% may avert 18.1% of infections and 24.5% of deaths. Projected FP use may avert 21.6% of infections and 18.5% of deaths. Unwanted fertility will account for 24.5% of infections and 19.8% of deaths. CONCLUSIONS: Existing FP use contributes as much or more than ARV-PMTCT in mitigating pediatric HIV in Uganda. Expanding FP services can substantially contribute towards PMTCT.

Financial Barriers and Lapses in Treatment and Care of HIV-Infected Adults in a Southern State in the United States.

Science.gov (United States)

Wohl, David A; Kuwahara, Rita K; Javadi, Kamran; Kirby, Christine; Rosen, David L; Napravnik, Sonia; Farel, Claire

2017-11-01

Antiretroviral (ARV) adherence has largely been considered from the perspective of an individual's behavior with less attention given to potential structural causes for lapses in treatment, such as the cost of medications and care. HIV medication expense is typically covered by third party payers. However, private insurance premiums and deductibles may rise, or policies terminated such as with a change in employment. Likewise, a patient's eligibility for publicly funded coverage like state AIDS Drug Assistance Programs (ADAP) or Medicaid can also be lost. We conducted a one-time survey of a sample of 300 patients receiving HIV care at a single large academic center in the south of United States to examine lapses in HIV therapy due to financial reasons. We found that during the prior year, financial issues including medication cost or coverage led to a lapse in ARVs in 10% (n = 31) of participants. However, of the 42% (n = 125) participants who had been enrolled in ADAP at any time during the prior year, 21% (n = 26) reported an ARV lapse due to problems with ADAP or medication cost. Respondents cited ADAP's required semi-annual renewal process and other administrative issues as the cause of ARV lapses. The median duration of missed ARVs was 2 weeks (range of financial burdens to care by respondents. In conclusion, although conducted at a single medical center and one state, this study suggests that a significant minority of HIV-infected patients encounter financial barriers to ARV access, and this is paradoxically more common among those enrolled in the state ADAP. Streamlining, supporting, and simplifying ADAP renewal procedures will likely reduce lapses in ARV adherence and persistence.

The efficacy and safety of standardized allergen-removed Rhus verniciflua extract as maintenance therapy after first-line chemotherapy in patients with advanced non-small cell lung cancer.

Science.gov (United States)

Lee, Jinsoo; Chae, Jean; Lee, Sookyung; Kim, Kyungsuk; Eo, Wankyu; Kim, Sehyun; Choi, Woncheol; Cheon, Seong Ha

2013-01-01

Chemotherapy improves the survival of patients with advanced non-small cell lung cancer (NSCLC), but tumor progression is often inevitable. Strategies are needed to improve the therapeutic efficacy of chemotherapy. Over recent years, there has been increasing interest in the role of maintenance therapy after first-line chemotherapy. We investigated the efficacy and safety of standardized allergen-removed Rhus verniciflua Stokes extract (aRVS) as maintenance therapy in patients with non-progressive disease following first-line chemotherapy. We reviewed the medical records of 33 patients with advanced NSCLC, who started treatment with aRVS in a state of tumor regression or stable disease after completion of four or six cycles of induction chemotherapy at the Integrative Cancer Center, Kyung Hee University Hospital at Gangdong from June 2006 to April 2012. The primary objective of this study was progression-free survival (PFS) of aRVS as maintenance therapy. Secondary objectives included assessments of disease control rate (DCR), overall survival (OS), and the safety of aRVS treatment. The median PFS was 5.2 months with a 6- and 12-month PFS rate of 40.6% and 12.9%, respectively. The DCR was 93.9% and the median OS was 34.8 months. The overall survival rates at 12, 24, and 36 months were 84.2%, 76.7% and 49.9%, respectively. We observed no hematologic toxicity, nephrotoxicity, or hepatotoxicity during aRVS treatment. In conclusion, maintenance therapy with aRVS for patients with advanced NSCLC is well-tolerated and offers encouraging improved PFS and OS compared with historical controls. Our data provide further evidence that aRVS may be used beyond disease progression in this clinical setting.

NF-κB and androgen receptor variant expression correlate with human BPH progression.

Science.gov (United States)

Austin, David C; Strand, Douglas W; Love, Harold L; Franco, Omar E; Jang, Alex; Grabowska, Magdalena M; Miller, Nicole L; Hameed, Omar; Clark, Peter E; Fowke, Jay H; Matusik, Robert J; Jin, Ren J; Hayward, Simon W

2016-04-01

Benign prostatic hyperplasia (BPH) is a common, chronic progressive disease. Inflammation is associated with prostatic enlargement and resistance to 5α-reductase inhibitor (5ARI) therapy. Activation of the nuclear factor-kappa B (NF-κB) pathway is linked to both inflammation and ligand-independent prostate cancer progression. NF-κB activation and androgen receptor variant (AR-V) expression were quantified in transition zone tissue samples from patients with a wide range of AUASS from incidental BPH in patients treated for low grade, localized peripheral zone prostate cancer to advanced disease requiring surgical intervention. To further investigate these pathways, human prostatic stromal and epithelial cell lines were transduced with constitutively active or kinase dead forms of IKK2 to regulate canonical NF-κB activity. The effects on AR full length (AR-FL) and androgen-independent AR-V expression as well as cellular growth and differentiation were assessed. Canonical NF-κB signaling was found to be upregulated in late versus early stage BPH, and to be strongly associated with non-insulin dependent diabetes mellitus. Elevated expression of AR-variant 7 (AR-V7), but not other AR variants, was found in advanced BPH samples. Expression of AR-V7 significantly correlated with the patient AUASS and TRUS volume. Forced activation of canonical NF-κB in human prostatic epithelial and stromal cells resulted in elevated expression of both AR-FL and AR-V7, with concomitant ligand-independent activation of AR reporters. Activation of NF-κB and over expression of AR-V7 in human prostatic epithelial cells maintained cell viability in the face of 5ARI treatment. Activation of NF-κB and AR-V7 in the prostate is associated with increased disease severity. AR-V7 expression is inducible in human prostate cells by forced activation of NF-κB resulting in resistance to 5ARI treatment, suggesting a potential mechanism by which patients may become resistant to 5ARI therapy. �

Prevalence of possible drug-drug interactions between antiretroviral agents in different age groups in a section of the private health care sector setting in South Africa.

Science.gov (United States)

Katende-Kyenda, N L; Lubbe, M S; Serfontein, J H P; Truter, I

2008-08-01

The chronic nature of human immunodeficiency virus (HIV) infection requires lifelong highly active antiretroviral (ARV) therapy (HAART) to continuously suppress HIV-1 viral replication, thus reducing morbidity and mortality. HAART is restricted by complex dosing, drug-drug interactions (DDIs) and toxicities. To determine the prevalence of possible DDIs between ARV drugs in different age groups in a section of the private primary health care sector in South Africa. A quantitative, retrospective drug utilization review was performed on 47 085 ARV prescriptions claimed through a national medicine claims database during 2006. Possible DDIs identified were classified according to a clinical significance rating as described by Tatro [Drug Interaction Facts 2005. St Louis, MO: Facts and Comparisons (2005)]. The total number of patients who received prescriptions that were claimed through the medicine claims database was 275 424, of whom 25.11% were males, 28.28% were females and the gender of 46.61% patients was unknown. Of the total number of patients, 3.27% were HIV patients of which an average of 5.23 +/- 3.86 ARV prescriptions (n = 47 085) per patient were claimed for representing 4.73% of the total number of prescriptions claimed during the study period (N = 993 804). HIV patients received an average of 2.36 +/- 0.61 ARVs per prescription. Only 4.95% of the prescriptions had one ARV medicine item, 56.04% two, 37.10% three, 1.75% four and 6 years and 12 and 60 years with patients <40 years and < or =60 years having the highest number of DDIs and patients older than 60 years the lowest. The majority of DDIs between the ARVs presented in significance levels 2 and 4. The most important interactions were between: indinavir (IDV) and ritonavir (n = 199); efavirenz (EFV) and lopinavir/ritonavir (n = 65) and EFV and IDV (n = 60) all interacting at level 2. The importance of using drug utilization study as an identification tool to provide insight into the prescribing and

Üle poolte tööõnnetuste salatakse maha / Gert D. Hankewitz

Index Scriptorium Estoniae

Hankewitz, Gert D.

2008-01-01

Tööõnnetuste tegelik arv võib olla üle kahe korra suurem ametlikust statistikast. Vt. samas: Diagramm: Tööõnnetuste arv; Tööõnnetused erinevates riikides; Sotsiaalministeeriumi kommentaar; Põhjuseks liigne utsitamine ja stress

Tasulise autoveo tegevusluba ja sõidukikaart : [nõuded, vastutavad isikud, kehtivusaeg

Index Scriptorium Estoniae

2005-01-01

Nõuded, vastutavad isikud, kehtivusaeg. Lisa: Tegevusloa ja sõidukikaardita korraldatavate vedude loetelu ; Kehtivate sõidukikaartide ja veoseveo ettevõtete arv maakonniti seisuga november 2005 ; Sõidukikaartide (SK) arv sõitjate- ja veoseveol maakonniti seisuga november 2005

M-health adoption and sustainability prognosis from a care givers’ and patients’ perspective

CSIR Research Space (South Africa)

Hwabamungu, B

2010-10-01

Full Text Available pharmacist, 11 counsellors, and 14 administrative personnel. It provides the following HIV/AIDS service: HIV/AIDS awareness, HIV/AIDS counseling, HIV/AIDS testing, ARV treatment, ARV distribution, patients? follow up and treatment adherence enforcement...

Human immunodeficiency virus type-1 (HIV-1) genetic diversity and ...

African Journals Online (AJOL)

PROGMANAGER

2013-04-24

Apr 24, 2013 ... objective of this study was to determine the genetic diversity of HIV-1 and the prevalence of antiretroviral (ARV) ... individuals in resource limited settings. Key words: ... management of HIV infection even as antiretroviral (ARV).

Transcript Levels of Androgen Receptor Variant 7 and Ubiquitin-Conjugating Enzyme 2C in Hormone Sensitive Prostate Cancer and Castration-Resistant Prostate Cancer.

Science.gov (United States)

Lee, Chan Ho; Ku, Ja Yoon; Ha, Jung Min; Bae, Sun Sik; Lee, Jeong Zoo; Kim, Choung-Soo; Ha, Hong Koo

2017-01-01

This study is designed to identify the androgen receptor variant 7 (AR-V7) status, clinical significance of AR-V7 in hormone sensitive prostate cancer (HSPC). Then, we evaluated AR-V7 and changes of its target gene, ubiquitin-conjugating enzyme E2C (UBE2C) which is an anaphase-promoting complex/cyclosome (APC/C)-specific ubiquitin-conjugating enzyme, in castration-resistant prostate cancer (CRPC) in serial tumor biopsies from patients receiving androgen deprivation therapy. We used RT-PCR and Q-PCR assay to evaluate AR-V7, androgen receptor full length (AR-FL), and UBE2C in tumor biopsies from patients with HSPC and CRPC. We examined associations between mRNA expression of AR-V7 and clinicopathologic factors. Furthermore, to identify other potential genes involved in the development of CRPC, RNA sequencing was conducted, using paired prostate cancer (PCa) tissues obtained immediately prior to treatment and at the time of therapeutic resistance. A total of 13 HSPC patients and three CRPC patients were enrolled. Neither a high Gleason score (score of 8 and 9) nor a high risk of PCa (a high risk of locally advanced PCa according to NCCN guidelines) was correlated with mRNA expression of AR-V7 in HSPC (P = 0.153 and P = 0.215). The mRNA expression of AR-FL, but not AR-V7, was significantly associated with the mRNA expression of UBE2C level in HSPC (P = 0.007). However, increased expression of AR-V7, not AR-FL, paralleled increased expression of UBE2C in the CRPC specimens (P = 0.03). AR-V7 expression status before ADT was likely related to shorter CRPC development in patients treating ADT. The result of the RNA-sequencing analysis using serial samples from the same patient before and after castration demonstrated an increased level of the PI3K regulatory subunit 1 (P = 0.018). Our study revealed the role of UBE2C as a marker of the androgen signaling pathway in PCa. Differential gene expression analysis using serial samples from the same patient

The global pediatric antiretroviral market: analyses of product availability and utilization reveal challenges for development of pediatric formulations and HIV/AIDS treatment in children

Directory of Open Access Journals (Sweden)

Jambert Elodie

2010-10-01

Full Text Available Abstract Background Important advances in the development and production of quality-certified pediatric antiretroviral (ARV formulations have recently been made despite significant market disincentives for manufacturers. This progress resulted from lobbying and innovative interventions from HIV/AIDS activists, civil society organizations, and international organizations. Research on uptake and dispersion of these improved products across countries and international organizations has not been conducted but is needed to inform next steps towards improving child health. Methods We used information from the World Health Organization Prequalification Programme and the United States Food and Drug Administration to describe trends in quality-certification of pediatric formulations and used 7,989 donor-funded, pediatric ARV purchase transactions from 2002-2009 to measure uptake and dispersion of new pediatric ARV formulations across countries and programs. Prices for new pediatric ARV formulations were compared to alternative dosage forms. Results Fewer ARV options exist for HIV/AIDS treatment in children than adults. Before 2005, most pediatric ARVs were produced by innovator companies in single-component solid and liquid forms. Five 2-in1 and four 3-in-1 generic pediatric fixed-dose combinations (FDCs in solid and dispersible forms have been quality-certified since 2005. Most (67% of these were produced by one quality-certified manufacturer. Uptake of new pediatric FDCs outside of UNITAID is low. UNITAID accounted for 97-100% of 2008-2009 market volume. In total, 33 and 34 countries reported solid or dispersible FDC purchases in 2008 and 2009, respectively, but most purchases were made through UNITAID. Only three Global Fund country recipients reported purchase of these FDCs in 2008. Prices for pediatric FDCs were considerably lower than liquids but typically higher than half of an adult FDC. Conclusion Pediatric ARV markets are more fragile than

Cancer Among Children With Perinatal Exposure to HIV and Antiretroviral Medications--New Jersey, 1995-2010.

Science.gov (United States)

Ivy, Wade; Nesheim, Steve R; Paul, Sindy M; Ibrahim, Abdel R; Chan, Miranda; Niu, Xiaoling; Lampe, Margaret A

2015-09-01

Concerns remain regarding the cancer risk associated with perinatal antiretroviral (ARV) exposure among infants. No excessive cancer risk has been found in short-term studies. Children born to HIV-infected women (HIV-exposed) in New Jersey from 1995 to 2008 were identified through the Enhanced HIV/AIDS Reporting System and cross-referenced with data from the New Jersey State Cancer Registry to identify new cases of cancer among children who were perinatally exposed to ARV. Matching of individuals in the Enhanced HIV/AIDS Reporting System to the New Jersey State Cancer Registry was conducted based on name, birth date, Social Security number, residential address, and sex using AutoMatch. Age- and sex-standardized incidence ratio (SIR) and exact 95% confidence intervals (CIs) were calculated using New Jersey (1979-2005) and US (1999-2009) cancer rates. Among 3087 children (29,099 person-years; median follow-up: 9.8 years), 4 were diagnosed with cancer. Cancer incidence among HIV-exposed children who were not exposed to ARV prophylaxis (22.5 per 100,000 person-years) did not differ significantly from the incidence among children who were exposed to any perinatal ARV prophylaxis (14.3 per 100,000 person-years). Furthermore, the number of cases observed among individuals exposed to ARV did not differ significantly from cases expected based on state (SIR = 1.21; 95% CI: 0.25 to 3.54) and national (SIR = 1.27; 95% CI: 0.26 to 3.70) reference rates. Our findings are reassuring that current use of ARV for perinatal HIV prophylaxis does not increase cancer risk. We found no evidence to alter the current federal guidelines of 2014 that recommend ARV prophylaxis of HIV-exposed infants.

Allergen-Removed Rhus verniciflua Extract Induces Ovarian Cancer Cell Death via JNK Activation.

Science.gov (United States)

Kang, Se-Hui; Hwang, In-Hu; Son, Eunju; Cho, Chong-Kwan; Choi, Jong-Soon; Park, Soo-Jung; Jang, Byeong-Churl; Lee, Kyung-Bok; Lee, Zee-Won; Lee, Jong Hoon; Yoo, Hwa-Seung; Jang, Ik-Soon

2016-01-01

Nuclear factor-[Formula: see text]B (NF-[Formula: see text]B)/Rel transcription factors are best known for their central roles in promoting cell survival in cancer. NF-[Formula: see text]B antagonizes tumor necrosis factor (TNF)-[Formula: see text]-induced apoptosis through a process involving attenuation of the c-Jun-N-terminal kinase (JNK). However, the role of JNK activation in apoptosis induced by negative regulation of NF-[Formula: see text]B is not completely understood. We found that allergen-removed Rhus verniciflua Stokes (aRVS) extract-mediated NF-[Formula: see text]B inhibition induces apoptosis in SKOV-3 ovarian cancer cells via the serial activation of caspases and SKOV-3 cells are most specifically suppressed by aRVS. Here, we show that in addition to activating caspases, aRVS extract negatively modulates the TNF-[Formula: see text]-mediated I[Formula: see text]B/NF-[Formula: see text]B pathway to promote JNK activation, which results in apoptosis. When the cytokine TNF-[Formula: see text] binds to the TNF receptor, I[Formula: see text]B dissociates from NF-[Formula: see text]B. As a result, the active NF-[Formula: see text]B translocates to the nucleus. aRVS extract (0.5[Formula: see text]mg/ml) clearly prevented NF-[Formula: see text]B from mobilizing to the nucleus, resulting in the upregulation of JNK phosphorylation. This subsequently increased Bax activation, leading to marked aRVS-induced apoptosis, whereas the JNK inhibitor SP600125 in aRVS extract treated SKOV-3 cells strongly inhibited Bax. Bax subfamily proteins induced apoptosis through caspase-3. Thus, these results indicate that aRVS extract contains components that inhibit NF-[Formula: see text]B signaling to upregulate JNK activation in ovarian cancer cells and support the potential of aRVS as a therapeutic agent for ovarian cancer.

24-Hour Blood Pressure Variability Assessed by Average Real Variability: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Mena, Luis J; Felix, Vanessa G; Melgarejo, Jesus D; Maestre, Gladys E

2017-10-19

Although 24-hour blood pressure (BP) variability (BPV) is predictive of cardiovascular outcomes independent of absolute BP levels, it is not regularly assessed in clinical practice. One possible limitation to routine BPV assessment is the lack of standardized methods for accurately estimating 24-hour BPV. We conducted a systematic review to assess the predictive power of reported BPV indexes to address appropriate quantification of 24-hour BPV, including the average real variability (ARV) index. Studies chosen for review were those that presented data for 24-hour BPV in adults from meta-analysis, longitudinal or cross-sectional design, and examined BPV in terms of the following issues: (1) methods used to calculate and evaluate ARV; (2) assessment of 24-hour BPV determined using noninvasive ambulatory BP monitoring; (3) multivariate analysis adjusted for covariates, including some measure of BP; (4) association of 24-hour BPV with subclinical organ damage; and (5) the predictive value of 24-hour BPV on target organ damage and rate of cardiovascular events. Of the 19 assessed studies, 17 reported significant associations between high ARV and the presence and progression of subclinical organ damage, as well as the incidence of hard end points, such as cardiovascular events. In all these cases, ARV remained a significant independent predictor ( P <0.05) after adjustment for BP and other clinical factors. In addition, increased ARV in systolic BP was associated with risk of all cardiovascular events (hazard ratio, 1.18; 95% confidence interval, 1.09-1.27). Only 2 cross-sectional studies did not find that high ARV was a significant risk factor. Current evidence suggests that ARV index adds significant prognostic information to 24-hour ambulatory BP monitoring and is a useful approach for studying the clinical value of BPV. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Modeling HIV/AIDS drug price determinants in Brazil: is generic competition a myth?

Science.gov (United States)

Meiners, Constance; Sagaon-Teyssier, Luis; Hasenclever, Lia; Moatti, Jean-Paul

2011-01-01

Brazil became the first developing country to guarantee free and universal access to HIV/AIDS treatment, with antiretroviral drugs (ARVs) being delivered to nearly 190,000 patients. The analysis of ARV price evolution and market dynamics in Brazil can help anticipate issues soon to afflict other developing countries, as the 2010 revision of the World Health Organization guidelines shifts demand towards more expensive treatments, and, at the same time, current evolution of international legislation and trade agreements on intellectual property rights may reduce availability of generic drugs for HIV care. Our analyses are based on effective prices paid for ARV procurement in Brazil between 1996 and 2009. Data panel structure was exploited to gather ex-ante and ex-post information and address various sources of statistical bias. In-difference estimation offered in-depth information on ARV market characteristics which significantly influence prices. Although overall ARV prices follow a declining trend, changing characteristics in the generic segment help explain recent increase in generic ARV prices. Our results show that generic suppliers are more likely to respond to factors influencing demand size and market competition, while originator suppliers tend to set prices strategically to offset compulsory licensing threats and generic competition. In order to guarantee the long term sustainability of access to antiretroviral treatment, our findings highlight the importance of preserving and stimulating generic market dynamics to sustain developing countries' bargaining power in price negotiations undertaken with originator companies.

Modeling HIV/AIDS drug price determinants in Brazil: is generic competition a myth?

Directory of Open Access Journals (Sweden)

Constance Meiners

Full Text Available BACKGROUND: Brazil became the first developing country to guarantee free and universal access to HIV/AIDS treatment, with antiretroviral drugs (ARVs being delivered to nearly 190,000 patients. The analysis of ARV price evolution and market dynamics in Brazil can help anticipate issues soon to afflict other developing countries, as the 2010 revision of the World Health Organization guidelines shifts demand towards more expensive treatments, and, at the same time, current evolution of international legislation and trade agreements on intellectual property rights may reduce availability of generic drugs for HIV care. METHODS AND FINDINGS: Our analyses are based on effective prices paid for ARV procurement in Brazil between 1996 and 2009. Data panel structure was exploited to gather ex-ante and ex-post information and address various sources of statistical bias. In-difference estimation offered in-depth information on ARV market characteristics which significantly influence prices. Although overall ARV prices follow a declining trend, changing characteristics in the generic segment help explain recent increase in generic ARV prices. Our results show that generic suppliers are more likely to respond to factors influencing demand size and market competition, while originator suppliers tend to set prices strategically to offset compulsory licensing threats and generic competition. SIGNIFICANCE: In order to guarantee the long term sustainability of access to antiretroviral treatment, our findings highlight the importance of preserving and stimulating generic market dynamics to sustain developing countries' bargaining power in price negotiations undertaken with originator companies.

Hain Karu : Tallinn ehitab jälle tõusvas tempos / Hain Karu ; interv. Tõnu Vare

Index Scriptorium Estoniae

Karu, Hain

2003-01-01

Tallinna Säästva Arengu ja Planeerimise Ameti asejuhataja sõnul on tänases situatsioonis Tallinnas elamufondi defitsiit: leibkondade arv on suurem kui eluasemete arv, seda näitab ka tüüpkorterite kiire hinnatõus

A clinical assessment of antiretroviral-treated patients Referred from ...

African Journals Online (AJOL)

HAART) on the immunological, virological and clinical status of two groups of patients in the South African government antiretroviral (ARV) programme in KwaZulu-Natal, viz. patients previously treated with ARVs in the private sector and then ...

Ion channel activity of membrane vesicles released from sea urchin sperm during the acrosome reaction

International Nuclear Information System (INIS)

Schulz, Joseph R.; Vega-Beltran, Jose L. de la; Beltran, Carmen; Vacquier, Victor D.; Darszon, Alberto

2004-01-01

The sperm acrosome reaction (AR) involves ion channel activation. In sea urchin sperm, the AR requires Ca 2+ and Na + influx and K + and H + efflux. During the AR, the plasma membrane fuses with the acrosomal vesicle membrane forming hybrid membrane vesicles that are released from sperm into the medium. This paper reports the isolation and preliminary characterization of these acrosome reaction vesicles (ARVs), using synaptosome-associated protein of 25 kDa (SNAP-25) as a marker. Isolated ARVs have a unique protein composition. The exocytosis regulatory proteins vesicle-associated membrane protein and SNAP-25 are inside ARVs, as judged by protease protection experiments, and membrane associated based on Triton X-114 partitioning. ARVs fused with planar bilayers display three main types of single channel activity. The most frequently recorded channel is cationic, weakly voltage dependent and has a low open probability that increases with negative potentials. This channel is activated by cAMP, blocked by Ba 2+ , and has a PK + /PNa + selectivity of 4.5. ARVs represent a novel membrane preparation suitable to deepen our understanding of ion channel activity in the AR and during fertilization

The Trans Pacific Partnership Agreement and access to HIV treatment in Vietnam.

Science.gov (United States)

Moir, Hazel V J; Tenni, Brigitte; Gleeson, Deborah; Lopert, Ruth

2018-04-01

In the Trans Pacific Partnership (TPP) Agreement negotiations, the USA successfully pursued intellectual property (IP) provisions that will affect the affordability of medicines, including anti-retrovirals (ARV) for HIV. Vietnam has the lowest GDP per capita of the 12 TPP countries and in 2013 provided ARVs for only 68% of eligible people living with HIV. Using the current Vietnamese IP regime as our base case, we analysed the potential impact of a regime making full use of legal IP flexibilities, and one based on the IP provisions of the final, agreed TPP text. Results indicate that at current funding levels 82% of Vietnam's eligible people living with HIV would receive ARVs if legal flexibilities were fully utilised, while as few as 30% may have access to ARVs under the TPP Agreement - more than halving the proportion currently treated.

Enteropathogenicity of Dutch and German avian reoviruses in SPF white leghorn chickens and broilers.

NARCIS (Netherlands)

Songserm, T.; Roozelaar, van D.; Kant-Eenbergen, H.C.M.; Pol, J.; Pijpers, A.; Huurne, ter A.A.H.M.

2003-01-01

The enteropathogenicity of avian reoviruses (ARVs), isolated from chickens affected with malabsorption syndrome (MAS) from The Netherlands and Germany was studied. In the first trial seven different ARVs isolated from MAS cases were inoculated in 1-day-old specific pathogenic free (SPF) white

HIV MANAGEMENT ON A NEVER-ENDING WAITING LIST

African Journals Online (AJOL)

2006-12-01

Dec 1, 2006 ... of sustained pressure by treatment activists and their allies who exposed the ... receive greater attention as access to ARVs is scaled up. There is an important role for human ..... pilot ARV projects.49. Thus, it would appear that ...

In-vitro photo-translocation of antiretroviral drug delivery into TZMbl cells

CSIR Research Space (South Africa)

Malabi, Rudzani

2017-01-01

Full Text Available The objectives of this study are to use femtosecond laser pulses in a photo-translocation system to deliver ARVs into HIV infected TZMbl cells, and to investigate the influence of ARVs and laser on cellular processes using different molecular...

Determinants of adherence to antiretroviral drugs among people living with HIV/AIDS in the Ife-Ijesa zone of Osun state, Nigeria

Directory of Open Access Journals (Sweden)

Muhammed O. Afolabi

2009-04-01

Method: 120 subjects who received ARV drugs at a federal government-designated ART site located within the Obafemi Awolowo University Teaching Hospital complex, (OAUTHC, Ile-Ife, and a community-based non-governmental organisation, Living Hope Care (LIHOC, Ilesa, from February to May 2006 were serially recruited and studied. Relevant data were collected using an interviewer-administered, patient medication adherence questionnaire. Focus group discussions were also held among the subjects to further elicit qualitative information on factors influencing adherence to ART. Results: The age of participants ranged from 21 to 65 years with a mean age of 40.2 + 10.3 years. Participants had been on ARV drugs for a period ranging between three and 60 months. The overall adherence rate in the study population was 44%. 66% of participants who accessed ARV drugs from LIHOC, Ilesa, had good adherence while only 14% of participants who accessed ARV drugs from OAUTHC, Ile-Ife, had good adherence. Participants with good adherence did not pay funds for the preliminary ARV eligibility investigations and they were also offered regular adherence counselling. These facilities were barely available in the group with poor adherence. Demographic factors such as age, gender and marital status did not seem to have any significant association with adherence level (p > 0.05. Conclusion: The level of adherence was high in a cohort of PLWHA accessing ARV drugs in Ilesa while it was low among PLWHA receiving ART in Ife. The most important reasons for this difference were lack of funds for investigations and poor psycho-social counselling.

The pricing and procurement of antiretroviral drugs: an observational study of data from the Global Fund.

Science.gov (United States)

Vasan, Ashwin; Hoos, David; Mukherjee, Joia S; Farmer, Paul E; Rosenfield, Allan G; Perriëns, Joseph H

2006-05-01

The Purchase price report released in August 2004 by the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) was the first publication of a significant amount of real transaction purchase data for antiretrovirals (ARVs). We did an observational study of the ARV transaction data in the Purchase price report to examine the procurement behaviour of principal recipients of Global Fund grants in developing countries. We found that, with a few exceptions for specific products (e.g. lamivudine) and regions (e.g. eastern Europe), prices in low-income countries were broadly consistent or lower than the lowest differential prices quoted by the research and development sector of the pharmaceutical industry. In lower middle-income countries, prices were more varied and in several instances (lopinavir/ritonavir, didanosine, and zidovudine/lamivudine) were very high compared with the per capita income of the country. In all low- and lower middle-income countries, ARV prices were still significantly high given limited local purchasing power and economic strength, thus reaffirming the need for donor support to achieve rapid scale-up of antiretroviral therapy. However, the price of ARVs will have to decrease to render scale-up financially sustainable for donors and eventually for governments themselves. An important first step in reducing prices will be to make available in the public domain as much ARV transaction data as possible to provide a factual basis for discussions on pricing. The price of ARVs has considerable implications for the sustainability of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) treatment in the developing world.

Antiretroviral therapy provided to HIV-infected Malawian women in a randomized trial diminishes the posiitive effect of lipid-based nutrient supplements on breast milk B-vitamins

Science.gov (United States)

Background: There is little information on B-vitamin concentrations in human milk or how they are affected by maternal B-vitamin deficiencies, antiretroviral (ARV) therapy or maternal supplementation. Objective: To evaluate effects of ARV therapy and/or lipid-based nutrient supplements (LNS) on B-v...

Juhtimissüsteemide selgroog. Lean ning ISO - terviklahendused tootmise haldamiseks / Anton Ovsjankin

Index Scriptorium Estoniae

Ovsjankin, Anton

2011-01-01

Kasvanud on juurutatavate Lean ja ISO süsteemide arv, kuid on kasvanud ka nende juurutamise ja arendamisega seotud ebaõnnestumiste arv. Põhjustest, miks jäävad paljud Leani ja ISO juurutanud ettevõtted ilma lubatud tulemusteta. Leani ja ISO haldamiseks vajalikest teguritest

Antiretrovirals, Fractures, and Osteonecrosis in a Large International HIV Cohort

DEFF Research Database (Denmark)

Borges, Álvaro H; Hoy, Jennifer; Florence, Eric

2017-01-01

Background: Antiretrovirals (ARVs) affect bone density and turnover, but their effect on risk of fractures and osteonecrosis of the femoral head is less understood. We investigated if exposure to ARVs increases the risk of both bone outcomes. Methods: EuroSIDA participants were followed to assess...

New targets and novel antiretrovirals | Wood | Southern African ...

African Journals Online (AJOL)

Highly active antiretroviral therapy (HAART) has to date been based on use of a triple combination of drugs chosen from three classes of antiretrovirals (ARVs), nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs). These ARV classes ...

Generic substitution of antiretrovirals: patients' and health care providers' opinions.

Science.gov (United States)

Kieran, Jennifer A; O'Reilly, Eimear; O'Dea, Siobhan; Bergin, Colm; O'Leary, Aisling

2017-10-01

There is interest in introducing generic antiretroviral drugs (ARVs) into high-income countries in order to maximise efficiency in health care budgets. Studies examining patients' and providers' knowledge and attitudes to generic substitution in HIV are few. This was a cross-sectional, observational study with a convenience sample of adult HIV-infected patients and health care providers (HCPs). Data on demographics, knowledge of generic medicine and facilitators of generic substitution were collected. Descriptive and univariate analysis was performed using SPSS V.23™. Questionnaires were completed by 66 patients. Seventy-one per cent would have no concerns with the introduction of generic ARVs. An increase in frequency of administration (61%) or pill burden (53%) would make patients less likely to accept generic ARVs. There were 30 respondents to the HCP survey. Concerns included the supply chain of generics, loss of fixed dose combinations, adherence and use of older medications. An increase in dosing frequency (76%) or an increase in pill burden (50%) would make HCPs less likely to prescribe a generic ARV. The main perceived advantage was financial. Generic substitution of ARVs would be acceptable to the majority of patients and HCPs. Reinvesting savings back into HIV services would facilitate the success of such a programme.

Regulatory challenges in developing long-acting antiretrovirals for treatment and prevention of HIV infection.

Science.gov (United States)

Arya, Vikram; Au, Stanley; Belew, Yodit; Miele, Peter; Struble, Kimberly

2015-07-01

To outline some of the regulatory challenges inherent to the development of long-acting antiretrovirals (ARVs) for the treatment or prevention of HIV infection. Despite advances in drug development that have reduced ARV dosing to once daily, suboptimal drug adherence remains an obstacle to successful HIV treatment. Further, large randomized trials of once daily oral ARVs for preexposure prophylaxis (PrEP) have shown that drug adherence correlates strongly with prophylactic effect and study outcomes. Thus, the prospect of developing long-acting ARVs, which may mitigate drug adherence issues, has attracted considerable attention lately. Because of their pharmacokinetic properties, the development of long-acting ARVs can present novel regulatory challenges. Chief among them is determining the appropriate dosing regimen, the need for an oral lead-in, and whether existing data with an approved oral agent, if available, can be leveraged for a treatment or prevention indication. For PrEP, because validated biomarkers are lacking, additional nonclinical studies and evaluation of tissue concentrations in multiple compartments may be necessary to identify optimal dosages. Study design and choice of controls for registrational trials of new long-acting PrEP agents might also prove challenging following the availability of an oral PrEP drug.

Struktuurireform muutis töö tõhusamaks = Structural reform makes work more effective / Aljona Mändlo

Index Scriptorium Estoniae

Mändlo, Aljona

2006-01-01

Tööturuameti ja tööhõiveametite haldussuutlikkuse tõstmiseks käivitatud projektist, struktuuri ja koosseisude muutustest. Vt lisad: Aktiivsed tööturumeetmed, toetuste saajate arv 1995-2005; Aktiivsed tööturumeetmed, koolitusel ja nõustamisel osalenute arv 1995-2005; Kõnekaid fakte

HIV antiretroviral medication stock-outs in Ghana: contributors and ...

African Journals Online (AJOL)

Although using ARVs produced in-country could reduce supply problems, the domestically-manufactured product currently does not meet World Health Organization (WHO) standards. We recommend focused efforts to produce WHO standard ARVs in Ghana, and a review of current supply chain management to identify and ...

Computer-based intervention in HIV clinical care setting improves antiretroviral adherence: the LifeWindows Project.

Science.gov (United States)

Fisher, Jeffrey D; Amico, K Rivet; Fisher, William A; Cornman, Deborah H; Shuper, Paul A; Trayling, Cynthia; Redding, Caroline; Barta, William; Lemieux, Anthony F; Altice, Frederick L; Dieckhaus, Kevin; Friedland, Gerald

2011-11-01

We evaluated the efficacy of LifeWindows, a theory-based, computer-administered antiretroviral (ARV) therapy adherence support intervention, delivered to HIV + patients at routine clinical care visits. 594 HIV + adults receiving HIV care at five clinics were randomized to intervention or control arms. Intervention vs. control impact in the intent-to-treat sample (including participants whose ARVs had been entirely discontinued, who infrequently attended care, or infrequently used LifeWindows) did not reach significance. Intervention impact in the On Protocol sample (328 intervention and control arm participants whose ARVs were not discontinued, who attended care and were exposed to LifeWindows regularly) was significant. On Protocol intervention vs. control participants achieved significantly higher levels of perfect 3-day ACTG-assessed adherence over time, with sensitivity analyses maintaining this effect down to 70% adherence. This study supports the utility of LifeWindows and illustrates that patients on ARVs who persist in care at clinical care sites can benefit from adherence promotion software.

The impact of HIV antiretroviral treatment perception on risky sexual behaviour in Botswana: a short report.

Science.gov (United States)

Letamo, Gobopamang; Keetile, Mpho; Navaneetham, Kannan

2017-12-01

The aim of this article is to investigate the impact of ART perception on risky sexual behaviours in Botswana. Using binary logistic regression analysis controlling for individual characteristics, the results tend to support the hypothesis that ART misconceptions do not necessarily increase risky sexual behaviours. In particular, the study findings suggest the belief that ARVs cure HIV and AIDS and that people on ARVs should not always use condoms do not necessarily lead to increased risky sexual behaviours, particularly among women. Gender differentials exist in the perceived sexual risk resulting from the use of ART. Risky sexual behaviours increase for women who, wrongly, believed that ARVs cure HIV and AIDS and people on ARVs should not always use condoms. Although there is evidence to suggest ART perceptions do not necessarily lead to increased risky sexual behaviours, HIV and AIDS prevention programmes are needed to strengthen their information, education and communication intervention component that can address misconceptions about ART treatment and provide correct information that is gender-appropriate.

HIV-1 infection and pregnancy in young women in Brazil: socioeconomic and drug resistance profiles in a cross-sectional study.

Science.gov (United States)

Lima, Yanna Andressa Ramos; Reis, Mônica Nogueira Guarda; Cardoso, Ludimila Paula Vaz; Stefani, Mariane Martins Araújo

2016-07-05

To describe socioeconomic and antiretroviral (ARV) drug resistance profiles among young pregnant women infected with HIV-1. A public health antenatal programme responsible for screening ∼90 000 pregnant women per year for nine different infectious diseases in Central Western Brazil. 96 young pregnant women (15-24 years) infected with HIV-1. Standard interviews and blood samples were taken at the time of recruitment, at the first medical appointment after confirmation of diagnosis of HIV-1 infection, and before ARV prophylaxis initiation. Clinical and laboratory data were retrieved from medical files. HIV-1 pol gene sequences (entire protease/PR, partial reverse transcriptase/RT) were obtained from plasma RNA. ARV resistance mutations (CPR/Stanford HIV-1; International AIDS Society-USA databases) were identified. The median age was 21 years; most reported pregnancies. Possible heterosexual transmission by an HIV-1 infected partner (17%) and commercial sex work (2%) were reported. The median of CD4 cell count was 526 cells/mm(3); the median viral load was: 10 056 copies/mL in ARV-naïve (48/96) patients and 5881 copies/mL in ARV-exposed (48/96) patients. Two probable seroconversion cases during pregnancy were identified in adolescents. One mother-to-child transmission case (1.0%) was observed. Transmitted drug resistance among ARV-naïve patients was 9.3% (CI 95% 3.3% to 19.6%); secondary drug resistance among ARV-exposed patients was 12.5% (CI 95% 4.7% to 25.6%). Despite high access to antenatal care, the low socioeconomic-educational profiles seen in these young HIV-1-infected women highlight the necessity of improved public health educational and preventive strategies regarding HIV infection and early unplanned pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

To be or not to be Violent

DEFF Research Database (Denmark)

Sen, Somdeep

2012-01-01

June 19, 2012: the Palestinian skies lit up again with an exchange of rockets and air strikes between Israel and Hamas in Gaza, breaking the uneasy calm that had prevailed since March when Islamic Jihad had engaged in hostilities with Israel following the assassination of Zuhir al-Qaisi, the Secr......June 19, 2012: the Palestinian skies lit up again with an exchange of rockets and air strikes between Israel and Hamas in Gaza, breaking the uneasy calm that had prevailed since March when Islamic Jihad had engaged in hostilities with Israel following the assassination of Zuhir al...

ORIGINAL ARTICLES Prevalence of drug-drug interactions of ...

African Journals Online (AJOL)

2008-02-02

Feb 2, 2008 ... Table II. Frequency of level 2 interactions between ARVs and the other drugs. Interacting ARVs and other drugs. N. %*. Didanosine + ketoconazole. 1. 0.91. Didanosine + ofloxacin. 1. 0.91. Didanosine + ciprofloxacin. 2. 1.82. Didanosine + iraconazole. 3. 2.73. Didanosine + ketoconazole. 2. 1.82. Efavirenz ...

Antiretroviral therapy

DEFF Research Database (Denmark)

Nam, Nguyen Thi Thu; Bygbjerg, Ib Christian; Mogensen, Hanne Overgaard

2011-01-01

In Vietnam, ARV access has been scaled up since 2005 in high HIV prevalence areas in order to meet increasing demands for HIV treatment. This paper aims to estimate ARV unmet need and its associated socio-demographic characteristics among HIV-positive women in Haiphong, Vietnam. A cross-sectional...

A retrospective PCR investigation of avian Orthoreovirus, chicken infectious anemia and fowl Aviadenovirus genomes contamination in commercial poultry vaccines in Brazil

Directory of Open Access Journals (Sweden)

P.R. Barrios

2012-02-01

Full Text Available Vacinas avícolas vivas comerciais produzidas entre 1991 e 2005 foram examinadas para a presença de genomas dos vírus da anemia infecciosa das galinhas (Gyrovirus CAV, da hepatite por corpúsculo de inclusão (Aviadenovirus FAdV e da artrite viral/síndrome da má absorção (Orthoreovirus aviário ARV. Vinte e seis partidas de vacinas vivas liofilizadas de oito fabricantes com lacre original foram examinadas. As extrações de DNA e PCR de CAV e FAdV, e de RNA e RT-PCR para ARV, foram descritas previamente. Contaminações triplas de ARV, CAV e FAdV foram detectadas em vacinas de mesmo fabricante, produzidas em 1991 e 1992 contra a doença de Newcastle (DN, e para a encefalomielite aviária, produzida em 1994. ARV e CAV em co-infecção foram encontrados em vacinas contra a doença de Marek liofilizadas produzidas em 1996 por dois fabricantes diferentes. Genoma de ARV foi detectado em vacinas contra a bronquite infecciosa de setembro e dezembro de 1998, doença infecciosa bursal, de dezembro de 1998 e DN de janeiro de 1998. Três dos oito fabricantes apresentaram vacinas com contaminação e cinco nunca apresentaram vacinas contaminadas. Nenhuma vacina produzida a partir de 2001 apresentou contaminação. Cogita-se um papel epidemiológico para vacinas vivas, como fonte de infecção para ARV, CAV e FAdV e, potencialmente determinante da atual alta disseminação destes.

Annotatie bij Hoge Raad 24 april 2007 (Ordebevelen op stations)

NARCIS (Netherlands)

Brouwer J.G., Jan; Schilder A.E., [No Value

2008-01-01

Samenvatting: Het ARV berustte ten tijde van het tenlastegelegde op art. 27 Spoorwegwet 1875. Art. 7 ARV richt zich, kort gezegd en voor zover hier van belang, tot een ieder die zich als niet-reiziger op een station bevindt met het gebod de aanwijzingen betreffende de orde, rust, veiligheid of een

Perceptions among Dutch men who have sex with men and their willingness to use rectal microbicides and oral pre-exposure prophylaxis to reduce HIV risk--a preliminary study

NARCIS (Netherlands)

Marra, Elske; Hankins, Catherine A.

2015-01-01

Oral pre-exposure prophylaxis (PrEP) with antiretroviral (ARV) tablets and topical PrEP or microbicides containing ARV drugs could help to reduce HIV incidence. These methods hold promise for men who have sex with men (MSM) who are at higher risk of acquiring HIV. This mixed-methods study in the

Patients’ knowledge and beliefs about antiretroviral treatment and factors associated with adherence in Mpumalanga Province, South Africa

Directory of Open Access Journals (Sweden)

Thuli G. Mthembu

2014-07-01

Doelwitte: Hierdie studie ondersoek pasiënte se kennis, houdings en ander faktore wat die navolging van ARV behandeling beïnvloed by Shongwe-hospitaal in die Nkomazi distrik in Mpumalanga. Metode: ‘n Bestekopname van 184 pasiënte, tussen die ouderdomme van 15 en 65 jaar, wat ARV behandeling ontvang is gedoen. Hulle is lukraak gekies en het ‘n vraelys voltooi rakende hul kennis en oortuigings ten opsigte van ARV-middels, asook die faktore wat die stiptelike gebruik van die middels beïnvloed. Resultate: Die steekproef het hoofsaaklik uit vroue (71.2% bestaan, en die meerderheid was werkloos (83.7%. Die meeste van die deelnemers het aangedui dat hulle hul ARV-medikasie die vorige twee dae (92.4% en sewe dae (84.2% grotendeels (ten minste 95% van medikasie volgens voorskrif geneem het. Die meerderheid van die studie deelnemers het redelike kennis van en positiewe houdings teenoor ARV-behandeling getoon. Vergeetagtigheid, die besigheid van normale daaglikse roetine, die ontvang van besoekers, besoeke aan kroeë asook uitslaap was die redes wat aangevoer is vir vernalating om medisyne te neem. Gevolgtrekking: Alhoewel, die meeste pasiënte in hierdie studie aanvanklik redelik goed gevaar het met die navolging van die behandelingsplan, moet die probleme wat ervaar is met die neem van medikasie aangespreek word om lang-termyn navolging van behandeling en retensie te bewerkstellig.

Sub therapeutic drug levels among HIV/TB co-infected patients ...

African Journals Online (AJOL)

Daniel W. Gunda

2016-11-01

Nov 1, 2016 ... NVP based regimen was associated with sub-therapeutic drug levels on uni- ... a number of important challenges including induction of sub- therapeutic levels of .... ARV plasma levels in the univariate model with p-values less than 0.05 .... clearance of ARVs.56 This may be one of the explanations that.

Vaesed tööloomad / Gert D. Hankewitz

Index Scriptorium Estoniae

Hankewitz, Gert D.

2008-01-01

Riikides, kus palgad ja elatustase on madalamad, tehakse rohkem ületunde, samas kui jõukates riikides on töötundide arv väiksem. Vt. samas: Neljapäevane töönädal ei tasunud ära. Diagramm: Reaalselt töötatud tundide arv nädalas riikide kaupa

Maxima: tarbimine elavneb alles kahe aasta pärast / Andres Reimer

Index Scriptorium Estoniae

Reimer, Andres

2009-01-01

Maxima grupi laienemine on peatatud, sh. ka Eestis. Maxima kaupluste arv vähenes Leedus kümne võrra, Eestis lisandus üks Maxima kauplus, Lätis jäi nende arv samaks. Prisma Peremarketi juhi Janne Tapio Lihavaineni hinnangul on Maxima poed liiga väikesed, et majanduskriisi ajal konkureerida

The outcome of prevention of mother to child transmission (PMTCT) of HIV infection programme in Nnewi, southeast Nigeria.

Science.gov (United States)

Ikechebelu, J I; Ugboaja, J O; Kalu, S O; Ugochukwu, E F

2011-01-01

A lot of challenges face the current efforts at reducing Mother to Child transmission of HIV infection (MTCT) in Sub Saharan Africa due to limited access to Highly active antiretroviral therapy (HAART) and breast feeding practices. A regular review of progress is necessary in order to identify areas of need. This is a one year prospective descriptive study of seven hundred and twenty six mother-infant pairs managed in the PMTCT programme in Nnamdi Azikiwe University Teaching Hospital, Nnewi Southeast Nigeria. The babies HIV status was tested with PCR for HIV DNA while the mothers provided information on infant feeding pattern and the use of antiretroviral (ARV) drugs including prophylaxis for the baby. Information was augmented from the antenatal records. The transmission rate was 2.8% for mothers, who were on HAART, did not breastfeed and whose babies received ARV prophylactic therapy. But for mothers who did not receive HAART, did breastfeed and whose babies did not received ARV prophylactic therapy, the transmission rate was 37.5%. When both the mother and child received ARV drugs, the transmission rate was significantly lower in those who did not breastfeed (2.8%) than in those who breastfed (12.5%)(P < 0.001). When both the mother and child did not receive ARV drugs, the transmission rate significantly lower in those who did not breastfeed (21.1%)than in those who breastfed (37.5%) (P < 0.02). The use of HAART in PMTCT programme in the under resourced areas can achieve similar success rates to that in the industrialized countries. Breastfeeding reduces the efficacy achieved by the use of ARV drugs. Provision of wider access to HAART as well as adequate counselling and support for safer infant feeding practices is recommended.

Abuse of antiretroviral drugs combined with addictive drugs by ...

African Journals Online (AJOL)

Reports of the use of antiretroviral drugs (ARVs) to produce a highly addictive drug called nyaope or whoonga are of major concern as ARVs are easily accessible in sub-Saharan Africa, including to pregnant women. Use of illicit drugs by pregnant women may result in serious adverse effects in their infants. We have ...

Religion and HIV in Tanzania: influence of religious beliefs on HIV stigma, disclosure, and treatment attitudes

Directory of Open Access Journals (Sweden)

Ostermann Jan

2009-03-01

Full Text Available Abstract Background Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV treatment. Methods A self-administered survey was distributed to a convenience sample of parishioners (n = 438 attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and people living with HIV/AIDS. Results Results indicate that shame-related HIV stigma is strongly associated with religious beliefs such as the belief that HIV is a punishment from God (p Conclusion The decision to start ARVs hinged primarily on education-level and knowledge about ARVs rather than on religious factors. Research results highlight the influence of religious beliefs on HIV-related stigma and willingness to disclose, and should help to inform HIV-education outreach for religious groups.

Hormonal Contraceptives Differentially Suppress TFV and TAF Inhibition of HIV Infection and TFV-DP in Blood and Genital Tract CD4+ T cells.

Science.gov (United States)

Shen, Zheng; Rodriguez-Garcia, Marta; Patel, Mickey V; Bodwell, Jack; Kashuba, Angela D M; Wira, Charles R

2017-12-18

HIV prevention research is focused on combining antiretrovirals (ARV) and progestin contraceptives to prevent HIV infection and pregnancy. The possibility that progestins compromise ARV anti-HIV activity prompted us to evaluate the effects of progestins on tenofovir (TFV) and TFV-alafenamide (TAF) on HIV infection and intracellular TFV-diphosphate (TFV-DP) concentrations in blood and genital CD4+ T cells. Following incubation of blood CD4+ T cells with TFV or TAF, Medroxyprogesterone acetate (MPA), but not Levonorgestrel, Norethisterone or progesterone, suppressed the anti-HIV effect of TFV by reducing intracellular TFV-DP, but had no effect on TAF inhibition of infection or TFV-DP. In contrast, with genital CD4+ T cells, MPA suppressed TAF inhibition of HIV infection and lowered of TFV-DP concentrations without affecting TFV protection. These findings demonstrate that MPA selectively compromises TFV and TAF protection in blood and genital CD4+ T cells and suggests that MPA may decrease ARV protection in individuals who use ARV intermittently for prevention.

Comparing two service delivery models for the prevention of mother-to-child transmission (PMTCT of HIV during transition from single-dose nevirapine to multi-drug antiretroviral regimens

Directory of Open Access Journals (Sweden)

Mugwaneza Placidie

2010-12-01

Full Text Available Abstract Background Mother-to-child transmission (MTCT of HIV has been eliminated from the developed world with the introduction of multi-drug antiretroviral (md-ARV regimens for the prevention of MTCT (PMTCT; but remains the major cause of HIV infection among sub-Saharan African children. This study compares two service delivery models of PMTCT interventions and documents the lessons learned and the challenges encountered during the transition from single-dose nevirapine (sd-nvp to md-ARV regimens in a resource-limited setting. Methods Program data collected from 32 clinical sites was used to describe trends and compare the performance (uptake of HIV testing, CD4 screening and ARV regimens initiated during pregnancy of sites providing PMTCT as a stand-alone service (stand-alone site versus sites providing PMTCT as well as antiretroviral therapy (ART (full package site. CD4 cell count screening, enrolment into ART services and the initiation of md-ARV regimens during pregnancy, including dual (zidovudine [AZT] +sd-nvp prophylaxis and highly active antiretroviral therapy (HAART were analysed. Results From July 2006 to December 2008, 1,622 pregnant women tested HIV positive (HIV+ during antenatal care (ANC. CD4 cell count screening during pregnancy increased from 60% to 70%, and the initiation of md-ARV regimens increased from 35.5% to 97% during this period. In 2008, women attending ANC at full package sites were 30% more likely to undergo CD4 cell count assessment during pregnancy than women attending stand-alone sites (relative risk (RR = 1.3; 95% confidence interval (CI: 1.1-1.4. Enrolment of HIV+ pregnant women in ART services was almost twice as likely at full package sites than at stand-alone sites (RR = 1.9; 95% CI: 1.5-2.3. However, no significant differences were detected between the two models of care in providing md-ARV (RR = 0.9; 95% CI: 0.9-1.0. Conclusions All sites successfully transitioned from sd-nvp to md-ARV regimens for PMTCT

Intervening in global markets to improve access to HIV/AIDS treatment: an analysis of international policies and the dynamics of global antiretroviral medicines markets.

Science.gov (United States)

Waning, Brenda; Kyle, Margaret; Diedrichsen, Ellen; Soucy, Lyne; Hochstadt, Jenny; Bärnighausen, Till; Moon, Suerie

2010-05-25

Universal access to antiretroviral therapy (ART) in low- and middle-income countries faces numerous challenges: increasing numbers of people needing ART, new guidelines recommending more expensive antiretroviral (ARV) medicines, limited financing, and few fixed-dose combination (FDC) products. Global initiatives aim to promote efficient global ARV markets, yet little is known about market dynamics and the impact of global policy interventions. We utilize several data sources, including 12,958 donor-funded, adult first-line ARV purchase transactions, to describe the market from 2002-2008. We examine relationships between market trends and: World Health Organization (WHO) HIV/AIDS treatment guidelines; WHO Prequalification Programme (WHO Prequal) and United States (US) Food and Drug Administration (FDA) approvals; and procurement policies of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM), US President's Emergency Plan for AIDS Relief (PEPFAR) and UNITAID. WHO recommended 7, 4, 24, and 6 first-line regimens in 2002, 2003, 2006 and 2009 guidelines, respectively. 2009 guidelines replaced a stavudine-based regimen ($88/person/year) with more expensive zidovudine- ($154-260/person/year) or tenofovir-based ($244-465/person/year) regimens. Purchase volumes for ARVs newly-recommended in 2006 (emtricitabine, tenofovir) increased >15-fold from 2006 to 2008. Twenty-four generic FDCs were quality-approved for older regimens but only four for newer regimens. Generic FDCs were available to GFATM recipients in 2004 but to PEPFAR recipients only after FDA approval in 2006. Price trends for single-component generic medicines mirrored generic FDC prices. Two large-scale purchasers, PEPFAR and UNITAID, together accounted for 53%, 84%, and 77% of market volume for abacavir, emtricitabine, and tenofovir, respectively, in 2008. PEPFAR and UNITAID purchases were often split across two manufacturers. Global initiatives facilitated the creation of fairly efficient markets

The effects of enhanced access to antiretroviral therapy: a qualitative study of community perceptions in Kampala city, Uganda.

Science.gov (United States)

Atuyambe, Lynn; Neema, Stella; Otolok-Tanga, Erasmus; Wamuyu-Maina, Gakenia; Kasasa, Simon; Wabwire-Mangen, Fred

2008-03-01

Since 2001, Antiretroviral Therapy (ART) has been integrated as part of the Uganda National Program for Comprehensive HIV/AIDS Care and Support. If patients take Antiretroviral drugs (ARVs) as prescribed, quality of life is expected to improve and patients become healthier. It is, however, postulated that scale up of ARVs could erode the previous achievement in behaviour change interventions. This study examined community perceptions and beliefs on whether enhanced access to ARVs increases risk behaviour. It also examined people's fears regarding HIV/AIDS infection and the use of ARVs. This was a qualitative study that utilized Focus Group Discussions (FGDs) and Key Informant (KI) interviews. Participants were purposefully sampled. Twenty FGDs comprising of 190 participants and 12 KI interviews were conducted. FGDs were conducted with adult men and women (above 25 years), and youth (male and female) while KI interviews were held with Kampala City Council officials, Kawempe Division Local Council officials, health workers and religious leaders. All data was tape recorded with consent from participants and transcribed thereafter. Typed data was analyzed manually using qualitative latent content analysis technique. Most participants felt that enhanced access to ART would increase risky sexual behaviour; namely promiscuity, lack of faithfulness among couples, multiple partners, prostitution, unprotected sexual practices, rape and lack of abstinence as the risky sexual behaviours. A few FGDs, however, indicated that increased ART access and counselling that HIV-positive people receive promoted positive health behaviour. Some of the participants expressed fears that the increased use of ARVs would promote HIV transmission because it would be difficult to differentiate between HIV-positive and HIV-negative persons since they all looked healthy. Furthermore, respondents expressed uncertainty about ARVs with regard to adherence, sustainable supply, and capacity to ensure

Outcomes in a cohort of women who discontinued maternal triple-antiretroviral regimens initially used to prevent mother-to-child transmission during pregnancy and breastfeeding--Kenya, 2003-2009.

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Timothy D Minniear

Full Text Available In 2012, the World Health Organization (WHO amended their 2010 guidelines for women receiving limited duration, triple-antiretroviral drug regimens during pregnancy and breastfeeding for prevention of mother-to-child transmission of HIV (tARV-PMTCT (Option B to include the option to continue lifelong combination antiretroviral therapy (cART (Option B+. We evaluated clinical and CD4 outcomes in women who had received antiretrovirals for prevention of mother-to-child transmission and then discontinued antiretrovirals 6-months postpartum.The Kisumu Breastfeeding Study, 2003-2009, was a prospective, non-randomized, open-label clinical trial of tARV-PMTCT in ARV-naïve, Kenyan women. Women received tARV-PMTCT from 34 weeks' gestation until 6-months postpartum when women were instructed to discontinue breastfeeding. Women with CD4 count (CD4 <250cells/mm3 or WHO stage III/IV prior to 6-months postpartum continued cART indefinitely. We estimated the change in CD4 after discontinuing tARV-PMTCT and the adjusted relative risk [aRR] for factors associated with declines in maternal CD4. We compared maternal and infant outcomes following weaning-when tARV-PMTCT discontinued-by maternal ARV status through 24-months postpartum. Compared with women who continued cART, discontinuing antiretrovirals was associated with infant HIV transmission and death (10.1% vs. 2.4%; P = 0.03. Among women who discontinued antiretrovirals, CD4<500 cells/mm3 at either initiation (21.8% vs. 1.5%; P = 0.002; aRR: 9.8; 95%-confidence interval [CI]: 2.4-40.6 or discontinuation (36.9% vs. 8.3%; P<0.0001; aRR: 4.4; 95%-CI: 1.9-5.0 were each associated with increased risk of women requiring cART for their own health within 6 months after discontinuing.Considering the serious health risks to the woman's infant and the brief reprieve from cART gained by stopping, every country should evaluate the need for and feasibility to implement WHO Option B+ for PMTCT. Evaluating CD4 at

Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV/AIDS in Italy: a Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians.

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Palummieri, Antonio; De Carli, Gabriella; Rosenthal, Éric; Cacoub, Patrice; Mussini, Cristina; Puro, Vincenzo

2017-11-28

Before Pre-Exposure Prophylaxis (PrEP) was officially recommended and made available, a few surveys among gay and bisexual men, and persons living with HIV/AIDS (PLWHA), identified an informal use of antiretrovirals (ARVs) for PrEP among HIV-negative individuals. Before PrEP availability in Italy, we aimed to assess whether PLWHA in Italy shared their ARVs with HIV-negative individuals, whether they knew people who were on PrEP, and describe the level of awareness and discussion on this preventive measure among them and people in their close circle. Two anonymous questionnaires investigating personal characteristics and PrEP awareness, knowledge, and experience were proposed to HIV specialists and their patients on ARVs in a one-week, cross-sectional survey (December 2013-January 2014). Among PLWHA, a Multivariable Logistic Regression analysis was conducted to identify factors associated with PrEP discussion with peers (close circle and/or HIV associations), and experience (use in close circle and/or personal ARV sharing). Eighty-seven specialists in 31 representative Infectious Diseases departments administered the questionnaire to 1405 PLWHA. Among specialists, 98% reported awareness, 65% knew the dosage schedule, and 14% had previously suggested or prescribed PrEP. Among PLWHA, 45.6% were somehow aware, discussed or had direct or indirect experience of PrEP: 38% "had heard" of PrEP, 24% were aware of studies in HIV-negative individuals demonstrating a risk reduction through the use of ARVs, 22% had discussed PrEP, 12% with peers; 9% reported PrEP use in close circle and 1% personal ARV sharing. Factors predictive of either PrEP discussion with peers or experience differed between men and women, but across all genders were mainly related to having access to information, with HIV association membership being the strongest predictor. At a time and place where there were neither official information nor proposals or interventions to guide public policies on PrEP in

Loss of retrovirus production in JB/RH melanoma cells transfected with H-2Kb and TAP-1 genes.

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Li, M; Xu, F; Muller, J; Huang, X; Hearing, V J; Gorelik, E

1999-01-20

JB/RH1 melanoma cells, as well as other melanomas of C57BL/6 mice (B16 and JB/MS), express a common melanoma-associated antigen (MAA) encoded by an ecotropic melanoma-associated retrovirus (MelARV). JB/RH1 cells do not express the H-2Kb molecules due to down-regulation of the H-2Kb and TAP-1 genes. When JB/RH1 cells were transfected with the H-2Kb and cotransfected with the TAP-1 gene, it resulted in the appearance of H-2Kb molecules and an increase in their immunogenicity, albeit they lost expression of retrovirus-encoded MAA recognized by MM2-9B6 mAb. Loss of MAA was found to result from a complete and stable elimination of ecotropic MelARV production in the H-2Kb/TAP-1-transfected JB/RH1 cells. Northern blot analysis showed no differences in ecotropic retroviral messages in MelARV-producing and -nonproducing melanoma cells, suggesting that loss of MelARV production was not due to down-regulation of MelARV transcription. Southern blot analysis revealed several rearrangements in the proviral DNA of H-2Kb-positive JB/RH1 melanoma cells. Sequence analysis of the ecotropic proviral DNA from these cells showed numerous nucleotide substitutions, some of which resulted in the appearance of a novel intraviral PstI restriction site and the loss of a HindIII restriction site in the pol region. PCR amplification of the proviral DNAs indicates that an ecotropic provirus found in the H-2Kb-positive cells is novel and does not preexist in the parental H-2Kb-negative melanoma cells. Conversely, the ecotropic provirus of the parental JB/RH1 cells was not amplifable from the H-2Kb-positive cells. Our data indicate that stable loss of retroviral production in the H-2Kb/TAP-1-transfected melanoma cells is probably due to the induction of recombination between a productive ecotropic MelARV and a defective nonecotropic provirus leading to the generation of a defective ecotropic provirus and the loss of MelARV production and expression of the retrovirus-encoded MAA. Copyright 1999

Proposed methodology for monitoring antiretroviral drugs price negotiations in Latin America and the Caribbean Propuesta de metodología para monitorear la negociación de precios de los medicamentos antirretrovirales en América Latina y el Caribe

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Claudia G. S. Osorio-de-Castro

2009-08-01

Full Text Available OBJECTIVES: The spread of HIV/AIDS challenges governments to provide antiretroviral (ARV treatment at affordable prices, and various initiatives have been developed with that intent. In Latin America and the Caribbean, four subregional negotiations were conducted during 2002-2005 to reduce drug prices and thus broaden access to ARVs. Studies were carried out to monitor the negotiations, and the development of a monitoring methodology was recommended. The objective of the current study was to develop and describe a potential methodology for monitoring ARV price negotiations. METHODS: The study, carried out in 2006-2007, consisted of a design phase and validation phase. The design phase included an extensive literature review and development of a theoretical framework. Validation was performed using health professional consensus and pilot studies in three countries-Barbados, Honduras, and Peru-representing the Caribbean, Central American, and Andean subregions. RESULTS: The results included a detailed logic model and a 40-indicator framework. Both were tested in the field. Indicators were evaluated for feasibility, pertinence, and sensitivity, based on the outcome of the pilot study. CONCLUSIONS: This monitoring methodology is designed to help countries self-evaluate progress toward implementation of ARV price negotiations. The results of the pilot study indicate that its implementation in the field helped elucidate the ARV price negotiation process by identifying local conditions and indirectly measuring countries' negotiating capacities.OBJETIVO: La diseminación del VIH/sida exige de los gobiernos suministrar el tratamiento antirretroviral (ARV a precios asequibles y se han desarrollado varias iniciativas con ese fin. En América Latina y el Caribe se han realizado cuatro negociaciones subregionales entre 2002 y 2005 para reducir los precios de los medicamentos y así ampliar el acceso a los ARV. Se han realizado estudios para monitorear las

Self-Report and Dry Blood Spot Measurement of Antiretroviral Medications as Markers of Adherence in Pregnant Women in Rural South Africa.

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Alcaide, Maria L; Ramlagan, Shandir; Rodriguez, Violeta J; Cook, Ryan; Peltzer, Karl; Weiss, Stephen M; Sifunda, Sibusiso; Jones, Deborah L

2017-07-01

Antiretroviral (ARV) adherence is essential to prevent mother-to-child transmission of HIV. This study compared self-reported adherence versus ARV detection in dried blood spots (DBS) among N = 392 HIV-infected pregnant women in South Africa (SA). Women completed two self-reported adherence measures [visual analog scale (VAS), AIDS Clinical Trials Group Adherence (ACTG)]. Adherence was 89% (VAS), 80% (ACTG), and 74% (DBS). Self-report measures marginally agreed with DBS (VAS: Kappa = 0.101, Area under the ROC curve (AUROC) = 0.543; ACTG: Kappa  = 0.081, AUROC = 0.538). Self-reported adherence was overestimated and agreement with DBS was poor. Validation of self-reported ARV adherence among pregnant HIV+ women in SA is needed.

Evolution of antiretroviral drug costs in Brazil in the context of free and universal access to AIDS treatment.

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Nunn, Amy S; Fonseca, Elize M; Bastos, Francisco I; Gruskin, Sofia; Salomon, Joshua A

2007-11-13

Little is known about the long-term drug costs associated with treating AIDS in developing countries. Brazil's AIDS treatment program has been cited widely as the developing world's largest and most successful AIDS treatment program. The program guarantees free access to highly active antiretroviral therapy (HAART) for all people living with HIV/AIDS in need of treatment. Brazil produces non-patented generic antiretroviral drugs (ARVs), procures many patented ARVs with negotiated price reductions, and recently issued a compulsory license to import one patented ARV. In this study, we investigate the drivers of recent ARV cost trends in Brazil through analysis of drug-specific prices and expenditures between 2001 and 2005. We compared Brazil's ARV prices to those in other low- and middle-income countries. We analyzed trends in drug expenditures for HAART in Brazil from 2001 to 2005 on the basis of cost data disaggregated by each ARV purchased by the Brazilian program. We decomposed the overall changes in expenditures to compare the relative impacts of changes in drug prices and drug purchase quantities. We also estimated the excess costs attributable to the difference between prices for generics in Brazil and the lowest global prices for these drugs. Finally, we estimated the savings attributable to Brazil's reduced prices for patented drugs. Negotiated drug prices in Brazil are lowest for patented ARVs for which generic competition is emerging. In recent years, the prices for efavirenz and lopinavir-ritonavir (lopinavir/r) have been lower in Brazil than in other middle-income countries. In contrast, the price of tenofovir is US$200 higher per patient per year than that reported in other middle-income countries. Despite precipitous price declines for four patented ARVs, total Brazilian drug expenditures doubled, to reach US$414 million in 2005. We find that the major driver of cost increases was increased purchase quantities of six specific drugs: patented lopinavir

Evolution of antiretroviral drug costs in Brazil in the context of free and universal access to AIDS treatment.

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Amy S Nunn

2007-11-01

Full Text Available Little is known about the long-term drug costs associated with treating AIDS in developing countries. Brazil's AIDS treatment program has been cited widely as the developing world's largest and most successful AIDS treatment program. The program guarantees free access to highly active antiretroviral therapy (HAART for all people living with HIV/AIDS in need of treatment. Brazil produces non-patented generic antiretroviral drugs (ARVs, procures many patented ARVs with negotiated price reductions, and recently issued a compulsory license to import one patented ARV. In this study, we investigate the drivers of recent ARV cost trends in Brazil through analysis of drug-specific prices and expenditures between 2001 and 2005.We compared Brazil's ARV prices to those in other low- and middle-income countries. We analyzed trends in drug expenditures for HAART in Brazil from 2001 to 2005 on the basis of cost data disaggregated by each ARV purchased by the Brazilian program. We decomposed the overall changes in expenditures to compare the relative impacts of changes in drug prices and drug purchase quantities. We also estimated the excess costs attributable to the difference between prices for generics in Brazil and the lowest global prices for these drugs. Finally, we estimated the savings attributable to Brazil's reduced prices for patented drugs. Negotiated drug prices in Brazil are lowest for patented ARVs for which generic competition is emerging. In recent years, the prices for efavirenz and lopinavir-ritonavir (lopinavir/r have been lower in Brazil than in other middle-income countries. In contrast, the price of tenofovir is US$200 higher per patient per year than that reported in other middle-income countries. Despite precipitous price declines for four patented ARVs, total Brazilian drug expenditures doubled, to reach US$414 million in 2005. We find that the major driver of cost increases was increased purchase quantities of six specific drugs

Does political ideology moderate stress: the special case of soldiers conducting forced evacuation.

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Shechner, Tomer; Slone, Michelle; Bialik, Gadi

2007-04-01

This study examined the moderating role of political ideology on psychological outcomes for Israeli soldiers participating in the forced evacuation of Jewish settlements from Gaza. Change in psychopathology and well-being was assessed for 3 concurrent mission groups differing in their political ideological contentiousness--forced evacuation, Gaza security, and Northern border security. After soldiers in each mission group were classified on the basis of relatively left- or right-wing political ideological tendencies, the authors examined differential impact of each mission on soldiers of differing political ideology. Results confirmed strong moderation effects of political ideology on psychological outcomes in these extreme contexts. Implications for research, prevention, and treatment are discussed. 2007 APA, all rights reserved

Is ideology a risk factor for PTSD symptom severity among Israeli political evacuees?

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Oren, Lior; Possick, Chaya

2010-08-01

To study the role of ideology in situations of extreme stress, a research questionnaire, measuring posttraumatic stress disorder (PTSD), settlement ideology (the importance of Jewish settlement in Gaza), and type of evacuation was administered to 326 Jewish residents who were evacuated from Gaza settlements by the Israeli government. Forty percent of the participants met the criteria of probable PTSD. Forcibly evicted individuals reported higher levels of settlement ideology and higher levels of PTSD symptom severity compared to voluntarily evacuated individuals. Contrary to previous studies, ideology was found to be positively associated with PTSD symptom severity. The results are explained by the conservation of resources and terror management theories. Theoretical and practical implications are discussed.

Costing of Paediatric Treatment alongside Clinical Trials under Low Resource Constraint Environments: Cotrimoxazole and Antiretroviral Medications in Children Living with HIV/AIDS

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Bona M. Chitah

2016-01-01

Full Text Available Introduction. Costing evidence is essential for policy makers for priority setting and resource allocation. It is in this context that the clinical trials of ARVs and cotrimoxazole provided a costing component to provide evidence for budgeting and resource needs alongside the clinical efficacy studies. Methods. A micro based costing approach was adopted, using case record forms for maintaining patient records. Costs for fixed assets were allocated based on the paediatric space. Medication and other resource costs were costed using the WHO/MSH Drug Price Indicators as well as procurement data where these were available. Results. The costs for cotrimoxazole and ARVs are significantly different. The average costs for human resources were US$22 and US$71 for physician costs and $1.3 and $16 for nursing costs while in-patient costs were $257 and $15 for the cotrimoxazole and ARV cohorts, respectively. Mean or average costs were $870 for the cotrimoxazole cohort and $218 for the ARV. The causal factors for the significant cost differences are attributable to the higher human resource time, higher infections of opportunistic conditions, and longer and higher frequency of hospitalisations, among others.

Pharmacologic and nonpharmacologic options for the management of HIV infection during pregnancy

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Carmen D Zorrilla

2009-12-01

Full Text Available Carmen D Zorrilla, Vivian Tamayo-AgraitDepartment of Obstetrics and Gynecology, University of Puerto Rico School of Medicine, Maternal Infant Studies Center (CEMI, San Juan, Puerto RicoAbstract: Over the past decade, significant advances have been made in the treatment of HIV-1 infection using both pharmacologic and nonpharmacologic strategies to prevent mother-to-child transmission (MTCT. Optimal prevention of the MTCT of HIV requires antiretroviral drugs (ARV during pregnancy, during labor, and to the infant. ARVs reduce viral replication, lowering maternal plasma viral load and thus the likelihood of MTCT. Postexposure prophylaxis of ARV agents in newborns protect against infection following potential exposure to maternal HIV during birth. In general, the choice of an ARV for treatment of HIV-infected women during pregnancy is complicated by the need to consider the effectiveness of the therapy for the maternal disease as well as the teratogenic or teratotoxic potential of these drugs. Clinicians managing HIV in pregnancy need to discuss the potential risks and benefits of available therapy options so that mothers can make informed decisions in choosing the best treatment regimen for themselves and for their children.Keywords: HIV, pregnancy, acquired immunodeficiency syndrome, antiretroviral agents

Synergistic activity profile of carbosilane dendrimer G2-STE16 in combination with other dendrimers and antiretrovirals as topical anti-HIV-1 microbicide.

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Sepúlveda-Crespo, Daniel; Lorente, Raquel; Leal, Manuel; Gómez, Rafael; De la Mata, Francisco J; Jiménez, José Luis; Muñoz-Fernández, M Ángeles

2014-04-01

Polyanionic carbosilane dendrimers represent opportunities to develop new anti-HIV microbicides. Dendrimers and antiretrovirals (ARVs) acting at different stages of HIV replication have been proposed as compounds to decrease new HIV infections. Thus, we determined the potential use of our G2-STE16 carbosilane dendrimer in combination with other carbosilane dendrimers and ARVs for the use as topical microbicide against HIV-1. We showed that these combinations obtained 100% inhibition and displayed a synergistic profile against different HIV-1 isolates in our model of TZM.bl cells. Our results also showed their potent activity in the presence of an acidic vaginal or seminal fluid environment and did not activate an inflammatory response. This study is the first step toward exploring the use of different anionic carbosilane dendrimers in combination and toward making a safe microbicide. Therefore, our results support further studies on dendrimer/dendrimer or dendrimer/ARV combinations as topical anti-HIV-1 microbicide. This paper describes the first steps toward the use of anionic carbosilane dendrimers in combination with antivirals to address HIV-1, paving the way to further studies on dendrimer/dendrimer or dendrimer/ARV combinations as topical anti-HIV-1 microbicides. © 2014.

Mother-to-child transmission of different HIV-1 subtypes among ARV Naïve infected pregnant women in Nigeria Transmissão materno-fetal de diferentes subtipos de HIV-1 entre gestantes infectadas na Nigéria

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G.N. Odaibo

2006-04-01

Full Text Available The rate of mother-to-child transmission (MTCT of HIV as well as the implications of the circulating multiple subtypes to MTCT in Nigeria are not known. This study was therefore undertaken to determine the differential rates of MTCT of HIV-1 subtypes detected among infected pregnant women before ARV intervention therapy became available in Nigeria. Twenty of the HIV-positive women who signed the informed consent form during pregnancy brought their babies for follow-up testing at age 18-24 months. Plasma samples from both mother and baby were tested for HIV antibody at the Department of Virology, UCH, Ibadan, Nigeria. All positive samples (plasma and peripheral blood mononuclear cells - PBMCs were shipped to the Institute of Tropical Medicine, Antwerp, Belgium, where the subtype of the infecting virus was determined using the HMA technique. Overall, a mother-to-child HIV transmission rate of 45% was found in this cohort. Specifically, 36.4%, 66.7% and 100% of the women infected with HIV-1 CRF02 (IbNg, G and B, respectively, transmitted the virus to their babies. As far as it can be ascertained, this is the first report on the rate of MTCT of HIV in Nigeria. The findings reported in this paper will form a useful reference for assessment of currently available therapeutic intervention of MTCT in the country.A taxa de transmissão materno-fetal (MTCT do HIV bem como as implicações dos múltiplos subtipos circulantes para MTCT na Nigéria não são conhecidos. Este estudo foi realizado para determinar as diferentes taxas de MTCT dos subtipos de HIV-1 detectados entre gestantes infectadas antes que a administração da terapia ARV estivesse disponível na Nigéria. Vinte das mulheres HIV positivas que assinaram o consentimento durante a gravidez trouxeram seus filhos para seguimento na idade de 18-24 meses. Amostras de plasma de ambos, mãe e filho foram testadas para anticorpos HIV no Departamento de Virologia, UCH, Ibadan, Nigéria. Todas as

Iisraeli valitsus haub sõjakäiku Gazasse / Igor Taro

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Taro, Igor

2007-01-01

Iisraeli võimude plaanist lõpetada radikaalse islamiliikumise Hamas omavoli Gaza sektoris. Palestiina autonoomia uueks peaministriks nimetati Salam Fayyad. Vt. samas: Röövitud reporteril lootus vabaneda

The effects of a lipid‐based nutrient supplement and antiretroviral therapy in a randomized controlled trial on iron, copper, and zinc in milk from HIV‐infected Malawian mothers and associations with maternal and infant biomarkers

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Shahab‐Ferdows, Setareh; Gertz, Erik; Flax, Valerie L.; Adair, Linda S.; Bentley, Margaret E.; Jamieson, Denise J.; Tegha, Gerald; Chasela, Charles S.; Kamwendo, Debbie; van der Horst, Charles M.; Allen, Lindsay H.

2017-01-01

Abstract We evaluated effects of antiretroviral (ARV) therapy and lipid‐based nutrient supplements (LNSs) on iron, copper, and zinc in milk of exclusively breastfeeding HIV‐infected Malawian mothers and their correlations with maternal and infant biomarkers. Human milk and blood at 2, 6, and 24 weeks post‐partum and blood during pregnancy (≤30 weeks gestation) were collected from 535 mothers/infant‐pairs in the Breastfeeding, Antiretrovirals, and Nutrition study. The participants received ARV, LNS, ARV and LNS, or no intervention from 0 to 28 weeks post‐partum. ARVs negatively affected copper and zinc milk concentrations, but only at 2 weeks, whereas LNS had no effect. Among all treatment groups, approximately 80–90% of copper and zinc and negatively correlated with milk iron at 2 and 6 weeks (r = −.18, p milk minerals with each other were the strongest correlations observed (r = .11–.47, p milk higher in iron when ferritin was higher or TfR lower. At 6 weeks, higher maternal α‐1‐acid glycoprotein and C‐reactive protein were associated with higher milk minerals in mildly anaemic women. Infant TfR was lower when milk mineral concentrations were higher at 6 weeks and when mothers were moderately anaemic during pregnancy. ARV affects copper and zinc milk concentrations in early lactation, and maternal haemoglobin during pregnancy and lactation could influence the association between milk minerals and maternal and infant iron status and biomarkers of inflammation. PMID:28851037

Short-Term Blood Pressure Variability Relates to the Presence of Subclinical Brain Small Vessel Disease in Primary Hypertension.

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Filomena, Josefina; Riba-Llena, Iolanda; Vinyoles, Ernest; Tovar, José L; Mundet, Xavier; Castañé, Xavier; Vilar, Andrea; López-Rueda, Antonio; Jiménez-Baladó, Joan; Cartanyà, Anna; Montaner, Joan; Delgado, Pilar

2015-09-01

Blood pressure (BP) variability is associated with stroke risk, but less is known about subclinical cerebral small vessel disease (CSVD). We aimed to determine whether CSVD relates to short-term BP variability independently of BP levels and also, whether they improve CSVD discrimination beyond clinical variables and office BP levels. This was a cohort study on asymptomatic hypertensives who underwent brain magnetic resonance imaging and 24-hour ambulatory BP monitoring. Office and average 24-hour, daytime and nighttime BP levels, and several metrics of BP variability (SD, weighted SD, coefficient of variation, and average real variability [ARV]) were calculated. Definition of CSVD was based on the presence of lacunar infarcts and white matter hyperintensity grades. Multivariate analysis and integrated discrimination improvement were performed to assess whether BP variability and levels were independently associated with CSVD and improved its discrimination. Four hundred eighty-seven individuals participated (median age, 64; 47% women). CSVD was identified in 18.9%, related to age, male sex, diabetes mellitus, use of treatment, ambulatory BP monitoring-defined BP levels, and ARV of systolic BP at any period. The highest prevalence (33.7%) was found in subjects with both 24-hour BP levels and ARV elevated. BP levels at any period and ARV (24 hours and nocturnal) emerged as independent predictors of CSVD, and discrimination was incrementally improved although not to a clinically significant extent (integrated discrimination improvement, 5.31%, 5.17% to 5.4%). Ambulatory BP monitoring-defined BP levels and ARV of systolic BP relate to subclinical CSVD in hypertensive individuals. © 2015 American Heart Association, Inc.

Antiretroviral treatment is associated with increased attentional load-dependent brain activation in HIV patients.

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Chang, L; Yakupov, R; Nakama, H; Stokes, B; Ernst, T

2008-06-01

The purpose of this paper was to determine whether antiretroviral medications, especially the nucleoside analogue reverse transcriptase inhibitors, lead to altered brain activation due to their potential neurotoxic effects in patients with human immunodeficiency virus (HIV) infection. Forty-two right-handed men were enrolled in three groups: seronegative controls (SN, n = 18), HIV subjects treated with antiretroviral medications (HIV+ARV, n = 12), or not treated with antiretroviral medications (HIV+NARV, n = 12). Each subject performed a set of visual attention tasks with increasing difficulty or load (tracking two, three or four balls) during functional magnetic resonance imaging. HIV subjects, both groups combined, showed greater load-dependent increases in brain activation in the right frontal regions compared to SN (p-corrected = 0.006). HIV+ARV additionally showed greater load-dependent increases in activation compared to SN in bilateral superior frontal regions (p-corrected = 0.032) and a lower percent accuracy on the performance of the most difficult task (tracking four balls). Region of interest analyses further demonstrated that SN showed load-dependent decreases (with repeated trials despite increasing difficulty), while HIV subjects showed load-dependent increases in activation with the more difficult tasks, especially those on ARVs. These findings suggest that chronic ARV treatments may lead to greater requirement of the attentional network reserve and hence less efficient usage of the network and less practice effects in these HIV patients. As the brain has a limited reserve capacity, exhausting the reserve capacity in HIV+ARV would lead to declined performance with more difficult tasks that require more attention.

HIV type-1 genotypic resistance profiles in vertically infected patients from Argentina reveal an association between K103N+L100I and L74V mutations.

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Aulicino, Paula C; Rocco, Carlos A; Mecikovsky, Debora; Bologna, Rosa; Mangano, Andrea; Sen, Luisa

2010-01-01

Patterns and pathways of HIV type-1 (HIV-1) antiretroviral (ARV) drug resistance-associated mutations in clinical isolates are conditioned by ARV history and factors such as viral subtype and fitness. Our aim was to analyse the frequency and association of ARV drug resistance mutations in a group of long-term vertically infected patients from Argentina. Plasma samples from 71 patients (38 children and 33 adolescents) were collected for genotypic HIV-1 ARV resistance testing during the period between February 2006 and October 2008. Statistically significant pairwise associations between ARV resistance mutations in pol, as well as associations between mutations and drug exposure, were identified using Fisher's exact tests with Bonferroni and false discovery rate corrections. Phylogenetic analyses were performed for subtype assignment. In protease (PR), resistance-associated mutations M46I/L, I54M/L/V/A/S and V82A/F/T/S/M/I were associated with each other and with minor mutations at codons 10, 24 and 71. Mutations V82A/F/T/S/M/I were primarily selected by the administration of ritonavir (RTV) in an historical ARV regimen. In reverse transcriptase, thymidine analogue mutation (TAM)1 profile was more common than TAM2. The non-nucleoside K103N+L100I mutations were observed at high frequency (15.5%) and were significantly associated with the nucleoside mutation L74V in BF recombinants. Associations of mutations at PR sites reflect the frequent use of RTV at an early time in this group of patients and convergent resistance mechanisms driven by the high exposure to protease inhibitors, as well as local HIV-1 diversity. The results provide clinical evidence of a molecular interaction between K103N+L100I and L74V mutations at the reverse transcriptase gene in vivo, limiting the future use of second-generation non-nucleoside reverse transcriptase inhibitors such as etravirine.

Intervening in global markets to improve access to HIV/AIDS treatment: an analysis of international policies and the dynamics of global antiretroviral medicines markets

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Hochstadt Jenny

2010-05-01

Full Text Available Abstract Background Universal access to antiretroviral therapy (ART in low- and middle-income countries faces numerous challenges: increasing numbers of people needing ART, new guidelines recommending more expensive antiretroviral (ARV medicines, limited financing, and few fixed-dose combination (FDC products. Global initiatives aim to promote efficient global ARV markets, yet little is known about market dynamics and the impact of global policy interventions. Methods We utilize several data sources, including 12,958 donor-funded, adult first-line ARV purchase transactions, to describe the market from 2002-2008. We examine relationships between market trends and: World Health Organization (WHO HIV/AIDS treatment guidelines; WHO Prequalification Programme (WHO Prequal and United States (US Food and Drug Administration (FDA approvals; and procurement policies of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM, US President's Emergency Plan for AIDS Relief (PEPFAR and UNITAID. Results WHO recommended 7, 4, 24, and 6 first-line regimens in 2002, 2003, 2006 and 2009 guidelines, respectively. 2009 guidelines replaced a stavudine-based regimen ($88/person/year with more expensive zidovudine- ($154-260/person/year or tenofovir-based ($244-465/person/year regimens. Purchase volumes for ARVs newly-recommended in 2006 (emtricitabine, tenofovir increased >15-fold from 2006 to 2008. Twenty-four generic FDCs were quality-approved for older regimens but only four for newer regimens. Generic FDCs were available to GFATM recipients in 2004 but to PEPFAR recipients only after FDA approval in 2006. Price trends for single-component generic medicines mirrored generic FDC prices. Two large-scale purchasers, PEPFAR and UNITAID, together accounted for 53%, 84%, and 77% of market volume for abacavir, emtricitabine, and tenofovir, respectively, in 2008. PEPFAR and UNITAID purchases were often split across two manufacturers. Conclusions Global initiatives

Reducing mother-to-child transmission of HIV: findings from an early infant diagnosis program in south-south region of Nigeria

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Anoje Chukwuemeka

2012-03-01

Full Text Available Abstract Background Early diagnosis of HIV in infants provides a critical opportunity to strengthen follow-up of HIV-exposed children and assure early access to antiretroviral (ARV treatment for infected children. This study describes findings from an Early Infant Diagnosis (EID program and the effectiveness of a prevention of mother-to-child transmission (PMTCT intervention in six health facilities in Cross-River and Akwa-Ibom states, south-south Nigeria. Methods This was a retrospective study. Records of 702 perinatally exposed babies aged six weeks to 18 months who had a DNA PCR test between November 2007 and July 2009 were reviewed. Details of the ARV regimen received to prevent mother-to-child transmission (MTCT, breastfeeding choices, HIV test results, turn around time (TAT for results and post test ART enrolment status of the babies were analysed. Results Two-thirds of mother-baby pairs received ARVs and 560 (80% babies had ever been breastfed. Transmission rates for mother-baby pairs who received ARVs for PMTCT was 4.8% (CI 1.3, 8.3 at zero to six weeks of age compared to 19.5% (CI 3.0, 35.5 when neither baby nor mother received an intervention. Regardless of intervention, the transmission rates for babies aged six weeks to six months who had mixed feeding was 25.6% (CI 29.5, 47.1 whereas the transmission rates for those who were exclusively breastfed was 11.8% (CI 5.4, 18.1. Vertical transmission of HIV was eight times (AOR 7.8, CI: 4.52-13.19 more likely in the sub-group of mother-baby pairs who did not receive ARVS compared with mother-baby pairs that did receive ARVs. The median TAT for test results was 47 days (IQR: 35-58. A follow-up of 125 HIV positive babies found that 31 (25% were enrolled into a paediatric ART program, nine (7% were known to have died before the return of their DNA PCR results, and 85 (67% could not be traced and were presumed to be lost-to-follow-up. Conclusion Reduction of MTCT of HIV is possible with

A Single-Blind randomized controlled trial to evaluate the effect of extended counseling on uptake of pre-antiretroviral care in eastern uganda

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Marrone Gaetano

2011-07-01

Full Text Available Abstract Background Many newly screened people living with HIV (PLHIV in Sub-Saharan Africa do not understand the importance of regular pre-antiretroviral (ARV care because most of them have been counseled by staff who lack basic counseling skills. This results in low uptake of pre-ARV care and late treatment initiation in resource-poor settings. The effect of providing post-test counseling by staff equipped with basic counseling skills, combined with home visits by community support agents on uptake of pre-ARV care for newly diagnosed PLHIV was evaluated through a randomized intervention trial in Uganda. Methods An intervention trial was performed consisting of post-test counseling by trained counselors, combined with monthly home visits by community support agents for continued counseling to newly screened PLHIV in Iganga district, Uganda between July 2009 and June 2010, Participants (N = 400 from three public recruitment centres were randomized to receive either the intervention, or the standard care (the existing post-test counseling by ARV clinic staff who lack basic training in counseling skills, the control arm. The outcome measure was the proportion of newly screened and counseled PLHIV in either arm who had been to their nearest health center for clinical check-up in the subsequent three months +2 months. Treatment was randomly assigned using computer-generated random numbers. The statistical significance of differences between the two study arms was assessed using chi-square and t-tests for categorical and quantitative data respectively. Risk ratios and 95% confidence intervals were used to assess the effect of the intervention. Results Participants in the intervention arm were 80% more likely to accept (take up pre-ARV care compared to those in the control arm (RR 1.8, 95% CI 1.4-2.1. No adverse events were reported. Conclusions Provision of post-test counseling by staff trained in basic counseling skills, combined with home visits by

Impending flop for brand antiretrovirals in the emerging markets?

Science.gov (United States)

Daniele, Dionisio; Daniela, Messeri

2008-01-01

Forecasts from Country choices, South-South partnerships and Clinton Foundation-UNITAID coalition show that present policies for brand ARVs are at the risk of flop in emerging South markets such as India, China, Thailand and Brazil.The dynamics explored in this article highlight the risks the originator companies are running in the emerging markets, along with their interest in direct agreements with the generic industry for the manufacturing and marketing of ARVs.Resulting information here would suggest the brand enterprises:To look for fast registration of their ARVs by regulatory authorities in all countries enlisted for differential pricing.To secure all formulations differentiated prices.To align with the Clinton-UNITAID prices for the corresponding generics.To pursue flexible negotiations with the generic companies to secure both counterparts long-term advantages.

Main tasks of studying strong regulation of excitation of complex electrical system generators

Energy Technology Data Exchange (ETDEWEB)

Gruzdev, I.A.; Yekimova, M.M.

1982-01-01

A survey is made of the current state of studies of the damping properties of complex electricity systems. The calculation programs of stability are based on frequency methods using the method of D-division. Now, when ARV of strong effect dominates at the SG, the task of coordinating their adjustments develops. Consequently, the following questions are discussed: study of the properties of quality functional with several points of regulation in the circuits of different structure; development of the efficient procedures for coordinating the ARV adjustment of the related energy systems; and creation of resources for solving these tasks. Results are presented of coordinating the ARV adjustments of the generators of the 3-machine electricity system. As an example, nonlinear relationships are shown between the obtained degree of stability and the coefficient of stabilization.

Armin Karu muutus Eesti rikkaimaks / Lauri Matsulevitsh

Index Scriptorium Estoniae

Matsulevitsh, Lauri

2006-01-01

Olympic Casino aktsiaid oli müügis 1,124 miljardi krooni eest, märgiti neid aga 7,5 miljardi krooni eest. Diagrammid: Viimaste börsiletulijate aktsia hinna liikumine kroonides esimesel kümnel päeval; Olympic tõi juurde uusi investoreid; Uute väärtpaberikontode arv; Aktsiaid märkinud jaeinvestorite arv viimastel IPOdel. Kommenteerivad Rainer Jürgenson, Peeter Koppel, Riho Talumaa ja Rainer Änilane

Noninvasive Detection of AR-FL/AR-V7 as a Predictive Biomarker for Therapeutic Resistance in Men with Metastatic Castration-Resistant Prostate Cancer

Science.gov (United States)

2017-10-01

acknowledged federal support) 5. Antonarakis ES, Armstrong AJ, Dehm SM, Luo J. Androgen receptor variant-driven prostate cancer : clinical implications...Resistant Prostate Cancer abstract Purpose A splice variant of the androgen receptor , AR-V7, confers resistance to AR-targeted therapies (ATTs) but not...androgen receptor ; AR-V7, androgen receptor splice variant 7; mCRPC, metastatic castration-resistant prostate cancer ; n/N, number of patients in that

Euroopa Liidu teadus ja tehnoloogia / Lembo Tanning

Index Scriptorium Estoniae

Tanning, Lembo

2001-01-01

Ilmunud ka: Buhgalterskije Novosti, nr. 7, 2001, lk. 42-47. Euroopa Liidu teaduse ja tehnoloogia areng ja hetkeseis. Tabelid ja diagrammid: töötajate arv EL-i kõrgtehnoloogia majandusharudes ja teadusintensiivses teeninduses; EL-i regioonide uurimis-arengutöödele tehtud kulutused ning patentide arv; EL-i regioonide kõrgtehnoloogia edetabel 1997; uurimis- ja arendustöödele tehtud riiklikud kulutused SKP-st 1998; teaduse ja tehnoloogia inimressursid 1999

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International Development Research Centre (IDRC) Digital Library (Canada)

IDRC supported an institutional assessment of the Institute for Social Studies Trust ... Enhancing the Framework for Entrepreneurship in the West Bank and Gaza ... SOCIAL SECURITY, RETIREMENT PENSIONS, HEALTH SYSTEM, SOCIAL ...

Acceso universal al Programa de VIH/SIDA de la Ciudad de México: resultados a seis años Universal access, six years results in the Mexico City HIV/AIDS Program

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Carmen Soler Claudín

2009-02-01

Full Text Available OBJETIVO: Analizar los resultados del Programa de Medicamentos Antirretrovirales Gratuitos del Programa de VIH/SIDA de la Ciudad de México (PVSCM en la población afectada del Distrito Federal. MATERIAL Y MÉTODOS: Se sistematizaron y analizaron datos de la Coordinación del PVSCM sobre atención médica, tratamiento antirretroviral (ARV y resultados de laboratorio especializado en un análisis retrospectivo del periodo 2001-2006, para evaluar su efecto en los pacientes atendidos. RESULTADOS. Se incluyen datos de 5 146 pacientes que recibieron tratamiento ARV. Al final del periodo, 74% de ellos permanecía vigente, 12.1% se perdió en el seguimiento y 13.9% había fallecido. CONCLUSIONES: En el Distrito Federal, durante el periodo evaluado se logró la ampliación de cobertura, eficacia en el tratamiento ARV e incremento de la sobrevida de los pacientes.OBJECTIVE: To analyze the results of the Free Antiretroviral Medication Program of the Mexico City HIV/AIDS Program among the affected population in Mexico City. MATERIAL AND METHODS: A retrospective analysis was conducted of medical attention, antiretroviral treatment and specialized laboratory results data from 2001 to 2006 from patients who sought services from the Mexico City HIV/AIDS Program. RESULTS: Data from 5 146 patients who were undergoing ARV are presented. At the end of the period studied, 74% were current, 12.2% were not found for follow-up and 13.9% had died. CONCLUSIONS: During the period evaluated, wider coverage was achieved in Mexico City as well as increased efficiency in ARV treatment and increased patient survival.

Antiretroviral drug expenditure, pricing and judicial demand: an analysis of federal procurement data in Brazil from 2004–2011

Science.gov (United States)

2014-01-01

Background Previous studies have described expenditures for antiretroviral (ARV) medicines in Brazil through 2005. While prior studies examined overall expenditures, they have not have analyzed drug procurement data in order to describe the role of court litigation on access and pricing. Methods ARV drug procurement from private sector sources for the years 2004–2011 was obtained through the general procurement database of the Brazilian Federal Government (SIASG). Procurement was measured in Defined Daily Doses (DDD) per 1000 persons-under-treatment per day. Expenditures and price per DDD were calculated and expressed in U.S. Dollars. Justifications for ARV purchases were examined in order to determine the relationship between health litigation and incorporation into Brazil’s national treatment guidelines. Results Drug procurement of ARVs from private sources underwent marked expansion in 2005, peaked in 2009, and stabilized to 2008 levels by 2011. Expenditures followed procurement curves. Medications which were procured for the first time after 2007 cost more than medicines which were introduced before 2007. Judicial actions initially resulted in purchases of newer medications for a select number of patients in Brazil but ultimately expanded availability to a larger population through incorporation into the national treatment guidelines. Conclusions Drug procurement and expenditures for ARVs in Brazil varied between 2004–2011. The procurement of some drugs from the private sector ceased after public manufacturers started producing them locally. Judicial demand has resulted in the incorporation of newer drugs into the national treatment guidelines. In order for the AIDS treatment program to remain sustainable, efforts should be pursued to reduce prices through generic drugs, price negotiation and other public health flexibilities such as compulsory licensing. PMID:24735589

Prevention of vaginal and rectal HIV transmission by antiretroviral combinations in humanized mice.

Directory of Open Access Journals (Sweden)

Philippe A Gallay

Full Text Available With more than 7,000 new HIV infections daily worldwide, there is an urgent need for non-vaccine biomedical prevention (nBP strategies that are safe, effective, and acceptable. Clinical trials have demonstrated that pre-exposure prophylaxis (PrEP with antiretrovirals (ARVs can be effective at preventing HIV infection. In contrast, other trials using the same ARVs failed to show consistent efficacy. Topical (vaginal and rectal dosing is a promising regimen for HIV PrEP as it leads to low systematic drug exposure. A series of titration studies were carried out in bone marrow/liver/thymus (BLT mice aimed at determining the adequate drug concentrations applied vaginally or rectally that offer protection against rectal or vaginal HIV challenge. The dose-response relationship of these agents was measured and showed that topical tenofovir disoproxil fumarate (TDF and emtricitabine (FTC can offer 100% protection against rectal or vaginal HIV challenges. From the challenge data, EC50 values of 4.6 μM for TDF and 0.6 μM for FTC for HIV vaginal administration and 6.1 μM TDF and 0.18 μM for FTC for rectal administration were obtained. These findings suggest that the BLT mouse model is highly suitable for studying the dose-response relationship in single and combination ARV studies of vaginal or rectal HIV exposure. Application of this sensitive HIV infection model to more complex binary and ternary ARV combinations, particularly where agents have different mechanisms of action, should allow selection of optimal ARV combinations to be advanced into pre-clinical and clinical development as nBP products.

Sõdurid hakkasid Gazat jõuga tühjendama / Arko Olesk

Index Scriptorium Estoniae

Olesk, Arko, 1981-

2005-01-01

Paljud juudi asunikud keeldusid vabatahtlikult asundustest lahkumast ning avaldasid sõduritele vastupanu, üle kogu Iisraeli kokku sõitnud äärmuslased protestivad Gazas juudi asunduste likvideerimise vastu. Lisa: Lahkumine Gazast

Proper Sterol Distribution Is Required for Candida albicans Hyphal Formation and Virulence

Science.gov (United States)

McCourt, Paula; Liu, Hsing-Yin; Parker, Josie E.; Gallo-Ebert, Christina; Donigan, Melissa; Bata, Adam; Giordano, Caroline; Kelly, Steven L.; Nickels, Joseph T.

2016-01-01

Candida albicans is an opportunistic fungus responsible for the majority of systemic fungal infections. Multiple factors contribute to C. albicans pathogenicity. C. albicans strains lacking CaArv1 are avirulent. Arv1 has a conserved Arv1 homology domain (AHD) that has a zinc-binding domain containing two cysteine clusters. Here, we explored the role of the CaAHD and zinc-binding motif in CaArv1-dependent virulence. Overall, we found that the CaAHD was necessary but not sufficient for cells to be virulent, whereas the zinc-binding domain was essential, as Caarv1/Caarv1 cells expressing the full-length zinc-binding domain mutants, Caarv1C3S and Caarv1C28S, were avirulent. Phenotypically, we found a direct correlation between the avirulence of Caarv1/Caarv1, Caarrv1AHD, Caarv1C3S, and Caarv1C28S cells and defects in bud site selection, septa formation and localization, and hyphal formation and elongation. Importantly, all avirulent mutant strains lacked the ability to maintain proper sterol distribution. Overall, our results have established the importance of the AHD and zinc-binding domain in fungal invasion, and have correlated an avirulent phenotype with the inability to maintain proper sterol distribution. PMID:27587298

Proper Sterol Distribution Is Required for Candida albicans Hyphal Formation and Virulence

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Paula McCourt

2016-11-01

Full Text Available Candida albicans is an opportunistic fungus responsible for the majority of systemic fungal infections. Multiple factors contribute to C. albicans pathogenicity. C. albicans strains lacking CaArv1 are avirulent. Arv1 has a conserved Arv1 homology domain (AHD that has a zinc-binding domain containing two cysteine clusters. Here, we explored the role of the CaAHD and zinc-binding motif in CaArv1-dependent virulence. Overall, we found that the CaAHD was necessary but not sufficient for cells to be virulent, whereas the zinc-binding domain was essential, as Caarv1/Caarv1 cells expressing the full-length zinc-binding domain mutants, Caarv1C3S and Caarv1C28S, were avirulent. Phenotypically, we found a direct correlation between the avirulence of Caarv1/Caarv1, Caarrv1AHD, Caarv1C3S, and Caarv1C28S cells and defects in bud site selection, septa formation and localization, and hyphal formation and elongation. Importantly, all avirulent mutant strains lacked the ability to maintain proper sterol distribution. Overall, our results have established the importance of the AHD and zinc-binding domain in fungal invasion, and have correlated an avirulent phenotype with the inability to maintain proper sterol distribution.

Assessing the Therapeutic Effect of 630 nm Light-Emitting Diodes Irradiation on the Recovery of Exercise-Induced Hand Muscle Fatigue with Surface Electromyogram

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Dandan Yang

2012-01-01

Full Text Available This paper aims to investigate the effect of light emitting diode therapy (LEDT on exercise-induced hand muscle fatigue by measuring the surface electromyography (sEMG of flexor digitorum superficialis. Ten healthy volunteers were randomly placed in the equal sized LEDT group and control group. All subjects performed a sustained fatiguing isometric contraction with the combination of four fingertips except thumb at 30% of maximal voluntary contraction (MVC until exhaustion. The active LEDT or an identical passive rest therapy was then applied to flexor digitorum superficialis. Each subject was required to perform a re-fatigue task immediately after therapy which was the same as the pre-fatigue task. Average rectified value (ARV and fractal dimension (FD of sEMG were calculated. ARV and FD were significantly different between active LEDT and passive rest groups at 20%–50%, 70%–80%, and 100% of normalized contraction time (P<0.05. Compared to passive rest, active LEDT induced significantly smaller increase in ARV values and decrease in FD values, which shows that LEDT is effective on the recovery of muscle fatigue. Our preliminary results also suggest that ARV and FD are potential replacements of biochemical markers to assess the effects of LEDT on muscle fatigue.

Low CD4+ T-cell levels and B-cell apoptosis in vertically HIV-exposed noninfected children and adolescents.

Science.gov (United States)

Miyamoto, Maristela; Pessoa, Silvana D; Ono, Erika; Machado, Daisy M; Salomão, Reinaldo; Succi, Regina C de M; Pahwa, Savita; de Moraes-Pinto, Maria Isabel

2010-12-01

Lymphocyte subsets, activation markers and apoptosis were assessed in 20 HIV-exposed noninfected (ENI) children born to HIV-infected women who were or not exposed to antiretroviral (ARV) drugs during pregnancy and early infancy. ENI children and adolescents were aged 6-18 years and they were compared to 25 age-matched healthy non-HIV-exposed children and adolescents (Control). ENI individuals presented lower CD4(+) T cells/mm(3) than Control group (control: 1120.3 vs. ENI: 876.3; t-test, p = 0.030). ENI individuals had higher B-cell apoptosis than Control group (Control: 36.6%, ARV exposed: 82.3%, ARV nonexposed: 68.5%; Kruskal-Wallis, p ENI and in Control children and adolescents. Subtle long-term immune alterations might persist among ENI individuals, but the clinical consequences if any are unknown, and these children require continued monitoring.

Association between antiretroviral exposure and renal impairment among HIV-positive persons with normal baseline renal function

DEFF Research Database (Denmark)

Nielsen, Lene Ryom; Mocroft, A.; Kirk, O.

2013-01-01

Background. Several antiretroviral agents (ARVs) are associated with chronic renal impairment, but the extent of such adverse events among human immunodeficiency virus (HIV)-positive persons with initially normal renal function is unknown.Methods. D:A:D study participants with an estimated...... glomerular filtration rate (eGFR) of ≥90 mL/min after 1 January 2004 were followed until they had a confirmed eGFR of ≤70 mL/min (the threshold below which we hypothesized that renal interventions may begin to occur) or ≤60 mL/min (a value indicative of moderately severe chronic kidney disease [CKD...... [95% CI, 1.16-1.28], respectively). Associations were unaffected by censoring for concomitant ARV use but diminished after discontinuation of these ARVs.Conclusions. Tenofovir, ritonavir-boosted atazanavir, and ritonavir-boosted lopinavir use were independent predictors of chronic renal impairment...

Current status of topical antiretroviral chemoprophylaxis.

Science.gov (United States)

Van Damme, Lut; Szpir, Michael

2012-11-01

Recent studies suggest that the vaginal delivery of antiretroviral (ARV) agents - such as tenofovir, dapivirine and UC781 - may be a promising way to reduce the high rates of HIV infection among women in developing countries. This review examines these developments. The Microbicide Trials Network 003 study, a large phase IIb trial, was unable to show that daily dosing with 1% tenofovir vaginal gel was effective for HIV prevention. Nevertheless, preclinical and early-phase clinical trials suggest that ARV drugs - formulated in vaginal gels, rings, films, tablets and diaphragms - could be effective for HIV chemoprophylaxis. Investigations of topical chemoprophylaxis methods have seen mixed results in the past 12-18 months. Product adherence may prove to be one of the field's greatest challenges. Phase II and III trials continue to explore different dosing strategies for topical products that contain one or more ARV agents.

Daite Jevrope nefti i gaza

Index Scriptorium Estoniae

2007-01-01

Euroopa Nõukogu Parlamentaarse Assamblee istungil võeti vastu resolutsioon, mis mõistab hukka energeetika kasutamist poliitilise tööriistana, kritiseerides Venemaa otsuseid naaberriikide suhtes. Eesti parlamendiliikme Marko Mihkelsoni ja Gruusia saadikute seisukohtadest

Modeling HIV/AIDS Drug Price Determinants in Brazil: Is Generic Competition a Myth?

OpenAIRE

Meiners, Constance; Sagaon-Teyssier, Luis; Hasenclever, Lia; Moatti, Jean-Paul

2011-01-01

BACKGROUND: Brazil became the first developing country to guarantee free and universal access to HIV/AIDS treatment, with antiretroviral drugs (ARVs) being delivered to nearly 190,000 patients. The analysis of ARV price evolution and market dynamics in Brazil can help anticipate issues soon to afflict other developing countries, as the 2010 revision of the World Health Organization guidelines shifts demand towards more expensive treatments, and, at the same time, current evolution of internat...

Management of HIV During Pregnancy

OpenAIRE

Chamma JP; Monteleone VF; V dos Reis L; Bonafe SM; Panão M

2016-01-01

According to UNAIDS, in 2015, one hundred and fifty thousand children were infected by HIV worldwide, therefore the use of antiretroviral therapy (ARV) during pregnancy is an important development for the reduction of maternal-fetal transmission. The treatment of a pregnant woman is done by combining two different ARV classes. The combination of two nucleoside reverse transcriptase inhibitors (NRTIs) with one non-nucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI) is...

Antiretroviral purchasing and prescription practices in Mexico: constraints, challenges and opportunities

OpenAIRE

Chaumont, Claire; Bautista-Arredondo, Sergio; Calva, Juan José; Bahena-González, Roberto Isaac; Sánchez-Juárez, Gerda Hitz; González de Araujo-Muriel, Arturo; Magis-Rodríguez, Carlos; Hernández-Ávila, Mauricio

2015-01-01

Objective. This study examines the antiretroviral (ARV) market characteristics for drugs procured and prescribed to Mexico's Social Protection System in Health beneficiaries between 2008 and 2013, and compares them with international data. Materials and methods. Procurement information from the National Center for the Prevention and the Control of HIV/AIDS was analyzed to estimate volumes and prices of key ARV. Annual costs were compared with data from the World Health Organization's Global P...

Vägivallalaine uputas Palestiina ühisvalitsuse

Index Scriptorium Estoniae

2007-01-01

Radikaalne islami vastupanuliikumise Hamas ja palestiinlaste mõõdukamat osa esindava Fatah'i võitlejad pidasid Gaza linnaosades veriseid lahingud. Autonoomia presidendi Mahmoud Abbasi ja Iisraeli peaministri Ehud Olmerti hukkamõistvast suhtumisest

Breaking Consensus: The Occupation and the Employment of the Israel Defense Forces

National Research Council Canada - National Science Library

Scoratow, Leon

2002-01-01

.... The occupation of the West Bank, Gaza, East Jerusalem, the Sinai, and Golan in 1967, forced Israelis to re-examine their deeply shared, or hegemonic views about security, peace, and war, especially...

Defense Against Rocket Attacks in the Presence of False Cues

National Research Council Canada - National Science Library

Harari, Lior

2008-01-01

Rocket attacks on civilian and military targets, from both Hezbollah (South Lebanon) and Hamas (Gaza strip) have been causing a major operational problem for the Israeli Defense Force for over two decades...

Iisraeli ühiskond on lõhenemas / Jüri Piirisild

Index Scriptorium Estoniae

Piirisild, Jüri

2004-01-01

Iisraeli sisepinged seoses juhtkonna plaaniga juudi asunikud Gaza sektorist välja viia ning aastakümneid kestnud konflikt palestiinlastega on mõjutanud nii riigi majandust kui usaldust peaminister Ariel Sharoni vastu

Crianças que vivem com AIDS e suas experiências com o uso de antirretrovirais Niños que viven con SIDA y sus experiencias con el uso de antirretrovirales Children living with AIDS and their experiences with antiretroviral therapy

Directory of Open Access Journals (Sweden)

Joel Kuyava

2012-09-01

Full Text Available Estudo com o objetivo de conhecer como a criança que vive com AIDS descreve sua experiência com o uso de antirretrovirais (ARV. Trata-se de um estudo qualitativo, exploratório, descritivo, realizado no ambulatório do Serviço de Assistência Especializada em Doença Sexualmente Transmissível, em Porto Alegre, no período entre maio e julho de 2009, com crianças em uso de ARV. A coleta das informações foi realizada utilizando-se a técnica de grupo focal. A análise, feita por meio da análise de conteúdo, evidenciou as seguintes categorias: modo de vida da criança com AIDS; manuseio da medicação; expectativas e sentimentos. O estudo trouxe contribuições importantes que ainda devem ser aprofundadas em relação a essa temática no universo infantil. A adesão aos ARV constitui-se um desafio para os profissionais da saúde e para a família. O conhecimento das vivências e estratégias das crianças pode oportunizar novas formas de ver, tratar e cuidar dessa parcela da população.Estudio con el objetivo de conocer cómo el niño que vive con SIDA describe su experiencia con el uso de antirretrovirales (ARV. Es un estudio cualitativo, exploratorio y descriptivo realizado en el ambulatorio del Servicio de Asistencia Especializada en Enfermedades Sexualmente Transmisibles, en Porto Alegre, entre mayo y julio de 2009, con niños en tratamiento con ARV. La recolección de informaciones fue realizada utilizándose la técnica de grupo focal. El análisis, hecho por medio del análisis de contenido, evidenció las siguientes categorías: Modo de vida del niño con SIDA; Manejo de la medicación; Expectativas y sentimientos. El estudio trajo contribuciones importantes que todavía se deben profundizar en cuanto a esta temática en el universo infantil. La adhesión a los ARV constituye un desafío para los profesionales de la salud y para la familia. El conocimiento de las vivencias y estrategias de los niños puede suscitar nuevas formas

HIV/AIDS related commodities supply chain management in public health facilities of Addis Ababa, Ethiopia: a cross-sectional survey.

Science.gov (United States)

Berhanemeskel, Eyerusalem; Beedemariam, Gebremedhin; Fenta, Teferi Gedif

2016-01-01

A wide range of pharmaceutical products are needed for diagnosis, treatment, and prevention of HIV/AIDS. However, interrupted supplies and stock-outs are the major challenges in the supply chain of ARV medicines and related commodities. The aim of this study was to assess the supply chain management of HIV/AIDS related commodities in public health facilities of Addis Ababa, Ethiopia. A descriptive cross-sectional survey complemented by qualitative method was conducted in 24 public health facilities (4 hospitals and 20 health centers). A semi-structured questionnaire and observation check list were used to collect data on HIV/AIDS related service, reporting and ordering; receiving, transportation and storage condition of ARV medicines and test kits; and supportive supervision and logistics management information system. In addition, in-depth interview with flexible probing techniques was used to complement the quantitative data with emphasis to the storage condition of ARV medicines and test kits. Quantitative data was analyzed using SPSS version-20. Analysis of qualitative data involved rigorous reading of transcripts in order to identify key themes and data was analyzed using thematic approach. The study revealed that 16 health centers and one hospital had recorded and reported patient medication record. Six months prior to the study, 14 health centers and 2 hospitals had stopped VCT services for one time or more. Three hospitals and 18 health centers claimed to have been able to submit the requisition and report concerning ARV medicines to Pharmaceutical Fund and Supply Agency according to the specific reporting period. More than three-fourth of the health centers had one or more emergency order of ARV medicines on the day of visit, while all of hospitals had emergency order more than 3 times within 6 months prior to the study. All of the hospitals and nearly half of the health centers had an emergency order of test kits more than 3 times in the past 6�

Islamist Women of Hamas : Between Feminism and Nationalism

Directory of Open Access Journals (Sweden)

Islah Jad

2012-01-01

Full Text Available In December, 1995,when Hamas announced the establishment of the Islamic National Salvation Party, a political organisation separate from its military wing, it opened the way for involvement of the Islamic movement in the political processes brought about in the West Bank and Gaza with the signing of the Oslo Accords and the arrival of the Palestinian National Authority. In speaking of the rights of different groups, including women, in its founding statement, and in setting up in Gaza a Women’s Action Department, the new Party opened its doors to the ‘new Islamic woman’ and to a significant evolution in Islamist gender ideology in Gaza, if not in the West Bank -- where, due to Hamas’ policy there of targeting only males, there exists no parallel to the Salvation Party or organisational support for women like that represented by the Women’s Action Department in Gaza. Hamas’ gender ideology, like that of the secularist parties, remains contradictory, and doors to women’s equality only partly open ; nevertheless, Islamist women have managed to build impressive, well-organised women’s constituencies among highly educated and professional women coming from poor and refugee backgrounds ; and the Salvation Party shows an increasing tendency to foster gender equality and more egalitarian social ideals, while holding fast to the agenda of national liberation. These advances have been achieved both through alternative interpretations of Islamic legal and religious texts, and through positive engagement with the discourses of other groups, whether secular feminists or nationalists. In contrast, secularists are losing ground by advocating a discourse of rights in isolation from the national agenda and in the absence of a mobilising organisation. These developments suggest possibilities for mutual accommodation between Islamist and other Palestinian groups. They suggest also that the nature of the state proposed by Islamists will depend to

Treatment Adherence and Outcomes of Antiretroviral Agents in HIV Positive Patients

International Nuclear Information System (INIS)

Tahir, N. B.; Uddin, Q. T.

2014-01-01

Objective: To describe the treatment outcomes in terms of adherence, outcomes and side effects of antiretroviral (ARV) agents. Study Design: An observational study. Place and Duration of Study: Teaching Hospital of Khyber Medical University, Institute of Medical Sciences, Kohat, from February 2007 to December 2012. Methodology: Human Immunodeficiency Virus (HIV) positive patients, taking 1st line ARV agents for at least 6 months were included. Adherence was calculated by self report on asking the number of doses missed in last 30 days. ARVs were provided on monthly basis. Adherence data was noted over a period of 6 months. ARVs outcomes were recorded in the form of adherence, CD4 count, functional status of the patient, change in weight, further transmission of the disease, number of hospital admissions and deaths. Adverse Drug Reactions (ARDs) to ARVs were assessed clinically and by laboratory markers. Mean and standard deviation were calculated for numerical variables while frequencies and percentages were calculated for categorical variables. Results: Total number of patients included in this study were 107. Out of them, 66.4% were males and 33.6% were females. The mean age was 39.9 +- 13.80 years. Patients taking AZT/3TC/NVP, AZT/3TC/EFZ, D4T/3TC/NVP, D4T/3TC/EFZ, TNF/3TC/NVP or EFZ were 49.5%, 22.4%, 10.3%, 4.7% and 13% respectively. Most adverse affects were observed in 10 days to 90 days of initiation of therapy. Rash was observed in 71 (66.4%) patients, anaemia in 4 (3.7%) patients while only one patient (0.93%) had nausea / vomiting. Thirty (28%) patients reported no side effects. Out of 107 patients, 98 (91.5%) were alive whereas 9 (8.4%) died at the end of the study period. Twelve patients had one hospital admission (11.21%) whereas 9 (8.4%) patients had two admissions during the study period. The first mean CD4 was 325.27 cells /mcL whereas mean last CD4 count was 389.86 cells/mcL. Conclusion: ARVs have very satisfactory outcomes in HIV/AIDS patients

Protease inhibitor associated mutations compromise the efficacy of therapy in human immunodeficiency virus – 1 (HIV-1 infected pediatric patients: a cross-sectional study

Directory of Open Access Journals (Sweden)

Petrova Anna

2007-07-01

Full Text Available Abstract Background Although the introduction of combined therapy with reverse transcriptase and protease inhibitors has resulted in considerable decrease in HIV related mortality; it has also induced the development of multiple drug-resistant HIV-1 variants. The few studies on HIV-1 mutagenesis in HIV infected children have not evaluated the impact of HIV-1 mutations on the clinical, virological and immunological presentation of HIV disease that is fundamental to optimizing the treatment regimens for these patients. Results A cross sectional study was conducted to evaluate the impact of treatment regimens and resistance mutation patterns on the clinical, virological, and immunological presentation of HIV disease in 41 children (25 male and 16 female at the Robert Wood Johnson Pediatric AIDS Program in New Brunswick, New Jersey. The study participants were symptomatic and had preceding treatment history with combined ARV regimens including protease inhibitors (PIs, nucleoside reverse transcriptase inhibitors (NRTIs and non-nucleoside reverse transcriptase inhibitors (NNRTIs. Fifteen (36.6% children were treated with NRTI+NNRTI+ PI, 6 (14.6% with NRTI+NNRTIs, 13 (31.7% with NRTI+PIs, and the remaining 7 (17.1% received NRTIs only. Combined ARV regimens did not significantly influence the incidence of NRTI and NNRTI associated mutations. The duration of ARV therapy and the child's age had no significant impact on the ARV related mutations. The clinico-immunological presentation of the HIV disease was not associated with ARV treatment regimens or number of resistance mutations. However, primary mutations in the protease (PR gene increased the likelihood of plasma viral load (PVL ≥ 10,000 copies/mL irrespective of the child's age, duration of ARV therapy, presence of NRTI and NNRTI mutation. Viremia ≥ 10,000 copies/mL was recorded in almost all the children with primary mutations in the PR region (n = 12/13, 92.3% as compared with only 50.0% (n

PATTERNS OF SEVEN AND COMPLICATED MALARIA IN CHILDREN

African Journals Online (AJOL)

GB

2016-01-01

Jan 1, 2016 ... Epidemiology and Outcomes of Hospitalized Burn Patients in Gaza ... BACKGROUNG: Burns are serious health problems and leading causes of mortality and .... Aymen E. et al .... injuries, disasters and costs from cigarettes.

Genetics Home Reference: 17-beta hydroxysteroid dehydrogenase 3 deficiency

Science.gov (United States)

... 000 newborns. It is more common in the Arab population of Gaza, where it affects 1 in ... fetus, resulting in the abnormalities in the external sex organs that occur in 17-beta hydroxysteroid dehydrogenase ...

Creating an Economically Enabling and Competitive Business ...

International Development Research Centre (IDRC) Digital Library (Canada)

Creating an Economically Enabling and Competitive Business Environment in the ... the scope of operations of private sector enterprises in the West Bank and Gaza. ... IWRA/IDRC webinar on climate change and adaptive water management.

Topical Delivery of Tenofovir Disoproxil Fumarate and Emtricitabine from Pod-Intravaginal Rings Protects Macaques from Multiple SHIV Exposures

OpenAIRE

Srinivasan, Priya; Moss, John A.; Gunawardana, Manjula; Churchman, Scott A.; Yang, Flora; Dinh, Chuong T.; Mitchell, James M.; Zhang, Jining; Fanter, Rob; Miller, Christine S.; Butkyavichene, Irina; McNicholl, Janet M.; Smith, Thomas J.; Baum, Marc M.; Smith, James M.

2016-01-01

Topical preexposure prophylaxis (PrEP) against HIV has been marginally successful in recent clinical trials with low adherence rates being a primary factor for failure. Controlled, sustained release of antiretroviral (ARV) drugs may help overcome these low adherence rates if the product is protective for extended periods of time. The oral combination of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) is currently the only FDA-approved ARV drug for HIV PrEP. A novel pod-intravagina...

Hvad betyder Holocaust i dag?

DEFF Research Database (Denmark)

Wæhrens, Anne

2013-01-01

Holocaust er del af europæernes fælles arv, men hvilken betydning har folkedrabet i dag? Hvorfor bliver Holocaust stadig mindet, og er der andre dele af historiens skyggesider, som også bør blive mindet?......Holocaust er del af europæernes fælles arv, men hvilken betydning har folkedrabet i dag? Hvorfor bliver Holocaust stadig mindet, og er der andre dele af historiens skyggesider, som også bør blive mindet?...

Community-based evaluation of PMTCT uptake in Nyanza Province, Kenya.

Directory of Open Access Journals (Sweden)

Pamela K Kohler

Full Text Available Facility-based assessments of prevention of mother-to-child HIV transmission (PMTCT programs may overestimate population coverage. There are few community-based studies that evaluate PMTCT coverage and uptake.During 2011, a cross-sectional community survey among women who gave birth in the prior year was performed using the KEMRI-CDC Health and Demographic Surveillance System in Western Kenya. A random sample (n = 405 and a sample of women known to be HIV-positive through previous home-based testing (n = 247 were enrolled. Rates and correlates of uptake of antenatal care (ANC, HIV-testing, and antiretrovirals (ARVs were determined.Among 405 women in the random sample, 379 (94% reported accessing ANC, most of whom (87% were HIV tested. Uptake of HIV testing was associated with employment, higher socioeconomic status, and partner HIV testing. Among 247 known HIV-positive women, 173 (70% self-disclosed their HIV status. Among 216 self-reported HIV-positive women (including 43 from the random sample, 82% took PMTCT ARVs, with 54% completing the full antenatal, peripartum, and postpartum course. Maternal ARV use was associated with more ANC visits and having an HIV tested partner. ARV use during delivery was lowest (62% and associated with facility delivery. Eighty percent of HIV infected women reported having their infant HIV tested, 11% of whom reported their child was HIV infected, 76% uninfected, 6% declined to say, 7% did not recall; 79% of infected children were reportedly receiving HIV care and treatment.Community-based assessments provide data that complements clinic-based PMTCT evaluations. In this survey, antenatal HIV test uptake was high; most HIV infected women received ARVs, though many women did not self-disclose HIV status to field team. Community-driven strategies that encourage early ANC, partner involvement, and skilled delivery, and provide PMTCT education, may facilitate further reductions in vertical transmission.

Inhibition of Human Cytochrome P450 Enzymes by Allergen Removed Rhus verniciflua Stoke Standardized Extract and Constituents

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Hyunsik Jung

2014-01-01

Full Text Available Objective. Potential interactions between herbal extracts and the cytochrome P450 (CYP system lead to serious adverse events or decreased drug efficacy. Rhus verniciflua stoke (RVS and its constituents have been reported to have various pharmacological properties. We evaluated the inhibitory potential of RVS and its constituents on the major CYP isoforms. Methods. The effects of allergen removed RVS (aRVS standardized extract and major components, fustin and fisetin isolated from aRVS, were evaluated on CYP1A2, CYP2C9, CYP2C19, CYP2D6, and CYP3A4 isoenzyme activity by a luminescent CYP recombinant human enzyme assay. Results. The aRVS extract showed relative potent inhibitory effects on the CYP2C9 (IC50, <0.001 μg/mL, CYP2C19 (IC50, 9.68 μg/mL, and CYP1A2 (IC50, 10.0 μg/mL. However, it showed weak inhibition on CYP3A4 and CYP2D6. Fustin showed moderate inhibitory effects on the CYP2C19 (IC50, 64.3 μg/mL and weak inhibition of the other CYP isoforms similar to aRVS. Fisetin showed potent inhibitory effects on CYP2C9, CYP2C19, and CYP1A2. Fisetin showed moderate inhibition of CYP2D6 and weak inhibition of CYP3A4. Conclusions. These results indicate that aRVS, a clinically available herbal medicine, could contribute to herb-drug interactions when orally coadministered with drugs metabolized by CYP2C9, CYP2C19, and CYP1A2.

Iisraeli ja Palestiina vaherahu algas vaenuga / Arko Olesk

Index Scriptorium Estoniae

Olesk, Arko, 1981-

2006-01-01

Palestiina president Mahmoud Abbas kinnitas Iisraeli peaministrile Ehud Olmertile, et Palestiina rühmitused on valmis lõpetama vägivalla Gazas, kuid siiski mõned Palestiina rühmitused ignoreerisid lepet. Kaart: Raketid Gazast

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African Journals Online (AJOL)

Alison

for biofortified crops in countries with a high burden of micronutrient malnutrition. This ..... The sustained improvement in OSP consumption and vitamin A intake in the treatment .... potatoes: the caes study of Gaza province in Mozambique.

Anwar Sadat's National Security Strategy in the October War: From Vision to Victory

National Research Council Canada - National Science Library

Bennett, Drew A; Arnold, Michael W

2000-01-01

...: recapturing Egyptian honor in the wake of the humiliating defeat to the Israelis in the 1967 Six-Day War, regaining Egyptian territory in the Sinai and Gaza lost in the Six-Day War, and proving...

The Relationship between Antisperm Antibodies Prevalence and ...

African Journals Online (AJOL)

Erah

African Journal of Reproductive Health September 2011; 15(3): 93. ORIGINAL RESEARCH .... may cross-react with those on human HSP60 and initiate an autoimmune ..... Palestinian women attended IVF center in Gaza complaining from ...

The Awareness of Health Professionals in Diagnostic Techniques ...

African Journals Online (AJOL)

hanumantp

clear that most reviewed articles used the same conventional methods in ... Knowledge about the possible correlation of occult blood with reasons other than ... diagnostic techniques used in the examination of intestinal parasites in Gaza Strip.

HIV antiretroviral medication stock-outs in Ghana: contributors and consequences.

Science.gov (United States)

Poku, Rebecca A; Owusu, Adobea Yaa; Mullen, Patricia Dolan; Markham, Christine; McCurdy, Sheryl A

2017-09-01

Drug stock-outs are an unfortunate yet common reality for patients living in low and middle income countries, particularly in sub-Saharan Africa where trouble with consistent stock of antiretroviral medications (ARVs) continues. Our study takes a snapshot of this problem in Ghana. Although the country launched its antiretroviral therapy (ART) programme in 2003, progress toward realising the full benefit of ART for treated individuals has been limited, in part, because of stock-outs. In Ghana's Greater Accra region, we conducted semi-structured interviews with 40 women living with HIV (WLHIV) and 15 individuals with a history of HIV-related work in government or non-governmental organisations, or healthcare facilities. We used repeated review with coding and mapping techniques to analyse the transcripts and identify common themes. Stock-outs of ARVs result in inconsistent administration of therapy, increased indirect medical costs for WLHIV, and negative labelling of patients. Inefficiencies in drug supply, poor coordination with port authorities, inadequate government funding and dependence on international aid contribute to the stock-outs experienced in Ghana. Although using ARVs produced in-country could reduce supply problems, the domestically-manufactured product currently does not meet World Health Organization (WHO) standards. We recommend focused efforts to produce WHO standard ARVs in Ghana, and a review of current supply chain management to identify and mend pitfalls in the system.

The relationship between dietary salt intake and ambulatory blood pressure variability in non-diabetic hypertensive patients

Directory of Open Access Journals (Sweden)

Nihal Ozkayar

2016-11-01

Full Text Available High dietary salt intake was reported to increase blood pressure by numerous studies, but no study has investigated the effect of dietary salt intake on blood pressure variability (BPV. This study aimed to determine if daily salt intake is related to ambulatory BPV. The study included 136 primary hypertensive patients (92 male, 44 female with a mean age of 50.7 ± 11.1 years. All the patients underwent 24-h ambulatory blood pressure monitoring to determine both the 24-h systolic and 24-h diastolic BPV. 24-h urine sodium was measured. The correlation between BPV and 24-h urinary sodium was investigated. Logarithmic transformation of 24-h urinary sodium [log(24-h urinary sodium] was positively correlated with the mean 24-h systolic ARV, and nighttime systolic ARV (r = 0.371 and p = 0.001, r = 0.329 and p = 0.028, respectively. Similarly, log(24-h urinary sodium was positively correlated with mean 24-h diastolic ARV and nighttime diastolic ARV (r = 0.381 and p = 0.001, r = 0.320 and p = 0.020 respectively. Log(24-h urinary sodium was an independent predictor of BPV based on multivariate regression analysis. Dietary salt intake might play a role in the pathogenesis of ambulatory BPV.

SELF WOUND MANAGEMENT PRACTICES BEFORE ATTENDING ANTIRABIES VACCINE CLINIC

Directory of Open Access Journals (Sweden)

Amit Kumar Mishra, Smita Panda, Prakash Chandra Panda

2015-07-01

Full Text Available Introduction: In INDIA almost 20000 people die (40% of world death each year from rabies. Most of these deaths could be prevented by post exposure prophylaxis with wound washing, rabies immunoglobulin & vaccination. Local wound management alone can reduce viral load by up to 80%. Objective: To study self-wound management practices in animal exposure patients before attending a tertiary level ARV clinic. Methodology: Data regarding wound management was collected by individual interview of patients attending the ARV clinic during OCT 2011 to MAR 2012. The data collected in the form of a questionnaire. Analysis of data was done in the Department Of Community Medicine, V.S.S. Medical College, Burla. Results: Total 493 cases of animal exposure were attended during the study period. Most common biting animal was dog (94.5%. 31% of cases were under the age of 10 years & 23% belongs to the age of 10-19 years. Male to female ratio was 3:1. Most of the cases (91% were of category III exposure. Immediate management of wound was practiced by 63-77% of cases before visiting ARV clinic; only 2% wash the wound with running water & soap for 15 minutes. 39% of cases applied Dettol/savlon at the wound side & other 38% applied turmeric, red chilli, kerosene, Band-Aid & ghee locally. Most cases (61% reported to ARV clinic within 24hours.

24-hour aortic blood pressure variability showed a stronger association with carotid damage than 24-hour brachial blood pressure variability: The SAFAR study.

Science.gov (United States)

Yu, Shikai; Chi, Chen; Protogerou, Athanase D; Safar, Michel E; Blacher, Jacques; Argyris, Antonis A; Nasothimiou, Efthimia G; Sfikakis, Petros P; Papaioannou, Theodore G; Xu, Henry; Zhang, Yi; Xu, Yawei

2018-03-01

We aim to compare 24-hour aortic blood pressure variability (BPV) with brachial BPV in relation to carotid damage as estimated by carotid intima-media thickness (CIMT) and cross-sectional area (CCSA). Four hundred and forty five individuals received brachial and aortic 24-hour ambulatory BP monitoring with a validated device (Mobil-O-Graph). Systolic BPV was estimated by average real variability (ARV) and time-weighted standard deviation (wSD). In multiple logistic regression analysis, CIMT > 900 μm was significantly and independently associated with aortic ARV (OR = 1.38; 95% CI: 1.04-1.84), aortic wSD (OR = 1.65; 95% CI: 1.19-2.29) and brachial ARV (OR = 1.53; 95% CI: 1.07-2.18), but not with brachial wSD. CCSA > 90th percentile was significantly and independently associated with aortic ARV (OR = 1.50; 95% CI: 1.07-2.10) and wSD (OR = 1.70; 95% CI: 1.12-2.56), but not with brachial BPVs. In receiver operator characteristics curve analysis, aortic wSD identified CCSA > 90th percentile better than brachial wSD (AUC: 0.73 vs 0.68, P < .01). In conclusion, aortic 24-hour systolic BPV showed a slightly stronger association with carotid damage than brachial BPV. ©2018 Wiley Periodicals, Inc.

Antiretroviral Resistance and Pregnancy Characteristics of Women with Perinatal and Nonperinatal HIV Infection.

Science.gov (United States)

Lazenby, Gweneth B; Mmeje, Okeoma; Fisher, Barbra M; Weinberg, Adriana; Aaron, Erika K; Keating, Maria; Luque, Amneris E; Willers, Denise; Cohan, Deborah; Money, Deborah

2016-01-01

Objective. To compare HIV drug resistance in pregnant women with perinatal HIV (PHIV) and those with nonperinatal HIV (NPHIV) infection. Methods. We conducted a multisite cohort study of PHIV and NPHIV women from 2000 to 2014. Sample size was calculated to identify a fourfold increase in antiretroviral (ARV) drug resistance in PHIV women. Continuous variables were compared using Student's t-test and Wilcoxon rank-sum tests. Categorical variables were compared using χ (2) and Fisher's exact tests. Univariate analysis was used to determine factors associated with antiretroviral drug resistance. Results. Forty-one PHIV and 41 NPHIV participants were included. Women with PHIV were more likely to have drug resistance than those with NPHIV ((55% versus 17%, p = 0.03), OR 6.0 (95% CI 1.0-34.8), p = 0.05), including multiclass resistance (15% versus 0, p = 0.03), and they were more likely to receive nonstandard ARVs during pregnancy (27% versus 5%, p = 0.01). PHIV and NPHIV women had similar rates of preterm birth (11% versus 28%, p = 0.08) and cesarean delivery (47% versus 46%, p = 0.9). Two infants born to a single NPHIV woman acquired HIV infection. Conclusions. PHIV women have a high frequency of HIV drug resistance mutations, leading to nonstandard ARVs use during pregnancy. Despite nonstandard ARV use during pregnancy, PHIV women did not experience increased rates of adverse pregnancy outcomes.

Enhancing the Framework for Entrepreneurship in the West Bank ...

International Development Research Centre (IDRC) Digital Library (Canada)

Outputs. Reports. Enhancing the framework for entrepreneurship in the West Bank and Gaza : 4th interim technical report (22 July 2013 - 21 January 2014) and final technical report (22 January 2012 - 21 January 2014). Download PDF ...

Possible Hematological Changes Associated with Acute ...

African Journals Online (AJOL)

physical development, and reduced school achievement in children.[11] In Gaza, acute ..... linear growth and hemoglobin levels.[39] Moreover, in a recent study .... in infants and toddlers: Results from a prospective study. Eur. J Epidemiol 2005 ...

Crumbling UNESCO and aggregating archaeology

Czech Academy of Sciences Publication Activity Database

Carman, J.; Turek, Jan

2017-01-01

Roč. 13, č. 3 (2017), s. 387-391 ISSN 1555-8622 Institutional support: RVO:67985912 Keywords : indigenous people of Amazonia * Canaanite site in Gaza * UNESCO * world archaeology * European Association of Archaeologists Subject RIV: AC - Archeology, Anthropology, Ethnology

Hydropolitics and the Prospect for Peace in the Arab- Israeli Conflict

National Research Council Canada - National Science Library

Gombert, Gregory

1998-01-01

... fundamental of all human needs, water. Since the Israeli occupation of the West Bank and Gaza Strip began after the 1967 Six Day War, Israeli military orders have denied Palestinian involvement in the management and development of water...

Hukkamõist, õigustused, blokaad / Kaivo Kopli

Index Scriptorium Estoniae

Kopli, Kaivo

2010-01-01

Iisraeli merevägi on valmis hõivama veel ühe Gaza sektorisse suunduva humanitaarabiga laeva, kuigi kuue abilaeva ülevõtmise operatsioonis hukkus mitu aktivisti. Iisrael kuulab üle kinnipeetud aktiviste. USA, ÜRO reageeringust seoses intsidendiga

Kriminaalpolitsei tulevikust / Arved Ant, Rauno Võsaste

Index Scriptorium Estoniae

Ant, Arved

2006-01-01

Kriminaalpolitsei hetkeolukorrast ja arenguvõimalustest, töökorralduse muutmisest, probleemikesksest tegutsemisest ning kriminaalpolitseinike motiveerimisest. Tabel: Politsei, kaitsepolitsei ja prokuratuuri palgaastmete võrdlustabel

The US Food and Drug Administration's tentative approval process and the global fight against HIV.

Science.gov (United States)

Chahal, Harinder Singh; Murray, Jeffrey S; Shimer, Martin; Capella, Peter; Presto, Ryan; Valdez, Mary Lou; Lurie, Peter G

2017-12-01

In 2004, the US government began to utilize the Food and Drug Administration's (USFDA) tentative approval process (tFDA) as a basis to determine which HIV drugs are appropriate to be purchased and used in resource-constrained settings. This process permits products that are not approved for marketing in the US, including medicines with active patents or marketing restrictions in the US, to be purchased and distributed in resource-constrained settings. Although the tFDA was originally intended to support the United States' President's Emergency Plan for AIDS Relief (PEPFAR), the USFDA list has become a cornerstone of international HIV programmes that support procurement of ARVs, such as the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Our objective in this article is to help the global HIV policy makers and implementers of HIV programmes better understand the benefits and limitations of the tFDA by providing an in-depth review of the relevant legal and regulatory processes. USFDA's dedicated tFDA process for ARVs used by the PEPFAR programme has a wide impact globally; however, the implementation and the regulatory processes governing the programme have not been thoroughly described in the medical literature. This paper seeks to help stakeholders better understand the legal and regulatory aspects associated with review of ARVs under the tFDA by describing the following: (1) the tFDA and its importance to global ARV procurement; (2) the regulatory pathways for applications under tFDA for the PEPFAR programme, including modifications to applications, review timelines and costs; (3) the role of US patents, US marketing exclusivity rights, and the Medicines Patents Pool in tFDA; and (4) an overview of how applications for PEPFAR programme are processed through the USFDA. We also provide a case study of a new ARV, tenofovir alafenamide fumarate (TAF), not yet reviewed by USFDA for PEPFAR use. In this paper, we describe the

Analysis of HIV early infant diagnosis data to estimate rates of perinatal HIV transmission in Zambia.

Directory of Open Access Journals (Sweden)

Kwasi Torpey

Full Text Available Mother-to-child transmission of HIV (MTCT remains the most prevalent source of pediatric HIV infection. Most PMTCT (prevention of mother-to-child transmission of HIV programs have concentrated monitoring and evaluation efforts on process rather than on outcome indicators. In this paper, we review service data from 28,320 children born to HIV-positive mothers to estimate MTCT rates.This study analyzed DNA PCR results and PMTCT data from perinatally exposed children zero to 12 months of age from five Zambian provinces between September 2007 and July 2010.The majority of children (58.6% had a PCR test conducted between age six weeks and six months. Exclusive breastfeeding (56.8% was the most frequent feeding method. An estimated 45.9% of mothers were below 30 years old and 93.3% had disclosed their HIV status. In terms of ARV regimen for PMTCT, 32.7% received AZT+single dose NVP (sdNVP, 30.9% received highly active antiretroviral treatment (HAART, 19.6% received sdNVP only and 12.9% received no ARVs. Transmission rates at six weeks when ARVs were received by both mother and baby, mother only, baby only, and none were 5.8%, 10.5%, 15.8% and 21.8% respectively. Transmission rates at six weeks where mother received HAART, AZT+sd NVP, sdNVP, and no intervention were 4.2%, 6.8%, 8.7% and 20.1% respectively. Based on adjusted analysis including ARV exposures and non ARV-related parameters, lower rates of positive PCR results were associated with 1 both mother and infant receiving prophylaxis, 2 children never breastfed and 3 mother being 30 years old or greater. Overall between September 2007 and July 2010, 12.2% of PCR results were HIV positive. Between September 2007 and January 2009, then between February 2009 and July 2010, proportions of positive PCR results were 15.1% and 11% respectively, a significant difference.The use of ARV drugs reduces vertical transmission of HIV in a program setting. Non-chemoprophylactic factors also play a significant

Visit-to-Visit Blood Pressure Variability in Young Adulthood and Hippocampal Volume and Integrity at Middle Age: The CARDIA Study (Coronary Artery Risk Development in Young Adults).

Science.gov (United States)

Yano, Yuichiro; Reis, Jared P; Levine, Deborah A; Bryan, R Nick; Viera, Anthony J; Shimbo, Daichi; Tedla, Yacob G; Allen, Norrina B; Schreiner, Pamela J; Bancks, Michael P; Sidney, Stephen; Pletcher, Mark J; Liu, Kiang; Greenland, Philip; Lloyd-Jones, Donald M; Launer, Lenore J

2017-12-01

The aims of this study are to assess the relationships of visit-to-visit blood pressure (BP) variability in young adulthood to hippocampal volume and integrity at middle age. We used data over 8 examinations spanning 25 years collected in the CARDIA study (Coronary Artery Risk Development in Young Adults) of black and white adults (age, 18-30 years) started in 1985 to 1986. Visit-to-visit BP variability was defined as by SD BP and average real variability (ARV BP , defined as the absolute differences of BP between successive BP measurements). Hippocampal tissue volume standardized by intracranial volume (%) and integrity assessed by fractional anisotropy were measured by 3-Tesla magnetic resonance imaging at the year-25 examination (n=545; mean age, 51 years; 54% women and 34% African Americans). Mean systolic BP (SBP)/diastolic BP levels were 110/69 mm Hg at year 0 (baseline), 117/73 mm Hg at year 25, and ARV SBP and SD SBP were 7.7 and 7.9 mm Hg, respectively. In multivariable-adjusted linear models, higher ARV SBP was associated with lower hippocampal volume (unstandardized regression coefficient [standard error] with 1-SD higher ARV SBP : -0.006 [0.003]), and higher SD SBP with lower hippocampal fractional anisotropy (-0.02 [0.01]; all P young adulthood may be useful in assessing the potential risk for reductions in hippocampal volume and integrity in midlife. © 2017 American Heart Association, Inc.

Clinical Relevance of Androgen Receptor Splice Variants in Castration-Resistant Prostate Cancer.

Science.gov (United States)

Maughan, Benjamin L; Antonarakis, Emmanuel S

2015-12-01

Metastatic castration-resistant prostate cancer (mCRPC) currently benefits from a wealth of treatment options, yet still remains lethal in the vast majority of patients. It is becoming increasingly understood that this disease entity continues to evolve over time, acquiring additional and diverse resistance mechanisms with each subsequent therapy used. This dynamic relationship between treatment pressure and disease resistance can be challenging for the managing clinician. The recent discovery of alternate splice variants of the androgen receptor (AR) is one potential mechanism of escape in mCRPC, and recognizing this resistance mechanism might be important for optimal treatment selection for our patients. AR-V7 appears to be the most relevant AR splice variant, and early clinical data suggest that it is a negative prognostic marker in mCRPC. Emerging evidence also suggests that detection of AR-V7 may be associated with resistance to novel hormonal therapy (abiraterone and enzalutamide) but may be compatible with sensitivity to taxane chemotherapy (docetaxel and cabazitaxel). Adding to this complexity is the observation that AR-V7 is a dynamic marker whose status may change across time and depending on selective pressures induced by different therapies. Finally, it is possible that AR-V7 may represent a therapeutic target in mCRPC if drugs can be designed that degrade or inhibit AR splice variants or block their transcriptional activity. Several such agents (including galeterone, EPI-506, and bromodomain/BET inhibitors) are now in clinical development.

Antiretroviral Resistance and Pregnancy Characteristics of Women with Perinatal and Nonperinatal HIV Infection

Directory of Open Access Journals (Sweden)

Gweneth B. Lazenby

2016-01-01

Full Text Available Objective. To compare HIV drug resistance in pregnant women with perinatal HIV (PHIV and those with nonperinatal HIV (NPHIV infection. Methods. We conducted a multisite cohort study of PHIV and NPHIV women from 2000 to 2014. Sample size was calculated to identify a fourfold increase in antiretroviral (ARV drug resistance in PHIV women. Continuous variables were compared using Student’s t-test and Wilcoxon rank-sum tests. Categorical variables were compared using χ2 and Fisher’s exact tests. Univariate analysis was used to determine factors associated with antiretroviral drug resistance. Results. Forty-one PHIV and 41 NPHIV participants were included. Women with PHIV were more likely to have drug resistance than those with NPHIV ((55% versus 17%, p=0.03, OR 6.0 (95% CI 1.0–34.8, p=0.05, including multiclass resistance (15% versus 0, p=0.03, and they were more likely to receive nonstandard ARVs during pregnancy (27% versus 5%, p=0.01. PHIV and NPHIV women had similar rates of preterm birth (11% versus 28%, p=0.08 and cesarean delivery (47% versus 46%, p=0.9. Two infants born to a single NPHIV woman acquired HIV infection. Conclusions. PHIV women have a high frequency of HIV drug resistance mutations, leading to nonstandard ARVs use during pregnancy. Despite nonstandard ARV use during pregnancy, PHIV women did not experience increased rates of adverse pregnancy outcomes.

Alpharetroviral self-inactivating vectors produced by a superinfection-resistant stable packaging cell line allow genetic modification of primary human T lymphocytes.

Science.gov (United States)

Labenski, Verena; Suerth, Julia D; Barczak, Elke; Heckl, Dirk; Levy, Camille; Bernadin, Ornellie; Charpentier, Emmanuelle; Williams, David A; Fehse, Boris; Verhoeyen, Els; Schambach, Axel

2016-08-01

Primary human T lymphocytes represent an important cell population for adoptive immunotherapies, including chimeric-antigen and T-cell receptor applications, as they have the capability to eliminate non-self, virus-infected and tumor cells. Given the increasing numbers of clinical immunotherapy applications, the development of an optimal vector platform for genetic T lymphocyte engineering, which allows cost-effective high-quality vector productions, remains a critical goal. Alpharetroviral self-inactivating vectors (ARV) have several advantages compared to other vector platforms, including a more random genomic integration pattern and reduced likelihood for inducing aberrant splicing of integrated proviruses. We developed an ARV platform for the transduction of primary human T lymphocytes. We demonstrated functional transgene transfer using the clinically relevant herpes-simplex-virus thymidine kinase variant TK.007. Proof-of-concept of alpharetroviral-mediated T-lymphocyte engineering was shown in vitro and in a humanized transplantation model in vivo. Furthermore, we established a stable, human alpharetroviral packaging cell line in which we deleted the entry receptor (SLC1A5) for RD114/TR-pseudotyped ARVs to prevent superinfection and enhance genomic integrity of the packaging cell line and viral particles. We showed that superinfection can be entirely prevented, while maintaining high recombinant virus titers. Taken together, this resulted in an improved production platform representing an economic strategy for translating the promising features of ARVs for therapeutic T-lymphocyte engineering. Copyright © 2016 Elsevier Ltd. All rights reserved.

The relationship between dietary salt intake and ambulatory blood pressure variability in non-diabetic hypertensive patients.

Science.gov (United States)

Ozkayar, Nihal; Dede, Fatih; Ates, Ihsan; Akyel, Fatma; Yildirim, Tolga; Altun, Bulent

High dietary salt intake was reported to increase blood pressure by numerous studies, but no study has investigated the effect of dietary salt intake on blood pressure variability (BPV). This study aimed to determine if daily salt intake is related to ambulatory BPV. The study included 136 primary hypertensive patients (92 male, 44 female) with a mean age of 50.7±11.1 years. All the patients underwent 24-h ambulatory blood pressure monitoring to determine both the 24-h systolic and 24-h diastolic BPV. 24-h urine sodium was measured. The correlation between BPV and 24-h urinary sodium was investigated. Logarithmic transformation of 24-h urinary sodium [log(24-h urinary sodium)] was positively correlated with the mean 24-h systolic ARV, and nighttime systolic ARV (r=0.371 and p=0.001, r=0.329 and p=0.028, respectively). Similarly, log(24-h urinary sodium) was positively correlated with mean 24-h diastolic ARV and nighttime diastolic ARV (r=0.381 and p=0.001, r=0.320 and p=0.020 respectively). Log(24-h urinary sodium) was an independent predictor of BPV based on multivariate regression analysis. Dietary salt intake might play a role in the pathogenesis of ambulatory BPV. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

Maternal anaemia and duration of zidovudine in antiretroviral regimens for preventing mother-to-child transmission: a randomized trial in three African countries.

Science.gov (United States)

Sartorius, Benn K D; Chersich, Matthew F; Mwaura, Mary; Meda, Nicolas; Temmerman, Marleen; Newell, Marie Louise; Farley, Timothy M M; Luchters, Stanley

2013-11-06

Although substantiated by little evidence, concerns about zidovudine-related anaemia in pregnancy have influenced antiretroviral (ARV) regimen choice for preventing mother-to-child transmission of HIV-1, especially in settings where anaemia is common. Eligible HIV-infected pregnant women in Burkina Faso, Kenya and South Africa were followed from 28 weeks of pregnancy until 12-24 months after delivery (n = 1070). Women with a CD4 count of 200-500 cells/mm(3) and gestational age 28-36 weeks were randomly assigned to zidovudine-containing triple-ARV prophylaxis continued during breastfeeding up to 6-months, or to zidovudine during pregnancy plus single-dose nevirapine (sd-NVP) at labour. Additionally, two cohorts were established, women with CD4 counts: 500 cells/mm(3) received zidovudine during pregnancy plus sd-NVP at labour. Mild (haemoglobin 8.0-10.9 g/dl) and severe anaemia (haemoglobin anaemia occurred subsequently in 194 (18.1%) women, mostly in those with low baseline haemoglobin, lowest socio-economic category, advanced HIV disease, prolonged breastfeeding (≥ 6 months) and shorter ARV exposure. Severe anaemia incidence was similar in the randomized arms (equivalence P-value = 0.32). After 1-2 months of ARV's, severe anaemia was significantly reduced in all groups, though remained highest in the low CD4 cohort. Severe anaemia occurs at a similar rate in women receiving longer triple zidovudine-containing regimens or shorter prophylaxis. Pregnant women with pre-existing anaemia and advanced HIV disease require close monitoring. ISRCTN71468401.

3 FI :LU S :_U4 ~- Z )~f

African Journals Online (AJOL)

supplies, a successful offensive under Genl. Rommel was ..... Halfway House, Alam Barghut and the coast- al plain. Orders were .... Boxes established to protect the rear of the Gaza'a. Line, ..... of drawing the Allied armour to the north while the ...

Serum lactate levels in infants exposed peripartum to antiretroviral agents to prevent mother-to-child transmission of HIV: Agence Nationale de Recherches Sur le SIDA et les Hépatites Virales 1209 study, Abidjan, Ivory Coast

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Ekouevi, Didier Koumavi; Touré, Ramata; Becquet, Renaud; Viho, Ida; Sakarovitch, Charlotte; Rouet, François; Towne-Gold, Besigin; Fassinou, Patricia; Leroy, Valériane; Blanche, Stéphane; Dabis, François

2006-01-01

Background Mitochondrial toxicity was described in infants exposed to long-term antiretroviral regimens (ARVs) containing nucleoside analogues for the prevention of mother-to-child transmission of HIV (PMTCT). We measured the serum lactate levels in children born to HIV-1 infected (HIV+) African women receiving short-term ARV PMTCT regimens. Methods A prospective study was conducted in women-child pairs from the third trimester of pregnancy to three months of life. The exposed group was formed by children exposed in utero to nucleoside analogue ARVs, zidovudine (ZDV) or ZDV + lamivudine (3TC) from 32–36 weeks of amenorrhea until delivery. All these women received nevirapine single-dose (NVPsd) at the beginning of labor. The children received ZDV during the first 7 days of life and a NVPsd at day 3. The control group was formed by infants born to HIV+ women who had received NVPsd only and not exposed to nucleoside analogue ARVs. Serum lactate levels were measured at 4, 6 and 12 weeks of life by Cobas Integra 400™. Results A total of 836 blood samples from 338 infants were collected (262 exposed and 76 controls). Median lactacidemia was 1.8 mmol/l, Interquartile Range [1.2–2.7 mmol/l]). Overall serum lactate levels ≥2.5 mmol/l, defining hyperlactatemia were observed in 39 of the 292 infants who had at least two serum lactate measurements, 13.4%, 95% confidence Interval [9.6–17.8%]. The three-month period prevalence of hyperlactatemia did not differ between the exposed group (13.1%) and the control group (14.3%) (p=0.84). All serum lactate levels returned to normal values in all subsequent samples No case of symptomatic hyperlactatemia was detected during the study period. Conclusion Increased lactate levels were identified equally in infants whose mother received a short-term of nucleoside analogues or NVPsd for PMTCT. Although not rare, hyperlactatemia was not related to short-term exposure to nucleoside analogue ARVs PMID:16950945

Expression of Genes for Drug Transporters in the Human Female Genital Tract and Modulatory Effect of Antiretroviral Drugs.

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Karolin Hijazi

Full Text Available Anti-retroviral (ARV -based microbicides are one of the strategies pursued to prevent HIV-1 transmission. Delivery of ARV drugs to subepithelial CD4+ T cells at concentrations for protection is likely determined by drug transporters expressed in the cervicovaginal epithelium. To define the role of drug transporters in mucosal disposition of topically applied ARV-based microbicides, these must be tested in epithelial cell line-based biopharmaceutical assays factoring the effect of relevant drug transporters. We have characterised gene expression of influx and efflux drug transporters in a panel of cervicovaginal cell lines and compared this to expression in cervicovaginal tissue. We also investigated the effect of dapivirine, darunavir and tenofovir, currently at advanced stages of microbicides development, on expression of drug transporters in cell lines. Expression of efflux ABC transporters in cervical tissue was best represented in HeLa, Ect1/E6E7 and End1/E6E7 cell lines. Expression of influx OCT and ENT transporters in ectocervix matched expression in Hela while expression of influx SLCO transporters in vagina was best reflected in VK2/E6E7 cell line. Stimulation with darunavir and dapivirine upregulated MRP transporters, including MRP5 involved in transport of tenofovir. Dapivirine also significantly downregulated tenofovir substrate MRP4 in cervical cell lines. Treatment with darunavir and dapivirine showed no significant effect on expression of BCRP, MRP2 and P-glycoprotein implicated in efflux of different ARV drugs. Darunavir strongly induced expression in most cell lines of CNT3 involved in cell uptake of nucleotide/nucleoside analogue reverse transcriptase inhibitors and SLCO drug transporters involved in cell uptake of protease inhibitors. This study provides insight into the suitability of cervicovaginal cell lines for assessment of ARV drugs in transport kinetics studies. The modulatory effect of darunavir and dapivirine on

Expression of Genes for Drug Transporters in the Human Female Genital Tract and Modulatory Effect of Antiretroviral Drugs.

Science.gov (United States)

Hijazi, Karolin; Cuppone, Anna M; Smith, Kieron; Stincarelli, Maria A; Ekeruche-Makinde, Julia; De Falco, Giulia; Hold, Georgina L; Shattock, Robin; Kelly, Charles G; Pozzi, Gianni; Iannelli, Francesco

2015-01-01

Anti-retroviral (ARV) -based microbicides are one of the strategies pursued to prevent HIV-1 transmission. Delivery of ARV drugs to subepithelial CD4+ T cells at concentrations for protection is likely determined by drug transporters expressed in the cervicovaginal epithelium. To define the role of drug transporters in mucosal disposition of topically applied ARV-based microbicides, these must be tested in epithelial cell line-based biopharmaceutical assays factoring the effect of relevant drug transporters. We have characterised gene expression of influx and efflux drug transporters in a panel of cervicovaginal cell lines and compared this to expression in cervicovaginal tissue. We also investigated the effect of dapivirine, darunavir and tenofovir, currently at advanced stages of microbicides development, on expression of drug transporters in cell lines. Expression of efflux ABC transporters in cervical tissue was best represented in HeLa, Ect1/E6E7 and End1/E6E7 cell lines. Expression of influx OCT and ENT transporters in ectocervix matched expression in Hela while expression of influx SLCO transporters in vagina was best reflected in VK2/E6E7 cell line. Stimulation with darunavir and dapivirine upregulated MRP transporters, including MRP5 involved in transport of tenofovir. Dapivirine also significantly downregulated tenofovir substrate MRP4 in cervical cell lines. Treatment with darunavir and dapivirine showed no significant effect on expression of BCRP, MRP2 and P-glycoprotein implicated in efflux of different ARV drugs. Darunavir strongly induced expression in most cell lines of CNT3 involved in cell uptake of nucleotide/nucleoside analogue reverse transcriptase inhibitors and SLCO drug transporters involved in cell uptake of protease inhibitors. This study provides insight into the suitability of cervicovaginal cell lines for assessment of ARV drugs in transport kinetics studies. The modulatory effect of darunavir and dapivirine on expression of drug

USA toetab Lähis-Ida konfliktides Iisraeli / Neeme Raud

Index Scriptorium Estoniae

Raud, Neeme, 1969-

2006-01-01

USA kasutas ÜRO Julgeolekunõukogus vetoõigust resolutsiooni suhtes, milles nõuti Iisraelilt Gaza sektoris toimuvate rünnakute kohest lõpetamist, USA ÜRO suursaadiku John Boltoni sõnul oleks dokumendi vastuvõtmine õõnestanud Julgeolekunõukogu usaldusväärsust

Lähis-Ida võitlus ägeneb

Index Scriptorium Estoniae

2006-01-01

Iisraeli valitsus otsustas 19. juulil toimunud istungil, et jätkab operatsioone Gaza sektoris ja Liibanonis. Lähis-Itta konflikti lahendama saabunud Euroopa Liidu välisasjade koordinaator Javier Solana kutsus Iisraeli ja Liibanoni äärmusrühmitust Hezbollah vaenutegevust lõpetama

Addressing violence against Palestinian women | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2011-02-04

Feb 4, 2011 ... ... in Gaza City while her husband lives — with her four grown children — in Egypt. ... This project is a first: neither the media, government officials, nor even ... Amal Hamad of the Palestinian Ministry of Social Affairs admits that ...

Partner Vetting System - Gaza & West Bank

Data.gov (United States)

US Agency for International Development — The PVS WB system supports the vetting of NGOs, their employees, and individuals who apply for USAID contracts, grants, cooperative agreements, or other funding...

Real-time imaging of cerebral infarction in rabbits using electrical impedance tomography.

Science.gov (United States)

Yang, Bin; Shi, Xuetao; Dai, Meng; Xu, Canhua; You, Fushen; Fu, Feng; Liu, Ruigang; Dong, Xiuzhen

2014-02-01

To investigate the possible use of electrical impedance tomography (EIT) in monitoring focal cerebral infarction in a rabbit model. A model of focal cerebral infarction was established in eight New Zealand rabbits using a photochemical method without craniectomy. Focal cerebral infarction was confirmed by histopathological examination. Intracranial impedance variation was measured using 16 electrodes placed in a circle on the scalp. EIT images were obtained using a damped least-squares reconstruction algorithm. The average resistivity value (ARV) of the infarct region on EIT images was calculated to quantify relative resistivity changes. A symmetry index was calculated to evaluate the relative difference in resistivity between the two sides of the cerebrum. EIT images and ARV curves showed that impedance changes caused by cerebral infarction increased linearly with irradiation time. A difference in ARV was found between measurements taken before and after infarct induction. Focal cerebral infarction can be monitored by EIT in the proposed animal model. The results are sufficiently encouraging that the authors plan to extend this study to humans, after further technical improvements.

High HIV-1 Diversity and Prevalence of Transmitted Drug Resistance Among Antiretroviral-Naive HIV-Infected Pregnant Women from Rio de Janeiro, Brazil.

Science.gov (United States)

Delatorre, Edson; Silva-de-Jesus, Carlos; Couto-Fernandez, José Carlos; Pilotto, Jose H; Morgado, Mariza G

2017-01-01

Antiretroviral (ARV) resistance mutations in human immunodeficiency virus type 1 (HIV-1) infection may reduce the efficacy of prophylactic therapy to prevent mother-to-child transmission (PMTCT) and future treatment options. This study evaluated the diversity and the prevalence of transmitted drug resistance (TDR) in protease (PR) and reverse transcriptase (RT) regions of HIV-1 pol gene among 87 ARV-naive HIV-1-infected pregnant women from Rio de Janeiro, Brazil, between 2012 and 2015. The viral diversity comprised HIV-1 subtypes B (67.8%), F1 (17.2%), and C (4.6%); the circulating recombinant forms 12_BF (2.3%), 28/29_BF, 39_BF, 02_AG (1.1% each) and unique recombinants forms (4.5%). The overall prevalence of any TDR was 17.2%, of which 5.7% for nucleoside RT inhibitors, 5.7% for non-nucleoside RT inhibitors, and 8% for PR inhibitors. The TDR prevalence found in this population may affect the virological outcome of the standard PMTCT ARV-regimens, reinforcing the importance of continuous monitoring.

Re-designing the Mozambique vaccine supply chain to improve access to vaccines.

Science.gov (United States)

Lee, Bruce Y; Haidari, Leila A; Prosser, Wendy; Connor, Diana L; Bechtel, Ruth; Dipuve, Amelia; Kassim, Hidayat; Khanlawia, Balbina; Brown, Shawn T

2016-09-22

Populations and routine childhood vaccine regimens have changed substantially since supply chains were designed in the 1980s, and introducing new vaccines during the "Decade of Vaccine" may exacerbate existing bottlenecks, further inhibiting the flow of all vaccines. Working with the Mozambique Ministry of Health, our team implemented a new process that integrated HERMES computational simulation modeling and on-the-ground implementers to evaluate and improve the Mozambique vaccine supply chain using a system-re-design that integrated new supply chain structures, information technology, equipment, personnel, and policies. The alternative system design raised vaccine availability (from 66% to 93% in Gaza; from 76% to 84% in Cabo Delgado) and reduced the logistics cost per dose administered (from $0.53 to $0.32 in Gaza; from $0.38 to $0.24 in Cabo Delgado) as compared to the multi-tiered system under the current EPI. The alternative system also produced higher availability at lower costs after new vaccine introductions. Since reviewing scenarios modeling deliveries every two months in the north of Gaza, the provincial directorate has decided to pilot this approach diverging from decades of policies dictating monthly deliveries. Re-design improved not only supply chain efficacy but also efficiency, important since resources to deliver vaccines are limited. The Mozambique experience and process can serve as a model for other countries during the Decade of Vaccines. For the Decade of Vaccines, getting vaccines at affordable prices to the market is not enough. Vaccines must reach the population to be successful. Copyright © 2016. Published by Elsevier Ltd.

Population-level effectiveness of PMTCT Option A on early mother-to-child (MTCT) transmission of HIV in South Africa: implications for eliminating MTCT.

Science.gov (United States)

Goga, Ameena E; Dinh, Thu-Ha; Jackson, Debra J; Lombard, Carl J; Puren, Adrian; Sherman, Gayle; Ramokolo, Vundli; Woldesenbet, Selamawit; Doherty, Tanya; Noveve, Nobuntu; Magasana, Vuyolwethu; Singh, Yagespari; Ramraj, Trisha; Bhardwaj, Sanjana; Pillay, Yogan

2016-12-01

Eliminating mother-to-child transmission of HIV (EMTCT), defined as ≤50 infant HIV infections per 100 000 live births, is a global priority. Since 2011 policies to prevent mother-to-child transmission of HIV (PMTCT) shifted from maternal antiretroviral (ARV) treatment or prophylaxis contingent on CD4 cell count to lifelong maternal ARV treatment (cART). We sought to measure progress with early (4-8 weeks postpartum) MTCT prevention and elimination, 2011-2013, at national and sub-national levels in South Africa, a high antenatal HIV prevalence setting ( ≈ 29%), where early MTCT was 3.5% in 2010. Two surveys were conducted (August 2011-March 2012 and October 2012-May 2013), in 580 health facilities, randomly selected after two-stage probability proportional to size sampling of facilities (the primary sampling unit), to provide valid national and sub-national-(provincial)-level estimates. Data collectors interviewed caregivers of eligible infants, reviewed patient-held charts, and collected infant dried blood spots (iDBS). Confirmed positive HIV enzyme immunoassay (EIA) and positive total HIV nucleic acid polymerase chain reaction (PCR) indicated infant HIV exposure or infection, respectively. Weighted survey analysis was conducted for each survey and for the pooled data. National data from 10 106 and 9120 participants were analyzed (2011-12 and 2012-13 surveys respectively). Infant HIV exposure was 32.2% (95% confidence interval (CI) 30.7-33.6%), in 2011-12 and 33.1% (95% CI 31.8-34.4%), provincial range of 22.1-43.6% in 2012-13. MTCT was 2.7% (95% CI 2.1%-3.2%) in 2011-12 and 2.6% (95% CI 2.0-3.2%), provincial range of 1.9-5.4% in 2012-13. HIV-infected ARV-exposed mothers had significantly lower unadjusted early MTCT (2.0% [2011-12: 1.6-2.5%; 2012-13:1.5-2.6%]) compared to HIV-infected ARV-naive mothers [10.2% in 2011-12 (6.5-13.8%); 9.2% in 2012-13 (5.6-12.7%)]. Pooled analyses demonstrated significantly lower early MTCT among exclusive breastfeeding

Suministro de antirretrovirales en Argentina: Programa Nacional de Lucha contra los Retrovirus del Humano, SIDA y ETS Antiretroviral drug supply in Argentina: National Program to Combat Human Retroviruses, AIDS, and STDs

Directory of Open Access Journals (Sweden)

Marisel Colautti

2009-01-01

Full Text Available OBJETIVOS: Evaluar el circuito de suministro de antirretrovirales (ARV dentro del Programa Nacional de Lucha contra los Retrovirus del Humano, SIDA y ETS, mediante indicadores de desempeño, y recuperar la perspectiva de actores involucrados en el circuito de provisión. Se busca mejorar las acciones programáticas satisfaciendo las necesidades de los pacientes. MÉTODOS: En el servicio de farmacia de dos hospitales de Rosario, Argentina, de abril a septiembre de 2005 se llevó a cabo una investigación evaluativa con un abordaje cuantitativo, mediante indicadores y basado en fuentes secundarias, y otro cualitativo, con entrevistas semiestructuradas. RESULTADOS: Los indicadores revelan el impacto de las interrupciones en la provisión de ARV desde el Programa (nivel central y la acumulación de stock en el nivel local para paliar esas faltas. Los cambios de tratamiento con ARV representan más de 50% de las prescripciones. El cumplimiento en el retiro de ARV se aleja del valor de referencia. Los entrevistados describieron estrategias alternativas para superar dificultades de comunicación entre niveles, acumular stock, garantizar disponibilidad y acortar tiempos de espera; se establecieron acuerdos informales ante la falta de normativas y la escasez de recursos humanos; las instancias jurisdiccionales (central, intermedia y local o municipal suman dificultades, y se reconocen esfuerzos del nivel local para mejorar la gestión. CONCLUSIONES: Estos hallazgos pueden ser el punto de partida para la construcción de propuestas que involucren equipos de trabajo afectados en el circuito de provisión en su totalidad, a fin de lograr una descentralización efectiva, en congruencia con el papel rector que le corresponde necesariamente al Programa.OBJECTIVES: To evaluate the supply cycle of antiretroviral (ARV drugs, overseen by the National Program to Combat Human Retroviruses, AIDS, and STDs, through its order fulfillment indicators, and to obtain input

31 CFR 594.510 - Official activities of certain international organizations; U.S. person employees of certain...

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2010-07-01

... governments of states bordering the West Bank or Gaza are authorized to engage in all transactions and... Secretariat, specifically including, among others, the World Bank, the International Monetary Fund, the World Food Programme, and the World Health Organization. [71 FR 27200, May 10, 2006] ...

31 CFR 595.508 - Official activities of certain international organizations; U.S. person employees of certain...

Science.gov (United States)

2010-07-01

... governments of states bordering the West Bank or Gaza are authorized to engage in all transactions and... Secretariat, specifically including, among others, the World Bank, the International Monetary Fund, the World Food Programme, and the World Health Organization. [71 FR 27201, May 10, 2006] ...

The effect of smoking on the healthy life expectancy of Palestinian men in the West Bank

DEFF Research Database (Denmark)

Brønnum-Hansen, Henrik; Jonassen, Marie; Shaheen, Amira

2018-01-01

differed between Palestinians living in and outside refugee camps. Methods: The study was based on representative samples of Palestinians living in the occupied Palestinian territory (West Bank and Gaza Strip), aged 25 years and older, collected by the Palestinian Central Bureau of Statistics in 2006...

Functionalization of lambda-zirconium phosphate with ...

Indian Academy of Sciences (India)

EDTA is commonly added to food packaging in order to complex metal ions .... Gaza strip in which the natural water suffers from very high degree of hardness. ... exchange reactions proceed very fast and the OHH2O- phase, ZrPO4OHH2O.

Raevus Iisrael valmistub pealetungiks Gazale / Kaarel Kaas

Index Scriptorium Estoniae

Kaas, Kaarel, 1978-

2006-01-01

Iisrael koondas eilseks oma armee Gaza lähedale ning ähvardas Palestiinat rünnata, kui ei vabastata pühapäeval palestiinlaste poolt röövitud noort Iisraeli sõdurit. Iisrael välistab läbirääkimiste alustamise

Réduction de la pauvreté par le truchement du développement du ...

International Development Research Centre (IDRC) Digital Library (Canada)

The prospect of indefinite Israeli occupation of the Palestinian territories, and their extreme dependence on foreign assistance and Israeli-controlled customs revenues, had led to the conclusion... View moreCreating an Economically Enabling and Competitive Business Environment in the West Bank and Gaza Strip ...

Activation of plantar flexor muscles is constrained by multiple muscle synergies rather than joint torques.

Directory of Open Access Journals (Sweden)

Takahito Suzuki

Full Text Available Behavioral evidence has suggested that a small number of muscle synergies may be responsible for activating a variety of muscles. Nevertheless, such dimensionality reduction may also be explained using the perspective of alternative hypotheses, such as predictions based on linear combinations of joint torques multiplied by corresponding coefficients. To compare the explanatory capacity of these hypotheses for describing muscle activation, we enrolled 12 male volunteers who performed isometric plantar flexor contractions at 10-100% of maximum effort. During each plantar flexor contraction, the knee extensor muscles were isometrically contracted at 0%, 50%, or 100% of maximum effort. Electromyographic activity was recorded from the vastus lateralis, medial gastrocnemius (MG, lateral gastrocnemius (LG, and soleus muscles and quantified using the average rectified value (ARV. At lower plantar flexion torque, regression analysis identified a clear linear relationship between the MG and soleus ARVs and between the MG and LG ARVs, suggesting the presence of muscle synergy (r2 > 0.65. The contraction of the knee extensor muscles induced a significant change in the slope of this relationship for both pairs of muscles (MG × soleus, P = 0.002; MG × LG, P = 0.006. Similarly, the slope of the linear relationship between the plantar flexion torque and the ARV of the MG or soleus changed significantly with knee extensor contraction (P = 0.031 and P = 0.041, respectively. These results suggest that muscle synergies characterized by non-mechanical constraints are selectively recruited according to whether contraction of the knee extensor muscles is performed simultaneously, which is relatively consistent with the muscle synergy hypothesis.

Antiretroviral agents and acid-base balance at delivery of the neonate

Directory of Open Access Journals (Sweden)

P. El-Beitune

2007-07-01

Full Text Available Limited evidence is available regarding antiretroviral (ARV safety for uninfected infants exposed to these drugs in utero. Our objective was to determine if ARV administered to pregnant women is associated with decreasing umbilical arterial pH and base excess in uninfected infants. A prospective study was conducted on 57 neonates divided into three groups: ZDV group, born to mothers taking zidovudine (N = 20, triple therapy (TT group, born to mothers taking zidovudine + lamivudine + nelfinavir (N = 25, and control group (N = 12, born to uninfected mothers. Umbilical cord blood was used to determine umbilical artery gases. A test was performed to calculate the sample by comparing means by the unpaired one-tailed t-test, with a = 0.05 and ß = 20%, indicating the need for a sample of 18 newborn infants for the study groups to detect differences higher than 20%. The control and ARV groups were similar in gestational age, birth weight, and Apgar scores. Values of pH, pCO2, bicarbonate, and base excess in cord arterial blood obtained at delivery from the newborns exposed to TT were 7.23, 43.2 mmHg, 19.5 mEq/L, and -8.5 nmol/L, respectively, with no significant difference compared to the control and ZDV groups. We conclude that intrauterine exposure to ARV is not associated with a pathological decrease in umbilical arterial pH or base excess. While our data are reassuring, follow-up is still limited and needs to be continued into adulthood because of the possible potential for adverse effects of triple antiretroviral agents.

Operational issues and barriers to implementation of prevention of mother-to-child transmission of HIV (PMTCT) interventions in Sub-Saharan Africa.

Science.gov (United States)

Aizire, Jim; Fowler, Mary G; Coovadia, Hoosen M

2013-03-01

Over the past 10 years substantial progress has been made in the implementation of prevention of mother-to-child transmission of HIV (PMTCT) interventions in Sub-Saharan Africa (SSA). In spite of this, new pediatric infections remain unacceptably high, contributing the majority (>90%) of the estimated 390,000 infections globally in 2010; and yet prolonged breastfeeding remains the norm and crucial to overall infant survival. However, there is reason for optimism given the 2010 World Health Organization PMTCT recommendations: to start HIV infected pregnant women with CD4 cell counts less than 350 cells/mm(3) on lifelong antiretroviral therapy (ART); and for mothers not eligible for ART to provide efficacious maternal and/or infant PMTCT antiretroviral (ARV) regimens to be taken during pregnancy, labor/delivery and through breastfeeding. Current attention is on whether to extend maternal ARVs for life once triple ARV PMTCT regimens are started. To dramatically reduce new pediatric infections, individual countries need to politically commit to rapid scale-up of a multi-pronged PMTCT effort: including primary prevention to reduce HIV incidence among women of reproductive age; increased access to family planning services; HIV screening of all pregnant and breastfeeding women followed by ART or ARVs for PMTCT; and comprehensive care for HIV affected families. Efforts to achieve population-level success in SSA need to critically address operational issues and challenges to implementation (health system) and utilization (social, economic and cultural barriers), at the country, health centre and client level that have led to the relatively slow progress in the scale-up of PMTCT strategies.

Poor functional immune recovery in aged HIV-1-infected patients following successfully treatment with antiretroviral therapy.

Science.gov (United States)

Kasahara, Taissa M; Hygino, Joana; Andrade, Regis M; Monteiro, Clarice; Sacramento, Priscila M; Andrade, Arnaldo F B; Bento, Cleonice A M

2015-10-01

Aging is now a well-recognized characteristic of the HIV-infected population and both AIDS and aging are characterized by a deficiency of the T-cell compartment. The objective of the present study was to evaluate the impact of antiretroviral (ARV) therapy in recovering functional response of T cells to both HIV-1-specific ENV peptides (ENV) and tetanus toxoid (TT), in young and aged AIDS patients who responded to ARV therapy by controlling virus replication and elevating CD4(+) T cell counts. Here, we observed that proliferative response of T-cells to either HIV-1-specific Env peptides or tetanus toxoid (TT) was significantly lower in older antiretroviral (ARV)-treated patients. With regard to cytokine profile, lower levels of IFN-γ, IL-17 and IL-21, associated with elevated IL-10 release, were produced by Env- or TT-stimulated T-cells from older patients. The IL-10 neutralization by anti-IL-10 mAb did not elevate IFN-γ and IL-21 release in older patients. Finally, even after a booster dose of TT, reduced anti-TT IgG titers were quantified in older AIDS patients and it was related to both lower IL-21 and IFN-γ production and reduced frequency of central memory T-cells. Our results reveal that ARV therapy, despite the adequate recovery of CD4(+) T cell counts and suppression of viremia, was less efficient in recovering adequate immune response in older AIDS patients. Copyright © 2015 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

Armour of the 14th c.-17th c. in the territory of vilnius castles according to the archaeological data

OpenAIRE

Bugys, Paulius

2008-01-01

Darbe yra analizuojamos Vilniaus pilių teritorijoje, archeologinių tyrimų metu, rastos šarvų detalės. Šioje teritorijoje aptiktas pakankamai didelis kiekis įvairiausių šarvų detalių, kurios datuojamos nuo XIV a. antrosios pusės iki XVII a. antros pusės. Publikacijų, skirtų Viduramžių ir renesanso ginkluotei, Lietuvoje yra labai nedaug, o archeologinių tyrimų metu aptiktai šarvuotei – išvis nėra. Todėl šio darbo objektu pasirinktos Vilniaus Pilių teritorijoje, archeologinių tyrimų metu, aptikt...

Hybrid Warfare: Preparing for Future Conflict

Science.gov (United States)

2015-02-17

ciceromagazine.com/?s=getting+behind+hybrid+warfare. Brown , Col Leslie F. “Twenty-First Century Warfare Will be Hybrid.” Carlisle Barracks, PA...Lebanon and Gaza.” Rand Corporation Occasional Paper. Santa Monica, CA: Rand Corporation, 2010. Jones, Gareth and Darya Korsunskaya. “U.S., EU

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International Development Research Centre (IDRC) Digital Library (Canada)

This knowledge can be used as a tool for addressing pressing global challenges. We share ... Creating an Economically Enabling and Competitive Business Environment in the West Bank and Gaza Strip ... The Zambian health care system has been negatively affected by globalization and faces severe resource constraints.

Forging an Indian Partnership

Science.gov (United States)

2012-01-01

the diplomatic front will be to recognize where interests intersect and generate mutually agreeable policies to advance those interests. Without the...Goldstone Report in the United Nations, a damning report accusing both the Israelis and Palestinians of pos­ sible war crimes in the Gaza Strip.74

'A Sense of Urgency': The EU, EU Member States and the Recognition of the Palestinian State

DEFF Research Database (Denmark)

Martins, Bruno Oliveira

2015-01-01

In the aftermath of the July-August 2014 war in Gaza, the Swedish government officially recognized the State of Palestine. This decision triggered a cascade of resolutions adopted in national parliaments of European Union member states and, eventually, led to the adoption of a European Parliament...

Mutable Conflicts

DEFF Research Database (Denmark)

Kublitz, Anja

their everyday life in Denmark, and to single out specific contemporary political events like the publishing of the cartoons of the Prophet Muhammad, local clashes with the Danish police and the Israeli invasion of Gaza. The ethnography discloses that the Palestinian-Israeli conflict is not a chronological...

PATTERNS OF SEVEN AND COMPLICATED MALARIA IN CHILDREN

African Journals Online (AJOL)

GB

2017-05-01

May 1, 2017 ... Syndrome among Type 2 Diabetes Patients in Gaza Strip, Palestine. Abdel Hamid ... This study was conducted to evaluate the association between physical ... diabetes and raised fasting plasma glucose (FPG), ..... women: a meta-analysis of data from eleven ... points of homeostasis model assessment of.

Israel: Strategic Asset or Strategic Liability?

Science.gov (United States)

2013-04-23

and most of the coastline to The Jews. Arab Palestinians were awarded the mountain region of the Palestinian heartland, Gaza Strip, and Western...French Mandate) Palestineg Transjordan British Mandate RED SEA Saudi Arabia D Area Separaled ancs Closed 10 Jewish 5eDiemenl 1921 • Alea

How to Contain Iranian Influence in the Levant

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2011-03-10

although not necessarily having complete authoritative control over Hezbollah’s military wing. Economic support to Lebanon is estimated between...existent since mid-2007?20 Economically in FY 2009 the West Bank and Gaza received U.S. funding to support Basic Education, Maternal and Child Health

Hizbullah’s Culture Wars -- Understanding Hizbullah through Social Movement Theory and Its Media Usage

Science.gov (United States)

2009-03-01

communicate its ideology to its people. Wiktorowicz explains, “Frames represent interpretive schemata that offer a language and cognitive tools for making...Lebanon conflict. It does show a bit more stylistic diversity in the articles covering the 2008-2009 Gaza conflict, although the shift is minor

Creating an Economically Enabling and Competitive Business ...

International Development Research Centre (IDRC) Digital Library (Canada)

Creating an Economically Enabling and Competitive Business Environment in the West Bank and Gaza Strip. The prospect of indefinite Israeli occupation of the Palestinian territories, and their extreme dependence on foreign assistance and Israeli-controlled customs revenues, had led to the conclusion that the Palestinian ...

Creating an Economically Enabling and Competitive Business ...

International Development Research Centre (IDRC) Digital Library (Canada)

Creating an Economically Enabling and Competitive Business Environment in the West Bank and Gaza Strip. The prospect of indefinite Israeli occupation of the ... Impact of implementing the Palestinian banking law on the performance of the private sector [Arabic language]. Documents. Impact of the commercial agents law ...

Private Sector and Enterprise Development

International Development Research Centre (IDRC) Digital Library (Canada)

Ministry of Technical Education and Vocational Training ..... and ..structures that offer services to private sector enterprises and represent .... investment climate reform and the adoption of good governance practices. ..... Over two-thirds of the labour force in Jordan, the West Bank & Gaza, Iraq and Syria is in the service sector.

WAJM 30 (1) 2011.CORRECTED Final.pmd

African Journals Online (AJOL)

user1

Clinical and Biochemical Features of Type 2 Diabetic Patients in Gaza Governorate ... et 32,9) que chez les témoins (181,2 ± 39,1, 139,8 ± 76,1 et 102,2 ±. 37,4) avec des différences de ..... REFERENCES. 1. American Diabetes Association.

Negotiating Custody Rights in Islamic Family Law

NARCIS (Netherlands)

N.Y. Shehada (Nahda)

2009-01-01

textabstractIntroduction The following examines the application of Islamic family law with regard to custody and custody rights in the Gaza city sharī‘a courts.1 Four objectives are pursued in the paper. First, it identifies areas of gender asymmetry in the legal code, which distinguishes

Information and Communication Technologies for Development in ...

International Development Research Centre (IDRC) Digital Library (Canada)

This project seeks to foster an inclusive knowledge society by building capacity to apply information and communication technology (ICT) to human, social and economic development in the Middle East, specifically Jordan, Lebanon, Palestine (West Bank and Gaza), Syria and Yemen. The project will focus on the areas of ...

Always the victim : Israel's present wars

NARCIS (Netherlands)

Reinhart, T.

2006-01-01

In the Israeli discourse, Israel has always been the innocent victim of vicious aggression from its neighbors. This perception of reality has only intensified with its two recent wars - against the Palestinians in Gaza and against Lebanon. On this view, in both cases Israel has manifested its good

Possible Hematological Changes Associated with Acute ...

African Journals Online (AJOL)

Blood samples were collected for estimation of complete blood count and for determination of serum iron, total iron binding capacity (TIBC), and transferrin ... could be considered as a common health problem in kindergarten children in Gaza, and it is possibly associated with changes in hemoglobin concentration and TIBC.

75 FR 8402 - Child Labor, Forced Labor, and Forced or Indentured Child Labor in the Production of Goods in...

Science.gov (United States)

2010-02-24

... . Executive Order No. 13126 (EO 13126) declared that it was ``the policy of the United States Government..., Vanuatu, Venezuela, Wallis and Futuna, West Bank and Gaza Strip, Western Sahara, Republic of Yemen, Zambia... penalize those responsible and the adequacy of these actions. (D) Government Policies on Child Labor DOL...

Vestibular involvement in adults with HIV/AIDS.

Science.gov (United States)

Heinze, Barbara M; Vinck, Bart M; Hofmeyr, Louis M; Swanepoel, De Wet

2014-04-01

HIV/AIDS is responsible for widespread clinical manifestations involving the head, and neck. The prevalence and nature of vestibular involvement is still largely unknown. This study, aimed to describe and compare the occurrence and nature of vestibular involvement among a group of, adults infected with HIV compared to a control group. It also aimed to compare the vestibular function, of symptomatic and asymptomatic HIV positive adults who receive antiretroviral (ARV) therapies to, subjects not receiving ARV. A cross-sectional study was conducted on 53 adults (29 male, 24 female, aged 23-49 years, mean=38.5, SD=4.4) infected with HIV, compared to a control group of 38 HIV negative adults (18, male, 20 female, aged 20-49 years, mean=36.9, SD=8.2). A structured interview probed the subjective, perception of vestibular symptoms. Medical records were reviewed for CD4+ cell counts and the use of, ARV medication. An otologic assessment and a comprehensive vestibular assessment (bedside, assessments, vestibular evoked myogenic potentials, ocular motor and positional tests and bithermal, caloric irrigation) were conducted. Vestibular involvement occurred in 79.2% of subjects with HIV in all categories of disease, progression, compared to 18.4% in those without HIV. Vestibular involvement increased from 18.9% in CDC category 1 to 30.2% in category 2. Vestibular involvement was 30.1% in category 3. There were, vestibular involvement in 35.9% of symptomatic HIV positive subjects, and 41.5% in asymptomatic, HIV positive subjects. There was no significant difference in the occurrence of vestibular involvement, in subjects receiving ARV therapies compared to those not receiving ARV therapies (p=.914; chi-square, test). The odds ratio indicates that individuals with HIV have a 16.61 times higher risk of developing, vestibular involvement during their lifetime of living with the disease and that it may occur despite, being asymptomatic. Vestibular involvement was significantly more

LB01.06: VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND CARDIOVASCULAR OUTCOMES IN FELODIPINE EVENT REDUCTION STUDY.

Science.gov (United States)

Zhang, Y; Zhang, X; Liu, L; Zanchetti, A

2015-06-01

Many antihypertensive outcome trials have shown that visit-to-visit blood pressure variability is correlated closely with clinical outcomes in hypertensive patients. The objective of the study was to investigate the relationship between visit-to-visit blood pressure variability (BPV) and the major cardiovascular outcomes in the Chinese hypertensive patients. Felodipine Event Reduction (FEVER) study was a double-blind, randomized trial on 9711 Chinese hypertensive patients, in whom cardiovascular outcomes were significantly reduced by more intense therapy achieving a mean of 138 mmHg SBP compared with less-intense therapy achieving a mean of 142 mmHg. Visit-to-visit BPV during the follow-up period [defined as standard deviation (SD), coefficient of variation (CV), and average real variability(ARV)] was derived from casual cuff BP measures after six months follow-up until the end of the study. Hazard ratios (HRs), for the incidence of CVD associated with SD, CV, and ARV of SBP and DBP were calculated using Cox proportional hazard models. Overall predictive power [area under receiver operating characteristic (AUC ROC) curve] of the level of blood pressure, blood pressure variability and other baseline characteristics was calculated. In FEVER study, visit-to-visit variability in SBP were significant predictors of subsequent stroke [eg, hazard ratios [HR] for ARV, SD and CV was 1.071 (95% CI: 1.025-1.118), 1.373 (95% CI: 1.159-1.626) and 0.572 (95% CI: 0.451-0,726)]. Visit-to-visit variability in DBP were also showed similar trend [eg, HR for ARV, SD and CV was 1.066 (95% CI: 0.992-1.145), 1.931 (95% CI: 1.435-2.598) and 0.558 (95% CI: 0.438-0,710)]. However, using the analysis of AUC ROC analysis, the risk importance sequence of the stroke events in this cohort was level of SBP, age, level of DBP ARV, SD, sex, CV and treatment. Visit-to-visit blood pressure variability has some effects on the cardiovascular outcomes in the Chinese hypertensive patents in the cohort in

Nurturing the Continuum of HIV Testing, Treatment and Prevention Matrix Cascade in Reducing HIV Transmission.

Science.gov (United States)

Yah, Clarence S

2017-11-01

Despite the shift in antiretroviral therapy (ARVs) eligibility cascade from CD4 ≤ 200 to CD4 ≤ 350 to CD4 ≤ 500 mm 3 , HIV related morbidity and mortality continue to escalate annually, as do HIV infections. The new paradigm of treatment for all HIV positives individual irrespective of CD4 count may significantly reduce HIV and related illnesses. The author assumes that all HIV infected partners should be eligible for HIV treatment and care, irrespective of CD4 count. A second assumption is that high risk HIV negative partners have free access to continuum of HIV pre-exposure prophylaxis (PrEP), post exposure prophylaxis (PEP) and other prevention packages. A literature review search was used to extract evidence-based ARVs-HIV treatment and prevention interventions among HIV positives and high risk partners respectively. Only articles published in English and indexed in journal nuclei were used for the study. The information was used to nurture understanding of HIV treatment and prevention approaches as well as HIV incidence multiplier effect among HIV serodiscordant partners. The imputed HIV incident reference was assumed at 1.2 per 100 person-years (2). This was based on the imputation that retention in care, adherence and other predetermined factors are functions of an effective health care delivery system. The model showed a reduced HIV transmission from 1.2 per 100 person-years to 1.032 per 100 person-years in 6 months. The average threshold period of HIV suppressed partners on ARVs to an undetectable level. The combined multiplier protective-effect probability of transmitting HIV from HIV positive partners on ARVs-suppressed viremic load to HIV negative partners on PrEP/PEP-prevention was detected at 86. The model showed a significant reduction in HIV incidence. Placing serodiscordant sexual partners in HIV treatment and prevention plays a significant role in reducing and controlling HIV infection. Therefore, the policy of enrolling all HIV positives

Improved testing of recent HIV-1 infections with the BioRad avidity assay compared to the limiting antigen avidity assay and BED Capture enzyme immunoassay: evaluation using reference sample panels from the German Seroconverter Cohort.

Directory of Open Access Journals (Sweden)

Andrea Hauser

Full Text Available BACKGROUND: The variety and limitations of current laboratory methods for estimating HIV-incidence has driven attempts to improve and standardize the performance of serological 'Tests for Recent HIV-Infections' (TRI. Primary and follow-up HIV-1 positive plasma samples from individuals with well-defined dates of infection collected as part of the German Seroconverter Cohort provided specimens highly suitable for use in comparing the performance of three TRIs: the AWARE™ BED™ EIA HIV-1 Incidence test (BED-CEIA, Genetic systems HIV-1/HIV-2 Plus O EIA antibody avidity-based assay (BioRad Avidity and Sedia™ HIV-1 LAg Avidity EIA (LAg Avidity. METHODS: The evaluation panel included 180 specimens: 44 from antiretroviral (ARV-naïve individuals with recently acquired HIV-infection (≤ 130 days; 25 B and 19 non-B subtypes and 136 from long-term (>12 months infected individuals [101 ARV-naïve subtype B, 16 non-B subtypes, 14 ARV-treated individuals, 5 slow progressors (SLP]. RESULTS: For long-term infected, ARV-naïve individuals the false recent rates (FRR of both the BioRad and LAg Avidity assays were 2% (2/101 for subtype B and 6% (1/16 for subtype 'non-B', while the FRR of the BED-CEIA was 7% (7/101 for subtype B and 25% (4/16 for subtype 'non-B' (all p>0.05. Misclassification of ARV-treated individuals and SLP was rare by LAg (1/14, 0/5 and BioRad Avidity assays (2/14, 1/5 but more frequent by BED-CEIA (5/14, 3/5. Among recently-infected individuals (subtype B, 60% (15/25 were correctly classified by BED-CEIA, 88% (22/25 by BioRad Avidity and significantly fewer by LAg (48%, 12/25 compared to BioRad Avidity (p = 0.005 with a higher true-recency rate among non-B infections for all assays. CONCLUSIONS: This study using well-characterized specimens demonstrated lower FRRs for both avidity methods than with the BED-CEIA. For recently infected individuals the BioRad Avidity assay was shown to give the most accurate results.

Operation «Brother’s Keeper» in Context of the Palestinian-Israeli Standoff

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Vladimir Mihailovich Morozov

2016-01-01

Full Text Available Nowadays the Gaza Strip radical movement HAMAS is the most dangerous opponent for the State of Israel in the Palestinian arena. In recent years most attention of the world community has been focused on the events in the Gaza Strip. This attention is caused by the dynamics of standoff and the scale of events occurred. During the period after authority setting in the Palestinian enclave by HAMAS movement Israel carried out a series of large-scale military operations. These were «Cast Lead», «Pillar of Defense» and «Protective Edge». However for better understanding of dynamics of the conflict between Israelis and Palestinians it is necessary to pay equal attention to confrontation both in the Gaza Strip and West Bank. In the article the authors study the events of June 2014 that were a part of the permanent standoff in the West Bank. In June 2014 after abduction of the three teenagers by radicals Israel carried out the operation «Brother's Keeper» which preceded the large-scale operation «Protective Edge». The actions of Israelis aimed at weakening the infrastructure of HAMAS. During the operation in the West Bank Israel used considerable forces. Israelis caused a painful blow to HAMAS. The results of the operation «Brother's Keeper» suggested that the radicals of the West Bank may get developed underground infrastructure and developed infrastructure for production of rockets. The events of summer 2014 in zone of the Palestinian- Israeli conflict showed that escalation may spread from one part of the Palestinian land to another.

Galeterone for the treatment of advanced prostate cancer: the evidence to date

Directory of Open Access Journals (Sweden)

Bastos DA

2016-07-01

Full Text Available Diogo A Bastos,1 Emmanuel S Antonarakis2 1Department of Oncology, Hospital Sirio-Libanes, Sao Paulo, Brazil; 2Department of Oncology and Urology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Major advances have been achieved recently in the treatment of metastatic castration-resistant prostate cancer, resulting in significant improvements in quality of life and survival with the use of several new agents, including the next-generation androgen receptor (AR-targeted drugs abiraterone and enzalutamide. However, virtually all patients will eventually progress on these therapies and most will ultimately die of treatment-refractory metastatic disease. Recently, several mechanisms of resistance to AR-directed therapies have been uncovered, including the AR splice variant 7 (AR-V7, which is a ligand-independent constitutionally-active form of the AR that has been associated with poor outcomes to abiraterone and enzalutamide. Galeterone, a potent anti-androgen with three modes of action (CYP17 lyase inhibition, AR antagonism, and AR degradation, is a novel agent under clinical development that could potentially target both full-length AR and aberrant AR, including AR-V7. In this manuscript, we will first discuss the biological mechanisms of action of galeterone and then review the safety and efficacy data from Phase I and II clinical studies of galeterone in patients with metastatic castration-resistant prostate cancer. A Phase III study of galeterone (compared against enzalutamide in AR-V7-positive patients is currently underway, and represents the first pivotal trial using a biomarker-selection design in this disease. Keywords: galeterone, AR splice variants, AR-V7, castration-resistant prostate cancer

Pharmacokinetics of Tenofovir Alafenamide When Co-administered With Other HIV Antiretrovirals.

Science.gov (United States)

Begley, Rebecca; Das, Moupali; Zhong, Lijie; Ling, John; Kearney, Brian P; Custodio, Joseph M

2018-04-10

Tenofovir alafenamide (TAF), a prodrug of the nucleotide analogue tenofovir (TFV), is an antiretroviral (ARV) agent approved either as a complete regimen (elvitegravir/cobicistat/emtricitabine (F)/tenofovir alafenamide (TAF), rilpivirine/F/TAF, bictegravir/F/TAF), or for use with other ARVs (F/TAF), for treatment of HIV. TAF is a substrate of P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) transporters. Disposition of TAF may be altered by co-medications that can inhibit or induce P-gp or BCRP transporters. The effects of ARVs on the pharmacokinetics (PK) of TAF were evaluated in 3 studies. Healthy participants received TAF administered alone or with rilpivirine (RPV) in study 1; with dolutegravir (DTG), ritonavir boosted atazanavir (ATV+RTV), lopinavir (LPV/RTV), or darunavir (DRV+RTV) in study 2; and with the pharmacokinetic enhancer cobicistat (COBI), or efavirenz (EFV) in study 3. Across the three studies, 98 participants received treatment with TAF and a coadministered agent (n=10-34/cohort). All study treatments were well tolerated. TAF and TFV exposures were unaffected following co-administration with RPV and DTG. Co-administration with Pgp/BCRP inhibitors such as COBI or PI based regimens (ATV+RTV, LPV/r or DRV+RTV) resulted in a range of 6% to 183% increases in TAF and 105% to 316% increases in TFV exposure, while co-administration with a Pgp inducer, EFV, resulted in a 15% to 24% decrease in TAF and TFV exposure. Evaluation of the drug interaction between TAF and other commonly prescribed boosted and unboosted ARVs provides characterization of the susceptibility of TAF and/or TFV PK to inhibitors or inducers of Pgp/BCRP transporters.

Traditional medicines, HIV, and related infections: workshop 2C.

Science.gov (United States)

Patel, M; Bessong, P; Liu, H

2011-04-01

Traditional medicines are an integral part of health care worldwide, even though their efficacy has not been scientifically proven. HIV-infected individuals may use them singularly or in combination with conventional medicines. Many in vitro studies have proven the anti-HIV, anti-Candida, and anti-herpes simplex virus potential of traditional plants and identified some of the mechanisms of action. Very few in vivo studies are available that involve a small number of participants and show controversial results. In addition, knowledge is limited of the role of traditional medicines in the enhancement of the immune system. The use of traditional medicines with antiretroviral drugs (ARVs) has created a problem because drug interactions compromise the efficacy of ARVs. Several currently popular plants have been studied in the laboratory for their interaction with ARVs, with disadvantageous results. Unfortunately, no clinical trials are available. The science of traditional medicines is relatively new and is at present being modernized worldwide. However, there are still ethical issues regarding traditional medicines that need to be addressed-for example, regulations regarding quality control and standardization of medicines, regulation and education of healers who deliver these medicines, and unregulated clinical trials. The workshop addressed the following questions about traditional medicine and their use in HIV infection: What are the mechanisms of action of anti-HIV traditional medicines? Should traditional medicines be used in conjunction with ARV? Do traditional medicines enhance the immune system? Should medicinal plants be used for the control of oral infections associated with HIV? What are the ethical issues surrounding the use of traditional medicines for the treatment of HIV and associated infections?

Results of antiretroviral treatment interruption and intensification in advanced multi-drug resistant HIV infection from the OPTIMA trial.

Directory of Open Access Journals (Sweden)

Mark Holodniy

2011-03-01

Full Text Available Guidance is needed on best medical management for advanced HIV disease with multidrug resistance (MDR and limited retreatment options. We assessed two novel antiretroviral (ARV treatment approaches in this setting.We conducted a 2×2 factorial randomized open label controlled trial in patients with a CD4 count≤300 cells/µl who had ARV treatment (ART failure requiring retreatment, to two options (a re-treatment with either standard (≤4 ARVs or intensive (≥5 ARVs ART and b either treatment starting immediately or after a 12-week monitored ART interruption. Primary outcome was time to developing a first AIDS-defining event (ADE or death from any cause. Analysis was by intention to treat. From 2001 to 2006, 368 patients were randomized. At baseline, mean age was 48 years, 2% were women, median CD4 count was 106/µl, mean viral load was 4.74 log(10 copies/ml, and 59% had a prior AIDS diagnosis. Median follow-up was 4.0 years in 1249 person-years of observation. There were no statistically significant differences in the primary composite outcome of ADE or death between re-treatment options of standard versus intensive ART (hazard ratio 1.17; CI 0.86-1.59, or between immediate retreatment initiation versus interruption before re-treatment (hazard ratio 0.93; CI 0.68-1.30, or in the rate of non-HIV associated serious adverse events between re-treatment options.We did not observe clinical benefit or harm assessed by the primary outcome in this largest and longest trial exploring both ART interruption and intensification in advanced MDR HIV infection with poor retreatment options.Clinicaltrials.gov NCT00050089.

Hematological parameters of human immunodeficiency virus positive pregnant women on antiretroviral therapy in Aminu Kano Teaching Hospital Kano, North Western Nigeria.

Science.gov (United States)

Abdulqadir, Ibrahim; Ahmed, Sagir Gumel; Kuliya, Aisha Gwarzo; Tukur, Jamilu; Yusuf, Aminu Abba; Musa, Abubakar Umar

2018-01-01

Human immunodeficiency virus (HIV) scourge continues to affect young women within the reproductive age group and pregnancy is a recognized indication for the use antiretroviral (ARV) drugs among HIV-positive women. The aim is to determine the combined effect of pregnancy, HIV and ARV drugs on the hematological parameters of the pregnant women. This was a comparative cross-sectional study conducted among 70 each of HIV-positive and negative pregnant women. Bio-demographic and clinical data were extracted from the client folder and 4 ml of blood sample was obtained from each participant. Full blood count was generated using Swelab automatic hematology analyzer while reticulocyte count and erythrocyte sedimentation rate (ESR) were conducted manually. Data analysis was performed using SPSS version software 16 while P women with HIV had statistically significant lower hematocrit and white blood cell (WBC) and higher ESR than pregnant women without HIV ( P 0.05). However, among HIV positive pregnant women, those with CD4 count 0.050) between women on first- and second-line ARV regimens. There is a significant difference in terms of hematological parameters between HIV-positive and HIV-negative pregnant women in this environment.

"Denial or Faith?" Therapy versus Messianism in Preparing for the Evacuation of Israeli Settlements

Science.gov (United States)

Amrami, Galia Plotkin

2015-01-01

This article offers an ethnographic account of the professional activities of mental health practitioners, employed by the state's religious education system. I analyze various models implemented by practitioners for the purposes of preparing pupils for the state-mandated evacuation of Jewish settlers from Gaza and the West Bank. By focusing on…

Z. ASTAL

African Journals Online (AJOL)

6(20C3) 9- 14. The Inhibitory Action of Aqueous Garlic Extract -oh the Growth of Certain Pathogenic Bacteria. Z. ASTAL. Khan Younis Hospital Laboratory, Khan Younis, Gaza-Palestinian Authority. This work reports the antibacterial effect of aqueous garlic (Allium sativum) extract on certain pathogenic Gram positive bacteria ...

JPRS Report, Near East and South Asia.

Science.gov (United States)

1989-07-27

Diary of Events From the Announcement of the Entry of the Border Guard into the Gaza Strip up until Last Week 6 March: 3 lightly injured in clashes...production. On April 7, pursuant to his earlier announcement, Aya - tollah Aredebili said 7,000 price inspectors were to be commissioned to control

Search Results | Page 2 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Results 11 - 20 of 420 ... Open Crowd-Sourced Online Digital Review of Asia Pacific ... Economic problems facing the West Bank and Gaza include high unemployment, ... Cambodia, Laos and Viet Nam are among the lowest income countries in Asia. ... The private sector is the largest health provider in India, and unregulated ...

States of Liberation

DEFF Research Database (Denmark)

Sen, Somdeep

in the context of the Palestinian quest for liberation. Based on ethnographic fieldwork in the Gaza Strip, the West Bank, Israel and Egypt, this dissertation argues that resistance and governance serve as means of emboldening the signature of Palestinian existence – as a cause and as a people. Hamas’ resistance...

Antiviral but Pronatal? ARVS and Reproductive Health

DEFF Research Database (Denmark)

Richey, Lisa Ann

2011-01-01

Winner of the American Anthropology Association 2012 Basker Prize and CAR's 2012 Most Notable Recent Collection Award......Winner of the American Anthropology Association 2012 Basker Prize and CAR's 2012 Most Notable Recent Collection Award...

Israel Fires But “Palestinian Claim to Citizenship Has Never Been Stronger”

DEFF Research Database (Denmark)

Pace, Michelle

2018-01-01

On March 30, which happened to be Good Friday – a Christian holiday commemorating the crucifixion of Jesus and His death at Calvary — Palestinians in the Gaza Strip set off for their “Great March of Return”. Their plan: walk, chant, and sit meters from an electric fence surrounding the greatest p...

: tous les projets | Page 538 | CRDI - Centre de recherches pour le ...

International Development Research Centre (IDRC) Digital Library (Canada)

Région: Middle East, Central Asia, Far East Asia, South Asia, Jordan, Lebanon, Malaysia, Syria, Yemen, Palestine, Réunion ... et de la communication (TIC) pour le développement humain, social et économique du Moyen-Orient, notamment en Jordanie, au Liban, en Palestine (Cisjordanie et Gaza), en Syrie et au Yémen.

The make or buy debate: Considering the limitations of domestic production in Tanzania

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Wilson Kinsley

2012-06-01

Full Text Available Abstract Background In order to ensure their population’s regular access to essential medicines, many least developed countries and developing countries are faced with the policy question of whether to import or manufacture drugs locally, in particular for life-saving antiretroviral medicines for HIV/AIDS patients. In order for domestic manufacturing to be viable and cost-effective, the local industry must be able to compete with international suppliers of medicines by producing sufficiently low cost ARVs. Methods This paper considers the ‘make-or-buy’ dilemma by using Tanzania as a case study. Key informant interviews, event-driven observation, and purposive sampling of documents were used to evaluate the case study. The case study focused on Tanzania’s imitation technology transfer agreement to locally manufacture a first-line ARV (3TC + d4T + NVP, reverse engineering the ARV. Results Tanzania is limited by weak political support for the use of TRIPS flexibilities, limited production capacity for ARVs and limited competitiveness in both domestic and regional markets. The Ministry of Health and Social Welfare encourages the use of flexibilities while others push for increased IP protection. Insufficient production capacity and lack of access to donor-financed tenders make it difficult to obtain economies of scale and provide competitive prices. Conclusions Within the “make-or-buy” context, it was determined that there are significant limitations in domestic manufacturing for developing countries. The case study highlights the difficulty of governments to make use of economies of scale and produce low-cost medicines, attract technology transfer, and utilize the flexibilities of the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS. The results demonstrate the importance of evaluating barriers to the use of TRIPS flexibilities and long-term planning across sectors in future technology transfer and

The make or buy debate: considering the limitations of domestic production in Tanzania.

Science.gov (United States)

Wilson, Kinsley Rose; Kohler, Jillian Clare; Ovtcharenko, Natalia

2012-06-29

In order to ensure their population's regular access to essential medicines, many least developed countries and developing countries are faced with the policy question of whether to import or manufacture drugs locally, in particular for life-saving antiretroviral medicines for HIV/AIDS patients. In order for domestic manufacturing to be viable and cost-effective, the local industry must be able to compete with international suppliers of medicines by producing sufficiently low cost ARVs. This paper considers the 'make-or-buy' dilemma by using Tanzania as a case study. Key informant interviews, event-driven observation, and purposive sampling of documents were used to evaluate the case study. The case study focused on Tanzania's imitation technology transfer agreement to locally manufacture a first-line ARV (3TC + d4T + NVP), reverse engineering the ARV. Tanzania is limited by weak political support for the use of TRIPS flexibilities, limited production capacity for ARVs and limited competitiveness in both domestic and regional markets. The Ministry of Health and Social Welfare encourages the use of flexibilities while others push for increased IP protection. Insufficient production capacity and lack of access to donor-financed tenders make it difficult to obtain economies of scale and provide competitive prices. Within the "make-or-buy" context, it was determined that there are significant limitations in domestic manufacturing for developing countries. The case study highlights the difficulty of governments to make use of economies of scale and produce low-cost medicines, attract technology transfer, and utilize the flexibilities of the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). The results demonstrate the importance of evaluating barriers to the use of TRIPS flexibilities and long-term planning across sectors in future technology transfer and manufacturing initiatives.

Nevirapine Concentration in Hair Samples Is a Strong Predictor of Virologic Suppression in a Prospective Cohort of HIV-Infected Patients.

Directory of Open Access Journals (Sweden)

Sanjiv M Baxi

Full Text Available Effective antiretroviral (ARV therapy depends on adequate drug exposure, yet methods to assess ARV exposure are limited. Concentrations of ARV in hair are the product of steady-state pharmacokinetics factors and longitudinal adherence. We investigated nevirapine (NVP concentrations in hair as a predictor of treatment response in women receiving ARVs. In participants of the Women's Interagency HIV Study, who reported NVP use for >1 month from 2003-2008, NVP concentrations in hair were measured via liquid-chromatography-tandem mass-spectrometry. The outcome was virologic suppression (plasma HIV RNA below assay threshold at the time of hair sampling and the primary predictor was nevirapine concentration categorized into quartiles. We controlled for age, race/ethnicity, pre-treatment HIV RNA, CD4 cell count, and self-reported adherence over the 6-month visit interval (categorized ≤ 74%, 75%-94% or ≥ 95%. We also assessed the relation of NVP concentration with changes in hepatic transaminase levels via multivariate random intercept logistic regression and linear regression analyses. 271 women contributed 1089 person-visits to the analysis (median 3 of semi-annual visits. Viral suppression was least frequent in concentration quartile 1 (86/178 (48.3% and increased in higher quartiles (to 158/204 (77.5% for quartile 4. The odds of viral suppression in the highest concentration quartile were 9.17 times (95% CI 3.2-26, P < 0.0001 those in the lowest. African-American race was associated with lower rates of virologic suppression independent of NVP hair concentration. NVP concentration was not significantly associated with patterns of serum transaminases. Concentration of NVP in hair was a strong independent predictor of virologic suppression in women taking NVP, stronger than self-reported adherence, but did not appear to be strongly predictive of hepatotoxicity.

A compact, multifunctional fusion module directs cholesterol-dependent homomultimerization and syncytiogenic efficiency of reovirus p10 FAST proteins.

Directory of Open Access Journals (Sweden)

Tim Key

2014-03-01

Full Text Available The homologous p10 fusion-associated small transmembrane (FAST proteins of the avian (ARV and Nelson Bay (NBV reoviruses are the smallest known viral membrane fusion proteins, and are virulence determinants of the fusogenic reoviruses. The small size of FAST proteins is incompatible with the paradigmatic membrane fusion pathway proposed for enveloped viral fusion proteins. Understanding how these diminutive viral fusogens mediate the complex process of membrane fusion is therefore of considerable interest, from both the pathogenesis and mechanism-of-action perspectives. Using chimeric ARV/NBV p10 constructs, the 36-40-residue ectodomain was identified as the major determinant of the differing fusion efficiencies of these homologous p10 proteins. Extensive mutagenic analysis determined the ectodomain comprises two distinct, essential functional motifs. Syncytiogenesis assays, thiol-specific surface biotinylation, and liposome lipid mixing assays identified an ∼25-residue, N-terminal motif that dictates formation of a cystine loop fusion peptide in both ARV and NBV p10. Surface immunofluorescence staining, FRET analysis and cholesterol depletion/repletion studies determined the cystine loop motif is connected through a two-residue linker to a 13-residue membrane-proximal ectodomain region (MPER. The MPER constitutes a second, independent motif governing reversible, cholesterol-dependent assembly of p10 multimers in the plasma membrane. Results further indicate that: (1 ARV and NBV homomultimers segregate to distinct, cholesterol-dependent microdomains in the plasma membrane; (2 p10 homomultimerization and cholesterol-dependent microdomain localization are co-dependent; and (3 the four juxtamembrane MPER residues present in the multimerization motif dictate species-specific microdomain association and homomultimerization. The p10 ectodomain therefore constitutes a remarkably compact, multifunctional fusion module that directs syncytiogenic

Stepped-Wedge Cluster Randomized Controlled Trial to Promote Option B+ Retention in Central Mozambique.

Science.gov (United States)

Pfeiffer, James T; Napúa, Manuel; Wagenaar, Bradley H; Chale, Falume; Hoek, Roxanne; Micek, Mark; Manuel, João; Michel, Cathy; Cowan, Jessica Greenberg; Cowan, James F; Gimbel, Sarah; Sherr, Kenneth; Gloyd, Stephen; Chapman, Rachel R

2017-11-01

This randomized trial studied performance of Option B+ in Mozambique and evaluated an enhanced retention package in public clinics. The study was conducted at 6 clinics in Manica and Sofala Provinces in central Mozambique. Seven hundred sixty-one pregnant women tested HIV+, immediately initiated antiretroviral (ARV) therapy, and were followed to track retention at 6 clinics from May 2014 to May 2015. Clinics were randomly allocated within a stepped-wedge fashion to intervention and control periods. The intervention included (1) workflow modifications and (2) active patient tracking. Retention was defined as percentage of patients returning for 30-, 60-, and 90-day medication refills within 25-35 days of previous refills. During control periods, 52.3% of women returned for 30-day refills vs. 70.8% in intervention periods [odds ratio (OR): 1.80; 95% confidence interval (CI): 1.05 to 3.08]. At 60 days, 46.1% control vs. 57.9% intervention were retained (OR: 1.82; CI: 1.06 to 3.11), and at 90 days, 38.3% control vs. 41.0% intervention (OR: 1.04; CI: 0.60 to 1.82). In prespecified subanalyses, birth before pickups was strongly associated with failure-women giving birth before ARV pickup were 33.3 times (CI: 4.4 to 250.3), 7.5 times (CI: 3.6 to 15.9), and 3.7 times (CI: 2.2 to 6.0) as likely to not return for ARV pickups at 30, 60, and 90 days, respectively. The intervention was effective at 30 and 60 days, but not at 90 days. Combined 90-day retention (40%) and adherence (22.5%) were low. Efforts to improve retention are particularly important for women giving birth before ARV refills.

Access to hepatitis C virus treatment: Lessons from implementation of strategies for increasing access to antiretroviral treatment.

Science.gov (United States)

Assefa, Yibeltal; Hill, Peter S; Williams, Owain D

2018-05-01

At September's 2017 United Nations General Assembly, a state-of-the-art HIV medicine was announced to be made available at just $75 per person per year. There have been a number of strategies that the global AIDS community and countries have utilized to reduce prices and make antiretrovirals (ARVs) accessible for people living with HIV/AIDS. There appears to be an opportunity for the treatment of hepatitis C virus infection using direct-acting antivirals (DAAs) to benefit from the often painful and laboured history of driving down the prices of ARVs. In general, the success of lowering prices for ARVs has stemmed from the politics needed to initially support generic entry into the on-patent market. The use of flexibilities present in the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) have been used to overcome patent barriers, with the use of compulsory licenses and/or the threat of their use as instruments for strengthening the bargaining power in price negotiations. These strategies have been combined with new financing mechanisms that have promoted more effective procurement and price negotiations. Partnership among the different stakeholders has also been critical in this regard. Countries have also invested in their health systems and implemented several strategies to reduce stigma and discrimination to increase access to and improve utilization of ARVs. This article suggests that any future international initiatives to increase access to DAAs can learn from these lessons surrounding price reduction, improved financing, advocacy, as well as health systems strengthening and stigma reduction. Adopting and reconfiguring these strategies will also incur substantial savings in time, money and lives. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Access to hepatitis C virus treatment: Lessons from implementation of strategies for increasing access to antiretroviral treatment

Directory of Open Access Journals (Sweden)

Yibeltal Assefa

2018-05-01

Full Text Available At September’s 2017 United Nations General Assembly, a state-of-the-art HIV medicine was announced to be made available at just $75 per person per year. There have been a number of strategies that the global AIDS community and countries have utilized to reduce prices and make antiretrovirals (ARVs accessible for people living with HIV/AIDS. There appears to be an opportunity for the treatment of hepatitis C virus infection using direct-acting antivirals (DAAs to benefit from the often painful and laboured history of driving down the prices of ARVs. In general, the success of lowering prices for ARVs has stemmed from the politics needed to initially support generic entry into the on-patent market. The use of flexibilities present in the World Trade Organization’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS have been used to overcome patent barriers, with the use of compulsory licenses and/or the threat of their use as instruments for strengthening the bargaining power in price negotiations.These strategies have been combined with new financing mechanisms that have promoted more effective procurement and price negotiations. Partnership among the different stakeholders has also been critical in this regard. Countries have also invested in their health systems and implemented several strategies to reduce stigma and discrimination to increase access to and improve utilization of ARVs. This article suggests that any future international initiatives to increase access to DAAs can learn from these lessons surrounding price reduction, improved financing, advocacy, as well as health systems strengthening and stigma reduction. Adopting and reconfiguring these strategies will also incur substantial savings in time, money and lives. Keywords: Acces to medicines, Hepatitis C virus, HIV, Antiretrovirals, Direct-acting antivirals

Development and validation of a liquid chromatography-MS/MS method for simultaneous quantification of tenofovir and efavirenz in biological tissues and fluids.

Science.gov (United States)

Barreiros, Luisa; Cunha-Reis, Cassilda; Silva, Eduarda M P; Carvalho, Joana R B; das Neves, José; Sarmento, Bruno; Segundo, Marcela A

2017-03-20

Millions of people worldwide live with human immunodeficiency virus (HIV) infection thus justifying the continuous search for new prevention and treatment strategies, including topical microbicide products combining antiretroviral drugs (ARVs) such as tenofovir (TFV) and efavirenz (EFV). Therefore, the aim of this work was to develop and validate a high performance liquid chromatography method coupled to triple quadrupole-tandem mass spectrometry (HPLC-MS/MS) for the quantification of TFV and EFV in biological matrices (mouse vaginal tissue, vaginal lavage and blood plasma). Chromatographic separation was achieved using a reversed phase C18 column (3μm, 100×2.1mm) at 45°C and elution in gradient mode using a combination of 0.1% (v/v) formic acid in water and 0.1% (v/v) formic acid in acetonitrile at 0.35mLmin -1 . Total run time was 9min, with retention time of 2.8 and 4.1min for TFV and EFV, respectively. The MS was operated in positive ionization mode (ESI+) for TFV and in negative ionization mode (ESI-) for EFV detection. Data were acquired in selected reaction monitoring (SRM) mode and deuterated ARVs were employed as internal standards. Calibration curves were linear for ARV concentrations ranging from 4 to 500ngmL -1 with LOD and LOQ for both analytes ≤0.4 and ≤0.7ngmL -1 in sample extracts, respectively. The method was found to be specific, accurate (96.0-106.0% of nominal values) and precise (RSDfluids were ≥88.4%. Matrix effects were observed for EFV determination in tissue and plasma extracts but compensated by the use of deuterated internal standards. The proposed methodology was successfully applied to a pharmacokinetic study following intravaginal administration of both ARVs. Copyright © 2016 Elsevier B.V. All rights reserved.

Morning pressor surge, blood pressure variability, and arterial stiffness in essential hypertension.

Science.gov (United States)

Pucci, Giacomo; Battista, Francesca; Anastasio, Fabio; Schillaci, Giuseppe

2017-02-01

An excess morning blood pressure surge (MBPS) may portend an increased cardiovascular risk, but the mechanisms thereof have been little investigated. The link between MBPS, short-term blood pressure (BP) variability, and arterial stiffness has not been entirely defined. In 602 consecutive untreated hypertensive patients (48 ± 12 years, 61% men, office BP 149/93 ± 17/10 mmHg), we measured carotid-femoral pulse wave velocity (cf-PWV, SphygmoCor) and 24-h ambulatory BP. Using self-reported sleep and wake times, MBPS was defined as sleep-trough (ST-MBPS), prewaking, rising. Short-term BP variability was calculated as weighted 24-h SBP SD and average real variability of 24-h SBP (ARV), that is, average of absolute differences between consecutive SBP readings. ST-MBPS (r = 0.16, P < 0.001) and rising MBPS (r = 0.12, P = 0.003) showed a direct correlation with cf-PWV, whereas prewaking MBPS had no such relation (r = 0.06, P = 0.14). Only ST-MBPS was independently associated with cf-PWV (t = 1.96, P = 0.04) after adjustment for age, sex, height, office mean arterial pressure, heart rate, and renal function. This association was lost after further adjustment for weighted 24-h SBP SD (P = 0.13) or ARV (P = 0.24). ARV was a significant mediator of the relationship between ST-MBPS and cf-PWV (P = 0.003). In untreated hypertension, ST-MBPS has a direct relation with aortic stiffness, which is mediated by an increased ARV. The adverse effects of MBPS may be partly explained by its link with arterial stiffness, mediated by short-term SBP variability.

Contribution of different antiretroviral regimens containing zidovudine, lamivudine and ritonavir-boosted lopinavir on HIV viral load reduction during pregnancy.

Science.gov (United States)

Sripan, Patumrat; Le Coeur, Sophie; Ingsrisawang, Lily; Cressey, Tim R; Bouazza, Naïm; Foissac, Frantz; Ngo-Giang-Huong, Nicole; Traisathit, Patrinee; Srirompotong, Ussanee; Ayudhaya, Orada Patamasingh Na; Puangsombat, Achara; Jungpipun, Jantana; Jittayanun, Kanokwan; Tréluyer, Jean-Marc; Jourdain, Gonzague; Lallemant, Marc; Urien, Saïk

2016-01-01

Antiretroviral (ARV) regimens used for the prevention of mother-to-child transmission of HIV have evolved over time. We evaluated the contribution of different ARV regimens on the reduction of the plasma HIV RNA viral load (VL) during pregnancy. A total of 1,833 VL measurements from ARV-naive pregnant women participating in perinatal prevention trials in Thailand were included. Women received either zidovudine (ZDV) monotherapy, ZDV plus lopinavir/ritonavir (LPV/r), or ZDV plus lamivudine (3TC) plus LPV/r. VL time-course during pregnancy was described as a function of pretreatment VL and treatment duration using an Emax non-linear mixed-effect model. VL reduction and median time to achieve a VL<50 copies/ml were estimated for each regimen. Among 745 women, 279 (37%), 145 (20%) and 321 (43%) received ZDV monotherapy, ZDV+LPV/r and ZDV+3TC+LPV/r, respectively. The predicted VL reduction from baseline to delivery after a median of 10 weeks of treatment were 0.5, 2.7 and 2.9 log10 copies/ml with ZDV monotherapy, ZDV+LPV/r and ZDV+3TC+LPV/r, respectively. At delivery, 1%, 57% and 63% of women receiving ZDV monotherapy, ZDV+LPV/r or ZDV+3TC+LPV/r had a VL<50 copies/ml. The addition of 3TC to ZDV+LPV/r reduced the time to achieve a VL<50 copies/ml and the higher the pretreatment VL, the larger the effect 3TC had on reducing the time to VL<50 copies/ml. The addition of 3TC to ZDV+LPV/r was associated with a slight further VL reduction but the time to reach a VL<50 copies/ml was shorter. This beneficial effect of 3TC is crucial for prevention of mother-to-child transmission in women who receive ARVs late and with high pretreatment VL.

Geographic and temporal trends in the molecular epidemiology and genetic mechanisms of transmitted HIV-1 drug resistance: an individual-patient- and sequence-level meta-analysis.

Science.gov (United States)

Rhee, Soo-Yon; Blanco, Jose Luis; Jordan, Michael R; Taylor, Jonathan; Lemey, Philippe; Varghese, Vici; Hamers, Raph L; Bertagnolio, Silvia; Rinke de Wit, Tobias F; Aghokeng, Avelin F; Albert, Jan; Avi, Radko; Avila-Rios, Santiago; Bessong, Pascal O; Brooks, James I; Boucher, Charles A B; Brumme, Zabrina L; Busch, Michael P; Bussmann, Hermann; Chaix, Marie-Laure; Chin, Bum Sik; D'Aquin, Toni T; De Gascun, Cillian F; Derache, Anne; Descamps, Diane; Deshpande, Alaka K; Djoko, Cyrille F; Eshleman, Susan H; Fleury, Herve; Frange, Pierre; Fujisaki, Seiichiro; Harrigan, P Richard; Hattori, Junko; Holguin, Africa; Hunt, Gillian M; Ichimura, Hiroshi; Kaleebu, Pontiano; Katzenstein, David; Kiertiburanakul, Sasisopin; Kim, Jerome H; Kim, Sung Soon; Li, Yanpeng; Lutsar, Irja; Morris, Lynn; Ndembi, Nicaise; Ng, Kee Peng; Paranjape, Ramesh S; Peeters, Martine; Poljak, Mario; Price, Matt A; Ragonnet-Cronin, Manon L; Reyes-Terán, Gustavo; Rolland, Morgane; Sirivichayakul, Sunee; Smith, Davey M; Soares, Marcelo A; Soriano, Vincent V; Ssemwanga, Deogratius; Stanojevic, Maja; Stefani, Mariane A; Sugiura, Wataru; Sungkanuparph, Somnuek; Tanuri, Amilcar; Tee, Kok Keng; Truong, Hong-Ha M; van de Vijver, David A M C; Vidal, Nicole; Yang, Chunfu; Yang, Rongge; Yebra, Gonzalo; Ioannidis, John P A; Vandamme, Anne-Mieke; Shafer, Robert W

2015-04-01

Regional and subtype-specific mutational patterns of HIV-1 transmitted drug resistance (TDR) are essential for informing first-line antiretroviral (ARV) therapy guidelines and designing diagnostic assays for use in regions where standard genotypic resistance testing is not affordable. We sought to understand the molecular epidemiology of TDR and to identify the HIV-1 drug-resistance mutations responsible for TDR in different regions and virus subtypes. We reviewed all GenBank submissions of HIV-1 reverse transcriptase sequences with or without protease and identified 287 studies published between March 1, 2000, and December 31, 2013, with more than 25 recently or chronically infected ARV-naïve individuals. These studies comprised 50,870 individuals from 111 countries. Each set of study sequences was analyzed for phylogenetic clustering and the presence of 93 surveillance drug-resistance mutations (SDRMs). The median overall TDR prevalence in sub-Saharan Africa (SSA), south/southeast Asia (SSEA), upper-income Asian countries, Latin America/Caribbean, Europe, and North America was 2.8%, 2.9%, 5.6%, 7.6%, 9.4%, and 11.5%, respectively. In SSA, there was a yearly 1.09-fold (95% CI: 1.05-1.14) increase in odds of TDR since national ARV scale-up attributable to an increase in non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance. The odds of NNRTI-associated TDR also increased in Latin America/Caribbean (odds ratio [OR] = 1.16; 95% CI: 1.06-1.25), North America (OR = 1.19; 95% CI: 1.12-1.26), Europe (OR = 1.07; 95% CI: 1.01-1.13), and upper-income Asian countries (OR = 1.33; 95% CI: 1.12-1.55). In SSEA, there was no significant change in the odds of TDR since national ARV scale-up (OR = 0.97; 95% CI: 0.92-1.02). An analysis limited to sequences with mixtures at less than 0.5% of their nucleotide positions—a proxy for recent infection—yielded trends comparable to those obtained using the complete dataset. Four NNRTI SDRMs—K101E, K103N, Y181C, and G190A�

Loomakasvatus esimesel poolaastal edukas / Matti Piirsalu

Index Scriptorium Estoniae

Piirsalu, Matti, 1947-

2004-01-01

Statistikaameti andmetel põhinev põllumajandussaaduste tootmise statistika 2004. aasta I poolaasta kohta. Tabelid: Loomade ja lindude arv seisuga 30. juuni; Põhiliste karjasaaduste tootmine I poolaastal

The Parliamentary Legislative Process in the Accession Countries of the Western Balkans / Zsolt Szabó

Index Scriptorium Estoniae

Szabó, Zsolt

2015-01-01

Õigusaktide menetlemisest ja vastuvõtmisest Balkani riikide parlamentides. Ka põhiandmed nende riikide parlamentide kohta (parlamendi ingliskeelne ja omakeelne nimetus, liikmete ja komiteede arv jne)

Increasing disability-free life expectancy among older adults in Palestine from 2006 to 2010.

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Brønnum-Hansen, Henrik; Duraidi, Mohammed; Qalalwa, Khaled; Jeune, Bernard

2015-04-01

The population of Palestine comprises almost 200 000 Palestinians aged 60 or older. The purpose of the study was to estimate disability-free life expectancy for Palestinians living in the West Bank and Gaza Strip and to evaluate changes from 2006 to 2010. The study combined mortality data and prevalence of activity limitation derived from the Palestinian Family Health Surveys carried out in 2006 and 2010. Based on questions about the ability to perform five basic daily activities, disability-free life expectancy was estimated. Changes between 2006 and 2010 were decomposed into contributions from changes in mortality and disability. Life expectancy at age 60 increased from 17.1 years in 2006 to 17.3 years in 2010 for men and from 18.7 years to 19.0 years for women. Disability-free life expectancy increased significantly, by 1.3 years for 60-year-old men (from 12.8 years to 14.1 years) and 1.8 years for 60-year-old women (from 12.6 years to 14.4 years). This increase was seen in the Gaza Strip as well as in the West Bank. While the modest contribution of the mortality effect did not differ between gender and regions, the strong contributions from the disability effects varied, being greatest for women in the Gaza Strip. The significant increase in disability-free life expectancy for both genders is remarkable and, to our knowledge, not seen in other low-income countries. This change may be due to decreasing incidence of disability and greater recovery from disability as a result of better prevention, care and rehabilitation of chronic diseases. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Cumulative Antiretroviral Exposure Measured in Hair Is Not Associated With Measures of HIV Persistence or Inflammation Among Individuals on Suppressive ART.

Science.gov (United States)

Gandhi, Monica; Gandhi, Rajesh T; Stefanescu, Andrei; Bosch, Ronald J; Cyktor, Joshua C; Horng, Howard; Louie, Alexander; Phung, Nhi; Eron, Joseph J; Hogg, Evelyn; Macatangay, Bernard J C; Hensel, Christopher; Fletcher, Courtney V; Mellors, John W; McMahon, Deborah K

2018-06-20

Data on the relationship of antiretroviral exposure to measures of human immunodeficiency virus (HIV) persistence are limited. To address this gap, multiple viral, immunologic, and pharmacologic measures were analyzed from individuals with sustained virologic suppression on therapy (median 7 years) in the AIDS Clinical Trials Group A5321 cohort. Among 110 participants on tenofovir-(TFV)-disoproxil-fumarate (TDF)/emtricitabine (FTC)-containing regimens, we found no significant correlation between hair concentrations of individual antiretrovirals (ARVs) in the regimen and measures of HIV persistence (plasma HIV-1 RNA by single copy assay, cell-associated-DNA, cell-associated RNA) or soluble markers of inflammation. These findings suggest that higher systemic ARV exposure may not impact HIV persistence or inflammation.

[Initial antiretroviral treatment in human immunodeficiency virus-infected patients in Spain: Decisions made in relation to particular immunovirological characteristics (PERFIL-es study)].

Science.gov (United States)

Viciana, Pompeyo; Ocampo, Antonio; Hevia, Henar; Palazuelos, Marta; Ledesma, Francisco

2014-02-01

The purpose of Perfil-es study was to identify the proportion of patients starting ARV treatment based on NNRTIs or PI/r, and to identify the variables involved in the therapeutic decision-making in standard clinical practice. An observational retrospective study performed in 65 Spanish hospitals. Was a total of 1,687 starts: 53% with NNRTI-based regimen and 42% with PI/r, and of the 642 patients analyzed, 72% had a CD4 count<350 cells/μl. The initiation of ARV treatment is still late in Spain. NNRTIs are the more frequent choice, although PI/r plays an important role. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Lawfare: A Decisive Element of 21st-Century Conflicts?

Science.gov (United States)

2009-01-01

the best of my knowledge, lawfare as used in today’s context first appeared in my 2001 essay for Harvard University’s Carr Center.2 At that time, the...the_ngo_ front_in_the_gaza_war_lawfare_against_israel>. 41 Lyric Wallwork Winik, “A Marine’s Toughest Mission,” Parade Magazine, January 19, 2003

Seizing Catastrophes

DEFF Research Database (Denmark)

Kublitz, Anja

2013-01-01

to a distant past but takes place in the present. They use the term Nakba not only to refer to the catastrophe of 1948 but also to designate current catastrophes, such as the Danish Muhammad cartoons affair in 2005 and the Israeli invasion of Gaza in 2008. Through an analysis of the 60th commemoration...

Justification, Perception of Severity and Harm, and Criminalization of Wife Abuse in the Palestinian Society

Science.gov (United States)

Haj-Yahia, Muhammad M.; Wilson, Rula M.; Naqvi, Syed Agha M.

2012-01-01

The purpose of this study was to examine the perceptions of Palestinian adults toward different dimensions of wife abuse. A cross-sectional survey, using a combination of self-administered questionnaires and interviews, was conducted among a systematic random sample of 624 adult Palestinian men and women from the West Bank and Gaza Strip (18 years…

Le CRDI en Cisjordanie et à Gaza

International Development Research Centre (IDRC) Digital Library (Canada)

Stress des adolescents et conflit qui perdure. En Cisjordanie, la violence politique et le conflit qui perdure ont aggravé le stress chez les adolescents, qui constituent près de la moitié de la population. À Ramallah, plus de 3 000 adolescents de 15 à 17 ans ont été interrogés par des chercheurs de l'Université de Birzeit et de ...

IDRC in the West Bank and Gaza

International Development Research Centre (IDRC) Digital Library (Canada)

stress. Researchers from Birzeit Univer- sity and Canada's Queen's University studied more than ... Research Institute, West Bank. The economy of ... youth. Research findings will inform the work ... Grantee: The American Near East. Refugee ...

Militarism's Killing Fields: From Gaza to Ferguson

Science.gov (United States)

Giroux, Henry

2014-01-01

Militarization and a military definition of life and culture have become normalized in the United States. This article explores the ways in which a military metaphysics has become the new normal for a nation not only at war abroad but also at home, especially with regards to the ongoing assaults waged by the state against youth, immigrants, and…

Ne boitess nefti i gaza / Andris Piebalgs

Index Scriptorium Estoniae

Piebalgs, Andris, 1957-

2008-01-01

Euroopa Komisjoni energiapoliitika volinik avaldab veendumust, et ei maksa karta tehinguid Venemaaga energeetika valdkonnas ja arvab, et Vene energiakandjad toovad rohkem kasu kui kahju. Venemaa energiaprojektidest ja -lepingutest Serbia ja Bulgaariaga

Hard Fighting: Israel in Lebanon and Gaza

Science.gov (United States)

2011-01-01

IDF is extremely careful to prevent its soldiers from being abducted. 10 Ina Friedman, “ Moral Morass,” The Jerusalem Report, September 4, 2006, p... relativism were among the factors that made the IDF war machine somewhat dysfunctional during the war.112 All of these issues, as will soon be seen...192Crooke and Perry, “How Hezbollah Defeated Israel: Part 1”; Uzi Mahnaimi, “Humbling of the Supertroops Shatters Israeli Army Morale ,” TimesOnline.co.uk

Quality of life of Syrian refugees living in camps in the Kurdistan Region of Iraq.

Science.gov (United States)

Aziz, Izaddin A; Hutchinson, Claire V; Maltby, John

2014-01-01

The current study explores the perceived quality of life of Syrian refugees who have entered the Kurdistan Region of Iraq. Two hundred and seventy participants residing in refugee camps in the Erbil region in Kurdistan completed the WHOQOL-BREF, which measures Quality of Life (QOL) within four domains; physical, psychological, social relationships and environment. Syrian refugees in Kurdistan scored significantly lower for general population norms on physical health, psychological and environment QOL, and score significantly lower for physical health and psychological QOL for refugees in the Gaza strip. However, respondents in the current sample scored significantly higher on environment QOL compared to refugees in the Gaza strip, and significantly higher on all the QOL domains than those reported for refugees in West Africa. Finally, Syrian refugees in Kurdistan scored significantly higher than general population norms for social relationships QOL. The current findings provide the first report of QOL domain scores among Syrian refugees in the Kurdistan camps and suggest that social relationships and environmental QOL circumstances are relatively satisfactory, and that further investigation might be focused on physical and psychological QOL.

Correlation between Lymphocyte CD4 Count, Treatment Duration, Opportunistic Infection and Cognitive Function in Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome (HIV-AIDS) Patients.

Science.gov (United States)

Fitri, Fasihah Irfani; Rambe, Aldy Safruddin; Fitri, Aida

2018-04-15

Human immunodeficiency virus (HIV) infection is an epidemic worldwide, despite the marked benefits of antiretroviral therapy (ARV) in reducing severe HIV-associated dementia. A milder form of neurocognitive disorders are still prevalent and remain a challenge. This study aimed to determine the correlation between plasma cluster of differentiation 4 (CD4) lymphocyte, duration of ARV treatment, opportunistic infections, and cognitive function in HIV-AIDS patients. A cross-sectional study involving 85 HIV-AIDS patients was conducted at Adam Malik General Hospital Medan, Indonesia. All subjects were subjected to physical, neurologic examination and Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) to assess cognitive function and measurement of lymphocyte CD4 counts. Out of the 85 subjects evaluated, the proportion concerning sexes include 52 males (61.2 %) and 33 females (38.8%). The mean age was 38.53 ± 9.77 years old. There was a significant correlation between CD4 lymphocyte counts and MoCA-INA score (r = 0.271, p = 0.012), but there was no significant correlation between duration of ARV treatment and MoCA-INA score. There was also no difference in MoCA-INA score based on the presence of opportunistic infection. Lymphocyte CD4 count was independently correlated with cognitive function in HIV-AIDS patients.

Economic modeling of HIV treatments.

Science.gov (United States)

Simpson, Kit N

2010-05-01

To review the general literature on microeconomic modeling and key points that must be considered in the general assessment of economic modeling reports, discuss the evolution of HIV economic models and identify models that illustrate this development over time, as well as examples of current studies. Recommend improvements in HIV economic modeling. Recent economic modeling studies of HIV include examinations of scaling up antiretroviral (ARV) in South Africa, screening prior to use of abacavir, preexposure prophylaxis, early start of ARV in developing countries and cost-effectiveness comparisons of specific ARV drugs using data from clinical trials. These studies all used extensively published second-generation Markov models in their analyses. There have been attempts to simplify approaches to cost-effectiveness estimates by using simple decision trees or cost-effectiveness calculations with short-time horizons. However, these approaches leave out important cumulative economic effects that will not appear early in a treatment. Many economic modeling studies were identified in the 'gray' literature, but limited descriptions precluded an assessment of their adherence to modeling guidelines, and thus to the validity of their findings. There is a need for developing third-generation models to accommodate new knowledge about adherence, adverse effects, and viral resistance.

The role of drugs in HIV prevention

Science.gov (United States)

Kembaren, T.

2018-03-01

WHO reports 36.7 million people are living with Human Immunodeficiency Virus (HIV) worldwide by 2016 with about 1.8 million new infections each year. It will be a specific health problem for the world in both developed and developing countries so it is necessary strategies to reduce HIV transmission to the community. HIV transmission in people with risk factors is largely determined by the amount of virus in the blood of people who are the source of infection. Antiretroviral (ARV) therapy has long been used in HIV patients, which serves to suppress viral replication so that the patient’s immunity increases; opportunistic infections are resolved and prolong the lifespan and lower transmission rates. In the HIV Prevention Trials Network (HPTN) study 052 there was a 96% reduction in transmission in earlier antiretroviral. ARV is also used in the prevention of transmission in people exposed to HIV virus that is Postexposure Prophylaxis as well as in people at risk before exposure (Pre-exposure Prophylaxis). Three prevention strategies with the provision of ARV is expected to be guided as a means of prevention of transmission in addition to behavioral changes has long been declared since the beginning of the HIV epidemic.

[Antiretroviral drug supply in Argentina: National Program to Combat Human Retroviruses, AIDS, and STDs].

Science.gov (United States)

Colautti, Marisel; Luppi, Irene; Salamano, Mercedes; Traverso, María Luz; Botta, Carina; Palchik, Valeria

2009-01-01

To evaluate the supply cycle of antiretroviral (ARV) drugs, overseen by the National Program to Combat Human Retroviruses, AIDS, and STDs, through its order fulfillment indicators, and to obtain input from supply chain stakeholders. A study was carried out from April-September 2005 in the pharmacies of two hospitals in Rosario, Argentina, involving both a quantitative analysis of indicators and secondary sources and a qualitative evaluation using semistructured interviews. The indicators reveal the impact that interruptions in ARV supply stream from the Program (central level) have and the overstocking that takes place at the pharmacies (local level) to manage the shortages. Changes in ARV treatment account for over 50% of the prescriptions. Fulfillments fall short of the reference value. The interviewees shared possible strategies for overcoming the communication gaps between levels, for building-up stock, for guaranteeing availability, and for shortening waiting times; reached informal agreements to deal with the lack of policies and the shortage of staff; acknowledged the challenges facing the jurisdictions (central, intermediate, and local/community); and recognized local efforts to improve management. These challenges could be the starting point for building teams to work on effectively decentralizing the entire supply chain and allowing the Program to fulfill its much-needed oversight role.

Análisis coste-efectividad de la adhesión inicial a la terapia antirretroviral entre individuos infectados por el VIH en Belo Horizonte, Brasil

Directory of Open Access Journals (Sweden)

Francisco de Assis Acurcio

2006-01-01

Full Text Available Fundamento: En Brasil, los antirretrovirales (ARV se distribu- yen a los portadores de VIH de forma gratuita por el Sistema Único de Salud. La adhesión al tratamiento es una de las principales variables en la cual los servicios de salud pueden intervenir para aumentar la efec- tividad de la medicación. El objetivo del estudio es evaluar la relación coste-efectividad de la adhesión inicial a la terapia ARV e identificar factores que influencien los costes y la evolución global del paciente. Métodos: Estudio prospectivo con individuos infectados por el VIH reclutados, después de la primera prescripción de ARV, en dos servicios públicos de referencia para el tratamiento del VIH/Sida en Brasil. La no-adhesión fue definida como la utilización 200 cels/mm3 y ser adherente al tratamiento AR Conclusiones: Los resultados observados sostienen la terapia AR V como una intervención coste-efectiva. Sin embar go, la baja adhesión aumenta los riesgos de fallo terapéutico y de progresión de la enfermedad, que resultan en un impacto negativo sobre la relación coste-efectividad de la terapia AR V.

In vitro antiviral activity of chestnut and quebracho woods extracts against avian reovirus and metapneumovirus.

Science.gov (United States)

Lupini, C; Cecchinato, M; Scagliarini, A; Graziani, R; Catelli, E

2009-12-01

Field evidences have suggested that a natural extract, containing tannins, could be effective against poultry enteric viral infections. Moreover previous studies have shown that vegetable tannins can have antiviral activity against human viruses. Based on this knowledge three different Chestnut (Castanea spp.) wood extracts and one Quebracho (Schinopsis spp.) wood extract, all containing tannins and currently used in the animal feed industry, were tested for in vitro antiviral activity against avian reovirus (ARV) and avian metapneumovirus (AMPV). The MTT assay was used to evaluate the 50% cytotoxic compounds concentration (CC(50)) on Vero cells. The antiviral properties were tested before and after the adsorption of the viruses to Vero cells. Antiviral activities were expressed as IC(50) (concentration required to inhibit 50% of viral cytopathic effect). CC(50)s of tested compounds were > 200 microg/ml. All compounds had an extracellular antiviral effect against both ARV and AMPV with IC(50) values ranging from 25 to 66 microg/ml. Quebracho extract had also evident intracellular anti-ARV activity (IC(50) 24 microg/ml). These preliminary results suggest that the examined vegetable extracts might be good candidates in the control of some avian virus infections. Nevertheless further in vivo experiments are required to confirm these findings.

Superior Efficacy of a Human Immunodeficiency Virus Vaccine Combined with Antiretroviral Prevention in Simian-Human Immunodeficiency Virus-Challenged Nonhuman Primates.

Science.gov (United States)

Le Grand, Roger; Dereuddre-Bosquet, Nathalie; Dispinseri, Stefania; Gosse, Leslie; Desjardins, Delphine; Shen, Xiaoying; Tolazzi, Monica; Ochsenbauer, Christina; Saidi, Hela; Tomaras, Georgia; Prague, Mélanie; Barnett, Susan W; Thiebaut, Rodolphe; Cope, Alethea; Scarlatti, Gabriella; Shattock, Robin J

2016-06-01

Although vaccines and antiretroviral (ARV) prevention have demonstrated partial success against human immunodeficiency virus (HIV) infection in clinical trials, their combined introduction could provide more potent protection. Furthermore, combination approaches could ameliorate the potential increased risk of infection following vaccination in the absence of protective immunity. We used a nonhuman primate model to determine potential interactions of combining a partially effective ARV microbicide with an envelope-based vaccine. The vaccine alone provided no protection from infection following 12 consecutive low-dose intravaginal challenges with simian-HIV strain SF162P3, with more animals infected compared to naive controls. The microbicide alone provided a 68% reduction in the risk of infection relative to that of the vaccine group and a 45% reduction relative to that of naive controls. The vaccine-microbicide combination provided an 88% reduction in the per-exposure risk of infection relative to the vaccine alone and a 79% reduction relative to that of the controls. Protected animals in the vaccine-microbicide group were challenged a further 12 times in the absence of microbicide and demonstrated a 98% reduction in the risk of infection. A total risk reduction of 91% was observed in this group over 24 exposures (P = 0.004). These important findings suggest that combined implementation of new biomedical prevention strategies may provide significant gains in HIV prevention. There is a pressing need to maximize the impact of new biomedical prevention tools in the face of the 2 million HIV infections that occur each year. Combined implementation of complementary biomedical approaches could create additive or synergistic effects that drive improved reduction of HIV incidence. Therefore, we assessed a combination of an untested vaccine with an ARV-based microbicide in a nonhuman primate vaginal challenge model. The vaccine alone provided no protection (and may have

Loomakasvatus esimeses kvartalis / Matti Piirsalu

Index Scriptorium Estoniae

Piirsalu, Matti, 1947-

2004-01-01

Statistikaameti andmetel põhinev põllumajandussaaduste tootmise statistika 2004. aasta I kvartali kohta. Tabelid: Loomade ja lindude arv seisuga 31. märts; Põhiliste karjasaaduste tootmine I kvartalis

Plaadid / Tiit Kusnets

Index Scriptorium Estoniae

Kusnets, Tiit

2004-01-01

Uutest plaatidest Luavrik Luavrik "Passioon & Fuuga", Arve Henriksen "Chiaroscuro", Bullfrog Brown "Mudhole Stories", "Scoonby-Doo 2", Bela fleck & Edgar Mayer "Music For Two", Christiana Milian "It's About Time"

Robotic Technologies for the Future Force - The ART STO

National Research Council Canada - National Science Library

Jaster, Jeffrey F

2005-01-01

.... The US Army's ARV Robotic Technologies (ART) Science and Technology Objective (STO) will develop a surrogate platform that will be used as a technology demonstrator for such robotic technologies...

Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese ...

African Journals Online (AJOL)

Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad - Vol ... Can decentralisation contribute to promoting rule-of-law structures? ... Challenges confronting health care workers in government's ARV rollout: rights and ...