This study aims to describe knowledge on HIV and antiretroviral (ARV) treatment and psychosocial factors among people living with HIV (PLWH) in Lima, Perú, to explore characteristics associated to ...this knowledge, and determine its impact on sustained viral suppression. A cross-sectional survey was conducted among 171 PLWH at the largest referral health care center in Lima. The psychosocial factors measured were depression, risk of alcoholism, use of illegal drugs and disclosure. A participant had "poor knowledge" when less than 80% of replies were correct. Sustained viral suppression was defined as two consecutive viral loads under 50 copies/mL. A total of 49% and 43% had poor HIV and ARV knowledge respectively; 48% of the study population screened positive for depression and 27% reported feeling unsupported by the person they disclosed to. The largest gaps in HIV and ARV knowledge were among 98 (57%) that did not recognize that HIV increased the risk of cancer and among 57 (33%) participants that did not disagree with the statement that taking a double dose of ARV if they missed one. Moderate depression was significantly associated to poor HIV and ARV knowledge. Non-disclosure and being on ARVs for less than 6 months were associated with not achieving sustained viral suppression. Our findings highlight important HIV and ARV knowledge gaps of PLWH and a high burden of psychosocial problems, especially of depression, among PLWH in Lima, Peru. Increasing knowledge and addressing depression and disclosure could improve care of PLWH.
By resituating Alexander von Humboldt in the “working world” of mining, this essay offers a case study of the way in which industry has shaped practice and theory in the history of science. While ...Humboldt’s experience as a miner in Saxony and Prussia provided him a venue in which to study fossilized vegetation, revealing a fundamental link between the migrations of plants and of peoples, industrial concerns about miners’ safety inspired a study of the interplay between plants and people that shaped his later articulation of the verticality of plant distribution. Moreover, the cartographic methods Humboldt employed during his American journey depended as much on drawing practices indebted to mining as they did on patterns of vertical mobility above and below the surface of the earth. These arguments ultimately encourage a departure from “Humboldtian Science,” a term that has veiled an originally Prusso-Saxon science beneath a set of Anglo-American connotations.
...when paired with Jefferson's Notes or Crevecoeur's Letters (Humboldt praises the former but also corrects it, in particular Jefferson's geographic coordinates for the Presidio of Sante Fe in New ...Mexico), New Spain provides evidence of how some naturalists were starting to analyze conquest's deleterious effects on humans and natural environments. Humboldt detailed New Spain's political economy to demystify early accounts that had distorted the colony by touting its abundant resources but casting the people as incompetent to use them. New Spain will help early American literary scholars better understand Humboldt's nascent environmental sensibility, which merges postcolonial critique and ecological wonder and later influences the work of nineteenth-century American writers from William Apess to Henry David Thoreau. lucas NOSSAMAN North Greenville University lucas NOSSAMAN is an assistant professor of English at North Greenville University in Tigerville, South Carolina.
It was recently hypothesized that Leishmania amastigotes could constitute a semi-quiescent stage characterized by low replication and reduced metabolic activity. This concept developed with ...Leishmania (Leishmania) mexicana and Leishmania (Leishmania) major models might explain numerous clinical and sub-clinical features of Leishmania (Viannia) braziliensis infections, like reactivation of the disease, non-response to chemotherapy or asymptomatic infections. We compared here in vitro the proliferative capability of L. (V.) braziliensis amastigotes and promastigotes, assessed the expression of key molecular parameters and performed metabolomic analysis. We found that contrary to the highly proliferative promastigotes, amastigotes (axenic and intracellular) do not show evidence of extensive proliferation. In parallel, amastigotes showed a significant decrease of (i) the kDNA mini-circle abundance, (ii) the intracellular ATP level, (iii) the ribosomal components: rRNA subunits 18S and 28S α and ribosomal proteins RPS15 and RPL19, (iv) total RNA and protein levels. An untargeted metabolomic study identified clear differences between the different life stages: in comparison to logarithmic promastigotes, axenic amastigotes showed (a) a strong decrease of 14 essential and non-essential amino acids and eight metabolites involved in polyamine synthesis, (b) extensive changes in the phospholipids composition and (c) increased levels of several endogenous and exogenous sterols. Altogether, our results show that L. (V.) braziliensis amastigotes can show a phenotype with negligible rate of proliferation, a lower capacity of biosynthesis, a reduced bio-energetic level and a strongly altered metabolism. Our results pave the way for further exploration of quiescence among amastigotes of this species.
Leptospirosis is a worldwide prevalent zoonosis and chronic kidney disease (CKD) is a leading global disease burden. Because of pathophysiological changes in the kidney, it has been suggested that ...these conditions may be associated. However, the extent of this interaction has not been synthetized. We aimed to systematically review and critically appraise the evidence on the association between leptospirosis and CKD.
Observational studies with a control group were selected. Leptospirosis, confirmed with laboratory methods, and CKD also based on a laboratory assessment, were the exposures and outcomes of interest. The search was conducted in EMBASE, MEDLINE, Global Health, Scopus and Web of Science. Studies selected for qualitative synthesis were assessed for risk of bias following the Newcastle-Ottawa Scale. 5,981 reports were screened, and 2 (n = 3,534) were included for qualitative synthesis. The studies were conducted in Taiwan and Nicaragua; these reported cross-sectional and longitudinal estimates. In the general population, the mean estimated glomerular filtration rate (eGFR) was lower (p<0.001) in people testing positive for antileptospira antibodies (eGFR = 98.3) than in negative controls (eGFR = 100.8). Among sugarcane applicants with high creatinine, those who were seropositive had lower eGFR (mean difference: -10.08). In a prospective analysis, people with high antileptospira antibodies titer at baseline and follow-up, had worse eGFR (p<0.05).
Although the available evidence suggests there may be a positive association between leptospirosis and CKD, whereby leptospirosis could be a risk factor for CKD, it is still premature to draw conclusions. There is an urgent need for research on this association.
Alexander von Humboldt and Aimé Bonpland in their Essay on the Geography of Plants discuss what was known in 1807 about the elevational limits of vascular plants in the Andes, North America, and the ...European Alps and suggest what factors might influence these upper elevational limits. Here, in light of current knowledge and techniques, I consider which species are thought to be the highest vascular plants in twenty mountain areas and two polar regions on Earth. I review how one can try to compare elevational limits in different parts of Earth. I discuss recent advances in high-elevation plant ecology that would surely have fascinated von Humboldt such as the special snow-roots in some snow-bed plants and the coldest place on Earth where a vascular plant is growing. I briefly outline an ignored von Humboldt legacy, Mendelssohn’s Humboldt Cantata. In conclusion I summarise the foundations and legacies that von Humboldt created for global high-elevation ecology and biogeography.
The flora of the Canary Islands has been subject to botanical studies for more than 200 years. Several biodiversity databases are available for the archipelago. However, there are various drivers of ...change in real biodiversity and the knowledge about it constantly needs to be kept track of. Island floras are both: exposed to species loss and to species introductions, either through natural processes or by anthropogenic drivers. Additionally, the evolution of endemic plant species plays a substantial role. Endemic species are sensitive to population decline due to small population sizes and possible low competitiveness against incoming species. Additionally, there is continuous progress in systematics and taxonomy. Species names or their taxonomic attribution can be modified. Here, we check published plant lists for the Canary Islands and literature, and compile currently accepted taxa into an updated checklist. For this FloCan checklist, several sources were compiled, checked for completeness and quality, and their taxonomy was updated. We illustrate how far plant names are considered in regional or global databases. This work represents the current state of knowledge on Canary Island plant diversity, including introduced and recently described taxa. We provide a comprehensive and updated basis for biogeographical and macroecological studies. Particularly, the number of non-native species is being extended substantially. The adaptation to standard international nomenclature supports integration into large-scale studies.
Although tuberculosis (TB) is usually curable with antibiotics, poor adherence to medication can lead to increased transmission, drug resistance, and death. Prior research has shown several factors ...to be associated with poor adherence, but this problem remains a substantial barrier to global TB control. We studied patients in a high-incidence district of Lima, Peru to identify factors associated with premature termination of treatment (treatment default).
We conducted a prospective cohort study of adult smear-positive TB patients enrolled between January 2010 and December 2011 with no history of TB disease. Descriptive statistics and multivariable logistic regression analyses were performed to determine risk factors associated with treatment default.
Of the 1233 patients studied, 127 (10%) defaulted from treatment. Patients who defaulted were more likely to have used illegal drugs (OR = 4.78, 95% CI: 3.05-7.49), have multidrug-resistant TB (OR = 3.04, 95% CI: 1.58-5.85), not have been tested for HIV (OR = 2.30, 95% CI: 1.50-3.54), drink alcohol at least weekly (OR = 2.22, 95% CI: 1.40-3.52), be underweight (OR = 2.08, 95% CI: 1.21-3.56), or not have completed secondary education (OR = 1.55, 95% CI: 1.03-2.33).
Our study identified several factors associated with defaulting from treatment, suggesting a complex set of causes that might lead to default. Addressing these factors individually would be difficult, but they might help to identify certain high-risk patients for supplemental intervention prior to treatment interruption. Treatment adherence remains a barrier to successful TB care and reducing the frequency of default is important for both the patients' health and the health of the community.
Tuberculosis (TB) transmission may occur with exposure to an infectious contact often in the setting of household environments, but extra-domiciliary transmission also may happen. We evaluated if ...using buses and/or minibuses as public transportation was associated with acquiring TB in a high incidence urban district in Lima, Peru.
Newly diagnosed TB cases with no history of previous treatment and community controls were recruited from August to December 2008 for a case-control study. Crude and adjusted odd ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression to study the association between bus/minibus use and TB risk.
One hundred forty TB cases and 80 controls were included. The overall use of buses/minibuses was 44.9%; 53.3% (72/135) among cases and 30.4% (24/79) among controls OR: 3.50, (95% CI: 1.60-7.64). In the TB group, 25.7% (36/140) of subjects reported having had a recent household TB contact, and 13% (18/139) reported having had a workplace TB contact; corresponding figures for controls were 3.8% (3/80) and 4.1% (3/73), respectivelyOR: 8.88 (95% CI: 2.64-29.92), and OR: 3.89 (95% CI: 1.10-13.70). In multivariate analyses, age, household income, household contact and using buses/minibuses to commute to work were independently associated with TB OR for bus/minibus use: 11.8 (95% CI: 1.45-96.07).
Bus/minibus use to commute to work is associated with TB risk in this high-incidence, urban population in Lima, Peru. Measures should be implemented to prevent TB transmission through this exposure.
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