Food security reduces multiple HIV infection risks for high-vulnerability adolescent mothers and non-mothers in South Africa: a cross-sectional study.

INTRODUCTION: Adolescent girls and young women, including adolescent mothers, in Southern Africa have high HIV seroconversion and transmission. We need to know which risks drive HIV infections, and what can reduce these risks. METHODS: We interviewed 1712 adolescent girls and young women (11-23 years), including 1024 adolescent mothers who had conceived before age 20 and had a living child, from two health municipalities of South Africa's Eastern Cape Province between March 2018 and July 2019. Recruitment was through multiple community, school and health facility channels. Associations between adolescent motherhood and seven HIV risk behaviours (multiple sexual partners, transactional sex, age-disparate sex, condomless sex, sex on substances, alcohol use and not in education or employment) were investigated using the generalized estimating equations method for multiple outcomes specified with a logit link and adjusting for nine covariates. Using the same model, we investigated associations between having enough food at home every day in the past week (food security) and the same seven HIV risk behaviours. When we found evidence of moderation by HIV status, we report stratum-specific odds ratios. RESULTS: Mean age was 17.51 years (SD: 2.54), 46% participants were living with HIV. Compared to non-mothers, adolescent mothers had lower odds of alcohol use (AOR = 0.47, 95% CI = 0.29-0.75), but higher odds of multiple sexual partners (AOR = 1.93, 95% CI = 1.35-2.74), age-disparate sex (HIV-uninfected AOR = 1.73, 95% CI = 1.03-2.91; living with HIV AOR = 5.10, 95% CI = 2.98-8.73), condomless sex (AOR = 8.20, 95% CI = 6.03-11.13), sex on substances (AOR = 1.88, 95% CI = 1.10-3.21) and not in education/employment (HIV-uninfected AOR = 1.83, 95% CI = 1.19-2.83; living with HIV AOR = 6.30, 95% CI = 4.09-9.69). Among non-mothers, food security was associated with lower odds of multiple sexual partners (AOR = 0.45, 95% CI = 0.26-0.78), transactional sex (AOR = 0.32, 95% CI = 0.13-0.82) and not in education/employment (AOR = 0.48, 95% CI = 0.29-0.77). Among adolescent mothers, food security was associated with lower odds of transactional sex (AOR = 0.17, 95% CI = 0.10-0.28), age-disparate sex (AOR = 0.66, 95% CI = 0.47-0.92), sex on substances (AOR = 0.51, 95% CI = 0.32-0.82), alcohol use (AOR = 0.45, 95% CI = 0.25-0.79) and not in education/employment (AOR = 0.56, 95% CI = 0.40-0.78). CONCLUSIONS: Adolescent motherhood is associated with multiple vulnerabilities to HIV infection and transmission. Social protection measures that increase food security are likely to reduce HIV risk pathways for adolescent girls and young women, especially adolescent mothers.

Contribution to Longobard dietary studies: Stable carbon and nitrogen isotope data from Castel Trosino (6th-8th c. CE, Ascoli Piceno, central Italy).

The arrival of the Longobards in Italy represents one of the most significant periods of the Early Middle Ages. Such arrival had social and political implications, particularly in relation to cultural admixture with local communities. One way to understand this is through the reconstruction of paleodiet via stable isotope analysis. So far, the subsistence strategy of this population in central Italy remains poorly explored. Stable carbon and nitrogen isotope analyses are presented here on a total of 19 human bone collagen samples from the cemetery of Castel Trosino. This isotopic investigation contributes to the dietary reconstruction of Early Medieval populations in Italy, providing a crucial isotopic dataset for an area still poorly explored.

Degree of Peripheral Thyroxin Deiodination, Frailty, and Long-Term Survival in Hospitalized Older Patients.

Context: Although the association between low free triiodothyronine (FT3) and poor outcome has been extensively reported in literature, the degree of peripheral thyroxin deiodination and its relationship with frailty and survival in hospitalized older patients has not yet been fully established. The aim of the current study was to evaluate the possible correlation between FT3/free thyroxine (FT4) ratio reduction, an indirect marker of thyroxin deiodination impairment, and frailty status and survival in hospitalized older patients. Methods: We consecutively enrolled older patients, hospitalized in the geriatrics ward of the University of Pisa. At admission, Multidimensional Geriatric Assessment (MGA) and Multi Prognostic Index (MPI), an indirect measure of frailty, were obtained from all the patients. Causes of hospitalization and prevalence of delirium were recorded. Blood samples for FT3, FT4, and thyrotropin value evaluation were drawn after an overnight fast. Results: A total of 643 patients (83.8 ± 7.4 years, 53% women) were studied. FT3 was inversely and strongly correlated, whereas FT4 was moderately positively correlated with MGA parameters, MPI score (P < 0.001 and P < 0.05, respectively), and survival (P < 0.001 and P = 0.09, respectively). FT3/FT4 ratio reduction was highly associated with worse MGA (P < 0.001) and MPI scores (P < 0.0001), even in patients without low FT3. The inclusion of FT3 in the final model of multivariate Cox regression confirmed the independent role of FT3/FT4 ratio in predicting survival (P = 0.005). Conclusion: Overall, our study documented a strong association between FT3/FT4 ratio reduction, a surrogate marker of peripheral thyroxin deiodination, and frailty. Moreover, FT3/FT4 ratio value emerged as independent marker of survival, even in patients with normal FT3 values.

Combining temporal planning with probabilistic reasoning for autonomous surveillance missions.

It is particularly challenging to devise techniques for underpinning the behaviour of autonomous vehicles in surveillance missions as these vehicles operate in uncertain and unpredictable environments where they must cope with little stability and tight deadlines in spite of their restricted resources. State-of-the-art techniques typically use probabilistic algorithms that suffer a high computational cost in complex real-world scenarios. To overcome these limitations, we propose a hybrid approach that combines the probabilistic reasoning based on the target motion model offered by Monte Carlo simulation with long-term strategic capabilities provided by automated task planning. We demonstrate our approach by focusing on one particular surveillance mission, search-and-tracking, and by using two different vehicles, a fixed-wing UAV deployed in simulation and the "Parrot AR.Drone2.0" quadcopter deployed in a physical environment. Our experimental results show that our unique way of integrating probabilistic and deterministic reasoning pays off when we tackle realistic missions.

What linear programming contributes: world food programme experience with the "cost of the diet" tool.

BACKGROUND: Linear programming has been used for analyzing children's complementary feeding diets, for optimizing nutrient adequacy of dietary recommendations for a population, and for estimating the economic value of fortified foods. OBJECTIVE: To describe and apply a linear programming tool ("Cost of the Diet") with data from Mozambique to determine what could be cost-effective fortification strategies. METHODS: Based on locally assessed average household dietary needs, seasonal market prices of available food products, and food composition data, the tool estimates the lowest-cost diet that meets almost all nutrient needs. The results were compared with expenditure data from Mozambique to establish the affordability of this diet by quintiles of the population. RESULTS: Three different applications were illustrated: identifying likely "limiting nutrients," comparing cost effectiveness of different fortification interventions at the household level, and assessing economic access to nutritious foods. The analysis identified iron, vitamin B2, and pantothenic acid as "limiting nutrients." Under the Mozambique conditions, vegetable oil was estimated as a more cost-efficient vehicle for vitamin A fortification than sugar; maize flour may also be an effective vehicle to provide other constraining micronutrients. Multiple micronutrient fortification of maize flour could reduce the cost of the "lowest-cost nutritious diet" by 18%, but even this diet can be afforded by only 20% of the Mozambican population. CONCLUSIONS: Within the context of fortification, linear programming can be a useful tool for identifying likely nutrient inadequacies, for comparing fortification options in terms of cost effectiveness, and for illustrating the potential benefit of fortification for improving household access to a nutritious diet.

In vitro antiviral activity of distamycin A against clinical isolates of herpes simplex virus 1 and 2 from transplanted patients.

OBJECTIVE(S): Herpes simplex virus (HSV) infections in immunocompromised individuals may require prolonged antiviral therapy resulting in the emergence of viral strains resistant to the currently employed antiviral drugs. Distamycin A (DA), a basic antibiotic belonging to the lexitropsin DNA minor groove binding drugs, exhibits antiviral properties. In this study we evaluated the in vitro cytotoxicity and antiviral activity of DA against HSV type 1 and HSV type 2 clinical isolates from transplanted patients and compared them with those of acyclovir (ACV) in search of alternative antiviral drugs. METHODS: Viral detection and typing was performed by multiplex PCR and immunofluorescence assay; the in vitro cytotoxicity of DA and the antiviral activity of ACV and DA was evaluated respectively by neutral red uptake assay and plaque reduction assay for HSV2 isolates and fluorescence reduction assay for HSV1 isolates. RESULTS: Tissue culture 50% cytotoxic concentration of DA was 58 muM. Tissue culture 50% inhibitory concentration values ranged from 0.16 to 7.4 muM for the ACV-sensitive and from 5.4 to 32 muM for the ACV-resistant viral strains. CONCLUSIONS: In spite of the lower activity against ACV-resistant strains, DA may be used as an antiherpetic drug.