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"Thomas, Deborah"
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An mHealth pilot designed to increase the reach of prevention of mother-to-child transmission of HIV (PMTCT) across the treatment cascade in a resource-constrained setting in Tanzania
Data collection and integrated reporting between the multiple health facilities for supporting more efficient care linkages is an indispensable element for prevention of mother-to-child transmission of HIV (PMTCT) by fostering continuity of patient care and improving the treatment cascade for HIV-infected pregnant women. mHealth potentially presents timely solutions to the data challenges related to efficient and effective care delivery in resource-constrained settings, particularly in low- and middle-income countries.
This randomized controlled pilot study used stratified random sampling for the selection of seven intervention and seven control sites in Misungwi, Tanzania, a rural district in the northwestern region. Twenty-eight health workers at seven intervention health facilities used the Tanzania Health Information Technology (T-HIT) system during a 3-month period from February 23, 2015, through May 23, 2015, to capture antenatal, delivery, and postnatal patient visits.
T-HIT was designed for use on tablets with the goal to improve reporting, surveillance and monitoring of HIV rates and care delivery in the remote and rural settings. Health workers successfully recorded 2,453 visits. Of these, 1,594 were antenatal visits, 484 deliveries were recorded, and 375 were postnatal visits. Within the antenatal visits, 96% of women had a single visit (1474). Healthcare workers were unable to test 6.7% of women antenatally for HIV.
The T-HIT pilot demonstrated the feasibility for implementing an mHealth integrated solution in a rural, low-resource setting that links tablet-based surveillance, health worker capacity-building and patient reminders into a single robust and responsive system. Although the implementation phase was only three months, the pilot generated evidence that T-HIT has potential for improving patient outcomes by providing more comprehensive, linked, and timely PMTCT care data at the individual and clinic levels.
Journal Article
Sovereignty unhinged : an illustrated primer for the study of present intensities, disavowals, and temporal derangements
\"Sovereignty Unhinged gathers essays that position affect as a lens to think through what sovereignty feels like in the contemporary moment, and examine the sense of what is possible-politically, economically, and socio-culturally-in a post-9/11 militarized world. Rather than adhering to master narratives, normative disciplinary frames, or the idea of an autonomous, rational subject, this volume examines the \"unhinging\" of sovereignty-the energies, excesses, and ambitions of being out of order, dislocated, even hysterical or mad. This volume brings together essays from leading anthropologists such as Akhil Gupta, Jessica Cattelino, and Yarimar Bonilla, as well as visual artwork by Lochlann Jain\"-- Provided by publisher.
BOOK
Prenatal exposure to ambient air pollution and traffic and indicators of adiposity in early childhood: the Healthy Start study
BackgroundPrenatal exposure to ambient air pollution and traffic have been related to a lower birth weight and may be associated with greater adiposity in childhood. We aimed to examine associations of maternal exposure to ambient air pollution and traffic during pregnancy with indicators of adiposity in early childhood.MethodsWe included 738 participants of the Colorado-based Healthy Start study whose height, weight, waist circumference and/or fat mass were measured at age 4–6 years. We estimated residential exposure to ambient concentrations of fine particulate matter (PM2.5) and ozone (O3) averaged by trimester and throughout pregnancy via inverse distance-weighted interpolation of central site monitoring data. We assessed the distance to the nearest major roadway and traffic density in multiple buffers surrounding the participants’ homes. Associations of prenatal exposure to air pollution and traffic with overweight, waist circumference, percent fat mass and fat mass index (FMI) were assessed by logistic and linear regression.ResultsAssociations of exposure to PM2.5 and O3 at the residential address during pregnancy with percent fat mass and FMI at age 4–6 years were inconsistent across trimesters. For example, second trimester PM2.5 was associated with a higher percent fat mass (adjusted difference 0.70% [95% CI 0.05, 1.35%] per interquartile range (IQR; 1.3 µg/m3) increase), while third trimester PM2.5 was associated with a lower percent fat mass (adjusted difference −1.17% [95% CI −1.84, −0.50%] per IQR (1.3 µg/m3) increase). Residential proximity to a highway during pregnancy was associated with higher odds of being overweight at age 4–6 years. We observed no associations of prenatal exposure to PM2.5 and O3 with overweight and waist circumference.ConclusionsWe found limited evidence of associations of prenatal exposure to ambient PM2.5 and O3 with indicators of adiposity at age 4–6 years. Suggestive relationships between residential proximity to a highway during pregnancy and greater adiposity merit further investigation.
Journal Article
Spatial Distribution of Mercury and Arsenic Levels in Water, Soil and Cassava Plants in a Community with Long History of Gold Mining in Tanzania
This study examined the spatial distribution of total mercury (THg) and total arsenic (TAs) in water, soil and cassava (Manihot esculenta) (leaves and roots) samples taken from areas in Rwamagasa village in northwestern Tanzania where daily living activities occur in close proximity to extensive artisanal and small scale gold mining. Results indicated that 33.3 % of the water sources had THg levels above the WHO guideline of 1.0 µg/L for safe drinking water, and 12.5 % had TAs levels above 10 µg/L. Cassava leaves were found to have higher THg (ranging from 8.3 to 167 µg/kg) and TAs (ranging from 60 to 1,120 µg/kg) levels than cassava roots, which ranged between 1.2–8.3 µg/kg for THg and 25–310 µg/kg for TAs. Concentrations of THg and TAs in soil samples ranged between 5.8–1,759 and 183–20,298 µg/kg, respectively. Both THg and TAs were found to be distributed throughout Rwamagasa village.
Journal Article
Three-text edition of Thomas Hobbes's political theory : The elements of law, De cive, and Leviathan
\"It is well known that Thomas Hobbes wrote his political theory multiple times. 'This little MS. treatise [The Elements of Law: Natural & Politic] grew to be his Booke De Cive, and at last grew there to be the so formidable LEVIATHAN.' The first work circulated in manuscript in 1640; the second, Latin version was published in 1642 and in a second edition in 1647; Leviathan came out four years later, with a Latin edition following in 1668. In composing De Cive and Leviathan, Hobbes drew on the earlier text(s), re-using, expanding, re-organizing, and adding to material that had appeared previously\"-- Provided by publisher.
BOOK
Safety and Efficacy of INCB018424, a JAK1 and JAK2 Inhibitor, in Myelofibrosis
The authors report on the clinical activity of a new oral inhibitor of Janus kinase 2 (JAK2) in patients with myelofibrosis. The drug improved a wide range of symptoms promptly, controlled them for >1 year, and appeared to inhibit disease progression to acute leukemia.
Myelofibrosis is manifested as primary myelofibrosis, post–essential thrombocythemia myelofibrosis, or post–polycythemia vera myelofibrosis and is characterized by clinical signs (e.g., progressive anemia, bone marrow fibrosis, and splenomegaly) and a constellation of debilitating symptoms (fatigue, weakness, bone pain, a hypercatabolic state, and weight loss).
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Survival in myelofibrosis is related to the number of risk factors and ranges from 2 to 4 years among patients with two or more risk factors (intermediate-2 or high risk) to 8 to 11 years among patients with no risk factors or one risk factor (intermediate-1 or low risk) (see Table 1A in the Supplementary Appendix, available with . . .
Journal Article
Mind, brain and technology : learning in the age of emerging technologies
\"As technology becomes increasingly integrated into our society, cultural expectations and needs are changing. Social understanding, family roles, organizational skills, and daily activities are all adapting to the demands of ever-present technology, causing changes in human brain, emotions, and behaviors. An understanding of the impact of technology upon our lives is essential if we are to adequately educate children for the future and plan for meaningful learning environments for them. Mind, Brain and Technology provides an overview of these changes from a wide variety of perspectives. Designed as a textbook for students in the fields and interdisciplinary areas of psychology, neuroscience, technology, computer science, and education, the book offers insights for researchers, professionals, educators, and anyone interested in learning more about the integration of mind, brain and technology in their lives. The book skilfully guides readers to explore alternatives, generate new ideas, and develop constructive plans both for their own lives and for future educational needs.\" -- Publisher's description
Book
Targeting MYC with modular synthetic transcriptional repressors derived from bHLH DNA-binding domains
Despite unequivocal roles in disease, transcription factors (TFs) remain largely untapped as pharmacologic targets due to the challenges in targeting protein–protein and protein–DNA interactions. Here we report a chemical strategy to generate modular synthetic transcriptional repressors (STRs) derived from the bHLH domain of MAX. Our synthetic approach yields chemically stabilized tertiary domain mimetics that cooperatively bind the MYC/MAX consensus E-box motif with nanomolar affinity, exhibit specificity that is equivalent to or beyond that of full-length TFs and directly compete with MYC/MAX protein for DNA binding. A lead STR directly inhibits MYC binding in cells, downregulates MYC-dependent expression programs at the proteome level and inhibits MYC-dependent cell proliferation. Co-crystallization and structure determination of a STR:E-box DNA complex confirms retention of DNA recognition in a near identical manner as full-length bHLH TFs. We additionally demonstrate structure-blind design of STRs derived from alternative bHLH-TFs, confirming that STRs can be used to develop highly specific mimetics of TFs targeting other gene regulatory elements.
Synthetic transcriptional repressors are engineered from natural DNA-binding domains.
Journal Article