On-line identification of fermentation processes for ethanol production.

A strategy for monitoring fermentation processes, specifically, simultaneous saccharification and fermentation (SSF) of corn mash, was developed. The strategy covered the development and use of first principles, semimechanistic and unstructured process model based on major kinetic phenomena, along with mass and energy balances. The model was then used as a reference model within an identification procedure capable of running on-line. The on-line identification procedure consists on updating the reference model through the estimation of corrective parameters for certain reaction rates using the most recent process measurements. The strategy makes use of standard laboratory measurements for sugars quantification and in situ temperature and liquid level data. The model, along with the on-line identification procedure, has been tested against real industrial data and have been able to accurately predict the main variables of operational interest, i.e., state variables and its dynamics, and key process indicators. The results demonstrate that the strategy is capable of monitoring, in real time, this complex industrial biomass fermentation. This new tool provides a great support for decision-making and opens a new range of opportunities for industrial optimization.

Effects of region of birth, educational level and age on late presentation among men who have sex with men newly diagnosed with HIV in a network of STI/HIV counselling and testing clinics in Spain.

This paper analyses late presentation (LP) of HIV infection, and its determinants, among men who have sex with men (MSM) in Spain, newly diagnosed with HIV (2003-2011) in 15 sexually transmitted infection/HIV counselling and testing clinics. LP was defined as <350 CD4 cells/µL or AIDS. In total, 3,081 MSM were included (2,499 having CD4/AIDS); overall LP was 25.3%. LP was higher in men older than 34 years, those not previously HIV-tested (adjusted odds ratio (aOR):3.1; 95% confidence intervals (CI):2.3-4.2) , and those tested > 12 months before diagnosis (12-24 months (aOR:1.4; 95% CI:1.0-2.0); > 24 months (aOR:2.2; 95% CI:1.7-3.0)). LP was less likely in MSM reporting a known HIV-infected partner as infection source or symptoms compatible with acute retroviral syndrome. 'Region of birth' interacted with 'educational level' and 'steady partner as infection source': only African and Latin-American MSM with low educational level were more likely to present late; Latin-American men attributing their infection to steady partner, but no other MSM, had LP more frequently. In Spain, HIV testing among MSM should be promoted, especially those > 34 years old and migrants with low educational level. The current recommendation that MSM be tested at least once a year is appropriate.

Trends in HIV testing, prevalence among first-time testers, and incidence in most-at-risk populations in Spain: the EPI-VIH Study, 2000 to 2009.

During 2000 to 2009, data on people undergoing HIV testing and on those newly diagnosed with HIV were collected in a network of 20 Spanish clinics specialising in sexually transmitted infections and/or HIV testing and counselling. The number of tests performed, overall and disaggregated by different variables, was obtained. HIV prevalence among first-time testers and HIV incidence among repeat testers were calculated. To evaluate trends, joinpoint regression models were fitted. In total, 236,939 HIV tests were performed for 165,745 individuals. Overall HIV prevalence among persons seeking HIV testing was 2.5% (95% CI: 2.4 to 2.6). Prevalence was highest in male sex workers who had sex with other men (19.0% (95% CI: 16.7 to 21.4)) and was lowest in female sex workers (0.8% (95% CI: 0.7 to 0.9)). Significant trends in prevalence were observed in men who have sex with men (MSM) (increasing) and heterosexual individuals (decreasing). The incidence analysis included 30,679 persons, 64,104 person-years (py) of follow-up and 642 seroconversions. The overall incidence rate (IR) was 1.0/100 py (95% CI: 0.9/100 to 1.1/100). Incidence was significantly higher in men and transgender females than in women (1.8/100 py (95% CI: 1.6 to 1.9), 1.2/100 py (95% CI: 0.5 to 2.8) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively) and increased with age until 35­39 years. IRs in MSM and people who inject drugs were significantly greater than in heterosexual individuals (2.5/100 py (95% CI: 2.3 to 2.7), 1.6/100 py (95% CI: 1.1 to 2.2) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively), and an upward trend was observed in MSM. Our results call for HIV prevention to be reinforced in MSM and transgender women in Spain.

[Clinical and epidemiological characteristics of persons newly diagnosed of HIV infection]. / Características clinicoepidemiológicas de los nuevos diagnósticos de infección por el virus de la inmunodeficiencia humana.

BACKGROUND: We describe the characteristics of people with a recent diagnosis of HIV infection. PATIENTS AND METHOD: Series of 126 new cases of HIV infection diagnosed in an infectious diseases Service. RESULTS: Sexual transmission was the commonest form of infection (74%). Fifteen percent of individuals were aged over 50 years and 16% were immigrants. A late diagnosis (stage C) accounted for 36% of cases and it was associated with being more than 50 years old (OR: 5.1; 95% CI: 1.6-16.8). CONCLUSIONS: It is necessary to implement HIV infection surveillance systems and to improve preventive services.

[HIV infection and cervical cancer: a note of caution for clinicians and health planners]. / Infección por VIH y cáncer de cérvix: una llamada de atención para clínicos y planificadores.

BACKGROUND: To estimate the association between HIV infection and cervical intraepithelial neoplasia (CIN). PATIENTS AND METHODS: Cross-sectional study based on data from 251 women from a Sexually Transmitted Diseases clinic. Patients with CIN were compared with those without CIN in terms of HIV infection and exposure to other risk factors, calculating the corresponding adjusted odds ratio (ORA) by logistic regression. RESULTS: HIV infection (ORA = 7.5; CI 95%: 2.5-22.1), having previous cytologies with cellular changes associated with human papillomavirus infection (ORA = 3.6; CI 95%: 1.3-10.2) and history of condylomas (ORA = 3.2; CI 95%: 1.2-8.4) were associated with CIN. CONCLUSIONS: The strong association observed between HIV and CIN, shows that it is necessary for health services planners and clinicians caring for HIV infected women to ensure that the latter receive the appropriate care to guarantee its early detection.

Müllerian abnormalities in fertile women and recurrent aborters.

Ninety-six women with recurrent first-trimester spontaneous abortions underwent hysterosalpingography to rule out müllerian abnormalities, both congenital and acquired. Results were compared with those in 96 women who had undergone hysterosalpingography before artificial insemination by donor and subsequently had a full-term, normal delivery. The patients with two recurrent, consecutive abortions had müllerian abnormalities similar to those in women with three consecutive abortions; however, they had different müllerian abnormalities than did the control group. Congenital and acquired malformations seen most often in patients with recurrent abortions were septate, arcuate and bicornuate uteri and incompetent cervical os. Pelvic examination did not discriminate between patients with recurrent abortions and the control group.