969 resultados para Low-level viremia


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BACKGROUND: The goal of antiretroviral therapy (ART) is to reduce HIV-related morbidity and mortality by suppressing HIV replication. The prognostic value of persistent low-level viremia (LLV), particularly for clinical outcomes, is unknown. OBJECTIVE: Assess the association of different levels of LLV with virological failure, AIDS event, and death among HIV-infected patients receiving combination ART. METHODS: We analyzed data from 18 cohorts in Europe and North America, contributing to the ART Cohort Collaboration. Eligible patients achieved viral load below 50 copies/ml within 3-9 months after ART initiation. LLV50-199 was defined as two consecutive viral loads between 50 and 199 copies/ml and LLV200-499 as two consecutive viral loads between 50 and 499 copies/ml, with at least one between 200 and 499 copies/ml. We used Cox models to estimate the association of LLV with virological failure (two consecutive viral loads at least 500 copies/ml or one viral load at least 500 copies/ml, followed by a modification of ART) and AIDS event/death. RESULTS: Among 17 902 patients, 624 (3.5%) experienced LLV50-199 and 482 (2.7%) LLV200-499. Median follow-up was 2.3 and 3.1 years for virological and clinical outcomes, respectively. There were 1903 virological failure, 532 AIDS events and 480 deaths. LLV200-499 was strongly associated with virological failure [adjusted hazard ratio (aHR) 3.97, 95% confidence interval (CI) 3.05-5.17]. LLV50-199 was weakly associated with virological failure (aHR 1.38, 95% CI 0.96-2.00). LLV50-199 and LLV200-499 were not associated with AIDS event/death (aHR 1.19, 95% CI 0.78-1.82; and aHR 1.11, 95% CI 0.72-1.71, respectively). CONCLUSION: LLV200-499 was strongly associated with virological failure, but not with AIDS event/death. Our results support the US guidelines, which define virological failure as a confirmed viral load above 200 copies/ml.

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Radioactive wastes are by-products of the use of radiation technologies. As with many technologies, the wastes are required to be disposed of in a safe manner so as to minimise risk to human health. This study examines the requirements for a hypothetical repository and develops techniques for decision making to permit the establishment of a shallow ground burial facility to receive an inventory of low-level radioactive wastes. Australia’s overall inventory is used as an example. Essential and desirable siting criteria are developed and applied to Australia's Northern Territory resulting in the selection of three candidate sites for laboratory investigations into soil behaviour. The essential quantifiable factors which govern radionuclide migration and ultimately influence radiation doses following facility closure are reviewed. Simplified batch and column procedures were developed to enable laboratory determination of distribution and retardation coefficient values for use in one-dimensional advection-dispersion transport equations. Batch and column experiments were conducted with Australian soils sampled from the three identified candidate sites using a radionuclide representative of the current national low-level radioactive waste inventory. The experimental results are discussed and site soil performance compared. The experimental results are subsequently used to compare the relative radiation health risks between each of the three sites investigated. A recommendation is made as to the preferred site to construct an engineered near-surface burial facility to receive the Australian low-level radioactive waste inventory.

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The findings of the recent independent review of the UK Liverpool Care Pathway (LCP)1, following substantial concerns raised by members of the public and health professionals found that the implementation of the LCP is often associated with poor care1. The Neuberger Report highlighted the complexity of various ethical, safety, clinical practice and negligence issues associated with pathway usage and how, despite technological advances, diagnosing dying continues to be challenging. The UK Government’s decision to phase out the LCP as policy following these findings, has generated considerable debate both within and beyond the UK. However, another key issue raised by the Neuberger’s report is the issue of the palliative care community’s perceived willingness to readily adopt new clinical practices in the absence of evidence. It is this translational issue that this editorial explores.

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The low-level jet (LLJ) over the Indian region, which is most prominent during the monsoon (June-September) season, has been studied with a general circulation model (GCM). The role of African orography in modulating this jet is the focus of this article. The presence o African orography intensifies the cross-equatorial flow. Contrary to previous modelling Studies we find that cross-equatorial flow occurs even in the absence of African orography, though this flow is muc weaker even when the Indian monsoon rainfall is high. However, the location of the meridional jet near the equator in the Somali region is linked to the Indian monsoon rainfall rather than to the land-sea contrast over Somalia. Also, the presence of African orography, and not the strength of the Indian monsoon, controls the vertical extent of the equatorial meridional wind. In an aqua-planet simulation, the cross-equatorial flow occurs about 30 to the west of the rainfall maximum. Thus, the longitudinal location of the equatorial Somali jet depends upon the occurrence of monsoon heating, but the vertical structure of the jet is on account of the western boundary current in the atmosphere due to the East African highlands under the influence of monsoonal heat source.

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To determine the potential role of flying foxes in transmission cycles of Japanese encephalitis virus (JEV) in Australia, we exposed Pteropus alecto (Megachiroptera: Pteropididae) to JEV via infected Culex annulirostris mosquitoes or inoculation. No flying foxes developed symptoms consistent with JEV infection. Anti-JEV IgG antibodies developed in 6/10 flying foxes exposed to infected Cx. annulirostris and in 5/5 inoculated flying foxes. Low-level viremia was detected by real-time reverse transcriptase polymerase chain reaction in 1/5 inoculated flying foxes and this animal was able to infect recipient mosquitoes. Although viremia was not detected in any of the 10 flying foxes that were exposed to JEV by mosquito bite, two animals infected recipient mosquitoes. Likewise, an inoculated flying fox without detectable viremia infected recipient mosquitoes. Although infection rates in recipient mosquitoes were low, the high population densities in roosting camps, coupled with migratory behavior indicate that flying foxes could play a role in the dispersal of JEV.

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This paper presents an SIMD machine which has been tuned to execute low-level vision algorithms employing the relaxation labeling paradigm. Novel features of the design include: 1. (1) a communication scheme capable of window accessing under a single instruction. 2. (2) flexible I/O instructions to load overlapped data segments; and 3. (3) data-conditional instructions which can be nested to an arbitrary degree. A time analysis of the stereo correspondence problem, as implemented on a simulated version of the machine using the probabilistic relaxation technique, shows a speed up of almost N2 for an N × N array of PEs.

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Silver nanoparticles (AgNPs) pose a high risk of exposure to the natural environment owing to their extensive usage in various consumer products. In the present study we attempted to understand the harmful effect of AgNPs at environmentally relevant low concentration levels (<= 1 ppm) towards two different freshwater bacterial isolates and their consortium. The standard plate count assay suggested that the AgNPs were toxic towards the fresh water bacterial isolates as well as the consortium, though toxicity was significantly reduced for the cells in the consortium. The oxidative stress assessment and membrane permeability studies corroborated with the toxicity data. The detailed electron microscopic studies suggested the cell degrading potential of the AgNPs, and the FT-IR studies confirmed the involvement of the surface groups in the toxic effects. No significant ion leaching from the AgNPs was observed at the applied concentration levels signifying the dominant role of the particle size, and size distribution in bacterial toxicity. The reduced toxicity for the cells in the consortium than the individual isolates has major significance in further studies on the ecotoxicity of the AgNPs. (C) 2014 Elsevier Inc. All rights reserved.

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The electronic structure of the (La0.8Sr0.2)(0.98)Mn1-xCrxO3 model series (x = 0, 0.05, or 0.1) was measured using soft X-ray synchrotron radiation at room and elevated temperature. O K-edge near-edge X-ray absorption fine structure (NEXAFS) spectra showed that low-level chromium substitution of (La, Sr)MnO3 resulted in lowered hybridisation between O 2p orbitals and M 3d and M 4sp valance orbitals. Mn L-3-edge resonant photoemission spectroscopy measurements indicated lowered Mn 3d-O 2p hybridisation with chromium substitution. Deconvolution of O K-edge NEXAFS spectra took into account the effects of exchange and crystal field splitting and included a novel approach whereby the pre-peak region was described using the nominally filled t(2g) up arrow state. 10% chromium substitution resulted in a 0.17 eV lowering in the energy of the t(2g) up arrow state, which appears to provide an explanation for the 0.15 eV rise in activation energy for the oxygen reduction reaction, while decreased overlap between hybrid O 2p-Mn 3d states was in qualitative agreement with lowered electronic conductivity. An orbital-level understanding of the thermodynamically predicted solid oxide fuel cell cathode poisoning mechanism involving low-level chromium substitution on the B-site of (La, Sr)MnO3 is presented. (C) 2015 AIP Publishing LLC.