CD4(+) T cell count decreases by ethnicity among untreated patients with HIV infection in South Africa and Switzerland

BACKGROUND: Estimates of the decrease in CD4(+) cell counts in untreated patients with human immunodeficiency virus (HIV) infection are important for patient care and public health. We analyzed CD4(+) cell count decreases in the Cape Town AIDS Cohort and the Swiss HIV Cohort Study. METHODS: We used mixed-effects models and joint models that allowed for the correlation between CD4(+) cell count decreases and survival and stratified analyses by the initial cell count (50-199, 200-349, 350-499, and 500-750 cells/microL). Results are presented as the mean decrease in CD4(+) cell count with 95% confidence intervals (CIs) during the first year after the initial CD4(+) cell count. RESULTS: A total of 784 South African (629 nonwhite) and 2030 Swiss (218 nonwhite) patients with HIV infection contributed 13,388 CD4(+) cell counts. Decreases in CD4(+) cell count were steeper in white patients, patients with higher initial CD4(+) cell counts, and older patients. Decreases ranged from a mean of 38 cells/microL (95% CI, 24-54 cells/microL) in nonwhite patients from the Swiss HIV Cohort Study 15-39 years of age with an initial CD4(+) cell count of 200-349 cells/microL to a mean of 210 cells/microL (95% CI, 143-268 cells/microL) in white patients in the Cape Town AIDS Cohort > or =40 years of age with an initial CD4(+) cell count of 500-750 cells/microL. CONCLUSIONS: Among both patients from Switzerland and patients from South Africa, CD4(+) cell count decreases were greater in white patients with HIV infection than they were in nonwhite patients with HIV infection.

Immune recovery after starting ART in HIV-infected patients presenting and not presenting with tuberculosis in South Africa

We studied the immune response after starting antiretroviral treatment (ART) in 15,646 HIV-infected patients with or without tuberculosis (TB) at presentation in 3 ART programs in South Africa between 2003 and 2010. Patients presenting with TB had similar increases in CD4 cells compared with all other patients (adjusted difference 4.9 cells/µL per 6 months, 95% confidence interval: 0.2 to 9.7). Younger age, advanced clinical stage, female sex, and lower CD4 cell count at ART start were all associated with steeper CD4 slopes. In South Africa, HIV-infected patients presenting with TB experience immune recovery after starting ART that is no worse than in other patients.

Description of the ERA-CLIM historical upper-air data

Historical, i.e. pre-1957, upper-air data are a valuable source of information on the state of the atmosphere, in some parts of the world dating back to the early 20th century. However, to date, reanalyses have only partially made use of these data, and only of observations made after 1948. Even for the period between 1948 (the starting year of the NCEP/NCAR (National Centers for Environmental Prediction/National Center for Atmospheric Research) reanalysis) and the International Geophysical Year in 1957 (the starting year of the ERA-40 reanalysis), when the global upper-air coverage reached more or less its current status, many observations have not yet been digitised. The Comprehensive Historical Upper-Air Network (CHUAN) already compiled a large collection of pre-1957 upper-air data. In the framework of the European project ERA-CLIM (European Reanalysis of Global Climate Observations), significant amounts of additional upper-air data have been catalogued (> 1.3 million station days), imaged (> 200 000 images) and digitised (> 700 000 station days) in order to prepare a new input data set for upcoming reanalyses. The records cover large parts of the globe, focussing on, so far, less well covered regions such as the tropics, the polar regions and the oceans, and on very early upper-air data from Europe and the US. The total number of digitised/inventoried records is 61/101 for moving upper-air data, i.e. data from ships, etc., and 735/1783 for fixed upper-air stations. Here, we give a detailed description of the resulting data set including the metadata and the quality checking procedures applied. The data will be included in the next version of CHUAN. The data are available at doi:10.1594/PANGAEA.821222

Adapting to climate change through sustainable land management: experiences of a pilot project in Tajikistan

Tajikistan is particularly exposed to the risks of climate change. Its widely degraded landscapes are badly prepared to cope with changes in precipitation patterns, increased temperatures, droughts, and the spread of pests and disease. Sustainable land management (SLM) provides a “basket of opportunities” to address these challenges, particularly for increasing land productivity, improving livelihoods, and protecting ecosystems. Within the Pilot Program for Climate Resilience (PPCR) in Tajikistan 70 SLM technologies and approaches on how to implement SLM were documented with the World Overview of Conservation Approaches and Technologies (WOCAT ) tools in 2011. For this purpose a climate change adaptation module was developed and tested in order to enhance the understanding about climate change resilience of SLM practices and community workshops conducted to on adaptation mechanisms by rural communities in Tajikistan. The analysis came up with four guiding principles for applying SLM for adapting to climate change: 1. Diversification of land use technologies and farm incomes; 2. Intensification of use of natural resources; 3. Expansion of highly productive land use technologies; 4. Protection of land and livelihoods from extreme weather events. Furthermore, SLM must be up-scaled from isolated plots to entire zones or landscapes and the project developed the concept of three concentric villages zones, the in-, near- and off-village zones. Land users, advisors, and decision- and policy makers face the task of finding management practices that best suit site-specific conditions. This task is most efficiently addressed in collaborative effort, and building up and managing a respective knowledge platform.

A Transatlantic Trade and Investment Partnership Agreement: Implications for Swiss Agriculture

To say that regionalism is gaining momentum has become an understatement. To mourn the lack of progress in multilateral trade rule-making is a commonplace in the discourse of politicians regretting the WTO negotiation standstill, and of “know-what-to-do” academics. The real problem is the uneven level-playing field resulting from increasing differences of rules and obligations. The Transatlantic Trade and Investment Partnership Agreement (TTIP) is a very ambitious project. WTI studies in 2014 have shown that the implications for Switzerland could be enormous. But even the combined market power of the two TTIP participants – the EU and the USA – will not level the playing field impairing the regulatory framework, and the market access barriers for trade in agriculture. Such differences will remain in three areas which, incidentally, are also vital for a global response to the food security challenge to feed 9 billion people before the year 2050: market access, non-tariff barriers, and trade-distorting domestic support programmes. This means that without multilateral progress the TTIP and other so-called mega-regionals, if successfully concluded, will exacerbate rather than lessen trade distortions. While this makes farmers in rich countries safer from competition, competitive production in all countries will be hampered. Consequently, and notwithstanding the many affirmations to the contrary, farm policies worldwide will continue to only address farmer security without increasing global food security. What are the implications of the TTIP for Swiss agriculture? This article, commissioned by Waseda University in Tokyo, finds that the failure to achieve further reforms – including a number of areas where earlier reforms have been reversed – is presenting Switzerland and Swiss agriculture with a terrible dilemma in the eventuality of a successful conclusion of the TTIP. If Swiss farm production is to survive for more than another generation, continuous reform efforts are required, and over-reliance on the traditional instruments of border protection and product support is to be avoided. Without a substantial TTIP obliging Switzerland to follow suit, autonomous reforms will remain extremely fragile.

Seven years of annual pollen influx at the forest limit in the Swiss Alps studied by pollen traps: relations to vegetation and climate

Annual pollen influx has been monitored in short transects across the altitudinal tree limit in four areas of the Swiss Alps with the use of modified Tauber traps placed at the ground surface. The study areas are Grindelwald (8 traps), Aletsch (8 traps), Simplon (5 traps), and Zermatt (5 traps). The vegetation around the traps is described. The results obtained are: (1) Peak years of pollen influx (one or two in seven years) follow years of high average air temperatures during June–November of the previous year for Larix and Picea, and less clearly for Pinus non-cembra, but not at all for Pinus cembra and Alnus viridis. (2) At the upper forest limit, the regional pollen influx of trees (trees absent within 100 m of the pollen trap) relates well to the average basal area of the same taxon within 10–15 km of the study areas for Pinus cembra, Larix, and Betula, but not for Picea, Pinus non-cembra, and Alnus viridis. (3) The example of Zermatt shows that pollen influx characterises the upper forest limit, if the latter is more or less intact. (4) Presence/absence of Picea, Pinus cembra, Larix, Pinus non-cembra, and Alnus viridis trees within 50–100 m of the traps is apparent in the pollen influx in peak years of pollen influx but not in other years, suggesting that forest-limit trees produce significant amounts of pollen only in some years. (5) Pollen influx averaged over the study period correlates well with the abundance of plants around the pollen traps for conifer trees (but not deciduous trees), Calluna, Gramineae, and Cyperaceae, and less clearly so Compositae Subfam. Cichorioideae and Potentilla-type. (6) Influx of extra-regional pollen derived from south of the Alps is highest in Simplon, which is open to southerly winds, slightly lower in Aletsch lying just north of Simplon, and lowest in Zermatt sheltered from the south by high mountains and Grindelwald lying north of the central Alps.

Innovation and Development in the Age of Climate Change Adaptation: Open or Closed?

Change Adaptation: Open or Closed? Paper read at the Second African International Economic Law Network Conference, 7-8 March 2013, Wits School of Law, Johannesburg, South Africa. In a time of rapid convergence of technologies, goods, services, hardware, software, the traditional classifications that informed past treaties fail to remove legal uncertainty, or advance welfare and innovation. As a result, we turn our attention to the role and needs of the public domain at the interface of existing intellectual property rights and new modes of creation, production and distribution of goods and services. The concept of open culture would have it that knowledge should be spread freely and its growth should come from further developing existing works on the basis of sharing and collaboration without the shackles of intellectual property. Intellectual property clauses find their way into regional, multilateral, bilateral and free trade agreements more often than not, and can cause public discontent and incite unrest. Many of these intellectual property clauses raise the bar on protection beyond the clauses found in the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). In this paper we address the question of the protection and development of the public domain in service of open innovation in accord with Article 15 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) in light of the Objectives (Article 7) and Principles (Article 8) set forth in TRIPS. Once areas of divergence and reinforcement between the intellectual property regime and human rights have been discussed, we will enter into options that allow for innovation and prosperity in the global south. We then conclude by discussing possible policy developments.