Determinants of CD4 cell count decline after treatment interruption

Patients who had started HAART (Highly Active Anti-Retroviral Treatment) under previous aggressive DHHS guidelines (1997) underwent a life-long continuous HAART that was associated with many short term as well as long term complications. Many interventions attempted to reduce those complications including intermittent treatment also called pulse therapy. Many studies were done to study the determinants of rate of fall in CD4 count after interruption as this data would help guide treatment interruptions. The data set used here was a part of a cohort study taking place at the Johns Hopkins AIDS service since January 1984, in which the data were collected both prospectively and retrospectively. The patients in this data set consisted of 47 patients receiving via pulse therapy with the aim of reducing the long-term complications. ^ The aim of this project was to study the impact of virologic and immunologic factors on the rate of CD4 loss after treatment interruption. The exposure variables under investigation included CD4 cell count and viral load at treatment initiation. The rates of change of CD4 cell count after treatment interruption was estimated from observed data using advanced longitudinal data analysis methods (i.e., linear mixed model). Using random effects accounted for repeated measures of CD4 per person after treatment interruption. The regression coefficient estimates from the model was then used to produce subject specific rates of CD4 change accounting for group trends in change. The exposure variables of interest were age, race, and gender, CD4 cell counts and HIV RNA levels at HAART initiation. ^ The rate of fall of CD4 count did not depend on CD4 cell count or viral load at initiation of treatment. Thus these factors may not be used to determine who can have a chance of successful treatment interruption. CD4 and viral load were again studied by t-tests and ANOVA test after grouping based on medians and quartiles to see any difference in means of rate of CD4 fall after interruption. There was no significant difference between the groups suggesting that there was no association between rate of fall of CD4 after treatment interruption and above mentioned exposure variables. ^

The association between CD4+ lymphocyte count and measures of body composition in HIV-infected men

Purpose. This project was designed to describe the association between wasting and CD4 cell counts in HIV-infected men in order to better understand the role of wasting in progression of HIV infection.^ Methods. Baseline and prevalence data were collected from a cross-sectional survey of 278 HIV-infected men seen at the Houston Veterans Affairs Medical Center Special Medicine Clinic, from June 1, 1991 to January 1, 1994. A follow-up study was conducted among those at risk, to investigate the incidence of wasting and the association between wasting and low CD4 cell counts. Wasting was described by four methods. Z-scores for age-, sex-, and height-adjusted weight; sex-, and age-adjusted mid-arm muscle circumference (MAMC); and fat-free mass; and the ratio of extra-cellular mass (ECM) to body-cell mass (BCM) $>$ 1.20. FFM, ECM, and BCM were estimated from bioelectrical impedance analysis. MAMC was calculated from triceps skinfold and mid-arm circumference. The relationship between wasting and covariates was examined with logistic regression in the cross-sectional study, and with Poisson regression in the follow-up study. The association between death and wasting was examined with Cox's regression.^ Results. The prevalence of wasting ranged from 5% (weight and ECM:BCM) to almost 14% (MAMC and FFM) among the 278 men examined. The odds of wasting, associated with baseline CD4 cell count $<$200, was significant for each method but weight, and ranged from 4.6 to 12.7. Use of antiviral therapy was significantly protective of MAMC, FFM and ECM:BCM (OR $\approx$ 0.2), whereas the need for antibacterial therapy was a risk (OR 3.1, 95% CI 1.1-8.7). The average incidence of wasting ranged from 4 to 16 per 100 person-years among the approximately 145 men followed for 160 person-years. Low CD4 cell count seemed to increase the risk of wasting, but statistical significance was not reached. The effect of the small sample size on the power to detect a significant association should be considered. Wasting, by MAMC and FFM, was significantly associated with death, after adjusting for baseline serum albumin concentration and CD4 cell count.^ Conclusions. Wasting by MAMC and FFM were strongly associated with baseline CD4 cell counts in both the prevalence and incidence study and strong predictors of death. Of the two methods, MAMC is convenient, has available reference population data, may be the most appropriate for assessing the nutritional status of HIV-infected men. ^

CHARACTERIZATION OF THE COUNT RATE PERFORMANCE AND EVALUATION OF THE EFFECTS OF HIGH COUNT RATES ON MODERN GAMMA CAMERAS

CHARACTERIZATION OF THE COUNT RATE PERFORMANCE AND EVALUATION OF THE EFFECTS OF HIGH COUNT RATES ON MODERN GAMMA CAMERAS Michael Stephen Silosky, B.S. Supervisory Professor: S. Cheenu Kappadath, Ph.D. Evaluation of count rate performance (CRP) is an integral component of gamma camera quality assurance and measurement of system dead time (τ) is important for quantitative SPECT. The CRP of three modern gamma cameras was characterized using established methods (Decay and Dual Source) under a variety of experimental conditions. For the Decay method, input count rate was plotted against observed count rate and fit to the paralyzable detector model (PDM) to estimate τ (Rates method). A novel expression for observed counts as a function of measurement time interval was derived and the observed counts were fit to this expression to estimate τ (Counts method). Correlation and Bland-Altman analysis were performed to assess agreement in estimates of τ between methods. The dependencies of τ on energy window definition and incident energy spectrum were characterized. The Dual Source method was also used to estimate τ and its agreement with the Decay method under identical conditions and the effects of total activity and the ratio of source activities were investigated. Additionally, the effects of count rate on several performance metrics were evaluated. The CRP curves for each system agreed with the PDM at low count rates but deviated substantially at high count rates. Estimates of τ for the paralyzable portion of the CRP curves using the Rates and Counts methods were highly correlated (r=0.999) but with a small (~6%) difference. No significant difference was observed between the highly correlated estimates of τ using the Decay or Dual Source methods under identical experimental conditions (r=0.996). Estimates of τ increased as a power-law function with decreasing ratio of counts in the photopeak to the total counts and linearly with decreasing spectral effective energy. Dual Source method estimates of τ varied as a quadratic with the ratio of the single source to combined source activities and linearly with total activity used across a large range. Image uniformity, spatial resolution, and energy resolution degraded linearly with count rate and image distorting effects were observed. Guidelines for CRP testing and a possible method for the correction of count rate losses for clinical images have been proposed.

Andrew Radde-Gallwitz, Basil of Caesarea, Gregory of Nyssa, and the Transformation of Divine Simplicity, Oxford University Press, Oxford, 2009; 261 pp. ISBN 978-0-19-957411-7.

Fil: Peretó Rivas, Rubén.

Michael Apple y Basil Bernstein : Teoría sociológica y regulación pedagógica. Dos discursos sobre la Educación y el Poder

Fil: Marano, María Gabriela. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Michael Apple y Basil Bernstein : Teoría sociológica y regulación pedagógica. Dos discursos sobre la Educación y el Poder

Fil: Marano, María Gabriela. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Michael Apple y Basil Bernstein : Teoría sociológica y regulación pedagógica. Dos discursos sobre la Educación y el Poder

Fil: Marano, María Gabriela. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Bird count in Mastbos forest (Breda, Netherlands) in the years 1950 to 1981

Notes from Henrik de Nie: The project started as a phenological study in cooperation with the (Dutch) meteorological institute (KNMI) to register the time of arrival of Fitis and Tjiftaf. During 1951 to 1969 he went every day to the wood (except 1966, in this year his wife died). Thereafter he went no more daily, but because he knew the wood very well and he was free to choice the day on which he did a survey, therefore he choose days with relatively good weather. He did not observe very common bird species, maybe because they are dependent on nest boxes and he did not want to be dependent on the management of the nest box-people (in fact I forgot precisely his arguments, and now I cannot ask him this): Common Starling; Eurasian Tree Sparrow (not common); Great Tit; Eurasian Blue Tit Pieter mentioned 14 species that scored many zero values or only one observation: Stock Dove; Common Cuckoo; Lesser Spotted Woodpecker; Eurasian Golden Oriole; Eurasian Nuthatch; Short-toed Treecreeper; Common Nightingale; Marsh Warbler; Lesser Whitethroat; Goldcrest; Common Firecrest (after 1970 he had difficulties in hearing these two species); Spotted Flycatcher; Eurasian Bullfinch; Black Woodpecker He also mentioned species that he found much fewer as: European Greenfinch; European Pied Flycatcher; Long-eared Owl; Red Crossbill; Sedge Warbler; Icterine Warbler; Eurasian Woodcock; Eurasian Siskin; European Green Woodpecker; Great Spotted Woodpecker; Eurasian Hobby; Western Barn Owl; Woodlark; Common Wood Pigeon; Little Owl; European Crested Tit; Hawfinch. But for these species I think that observations are strongly dependent on the number of visits to the wood. Also here, many zeros and few 1 x during the whole series of visits.