Generation of a recombinant Gag virus-like-particle panel for the evaluation of p24 antigen detection by diagnostic HIV tests.

BACKGROUND Detection of HIV-1 p24 antigen permits early identification of primary HIV infection and timely intervention to limit further spread of the infection. Principally, HIV screening should equally detect all viral variants, but reagents for a standardised test evaluation are limited. Therefore, we aimed to create an inexhaustible panel of diverse HIV-1 p24 antigens. METHODS We generated a panel of 43 recombinantly expressed virus-like particles (VLPs), containing the structural Gag proteins of HIV-1 subtypes A-H and circulating recombinant forms (CRF) CRF01_AE, CRF02_AG, CRF12_BF, CRF20_BG and group O. Eleven 4th generation antigen/antibody tests and five antigen-only tests were evaluated for their ability to detect VLPs diluted in human plasma to p24 concentrations equivalent to 50, 10 and 2 IU/ml of the WHO p24 standard. Three tests were also evaluated for their ability to detect p24 after heat-denaturation for immune-complex disruption, a pre-requisite for ultrasensitive p24 detection. RESULTS Our VLP panel exhibited an average intra-clade p24 diversity of 6.7%. Among the 4th generation tests, the Abbott Architect and Siemens Enzygnost Integral 4 had the highest sensitivity of 97.7% and 93%, respectively. Alere Determine Combo and BioRad Access were least sensitive with 10.1% and 40.3%, respectively. Antigen-only tests were slightly more sensitive than combination tests. Almost all tests detected the WHO HIV-1 p24 standard at a concentration of 2 IU/ml, but their ability to detect this input for different subtypes varied greatly. Heat-treatment lowered overall detectability of HIV-1 p24 in two of the three tests, but only few VLPs had a more than 3-fold loss in p24 detection. CONCLUSIONS The HIV-1 Gag subtype panel has a broad diversity and proved useful for a standardised evaluation of the detection limit and breadth of subtype detection of p24 antigen-detecting tests. Several tests exhibited problems, particularly with non-B subtypes.

Identifying observable criteria defining a critical situation involving football fans: an expert focus group study

Critical situations (CSs) involving football fans is a well-researched phenomenon with most studies examining factors leading to an escalation of violence (e.g. Braun & Vliegenthart, 2008). However, research so far has fallen short of analysing CSs that do not escalate (e.g. Hylander & Guvå, 2010) as well as establishing observable criteria that constitute such CSs. Granström et al. (2009), for instance, put forward a definition of a CS describing such situations as characterised by a discrepancy between peace and war-making behaviours between police and demonstrators. Still, this definition remains vague and does not provide concrete, defining criteria that can be identified on site. The present study looks beyond fans’ violent acts per se and focuses on these situations with a potentially – but not necessarily - violent outcome. The aim of this preliminary study is to identify observable criteria defining such a CS involving football fans. This focus group comprised of five experts working with football fans in the German-speaking area of Switzerland who discussed observable characteristics of a CS. Inductive content analysis led to the identification of specific criteria such as, “arrest of a fan”, “insufficient distance (<30m) between fans and police” and “fans mask themselves”. These criteria were then assigned to four phases of a CS highlighting the dynamic aspect of this phenomenon: Antecedents, Causes, Reactions, Consequence. Specifically, Causes, Reactions and Consequences are observable on site, while Antecedents include relevant, background information directly influencing a CS. This study puts forward a working definition of a CS that can facilitate the assessment of actual situations in the football context as well as for further research on fan violence prevention and control. These results also highlight similarities with studies investigating fan violence in other European countries while acknowledging unique characteristics of the Swiss German fan culture.

Decomposition studies of group 6 hexacarbonyl complexes. Part 1: Production and decomposition of Mo(CO)6 and W(CO)6

Chemical studies of superheavy elements require fast and efficient techniques, due to short half-lives and low production rates of the investigated nuclides. Here, we advocate for using a tubular flow reactor for assessing the thermal stability of the Sg carbonyl complex – Sg(CO)6. The experimental setup was tested with Mo and W carbonyl complexes, as their properties are established and supported by theoretical predictions. The suggested approach proved to be effective in discriminating between the thermal stabilities of Mo(CO)6 and W(CO)6. Therefore, an experimental verification of the predicted Sg–CO bond dissociation energy seems to be feasible by applying this technique. By investigating the effect of 104,105Mo beta-decay on the formation of 104,105Tc carbonyl complex, we estimated the lower reaction time limit for the metal carbonyl synthesis in the gas phase to be more than 100 ms. We examined further the influence of the wall material of the recoil chamber, the carrier gas composition, the gas flow rate, and the pressure on the production yield of 104Mo(CO)6, so that the future stability tests with Sg(CO)6 can be optimized accordingly.

Mycobacterium saopaulense sp. nov., a rapidly growing mycobacterium closely related to members of the Mycobacterium chelonae--Mycobacterium abscessus group

Five isolates of non-pigmented, rapidly growing mycobacteria were isolated from three patients and,in an earlier study, from zebrafish. Phenotypic and molecular tests confirmed that these isolates belong to the Mycobacterium chelonae-Mycobacterium abscessus group, but they could not be confidently assigned to any known species of this group. Phenotypic analysis and biochemical tests were not helpful for distinguishing these isolates from other members of the M. chelonae–M.abscessus group. The isolates presented higher drug resistance in comparison with other members of the group, showing susceptibility only to clarithromycin. The five isolates showed a unique PCR restriction analysis pattern of the hsp65 gene, 100 % similarity in 16S rRNA gene and hsp65 sequences and 1-2 nt differences in rpoB and internal transcribed spacer (ITS) sequences.Phylogenetic analysis of a concatenated dataset including 16S rRNA gene, hsp65, and rpoB sequences from type strains of more closely related species placed the five isolates together, as a distinct lineage from previously described species, suggesting a sister relationship to a group consisting of M. chelonae, Mycobacterium salmoniphilum, Mycobacterium franklinii and Mycobacterium immunogenum. DNA–DNA hybridization values .70 % confirmed that the five isolates belong to the same species, while values ,70 % between one of the isolates and the type strains of M. chelonae and M. abscessus confirmed that the isolates belong to a distinct species. The polyphasic characterization of these isolates, supported by DNA–DNA hybridization results,demonstrated that they share characteristics with M. chelonae–M. abscessus members, butconstitute a different species, for which the name Mycobacterium saopaulense sp. nov. is proposed. The type strain is EPM10906T (5CCUG 66554T5LMG 28586T5INCQS 0733T).

Alpha C protein of group B Streptococcus as a potential vaccine candidate

Group B Streptococcus (GBS) is a leading cause of life-threatening infection in neonates and young infants, pregnant women, and non-pregnant adults with underlying medical conditions. Immunization has theoretical potential to prevent significant morbidity and mortality from GBS disease. Alpha C protein (α C), found in 70% of non-type III capsule polysaccharide group B Streptococcus, elicits antibodies protective against α C-expressing strains in experimental animals and is an appealing carrier for a GBS conjugate vaccine. We determined whether natural exposure to α C elicits antibodies in women and if high maternal α C-specific serum antibody at delivery is associated with protection against neonatal disease. An ELISA was designed to measure α C-specific IgM and IgG in human sera. A case-control design (1:3 ratio) was used to match α C-expressing GBS colonized and non-colonized women by age and compare quantified serum α C-specific IgM and IgG. Sera also were analyzed from bacteremic neonates and their mothers and from women with invasive GBS disease. Antibody concentrations were compared using t-tests on log-transformed data. Geometric mean concentrations of α C-specific IgM and IgG were similar in sera from 58 α C strain colonized and 174 age-matched non-colonized women (IgG 245 and 313 ng/ml; IgM 257 and 229 ng/ml, respectively). Delivery sera from mothers of 42 neonates with GBS α C sepsis had similar concentrations of α C-specific IgM (245 ng/ml) and IgG (371 ng/ml), but acute sera from 13 women with invasive α C-expressing GBS infection had significantly higher concentrations (IgM 383 and IgG 476 ng/ml [p=0.036 and 0.038, respectively]). Convalescent sera from 5 of these women 16-49 days later had high α C-specific IgM and IgG concentrations (1355 and 4173 ng/ml, respectively). In vitro killing of α C-expressing GBS correlated with total α C-specific antibody concentration. Invasive disease but not colonization elicits α C-specific IgM and IgG in adults. Whether α C-specific IgG induced by vaccine would protect against disease in neonates merits further investigation. ^

Epidemiological characteristics and diagnostic approach in patients admitted to the emergency room for transient loos of consciousness: Group for Syncope Study in the Emergency Room (GESINUR) study

Aims: To assess the clinical presentation and acute management of patients with transient loss of consciousness (T-LOC) in the emergency department (ED). Methods and results: A multi-centre prospective observational study was carried out in 19 Spanish hospitals over 1 month. The patients included were 14 years old and were admitted to the ED because of an episode of T-LOC. Questionnaires and corresponding electrocardiograms (ECGs) were reviewed by a Steering Committee (SC) to unify diagnostic criteria, evaluate adherence to guidelines, and diagnose correctly the ECGs. We included 1419 patients (prevalence, 1.14%).ECG was performed in 1335 patients (94%) in the ED: 498 (37.3%) ECGs were classified as abnormal. The positive diagnostic yield ranged from 0% for the chest X-ray to 12% for the orthostatic test. In the ED, 1217 (86%) patients received a final diagnosis of syncope, whereas the remaining 202 (14%) were diagnosed of non-syncopal transient lossof consciousness (NST-LOC). After final review by the SC, 1080 patients (76%) were diagnosed of syncope, whereas 339 (24%) were diagnosed of NST-LOC (P , 0.001). Syncope was diagnosed correctly in 84% of patients. Only 25% of patients with T-LOC were admitted to hospitals. Conclusion Adherence to clinical guidelines for syncope management was low; many diagnostic tests were performed with low diagnostic yield. Important differences were observed between syncope diagnoses at the ED and by SC decision.

Sola romani: morteros hidráulicos romanos en la Península Ibérica

En esta investigación se han analizado morteros de cal de cronología romana en el interior de la Península Ibérica. Para ello, se seleccionó una serie de muestras procedentes de diversos yacimientos, y de estructuras de carácter industrial. Estas muestras presentan aditivos cerámicos y conglomerantes de cal, como característica principal. Desde un principio el esfuerzo debía de centrarse en los fragmentos cerámicos presentes en los morteros. Para ello se documentaron varios morteros con aditivos cerámicos, a fin de conocer sus características básicas (componentes, distribución, micro-estratigrafía, granulometría, etc.). Por ello, y una vez tomadas las muestras, ésta fueron tratadas y procesadas para desarrollar una primera fase de estudio por medio de macroscopía. Se obtuvieron buenos resultados en cuanto a la caracterización visual de los morteros, localizando y documentando los fragmentos cerámicos. Durante la observación de dichos aditivos se observó que los fragmentos cerámicos tenían unas coronas o anillos de coloración que recorrían el borde, justo al contacto con la matriz de cal. Fueron seleccionados algunos fragmentos en los que eran más visibles dichos anillos. A fin de conocer la posible relación entre algunos yacimientos cercanos y la presencia de dicho anillo cromáticos se desarrolló una microscopía óptica polarizada, realizando láminas delgadas de las muestras y sobre los fragmentos cerámicos más determinantes, en concreto de una serie de enclaves del valle del Henares. Además de caracterizar microscópicamente los morteros, se observó que los anillos no eran un defecto visual ni una alteración física, producida tal vez por la extracción, la fase del corte o por la cocción de la cerámica. Tras analizar varios ejemplares se pudo apreciar que esos anillos eran habituales en todas las muestras y que se presentaban de diferente manera, es decir, que se observaban en granos cerámicos de diferentes características físicas (cochura, tamaño, situación con respecto del conglomerante, etc.). A fin de conocer los aspectos químicos de dicha alteración se seleccionó un grupo de muestras en las que los resultados macroscópicos habían sido muy claros, y en las que la microscopía óptica polarizada había determinado en los bordes, áreas adecuadas para otros análisis. Se realizó un mapeado o mapping de elementos químicos, a fin de saber qué podía estar sucediendo en esa interfaz entre el fragmento cerámico y la matriz de cal. Gracias a los resultados obtenidos se comprobó que existía una acumulación potencial de calcio tanto en el interior de los granos cerámicos como en el exterior, justo en la zona de contacto con el conglomerante, formando manchas que recorrían longitudinalmente el borde. Estos datos fueron muy útiles para llevar a cabo la siguiente fase de estudio, que permitiría conocer puntualmente qué estaba sucediendo químicamente en esa zona de contacto. Finalmente y con el objetivo de describir química y puntualmente este efecto en las adiciones cerámicas, se volvió a seleccionar una serie de muestras, escogidas esta vez en función de los granos cerámicos que cumpliesen unas variables estadísticas. Se eligieron granos con distintos tipos de cocciones, así como granos con tamaños diversos y granos con aditivo ceniciento en la matriz de cal, pensando que podrían ser las variables más útiles de interpretar de existir algún tipo de cambio químico entre la arcilla cocida y la matriz de cal. Tales variables se adaptaron a un sistema estadístico multi-varial y geométrico, con el objetivo de sintetizar los resultados y visualizar de forma óptima los datos en conjunto, como se ha comentado en varias ocasiones en este trabajo. Una vez seleccionados los granos por variables se procedió a realizar un análisis lineal y espectral semi-cuantitativo de SEM-EDX, con el que se caracterizaba químicamente una sección lineal del grano, desde la matriz de arcilla cocida de la cerámica hasta la matriz de cal –del interior al exterior del grano- pasando por el centro de la banda de reacción. Este análisis permitió determinar que se había producido una serie de cambios químicos porcentuales en los granos de cerámica. Dichos cambios se resumen en un incremento global de los porcentajes de calcio en el interior de las bandas de reacción de la cerámica, desde el borde mismo del anillo hasta el exterior. Así también se observaron picos porcentuales en el interfaz del fragmento cerámico con la matriz de cal, lo que confirmaba los resultados obtenidos por medio del mapping. Globalmente en todas las muestras se apreció un hombro en las gráficas de calcio a su paso por la zona de afección del anillo de reacción. Los restantes porcentajes de magnesio, silicio y aluminio se mantienen normales. En esta tesis se ha confirmado que dicho incremento global de calcio se acentúa en las muestras en donde no hay cenizas en la matriz de cal. Los casos correspondientes a estos granos sufren un incremento mayor que en el resto. La segunda variable que sufre un mayor incremento de calcio es la que corresponde a granos con buena cocción de la arcilla. Por lo tanto, parece que la tercera variable, la que corresponde con el tamaño del fragmento cerámico, no es decisiva. Por lo tanto, teniendo en cuenta la prueba visual de los anillos de reacción, y atendiendo a los resultados químicos, podríamos pensar que ese incremento de calcio en la banda de reacción de los fragmentos cerámicos se debió a una absorción de calcio en el interior de la arcilla cocida en la fase inmediatamente previa al fraguado, incluso durante el apagado de la cal. Es en este punto donde estaría la clave del cambio químico que se produce en esta interfaz, el calcio sílice-aluminato del que algunos autores ya han investigado. Esta absorción de calcio en el interior del grano no vendría sola, sino que generaría una costra de cal en el interfaz exterior de la cerámica, la cual ha sido observada químicamente por mapping y mineralógicamente por medio de microscopía óptica de polarización. La consecuencia de estos resultados es, primero, la mejora de nuestro conocimiento general acerca del factor hidráulico en los morteros. Asimismo se aprecia que la incorporación de materiales orgánicos como cenizas, puede alterar los porcentajes de calcio en el interior de los aditivos cerámicos, por lo que habría que sopesar, en trabajos futuros, si este tipo de material es adecuado o no en las mezclas destinadas a la restauración, así como seguir indagando en las propiedades de los morteros con la incorporación de aditivos orgánicos. Desde el punto de vista de la catalogación de los suelos industriales hidráulicos de época romana, además de mejorar la documentación incorporando micro-estratigrafías y granulometrías, la investigación de este material histórico constructivo mejora en cuanto a que se incorporan ensayos sencillos, que facilitan incluso la peritación de un estado de conservación por medio de una lupa binocular. Arqueológicamente hablando, es muy interesante correlacionar fábricas diferentes de estructuras situadas o bien en un mismo yacimiento, o bien en una misma área regional. Los estudios de caracterización y micro-estratigrafía no sólo aportan datos nuevos de cara a la restauración de morteros, sino que crean la posibilidad de generar patrones constructivos que sirvan de fósiles-guía para datar relativamente a unas estructuras o a otras. En lo referido a los resultados obtenidos en los diferentes complejos arqueológicos se ha observado una diferencia entre los morteros destinados a piletas y cubetas con respecto a los suelos industriales de uso indeterminado. La muestra correspondiente al yacimiento de Las Arenas no dispone de ninguna micro-estratigrafía, como sí por el contrario en las muestras obtenidas en Rotonda de Mejorada, Val de la Viña y La Magdalena. En estos enclaves las estructuras presentan grandes similitudes, con diferentes niveles constructivos empleando morteros de cal con áridos y gravas en las capas interiores, y áridos con adiciones cerámicas en las exteriores. En lo relativo a la granulometría las adiciones cerámicas de las muestras de Val de la Viña y La Magdalena presentan varias coincidencias en cuanto al tamaño de los granos y la distribución. Asimismo, de las muestras tomadas en La Magdalena, existe una gran diferencia entre las muestras MG1, MG2, MG3 y MG4 con respecto a las muestras MG5 y MG6, correspondientes éstas últimas a un mortero con fragmentos cerámicos de gran tamaño. Las estructuras EMG1 y EMG2, correspondientes a una cubeta y una pileta de La Magdalena, guardan similitud en lo referido a la micro-estratigrafía y a la granulometría. Se ha determinado que su función, así como su fabricación, debieron estar vinculadas a un mismo contexto cronocultural. Química y mineralógicamente, las muestras presentan características iguales, con presencia de un conglomerante de cal con áridos y aditivos cerámicos de diferentes cochuras. Destaca la muestra de Las Arenas, con un tamaño de los fragmentos cerámicos muy superior al resto, seguido de la estructura EMG3 de La Magdalena. Las muestras restantes de éste enclave, junto con las muestras recogidas en Val de la Viña y Rotonda de Mejorada presentan condiciones similares. En conclusión, los datos revelan que existían diferentes fábricas destinadas a distintas finalidades, y que las estructuras industriales empleaban aditivos cerámicos para la manipulación de productos con líquidos, de distintas densidades pero que requerían de cierto grado de hidraulicidad. ABSTRACT Lime Roman mortars from the Iberian Peninsula has been analyzed in this reesearch. A group of samples were selected from some sites and all the samples come from industrial structures. All this samples show ceramic additives. From the start, the effort was centered in the pieces of pottery that were found in the mortars. The samples were treated and processed to develop a first phase of the research using macroscopy. With this technique, great results were achieved in the characterization of mortars, the microstratigraphy and the location of the ceramic pieces. While observing these pieces, it was seen that the fragments of pottery had a ring bordering the piece. The pieces with the bigger and more vivid rings were chosen and they were analyzed by a polarized light microscope. The mortars were characterized microscopically and it also showed that the rings were not a physical alteration or a visual defect. After some more tests, the rings were a chemical change associated with the hydraulicity of the mortar. The best samples were selected and mappings of their chemical elements were performed in order to know what could be happening in the interface between the ceramic matrix fragment and lime. With the results obtained it was found that there was a potential; both calcium accumulation within the ceramic grains and outside, just in the area of contact with the binder, forming spots longitudinally along the edge. These data were very useful for carrying out the next phase of study, which would meet promptly what was happening chemically in the area of contact. Another group of samples were taken, and this time focused on ceramic grains that met a statistical variables. Grains were chosen with two types of cooking as well as grains with different sizes and grains with ash additive in the matrix of lime, thinking that might be the most logical to be some sort of chemical change between the baked clay and lime array variables . Such variables were adapted to a multi-varial and geometric statistical system in order to synthesize the results and optimally display the data together, as mentioned several times in this work. After selecting the variables grains proceeded to perform a linear and spectral analysis SEM-EDX. This analysis led to determine that the chemical changes were graduals. These changes are summarized in an increase in the percentages of calcium inside the reaction rim of ceramics, from the edge to the outer ring. So percentage increasing is also observed at the interface of the ceramic matrix fragment with lime, confirming the results obtained by the mapping. Overall in all samples can be seen a shoulder in graphic calcium through the area of the ring reaction condition. The remaining percentages of magnesium, silicon and aluminum are usual. We have promptly confirmed that the increase of calcium is accentuated in samples where there is no ash and lime matrix. Cases for these grains suffer a greater increase than the rest. The second variable suffering more calcium is increased corresponding to good cooking grains with clay. Therefore, it appears that the variable size of the fragment is not critical. Therefore, considering the visual tests to the rings and their response to chemical results, we might think that increasing calcium inside the ceramic fragments was due to an injection of calcium inside clay in the run-up to the setting phase. It is at this point that would be the key to the chemical change that occurs at this interface, silica-calcium aluminate some authors have already investigated. This injection of calcium into the grain does not come alone, but generate a lime crust on the outside interface of ceramics, which we tested for mapping is real in our samples. The consequence of these results is the improvement of our understanding of historical hydraulic factor in building materials, such as mortar. For example, knowing that the incorporation of organic materials such as ash powder, may be detrimental to the injection of calcium inside the ceramic additives. Archaeologically speaking, it's very interesting to correlate different factories or structures located on a single site, or in the same regional area. Characterization studies and microstratigraphy not only provide new information to help restore mortars, but create the possibility of generating constructive patterns that serve as guide fossils to determinate the age of the structures. With regard to the results obtained in different archaeological sites it has seen a difference between mortars of pools or sinks with respect to industrial floors of undetermined use. The sample of the site of Las Arenas does not have any micro-stratigraphy, as if instead in the samples obtained in Rotonda de Mejorada, Val de la Viña and La Magdalena sites. In these settlements the structures are really similar, with different construction levels using lime mortars with aggregates and gravel in the inner layers, and ceramic aggregates as external additions. With regard to the grain size of the ceramic additions Val de la Viña and La Magdalena samples has several coincidences about the size of grains and distribution. Also, samples taken at La Magdalena, there is a difference between the MG1, MG2, MG3 and MG4 samples and the MG5 and MG6 samples, so the last corresponding to a mortar samples with larger ceramic fragments. The EMG1 and EMG2 structures, corresponding to a bucket and a pool of La Magdalena settlement, have similarities with regard to micro-stratigraphy and grain size. It has been determined that the function and manufacturing must be linked with a same chronocultural context.

Improving some thermodynamic consistency tests for VLE data evaluation

Thermodynamics Conference 2013 (Statistical Mechanics and Thermodynamics Group of the Royal Society of Chemistry), The University of Manchester, 3-6 September 2013.

Group-Based Symptom Trajectories in Indicated Prevention of Adolescent Depression

Background: Adolescent depression prevention research has focused on mean intervention outcomes, but has not considered heterogeneity in symptom course. Here, we empirically identify subgroups with distinct trajectories of depressive symptom change among adolescents enrolled in two indicated depression preven- tion trials and examine how cognitive-behavioral (CB) interventions and baseline predictors relate to trajectory membership. Methods: Six hundred thirty-one participants were assigned to one of three conditions: CB group intervention, CB bibliotherapy, and brochure control. We used group-based trajectory modeling to identify trajectories of depressive symptoms from pretest to 2-year follow-up. We examined associations between class membership and conditions using chi- square tests and baseline predictors using multinomial regressions. Results: We identified four trajectories in the full sample. Qualitatively similar trajectories were found in each condition separately. Two trajectories of positive symptom course (low-declining, high-declining) had declining symptoms and were dis- tinguished by baseline symptom severity. Two trajectories of negative course (high-persistent, resurging), respectively, showed no decline in symptoms or de- cline followed by symptom reappearance. Participants in the brochure control condition were significantly more likely to populate the high-persistent trajectory relative to either CB condition and were significantly less likely to populate the low-declining trajectory relative to CB group. Several baseline factors predicted trajectory classes, but gender was the most informative prognostic factor, with males having increased odds of membership in a high-persistent trajectory rel- ative to other trajectories. Conclusions: Findings suggest that CB preventive interventions do not alter the nature of trajectories, but reduce the risk that adolescents follow a trajectory of chronically elevated symptoms.

Genotypic Resistance Tests Sequences Reveal the Role of Marginalized Populations in HIV-1 Transmission in Switzerland.

Targeting hard-to-reach/marginalized populations is essential for preventing HIV-transmission. A unique opportunity to identify such populations in Switzerland is provided by a database of all genotypic-resistance-tests from Switzerland, including both sequences from the Swiss HIV Cohort Study (SHCS) and non-cohort sequences. A phylogenetic tree was built using 11,127 SHCS and 2,875 Swiss non-SHCS sequences. Demographics were imputed for non-SHCS patients using a phylogenetic proximity approach. Factors associated with non-cohort outbreaks were determined using logistic regression. Non-B subtype (univariable odds-ratio (OR): 1.9; 95% confidence interval (CI): 1.8-2.1), female gender (OR: 1.6; 95% CI: 1.4-1.7), black ethnicity (OR: 1.9; 95% CI: 1.7-2.1) and heterosexual transmission group (OR:1.8; 95% CI: 1.6-2.0), were all associated with underrepresentation in the SHCS. We found 344 purely non-SHCS transmission clusters, however, these outbreaks were small (median 2, maximum 7 patients) with a strong overlap with the SHCS'. 65% of non-SHCS sequences were part of clusters composed of >= 50% SHCS sequences. Our data suggests that marginalized-populations are underrepresented in the SHCS. However, the limited size of outbreaks among non-SHCS patients in-care implies that no major HIV outbreak in Switzerland was missed by the SHCS surveillance. This study demonstrates the potential of sequence data to assess and extend the scope of infectious-disease surveillance.

Group-Based Symptom Trajectories in Indicated Prevention of Adolescent Depression

Background: Adolescent depression prevention research has focused on mean intervention outcomes, but has not considered heterogeneity in symptom course. Here, we empirically identify subgroups with distinct trajectories of depressive symptom change among adolescents enrolled in two indicated depression preven- tion trials and examine how cognitive-behavioral (CB) interventions and baseline predictors relate to trajectory membership. Methods: Six hundred thirty-one participants were assigned to one of three conditions: CB group intervention, CB bibliotherapy, and brochure control. We used group-based trajectory modeling to identify trajectories of depressive symptoms from pretest to 2-year follow-up. We examined associations between class membership and conditions using chi- square tests and baseline predictors using multinomial regressions. Results: We identified four trajectories in the full sample. Qualitatively similar trajectories were found in each condition separately. Two trajectories of positive symptom course (low-declining, high-declining) had declining symptoms and were dis- tinguished by baseline symptom severity. Two trajectories of negative course (high-persistent, resurging), respectively, showed no decline in symptoms or de- cline followed by symptom reappearance. Participants in the brochure control condition were significantly more likely to populate the high-persistent trajectory relative to either CB condition and were significantly less likely to populate the low-declining trajectory relative to CB group. Several baseline factors predicted trajectory classes, but gender was the most informative prognostic factor, with males having increased odds of membership in a high-persistent trajectory rel- ative to other trajectories. Conclusions: Findings suggest that CB preventive interventions do not alter the nature of trajectories, but reduce the risk that adolescents follow a trajectory of chronically elevated symptoms.

The Impact of a Group Health Cooperative HPV Vaccination Promotion Program on Initiation of the HPV Vaccine

Thesis (Master's)--University of Washington, 2016-06

Genetic and environmental sources of covariance between reading tests used in neuropsychological assessment and IQ subtests

In this study, we examined genetic and environmental influences on covariation among two reading tests used in neuropsychological assessment (Cambridge Contextual Reading Test [CCRT], [Beardsall, L., and Huppert, F. A. ( 1994). J. Clin. Exp. Neuropsychol. 16: 232 - 242], Schonell Graded Word Reading Test [SGWRT], [ Schonell, F. J., and Schonell, P. E. ( 1960). Diagnostic and attainment testing. Edinburgh: Oliver and Boyd.]) and among a selection of IQ subtests from the Multidimensional Aptitude Battery (MAB), [Jackson, D. N. (1984). Multidimensional aptitude battery, Ontario: Research Psychologists Press.] and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) [Wechsler, D. (1981). Manual for the Wechsler Adult Intelligence Scale-Revised (WAIS-R). San Antonio: The Psychological Corporation]. Participants were 225 monozygotic and 275 dizygotic twin pairs aged from 15 years to 18 years ( mean, 16 years). For Verbal IQ subtests, phenotypic correlations with the reading tests ranged from 0.44 to 0.65. For Performance IQ subtests, phenotypic correlations with the reading tests ranged from 0.23 to 0.34. Results of Structural Equation Modeling (SEM) supported a model with one genetic General factor and three genetic group factors ( Verbal, Performance, Reading). Reading performance was influenced by the genetic General factor ( accounting for 13% and 20% of the variance for the CCRT and SGWRT, respectively), the genetic Verbal factor ( explaining 17% and 19% of variance for the CCRT and SGWRT), and the genetic Reading factor ( explaining 21% of the variance for both the CCRT and SGWRT). A common environment factor accounted for 25% and 14% of the CCRT and SGWRT variance, respectively. Genetic influences accounted for more than half of the phenotypic covariance between the reading tests and each of the IQ subtests. The heritabilities of the CCRT and SGWRT were 0.54 and 0.65, respectively. Observable covariance between reading assessments used by neuropsychologists to estimate IQ and IQ subtests appears to be largely due to genetic effects.

Noninvasive tests for arterial structure, function, and compliance: Do they identify risk or diagnose disease?

Background: Brachial artery reactivity (BAR), carotid intima-media thickness (IMT), and applanation tonometry for evaluation of total arterial compliance may provide information about preclinical vascular disease. We sought to determine whether these tests could be used to identify patients with coronary artery disease (CAD) without being influenced by their ability to identify those at risk ford CAD developing. Methods: We studied 100 patients and compared 3 groups: 35 patients with known CAD; 34 patients with symptoms and risk factors but no CAD identified by stress echocardiography (risk group); and 31 control subjects. BAR and IMT were measured using standard methods, and total arterial compliance was calculated by the pulse-pressure method from simultaneous radial applanation tonometry and pulsed wave Doppler of the left ventricular outflow. Ischemia was identified as a new or worsening wall-motion abnormality induced by stress. Results: In a comparison between the control subjects and patients either at risk for developing CAD or with CAD, the predictors of risk for CAD were: age (P = .01); smoking history (P = .002); hypercholesterolemia (P = .002); and hypertension (P = .004) (model R = 0.82; P = .0001). The independent predictors of CAD were: IMT (P = .001); BAR (P = .04); sex (P = .005); and hypertension (P = .005) (model R = 0.80; P = .0001). Conclusion: IMT, BAR, and traditional cardiovascular risk factors appear to identify patients at risk for CAD developing. However, only IMT was significantly different between patients at risk for developing CAD and those with overt CAD.