Choice of Initial Combination Antiretroviral Therapy in Individuals With HIV Infection: Determinants and Outcomes.

BACKGROUND Current guidelines give recommendations for preferred combination antiretroviral therapy (cART). We investigated factors influencing the choice of initial cART in clinical practice and its outcome. METHODS We analyzed treatment-naive adults with human immunodeficiency virus (HIV) infection participating in the Swiss HIV Cohort Study and starting cART from January 1, 2005, through December 31, 2009. The primary end point was the choice of the initial antiretroviral regimen. Secondary end points were virologic suppression, the increase in CD4 cell counts from baseline, and treatment modification within 12 months after starting treatment. RESULTS A total of 1957 patients were analyzed. Tenofovir-emtricitabine (TDF-FTC)-efavirenz was the most frequently prescribed cART (29.9%), followed by TDF-FTC-lopinavir/r (16.9%), TDF-FTC-atazanavir/r (12.9%), zidovudine-lamivudine (ZDV-3TC)-lopinavir/r (12.8%), and abacavir/lamivudine (ABC-3TC)-efavirenz (5.7%). Differences in prescription were noted among different Swiss HIV Cohort Study sites (P < .001). In multivariate analysis, compared with TDF-FTC-efavirenz, starting TDF-FTC-lopinavir/r was associated with prior AIDS (relative risk ratio, 2.78; 95% CI, 1.78-4.35), HIV-RNA greater than 100 000 copies/mL (1.53; 1.07-2.18), and CD4 greater than 350 cells/μL (1.67; 1.04-2.70); TDF-FTC-atazanavir/r with a depressive disorder (1.77; 1.04-3.01), HIV-RNA greater than 100 000 copies/mL (1.54; 1.05-2.25), and an opiate substitution program (2.76; 1.09-7.00); and ZDV-3TC-lopinavir/r with female sex (3.89; 2.39-6.31) and CD4 cell counts greater than 350 cells/μL (4.50; 2.58-7.86). At 12 months, 1715 patients (87.6%) achieved viral load less than 50 copies/mL and CD4 cell counts increased by a median (interquartile range) of 173 (89-269) cells/μL. Virologic suppression was more likely with TDF-FTC-efavirenz, and CD4 increase was higher with ZDV-3TC-lopinavir/r. No differences in outcome were observed among Swiss HIV Cohort Study sites. CONCLUSIONS Large differences in prescription but not in outcome were observed among study sites. A trend toward individualized cART was noted suggesting that initial cART is significantly influenced by physician's preference and patient characteristics. Our study highlights the need for evidence-based data for determining the best initial regimen for different HIV-infected persons.

Cell therapies for tendons: old cell choice for modern innovation.

Although tissue engineering and cell therapies are becoming realistic approaches for medical therapeutics, it is likely that musculoskeletal applications will be among the first to benefit on a large scale. Cell sources for tissue engineering and cell therapies for tendon pathologies are reviewed with an emphasis on small defect tendon injuries as seen in the hand which could adapt well to injectable cell administration. Specifically, cell sources including tenocytes, tendon sheath fibroblasts, bone marrow or adipose-derived stem cells, amniotic cells, placenta cells and platelet-derivatives have been proposed to enhance tendon regeneration. The associated advantages and disadvantages for these different strategies will be discussed and evolving regulatory requirements for cellular therapies will also be addressed. Human progenitor tenocytes, along with their clinical cell banking potential, will be presented as an alternative cell source solution. Similar cell banking techniques have already been described with other progenitor cell types in the 1950's for vaccine production, and these "old" cell types incite potentially interesting therapeutic options that could be improved with modern innovation for tendon regeneration and repair.

Ectoparasite affects choice and use of roost sites in the great tit, Parus major

Many diurnal bird species roost at night in holes. As a regular visitor of a hole they are therefore a welcome host for several species of ectoparasites. The interactions of ectoparasites with the behaviour, life-history traits and population demography of their hosts are largely unknown. In the present study the effects of the haematophagous hen flea, Ceratophyllus gallinae , on the great tit's choice of winter roost site were investigated experimentally. Three experiments tested (1) whether great tits prefer a clean nestbox to one containing an old, but parasite-free nest, (2) whether they prefer a parasite-free nestbox to one infested with the haematophagous hen flea, and (3) whether they prefer not to use a nestbox when there is only an infested box available in their territory. In the first experiment there was no discrimination and both kinds of boxes were used equally often. In the second experiment the great tits clearly preferred to roost in the box without ectoparasites. In the third experiment a significantly higher proportion of the infested nestboxes were not used for roosting compared with the parasite-free boxes. Recently the validity of the conclusions drawn from nestbox studies where the naturally occurring detrimental ectoparasites are eliminated by the routine removal of old nests between breeding seasons has been questioned. This study shows that ectoparasites affect host behaviour and therefore lends support to that criticism.

Modelling non-industrial private forest landowners' strategic decision making by using logistic regression and neural networks: case of predicting the choice of forest taxation basis

Summary

Discrete contribution to psi ' -> J/psi plus gamma gamma

HadronPhysics2 (Grant Agreement No. 227431) (EU)

Dynamical properties of discrete breathers in curved chains with first and second neighbor interaction

We present the study of discrete breather dynamics in curved polymerlike chains consisting of masses connected via nonlinear springs. The polymer chains are one dimensional but not rectilinear and their motion takes place on a plane. After constructing breathers following numerically accurate procedures, we launch them in the chains and investigate properties of their propagation dynamics. We find that breather motion is strongly affected by the presence of curved regions of polymers, while the breathers themselves show a very strong resilience and remarkable stability in the presence of geometrical changes. For chains with strong angular rigidity we find that breathers either pass through bent regions or get reflected while retaining their frequency. Their motion is practically lossless and seems to be determined through local energy conservation. For less rigid chains modeled via second neighbor interactions, we find similarly that chain geometry typically does not destroy the localized breather states but, contrary to the angularly rigid chains, it induces some small but constant energy loss. Furthermore, we find that a curved segment acts as an active gate reflecting or refracting the incident breather and transforming its velocity to a value that depends on the discrete breathers frequency. We analyze the physical reasoning behind these seemingly general breather properties.

Interaction of a discrete breather with a lattice junction

We study the scattering of a moving discrete breather (DB) on a junction in a Fermi-Pasta-Ulam chain consisting of two segments with different masses of the particles. We consider four distinct cases: (i) a light-heavy (abrupt) junction in which the DB impinges on the junction from the segment with lighter mass, (ii) a heavy-light junction, (iii) an up mass ramp in which the mass in the heavier segment increases continuously as one moves away from the junction point, and (iv) a down mass ramp. Depending on the mass difference and DB characteristics (frequency and velocity), the DB can either reflect from, or transmit through, or get trapped at the junction or on the ramp. For the heavy-light junction, the DB can even split at the junction into a reflected and a transmitted DB. The latter is found to subsequently split into two or more DBs. For the down mass ramp the DB gets accelerated in several stages, with accompanying radiation (phonons). These results are rationalized by calculating the Peierls-Nabarro barrier for the various cases. We also point out implications of our results in realistic situations such as electron-phonon coupled chains.

Confinement of discrete breathers in inhomogeneously profiled nonlinear chains

We investigate numerically the scattering of a moving discrete breather on a pair of junctions in a Fermi-Pasta-Ulam chain. These junctions delimit an extended region with different masses of the particles. We consider (i) a rectangular trap, (ii) a wedge shaped trap, and (iii) a smoothly varying convex or concave mass profile. All three cases lead to DB confinement, with the ease of trapping depending on the profile of the trap. We also study the collision and trapping of two DBs within the profile as a function of trap width, shape, and approach time at the two junctions. The latter controls whether one or both DBs are trapped.

Les règles n'ont plus la cote: une question de contraception ou de choix [To bleed or not--a new dogma or a real choice in contraception?]

On en parle ! Il est question de la suppression des règles par l'administration de contraceptifs oestro-progestatifs (pilule, patch ou anneau vaginal) en cycles longs (cycles prolongés ; cycles étendus ; extended cycles) entraînant des périodes d'aménorrhée, rythmées par des intervalles libres de sept jours sans administration hormonale. L'indication à ce mode de prescription est presque unanimement reconnue pour le traitement des pathologies bénéficiant de la suppression des règles et des fluctuations hormonales inhérentes à l'activité ovarienne. Ce traitement suscite cependant également de l'intérêt pour une indication du type mode de vie. Les modalités thérapeutiques, les avantages et inconvénients sont examinés à la lumière de l'attente des femmes et de leur droit au choix éclairé et libre. Let's talk about it ! Suppression of menstruation, by extending the duration of contraceptives containing estro-progestins (oral contraception, patch or vaginal ring) to long cycles, is a new approach in the field of contraception. These extended cycles aim at obtaining prolonged amenorrhea, interrupted periodically by a free interval of 7 days without hormone intake and thus causing breakthrough bleeding. Pathologies, which are supposed to get some benefit from the suppression of menstruation and of hormone level variations related to ovarian activity, are widely recognized as an indication. Some interest is also coming up for so called life style indications. Treatment issues, advantages and disadvantages are examined in the light of women's expectations and right to access to informed consent and independent choice.

Homeodomain binding motifs modulate the probability of odorant receptor gene choice in transgenic mice.

Odorant receptor (OR) genes constitute with 1200 members the largest gene family in the mouse genome. A mature olfactory sensory neuron (OSN) is thought to express just one OR gene, and from one allele. The cell bodies of OSNs that express a given OR gene display a mosaic pattern within a particular region of the main olfactory epithelium. The mechanisms and cis-acting DNA elements that regulate the expression of one OR gene per OSN - OR gene choice - remain poorly understood. Here, we describe a reporter assay to identify minimal promoters for OR genes in transgenic mice, which are produced by the conventional method of pronuclear injection of DNA. The promoter transgenes are devoid of an OR coding sequence, and instead drive expression of the axonal marker tau-β-galactosidase. For four mouse OR genes (M71, M72, MOR23, and P3) and one human OR gene (hM72), a mosaic, OSN-specific pattern of reporter expression can be obtained in transgenic mice with contiguous DNA segments of only ~300 bp that are centered around the transcription start site (TSS). The ~150bp region upstream of the TSS contains three conserved sequence motifs, including homeodomain (HD) binding sites. Such HD binding sites are also present in the H and P elements, DNA sequences that are known to strongly influence OR gene expression. When a 19mer encompassing a HD binding site from the P element is multimerized nine times and added upstream of a MOR23 minigene that contains the MOR23 coding region, we observe a dramatic increase in the number of transgene-expressing founders and lines and in the number of labeled OSNs. By contrast, a nine times multimerized 19mer with a mutant HD binding site does not have these effects. We hypothesize that HD binding sites in the H and P elements and in OR promoters modulate the probability of OR gene choice.

Discrete analysis of dividend payments in a non-life insurance portfolio

The process of free reserves in a non-life insurance portfolio as defined in the classical model of risk theory is modified by the introduction of dividend policies that set maximum levels for the accumulation of reserves. The first part of the work formulates the quantification of the dividend payments via the expectation of their current value under diferent hypotheses. The second part presents a solution based on a system of linear equations for discrete dividend payments in the case of a constant dividend barrier, illustrated by solving a specific case.