Clinical assessment of HIV-associated lipodystrophy syndrome: bioelectrical impedance analysis, anthropometry and clinical scores

Background Diagnosis of the HIV-associated lipodystrophy syndrome is based on clinical assessment, in lack of a consensus about case definition and reference methods. Three bedside methods were compared in their diagnostic value for lipodystrophy. Patients and Methods. Consecutive HIV-infected outpatients (n = 278) were investigated, 128 of which also had data from 1997 available. Segmental bioelectrical impedance analysis (BIA) and waist, hip and thigh circumferences were performed. Changes in seven body regions were rated by physicians and patients using linear analogue scale assessment (LASA). Diagnostic cut-off values were searched by receiver operator characteristics. Results. Lipodystrophy was diagnosed in 85 patients (31%). BIA demonstrated higher fat-free mass in patients with lipodystrophy but not after controlling for body mass index and sex. Segmental BIA was not superior to whole body BIA in detecting lipodystrophy. Fat-free mass increased from 1997 to 1999 independent from lipodystrophy. Waist-hip and waist-thigh ratios were higher in patients with lipodystrophy. BIA, anthropometry and LASA did not provide sufficient diagnostic cut-off values for lipodystrophy. Agreement between methods, and between patient and physician rating, was poor. Conclusion: These methods do not fulfil the urgent need for quantitative diagnostic tools for lipodystrophy. BIA estimates of fat free mass may be biased by lipodystrophy, indicating a need for re-calibration in HIV infected populations. (C) 2001 Harcourt Publishers Ltd.

Automatic construction of explicit R matrices for the one-parameter families of irreducible typical highest weight (0(m)vertical bar alpha(n)) representations of U-q[gl(m vertical bar n)]

We detail the automatic construction of R matrices corresponding to (the tensor products of) the (O-m\alpha(n)) families of highest-weight representations of the quantum superalgebras Uq[gl(m\n)]. These representations are irreducible, contain a free complex parameter a, and are 2(mn)-dimensional. Our R matrices are actually (sparse) rank 4 tensors, containing a total of 2(4mn) components, each of which is in general an algebraic expression in the two complex variables q and a. Although the constructions are straightforward, we describe them in full here, to fill a perceived gap in the literature. As the algorithms are generally impracticable for manual calculation, we have implemented the entire process in MATHEMATICA; illustrating our results with U-q [gl(3\1)]. (C) 2002 Published by Elsevier Science B.V.

Urine D-arabinitol/L-arabinitol ratio in diagnosing Candida infection in patients with haematological malignancy and HIV infection

Adult patients with hematologic malignancies along with HIV infected patients were prospectively studied to determine the performance of urine D-arabinitol/L-arabinitol (DA/LA) ratio in diagnosing invasive candidiasis. Ten evaluable febrile neutropenic patients had proven invasive candidiasis and elevated DA/LA ratios were found in 5. Invasive candidiasis with normal DA/LA ratios was most frequently due to Candida krusei infection. This Candida species is a non-producer of arabinitol. Only 4 of 81 febrile neutropenic patients given either antifungal prophylaxis or empiric antifungal treatment had elevated DA/LA ratios. Only 1 of 15 HIV positive patients with either oropharyngeal or esophageal candidiasis had elevated DA/LA ratios. Widespread use of fluconazole prophylaxis in bone marrow transplantation patients at the study hospital has led to an increased prevalence of C. krusei infection. This is the likely reason for the low sensitivity of the test in proven and suspected invasive Candida infections reported here. (C) 2002 Elsevier Science Inc. All rights reserved.

Mechanistic aspects of HIV-1 reverse transcription initiation

During reverse transcription, the positive-strand HIV-1 RNA genome is converted into a double-stranded DNA copy which can be permanently integrated into the host cell genome. Recent analyses show that HIV-1 reverse transcription is a highly regulated process. The initiation reaction can be distinguished from a subsequent elongation reaction carried out by a reverse transcription complex composed of (at least) heterodimeric reverse transcriptase, cellular tRNA(lys3) and HIV-1 genomic RNA sequences. In addition, viral factors including Tat, Nef, Vif, Vpr, IN and NCp7, cellular proteins, and TAR RNA and other RNA stem-loop structures appear to influence this complex and contribute to the efficiency of the initiation reaction. As viral resistance to many antiretroviral compounds is a continuing problem, understanding the ways in which these factors influence the reverse transcription complex will likely lead to novel antiretroviral strategies. Copyright (C) 2001 John Wiley Sons, Ltd.

Vertical fluxes of sediment in oscillatory sheet flow

Time series of vertical sediment fluxes are derived from concentration time series in sheet flow under waves. While the concentrations C(z,t) vary very little with time for \z\ < 10d(50), the measured vertical sediment fluxes Q(zs)(z,t) vary strongly with time in this vertical band and their time variation follows, to some extent, the variation of the grain roughness Shields parameter 02,5(t). Thus, sediment distribution models based on the pickup function boundary condition are in some qualitative agreement with the measurements. However, the pickup function models are only able to model the upward bursts of sediment during the accelerating phases of the flow. They are, so far, unable to model the following strong downward sediment fluxes, which are observed during the periods of flow deceleration. Classical pickup functions, which essentially depend on the Shields parameter, are also incapable of modelling the secondary entrainment fluxes, which sometimes occur at free stream velocity reversal. The measured vertical fluxes indicate that the effective sediment settling velocity in the high [(0.3 < C(z,t) < 0.4] concentration area is typically only a few percent of the clear water settling velocity, while the measurements of Richardson and Jeronimo [Chem. Eng. Sci. 34 (1979) 1419], from a different physical setting, lead to estimates of the order 20%. The data does not support gradient diffusion as a model for sediment entrainment from the bed. That is, detailed modelling of the observed near-bed fluxes would require diffusivities that go negative during periods of flow deceleration. An observed general trend for concentration variability to increase with elevation close to the bed is also irreconcilable with diffusion models driven by a bottom boundary condition. (C) 2002 Published by Elsevier Science B.V.

Development of the HIV/AIDS stress scale

Development of a self-report measure of stress specific to HIV/AIDS is needed to advance our understanding of the role of stress in adaptation to HIV/AIDS: hence, the aim of this study was the development of the HIV/AIDS Stress Scale. A total of 132 homosexual/bisexual men with HIV/AIDS v ere interviewed and completed the HIV/AIDS Stress Scale and measures of coping strategies, appraisal, social support and adjustment (global distress, depression, social adjustment, number of HIV symptoms, and subjective health status) at three time points. Thirty-nine primary caregivers were interviewed and completed measures of stress and adjustment. Exploratory factor analyses of the HIV/AIDS Stress Scale items revealed three factors: Social, Instrumental and Emotional/Existential Stress. Factors had adequate internal reliabilities and were stable over 12 months. Construct validation data are consistent with recent stress/coping research that links higher levels of stress with more HIV symptoms. reliance on emotion-focused coping, lower social support, poorer levels of adjustment and higher levels of caregiver stress. Results extend this research by revealing new differential relations between various stress dimensions and stress/coping variables. Convergent validation data suggest that the HIV/AIDS Stress Scale shares conceptual similarity with threat appraisal. and differs from control liability and challenge appraisals. The HIV/AIDS Stress Scale shows potential for the elucidation of the role of stress in coping and adaptation to HIV/AIDS and disease progression in both research and clinical applications.

The efficacy of a psychosocial intervention for HIV/AIDS caregiving dyads and individual caregivers: a controlled treatment outcome study

The present study examined the comparative efficacy of intervening at the caregiver/care-recipient dyadic level, versus the individual caregiver level, for caregivers and their care-recipients with HIV/AIDS. Participants were randomly assigned to a Dyad Intervention (DI), a Caregiver Intervention (CI) or Wait List Control group (WLC), and assessed by interview and self-administered scales immediately before treatment and eight weeks later. Participants in the intervention groups also completed a four-month follow-up assessment. Dependent variables included global distress, social adjustment, dyadic adjustment, subjective health status, HIV/AIDS knowledge and target problem ratings. Results showed that caregivers in the DI group showed greater improvement from pre- to post-treatment on global distress, dyadic adjustment and target problems than the CI and WLC caregivers. The CI and DI caregivers showed greater improvement than the WLC group on all dependent variables except social adjustment. Care-recipients in the DI group improved significantly from pre- to post-treatment on dyadic adjustment, social adjustment, knowledge, subjective health status and Target Problem 1, whereas the CI and WLC care-recipients failed to improve on any of these measures. The treatment gains made by the DI caregivers and care-recipients on most dependent variables were maintained at a four-month follow-up. Findings support a reciprocal determinism approach to the process of dyadic adjustment and suggest that intervening at the caregiver/care-recipient level may produce better outcomes for both the caregiver and care-recipient than intervening at the individual caregiver level.

Design of microchannel free-space optical interconnects based on vertical-cavity surface-emitting laser arrays

We investigate the design of free-space optical interconnects (FSOIs) based on arrays of vertical-cavity surface-emitting lasers (VCSELs), microlenses, and photodetectors. We explain the effect of the modal structure of a multimodeVCSEL beam on the performance of a FSOI with microchannel architecture. A Gaussian-beam diffraction model is used in combination with the experimentally obtained spectrally resolved VCSEL beam profiles to determine the optical channel crosstalk and the signal-to-noise ratio (SNR) in the system. The dependence of the SNR on the feature parameters of a FSOI is investigated. We found that the presence of higher-order modes reduces the SNR and the maximum feasible interconnect distance. We also found that the positioning of a VCSEL array relative to the transmitter microlens has a significant impact on the SNR and the maximum feasible interconnect distance. Our analysis shows that the departure from the traditional confocal system yields several advantages including the extended interconnect distance and/or improved SNR. The results show that FSOIs based on multimode VCSELs can be efficiently utilized in both chip-level and board-level interconnects. (C) 2002 Optical Society of America.

Distributional profiles of homologous open reading frames among bacterial phyla: implications for vertical and lateral transmission

If open reading frames (ORFs) have been transmitted primarily by vertical descent, the distributional profile of orthologues of each ORF should be congruent with the organismal tree or a subtree thereof. Distributional patterns not reconciled parsimoniously with tree-like descent and loss are prima facie evidence of lateral gene transfer. Herein, a rigorous criterion for recognizing ORF distributions is described and implemented; it does not require the inference of phylogenetic trees, nor does it assume any specific tree. Because lineage-specific differences in rates of sequence change can also generate unexpected distributional patterns, rate artefacts, were controlled for by requiring pairwise matches between ORFs to exceed a rigorous inclusion threshold, but absence of a match was assessed against a more-permissive exclusion threshold. Applying this dual-threshold criterion to cross-domain and cross-phylum distributional patterns for ORFs in 23 bacterial genomes, a relative abundance of ORFs was observed that find a match in exactly seven other bacterial phyla; 94-99% of these ORFs also find matches among the Archaea and/or Eukarya. In the larger (and some smaller) bacterial genomes, ORFs that find matches in exactly one other bacterial phylum are also relatively abundant, but fewer of these have non-bacterial homologues; most of their matches within the Bacteria are to the Proteobacteria and/or Firmicutes, which cannot be sister lineages to all bacteria. ORFs that are neither distributed universally among the Bacteria, nor necessarily shared with topologically adjacent lineages, are preferentially enriched in large bacterial genomes.

A Poincare-Birkhoff-Witt commutator lemma for U-q[gl(m vertical bar n)]

We present and prove in detail a Poincare-Birkhoff-Witt commutator lemma for the quantum superalgebra U-q[gl(m\n)]. (C) 2003 American Institute of Physics.

Applying discrete element modelling to vertical and horizontal shaft impact crushers

The PFC3D (particle flow code) that models the movement and interaction of particles by the DEM techniques was employed to simulate the particle movement and to calculate the velocity and energy distribution of collision in two types of impact crusher: the Canica vertical shaft crusher and the BJD horizontal shaft swing hammer mill. The distribution of collision energies was then converted into a product size distribution for a particular ore type using JKMRC impact breakage test data. Experimental data of the Canica VSI crusher treating quarry and the BJD hammer mill treating coal were used to verify the DEM simulation results. Upon the DEM procedures being validated, a detailed simulation study was conducted to investigate the effects of the machine design and operational conditions on velocity and energy distributions of collision inside the milling chamber and on the particle breakage behaviour. (C) 2003 Elsevier Ltd. All rights reserved.

gl(2 vertical bar 2) current superalgebra and non-unitary conformal field theory

Motivated by application of current superalgebras in the study of disordered systems such as the random XY and Dirac models, we investigate gl(2\2) current superalgebra at general level k. We construct its free field representation and corresponding Sugawara energy-momentum tensor in the non-standard basis. Three screen currents of the first kind are also presented. (C) 2003 Elsevier B.V. All rights reserved.

The first strand transfer reaction of HIV-1 reverse transcription is more efficient in infected cells than in cell-free natural endogenous reverse transcription reactions

Background: In the presence of dNTPs, intact HIV-1 virions are capable of reverse transcribing at least part of their genome, a process known as natural endogenous reverse transcription (NERT). PCR analysis of virion DNA produced by NERT revealed that the first strand transfer reaction (1stST) was inefficient in intact virions, with minus strand (-) strong stop DNA (ssDNA) copy numbers up to 200 times higher than post-1stST products measured using primers in U3 and U5. This was in marked contrast to the efficiency of 1stST observed in single-round cell infection assays, in which (-) ssDNA and U3-U5 copy numbers were indistinguishable. Objectives: To investigate the reasons for the discrepancy in first strand transfer efficiency between intact cell-free virus and the infection process. Study design: Alterations of both NERT reactions and the conditions of cell infection were used to test whether uncoating and/or entry play a role in the discrepancy in first strand transfer efficiency. Results and Conclusions: The difference in 1stST efficiency could not be attributed simply to viral uncoating, since addition of very low concentrations of detergent to NERT reactions removed the viral envelope without disrupting the reverse transcription complex, and these conditions resulted in no improvement in 1stST efficiency. Virus pseudotyped with surface glycoproteins from either vesicular stomatitis virus or amphotrophic murine leukaemia virus also showed low levels of 1stST in low detergent NERT assays and equivalent levels of (-) ssDNA and 1stST in single-round infections of cells, demonstrating that the gp120-mediated infection process did not select for virions capable of carrying out 1stST. These data indicate that a post-entry event or factor may be involved in efficient HIV-1 reverse transcription in vivo. (C) 2002 Elsevier Science B.V. All rights reserved.