Assessment of a real-time PCR test to diagnose syphilis from diverse biological samples

OBJECTIVES: To investigate the contribution of a real-time PCR assay for the detection of Treponema pallidum in various biological specimens with the secondary objective of comparing its value according to HIV status. METHODS: Prospective cohort of incident syphilis cases from three Swiss hospitals (Geneva and Bern University Hospitals, Outpatient Clinic for Dermatology of Triemli, Zurich) diagnosed between January 2006 and September 2008. A case-control study was nested into the cohort. Biological specimens (blood, lesion swab or urine) were taken at diagnosis (as clinical information) and analysed by real-time PCR using the T pallidum 47 kDa gene. RESULTS: 126 specimens were collected from 74 patients with primary (n = 26), secondary (n = 40) and latent (n = 8) syphilis. Among primary syphilis, sensitivity was 80% in lesion swabs, 28% in whole blood, 55% in serum and 29% in urine, whereas among secondary syphilis, it was 20%, 36%, 47% and 44%, respectively. Among secondary syphilis, plasma and cerebrospinal fluid were also tested and provided a sensitivity of 100% and 50%, respectively. The global sensitivity of T pallidum by PCR (irrespective of the compartment tested) was 65% during primary, 53% during secondary and null during latent syphilis. No difference regarding serology or PCR results was observed among HIV-infected patients. Specificity was 100%. CONCLUSIONS: Syphilis PCR provides better sensitivity in lesion swabs from primary syphilis and displays only moderate sensitivity in blood from primary and secondary syphilis. HIV status did not modify the internal validity of PCR for the diagnosis of primary or secondary syphilis.

Facebook’s Real Name Policy: Bye-Bye, Max Mustermann?

Facebook requires all members to use their real names and email addresses when joining the social network. Not only does the policy seem to be difficult to enforce (as the prevalence of accounts with people’s pets or fake names suggests), but it may also interfere with European (and, in particular, German) data protection laws. A German Data Protection Commissioner recently took action and ordered that Facebook permit pseudonymous accounts as its current anti-pseudonymous policy violates § 13 VI of the German Telemedia Act. This provision requires telemedia providers to allow for an anonymous or pseudonymous use of services insofar as this is reasonable and technically feasible. Irrespective of whether the pseudonymous use of Facebook is reasonable, the case can be narrowed down to one single question: Does German data protection law apply to Facebook? In that respect, this paper analyses the current Facebook dispute, in particular in relation to who controls the processing of personal data of Facebook users in Germany. It also briefly discusses whether a real name policy really presents a fix for anti-normative and anti-social behaviour on the Internet.

Gingival fluid cytokine expression and subgingival bacterial counts during pregnancy and postpartum: a case series

OBJECTIVES The aim of this study was to assess gingival fluid (GCF) cytokine messenger RNA (mRNA) levels, subgingival bacteria, and clinical periodontal conditions during a normal pregnancy to postpartum. MATERIALS AND METHODS Subgingival bacterial samples were analyzed with the checkerboard DNA-DNA hybridization method. GCF samples were assessed with real-time PCR including five proinflammatory cytokines and secretory leukocyte protease inhibitor. RESULTS Nineteen pregnant women with a mean age of 32 years (S.D. ± 4 years, range 26-42) participated in the study. Full-mouth bleeding scores (BOP) decreased from an average of 41.2% (S.D. ± 18.6%) at the 12th week of pregnancy to 26.6% (S.D. ± 14.4%) at the 4-6 weeks postpartum (p < 0.001). Between week 12 and 4-6 weeks postpartum, the mean probing pocket depth changed from 2.4 mm (S.D. ± 0.4) to 2.3 mm (S.D. ± 0.3) (p = 0.34). Higher counts of Eubacterium saburreum, Parvimonas micra, Selenomonas noxia, and Staphylococcus aureus were found at week 12 of pregnancy than at the 4-6 weeks postpartum examinations (p < 0.001). During and after pregnancy, statistically significant correlations between BOP scores and bacterial counts were observed. BOP scores and GCF levels of selected cytokines were not related to each other and no differences in GCF levels of the cytokines were observed between samples from the 12th week of pregnancy to 4-6 weeks postpartum. Decreasing postpartum counts of Porphyromonas endodontalis and Pseudomonas aeruginosa were associated with decreasing levels of Il-8 and Il-1β. CONCLUSIONS BOP decreased after pregnancy without any active periodontal therapy. Associations between bacterial counts and cytokine levels varied greatly in pregnant women with gingivitis and a normal pregnancy outcome. Postpartum associations between GCF cytokines and bacterial counts were more consistent. CLINICAL RELEVANCE Combined assessments of gingival fluid cytokines and subgingival bacteria may provide important information on host response.

Wearable schizophrenia treatment with real-time affective context awareness

The Personal Health Assistant Project (PHA) is a pilot system implementation sponsored by the Kozani Region Governors’ Association (KRGA) and installed in one of the two major public hospitals of the city of Kozani. PHA is intended to demonstrate how a secure, networked, multipurpose electronic health and food benefits digital signage system can transform common TV sets inside patient homes or hospital rooms into health care media players and facilitate information sharing and improve administrative efficiency among private doctors, public health care providers, informal caregivers, and nutrition program private companies, while placing individual patients firmly in control of the information at hand. This case evaluation of the PHA demonstration is intended to provide critical information to other decision makers considering implementing PHA or related digital signage technology at other institutions and public hospitals around the globe.

Real-life results of balloon kyphoplasty for vertebral compression fractures from the SWISSspine registry

BACKGROUND CONTEXT The Swiss Federal Office of Public Health mandated a nationwide health technology assessment-registry for balloon kyphoplasty (BKP) for decision making on reimbursement of these interventions. The early results of the registry led to a permanent coverage of BKP by basic health insurance. The documentation was continued for further evidence generation. PURPOSE This analysis reports on the 1 year results of patients after BKP treatment. STUDY DESIGN Prospective multicenter observational case series. PATIENT SAMPLE The data on 625 cases with 819 treated vertebrae were documented from March 2005 to May 2012. OUTCOME MEASURES Surgeon-administered outcome instruments were primary intervention form for BKP and the follow-up form; patient self-reported measures were EuroQol-5D questionnaire, North American Spine Society outcome instrument /Core Outcome Measures Index (including visual analog scale), and a comorbidity questionnaire. Outcome measures were back pain, medication, quality of life (QoL), cement extrusions, and new fractures within the first postoperative year. METHODS Data were recorded preoperatively and at 3 to 6-month and 1-year follow-ups. Wilcoxon signed-rank test was used for comparison of pre- with postoperative measurements. Multivariate logistic regression was used to identify factors with a significant influence on the outcome. RESULTS Seventy percent of patients were women with mean age of 71 years (range, 18-91 years); mean age of men was 65 years (range, 15-93 years). Significant and clinically relevant reduction of back pain, improvement of QoL, and reduction of pain killer consumption was seen within the first postoperative year. Preoperative back pain decreased from 69.3 to 29.0 at 3 to 6-month and remained unchanged at 1-year follow-ups. Consequently, QoL improved from 0.23 to 0.71 and 0.75 at the same follow-up intervals. The overall vertebra-based cement extrusion rates with and without extrusions into intervertebral discs were 22.1% and 15.3%, respectively. Symptomatic cement extrusions with radiculopathy were five (0.8%). A new vertebral fracture within a year from the BKP surgery was observed in 18.4% of the patients. CONCLUSIONS The results of the largest observational study for BKP so far are consistent with published randomized trials and systematic reviews. In this routine health care setting, BKP is safe and effective in reducing pain, improving QoL, and lowering pain_killer consumption and has an acceptable rate of cement extrusions. Postoperative outcome results show clear and significant clinical improvement at early follow-up that remain stable during the first postoperative year.

A relation between screening masses and real-time rates

Thermal screening masses related to the conserved vector current are determined for the case that the current carries a non-zero Matsubara frequency, both in a weak-coupling approach and through lattice QCD. We point out that such screening masses are sensitive to the same infrared physics as light-cone real-time rates. In particular, on the perturbative side, the inhomogeneous Schrödinger equation determining screening correlators is shown to have the same general form as the equation implementing LPM resummation for the soft-dilepton and photon production rates from a hot QCD plasma. The static potential appearing in the equation is identical to that whose soft part has been determined up to NLO and on the lattice in the context of jet quenching. Numerical results based on this potential suggest that screening masses overshoot the free results (multiples of 2πT) more strongly than at zero Matsubara frequency. Four-dimensional lattice simulations in two-flavour QCD at temperatures of 250 and 340 MeV confirm the non-static screening masses at the 10% level. Overall our results lend support to studies of jet quenching based on the same potential at T ≳ 250 MeV.

Evaluation of treatment response after chemoembolisation (TACE) in hepatocellular carcinoma using real time image fusion of contrast-enhanced ultrasound (CEUS) and computed tomography (CT)--preliminary results.

OBJECTIVE To evaluate treatment response of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) with a new real-time imaging fusion technique of contrast-enhanced ultrasound (CEUS) with multi-slice detection computed tomography (CT) in comparison to conventional post-interventional follow-up. MATERIAL AND METHODS 40 patients with HCC (26 male, ages 46-81 years) were evaluated 24 hours after TACE using CEUS with ultrasound volume navigation and image fusion with CT compared to non-enhanced CT and follow-up contrast-enhanced CT after 6-8 weeks. Reduction of tumor vascularization to less than 25% was regarded as "successful" treatment, whereas reduction to levels >25% was considered as "partial" treatment response. Homogenous lipiodol retention was regarded as successful treatment in non-enhanced CT. RESULTS Post-interventional image fusion of CEUS with CT was feasible in all 40 patients. In 24 patients (24/40), post-interventional image fusion with CEUS revealed residual tumor vascularity, that was confirmed by contrast-enhanced CT 6-8 weeks later in 24/24 patients. In 16 patients (16/40), post-interventional image fusion with CEUS demonstrated successful treatment, but follow-up CT detected residual viable tumor (6/16). Non-enhanced CT did not identify any case of treatment failure. Image fusion with CEUS assessed treatment efficacy with a specificity of 100%, sensitivity of 80% and a positive predictive value of 1 (negative predictive value 0.63). CONCLUSIONS Image fusion of CEUS with CT allows a reliable, highly specific post-interventional evaluation of embolization response with good sensitivity without any further radiation exposure. It can detect residual viable tumor at early state, resulting in a close patient monitoring or re-therapy.

Molecular Analyses Define Vα7.2-Jα33+ MAIT Cell Depletion in HIV Infection: A Case-Control Study

Mucosal-associated invariant T (MAIT) cells are an abundant antibacterial innate-like lymphocyte population. There are conflicting reports as to their fate in HIV infection. The objective of this study was to determine whether MAIT cells are truly depleted in HIV infection.In this case-control study of HIV-positive patients and healthy controls, quantitative real-time polymerase chain reaction was used to assess the abundance of messenger RNA (mRNA) and genomic DNA (gDNA) encoding the canonical MAIT cell T cell receptor (Vα7.2-Jα33). Comparison was made with flow cytometry.Significant depletion of both Vα7.2-Jα33 mRNA and gDNA was seen in HIV infection. Depletion of Vα7.2+CD161++ T cells was confirmed by flow cytometry. In HIV infection, the abundance of Vα7.2-Jα33 mRNA correlated most strongly with the frequency of Vα7.2+CD161++ cells. No increase was observed in the frequency of Vα7.2+CD161- cells among CD3+CD4- lymphocytes.MAIT cells are depleted from blood in HIV infection as confirmed by independent assays. Significant accumulation of a CD161- MAIT cell population is unlikely. Molecular approaches represent a suitable alternative to flow cytometry-based assays for tracking of MAIT cells in HIV and other settings.

Pitfalls of practicing cancer epidemiology in resource-limited settings: the case of survival and loss to follow-up after a diagnosis of Kaposi's sarcoma in five countries across sub-Saharan Africa.

BACKGROUND Survival after diagnosis is a fundamental concern in cancer epidemiology. In resource-rich settings, ambient clinical databases, municipal data and cancer registries make survival estimation in real-world populations relatively straightforward. In resource-poor settings, given the deficiencies in a variety of health-related data systems, it is less clear how well we can determine cancer survival from ambient data. METHODS We addressed this issue in sub-Saharan Africa for Kaposi's sarcoma (KS), a cancer for which incidence has exploded with the HIV epidemic but for which survival in the region may be changing with the recent advent of antiretroviral therapy (ART). From 33 primary care HIV Clinics in Kenya, Uganda, Malawi, Nigeria and Cameroon participating in the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Consortia in 2009-2012, we identified 1328 adults with newly diagnosed KS. Patients were evaluated from KS diagnosis until death, transfer to another facility or database closure. RESULTS Nominally, 22% of patients were estimated to be dead by 2 years, but this estimate was clouded by 45% cumulative lost to follow-up with unknown vital status by 2 years. After adjustment for site and CD4 count, age <30 years and male sex were independently associated with becoming lost. CONCLUSIONS In this community-based sample of patients diagnosed with KS in sub-Saharan Africa, almost half became lost to follow-up by 2 years. This precluded accurate estimation of survival. Until we either generally strengthen data systems or implement cancer-specific enhancements (e.g., tracking of the lost) in the region, insights from cancer epidemiology will be limited.

Non-Parametric Tests of Real Exchange rates in the Post-Bretton Woods Era

This paper examines the mean-reverting property of real exchange rates. Earlier studies have generally not been able to reject the null hypothesis of a unit-root in real exchange rates, especially for the post-Bretton Woods floating period. The results imply that long-run purchasing power parity does not hold. More recent studies, especially those using panel unit-root tests, have found more favorable results, however. But, Karlsson and Löthgren (2000) and others have recently pointed out several potential pitfalls of panel unit-root tests. Thus, the panel unit-root test results are suggestive, but they are far from conclusive. Moreover, consistent individual country time series evidence that supports long-run purchasing power parity continues to be scarce. In this paper, we test for long memory using Lo's (1991) modified rescaled range test, and the rescaled variance test of Giraitis, Kokoszka, Leipus, and Teyssière (2003). Our testing procedure provides a non-parametric alternative to the parametric tests commonly used in this literature. Our data set consists of monthly observations from April 1973 to April 2001 of the G-7 countries in the OECD. Our two tests find conflicting results when we use U.S. dollar real exchange rates. However, when non-U.S. dollar real exchange rates are used, we find only two cases out of fifteen where the null hypothesis of an unit-root with short-term dependence can be rejected in favor of the alternative hypothesis of long-term dependence using the modified rescaled range test, and only one case when using the rescaled variance test. Our results therefore provide a contrast to the recent favorable panel unit-root test results.

Acceso abierto real y potencial a la producción científica de un país. El caso argentino

Se aporta una metodología para estimar la disponibilidad real y potencial de la producción científica de un país, según el modelo de acceso de las revistas elegidas por los investigadores para publicar sus artículos. Se estudia el caso de la producción científica argentina del período 2008-2010 en medicina, física y astronomía, agricultura y ciencias biológicas, y ciencias sociales y humanidades. La producción fue recogida de la base de datos Scopus y los modelos de acceso de las revistas, determinados a partir de la consulta a DOAJ, e-revist@s, SciELO, RedALyC, PubMed, Romeo-Sherpa y Dulcinea. Se concluye que Argentina presenta condiciones muy favorables para liberar un alto porcentaje de la literatura científica generada en el país bajo la modalidad de acceso abierto a través de repositorios; y que la metodología es reproducible para realizar comparaciones con otros países y campos temáticos. Los resultados aportan conocimiento útil a los gestores de repositorios de las instituciones académicas y de investigación de cara a promocionar su desarrollo y justificar su sostenimiento

Expansión urbana sobre tierras indígenas. El pueblo de La Toma en la Real Audiencia de Buenos Aires

A partir del estudio del caso de La Toma entre fines del siglo XVIII y principios del siglo XIX, se abordan los conflictos por las tierras de aquella parte de la población indígena encomendada y asentada en la jurisdicción de Córdoba, que fue reducida en "pueblos de indios" en el siglo XVII y que logró preservar el control sobre sus tierras comunales durante los dos siglos siguientes. Específicamente, se reconstruyen los intentos del cabildo, la Compañía de Jesús y los vecinos españoles por ocupar de hecho las tierras de ese pueblo de indios asentado en las cercanías de la ciudad de Córdoba y por legalizar esa situación, así como las estrategias indígenas de defensa de sus derechos, que contaron con el apoyo de los funcionarios la Real Audiencia de Buenos Aires y permitieron eludir las trabas impuestas por la justicia local.

Case studies of the effects of a total solar eclipse on weather with varying degrees of cloud cover using a local numerical weather prediction model

The importance of renewable energies for the European electricity market is growing rapidly. This presents transmission grids and the power market in general with new challenges which stem from the higher spatiotemporal variability of power generation. This uncertainty is due to the fact that renewable power production results from weather phenomena, thus making it difficult to plan and control. We present a sensitivity study of a total solar eclipse in central Europe in March. The weather in Germany and Europe was modeled using the German Weather Service's local area models COSMO-DE and COSMO-EU, respectively (http://www.cosmo-model.org/). The simulations were performed with and without considering a solar eclipse for the following 3 situations: 1. An idealized, clear-sky situation for the entire model area (Europe, COSMO-EU) 2. A real weather situation with mostly cloudy skies (Germany, COSMO-DE) 3. A real weather situation with mostly clear skies (Germany, COSMO-DE) The data should help to evaluate the effects of a total solar eclipse on the weather in the planetary boundary layer. The results show that a total solar eclipse has significant effects particularly on the main variables for renewable energy production, such as solar irradiation and temperature near the ground.

Acceso abierto real y potencial a la producción científica de un país. El caso argentino

Se aporta una metodología para estimar la disponibilidad real y potencial de la producción científica de un país, según el modelo de acceso de las revistas elegidas por los investigadores para publicar sus artículos. Se estudia el caso de la producción científica argentina del período 2008-2010 en medicina, física y astronomía, agricultura y ciencias biológicas, y ciencias sociales y humanidades. La producción fue recogida de la base de datos Scopus y los modelos de acceso de las revistas, determinados a partir de la consulta a DOAJ, e-revist@s, SciELO, RedALyC, PubMed, Romeo-Sherpa y Dulcinea. Se concluye que Argentina presenta condiciones muy favorables para liberar un alto porcentaje de la literatura científica generada en el país bajo la modalidad de acceso abierto a través de repositorios; y que la metodología es reproducible para realizar comparaciones con otros países y campos temáticos. Los resultados aportan conocimiento útil a los gestores de repositorios de las instituciones académicas y de investigación de cara a promocionar su desarrollo y justificar su sostenimiento

Expansión urbana sobre tierras indígenas. El pueblo de La Toma en la Real Audiencia de Buenos Aires

A partir del estudio del caso de La Toma entre fines del siglo XVIII y principios del siglo XIX, se abordan los conflictos por las tierras de aquella parte de la población indígena encomendada y asentada en la jurisdicción de Córdoba, que fue reducida en "pueblos de indios" en el siglo XVII y que logró preservar el control sobre sus tierras comunales durante los dos siglos siguientes. Específicamente, se reconstruyen los intentos del cabildo, la Compañía de Jesús y los vecinos españoles por ocupar de hecho las tierras de ese pueblo de indios asentado en las cercanías de la ciudad de Córdoba y por legalizar esa situación, así como las estrategias indígenas de defensa de sus derechos, que contaron con el apoyo de los funcionarios la Real Audiencia de Buenos Aires y permitieron eludir las trabas impuestas por la justicia local.