lntergenerational differences in overweight and obesity levels in Switzerland

Background/Introduction: There is little information regarding intergenerational trends in obesity levels in Switzerland. We aimed at assessing generational differences in obesity levels. Methods: Data from MONICA (1984-1986) and CoLaus-(2003-2006) surveys. Analyses were stratified by gender and age groups (35-44, 45-54, 55-64 and 65-74 years). Results: No changes were found for body mass index (BMI) between surveys (26.2±3.4 vs. 26.6±4.0 kg/m2 in men and 24.8±4.3 vs. 25.1±4.8 kg/m2 in women, for MONICA and CoLaus, respectively). ln men, the prevalence of overweight decreased from 48.6% to 46.0% and the prevalence of obesity increased slightly from 12.4% to 16.7% (p=NS). ln women, the prevalence of overweight decreased from 29.4% to 28.4% and the prevalence of obesity increased slightly from 12.9% to 14.5% (p=NS). After multivariate adjustment on age, education and smoking levels, the odds ratio (OR) and (95% confidence interval) of being obese in 2003-6 relative to 1984-6 was 1.36 (1.01-1.83) in men and 1.44 (1.07-1.93) in women, while no significant trend was found for overweight. After stratifying for age, no increase in BMI levels was found for bath genders. Obesity levels increased in participants aged 35-44 years (from 6.2% to 11.5% in men and from 4.9% to 10.0% in women, p<0.001) and 45-54 years (from 6.2% to 14.5% in men and 4.9% to 14.5% in women, p<0.001 ). After multivariate adjustment on age, education and smoking levels, the increase in obesity levels was signifiant in women aged 35-44, OR=2.10 (1.02-4.30), while a similar, albeit nonsignificant trend was obser11ed in men: 1.85 (0.97-3.51 ). Conclusion: BMI levels appear to have levelled off in Switzerland, but the prevalence of obesity is still on the rise. The increase in obesity levels among the youngest generations is of particular concern.

Ruling out coronary heart disease in primary care patients with chest pain: a clinical prediction score.

ABSTRACT: BACKGROUND: Chest pain raises concern for the possibility of coronary heart disease. Scoring methods have been developed to identify coronary heart disease in emergency settings, but not in primary care. METHODS: Data were collected from a multicenter Swiss clinical cohort study including 672 consecutive patients with chest pain, who had visited one of 59 family practitioners' offices. Using delayed diagnosis we derived a prediction rule to rule out coronary heart disease by means of a logistic regression model. Known cardiovascular risk factors, pain characteristics, and physical signs associated with coronary heart disease were explored to develop a clinical score. Patients diagnosed with angina or acute myocardial infarction within the year following their initial visit comprised the coronary heart disease group. RESULTS: The coronary heart disease score was derived from eight variables: age, gender, duration of chest pain from 1 to 60 minutes, substernal chest pain location, pain increases with exertion, absence of tenderness point at palpation, cardiovascular risks factors, and personal history of cardiovascular disease. Area under the receiver operating characteristics curve was of 0.95 with a 95% confidence interval of 0.92; 0.97. From this score, 413 patients were considered as low risk for values of percentile 5 of the coronary heart disease patients. Internal validity was confirmed by bootstrapping. External validation using data from a German cohort (Marburg, n = 774) revealed a receiver operating characteristics curve of 0.75 (95% confidence interval, 0.72; 0.81) with a sensitivity of 85.6% and a specificity of 47.2%. CONCLUSIONS: This score, based only on history and physical examination, is a complementary tool for ruling out coronary heart disease in primary care patients complaining of chest pain.

Serie estratigráfica de Liásico de la provincia de Girona

From several small stratigraphic sections, we have reconstituted the Liassic interval of the Girona Province (NE Spain). We have been able to identify paleontologically the Carixian (Jamesoni, Ibex, and perhaps, Davoei zones), the Lower Domerian (Stockesi zone), and the Middle Toarcian (possibily Variabilis zone, as well as Thouarsense and Insigne zones). The Lower Toarcian (Serpentinus zone) is represented by fossil remains no ‘in situ’. The lowest Toarcián (Tenuicos-tatum zone) as well as the Middle and Upper Domerian (Margaritatus and Spinatum zones respectively, are probably represented by stratigraphic gaps

Sampling strategies for tropical forest nutrient cycling studies: a case study in São Paulo, Brazil

The precise sampling of soil, biological or micro climatic attributes in tropical forests, which are characterized by a high diversity of species and complex spatial variability, is a difficult task. We found few basic studies to guide sampling procedures. The objective of this study was to define a sampling strategy and data analysis for some parameters frequently used in nutrient cycling studies, i. e., litter amount, total nutrient amounts in litter and its composition (Ca, Mg, Κ, Ν and P), and soil attributes at three depths (organic matter, Ρ content, cation exchange capacity and base saturation). A natural remnant forest in the West of São Paulo State (Brazil) was selected as study area and samples were collected in July, 1989. The total amount of litter and its total nutrient amounts had a high spatial independent variance. Conversely, the variance of litter composition was lower and the spatial dependency was peculiar to each nutrient. The sampling strategy for the estimation of litter amounts and the amount of nutrient in litter should be different than the sampling strategy for nutrient composition. For the estimation of litter amounts and the amount of nutrients in litter (related to quantity) a large number of randomly distributed determinations are needed. Otherwise, for the estimation of litter nutrient composition (related to quality) a smaller amount of spatially located samples should be analyzed. The determination of sampling for soil attributes differed according to the depth. Overall, surface samples (0-5 cm) showed high short distance spatial dependent variance, whereas, subsurface samples exhibited spatial dependency in longer distances. Short transects with sampling interval of 5-10 m are recommended for surface sampling. Subsurface samples must also be spatially located, but with transects or grids with longer distances between sampling points over the entire area. Composite soil samples would not provide a complete understanding of the relation between soil properties and surface dynamic processes or landscape aspects. Precise distribution of Ρ was difficult to estimate.

Climatic and biotic upheavals following the end-Permian mass extinction

Recovery from the end-Permian mass extinction is frequently described as delayed(1-3), with complex ecological communities typically not found in the fossil record until the Middle Triassic epoch. However, the taxonomic diversity of a number of marine groups, ranging from ammonoids to benthic foraminifera, peaked rapidly in the Early Triassic(4-10). These variations in biodiversity occur amidst pronounced excursions in the carbon isotope record, which are compatible with episodes of massive CO2 outgassing from the Siberian Large Igneous Province(4,11-13). Here we present a high-resolution Early Triassic temperature record based on the oxygen isotope composition of pristine apatite from fossil conodonts. Our reconstruction shows that the beginning of the Smithian substage of the Early Triassic was marked by a cooler climate, followed by an interval of warmth lasting until the Spathian substage boundary. Cooler conditions resumed in the Spathian. We find the greatest increases in taxonomic diversity during the cooler phases of the early Smithian and early Spathian. In contrast, a period of extreme warmth in the middle and late Smithian was associated with floral ecological change and high faunal taxonomic turnover in the ocean. We suggest that climate upheaval and carbon-cycle perturbations due to volcanic outgassing were important drivers of Early Triassic biotic recovery.

Viscous fingering in liquid crystals: Anisotropy and morphological transitions

We show that a minimal model for viscous fingering with a nematic liquid crystal in which anisotropy is considered to enter through two different viscosities in two perpendicular directions can be mapped to a twofold anisotropy in the surface tension. We numerically integrate the dynamics of the resulting problem with the phase-field approach to find and characterize a transition between tip splitting and side branching as a function of both anisotropy and dimensionless surface tension. This anisotropy dependence could explain the experimentally observed (reentrant) transition as temperature and applied pressure are varied. Our observations are also consistent with previous experimental evidence in viscous fingering within an etched cell and simulations of solidification.

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.

Weakening processes in thrust faults: insights from the Monte Perdido thrust fault (southern Pyrenees, Spain)

The Monte Perdido thrust fault (southern Pyrenees) consists of a 6-m-thick interval of intensely deformed clay-bearing rocks. The fault zone is affected by a pervasive pressure solution seam and numerous shear surfaces. Calcite extensional-shear veins are present along the shear surfaces. The angular relationships between the two structures indicate that shear surfaces developed at a high angle (70°) to the local principal maximum stress axis r1. Two main stages of deformation are present. The first stage corresponds to the development of calcite shear veins by a combination of shear surface reactivation and extensional mode I rupture. The second stage of deformation corresponds to chlorite precipitation along the previously reactivated shear surfaces. The pore fluid factor k computed for the two deformation episodes indicates high fluid pressures during the Monte Perdido thrust activity. During the first stage of deformation, the reactivation of the shear surface was facilitated by a suprahydrostatic fluid pressure with a pore fluid factor kv equal to 0.89. For the second stage, the fluid pressure remained still high (with a k value ranging between 0.77 and 0.84) even with the presence of weak chlorite along the shear surfaces. Furthermore, evidence of hydrostatic fluid pressure during calcite cement precipitation supports that incremental shear surface reactivations are correlated with cyclic fluid pressure fluctuations consis- tent with a fault-valve model.

Idiopathic chiasmal neuritis: clinical features and prognosis.

OBJECTIVES: To describe the clinical features of idiopathic chiasmal neuritis in a large cohort of patients and to report their visual and neurologic outcomes. DESIGN: A retrospective medical record review of consecutive patients with chiasmal neuritis at a single institution. Patients with clinical or radiographic evidence of inflammation involving the intraorbital optic nerve and patients with a systemic inflammatory or neoplastic disorder were excluded. RESULTS: Twenty patients were identified (14 female, 6 male; mean age, 37 years). Visual acuity at initial examination ranged from 20/15 to light perception. Progressive visual loss beyond 1 month was documented in 1 patient. Twelve of 15 patients who underwent magnetic resonance imaging demonstrated chiasmal enlargement and/or enhancement; 6 patients had 1 or more white matter lesions. Follow-up time ranged from 2 weeks to 22 years, with a mean of 5.7 years. The final median visual acuity was 20/20 (range, 20/15-20/50) and visual fields were normal or improved. Of 15 patients with a minimum follow-up interval of 1 year, 6 developed multiple sclerosis. CONCLUSIONS: The demographic and clinical features of idiopathic chiasmal neuritis resemble those of idiopathic optic neuritis. Visual prognosis is excellent. In this series, 40% of patients subsequently developed multiple sclerosis.

Étude des sédiments quaternaires, de la molasse et sa tectonique, dans le Grand Lac (Léman) à partir de données sismiques 2D et 3D

RESUME L'Institut de Géophysique de l'Université de Lausanne a développé au cours de ces dernières années un système d'acquisition de sismique réflexion multitrace à haute résolution 2D et 3D. L'objectif de cette thèse était de poursuivre ce développement tout améliorant les connaissances de la géologie sous le lac Léman, en étudiant en particulier la configuration des grands accidents sous-lacustres dans la Molasse (Tertiaire) qui forme l'essentiel du substratum des formations quaternaires. En configuration 2D, notre système permet d'acquérir des profils sismiques avec une distance inter-CDP de 1,25 m. La couverture varie entre 6 et 18 selon le nombre de traces et la distance inter-tir. Le canon à air (15/15 eu. in.), offre une résolution verticale de 1,25 ni et une pénétration maximale de 300 m sous le fond de l'eau. Nous avons acquis au total plus de 400 km de sections 2D dans le Grand Lac et le Haut Lac entre octobre 2000 et juillet 2004. Une campagne de sismique 3D a fourni des données au large d'Evian sur une surface de 442,5 m sur 1450 m, soit 0,64 km2. La navigation ainsi que le positionnement des hydrophones et de la source ont été réalisés avec des GPS différentiels. Nous avons utilisé un traitement sismique conventionnel, sans appliquer d'AGC et en utilisant une migration post-stack. L'interprétation du substratum antéquaternaire est basée sur l'identification des sismofaciès, sur leurs relations avec les unités géologiques adjacentes au lac, ainsi que sur quelques données de forages. Nous obtenons ainsi une carte des unités géologiques dans le Grand Lac. Nous précisons la position du chevauchement subalpin entre la ville de Lausanne, sur la rive nord, et le bassin de Sciez, sur la rive sud. Dans la Molasse de Plateau, nous avons identifié les décrochements de Pontarlier et de St. Cergue ainsi que plusieurs failles non reconnues jusqu'ici. Nous avons cartographié les accidents qui affectent la Molasse subalpine ainsi que le plan de chevauchement du flysch sur la Molasse près de la rive sud du lac. Une nouvelle carte tectonique de la région lémanique a ainsi pu être dressée. L'analyse du substratum ne montre pas de failles suggérant une origine tectonique de la cuvette lémanique. Par contre, nous suggérons que la forme du creusement glaciaire, donc de la forme du lac Léman, a été influencée par la présence de failles dans le substratum antéquaternaire. L'analyse des sédiments quaternaires nous a permis de tracer des cartes des différentes interfaces ou unités qui les composent. La carte du toit du substratum antéquaternaire montre la présence de chenaux d'origine glaciaire dont la profondeur maximale atteint la cote -200 ni. Leur pente est dirigée vers le nord-est, à l'inverse du sens d'écoulement actuel des eaux. Nous expliquons cette observation par l'existence de circulations sous-glaciaires d'eau artésienne. Les sédiments glaciaires dont l'épaisseur maximale atteint 150 ni au centre du lac ont enregistré les différentes récurrences glaciaires. Dans la zone d'Evian, nous mettons en évidence la présence de lentilles de sédiments glaciolacustres perchées sur le flanc de la cuvette lémanique. Nous avons corrélé ces unités avec des données de forage et concluons qu'il s'agit du complexe inférieur de la pile sédimentaire d'Evian. Celui-ci, âgé de plus de 30 000 ans, serait un dépôt de Kame associé à un lac périglaciaire. La sismique réflexion 3D permet de préciser l'orientation de l'alimentation en matériel détritique de l'unité. La finesse des images obtenues nous permet également d'établir quels types d'érosion ont affecté certaines unités. Les sédiments lacustres, dont l'épaisseur maximale imagée atteint plus de 225 m et sans doute 400 ni sous le delta du Rhône, indiquent plusieurs mécanismes de dépôts. A la base, une mégaturbidite, épaisse d'une trentaine de mètres en moyenne, s'étend entre l'embouchure de la Dranse et le delta du Rhône. Au-dessus, la décantation des particules en suspension d'origine biologique et détritique fournit l'essentiel des sédiments. Dans la partie orientale du lac, les apports détritiques du Rhône forment un delta qui prograde vers l'ouest en s'imbriquant avec les sédiments déposés par décantation. La structure superficielle du delta a brutalement évolué, probablement à la suite de l'évènement catastrophique du Tauredunum (563 A.D.). Sa trace probable se marque par la présence d'une surface érosive que nous avons cartographiée. Le delta a ensuite changé de géométrie, avec notamment un déplacement des chenaux sous-lacustres. Sur l'ensemble de nos sections sismiques, nous n'observons aucune faille dans les sédiments quaternaires qui attesterait d'une tectonique postglaciaire du substratum. ABSTRACT During the last few years the institute of Geophysics of the University of Lausanne cleveloped a 2D and 3D high-resolution multichannel seismic reflection acquisition system. The objective of the present work was to carry on this development white improving our knowledge of the geology under Lake Geneva, in particular by studying the configuration of the large accidents affecting the Tertiary Molasse that makes up the basement of most Quaternary deposits. In its 2D configuration, our system makes it possible to acquire seismic profiles with a CDP interval of 1.25 m. The fold varies from 6 to 18 depending on the number of traces and the shooting interval. Our air gun (15/15 cu. in.) provides a vertical resolution of 1.25 m and a maximum penetration depth of approximately 300 m under water bottom. We acquired more than 400 km of 2D sections in the Grand Lac and the Haut Lac between October 2000 and July 2004. A 3D seismic survey off the city of Evian provided data on a surface of 442.5 m x 1450 m (0.64 km2). Ship's navigation as well as hydrophone- and source positioning were carried out with differential GPS. The seismic data were processed following a conventional sequence without .applying AGC and using post-stack migration. The interpretation of the pre-Quaternary substratum is based on sismofacies, on their relationships with terrestrial geological units and on some borehole data. We thus obtained a map of the geological units in the Grand Lac. We defined the location of the subalpine thrust from Lausanne, on the north shore, to the Sciez Basin, on the south shore. Within the Molasse de Plateau, we identified the already know Pontarlier and St Cergue transforms Fault as well as faults. We mapped faults that affect subalpine Molasse as well as the thrust fault plane between alpine flysch and Molasse near the lake's south shore. A new tectonic map of the Lake Geneva region could thus be drawn up. The substratum does not show faults indicating a tectonic origin for the Lake Geneva Basin. However, we suggest that the orientation of glacial erosion, and thus the shape of Lake Geneva, vas influenced by the presence of faults in the pre-Quaternary basement. The analysis of Quaternary sediments enabled us to draw up maps of various discontinuities or internal units. The top pre-Quaternary basement map shows channels of glacial origin, the deepest of them reaching an altitude of 200 m a.s.l. The channel's slopes are directed to the North-East, in opposite direction of the present water flow. We explain this observation by the presence of artesian subglacial water circulation. Glacial sediments, the maximum thickness of which reaches 150 m in the central part of the lake, record several glacial recurrences. In the Evian area, we found lenses of glacio-lacustrine sediments set high up on the flank of the Lake Geneva Bassin. We correlated these units with on-land borehole data and concluded that they represent the lower complex of the Evian sedimentary pile. The lower complex is aider than 30 000 years, and it could be a Kame deposit associated with a periglacial lake. Our 3D seismic reflexion survey enables us to specify the supply direction of detrital material in this unit. With detailed seismic images we established how some units were affected by different erosion types. The lacustrine sediments we imaged in Lake Geneva are thicker than 225 m and 400 m or more Linder the Rhone Delta. They indicate several depositional mechanisms. Their base is a major turbidite, thirty meters thick on average, that spreads between the Dranse mouth and the Rhone delta. Above this unit, settling of suspended biological and detrital particles provides most of the sediments. In the eastern part of the lake, detrital contribution from the Rhone builds a delta that progrades to the west and imbricates with the settling sediments. The shallow structure of the Rhone delta abruptly evolved, probably after the catastrophic Tauredunum event (563 A.D.). It probably coincides with an erosive surface that we mapped. As a result, the delta geometry changed, in particular associated with a displacement of water bottom channels. In all our seismic sections, we do not observe fault in the Quaternary sediments that would attest postglacial tectonic activity in the basement.

Anàlisi i quantificació de les accions i el temps de joc en l'hoquei sobre patins en equips de l'OK Lliga

Quantificar les variables temporal, les accions tècniques i els desplaçaments dels jugador al llarg de la competició proporciona una informació excel·lent per deduir les càrregues físiques i fisiològiques a les que estan sotmesos. Per aquest estudi es van visualitzar 4 partits de la Copa del Rei 2012. Es va enregistrà sistemàticament les dades en fulls de registre. Les principals dades analitzades van ser: temps total, temps real, temps de pausa, temps d’acció i relació entre el temps d’acció i el temps de pausa (densitat de treball). També es va analitzar: les incidències reglamentaries, les accions tècniques del jugador i els desplaçaments del jugador. El 45% de les accions es van produir entre 0 i 30s, i el promig d’interval de participació va ser 19:29s ±2:09. Més del 50% de les pauses es van produir entre 11s i 30s, i el promig d’interval de pausa va ser de 24:57s. Aquest va determinar que la densitat de treball era 1:1.3. Aproximadament el 70% de les incidències reglamentàries van ser faltes d’equip I tècniques. Van haver-hi 56 conduccions, 10 driblins, 12 remats, (3 xuts, 2 punxades/escopides, 5 remats de primeres i 2 arrossegades) i 80 passades. Finalment, en un partit el 42,23% dels desplaçaments van ser a baixa intensitat, el 27,02% van ser a intensitat mitjana i el 30,75% van ser a alta intensitat. A més a més, el 81,90% dels desplaçaments a alta intensitat van durar de 0s a 5s, el 54,56% a intensitat mitjana van durar de 6 a 10 s. I el 49,32% a intensitat baixa també van durar 6s a 10s. L’hoquei sobre patins és un esport en el que hi predominen els esforços intermitents a gran intensitat i de curta durada amb una important sol·licitació de la via anaeròbica alàctica. Analitzar la dimensió temporal, les accions tècniques i els desplaçaments dels jugador durant la competició permet estimar les exigències físiques i requeriments energètics, i aquest faciliten l’elaboració d’entrenaments més específics.

Lake dwellers occupation gap in Lake Geneva (France-Switzerland) possibly explained by an earthquake-mass movement-tsunami event during Early Bronze Age

High-resolution seismic and sediment core data from the 'Grand Lac' basin of Lake Geneva reveal traces of repeated slope instabilities with one main slide-evolved mass-flow (minimum volume 0.13 km3) that originated from the northern lateral slope of the lake near the city of Lausanne. Radiocarbon dating of organic remains sampled from the top of the main deposit gives an age interval of 1865-1608 BC. This date coincides with the age interval for a mass movement event described in the 'Petit Lac' basin of Lake Geneva (1872-1622 BC). Because multiple mass movements took place at the same time in different parts of the lake, we consider the most likely trigger mechanism to be a strong earthquake (Mw 6) that occurred in the period between 1872 and 1608 BC. Based on numerical simulations, we show the major deposit near Lausanne would have generated a tsunami with local wave heights of up to 6 m. The combined effects of the earthquake and the following tsunami provide a possible explanation for a gap in lake dwellers occupation along the shores of Lake Geneva revealed by dendrochronological dating of two palafitte archaeological sites.

Nuevas técnicas de estadística espacial para la detección de clusters residenciales de población inmigrante

La estadística aplicada a la geografía ha experimentado un avance espectacular en las últimas dos décadas introduciéndose el espacio como eje fundamental del análisis. Este avance se ha visto acompañado por un rápido desarrollo de aplicaciones estadísticas integradas en los sistemas de información geográfica, constituyéndose de esta forma en un conjunto de herramientas imprescindibles en la planificación territorial. Por otro lado, en España, el incremento de población inmigrada en un corto intervalo de tiempo ha hecho necesario analizar su distribución espacial en las áreas urbanas. Los índices de autocorrelación espacial, tanto global como local, y su representación cartográfica constituyen una técnica adecuada para la detección de clusters y patrones espaciales y abre la posibilidad de plantear diferentes modelos econométricos. A partir del caso de la ciudad de Barcelona se aplican las técnicas descritas y se observan los diferentes comportamientos según el grupo de población estudiado.

Virological and immunological responses to efavirenz or boosted lopinavir as first-line therapy for patients with HIV.

BACKGROUND: Efavirenz and lopinavir boosted with ritonavir are both recommended as first-line therapies for patients with HIV when combined with two nucleoside reverse transcriptase inhibitors. It is uncertain which therapy is more effective for patients starting therapy with an advanced infection. METHODS: We estimated the relative effect of these two therapies on rates of virological and immunological failure within the Swiss HIV Cohort Study and considered whether estimates depended on the CD4(+) T-cell count when starting therapy. We defined virological failure as either an incomplete virological response or viral rebound after viral suppression and immunological failure as failure to achieve an expected CD4(+) T-cell increase calculated from EuroSIDA statistics. RESULTS: Patients starting efavirenz (n=660) and lopinavir (n=541) were followed for a median of 4.5 and 3.1 years, respectively. Virological failure was less likely for patients on efavirenz, with the adjusted hazard ratio (95% confidence interval) of 0.63 (0.50-0.78) then multiplied by a factor of 1.00 (0.90-1.12) for each 100 cells/mm(3) decrease in CD4(+) T-cell count below the mean when starting therapy. Immunological failure was also less likely for patients on efavirenz, with the adjusted hazard ratio of 0.68 (0.51-0.91) then multiplied by a factor of 1.29 (1.14-1.46) for each 100 cells/mm(3) decrease in CD4(+) T-cell count below the mean when starting therapy. CONCLUSIONS: Virological failure is less likely with efavirenz regardless of the CD4(+) T-cell count when starting therapy. Immunological failure is also less likely with efavirenz; however, this advantage disappears if patients start therapy with a low CD4(+) T-cell count.

Sidebranching induced by external noise in solutal dendritic growth

We have studied sidebranching induced by fluctuations in dendritic growth. The amplitude of sidebranching induced by internal (equilibrium) concentration fluctuations in the case of solidification with solutal diffusion is computed. This amplitude turns out to be significantly smaller than values reported in previous experiments. The effects of other possible sources of fluctuations (of an external origin) are examined by introducing nonconserved noise in a phase-field model. This reproduces the characteristics of sidebranching found in experiments. Results also show that sidebranching induced by external noise is qualitatively similar to that of internal noise, and it is only distinguished by its amplitude.