Relevant gender differences in epidemiological profile, exposure to first antiretroviral regimen and survival in the Spanish AIDS Research Network Cohort.

BACKGROUND The possible differences in the disease spectrum and prognosis of HIV infection in women and men is a major point of concern. Women are under-represented in randomized clinical trials and in some cohorts. Discordant results have often been obtained depending on the setting. METHODS We assessed gender differences in clinical and epidemiological features, antiretroviral treatment (ART) exposure and survival in two multicentre cohorts of HIV-positive subjects in Spain: CoRIS-MD and CoRIS. Competing risk regression models were used to assess gender effect on time to start ART and time to first ART change, and a Cox regression model to estimate gender effect on time to death. RESULTS Between January 1996 and December 2008, 1,953 women and 6,072 men naive to ART at study entry were included. The trend analysis over time showed the percentage of women in the younger (<20 years) and older (>50 years) strata increased significantly (P<0.001) from 0.5% and 1.8% in 1996 to 4.9% and 4.2% in 2008, respectively. By competing risk analysis women started ART earlier than men (adjusted subhazard ratio [ASHR] 1.21, 95% CI 1.11, 1.31) in CoRIS cohort, while in CoRIS-MD none of these differences were observed. In both cohorts women showed a shorter time to the first ART change (ASHR 1.10, 95% CI 1.01, 1.19). Pregnancy and patient's/physician's decisions as reasons for changing were more frequent in women than in men in CoRIS. In the Cox regression model, gender was not associated with differences in survival. CONCLUSIONS In two large cohorts in Spain, we observed relevant gender differences in epidemiological characteristics and antiretroviral exposure outcomes, while survival differences were not attributable to gender.

Reflux vésico-­‐urétéral et atteinte rénale: rôle de l'albuminurie

Introduction :¦Le reflux vésico-urétéral (RVU) touche environs 1% des nouveau-nés et est retrouvé chez 25 à 30 % des enfants ayant une pyélonéphrite. Le RVU peut être associé à une hypoplasie/dysplasie rénale ou/et à des cicatrices rénales causées par les pyélonéphrites. Ces changements morphologiques sont plus ou moins importants selon le grade du reflux et peuvent conduire à une insuffisance rénale chronique et potentiellement évoluer en une insuffisance rénale terminale.¦La microalbuminurie (MA) reflète une augmentation anormale de la perméabilité capillaire glomérulaire et est un indicateur prédictif de la péjoration de la fonction rénale vers l'insuffisance chronique. La MA est également un facteur de risque cardiovasculaire.¦Objectif :¦Le but de cette recherche transversale est d'évaluer la présence de MA chez des patients atteints de RVU et de voir s'il est possible de corréler la MA avec le degré de reflux, la présence d'une hyperfiltration et le degré de l'insuffisance rénale.¦Patients et méthode :¦Une base de données de 160 dossiers médicaux du service de pédiatrie du CHUV, portant sur les années 2007, 2008, 2009 et 2010, va être investiguée. Ces dossiers regroupent tous les patients atteints de RVU ayant eu une exploration fonctionnelle rénale, dont l'âge varie du nouveau-né au jeune adulte âgé de 21 ans. Les variables suivantes seront considérées et analysées en détail: âge, sexe, taille, type de RVU, taux de filtration glomérulaire (TFG), flux plasmatique rénal (FPR), fraction de filtration (FF), albuminurie, rapport albumine/créatinine.¦- Les RVU sont classés en cinq grades (I, II, III, IV, V) et peuvent être uni- ou bilatéraux¦- Le TFG est calculé avec la clairance à l'inuline, un polymère de glucose filtré, non réabsorbé, ni sécrété, qu'on perfuse au patient. TFG = Uin V/Pin (ml/min)¦- Le FPR est calculé avec la clairance au PAH (acide para-amino-hippurique), une substance entièrement filtrée et sécrétée au premier passage et qu'on injecte au patient. FPR = UPAHV / PPAH (ml/min)¦- La FF est la proportion du FPR qui est filtrée.¦FF= TGF / FPR ou FF = Cl in / Cl PAH¦- La MA a été mesurée par la méthode Immulite (Siemens) jusqu'en fin août 2010 et par la méthode ALBT2 (Roche Diagnostics) à partir d'octobre 2010. Le taux normal d'albuminurie est de moins de 20 mg/l sur un échantillon d'urine.¦- Le rapport albumine urinaire / créatinine urinaire permet d'éviter les problèmes de variation de volume urinaire lors de l'analyse d'échantillon urinaire d'une seule miction. Le rapport normal est de moins de 2,5 g/mol de créatinine.¦Un questionnaire sera envoyé aux patients pour obtenir des précisions sur la fréquence et la sévérité des infections urinaires éventuellement survenues depuis.¦Les dossiers seront revus pour connaître l'évolution du RVU.¦Résultats attendus et discussion: Les résultats nous permettront :¦1) De savoir si les patients avec un RVU ont une MA¦2) De savoir si la MA varie en fonction du grade de leur reflux¦3) De savoir si la MA varie en fonction de l'hyperfiltration mesurée par la FF.¦Interprétation :¦Si la MA varie en fonction de la FF cela indiquera que la MA est la conséquence directe de l'hyperfiltration compensatrice de la perte de la masse néphronique et qu'elle est ainsi le reflet d'une cause principalement mécanique. Si la MA ne varie pas en fonction de la FF cela indiquera qu'elle est liée à l'hypoplasie/dysplasie ou/et aux cicatrices dues aux pyélonéphrites. Elle pourra alors être par exemple la conséquence d'une néphropathie glomérulotubulointerstitielle.¦Du point de vue pratique, cette étude permettra de déterminer si la simple mesure da la MA peut aider à prédire le degré de l'atteinte rénale et/ou le degré de l'hyperfiltration dans ce groupe de patients atteints de RVU.¦Bibliographie¦1. Silbernagl S, Despopoulos A. Atlas de poche de physiologie. Paris : Flammarion médecine-sciences; 2004.¦2. Brenner BM, Rector FC. The Kidney . Philadelphia : WB Saunders Company; 1996.¦3. Brandström P, Esbjörner E, Herthelius M, Holmdahl G, Läckgren G, Nevéus T, et al. The Swedish Reflux Trial in Children: I. Study Design and Study Population Characteristics. The Journal of Urology. 2010;184:274-279.¦4. Holmdahl G, Brandström P, Läckgren G, Sillén U, Stokland E, Jodal U, et al. The Swedish Reflux Trial in Children: II. Vesicoureteral Reflux Outcome. The Journal of Urology. 2010;184:280-285.¦5. Brandström P, Esbjörner E, Herthelius M, Swerkersson S, Jodal U, Hansson S. The Swedish Reflux Trial in Children: III. Urinary Tract Infection Pattern. The Journal of Urology. 2010;184:286-291.¦6. Brandström P, Nevéus T, Sixt R, Stokland E, Jodal U, Hansson S. The Swedish Reflux Trial in Children: IV. Renal Damage. The Journal of Urology. 2010;184:292-297.¦7. Ruggenenti P, Remuzzi G. Time to abandon microalbuminuria? Kidney Int. 2006;70:1214-1222.¦8. Hostetter TH, Olson JL, Rennke HG, Venkatachalam MA, Brenner BM. Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation. J. Am. Soc. Nephrol. 2001;12:1315-1325.¦9. Basic J, Golubovic E, Miljkovic P, Bjelakovic G, Cvetkovic T, Milosevic V. Microalbuminuria in children with vesicoureteral reflux. Ren Fail. 2008:639-643.¦10. González E, Papazyan JP, Girardin E. Impact of vesicoureteral reflux on the size of renal lesions after an episode of acute pyelonephritis. The Journal of Urology. 2005;173:571-575.

CATMA, a comprehensive genome-scale resource for silencing and transcript profiling of Arabidopsis genes.

BACKGROUND: The Complete Arabidopsis Transcript MicroArray (CATMA) initiative combines the efforts of laboratories in eight European countries 1 to deliver gene-specific sequence tags (GSTs) for the Arabidopsis research community. The CATMA initiative offers the power and flexibility to regularly update the GST collection according to evolving knowledge about the gene repertoire. These GST amplicons can easily be reamplified and shared, subsets can be picked at will to print dedicated arrays, and the GSTs can be cloned and used for other functional studies. This ongoing initiative has already produced approximately 24,000 GSTs that have been made publicly available for spotted microarray printing and RNA interference. RESULTS: GSTs from the CATMA version 2 repertoire (CATMAv2, created in 2002) were mapped onto the gene models from two independent Arabidopsis nuclear genome annotation efforts, TIGR5 and PSB-EuGène, to consolidate a list of genes that were targeted by previously designed CATMA tags. A total of 9,027 gene models were not tagged by any amplified CATMAv2 GST, and 2,533 amplified GSTs were no longer predicted to tag an updated gene model. To validate the efficacy of GST mapping criteria and design rules, the predicted and experimentally observed hybridization characteristics associated to GST features were correlated in transcript profiling datasets obtained with the CATMAv2 microarray, confirming the reliability of this platform. To complete the CATMA repertoire, all 9,027 gene models for which no GST had yet been designed were processed with an adjusted version of the Specific Primer and Amplicon Design Software (SPADS). A total of 5,756 novel GSTs were designed and amplified by PCR from genomic DNA. Together with the pre-existing GST collection, this new addition constitutes the CATMAv3 repertoire. It comprises 30,343 unique amplified sequences that tag 24,202 and 23,009 protein-encoding nuclear gene models in the TAIR6 and EuGène genome annotations, respectively. To cover the remaining untagged genes, we identified 543 additional GSTs using less stringent design criteria and designed 990 sequence tags matching multiple members of gene families (Gene Family Tags or GFTs) to cover any remaining untagged genes. These latter 1,533 features constitute the CATMAv4 addition. CONCLUSION: To update the CATMA GST repertoire, we designed 7,289 additional sequence tags, bringing the total number of tagged TAIR6-annotated Arabidopsis nuclear protein-coding genes to 26,173. This resource is used both for the production of spotted microarrays and the large-scale cloning of hairpin RNA silencing vectors. All information about the resulting updated CATMA repertoire is available through the CATMA database http://www.catma.org.

Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries.

With advances in the effectiveness of treatment and disease management, the contribution of chronic comorbid diseases (comorbidities) found within the Charlson comorbidity index to mortality is likely to have changed since development of the index in 1984. The authors reevaluated the Charlson index and reassigned weights to each condition by identifying and following patients to observe mortality within 1 year after hospital discharge. They applied the updated index and weights to hospital discharge data from 6 countries and tested for their ability to predict in-hospital mortality. Compared with the original Charlson weights, weights generated from the Calgary, Alberta, Canada, data (2004) were 0 for 5 comorbidities, decreased for 3 comorbidities, increased for 4 comorbidities, and did not change for 5 comorbidities. The C statistics for discriminating in-hospital mortality between the new score generated from the 12 comorbidities and the Charlson score were 0.825 (new) and 0.808 (old), respectively, in Australian data (2008), 0.828 and 0.825 in Canadian data (2008), 0.878 and 0.882 in French data (2004), 0.727 and 0.723 in Japanese data (2008), 0.831 and 0.836 in New Zealand data (2008), and 0.869 and 0.876 in Swiss data (2008). The updated index of 12 comorbidities showed good-to-excellent discrimination in predicting in-hospital mortality in data from 6 countries and may be more appropriate for use with more recent administrative data.

Disentangling reasons for low Y chromosome variation in the greater white-toothed shrew (Crocidura russula).

Y chromosome variation is determined by several confounding factors including mutation rate, effective population size, demography, and selection. Disentangling these factors is essential to better understand the evolutionary properties of the Y chromosome. We analyzed genetic variation on the Y chromosome, X chromosome, and mtDNA of the greater white-toothed shrew, a species with low variance in male reproductive success and limited sex-biased dispersal, which enables us to control to some extent for life-history effects. We also compared ancestral (Moroccan) to derived (European) populations to investigate the role of demographic history in determining Y variation. Recent colonization of Europe by a small number of founders (combined with low mutation rates) is largely responsible for low diversity observed on the European Y and X chromosomes compared to mtDNA. After accounting for mutation rate, copy number, and demography, the Y chromosome still displays a deficit in variation relative to the X in both populations. This is possibly influenced by directional selection, but the slightly higher variance in male reproductive success is also likely to play a role, even though the difference is small compared to that in highly polygynous species. This study illustrates that demography and life-history effects should be scrutinized before inferring strong selective pressure as a reason for low diversity on the Y chromosome.

Post-collisional Neogene magmatism of the Mediterranean Maghreb margin: a consequence of slab breakoff

A 1 200 km-long linear magmatic belt extends along the Mediterranean coast the Maghreb from Eastern Tunisia to Morocco. This belt is mainly composed of Langan calc-alkaline metaluminous to peraluminous granitoids and associated andesites/cites Central and Eastern Algeria. In Tunisia and Oranie/Western Morocco, calc alkaline activity started later (during the Serravallian) and was followed by the placement of alkali basalts and basanites since the Tortonian to the Pliocene and, in me places, the Pleistocene. Available data on the tectonic setting, petrology, age and biochemistry of this belt show that most of its striking features, e.g. (1) very low magma production rate, subduction-related geochemical imprint, extensive crustal contamination the calc-alkaline magmatism and (2) progressive magmatic change from calc-alkaline alkaline, are consistent with magma generation during a slab breakoff process as proposed Carminati et al, in 1998. The magmatism associated with this breakoff started in Central Eastern Algeria at 16 Ma, then propagated eastwards and westwards, The upward of asthenospheric enriched plume-type mantle through the tear in the downgoing first triggered melting of the overlying lithospheric mantle which had been metasomatised during a previous subduction period. Heat supply from this uprising asthenosphere may have warmed up the continental crust and made its involvement in assimilation processes easier. As the asthenosphere ascended through the `window' in the slab, partial melting occurred at the uprising boundary between asthenosphere and lithosphere, generating basalts with transitional characteristics between those of calc-alkaline and alkaline basalts. As the asthhenospheric upwelling proceeded partial:melting then occurred in the sole asthenospheric mantle, producing alkali basalts. (C) 2000 Academie des sciences Editions scientifiques et medicales Elsevier SAS.

The Ladinian flora from the Cassina beds (Meride Limestone, Monte San Giorgio, Switzerland): Preliminary results

A newly opened excavation in the Cassina beds of the Lower Meride Limestone (Monte San Giorgio UNESCO WHL, Canton Ticino, Southern Alps) has yielded a small collection of Ladinian plant fossils, together with vertebrate (mostly fish) and invertebrate remains The flora contains at least five species, conifer remains assignable to the genera Elatocladus, Voltzia and Pelourdea are the most common elements A new species, Elatocladus cassinae n Sp, is formally, described Co-occurring with the conifers arc seed ferns (Ptilozamites) and a few putative cycadalean remains (Taemopteris) Among the identified genera, only Volizia has previously been reported from Monte San Giorgio The fossils presented in this paper indicate that a diversified flora thrived in the region during the Ladman Floral composition and preservation patterns are suggestive of a taphonomically-biased record and a relatively far-away source area

Iowa Department of Economic Development, Agency Performance Plan

Annual Report, Agency Performance Plan

Ionotropic and metabotropic mechanisms in chemoreception: 'chance or design'?

Chemosensory receptors convert an enormous diversity of chemical signals from the external world into a common language of electrical activity in the brain. Mammals and insects use several families of transmembrane receptor proteins to recognize distinct classes of volatile and non-volatile chemicals that are produced by conspecifics or other environmental sources. A comparison of the signalling mechanisms of mammalian and insect receptors has revealed an unexpected functional distinction: mammals rely almost exclusively on metabotropic ligand-binding receptors, which use second messenger signalling cascades to indirectly activate ion channels, whereas insects use ionotropic receptors, which are gated directly by chemical stimuli, thereby leading to neuronal depolarization. In this review, we consider possible reasons for this dichotomy, taking into account biophysical, cell biological, ecological and evolutionary influences on how information is extracted from chemosensory cues by these animal classes.

Perioperative nutrition is still a surgical orphan

Objective: To assess if screening programs and treatment of preoperative malnutrition have been implemented into surgical practice to decrease morbidity. There is strong evidence that postoperative morbidity can be minimized by early identifying and treating patients at nutritional risk before major surgery.The validated nutritional risk score (NRS) is recommended by the European Society of Parenteral and Enteral Nutrition for nutritional screening. It remains unclear whether routine preoperative nutritional assessment and perioperative nutrition is widely implemented.Methods: A survey was conducted in 173 Swiss and Austrian surgical departments. Implementation of nutritional screening, perioperative nutrition, and estimated impact on clinical outcome were assessed. Non-responders were repeatedly contacted by the authors.Results: The overall response rate was 55%, whereby 69% (54/78) of Swiss and 44% (42/95) of Austrian centers responded. Despite 80% and 59% of the responding centers are aware of a reduced complication rate and shortened hospital stay, respectively, only 20% of them implemented routine nutritional screening. Financial (49%) and logistic restrictions (33%) are the predominant reasons against the routine clinical use. Screening is mainly performed either in the outpatient's clinic (52%) or during admission (54%). The NRS is only used by 14%. Instead, various clinical (78%), e.g. BMI and laboratory findings (56%), e.g. albumine, are used. Indication for perioperative nutrition is based on preoperative screening in 49%.While 23% use preoperative nutrition, 68% apply nutritional support pre- and postoperatively. Preoperative nutritional treatment ranged from three days (33%), to five days (31%) and even seven days (20%).Conclusion: Despite malnutrition is well recognized as major risk factor for increased postoperative morbidity, the majority of surgeons are reluctant to implement routine screening and nutritional support. If nutritional assessment is performed, local institutional screening parameters are still preferred. It remains difficult to overcome traditions, and to change surgeon's mind.