Kaposi sarcoma-associated herpes virus and response to antiretroviral therapy: a prospective study of HIV-infected adults

BACKGROUND The possible impact of coinfection with the Kaposi sarcoma-associated herpes virus (KSHV) on the response to antiretroviral therapy (ART) is unknown. Prospective studies are rare, particularly in Africa. METHODS We enrolled a prospective cohort of HIV-infected adults initiating ART in Johannesburg, South Africa. The subjects were defined as seropositive to KSHV if they were reactive to either KSHV lytic K8.1 or latent Orf73 antigen or to both. The subjects were followed from ART initiation until 18 months of treatment. HIV viral load and CD4 counts were tested 6 monthly. Linear generalized estimating and log-binomial regression models were used to estimate the effect of KSHV infection on immunologic recovery and response and HIV viral load suppression within 18 months after ART initiation. RESULTS Three hundred eighty-five subjects initiating ART from November 2008 to March 2009 were considered to be eligible including 184 (48%) KSHV+. The KSHV+ group was similar to the KSHV- in terms of age, gender, initiating CD4 count, body mass index, tuberculosis, and hemoglobin levels. The KSHV+ group gained a similar number of cells at 6 [difference of 10 cells per cubic millimeter, 95% confidence interval (CI): -11 to 31], 12 (3 cells per cubic millimeter, 95% CI: -19 to 25), and 18 months (24 cells per cubic millimeter, 95% CI: -13 to 61) compared with that gained by the KSHV- group. Adjusted relative risk of failure to suppress viral load to <400 copies per milliliter (1.03; 95% CI: 0.90 to 1.17) were similar for KSHV+ and KSHV- by 6 months on treatment. CONCLUSIONS In a population with a high KSHV prevalence, HIV-positive adults coinfected with KSHV achieved similar immunologic and virologic responses to ART early after treatment initiation compared with those with KSHV-.

CD4 count slope and mortality in HIV-infected patients on antiretroviral therapy: multicohort analysis from South Africa

BACKGROUND In many resource-limited settings monitoring of combination antiretroviral therapy (cART) is based on the current CD4 count, with limited access to HIV RNA tests or laboratory diagnostics. We examined whether the CD4 count slope over 6 months could provide additional prognostic information. METHODS We analyzed data from a large multicohort study in South Africa, where HIV RNA is routinely monitored. Adult HIV-positive patients initiating cART between 2003 and 2010 were included. Mortality was analyzed in Cox models; CD4 count slope by HIV RNA level was assessed using linear mixed models. RESULTS About 44,829 patients (median age: 35 years, 58% female, median CD4 count at cART initiation: 116 cells/mm) were followed up for a median of 1.9 years, with 3706 deaths. Mean CD4 count slopes per week ranged from 1.4 [95% confidence interval (CI): 1.2 to 1.6] cells per cubic millimeter when HIV RNA was <400 copies per milliliter to -0.32 (95% CI: -0.47 to -0.18) cells per cubic millimeter with >100,000 copies per milliliter. The association of CD4 slope with mortality depended on current CD4 count: the adjusted hazard ratio (aHRs) comparing a >25% increase over 6 months with a >25% decrease was 0.68 (95% CI: 0.58 to 0.79) at <100 cells per cubic millimeter but 1.11 (95% CI: 0.78 to 1.58) at 201-350 cells per cubic millimeter. In contrast, the aHR for current CD4 count, comparing >350 with <100 cells per cubic millimeter, was 0.10 (95% CI: 0.05 to 0.20). CONCLUSIONS Absolute CD4 count remains a strong risk for mortality with a stable effect size over the first 4 years of cART. However, CD4 count slope and HIV RNA provide independently added to the model.

Gastric pharmacobezoars in quetiapine extended-release overdose: a case series

OBJECTIVE Although extended-release (XR) formulations are recognized to bear some risk of pharmacobezoar formation in overdose, there are no previously documented reports of this phenomenon with quetiapine. We describe nine cases of pharmacobezoar formation in acute quetiapine XR overdose. METHODS Observational case series of all patients who underwent gastroscopy after quetiapine XR overdose, which were reported by physicians to the Swiss Toxicological Information Centre between January 2010 and December 2012, with detailed analysis of cases with documented pharmacobezoar. RESULTS Gastric pharmacobezoars were detected in 9 out of 19 gastroscopic evaluations performed during the study period. All these patients ingested a large dose of quetiapine XR (10-61 tablets; 6-24.4 g quetiapine). All patients but one also coingested at least one other substance, and in three cases another XR drug formulation. Gastroscopic pharmacobezoar removal was achieved without complications in all patients, but was difficult due to the particular "gelatinous-sticky-pasty" consistency of the concretion. The subsequent clinical course was favorable. CONCLUSIONS The possibility of pharmacobezoar formation following a large quetiapine XR overdose should be considered, as this may influence acute patient management. Complete endoscopic pharmacobezoar removal may be a promising approach in selected cases, but further studies are needed to define its role.

Incidence and causative agents of chemical eye injuries in Switzerland

CONTEXT Chemical eye injuries are ophthalmological emergencies with a high risk of secondary complications and severe visual loss. Only limited epidemiological data for such injuries are available for many countries. PATIENTS AND METHODS We performed two independent studies. The cause of chemical eye injuries was assessed with a prospective questionnaire study. Questionnaires were sent to all ophthalmologists in Switzerland. A total of 163 patients (205 eyes) were included, between December 2012 and October 2014. Independent of the questionnaire study, the incidence of chemical eye injuries was assessed with a retrospective cohort study design using the database of the mandatory accident insurance. RESULTS Ophthalmological questionnaires revealed that plaster/cement (20.5%), alkaline (12.2%) and acid (10.2%) solutions caused the highest number of chemical injuries. Only 2% of all injuries were classified as grade III and none as grade IV (Roper-Hall classification). The official toxicological information phone-hotline was contacted in 4.3% of cases. Using data from the accident insurance, an incidence of chemical eye injuries of about 50/100 000/year was found in the working population. CONCLUSION Here, we present data on the involved agents of chemical eye injuries in Switzerland, and also the incidence of such injuries in the working population. This may also help to assess the need for further education programs and to improve and direct preventive measures.

Multifaceted responsiveness

The idea of responsiveness is closely related to therapist style and therapeutic relationship. While this may be the most important aspect of the therapeutic process from a responsiveness perspective, responsiveness is also crucial when it comes to deciding for themes and goals, and particular methods or interventions. Findings related to this notion that have been accumulated in our research group will be presented along with conceptual considerations. This will be complemented by some reflections from a basic psychology perspective.

The origin of letters and numerals : according to the Sefer Yetzirah

[Philadelphia], Univ., Diss., [1914]

Maximizing the number of polychronous groups in spiking networks

In this paper we investigate the effect of biasing the axonal connection delay values in the number of polychronous groups produced for a spiking neuron network model. We use an estimation of distribution algorithm (EDA) that learns tree models to search for optimal delay configurations. Our results indicate that the introduced approach can be used to considerably increase the number of such groups.

IBPOWER Project, Intermediate band materials and solar cells for photovoltaics with high efficiency and reduced cost

IBPOWER is a Project awarded under the 7th European Framework Programme that aims to advance research on intermediate band solar cells (IBSCs). These are solar cells conceived to absorb below bandgap energy photons by means of an electronic energy band that is located within the semiconductor bandgap, whilst producing photocurrent with output voltage still limited by the total semiconductor bandgap. IBPOWER employs two basic strategies for implementing the IBSC concept. The first is based on the use of quantum dots, the IB arising from the confined energy levels of the electrons in the dots. Quantum dots have led to devices that demonstrate the physical operation principles of the IB concept and have allowed identification of the problems to be solved to achieve actual high efficiencies. The second approach is based on the creation of bulk intermediate band materials by the insertion of an appropriate impurity into a bulk semiconductor. Under this approach it is expected that, when inserted at high densities, these impurities will find it difficult to capture electrons by producing a breathing mode and will cease behaving as non-radiative recombination centres. Towards this end the following systems are being investigated: a) Mn: In1-xGax N; b) transition metals in GaAs and c) thin films.

A hierarchical strategy for real-time tracking on-board UAVs

In this paper, we present a real-time tracking strategy based on direct methods for tracking tasks on-board UAVs, that is able to overcome problems posed by the challenging conditions of the task: e.g. constant vibrations, fast 3D changes, and limited capacity on-board. The vast majority of approaches make use of feature-based methods to track objects. Nonetheless, in this paper we show that although some of these feature-based solutions are faster, direct methods can be more robust under fast 3D motions (fast changes in position), some changes in appearance, constant vibrations (without requiring any specific hardware or software for video stabilization), and situations where part of the object to track is out the field of view of the camera. The performance of the proposed strategy is evaluated with images from real-flight tests using different evaluation mechanisms (e.g. accurate position estimation using a Vicon sytem). Results show that our tracking strategy performs better than well known feature-based algorithms and well known configurations of direct methods, and that the recovered data is robust enough for vision-in-the-loop tasks.

Use of Biological Motion based Cues and Ecological Sounds in the Neurorehabilitation of Apraxia

Technological progress in the area of informatics and human interface platforms create a window of opportunities for the neurorehablitation of patients with motor impairments. The CogWatch project (www.cogwatch.eu) aims to create an intelligent assistance system to improve motor planning and execution in patients with apraxia during their daily activities. Due to the brain damage caused by cardiovascular incident these patients suffer from impairments in the ability to use tools, and to sequence actions during daily tasks (such as making breakfast). Based on the common coding theory (Hommel et al., 2001) and mirror neuron primate research (Rizzolatti et al., 2001) we aim to explore use of cues, which incorporate aspects of biological motion from healthy adults performing everyday tasks requiring tool use and ecological sounds linked to the action goal. We hypothesize that patients with apraxia will benefit from supplementary sensory information relevant to the task, which will reinforce the selection of the appropriate motor plan. Findings from this study determine the type of sensory guidance in the CogWatch interface. Rationale for the experimental design is presented and the relevant literature is discussed.

The Pittsburgh district civic frontage

I. The community: Pittsburgh the year of the survey, by E. T. Devine. Pittsburgh: an interpretation of its growth, by R. A. Woods. Coalition of Pittsburgh's civic forces, by A. T. Burns.--II. Civic conditions: Civic improvement possibilities in Pittsburgh, by C. M. Robinson. Thirty-five years of typhoid, by F. E. Wing. The housing of Pittsburgh's workers, by Emily W. Dinwiddie and F. Elisabeth Crowell. Three studies in housing and responsibility: Skunk hollow, by Florence L. Lattimore. Painter's row, Tammany hall, by F. Elisabeth Crowell. The aldermen and their courts, by H. V. Blaxter and A. H. Kerr. The disproportion of taxation in Pittsburgh, by S. M. Harrison.--III. Children and the city: Pittsburgh schools, by Lila Ver P. North. The playgrounds of Pittsburgh, by Beulah Kennard. The public library, by Frances J. Olcott. Pittsburgh as a foster mother, by Florence L. Lattimore.--Appendices.

Crashworthiness analysis of the UMTA state-of-the-art cars. Final report.

Transportation Systems Center, Cambridge, Mass.