Are They Really Lost? "True" Status and Reasons for Treatment Discontinuation among HIV Infected Patients on Antiretroviral Therapy Considered Lost to Follow Up in Urban Malawi

INTRODUCTION Patients who are lost to follow-up (LTFU) while on antiretroviral therapy (ART) pose challenges to the long-term success of ART programs. We describe the extent to which patients considered LTFU are misclassified as true disengagement from care when they are still alive on ART and explain reasons for ART discontinuation using our active tracing program to further improve ART retention programs and policies. METHODS We identified adult ART patients who missed clinic appointment by more than 3 weeks between January 2006 and December 2010, assuming that such patients would miss their doses of antiretroviral drugs. Patients considered LTFU who consented during ART registration were traced by phone or home visits; true ART status after tracing was documented. Reasons for ART discontinuation were also recorded for those who stopped ART. RESULTS Of the 4,560 suspected LTFU cases, 1,384 (30%) could not be traced. Of the 3,176 successfully traced patients, 952 (30%) were dead and 2,224 (70%) were alive, of which 2,183 (99.5%) started ART according to phone-based self-reports or physical verification during in-person interviews. Of those who started ART, 957 (44%) stopped ART and 1,226 (56%) reported still taking ART at the time of interview by sourcing drugs from another clinic, using alternative ART sources or making brief ART interruptions. Among 940 cases with reasons for ART discontinuations, failure to remember (17%), too weak/sick (12%), travel (46%), and lack of transport to the clinic (16%) were frequently cited; reasons differed by gender. CONCLUSION The LTFU category comprises sizeable proportions of patients still taking ART that may potentially bias retention estimates and misdirect resources at the clinic and national levels if not properly accounted for. Clinics should consider further decentralization efforts, increasing drug allocations for frequent travels, and improving communication on patient transfers between clinics to increase retention and adherence.

Recommendations for sex/gender neuroimaging research: Key principles and implications for research design, analysis and interpretation

Neuroimaging (NI) technologies are having increasing impact in the study of complex cognitive and social processes. In this emerging field of social cognitive neuroscience, a central goal should be to increase the understanding of the interaction between the neurobiology of the individual and the environment in which humans develop and function. The study of sex/gender is often a focus for NI research, and may be motivated by a desire to better understand general developmental principles, mental health problems that show female-male disparities, and gendered differences in society. In order to ensure the maximum possible contribution of NI research to these goals, we draw attention to four key principles—overlap, mosaicism, contingency and entanglement—that have emerged from sex/gender research and that should inform NI research design, analysis and interpretation. We discuss the implications of these principles in the form of constructive guidelines and suggestions for researchers, editors, reviewers and science communicators.

Pre-therapy inflammation and coagulation activation and long-term CD4 count responses to the initiation of antiretroviral therapy

OBJECTIVES Pre-antiretroviral therapy (ART) inflammation and coagulation activation predict clinical outcomes in HIV-positive individuals. We assessed whether pre-ART inflammatory marker levels predicted the CD4 count response to ART. METHODS Analyses were based on data from the Strategic Management of Antiretroviral Therapy (SMART) trial, an international trial evaluating continuous vs. interrupted ART, and the Flexible Initial Retrovirus Suppressive Therapies (FIRST) trial, evaluating three first-line ART regimens with at least two drug classes. For this analysis, participants had to be ART-naïve or off ART at randomization and (re)starting ART and have C-reactive protein (CRP), interleukin-6 (IL-6) and D-dimer measured pre-ART. Using random effects linear models, we assessed the association between each of the biomarker levels, categorized as quartiles, and change in CD4 count from ART initiation to 24 months post-ART. Analyses adjusted for CD4 count at ART initiation (baseline), study arm, follow-up time and other known confounders. RESULTS Overall, 1084 individuals [659 from SMART (26% ART naïve) and 425 from FIRST] met the eligibility criteria, providing 8264 CD4 count measurements. Seventy-five per cent of individuals were male with the mean age of 42 years. The median (interquartile range) baseline CD4 counts were 416 (350-530) and 100 (22-300) cells/μL in SMART and FIRST, respectively. All of the biomarkers were inversely associated with baseline CD4 count in FIRST but not in SMART. In adjusted models, there was no clear relationship between changing biomarker levels and mean change in CD4 count post-ART (P for trend: CRP, P = 0.97; IL-6, P = 0.25; and D-dimer, P = 0.29). CONCLUSIONS Pre-ART inflammation and coagulation activation do not predict CD4 count response to ART and appear to influence the risk of clinical outcomes through other mechanisms than blunting long-term CD4 count gain.

Made in God's Image! - What Does It Mean? Science and Religion in Conversation

How can we best interpret the traditional Christian affirmation that human beings are made in God's image in light of contact and dialogue between religion and science? And what, if any, are the environmental implications of this conversation between the two?

John La Farge as collector of Japanese art : motivations and reflections

Throughout his lifetime, American artist John La Farge (1835-1910) amassed an enormous collection of art and books. La Farge’s study of art and culture encompassed several genres and aesthetic elements. La Farge has been credited as the first American artist — even prior to James Abbott McNeill Whistler (1834-1903)— to integrate visual elements and cultural awareness of the Far East within his own Western-trained art. Although many scholars have studied La Farge’s art and life from various perspectives, including his interest in Asian art, the object of the present study is solely focused on La Farge’s collecting of Japanese art.

Promoting interculturalism through art education : a case study Portugal and Latvia

This study examines art student’s awareness, understanding and practices of intercultural art education in higher institution of art. Specifically, the research focused on Art Academy of Latvia, Riga. The purpose was to promote “interculturalism’’ among students and to acquaint them with the knowledge and skills of developing and reflecting on their cultural values and that of others’. For 10 weeks, 7 students in the Art Academy of Latvia explored the Traditional African Ceramics. My research included data gathered from student questionnaires, class discussions, interviews, observations, student artwork and photographs from their personal activities. I likewise took note of the students’ practical works and their approach to African-based ceramics. First, in literature review, I discuss my purpose of study, why the study is important, limitations, statements of problem, and further research. Secondly, I examine culture and paradigms of cultures, comprehensive context of the African history and traditions of the African ceramics, the importance of intercultural art education. Then, I describe how the case study in Latvia was carried out among 7 participants’ who are students from 2nd year – masters’ level. The case study involved 7 students from the department of graphics, glass, ceramics and painting with the aim of promoting intercultural learning among art students. The case study reveals participants’ attitude towards intercultural education and reveal the importance of intercultural education in higher institutions of art as well as other institutions of learning. Although the participants were positive attitude towards other culture, the study reveals that creating awareness through intercultural art and exposing students to other culture enhances their creativity ability to explore other culture and they are more likely to be opened in sharing their experiences and their cultural perspective. Experiencing culture based- art create awareness of other cultures

Patenting Systems, Patentable Subject Matter, and Prior Art

The International School of Solid State Physics presented the 56th Course"Materials for Renewable Energy” in Erice (Italy), from July 18th to 28th 2012. This course was sponsored by the Italian Ministry of Education, University and Scientific Research, the Materials Research Society and the European Materials Research Society. The event was hosted at the "Ettore Majorana Foundation and Centre for Scientific Culture”. The school reviewed critical materials issues for the production and storage of renewable and sustainable energy. The aim of the School was to present the state-of-the-art and future perspectives in this critical area. It was to bring together the international community of students, young scientists, and experts in a unique atmosphere for reciprocal benefits in terms of enthusiasm, knowledge and new ideas.

The Pentateuch in contrast with the science and moral sense of our age.

Each part has separate t.-p.: part 6 has title: The Pentateuch and book of Joshua in face of the science and moral sense of our age.

On science and revelation. Being the presidential address delivered at the annual meeting of the Victoria Institute.

On title page: Author's copy.

Art treasures of Belgium.

Vol. 2, with subtitle, Sculpture, published as Art, life and science in Belgium, 2nd ser., no.3.

A history of mediaeval Christianity and Sacred art in Italy.

Intended as a sequal to His A history of Ancient Christianity and Sacred Art in Italy, 1866.