934 resultados para epidemiology, measurement, special needs populations
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Elasmobranch stock assessment studies are usually made through fisheries surveys data. However, in large marine protected areas (MPAs) the use of destructive techniques must be dismissed in order to avoid population impacts. In 2005, while conducting a marine habitat survey in two marine Special Areas of Conservation (Sebadales de Playa de Inglés and Franja Marina de Mogán) in south Gran Canary Island (Canary Islands, Spain) with underwater towed video (UTV) and underwater visual census (UVC) transects, we recognized the opportunity rose to assess elasmobranch populations through UTV. Number of observed species and specimens, overall field work effort and total surveyed area were determined and compared between methods. Mean observations per day per unit of time (MOPUT) and mean observations per day per unit of surveyed area (MOPUA) were also compared through Mann–Whitney rank sum statistical test (α=0.05). Data analysis demonstrated that UTV is a very useful tool to rapidly assess elasmobranch populations in large MPAs in good visibility underwater environments. It can assess larger areas than UVC with the same effort (statistically significant difference found for the MOPUT; p=<0.001), leading to more observed species (5 vs 2) and specimens (46 vs 3) per day of work, with no loss in resolution power (MOPUA values were not significantly different between UTV and UVC; p=0.104).
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The project was developed into three parts: the analysis of p63 isoform in breast tumours; the study of intra-tumour eterogeneicity in metaplastic breast carcinoma; the analysis of oncocytic breast carcinoma. p63 is a sequence-specific DNA-binding factor, homologue of the tumour suppressor and transcription factor p53. The human p63 gene is composed of 15 exons and transcription can occur from two distinct promoters: the transactivating isoforms (TAp63) are generated by a promoter upstream of exon 1, while the alternative promoter located in intron 3 leads to the expression of N-terminal truncated isoforms (ΔNp63). It has been demonstrated that anti-p63 antibodies decorate the majority of squamous cell carcinomas of different organs; moreover tumours with myoepithelial differentiation of the breast show nuclear p63 expression. Two new isoforms have been described with the same sequence as TAp63 and ΔNp63 but lacking exon 4: d4TAp63 and ΔNp73L, respectively. Purpose of the study was to investigate the molecular expression of N-terminal p63 isoforms in benign and malignant breast tissues. In the present study 40 specimens from normal breast, benign lesions, DIN/DCIS, and invasive carcinomas were analyzed by immunohistochemistry and RT-PCR (Reverse Transcriptase-PCR) in order to disclose the patterns of p63 expression. We have observed that the full-length isoforms can be detected in non neoplastic and neoplastic lesions, while the short isoforms are only present in the neoplastic cells of invasive carcinomas. Metaplastic carcinomas of the breast are a heterogeneous group of neoplasms which exhibit varied patterns of metaplasia and differentiation. The existence of such non-modal populations harbouring distinct genetic aberrations may explain the phenotypic diversity observed within a given tumour. Intra-tumour morphological heterogeneity is not uncommon in breast cancer and it can often be appreciated in metaplastic breast carcinomas. Aim of this study was to determine the existence of intra-tumour genetic heterogeneity in metaplastic breast cancers and whether areas with distinct morphological features in a given tumour might be underpinned by distinct patterns of genetic aberrations. 47 cases of metaplastic breast carcinomas were retrieved. Out of the 47 cases, 9 had areas that were of sufficient dimensions to be independently microdissected. Our results indicate that at least some breast cancers are composed of multiple non-modal populations of clonally related cells and provide direct evidence that at least some types of metaplastic breast cancers are composed of multiple non-modal clones harbouring distinct genetic aberrations. Oncocytic tumours represent a distinctive set of lesions with typical granular cytoplasmatic eosinophilia of the neoplastic cells. Only rare example of breast oncocytic carcinomas have been reported in literature and the incidence is probably underestimated. In this study we have analysed 33 cases of oncocytic invasive breast carcinoma of the breast, selected according to morphological and immunohistochemical criteria. These tumours were morphologically classified and studied by immunohistochemistry and aCGH. We have concluded that oncocytic breast carcinoma is a morphologic entity with distinctive ultrastructural and histological features; immunohistochemically is characterized by a luminal profile, it has a frequency of 19.8%, has not distinctive clinical features and, at molecular level, shows a specific constellation of genetic aberration.
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Quality control of medical radiological systems is of fundamental importance, and requires efficient methods for accurately determine the X-ray source spectrum. Straightforward measurements of X-ray spectra in standard operating require the limitation of the high photon flux, and therefore the measure has to be performed in a laboratory. However, the optimal quality control requires frequent in situ measurements which can be only performed using a portable system. To reduce the photon flux by 3 magnitude orders an indirect technique based on the scattering of the X-ray source beam by a solid target is used. The measured spectrum presents a lack of information because of transport and detection effects. The solution is then unfolded by solving the matrix equation that represents formally the scattering problem. However, the algebraic system is ill-conditioned and, therefore, it is not possible to obtain a satisfactory solution. Special strategies are necessary to circumvent the ill-conditioning. Numerous attempts have been done to solve this problem by using purely mathematical methods. In this thesis, a more physical point of view is adopted. The proposed method uses both the forward and the adjoint solutions of the Boltzmann transport equation to generate a better conditioned linear algebraic system. The procedure has been tested first on numerical experiments, giving excellent results. Then, the method has been verified with experimental measurements performed at the Operational Unit of Health Physics of the University of Bologna. The reconstructed spectra have been compared with the ones obtained with straightforward measurements, showing very good agreement.
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In 2010, 2011 and 2012 growing seasons, the occurrence of the ascomycetes Podosphaera fusca and Golovinomyces orontii, causal agents of powdery mildew disease, was monitored on cultivated cucurbits located in Bologna and Mantua provinces to determine the epidemiology of the species. To identify the pathogens, both morphological and molecular identifications were performed on infected leaf samples and a Multiplex-PCR was performed to identify the mating type genes of P. fusca isolates. The investigations indicated a temporal succession of the two species with the earlier infections caused by G. orontii, that seems to be the predominant species till the middle of July when it progressively disappears and P. fusca becomes the main species infecting cucurbits till the end of October. The temporal variation is likely due to the different overwintering strategies of the two species instead of climatic conditions. Only chasmothecia of P. fusca were recorded and mating type alleles ratio tended to be 1:1. Considering that only chasmothecia of P. fusca were found, molecular-genetic analysis were carried out to find some evidence of recombination within this species by MLST and AFLP methods. Surprisingly, no variations were observed within isolates for the 8 MLST markers used. According to this result, AFLP analysis showed a high similarity within isolates, with SM similarity coefficient ranging between 0.91-1.00 and also, sequencing of 12 polymorphic bands revealed identity to some gene involved in mutation and selection. The results suggest that populations of P. fusca are likely to be a clonal population with some differences among isolates probably due to agricultural practices such as fungicides treatments and cultivated hosts. Therefore, asexual reproduction, producing a lot of fungal biomass that can be easily transported by wind, is the most common and useful way to the spread and colonization of the pathogen.
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Il lavoro svolto in questa tesi si propone di valutare la variabilità della composizione corporea nell’infanzia e nell’adolescenza, con particolare attenzione alla transizione dalla prima alla seconda, in relazione allo stato nutrizionale ed agli stili di vita. Lo studio è stato condotto eseguendo misure antropometriche presso scuole primarie e secondarie di Bologna. Sono stati analizzati inoltre dati acquisiti a partire dal 2004. Il campione analizzato comprende 3546 soggetti di età compresa tra 6 anni e 14 anni. In particolare sono state analizzate le principali misurazioni utili per il calcolo della composizione corporea, evidenziando i parametri antropometrici principali quali BMI, circonferenza vita, WHR, %F e FFM. Questi caratteri sono stati quindi messi in relazione con le informazioni inerenti l’attività sportiva extrascolastica e gli stili di vita dei soggetti esaminati. L’analisi trasversale delle principali caratteristiche antropometriche ha fornito un interessante panorama della situazione italiana e del nord Italia; lo studio longitudinale delle variabili antropometriche permette di ottenere un quadro aggiornato dei principali incrementi delle misure corporee. La valutazione della variabilità della composizione corporea in relazione all’attività sportiva e allo stile di vita durante il processo di accrescimento ha indicato come abitudini sane e propensione all’attività motoria sono sicuramente in grado di apportare miglioramenti nella modificazione della composizione corporea nel processo evolutivo specialmente se somministrate con modalità adeguate all’età e alle esigenze individuali. Questi aspetti sono certamente rilevanti e complessi, sarebbe infatti interessante in prospettiva futura riuscire ad indagare ancora più dettagliatamente sull’interazione tra i fattori che determinano e modificano la composizione corporea in un periodo della vita così particolare come la transizione dall’infanzia all’adolescenza.
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Atmospheric aerosol particles serving as cloud condensation nuclei (CCN) are key elements of the hydrological cycle and climate. Knowledge of the spatial and temporal distribution of CCN in the atmosphere is essential to understand and describe the effects of aerosols in meteorological models. In this study, CCN properties were measured in polluted and pristine air of different continental regions, and the results were parameterized for efficient prediction of CCN concentrations.The continuous-flow CCN counter used for size-resolved measurements of CCN efficiency spectra (activation curves) was calibrated with ammonium sulfate and sodium chloride aerosols for a wide range of water vapor supersaturations (S=0.068% to 1.27%). A comprehensive uncertainty analysis showed that the instrument calibration depends strongly on the applied particle generation techniques, Köhler model calculations, and water activity parameterizations (relative deviations in S up to 25%). Laboratory experiments and a comparison with other CCN instruments confirmed the high accuracy and precision of the calibration and measurement procedures developed and applied in this study.The mean CCN number concentrations (NCCN,S) observed in polluted mega-city air and biomass burning smoke (Beijing and Pearl River Delta, China) ranged from 1000 cm−3 at S=0.068% to 16 000 cm−3 at S=1.27%, which is about two orders of magnitude higher than in pristine air at remote continental sites (Swiss Alps, Amazonian rainforest). Effective average hygroscopicity parameters, κ, describing the influence of chemical composition on the CCN activity of aerosol particles were derived from the measurement data. They varied in the range of 0.3±0.2, were size-dependent, and could be parameterized as a function of organic and inorganic aerosol mass fraction. At low S (≤0.27%), substantial portions of externally mixed CCN-inactive particles with much lower hygroscopicity were observed in polluted air (fresh soot particles with κ≈0.01). Thus, the aerosol particle mixing state needs to be known for highly accurate predictions of NCCN,S. Nevertheless, the observed CCN number concentrations could be efficiently approximated using measured aerosol particle number size distributions and a simple κ-Köhler model with a single proxy for the effective average particle hygroscopicity. The relative deviations between observations and model predictions were on average less than 20% when a constant average value of κ=0.3 was used in conjunction with variable size distribution data. With a constant average size distribution, however, the deviations increased up to 100% and more. The measurement and model results demonstrate that the aerosol particle number and size are the major predictors for the variability of the CCN concentration in continental boundary layer air, followed by particle composition and hygroscopicity as relatively minor modulators. Depending on the required and applicable level of detail, the measurement results and parameterizations presented in this study can be directly implemented in detailed process models as well as in large-scale atmospheric and climate models for efficient description of the CCN activity of atmospheric aerosols.
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In hadronischen Kollisionen entstehen bei einem Großteil der Ereignisse mit einem hohen Impulsübertrag Paare aus hochenergetischen Jets. Deren Produktion und Eigenschaften können mit hoher Genauigkeit durch die Störungstheorie in der Quantenchromodynamik (QCD) vorhergesagt werden. Die Produktion von \textit{bottom}-Quarks in solchen Kollisionen kann als Maßstab genutzt werden, um die Vorhersagen der QCD zu testen, da diese Quarks die Dynamik des Produktionsprozesses bei Skalen wieder spiegelt, in der eine Störungsrechnung ohne Einschränkungen möglich ist. Auf Grund der hohen Masse von Teilchen, die ein \textit{bottom}-Quark enthalten, erhält der gemessene, hadronische Zustand den größten Teil der Information von dem Produktionsprozess der Quarks. Weil sie eine große Produktionsrate besitzen, spielen sie und ihre Zerfallsprodukte eine wichtige Rolle als Untergrund in vielen Analysen, insbesondere in Suchen nach neuer Physik. In ihrer herausragenden Stellung in der dritten Quark-Generation könnten sich vermehrt Zeichen im Vergleich zu den leichteren Quarks für neue Phänomene zeigen. Daher ist die Untersuchung des Verhältnisses zwischen der Produktion von Jets, die solche \textit{bottom}-Quarks enthalten, auch bekannt als $b$-Jets, und aller nachgewiesener Jets ein wichtiger Indikator für neue massive Objekte. In dieser Arbeit werden die Produktionsrate und die Korrelationen von Paaren aus $b$-Jets bestimmt und nach ersten Hinweisen eines neuen massiven Teilchens, das bisher nicht im Standard-Modell enthalten ist, in dem invarianten Massenspektrum der $b$-Jets gesucht. Am Large Hadron Collider (LHC) kollidieren zwei Protonenstrahlen bei einer Schwerpunktsenergie von $\sqrt s = 7$ TeV, und es werden viele solcher Paare aus $b$-Jets produziert. Diese Analyse benutzt die aufgezeichneten Kollisionen des ATLAS-Detektors. Die integrierte Luminosität der verwendbaren Daten beläuft sich auf 34~pb$^{-1}$. $b$-Jets werden mit Hilfe ihrer langen Lebensdauer und den rekonstruierten, geladenen Zerfallsprodukten identifiziert. Für diese Analyse müssen insbesondere die Unterschiede im Verhalten von Jets, die aus leichten Objekten wie Gluonen und leichten Quarks hervorgehen, zu diesen $b$-Jets beachtet werden. Die Energieskala dieser $b$-Jets wird untersucht und die zusätzlichen Unsicherheit in der Energiemessung der Jets bestimmt. Effekte bei der Jet-Rekonstruktion im Detektor, die einzigartig für $b$-Jets sind, werden studiert, um letztlich diese Messung unabhängig vom Detektor und auf Niveau der Hadronen auswerten zu können. Hiernach wird die Messung zu Vorhersagen auf nächst-zu-führender Ordnung verglichen. Dabei stellt sich heraus, dass die Vorhersagen in Übereinstimmung zu den aufgenommenen Daten sind. Daraus lässt sich schließen, dass der zugrunde liegende Produktionsmechanismus auch in diesem neu erschlossenen Energiebereich am LHC gültig ist. Jedoch werden auch erste Hinweise auf Mängel in der Beschreibung der Eigenschaften dieser Ereignisse gefunden. Weiterhin können keine Anhaltspunkte für eine neue Resonanz, die in Paare aus $b$-Jets zerfällt, in dem invarianten Massenspektrum bis etwa 1.7~TeV gefunden werden. Für das Auftreten einer solchen Resonanz mit einer Gauß-förmigen Massenverteilung werden modell-unabhängige Grenzen berechnet.
Resumo:
Die rasante Entwicklung der Computerindustrie durch die stetige Verkleinerung der Transistoren führt immer schneller zum Erreichen der Grenze der Si-Technologie, ab der die Tunnelprozesse in den Transistoren ihre weitere Verkleinerung und Erhöhung ihrer Dichte in den Prozessoren nicht mehr zulassen. Die Zukunft der Computertechnologie liegt in der Verarbeitung der Quanteninformation. Für die Entwicklung von Quantencomputern ist die Detektion und gezielte Manipulation einzelner Spins in Festkörpern von größter Bedeutung. Die Standardmethoden der Spindetektion, wie ESR, erlauben jedoch nur die Detektion von Spinensembles. Die Idee, die das Auslesen von einzelnen Spins ermöglich sollte, besteht darin, die Manipulation getrennt von der Detektion auszuführen.rn Bei dem NV−-Zentrum handelt es sich um eine spezielle Gitterfehlstelle im Diamant, die sich als einen atomaren, optisch auslesbaren Magnetfeldsensor benutzen lässt. Durch die Messung seiner Fluoreszenz sollte es möglich sein die Manipulation anderer, optisch nicht detektierbaren, “Dunkelspins“ in unmittelbarer Nähe des NV-Zentrums mittels der Spin-Spin-Kopplung zu detektieren. Das vorgeschlagene Modell des Quantencomputers basiert auf dem in SWCNT eingeschlossenen N@C60.Die Peapods, wie die Einheiten aus den in Kohlenstoffnanoröhre gepackten Fullerenen mit eingefangenem Stickstoff genannt werden, sollen die Grundlage für die Recheneinheiten eines wahren skalierbaren Quantencomputers bilden. Die in ihnen mit dem Stickstoff-Elektronenspin durchgeführten Rechnungen sollen mit den oberflächennahen NV-Zentren (von Diamantplatten), über denen sie positioniert sein sollen, optisch ausgelesen werden.rnrnDie vorliegende Arbeit hatte das primäre Ziel, die Kopplung der oberflächennahen NV-Einzelzentren an die optisch nicht detektierbaren Spins der Radikal-Moleküle auf der Diamantoberfläche mittels der ODMR-Kopplungsexperimente optisch zu detektieren und damit entscheidende Schritte auf dem Wege der Realisierung eines Quantenregisters zu tun.rn Es wurde ein sich im Entwicklungsstadium befindende ODMR-Setup wieder aufgebaut und seine bisherige Funktionsweise wurde an kommerziellen NV-Zentrum-reichen Nanodiamanten verifiziert. Im nächsten Schritt wurde die Effektivität und Weise der Messung an die Detektion und Manipulation der oberflächennah (< 7 nm Tiefe) implantieren NV-Einzelzenten in Diamantplatten angepasst.Ein sehr großer Teil der Arbeit, der hier nur bedingt beschrieben werden kann, bestand aus derrnAnpassung der existierenden Steuersoftware an die Problematik der praktischen Messung. Anschließend wurde die korrekte Funktion aller implementierten Pulssequenzen und anderer Software-Verbesserungen durch die Messung an oberflächennah implantierten NV-Einzelzentren verifiziert. Auch wurde der Messplatz um die zur Messung der Doppelresonanz notwendigen Komponenten wie einen steuerbaren Elektromagneten und RF-Signalquelle erweitert. Unter der Berücksichtigung der thermischen Stabilität von N@C60 wurde für zukünftige Experimente auch ein optischer Kryostat geplant, gebaut, in das Setup integriert und charakterisiert.rn Die Spin-Spin-Kopplungsexperimente wurden mit dem sauerstoffstabilen Galvinoxyl-Radikalals einem Modell-System für Kopplung durchgeführt. Dabei wurde über die Kopplung mit einem NVZentrum das RF-Spektrum des gekoppelten Radikal-Spins beobachtet. Auch konnte von dem gekoppelten Spin eine Rabi-Nutation aufgenommen werden.rn Es wurden auch weitere Aspekte der Peapod Messung und Oberflächenimplantation betrachtet.Es wurde untersucht, ob sich die NV-Detektion durch die SWCNTs, Peapods oder Fullerene stören lässt. Es zeigte sich, dass die Komponenten des geplanten Quantencomputers, bis auf die C60-Cluster, für eine ODMR-Messanordnung nicht detektierbar sind und die NV-Messung nicht stören werden. Es wurde auch betrachtet, welche Arten von kommerziellen Diamantplatten für die Oberflächenimplantation geeignet sind, für die Kopplungsmessungen geeignete Dichte der implantierten NV-Zentren abgeschätzt und eine Implantation mit abgeschätzter Dichte betrachtet.
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The future goal of modern physics is the discovery of physics beyond the Standard Model. One of the most significant hints for New Physics can be seen in the anomalous magnetic moment of the muon - one of the most precise measured variables in modern physics and the main motivation of this work. This variable is associated with the coupling of the muon, an elementary particle, to an external electromagnetic field and is defined as a = (g - 2)/2, whereas g is the gyromagnetic factor of the muon. The muon anomaly has been measured with a relative accuracy of 0.5·10-6. However, a difference between the direct measurement and the Standard Model prediction of 3.6 standard deviations can be observed. This could be a hint for the existence of New Physics. Unfortunately, it is, yet, not significant enough to claim an observation and, thus, more precise measurements and calculations have to be performed.rnThe muon anomaly has three contributions, whereas the ones from quantum electrodynamics and weak interaction can be determined from perturbative calculations. This cannot be done in case of the hadronic contributions at low energies. The leading order contribution - the hadronic vacuum polarization - can be computed via a dispersion integral, which needs as input hadronic cross section measurements from electron-positron annihilations. Hence, it is essential for a precise prediction of the muon anomaly to measure these hadronic cross sections, σ(e+e-→hadrons), with high accuracy. With a contribution of more than 70%, the final state containing two charged pions is the most important one in this context.rnIn this thesis, a new measurement of the σ(e+e-→π+π-) cross section and the pion form factor is performed with an accuracy of 0.9% in the dominant ρ(770) resonance region between 600 and rn900 MeV at the BESIII experiment. The two-pion contribution to the leading-order (LO) hadronic vacuum polarization contribution to (g - 2) from the BESIII result, obtained in this work, is computed to be a(ππ,LO,600-900 MeV) = (368.2±2.5stat±3.3sys)·10-10. With the result presented in this thesis, we make an important contribution on the way to solve the (g - 2) puzzle.
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The advantages, limitations and potential applications of available methods for studying erosion of enamel and dentine are reviewed. Special emphasis is placed on the influence of histological differences between the dental hard tissue and the stage of the erosive lesion. No method is suitable for all stages of the lesion. Factors determining the applicability of the methods are: surface condition of the specimen, type of the experimental model, nature of the lesion, need for longitudinal measurements and type of outcome. The most suitable and most widely used methods are: chemical analyses of mineral release and enamel surface hardness for early erosion, and surface profilometry and microradiography for advanced erosion. Morphological changes in eroded dental tissue have usually been characterised by scanning electron microscopy. Novel methods have also been used, but little is known of their potential and limitations. Therefore, there is a need for their further development, evaluation, consolidation and, in particular, validation.
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This article contributes to the research on demographics and public health of urban populations of preindustrial Europe. The key source is a burial register that contains information on the deceased, such as age and sex, residence and cause of death. This register is one of the earliest compilations of data sets of individuals with this high degree of completeness and consistency. Critical assessment of the register's origin, formation and upkeep promises high validity and reliability. Between 1805 and 1815, 4,390 deceased inhabitants were registered. Information concerning these individuals provides the basis for this study. Life tables of Bern's population were created using different models. The causes of death were classified and their frequency calculated. Furthermore, the susceptibility of age groups to certain causes of death was established. Special attention was given to causes of death and mortality of newborns, infants and birth-giving women. In comparison to other cities and regions in Central Europe, Bern's mortality structure shows low rates for infants (q0=0.144) and children (q1-4=0.068). This could have simply indicated better living conditions. Life expectancy at birth was 43 years. Mortality was high in winter and spring, and decreased in summer to a low level with a short rise in August. The study of the causes of death was inhibited by difficulties in translating early 19th century nomenclature into the modern medical system. Nonetheless, death from metabolic disorders, illnesses of the respiratory system, and debilitation were the most prominent causes in Bern. Apparently, the worst killer of infants up to 12 months was the "gichteren", an obsolete German term for lethal spasmodic convulsions. The exact modern identification of this disease remains unclear. Possibilities such as infant tetanus or infant epilepsy are discussed. The maternal death rate of 0.72% is comparable with values calculated from contemporaneous sources. Relevance of childbed fever in the early 1800s was low. Bern's data indicate that the extent of deaths related to childbirth in this period is overrated. This research has an explicit interdisciplinary value for various fields including both the humanities and natural sciences, since information reported here represents the complete age and sex structure of a deceased population. Physical anthropologists can use these data as a true reference group for their palaeodemographic studies of preindustrial Central Europe of the late 18th and early 19th century. It is a call to both historians and anthropologists to use our resources to a better effect through combination of methods and exchange of knowledge.
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Background In Switzerland and other developed countries, the number of tuberculosis (TB) cases has been decreasing for decades, but HIV-infected patients and migrants remain risk groups. The aim of this study was to compare characteristics of TB in HIV-negative and HIV-infected patients diagnosed in Switzerland, and between coinfected patients enrolled and not enrolled in the national Swiss HIV Cohort Study (SHCS). Methods and Findings All patients diagnosed with culture-confirmed TB in the SHCS and a random sample of culture-confirmed cases reported to the national TB registry 2000–2008 were included. Outcomes were assessed in HIV-infected patients and considered successful in case of cure or treatment completion. Ninety-three SHCS patients and 288 patients selected randomly from 4221 registered patients were analyzed. The registry sample included 10 (3.5%) coinfected patients not enrolled in the SHCS: the estimated number of HIV-infected patients not enrolled in the SHCS but reported to the registry 2000–2008 was 146 (95% CI 122–173). Coinfected patients were more likely to be from sub-Saharan Africa (51.5% versus 15.8%, P<0.0001) and to present disseminated disease (23.9% vs. 3.4%, P<0.0001) than HIV-negative patients. Coinfected patients not enrolled in the SHCS were asylum seekers or migrant workers, with lower CD4 cell counts at TB diagnosis (median CD4 count 79 cells/µL compared to 149 cells/µL among SHCS patients, P = 0.07). There were 6 patients (60.0%) with successful outcomes compared to 82 (88.2%) patients in the SHCS (P = 0.023). Conclusions The clinical presentation of coinfected patients differed from HIV-negative TB patients. The number of HIV-infected patients diagnosed with TB outside the SHCS is similar to the number diagnosed within the cohort but outcomes are poorer in patients not followed up in the national cohort. Special efforts are required to address the needs of this vulnerable population.
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Today's malaria control efforts are limited by our incomplete understanding of the biology of Plasmodium and of the complex relationships between human populations and the multiple species of mosquito and parasite. Research priorities include the development of in vitro culture systems for the complete life cycle of P. falciparum and P. vivax and the development of an appropriate liver culture system to study hepatic stages. In addition, genetic technologies for the manipulation of Plasmodium need to be improved, the entire parasite metabolome needs to be characterized to identify new druggable targets, and improved information systems for monitoring the changes in epidemiology, pathology, and host-parasite-vector interactions as a result of intensified control need to be established to bridge the gap between bench, preclinical, clinical, and population-based sciences.
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The various types of glomerulonephritis, including many forms of vasculitis, are responsible for about 15% of cases of end-stage renal disease (ESRD). Arterial hypertension represents a frequent finding in patients suffering from glomerulonephritis or vasculitis and hypertension also serves as an indicator for these severe types of diseases. In addition, there are symptoms and signs like hematuria, proteinuria and renal failure. Especially, rapidly progressive glomerulonephritis (RPGN) constitutes a medical emergency and must not be missed by treating physicians. This disease can either occur limited to the kidneys or in the context of a systemic inflammatory disorder, like a vasculitis. If left untreated, RPGN can lead to a necrotizing destruction of glomeruli causing irreversible kidney damage within several months or even weeks. With respect to the immunologically caused vasculitis, there are - depending upon the severity and type of organ involved - many clinical warning signs to be recognized, such as arterial hypertension, hemoptysis, arthalgias, muscle pain, palpable purpura, hematuria, proteinuria and renal failure. In addition, constitutional signs, such as fever and loss of body weight may occur concurrently. Investigations of glomerulonephritis or vasculitis must contain a careful and complete examination of family history and medications used by the respective patient. Thereafter, a thorough clinical examination must follow, including skin, joints and measurement of arterial blood pressure. In addition, a spectrum of laboratory analyses is required in blood, such as full blood screen, erythrocyte sedimentation rate, CRP, creatinine, urea and glucose, and in urine, including urinalysis looking for hematuria, red cell casts and proteinuria. Importantly, proteinuria needs to be quantified by the utilization of a random urine sample. Proteinuria > 3g/d is diagnostic for a glomerular damage. These basic tests are usually followed by more specialized analyses, such as a screening for infections, including search for HIV, hepatitis B or C and various bacteria, and for systemic inflammatory diseases, including tests for antibodies, such as ANA, anti-dsDNA, ANCA, anti-GBM and anti-CCP. In cases of membranous nephropathy, antibodies against phospholipase-A2-receptor need to be looked for. Depending upon the given clinical circumstances and the type of disease, a reasonable tumor screening must be performed, especially in cases of membranous and minimal-change nephropathy. Finally, radiological examinations will complete the initial work-up. In most cases, at least an ultrasound of the kidney is mandatory. Thereafter, in most cases a renal biopsy is required to establish a firm diagnosis to define all treatment options and their chance of success. The elimination of a specific cause for a given glomerulonephritis or vasculitis, such as an infection, a malignancy or a drug-related side-effect, remains the key principle in the management of these diseases. ACE-inhibitors, angiotensin receptor-blockers, aldosteron antagonists and renin-inhibitors remain the mainstay in the therapy of arterial hypertension with proteinuria. Only in cases of persistently high proteinuria, ACE-inhibitors and angiotensin receptor blockers can be prescribed in combination. Certain types of glomerulonephritis and essentially all forms of vasculitis require some form of more specific anti-inflammatory therapy. Respective immunosuppressive drug regimens contain traditionally medications, such as glucocorticoids (e. g. prednisone), cyclosporine A, mycophenolate mofetil, cyclophosphamide, and azathioprine. With respect to more severe forms of glomerulonephritis and vasculitis, the antibody rituximab represents a new and less toxic alternative to cyclophosphamide. Finally, in certain special cases, like Goodpasture's syndrome or severe ANCA-positive vasculitis, a plasma exchange will be useful and even required.
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Despite the impact of red blood cell (RBC) Life-spans in some disease areas such as diabetes or anemia of chronic kidney disease, there is no consensus on how to quantitatively best describe the process. Several models have been proposed to explain the elimination process of RBCs: random destruction process, homogeneous life-span model, or a series of 4-transit compartment model. The aim of this work was to explore the different models that have been proposed in literature, and modifications to those. The impact of choosing the right model on future outcomes prediction--in the above mentioned areas--was also investigated. Both data from indirect (clinical data) and direct life-span measurement (biotin-labeled data) methods were analyzed using non-linear mixed effects models. Analysis showed that: (1) predictions from non-steady state data will depend on the RBC model chosen; (2) the transit compartment model, which considers variation in life-span in the RBC population, better describes RBC survival data than the random destruction or homogenous life-span models; and (3) the additional incorporation of random destruction patterns, although improving the description of the RBC survival data, does not appear to provide a marked improvement when describing clinical data.