Trends in life expectancy of HIV-positive adults on antiretroviral therapy across the globe: comparisons with general population.

PURPOSE OF REVIEW Improved virological and immunological outcomes and reduced toxicity of antiretroviral combination therapy (ART) raise the hope that life expectancy of HIV-positive persons on ART will approach that of the general population. We systematically review the literature and summarize published estimates of life expectancy of HIV-positive populations on ART. We compare their life expectancy with the life expectancy of the general or, in sub-Saharan Africa, HIV-negative populations, by time period and gender. RECENT FINDINGS Ten relevant studies were published from 2006 to 2015. Three studies were from Canada, two from European countries, three from sub-Saharan Africa and two were multicountry studies. Life expectancy increased over time in all studies and regions. Expressed as the percentage of life expectancy in the HIV-negative or general population, estimated life expectancy at age 20 years in HIV-positive people on ART ranged from 60.3% (95% CI 58.0-62.6%) in Rwanda (2008-2011) to 89.1% (95% CI 84.7-93.6%) in Canada (2008-2012). The percentage of life expectancy in the HIV-negative or general population achieved was higher in HIV-positive women than in HIV-positive men in all countries, except for Canada wherein the opposite was the case. SUMMARY Life expectancy in HIV-positive people on ART has improved worldwide in recent years, but important gaps remain compared with the general and HIV-negative population, and between regions and genders.

Evaluation of Knowledge Regarding Diagnostic Strategies for Genetic Diseases in Select Residents

Genetics education for physicians has been a popular publication topic in the United States and in Europe for over 20 years. Decreasing numbers of medical genetics professionals and an increasing volume of genetic information has created a dire need for increased genetics training in medical school and in clinical practice. This study aimed to assess how well pediatrics-focused primary care physicians apply their general genetics knowledge to clinical genetic testing using scenario-based questions. We chose to specifically focus on knowledge of the diagnostic applicability of Chromosomal Microarray (CMA) technology in pediatrics because of its recent recommendation by the International Standard Cytogenomic Array (ISCA) Consortium as a first-tier genetic test for individuals with developmental disabilities and/or congenital anomalies. Proficiency in ordering baseline genetic testing was evaluated for eighty-one respondents from four pediatrics-focused residencies (categorical pediatrics, pediatric neurology, internal medicine/pediatrics, and family practice) at two large residency programs in Houston, Texas. Similar to other studies, we found an overall deficit of genetic testing knowledge, especially among family practice residents. Interestingly, residents who elected to complete a genetics rotation in medical school scored significantly better than expected, as well as better than residents who did not elect to complete a genetics rotation. We suspect that the insufficient knowledge among physicians regarding a baseline genetics work-up is leading to redundant (i.e. concurrent karyotype and CMA) and incorrect (i.e. ordering CMA to detect achondroplasia) genetic testing and is contributing to rising health care costs in the United States. Our results provide specific teaching points upon which medical schools can focus education about clinical genetic testing and suggest that increased collaboration between primary care physicians and genetics professionals could benefit patient health care overall.

Grain-size distribution, sedimentation rate and x-ray fluorescence data of four sediment cores off the Senegal River estuary

Fine-grained sediment depocenters on continental shelves are of increased scientific interest since they record environmental changes sensitively. A north-south elongated mud depocenter extends along the Senegalese coast in mid-shelf position. Shallow-acoustic profiling was carried out to determine extent, geometry and internal structures of this sedimentary body. In addition, four sediment cores were retrieved with the main aim to identify how paleoclimatic signals and coastal changes have controlled the formation of this mud depocenter. A general paleoclimatic pattern in terms of fluvial input appears to be recorded in this depositional archive. Intervals characterized by high terrigenous input, high sedimentation rates and fine grain sizes occur roughly contemporaneously in all cores and are interpreted as corresponding to intensified river discharge related to more humid conditions in the hinterland. From 2750 to 1900 and from 1000 to 700 cal a BP, wetter conditions are recorded off Senegal, an observation which is in accordance with other records from NW-Africa. Nevertheless, the three employed proxies (sedimentation rate, grain size and elemental distribution) do not always display consistent inter-core patterns. Major differences between the individual core records are attributed to sediment remobilization which was linked to local hydrographic variations as well as reorganizations of the coastal system. The Senegal mud belt is a layered inhomogeneous sedimentary body deposited on an irregular erosive surface. Early Holocene deceleration in the rate of the sea-level rise could have enabled initial mud deposition on the shelf. These favorable conditions for mud deposition occur coevally with a humid period over NW-Africa, thus, high river discharge. Sedimentation started preferentially in the northern areas of the mud belt. During mid-Holocene, a marine incursion led to the formation of an embayment. Afterwards, sedimentation in the north was interrupted in association with a remarkable southward shift in the location of the active depocenter as it is reflected by the sedimentary architecture and confirmed by radiocarbon dates. These sub-recent shifts in depocenters location are caused by migrations of the Senegal River mouth. During late Holocene times, the weakening of river discharge allowed the longshore currents to build up a chain of beach barriers which have forced the river mouth to shift southwards.

Stable oxygen isotope data of Globorotalia inflata and radiocarbon dates for sediment cores GeoB6211-2, GeoB13862-1, and GeoB6308-3

The Southern Westerly Winds (SWW) exert a crucial influence over the world ocean and climate. Nevertheless, a comprehensive understanding of the Holocene temporal and spatial evolution of the SWW remains a significant challenge due to the sparsity of high-resolution marine archives and appropriate SWW proxies. Here, we present a north-south transect of high-resolution planktonic foraminiferal oxygen isotope records from the western South Atlantic. Our proxy records reveal Holocene migrations of the Brazil- Malvinas Confluence (BMC), a highly sensitive feature for changes in the position and strength of the northern portion of the SWW. Through the tight coupling of the BMC position to the large-scale wind field, the records allow a quantitative reconstruction of Holocene latitudinal displacements of the SWW across the South Atlantic. Our data reveal a gradual poleward movement of the SWW by about 1-1.5° from the early to the mid-Holocene. Afterwards variability in the SWW is dominated by millennial-scale displacements in the order of 1° in latitude with no recognizable longer-term trend. These findings are confronted with results from a state-of-the-art transient Holocene climate simulation using a comprehensive coupled atmosphere-ocean general circulation model. Proxy-inferred and modeled SWW shifts compare qualitatively, but the model underestimates both orbitally forced multi-millennial and internal millennial SWW variability by almost an order of magnitude. The underestimated natural variability implies a substantial uncertainty in model projections of future SWW shifts.

Chemical composition of manganese nodules and crusts from the Pacific and Indian Ocean and Loch Fyne, Scotland

The first part of this thesis includes some topics of a non-geochemical nature but which are of importance in interpreting the geochemistry of nodules. The points covered include their distribution, petrography, structure, mineralogy and internal compositional variations. Part Two includes the geochemistry of both nodules and that of their surrounding sediments, This geochemical study has been divided into firstly, a general geochemical study of both nodules and sediments using a statistical approach to the interpretation of the data, secondly, the regional geochemistry of Pacific and Indian Ocean nodules and sediments, the latter entirely uninvestigated in the past, and thirdly, local variations in the composition of nodules. Throughout, emphasis has been placed on the geochemistry of nodules in terms of their environment of formation.

Balanced scorecard to improve strategic management control at School of Mines and Energy, Universidad Politécnica de Madrid

We studied the situation in Spanish public universities regarding the use of the Balanced Scorecard (BSC), as an instrument of control and strategic management. Also, we studied its application to the School of Mines and Energy at Universidad Politécnica de Madrid. The main advantage of the BSC is that improves the organizational structure of the workplace and the achievement of the objectives that ensure long-term success. First we review the strategy for success used in the Spanish educational system and specifically in the Spanish public universities. Then using the BSC and applying the main strategic lines for the successful management of the School of Mines and Energy at Universidad Politécnica de Madrid. The strategic lines affect all the college groups and the success of the BSC tool is to increase communication between the faculties, personal auxiliary, students and society in general that make up the university. First we performed a SWOT analysis (DAFO in Spanish) there are proposed different perspectives that focus the long-term strategic objectives. The BSC is designed based on the strategic objectives that set the direction through using indicators and initiatives, the goals are achieved up to the programmed schedule. In the perspective of teaching, objectives are set to update facilities and increase partnerships with other universities and businesses, encouraging ongoing training of staff and improved coordination and internal communication. The internal process perspective aims at improving the marketing, the promotion of the international dimension of the school through strategic alliances, better mobility for students and professors and improved teaching and research quality results. It continues with improving the image of the school between customer?s perspective, the quality perceived by students and the loyalty of the teaching staff by retaining talent. Finally, the financial perspective which should contain costs without harming the quality, improving the employability of students and achieve relevant jobs at teaching and research through international measurement standards.

Recruitment of SMRT/N-CoR-mSin3A-HDAC-repressing complexes is not a general mechanism for BTB/POZ transcriptional repressors: The case of HIC-1 and γFBP-B

Hypermethylated in cancer (HIC-1), a new candidate tumor suppressor gene located in 17p13.3, encodes a protein with five C2H2 zinc fingers and an N-terminal broad complex, tramtrack, and bric à brac/poxviruses and zinc-finger (BTB/POZ) domain found in actin binding proteins or transcriptional regulators involved in chromatin modeling. In the human B cell lymphoma (BCL-6) and promyelocityc leukemia (PLZF) oncoproteins, this domain mediates transcriptional repression through its ability to recruit a silencing mediator of retinoid and thyroid hormone receptor (SMRT)/nuclear receptor corepressor (N-CoR)-mSin3A-histone deacetylase (HDAC) complex, a mechanism shared with numerous transcription factors. HIC-1 appears unique because it contains a 13-aa insertion acquired late in evolution, because it is not found in its avian homologue, γF1-binding protein isoform B (γFBP-B), a transcriptional repressor of the γF-crystallin gene. This insertion, located in a conserved region involved in the dimerization and scaffolding of the BTB/POZ domain, mainly affects slightly the ability of the HIC-1 and γFBP-B BTB/POZ domains to homo- and heterodimerize in vivo, as shown by mammalian two-hybrid experiments. Both the HIC-1 and γFBP-B BTB/POZ domains behave as autonomous transcriptional repression domains. However, in striking contrast with BCL-6 and PLZF, both HIC-1 and γFBP-B similarly fail to interact with members of the HDAC complexes (SMRT/N-CoR, mSin3A or HDAC-1) in vivo and in vitro. In addition, a general and specific inhibitor of HDACs, trichostatin A, did not alleviate the HIC-1- and γFBP-B-mediated transcriptional repression, as previously shown for BCL-6. Taken together, our studies show that the recruitment onto target promoters of an HDAC complex is not a general property of transcriptional repressors containing a conserved BTB/POZ domain.

Analysis of internal astigmatism and higher order aberrations in eyes implanted with a new diffractive multifocal toric intraocular lens

Background To evaluate the intraocular lens (IOL) position by analyzing the postoperative axis of internal astigmatism as well as the higher-order aberration (HOA) profile after cataract surgery following the implantation of a diffractive multifocal toric IOL. Methods Prospective study including 51 eyes with corneal astigmatism of 1.25D or higher of 29 patients with ages ranging between 20 and 61 years old. All cases underwent uneventful cataract surgery with implantation of the AT LISA 909 M toric IOL (Zeiss). Visual, refractive and corneal topograpy changes were evaluated during a 12-month follow-up. In addition, the axis of internal astigmatism as well as ocular, corneal, and internal HOA (5-mm pupil) were evaluated postoperatively by means of an integrated aberrometer (OPD Scan II, Nidek). Results A significant improvement in uncorrected distance and near visual acuities (p < 0.01) was found, which was consistent with a significant correction of manifest astigmatism (p < 0.01). No significant changes were observed in corneal astigmatism (p = 0.32). With regard to IOL alignment, the difference between the axes of postoperative internal and preoperative corneal astigmatisms was close to perpendicularity (12 months, 87.16° ± 7.14), without significant changes during the first 6 months (p ≥ 0.46). Small but significant changes were detected afterwards (p = 0.01). Additionally, this angular difference correlated with the postoperative magnitude of manifest cylinder (r = 0.31, p = 0.03). Minimal contribution of intraocular optics to the global magnitude of HOA was observed. Conclusions The diffractive multifocal toric IOL evaluated is able to provide a predictable astigmatic correction with apparent excellent levels of optical quality during the first year after implantation.

Building up European leadership - an assessment of the recent process. CHALLENGE EUROPE Issue 22 - Challenges and new beginnings: Priorities for the EU's new leadership, September 2014.

Europe is in need of a new leadership capacity able to recreate stronger European unity in the external and internal fronts. Otherwise, anti-European forces will increase their influence and presence in European governments and EU institutions with large implications for the direction of European integration. This will be the central concern in making a first short assessment of the recent process of building European leadership capacity for the next five years to come. This assessment will particularly focus on the choice of the President of the European Commission, of the President of the European Council and, finally of the members of the European Commission.

Research and development in progress : biology and medicine /

"TID-4500 ; Biology and Medicine."

Sanitary and medical reports for 1873-74 /

On spine: [v.] III.

U.S. imports for consumption and general imports.

Mode of access: Internet.

Policy and procedures manual for guidance of Federal agencies.

1. The United States General Accounting Office.--2. Accounting principles and standards and internal auditing guidelines.--3. Audit.--4. Claims--General.--5. Transportation.--6. Payroll, leave, and allowances.--7. Standardized fiscal procedures.--8. Management and services.--9. Accounting forms.

Medicine.

Editors: D.L. Edsall and John Howland.

[Reports and discussions of meeting held at the College of Veterinary Medicine, Michigan University, August 19, 1961]

Transcript of tape recorded notes.