Durability of antiretroviral therapy and predictors of virologic failure among perinatally HIV-infected children in Tanzania: a four-year follow-up.

BACKGROUND: In Tanzania, HIV-1 RNA testing is rarely available and not standard of care. Determining virologic failure is challenging and resistance mutations accumulate, thereby compromising second-line therapy. We evaluated durability of antiretroviral therapy (ART) and predictors of virologic failure among a pediatric cohort at four-year follow-up. METHODS: This was a prospective cross-sectional study with retrospective chart review evaluating a perinatally HIV-infected Tanzanian cohort enrolled in 2008-09 with repeat HIV-1 RNA in 2012-13. Demographic, clinical, and laboratory data were extracted from charts, resistance mutations from 2008-9 were analyzed, and prospective HIV RNA was obtained. RESULTS: 161 (78%) participants of the original cohort consented to repeat HIV RNA. The average age was 12.2 years (55% adolescents ≥12 years). Average time on ART was 6.4 years with 41% receiving second-line (protease inhibitor based) therapy. Among those originally suppressed on a first-line (non-nucleoside reverse transcriptase based regimen) 76% remained suppressed. Of those originally failing first-line, 88% were switched to second-line and 72% have suppressed virus. Increased level of viremia and duration of ART trended with an increased number of thymidine analogue mutations (TAMs). Increased TAMs increased the odds of virologic failure (p = 0.18), as did adolescent age (p < 0.01). CONCLUSIONS: After viral load testing in 2008-09 many participants switched to second-line therapy. The majority achieved virologic suppression despite multiple resistance mutations. Though virologic testing would likely hasten the switch to second-line among those failing, methods to improve adherence is critical to maximize durability of ART and improve virologic outcomes among youth in resource-limited settings.

Unipedal balance is affected by lower extremity joint arthroplasty procedure 1 year following surgery.

Lower Extremity Joint Arthroplasty (LEJA) surgery is an effective way to alleviate painful osteoarthritis. Unfortunately, these surgeries do not normalize the loading asymmetry during the single leg stance phase of gait. Therefore, we examined single leg balance in 234 TJA patients (75 hips, 65 knees, 94 ankles) approximately 12 months following surgery. Patients passed if they maintained single leg balance for 10s with their eyes open. Patients one year following total hip arthroplasty (THA-63%) and total knee arthroplasty (TKA-69%) had similar pass rates compared to a total ankle arthroplasty (TAA-9%). Patients following THA and TKA exhibit better unilateral balance in comparison with TAA patients. It may be beneficial to include a rigorous proprioception and balance training program in TAA patients to optimize functional outcomes.

SCHUBERT’S WINTERREISE AND THE PIANO TRIO IN Eb; TWO REMARKABLE WORKS FROM ONE REMARKABLE YEAR – 1827: A RECORDING PROJECT

During Franz Schubert’s penultimate year of 1827, he produced two profoundly important and mature works that are the focus of this recording project. The works are, in chronological order: • Winterreise (cycle of 24 songs on the poetry of Wilhelm Müller, 1794-1827) • Piano Trio in Eb Major, Op. 100, D. 929 A unique feature of the project is to present Winterreise in two poetic orders: as traditionally performed and published by Schubert, and in the final ordering published by the poet. The program notes accompanying the dissertation’s three compact discs have extensive information as well as comparative tables of Müller’s and Schubert’s final ordering of the cycle. There are significant differences in ordering, and ultimately the listener will determine which is more dramatically satisfying. Dark melancholy is the central emotion in Winterreise, which Schubert composed at various times throughout 1827 in a mood of corresponding gloom and distress. By contrast, the summer and fall of that year produced, in quick succession, the two glowing and remarkable Piano Trios in Bb and Eb, the second of which is included on these compact discs. The contrast between the trios and Winterreise follows the outward circumstances of Schubert’s life and health, a pattern of sorrow and later consolation and elation. The sound recordings for this dissertation recording project are available on three compact discs that can be found in the Digital Repository at the University of Maryland (DRUM). Winterreise was recorded in August 2009, at the University of Baltimore recital hall in Baltimore, Maryland with University of Maryland Professor François Loup. The trio, recorded in live performance in Baltimore in the spring of 2010, features two members of the Baltimore Symphony Orchestra: Qing Li, B.S.O. principal second violin, and Bo Li, B.S.O. section cellist.

Scholarly research productivity is not related to higher three-year licensure pass rates for physical therapy academic programs.

BACKGROUND: In the domain of academia, the scholarship of research may include, but not limited to, peer-reviewed publications, presentations, or grant submissions. Programmatic research productivity is one of many measures of academic program reputation and ranking. Another measure or tool for quantifying learning success among physical therapists education programs in the USA is 100 % three year pass rates of graduates on the standardized National Physical Therapy Examination (NPTE). In this study, we endeavored to determine if there was an association between research productivity through artifacts and 100 % three year pass rates on the NPTE. METHODS: This observational study involved using pre-approved database exploration representing all accredited programs in the USA who graduated physical therapists during 2009, 2010 and 2011. Descriptive variables captured included raw research productivity artifacts such as peer reviewed publications and books, number of professional presentations, number of scholarly submissions, total grant dollars, and numbers of grants submitted. Descriptive statistics and comparisons (using chi square and t-tests) among program characteristics and research artifacts were calculated. Univariate logistic regression analyses, with appropriate control variables were used to determine associations between research artifacts and 100 % pass rates. RESULTS: Number of scholarly artifacts submitted, faculty with grants, and grant proposals submitted were significantly higher in programs with 100 % three year pass rates. However, after controlling for program characteristics such as grade point average, diversity percentage of cohort, public/private institution, and number of faculty, there were no significant associations between scholarly artifacts and 100 % three year pass rates. CONCLUSIONS: Factors outside of research artifacts are likely better predictors for passing the NPTE.

Site Report for Phase III Archaeological Investigations at Reynolds Tavern (18AP23), 4 Church Circle, Annapolis, Maryland. 1982-1984

This report details the archaeology completed at Reynolds Tavern in the years 1982,1983, and 1984. It was completed in 2013, nearly 30 years after the excavation took place, using archival materials such as the draft interim reports, unit summary forms, original notes and photographs which are currently stored in the University Archives at Hornbake Library, at the University of Maryland, College Park. This report has been a collaboration across time and space, drawing from preliminary reports written by Anne Yenstch and Susan Mira in 1982 and Joe Dent and Beth Ford in 1983, as well as original notes from students of the field schools held there during those years, various analyses by scholars from many universities (including the University of Maryland, University of Georgia, and the College of William and Mary), and historical research by Nancy Baker. Thomas Cuddy began the writing of this report in 2002, completing the first three chapters in addition to the artifact analysis that led to the postexcavation identification of the African bundles in the Reynolds Tavern basement. This remarkable discovery was made along with Mark Leone of the University of Maryland, founder and director of Archaeology in Annapolis, who also served as the Principle Investigator during all three years of the Reynolds Tavern excavations. Dr. Leone contributed the fifth and final chapter to this report, the Conclusions and Recommendations, during its final compilation in 2013. The final report, including the fourth chapter on the archaeology itself, was written in part and compiled by Patricia Markert of the University of Maryland in the spring of 2013. Reynolds Tavern has been part of the landscape of Annapolis for two-hundred and fifty five years (at the time of the publication of this report). It sits on Church Circle facing St. Anne’s Church, and is a beautiful example of 18th century Georgian architecture as well one of the defining features of Historic Annapolis today. It currently operates as a popular restaurant and pub, but has served variously as a hat shop, a tavern, an inn, a library and a bank over time, among other things. Its long history contributes to its significance as an archaeological site, and also as a historic marker in present day Annapolis. The archaeology conducted at Reynolds Tavern shed light on life in 18th and 19th century Annapolis, illuminating details of the occupants’ lives through the material traces they left behind. These include an 18th century cobblestone road that ran diagonally through the Tavern’s yard, telling of the movement through early Annapolis; a large and intact well, which was found ii to contain a 19 foot wooden pipe; a large, ovular privy containing many of the objects used on a day to day basis at the Tavern or the structures around it; a subterranean brick storage feature in the basement of the Tavern, which may have been used by Reynolds during his days operating a hat shop; and also in the basement, two African caches of objects, providing a glimpse into West African spiritual practices alive in historic Annapolis and the presence of African American individuals at the Tavern in the 18th and 19th centuries. The purpose of this report is to detail these archaeological investigations and their findings, so that a public record will be available and the archaeology completed at Reynolds Tavern can continue to contribute to the history of Annapolis.

Persistence at one year of age of antigen-induced cellular immune responses in preterm infants vaccinated against whooping cough: comparison of three different vaccines and effect of a booster dose.

Due to their high risk of developing severe Bordetella pertussis (Bp) infections, it is recommended to immunize preterm infants at their chronological age. However, little is known about the persistence of their specific immune responses, especially of the cellular responses recognized to play a role in protection. We compared here the cellular immune responses to two major antigens of Bp between three groups of one year-old children born prematurely, who received for their primary vaccination respectively the whole cell vaccine Tetracoq(®) (TC), the acellular vaccine Tetravac(®) (TV), or the acellular vaccine Infanrix-hexa(®) (IR). Whereas most children had still detectable IFN-γ responses at one year of age, they were lower in the IR-vaccinated children compared to the two other groups. In contrast, both the TV- and the IR-vaccinated children displayed higher Th2-type immune responses, resulting in higher antigen-specific IFN-γ/IL-5 ratios in TC- than in TV- or IR-vaccinated children. The IFN-γ/IL-5 ratio of mitogen-induced cytokines was also lower in IR- compared to TC- or TV-vaccinated children. No major differences in the immune responses were noted after the booster compared to the pre-booster responses for each vaccine. The IR-vaccinated children had a persistently low specific Th1-type immune response associated with high specific Th2-type immune responses, resulting in lower antigen-specific IFN-γ/IL-5 ratios compared to the two other groups. We conclude that antigen-specific cellular immune responses persisted in one year-old children born prematurely and vaccinated during infancy at their chronological age, that a booster dose did not significantly boost the cellular immune responses, and that the Th1/Th2 balance of the immune responses is modulated by the different vaccines.

Cytokine and antibody profiles in 1-year-old children vaccinated with either acellular or whole-cell pertussis vaccine during infancy.

Two different types of pertussis vaccines are currently available to protect children against whooping cough, the first-generation whole-cell (Pw) vaccines and the more recent acellular (Pa) vaccines. Both types provide good protection, yet induce different types of immune responses in 6-month-old infants, with a strong Th1 response induced by Pw vaccines compared to a mixed Th1/Th2 response and a delay in non-specific IFN-gamma secretions after the administration of Pa vaccines. We show here that at 13 months of age, most Pw- or Pa-vaccinated children display Bordetella pertussis-specific T-cell responses, in addition to significant antibody levels, although a higher Th2/Th1 cytokine ratio remained in Pa recipients compared to Pw recipients. In contrast, the proportion of children with tetanus toxin-specific T-cell responses was lower in Pa than in Pw vaccine recipients, although most children had protective anti-tetanus toxin IgG levels. In addition, the global Th2 bias observed in 6-month-old infants vaccinated with a Pa vaccine was normalized at 13 months.

Reproduction of algebraic structures by 16-18 year old students

In this exploratory research we analyze the structure sense evidenced by 33 secondary students (16-18 years old) in tasks requiring to reproduce the structure of given algebraic expressions. The expressions used were algebraic fractions related to algebraic identities. There were big differences between the students performance which allowed differencing levels in students´ structure sense. Questions and conjectures to be addressed in future research are presented.

Observations and analysis of a 63-year-old reinforced concrete promenade railing exposed to the North Sea

Despite being exposed to the harsh sea-spray environment of the North Sea at Arbroath, Scotland, for over 63 years, many of the reinforced concrete precast beam elements of the 1.5 km long promenade railing are still in very good condition and show little evidence of reinforcement corrosion. In contrast, railing replacements constructed in about 1968 and in 1993 are almost all badly cracked as a result of extensive corrosion of the longitudinal reinforcement. This is despite the newer concrete appearing to be of better quality than the 1943 concrete. Statistics for maximum crack width for each of the three populations, based on measurements made in 2004 and in 2006, are presented. In situ and laboratory measurements show that the 1943 concrete appears to have high permeability but it also shows high electrical resistivity. Chloride penetration measurements show the 1943 and 1993 concretes to have similar chloride profiles and similar chloride concentrations at the reinforcement bars. This is inconsistent with the 1943 beams showing much less reinforcement corrosion than their later replacements and casts doubt on the conventional practice for durability design focusing on reducing concrete permeability through denser concretes or greater cover.

Psychology and interventions for pupils at risk of underachievement and school exclusion: the year 10 effect

Findings are presented from a longitudinal study of over 1,500 adolescents. Some were engaged in interventions aimed at reducing social disaffection. Participants completed measures of social-identification, academic self-concept and motivation, and social, emotional and behavioural difficulties. Consistent with our previous research, developmental trends in identity and self-concept were found - adolescents became more negative about some school-based factors and more positive about aspects of identity. Trends were less clear in the 120 adolescents receiving interventions. Findings demonstrate the importance of psychology in work with young people. [Source: (2008) 'Invited Address, IUPsyS Invited Symposium, Invited Symposium, Symposium, Paper Session, Poster Session', International Journal of Psychology, 43:3, 348 - 527]

Condition assessment of a 63-year old reinforced concrete structure exposed to the North Sea

This paper describes the condition of a reinforced concrete balustrade consisting of some 1000 individual beam elements all exposed similarly to the hostile marine environment of the North Sea at Arbroath, Scotland since 1943. A comparison is made of the condition of the original construction with the condition of repairs carried out in 1968 and in 1993. It is shown that the 1943 construction shows very little corrosion-induced cracking and little rust staining even though it does not appear to be of high construction quality. Only a very low percentage of the balustrade beams have been replaced. In contrast the beam installed in 1968 and later in 1993 show very considerable and large concrete cracks directly attributable to the corrosion of the longitudinal reinforcement, even though the concrete is of a higher quality and density. A detailed condition survey and statistics of crack sizes are presented in the paper. It is found that the higher corrosion resistance of the 1943 concrete is generally consistent with the concrete electrical resistivity measurements but the degree of corrosion of the reinforcing bars is inconsistent with chloride penetration measurements. The results are compared with the very few observations available in the literature for ageing concrete structures in marine environments. The results cast doubt on the conventional wisdom that chloride content at the reinforcement correlates well with reinforcement corrosion.

‘The trouble with Year 10’: 13 – 16 year old school students’ attitudes to higher education

This study looked at the impact of Widening Participation interventions on the attitudes of young people towards higher education. A total of 2731 adolescents aged 13–16 years completed a self-report measure of their attitudes to higher education, general and academic self concept and identification with school, family and peers. This was matched with data on the students’ academic attainment and social backgrounds. As expected, attainment scores were significantly positively correlated with take up of Widening Participation activities aimed at increasing participation in higher education, attitudes towards going to university and academic motivation. However, attainment was negatively correlated with perceptions of family attending university and identification with family. Regression analyses found that perceptions of family views about attending university were not a predictor of taking part in Widening Participation activities but were a predictor of attitudes towards higher education. Students in Year 10 aged 14–15 were significantly more negative on most factors than either older or younger students.