Tenofovir in second-line ART in Zambia and South Africa: collaborative analysis of cohort studies

Tenofovir (TDF) is increasingly used in second-line antiretroviral treatment (ART) in sub-Saharan Africa. We compared outcomes of second-line ART containing and not containing TDF in cohort studies from Zambia and the Republic of South Africa (RSA).

Pediatric severe asthma is characterized by eosinophilia and remodeling without T(H)2 cytokines

BACKGROUND: The pathology of pediatric severe therapy-resistant asthma (STRA) is little understood. OBJECTIVES: We hypothesized that STRA in children is characterized by airway eosinophilia and mast cell inflammation and is driven by the T(H)2 cytokines IL-4, IL-5, and IL-13. METHODS: Sixty-nine children (mean age, 11.8 years; interquartile range, 5.6-17.3 years; patients with STRA, n = 53; control subjects, n = 16) underwent fiberoptic bronchoscopy, bronchoalveolar lavage (BAL), and endobronchial biopsy. Airway inflammation, remodeling, and BAL fluid and biopsy specimen T(H)2 cytokines were quantified. Children with STRA also underwent symptom assessment (Asthma Control Test), spirometry, exhaled nitric oxide and induced sputum evaluation. RESULTS: Children with STRA had significantly increased BAL fluid and biopsy specimen eosinophil counts compared with those found in control subjects (BAL fluid, P < .001; biopsy specimen, P < .01); within the STRA group, there was marked between-patient variability in eosinophilia. Submucosal mast cell, neutrophil, and lymphocyte counts were similar in both groups. Reticular basement membrane thickness and airway smooth muscle were increased in patients with STRA compared with those found in control subjects (P < .0001 and P < .001, respectively). There was no increase in BAL fluid IL-4, IL-5, or IL-13 levels in patients with STRA compared with control subjects, and these cytokines were rarely detected in induced sputum. Biopsy IL-5(+) and IL-13(+) cell counts were also not higher in patients with STRA compared with those seen in control subjects. The subgroup (n = 15) of children with STRA with detectable BAL fluid T(H)2 cytokines had significantly lower lung function than those with undetectable BAL fluid T(H)2 cytokines. CONCLUSIONS: STRA in children was characterized by remodeling and variable airway eosinophil counts. However, unlike in adults, there was no neutrophilia, and despite the wide range in eosinophil counts, the T(H)2 mediators that are thought to drive allergic asthma were mostly absent.

ON THE DIGITAL-POLITICAL TOPOGRAPHY OF MUSIC

The persuasive power of music is often relegated to the dimension of pathos: that which moves us emotionally. Yet, the music commodity is now situated in and around the liminal spaces of digitality. To think about how music functions, how it argues across media, and how it moves us, we must examine its material and immaterial realities as they present themselves to us and as we so create them. This dissertation rethinks the relationship between rhetoric and music by examining the creation, performance, and distribution of music in its material and immaterial forms to demonstrate its persuasive power. While both Plato and Aristotle understood music as a means to move men toward virtue, Aristotle tells us in his Laws, through the Athenian Stranger, that the very best kinds of music can help guide us to truth. From this starting point, I assess the historical problem of understanding the rhetorical potential of music as merely that which directs or imitates the emotions: that which “Soothes the savage breast,” as William Congreve writes. By furthering work by Vickers and Farnsworth, who suggest that the Baroque fascination with applying rhetorical figures to musical figures is an insufficient framework for assessing the rhetorical potential of music, I demonstrate the gravity of musical persuasion in its political weight, in its violence—the subjective violence of musical torture at Guantanamo and the objective, ideological violence of music—and in what Jacques Attali calls the prophetic nature of music. I argue that music has a significant function, and as a non-discursive form of argumentation, works on us beyond affect. Moreover, with the emergence of digital music distribution and domestic digital recording technologies, the digital music commodity in its material and immaterial forms allows for ruptures in the former methods of musical composition, production, and distribution and in the political potential of music which Jacques Attali describes as being able to foresee new political realities. I thus suggest a new theoretical framework for thinking about rhetoric and music by expanding on Lloyd Bitzer’s rhetorical situation, by offering the idea of “openings” to the existing exigence, audience, and constraints. The prophetic and rhetorical power of music in the aleatoric moment can help provide openings from which new exigencies can be conceived. We must, therefore, reconsider the role of rhetorical-musical composition for the citizen, not merely as a tool for entertainment or emotional persuasion, but as an arena for engaging with the political.

The Electrowinning of Manganese from Rhodochrosite

Manganese is commonly known to be a metal of great strategic importance. It is essential in the production of all steels, first as a scavenger to remove oxygen and sulfur, and second as an alloying element in wear-resis­tant steels.

Thermal plasticity of mitochondria: a latitudinal comparison between Southern Ocean molluscs

Mitochondrial volume density (Vv((mt,f))), cristae surface density (Sv((im,mt))), cristae surface area (Sv((im,f))) and citrate synthase (CS) activity were analysed as indicators of thermal acclimation in foot muscle of the limpet, Nacella concinna, and the clam, Laternula elliptica, collected from 4 locations within the Southern Ocean, South Georgia (54 degrees S, N. concinna only), Signy (60 degrees S), Jubany (L. elliptica only -62 degrees S) and Rothera (67 degrees S). Animals were acclimated to 0.0 degrees C whilst a sub-set of N. concinna (South Georgia, Signy and Rothera) and L. elliptica (Rothera) were acclimated to 3.0 degrees C. At 0.0 degrees C N. concinna had higher Vv((mt,f)), Sv((im,mt)), Sv((im,f)) and muscle fibre specific CS activity than L. elliptica which correlated with the more active life style of N. concinna. However, mitochondrial density was very low, 1-2% in both species, suggesting that low temperature compensation of mitochondrial density is not a universal evolutionary response of Antarctic marine ectotherms. Both Sv((im,mt)) and Sv((im,f)) were reduced by warm acclimation of N. concinna. South Georgia N. concinna maintained muscle fibre specific CS activity after acclimation, in contrast to N. concinna from Rothera and Signy and L. elliptica from Rothera, indicating that they have the physiological plasticity to respond to their warmer, more variable thermal environment.

Turkey. A Generalist Approach in Social Work Education

A global review of social work education reveals considerable similarity among countries as well as significant differences. Historically, programs of social work education are informed by humanistic values and encompass knowledge of social problems, an understanding of individuals and their environment in interaction, and method of intervention into social and human difficulties. At the same time, structure of social work within the educational system and the length of training vary considerably from country to country. There is no serious international standards' setting for social work education, programs, educators and students around the world. Education programs exist at differing levels of education and for differing periods of time. There are no worldwide data on the number and qualifications of teachers of social work, the number and characteristics of social work students, variations in curricula and type of practicum (Hokeenstad and Kendall, 2001; Hokenstad, Midgley, 1998). North American and European models have had a major influence on social work educational programs in most parts of the world, especially developing countries. Still, the amount of western influence on social work education in developing countries is an issue that continues to be discussed (Hockenstad, Khinduka and Midgley, 1992; Frumkin, Lloyd, 2001). The programs in practice in Europe and North America have influenced the implementation of social work education programs. In recent years this influence has had a big part in the acceptance of the generalist approach. It is very important that social work education programs must be planned in accordance with the social structure and the development process of the society. Because of this, information on the social indicators and social welfare services will be given first then social work education will be stressed upon.

Candidatus Syngnamydia venezia, a novel member of the phylum Chlamydiae from the broad nosed pipefish, Syngnathus typhle

Chlamydia are obligate intracellular bacteria and important pathogens of humans and animals. Chlamydia-related bacteria are also major fish pathogens, infecting epithelial cells of the gills and skin to cause the disease epitheliocystis. Given the wide distribution, ancient origins and spectacular diversity of bony fishes, this group offers a rich resource for the identification and isolation of novel Chlamydia. The broad-nosed pipefish (Syngnathus typhle) is a widely distributed and genetically diverse temperate fish species, susceptible to epitheliocystis across much of its range. We describe here a new bacterial species, Candidatus Syngnamydia venezia; epitheliocystis agent of S. typhle and close relative to other chlamydial pathogens which are known to infect diverse hosts ranging from invertebrates to humans

Zidovudine impairs immunological recovery on first-line antiretroviral therapy: collaborative analysis of cohort studies in southern Africa

OBJECTIVES Zidovudine (ZDV) is recommended for first-line antiretroviral therapy (ART) in resource-limited settings. ZDV may, however, lead to anemia and impaired immunological response. We compared CD4+ cell counts over 5 years between patients starting ART with and without ZDV in southern Africa. DESIGN Cohort study. METHODS Patients aged at least 16 years who started first-line ART in South Africa, Botswana, Zambia, or Lesotho were included. We used linear mixed-effect models to compare CD4+ cell count trajectories between patients on ZDV-containing regimens and patients on other regimens, censoring follow-up at first treatment change. Impaired immunological recovery, defined as a CD4+ cell count below 100 cells/μl at 1 year, was assessed in logistic regression. Analyses were adjusted for baseline CD4+ cell count and hemoglobin level, age, sex, type of regimen, viral load monitoring, and calendar year. RESULTS A total of 72,597 patients starting ART, including 19,758 (27.2%) on ZDV, were analyzed. Patients on ZDV had higher CD4+ cell counts (150 vs.128 cells/μl) and hemoglobin level (12.0 vs. 11.0 g/dl) at baseline, and were less likely to be women than those on other regimens. Adjusted differences in CD4+ cell counts between regimens containing and not containing ZDV were -16 cells/μl [95% confidence interval (CI) -18 to -14] at 1 year and -56 cells/μl (95% CI -59 to -52) at 5 years. Impaired immunological recovery was more likely with ZDV compared to other regimens (odds ratio 1.40, 95% CI 1.22-1.61). CONCLUSION In southern Africa, ZDV is associated with inferior immunological recovery compared to other backbones. Replacing ZDV with another nucleoside reverse transcriptase inhibitor could avoid unnecessary switches to second-line ART.

Effect of Relaxin on Parturition in Ruminants

The biology of relaxin differs in many respects between ruminants and nonruminants. Immunoreactive blood concentration of circulating relaxin is much less in ruminant (cattle and sheep) than in nonruminant (pigs) farm animals. The ovaries of the pig produce abundant quantities of the hormone in late pregnancy, whereas tissue sources of relaxin are not clearly defined in sheep and cattle. Relaxin facilitates parturition by cervical dilation and pelvic canal expansion in several mammalian species. Relaxin injected intramuscularly during late pregnancy can cause earlier parturition in cattle, but in sheep limited evidence indicates it does not induce earlier delivery than seen in diluent-treated controls. Intravenous infusion of increasing dosages of relaxin in beef heifers the last days of pregnancy decreased plasma progesterone concentration compared with phosphate buffer controls, but oxytocin plasma concentrations remained similar throughout the posttreatment period. Although continuous intravenous infusion of relaxin depressed blood levels of progesterone, it did not result in earlier parturition than seen in the diluent treated controls. Thus, the timing and method of relaxin administration during late pregnancy in ruminants affect remodelling of collagen and pelvic canal relaxation and can result in earlier parturition.

Growth after Hypophyseal Stalk Transection and Hypophysectomy in Beef Calves

Growth hormone (GH) is a metabolic hormone that plays an important role in long-bone growth and muscle accretion in mammals. The anterior pituitary gland at the base of the brain is the primary site of GH production and release into the general circulation. Neurons in the arcuate nucleus of the hypothalamus in the lower part of the brain secrete GH-releasing hormone ([GHRH] or factor [GRF]) and GH-release-inhibiting hormone ([GHRIH] or somatostatin [SRIH]) that acutely modulate GH secretion by the pituitary gland. The pituitary gland is connected to the median eminence of the hypothalamus by a stalk (hypophyseal stalk). Complete surgical removal of the pituitary gland (hypophysectomy) arrests growth and greatly impairs metabolism in laboratory and farm animal species. Daily subcutaneous injection of bovine GH (bGH) in immature hypophysectomized rats significantly increased body growth and epiphyseal plate width of the long-bone (tibia) compared with diluent-treated hypophysectomized controls. Growth rate was less, however, in the bGH-treated animals compared with intact controls. In beef calves, hypophysectomy completely arrested body weight gain and long-bone growth. GH is secreted in an episodic pattern in young growing intact calves. Episodic GH secretion was abolished immediately following hypophyseal stalk transection, and basal GH blood concentration was less than in shamoperated controls. Regardless, growth continued in these stalk-transected calves during a 1,008-day period, but at a lower growth rate than seen in the sham-operated controls. At autopsy, pituitary gland weight was greatly decreased in hypophyseal stalktransected compared with sham-operated calves. Thus, in spite of obliterated episodic GH release and decreased basal secretion of GH, the isolated pituitary gland of hypophyseal stalk transected calves continues to secrete sufficient amounts of GH for significant growth and development throughout a long period.

Strategies for Artificial Insemination of Cattle at Synchronized Ovulation or Synchronized Estrus

Two synchronization protocols in lactating dairy and beef cows and in dairy heifers were tested for efficacy of breeding by artificial insemination (AI) with or without estrus detection. Controls received three prostaglandin F2a (PGF2a) injections 14 days apart before AI at observed estrus. Pregnancy rates were compared with animals on the Ovsynch protocol that combined gonadotropin releasing hormone (GnRH) and PGF2a treatments with a timed AI 16 to 20 hours after the second GnRH injection. The pregnancy rates were similar at synchronized ovulation to fixed-time AI in lactating cows, but not effective in heifers because of the lack of synchronization.