Late presentation for HIV care across Europe: update from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study, 2010 to 2013.

Late presentation (LP) for HIV care across Europe remains a significant issue. We provide a cross-European update from 34 countries on the prevalence and risk factors of LP for 2010-2013. People aged ≥ 16 presenting for HIV care (earliest of HIV-diagnosis, first clinic visit or cohort enrollment) after 1 January 2010 with available CD4 count within six months of presentation were included. LP was defined as presentation with a CD4 count < 350/mm(3) or an AIDS defining event (at any CD4), in the six months following HIV diagnosis. Logistic regression investigated changes in LP over time. A total of 30,454 people were included. The median CD4 count at presentation was 368/mm(3) (interquartile range (IQR) 193-555/mm(3)), with no change over time (p = 0.70). In 2010, 4,775/10,766 (47.5%) were LP whereas in 2013, 1,642/3,375 (48.7%) were LP (p = 0.63). LP was most common in central Europe (4,791/9,625, 49.8%), followed by northern (5,704/11,692; 48.8%), southern (3,550/7,760; 45.8%) and eastern Europe (541/1,377; 38.3%; p < 0.0001). There was a significant increase in LP in male and female people who inject drugs (PWID) (adjusted odds ratio (aOR)/year later 1.16; 95% confidence interval (CI): 1.02-1.32), and a significant decline in LP in northern Europe (aOR/year later 0.89; 95% CI: 0.85-0.94). Further improvements in effective HIV testing strategies, with a focus on vulnerable groups, are required across the European continent.

Hepatitis C in HIV-infected individuals: a systematic review and meta-analysis of estimated prevalence in Africa.

INTRODUCTION Although hepatitis C virus (HCV) screening is recommended for all HIV-infected patients initiating antiretroviral therapy, data on epidemiologic characteristics of HCV infection in resource-limited settings are scarce. METHODS We searched PubMed and EMBASE for studies assessing the prevalence of HCV infection among HIV-infected individuals in Africa and extracted data on laboratory methods used. Prevalence estimates from individual studies were combined for each country using random-effects meta-analysis. The importance of study design, population and setting as well as type of test (anti-HCV antibody tests and polymerase chain reactions) was examined with meta-regression. RESULTS Three randomized controlled trials, 28 cohort studies and 121 cross-sectional analyses with 108,180 HIV-infected individuals from 35 countries were included. The majority of data came from outpatient populations (55%), followed by blood donors (15%) and pregnant women (14%). Based on estimates from 159 study populations, anti-HCV positivity prevalence ranged between 3.3% (95% confidence interval (CI) 1.8-4.7) in Southern Africa and 42.3% (95% CI 4.1-80.5) in North Africa. Study design, type of setting and age distribution did not influence this prevalence significantly. The prevalence of replicating HCV infection, estimated from data of 29 cohorts, was 2.0% (95% CI 1.5-2.6). Ten studies from nine countries reported the HCV genotype of 74 samples, 53% were genotype 1, 24% genotype 2, 14% genotype 4 and 9% genotypes 3, 5 or 6. CONCLUSIONS The prevalence of anti-HCV antibodies is high in HIV-infected patients in Africa, but replicating HCV infection is rare and varies widely across countries.

Ms. germ. oct. 22 - Unser Vrouwen Klage. Die Fünfzehn Zeichen des Jüngsten Gerichts. Gedicht vom Leiden Christi

Vorbesitzer: Johann Friedrich Boehmer

Fruchttragender Näglein (No. 1) - nicht tragender (No. 2)

Louise von Panhuys

Niccolò Paganini, Brustbild

Signatur des Originals: S 36/G00114

Na 1 Nachlass Max Horkheimer, 641 - "The Lessons of Fascism" (p. IX 20.1-10)

"The Lesson of Facism" (GS 8, S. 9-37); 1. Beitrag zum UNESCO- Projekt "Tensions Affecting International Understanding", Paris, 1948; veröffentlicht in: Hadley Cantril (editor), "Tensions That Cause Wars", Urbana, I 11., 1950, Seite 209-242. a)-d) Typoskripte mit eigenständigen und ,oder handschriftlichen Korrekturen e) deutscher Entwurf, Typsokript ,15 Blatt f) dass., Teilstück, Typoskript, 5 Blatt g) dassselbe, Typoskript mit eigenhändigen Korrekturen, 12 Blatt h)-k) deutsche Fassung, übersetzt vom Institut für Sozialforschung, 1961 h) Typoskript mit eigenhändigen und handschriftlichen Korrekturen, mit dem Titel "Die Lehren aus dem Faschismus", 30 Blatt i) Typoskript mit handschriftlichen Korrekturen, mit dem Titel "Lehren des Nationalsozialismus", 30 Blatt; mit 1 eigenhändigen Memorandum von Friedrich Pollock, 1 Blatt k)Typoskript mit handschriftlichen Korrekturen von Friedrich Pollock, 19 Blatt; 2. Eigenhändige Notizen und Entwürfe, 21 Blatt; 3. Max Horkheimer, Gordon W. Allport, Gilbert Freyre, Georges Gurvitch, Arne Naess, John Rickman, Harry S. Sullivan, Alexandre Szalai: "Statment on Tensions Affecting International Understanding"; Typsokript mit eigenhändigen Unterschriften, 5 Blatt; 4. Biographische und bibliographische Angaben zu den Verfassern von 3. a) 4 Blatt, mit eigenhändigen Notizen von Max Horkheimer b) 9 Blatt; 5. 2 Photos; 6. Max Horkheimer [?]: "An International Social Science Institut"; Typoskript mit eigenhändigen Ergänzungen, 2 Blatt; 7. Cantril, Hadley: "The Human Sciences and World Peace. The Unesco Projekt 'Tensions Affecting International Understanding'" a) Drucksache, 4 Blatt, mit eigenhändigen Notizen von Max Horkheimer b) als Typoskript vervielfältigt 4 Blatt; 8. Einladungen, 4 Blatt; 9. Kehoe, Kathleen, UNESCO: 1 Brief mit Unterschrift an Max Horkheimer, Paris, 18.06.1948, 1 Blatt; 10. Janowitz, Morris: 1 Brief- Kopie an Max Horkheimer, New York, 17.06.1948, 1 Blatt;

Na 1 Nachlass Max Horkheimer, 642 - "Materialien. Druckseiten aus Zeitschriften", "Menschen im Großbetrieb" und "Vorwort zu: 'Zeugnisse. Theodor W. Adorno zum 60. Geburtstag'" (p. IX 20.11-76-IX 22)

11. Salomon, Albert: "The Spirit of the Soldier and Nazi Militarism". Social Research, Februar 1942, 13 Blatt; 12. Dicks, H.V.: "The Psychological Foundations of the Wehrmacht". Als Typoskript vervielfältigt, 42 Blatt; 13. Clark, Robert A.: "Aggressivness and Military Training". American Journal of Sociology, Volume 51, Number 5, March 1946, 5 Blatt; 14. Stagner, Ross: "Fascist Attitudes: Their Determening Conditions". The Journal of Social Psychology, Volume III, Number 4, 1936, 9 Blatt; 15. Apple, Kenneth E.: "Nationalism and Souvereignity: A Psychiatric View." The Journal of Normal and Abnorma Psychology, Volume 40, Number 4, October 1945, 4 Blatt; 16. Schreier, Fritz: "German Aggressivness- Its Reasons and Types". Journal of Normal and Abnormal Psychology, Volume 38, Number 2, April 1943, 7 Blatt; 17. Stagner, Ross: "Fascist Attitudes: An Exploratory Study". The Journal of Social Psychology, Volume III, Number 3, 1936, 6 Blatt; 18. Stagner, Ross und Katzoff, E. T.: "Fascist Attitudes: Factor Analysis of Item Correlations". The Journal of Social Psychology, 16, 1942, 4 Blatt; 19. Stagner, Ross und Osgood, Charles E.: "Impact of War on a Nationalistic Frame of Reference". The Journal of Social Psychology, 24, 1946, 15 Blatt; 20. Day, Daniel Droba und Quackenbusch, O.F.: Attitudes Towards Defensive, Cooperative and Aggressive War". The Journal of Social Psychology, 16, 1942, 5 Blatt; 21. Kecskemeti, Paul und Leites, Nathan: "Some Psychological Hypotheses on Nazi Germany: I". The Journal of Social Psychology, 26, 1947, 22 Blatt; 22. Dieselben: "Some Psychological Hypotheses on Nazi Germany: II". Ebenda, 27, 1948, 14 Blatt; 23. Parsons, Tollcott: "Certain Primary Sources and Pattersens of Aggression in the Social Structure of the Western World". Psychiatry, Volume 10, Number 2, May 1047, 8 Blatt; 24. Zerner, Elizabeth H.: "German Occupation and Anti-Semitism in France". Public Opinion Quarterly, Summer 1948, 5 Blatt; 25. Hauser, Ernest O.: "Doctor [Julian] Huxley`s Wonderful Zoo". The Saturday Evening Post, ohne Datum, 5 Blatt; 26. Zeitungsabschnitt, 1 Blatt; "Menschen im Großbetrieb" (GS 8, S. 95-105); Veröffentlicht in: Deutsche Zeitung, 19.02.1955. a) Typoskript mit dem Titel "Meinungsforschung im Betrieb" mit handschriftlichen Korrekturen, 10 Blatt b) Typoskript mit dem Titel "Der Mensch im Großbetrieb", mit eigenhändigen Korrekturen und einer handschriftlichen Notiz von Theodor W. Adorno, 17 Blatt c) Typoskript mit eigenhändigen Korrekturen, 17 Blatt d) Zeitungsdruck mit dem Titel "Menschen im Großbetrieb", mit eigenhändigen Korrekturen, 1 Blatt e)-f) Dasselbe , 1 Blatt; "Vorwort" zu: "Zeugnisse. Theodor W. Adorno zum 60. Geburtstag"; Veröffentlicht: Ebenda, Frankfurt am Main, 1963. a)-b) Typoskript mit eigenhändigen Korrekturen, 1 Blatt c) Typoskript, 2 Blatt;

Na 1 Nachlass Max Horkheimer, 653 - Vorlesungen: "Eclipse of Reason"; "Society and Reason" (p. IX 36.6-12)

6. Vorlesungen 1. - 5. mit dem Titel "Society and Reason". a) Typoskript mit handschriftlichen Randbemerkungen von Theodor W. Adorno, 139 Blatt b) Typoskript, 139 Blatt; 7. Teilstück, Typoskript mit eigenhändigen Korrekturen, 1 Blatt; 8. Eigenhändige Notizen, 4 Blatt; 9. Stichworte zu den Vorlesungen I-III. Typoskript mit eigenhändigen Ergänzungen, 2 Blatt a) Einladungskarte zur Vorlesungsreihe "Society and Reason". Als Typoskript vervielfältigt, 1 Blatt b) Gliederung. Typoskript, 1 Blatt; 10. "Über Probleme des wissenschaftlichen Stils". Reaktion auf ein Schriftstück (aus einem Brief an Friedrich Pollock). a) Typoskript, datiert: 28.11.1943, 3 Blatt b) Max Horkheimer: 1 Brief an Friedrich Pollock, ohne Ort, 28.11.1943, 5 Blatt; 11. Columbia University, New York: 1 Brief (Abschrift) an Max Horkheimer, New York, 5.3.1943, und Stichworte zu den Vorlesungen, 2 Blatt; 12. Zeitungsausschnitt, 1 Blatt.;

Enlarged tracheoesophageal puncture: A systematic review and retrospective analysis

Background. An enlarged tracheoesophageal puncture (TEP) results in aspiration around the voice prosthesis (VP) and may lead to pneumonia. The aims of this research were: (1) to conduct a systematic review and meta-analysis on enlarged TEP; (2) to analyze preoperative, perioperative, and postoperative risk factors for enlarged TEP; and (3) to evaluate control of leakage around the VP using conservative treatments and adverse events in patients with enlarged TEP.^ Methods. A systematic review was conducted (1978-2008). A summary risk estimate was calculated using a random-effects meta-analysis model. A retrospective cohort study was completed. Patients who underwent total laryngectomy and TEP at The University of Texas M. D. Anderson Cancer Center (MDACC) were included. Multiple logistic regression methods were used to assess risk factors for enlargement. Descriptive and bivariate statistics were calculated to evaluate outcomes and adverse events. Results: Twenty-seven manuscripts were included in the systematic review. The summary risk estimate of enlarged TEP/leakage around the VP was 7.2% (95% CI: 4.8%-9.6%). Temporary VP removal and TEP-site injections were the most commonly reported treatments. Neither prosthetic diameter (p=0.076) nor timing of TEP (p=0.297) significantly increased risk of enlargement per stratified analyses of published outcomes. The cumulative incidence of enlarged TEP was 18.6% (36/194, 95% CI: 13.0%-24.1%) in the MDACC cohort. Enlarged TEP occurred exclusively in irradiated patients. Adjusting for length of follow-up and timing of TEP, advanced nodal disease (ORadjusted: 4.3, 95% CI: 1.0-19.1), stricture (ORadjusted : 3.2, 95% CI: 1.2-8.6), and locoregional recurrence/distant metastasis after laryngectomy (ORadjusted: 6.2, 95% CI: 2.3-16.4) increased risk of enlarged TEP. At last follow-up, conservative methods controlled leakage around the VP in 81% (29/36) of patients. Unresolved leakage was associated with recurrent cancer (p=0.081) and TEP-site irregularity (p=0.003). Relative to those without enlargement, enlarged TEP patients had significantly higher risk of pneumonia (RR: 3.4, 95% CI: 1.9-6.2).^ Conclusions. These data establish that enlarged TEP poses serious health risks, and provide insight into medical and oncologic factors that may contribute to development of this complication. In addition, this research supports the use of conservative treatments to address leakage after enlarged TEP in lieu of complete TEP closure.^

Effects of breastfeeding and naturally acquired immunity on infection with {\it Giardia lamblia}: A study in a cohort of Mexican infants

Giardia lamblia is one of the most common causes of gastrointestinal tract infection among young children worldwide. Yet host protection against this parasite and the effect of infection with Giardia on infant growth are poorly understood. It was hypothesized that among young children, protection against infection with Giardia is afforded by breastfeeding and previous infection with the parasite and further, that infection with Giardia decreases growth velocity. From 4/88 to 4/90, 197 infants in a poor area of Mexico City were followed from 0 to 18 months of age, with stool specimens, symptoms and feeding status data collected weekly. A total of 6,031 stool specimens were tested for Giardia antigen by enzyme-linked immunosorbent assay. There were 1.0 Giardia infections per child-year; 25% were symptomatic and 54% lasted more than 1 month; 94 infants had 1, and 33 had 2 or more infections. Breastfeeding status was coded and analyzed for each child-week of follow up. 91% of study infants were breastfed from birth, 57% at 6 months and 38% at 12 months of age. Rate ratios for non-breastfeeding adjusted for confounding factors were calculated from stratified analyses and the Cox proportional hazards model. Not breastfeeding was a significant risk factor for first infection with Giardia vs. any breastfeeding (adjusted RR = 1.8; 1.1, 2.8) at all ages; a dose response was demonstrated by degree of breastfeeding. The adjusted rate ratio for non-breastfeeding vs. partial breastfeeding was 1.6 (1.03, 2.6) and for non-breastfeeding vs. complete breastfeeding was 4.7 (1.4, 15.9). Among Giardia infected infants, breastfeeding did not protect against diarrheal symptoms or shorten the duration of carriage. First and repeat infections with Giardia did not differ in duration or the percent symptomatic. The analysis of growth and Giardia infection was inconclusive but suggested that a history of Giardia infection might be associated with decreased weight velocity, while an immediate chronic infection might be associated with increased weight velocity. In summary, these data indicate that breastfeeding protects infants against infection with Giardia; provide no evidence of protection against repeat infections resulting from a prior infection and suggest but do not establish that a history of Giardia infection might be associated with decreased growth in young children. ^

Cardiovascular diseases risk factors during the first year of life

The pattern of change in cardiovascular risk factors, blood pressure (SBP and DBP) and plasma total cholesterol (TC), over time, their tracking and their relation to anthropometric measurements during the first year of life were investigated. Also, the effect of breast feeding on TC and the relationship of blood pressure measurements and family history of CVD risk factors were examined. One hundred five newborn term, healthy infants who were seen at a pediatric clinic in The Woodlands, Texas were followed longitudinally from 2 weeks to 1 year of age. TC, blood pressure, weight and length of the infants were measured at age 2 weeks, and again at 2, 4, 6, 9 and 12 months. In addition, family history, maternal and paternal, of CVD risk factors was obtained. Data analyses included only 40 infants who completed one year of follow up.^ At 2 weeks of age, the median value for TC was 23 mg/dl higher for females than for males. This difference disappeared as infants got older. For males, most of the increase in TC median levels, from 114 to 137 mg/dl, occurred between the ages of 2 weeks and 2 months, whereas for the female group, TC levels increased moderately, about 10 mg/dl, between 9 and 12 months of age. Tracking of TC was examined by using Spearman's correlation analysis. There were strong correlations between measurements taken as early as 2 weeks of age with later measurements. These correlations were stronger and more significant for males than for females (for males, r varied between 0.51 to 0.70, whereas for females, r varied between 0.11 to 0.70). The association of body measurements with TC is no more than modest and is closer for female infants than for male infants. Analysis, also, showed that infants who received breast milk had a TC mean value 47 mg/dl higher than that for infants who received formula milk only during the period of breast feeding and this difference disappeared by age 12 months.^ In both genders, most of the increase in blood pressure (about 10-15 mmHg in both SBP and DBP) occurred during the first 4 months of life. Most of the increase for male infants occurred during the first 2 months of life, while for females, the increase in SBP and DBP was between the age of 2 and 4 months. Neither SBP nor DBP track well during the first year of life and most of the correlations between measurements at different ages were not significant for either gender. The cross-sectional relationship of blood pressure measurements and selected body measurements was assessed. For females, only at age of 12 months did DBP have positive and significant correlations with weight, length and Quetelet index (r = 0.57, 0.60 and 0.57, respectively). There were no significant correlations between blood pressure and body measurements for males. Finally, analysis showed that maternal history of CV risk factors was significantly related to SBP in the female infant group, but not for males. For DBP, neither maternal nor paternal history was related. ^

AN ATTEMPT TO MEASURE FOOD SAFETY STATUS

The main objective of this study was to attempt to develop some indicators for measuring the food safety status of a country. A conceptual model was put forth by the investigator. The assumption was that food safety status was multifactorily influenced by medico-health levels, food-nutrition programs, and consumer protection activities. However, all these in turn depended upon socio-economic status of the country.^ Twenty-six indicators were reviewed and examined. Seventeen were first screened and three were finally selected, by the stepwise multiple regression analysis, to reflect the food safety status. Sixty-one countries/areas were included in this study.^ The three indicators were life expectancy at birth with multiple correlation coefficient (R2 = 34.62%), adult literacy rate (R2 = 29.66%), and child mortality rate for ages 1-4 (R2 = 9.99%). They showed a cumulative R2 of 57.79%. ^

The incidence of necrotizing changes in adults with pneumococcal pneumonia

Background. Necrotizing pneumonia is generally considered a rare complication of pneumococcal pneumonia in adults. We systematically studied the incidence of necrotizing changes in adult patients with pneumococcal pneumonia, and examined the severity of infection, the role of causative serotype and the association with bacteremia. ^ Methods. We used a data base of all pneumococcal infections identified at our medical center between 2000 and 2010. Original readings of chest X-rays (CXR) and computerized tomography (CT) were noted. All images were then reread independently by 2 radiologists. The severity of disease was assessed using the SMART-COP scoring system. ^ Results. There were 351 cases of pneumococcal pneumonia. Necrosis was reported in no original CXR readings and 6 of 136 (4.4%) CTs. With re-reading, 8 of 351 (2.3%) CXR and 15 of 136 (11.0%) CT had necrotizing changes. Overall, these changes were found in 23 of 351 (6.6%, 95% CI 4.0 - 9.1) patients. The incidence of bacteremia and the admitting SMART-COP scores were similar in patients with and without necrosis (P=1.00 and P=0.32, respectively). Type 3 pneumococcus was more commonly isolated from patients with than from patients without necrotizing pneumonia (P=0.05), but a total of 10 serotypes were identified among 16 cases in which the organism was available for typing. ^ Conclusions. Necrotizing changes in the lungs were seen in 6.6% (95% CI 4.0 - 9.1) of a large series of adults with pneumococcal pneumonia. Patients with necrosis were not more likely to have bacteremia or more severe disease. Type 3 pneumococcus was commonly implicated, but 9 other serotypes were also identified.^

Stability and potential application of spliced nuclear pre -mRNA introns

A major portion of this thesis work was dedicated to study the nature and significance of spliced introns. The initial work was focused on studying the IVS1$\sb{\rm C\beta 1}$ intron from a T-cell receptor (TCR)-$\beta$ gene. Compared to an intron lariat control from adenovirus pre-mRNA that was spliced in vitro, IVS1$\sb{\rm C\beta 1}$ was debranched less efficiently by HeLa S100 extracts, although IVS1$\sb{\rm C\beta 1}$ also used the consensus branchpoint in vivo. Subcellular-fractionation analysis showed that most IVS1$\sb{\rm C\beta 1}$ lariats cofractionated with pre-mRNA in the nucleus, consistent with the possibility that intron degradation releases splicing factors which will be available for further rounds of splicing. The half-life of IVS1$\sb{\rm C\beta 1}$ from the endogenous TCR-$\beta$ gene was measured using the general transcription inhibitor actinomycin D to be about $\sim$15 min, which was similar to that of unstable mRNAs such as c-myc mRNA.^ The general transcription inhibitor DRB was also used for intron stability analysis. Unexpectedly, DRB decreased intron and pre-mRNA levels only initially, it later increased the levels of intron-containing RNAs. Inhibition of transcription initiation appeared to be the major early effect (the reduction phase); whereas enhanced premature transcription termination was dominant later (the induction phase).^ Having established the procedures for studying in vivo spliced introns, this approach was applied to study the mechanism of nonsense-mediated downregulation (NMD), a phenomena in which premature termination codons (PTCs) decrease the levels of mRNAs. In this study, the novel intron-oriented approach was applied to study the mechanism of NMD. The levels of spliced introns immediately upstream and downstream of a PTC-bearing exon in a TCR-$\beta$ gene were identified and analyzed along with their pre-mRNA. Although PTC reduced the mRNA levels by 4 to 9 fold, the steady-state levels of spliced introns and the pre-mRNA-to-intron ratios were not significantly altered, indicating that the PTC did not significantly inhibit TCR-$\beta$ RNA splicing. Consistent with this conclusion, the half-lives of the PTC$\sp+$ and PTC$\sp-$ pre-mRNA were similar. The protein synthesis inhibitor cyclohexmide (CHX) upregulated the levels of the PTC$\sp+$ mRNA over 10 fold without affecting the levels of the spliced introns, suggesting that the reversal effect of CHX was through stabilization, not production. These results indicated that inhibition of splicing could not be the major mechanism for the NMD pathway of the TCR-$\beta$ gene, instead, suggesting that mRNA destabilization may be more important. (Abstract shortened by UMI.) ^

Granulometry of two sediment cores from Maxwell Bay, South Shetland Islands, West Antarctica

The climate evolution of the South Shetland Islands during the last c. 2000 years is inferred from the multiproxy analyses of a long (928 cm) sediment core retrieved from Maxwell Bay off King George Island. The vertical sediment flux at the core location is controlled by summer melting processes that cause sediment-laden meltwater plumes to form. These leave a characteristic signature in the sediments of NE Maxwell Bay. We use this signature to distinguish summer and winter-dominated periods. During the Medieval Warm Period, sediments are generally finer which indicates summer-type conditions. In contrast, during the Little Ice Age (LIA) sediments are generally coarser and are indicative of winter-dominated conditions. Comparison with Northern and Southern Hemisphere, Antarctic, and global temperature reconstructions reveals that the mean grain-size curve from Maxwell Bay closely resembles the curve of the global temperature reconstruction. We show that the medieval warming occurred earlier in the Southern than in the Northern Hemisphere, which might indicate that the warming was driven by processes occurring in the south. The beginning of the LIA appears to be almost synchronous in both hemispheres. The warming after the LIA closely resembles the Northern Hemisphere record which might indicate this phase of cooling was driven by processes occurring in the north. Although the recent rapid regional warming is clearly visible, the Maxwell Bay record does not show the dominance of summer-type sediments until the 1970s. Continued warming in this area will likely affect the marine ecosystem through meltwater induced turbidity of the surface waters as well as an extension of the vegetation period due to the predicted decrease of sea ice in this area.