Variable impact on mortality of AIDS-defining events diagnosed during combination antiretroviral therapy: not all AIDS-defining conditions are created equal

BACKGROUND: The extent to which mortality differs following individual acquired immunodeficiency syndrome (AIDS)-defining events (ADEs) has not been assessed among patients initiating combination antiretroviral therapy. METHODS: We analyzed data from 31,620 patients with no prior ADEs who started combination antiretroviral therapy. Cox proportional hazards models were used to estimate mortality hazard ratios for each ADE that occurred in >50 patients, after stratification by cohort and adjustment for sex, HIV transmission group, number of antiretroviral drugs initiated, regimen, age, date of starting combination antiretroviral therapy, and CD4+ cell count and HIV RNA load at initiation of combination antiretroviral therapy. ADEs that occurred in <50 patients were grouped together to form a "rare ADEs" category. RESULTS: During a median follow-up period of 43 months (interquartile range, 19-70 months), 2880 ADEs were diagnosed in 2262 patients; 1146 patients died. The most common ADEs were esophageal candidiasis (in 360 patients), Pneumocystis jiroveci pneumonia (320 patients), and Kaposi sarcoma (308 patients). The greatest mortality hazard ratio was associated with non-Hodgkin's lymphoma (hazard ratio, 17.59; 95% confidence interval, 13.84-22.35) and progressive multifocal leukoencephalopathy (hazard ratio, 10.0; 95% confidence interval, 6.70-14.92). Three groups of ADEs were identified on the basis of the ranked hazard ratios with bootstrapped confidence intervals: severe (non-Hodgkin's lymphoma and progressive multifocal leukoencephalopathy [hazard ratio, 7.26; 95% confidence interval, 5.55-9.48]), moderate (cryptococcosis, cerebral toxoplasmosis, AIDS dementia complex, disseminated Mycobacterium avium complex, and rare ADEs [hazard ratio, 2.35; 95% confidence interval, 1.76-3.13]), and mild (all other ADEs [hazard ratio, 1.47; 95% confidence interval, 1.08-2.00]). CONCLUSIONS: In the combination antiretroviral therapy era, mortality rates subsequent to an ADE depend on the specific diagnosis. The proposed classification of ADEs may be useful in clinical end point trials, prognostic studies, and patient management.

Not all university degrees yield the same return: private and social returns to higher education for males in Spain

In this paper we use micro data from the Spanish Family Expenditure Survey for 1990 to estimate, for the first time, the private and social rates of return of different university degrees in Spain. We compute internal rates of return and include investment on higher education financed by the public purse to estimate social rates of return. Our main finding is that, as presumed, there is large heterogeneity in rates of return amongst different university

Schizotypy : do not worry, it is not all worrisome

A long-standing tradition in personality research in psychology, and nowadays increasingly in psychiatry, is that psychotic and psychotic-like thoughts are considered common experiences in the general population. Given their widespread occurrence, such experiences cannot merely reflect pathological functioning. Moreover, reflecting the multi-dimensionality of schizotypy, some dimensions might be informative for healthy functioning while others less so. Here, we explored these possibilities by reviewing research that links schizotypy to favourable functioning such as subjective wellbeing, cognitive functioning (major focus on creativity) and personality correlates. This research highlights the existence of healthy people with psychotic-like traits who mainly experience positive schizotypy (but also affective features mapping onto bipolar disorder). These individuals seem to benefit from a healthy way to organise their thoughts and experiences, i.e. they employ an adaptive cognitive framework to explain and integrate their unusual experiences. We conclude that, instead of focussing only on the pathological, future studies should explore the behavioural, genetic, imaging and psychopharmacological correlates that define the healthy expression of psychotic-like traits. Such studies would inform on protective or compensatory mechanisms of psychosis-risk and could usefully inform us on the evolutionary advantages of the psychosis dimension.

Not all inflammatory markers are linked to kidney function: results from a population-based study.

BACKGROUND: Several studies have reported increased levels of inflammatory biomarkers in chronic kidney disease (CKD), but data from the general population are sparse. In this study, we assessed levels of the inflammatory markers C-reactive protein (hsCRP), tumor necrosis factor α (TNF-α), interleukin (IL)-1β and IL-6 across all ranges of renal function. METHODS: We conducted a cross-sectional study in a random sample of 6,184 Caucasian subjects aged 35-75 years in Lausanne, Switzerland. Serum levels of hsCRP, TNF-α, IL-6, and IL-1β were measured in 6,067 participants (98.1%); serum creatinine-based estimated glomerular filtration rate (eGFR(creat), CKD-EPI formula) was used to assess renal function, and albumin/creatinine ratio on spot morning urine to assess microalbuminuria (MAU). RESULTS: Higher serum levels of IL-6, TNF-α and hsCRP and lower levels of IL-1β were associated with a lower renal function, CKD (eGFR(creat) <60 ml/min/1.73 m(2); n = 283), and MAU (n = 583). In multivariate linear regression analysis adjusted for age, sex, hypertension, smoking, diabetes, body mass index, lipids, antihypertensive and hypolipemic therapy, only log-transformed TNF-α remained independently associated with lower renal function (β -0.54 ±0.19). In multivariate logistic regression analysis, higher TNF-α levels were associated with CKD (OR 1.17; 95% CI 1.01-1.35), whereas higher levels of IL-6 (OR 1.09; 95% CI 1.02-1.16) and hsCRP (OR 1.21; 95% CI 1.10-1.32) were associated with MAU. CONCLUSION: We did not confirm a significant association between renal function and IL-6, IL-1β and hsCRP in the general population. However, our results demonstrate a significant association between TNF-α and renal function, suggesting a potential link between inflammation and the development of CKD. These data also confirm the association between MAU and inflammation.

Using the HEGY Procedure When Not All Roots Are Present

Empirical studies have shown little evidence to support the presence of all unit roots present in the $^{\Delta_4}$ filter in quarterly seasonal time series. This paper analyses the performance of the Hylleberg, Engle, Granger and Yoo (1990) (HEGY) procedure when the roots under the null are not all present. We exploit the Vector of Quarters representation and cointegration relationship between the quarters when factors $(1-L),(1+L),\bigg(1+L^2\bigg),\bigg(1-L^2\bigg) y \bigg(1+L+L^2+L^3\bigg)$ are a source of nonstationarity in a process in order to obtain the distribution of tests of the HEGY procedure when the underlying processes have a root at the zero, Nyquist frequency, two complex conjugates of frequency $^{\pi/2}$ and two combinations of the previous cases. We show both theoretically and through a Monte-Carlo analysis that the t-ratios $^{t_{{\hat\pi}_1}}$ and $^{t_{{\hat\pi}_2}}$ and the F-type tests used in the HEGY procedure have the same distribution as under the null of a seasonal random walk when the root(s) is/are present, although this is not the case for the t-ratio tests associated with unit roots at frequency $^{\pi/2}$.

Using the HEGY Procedure When Not All Roots Are Present

Empirical studies have shown little evidence to support the presence of all unit roots present in the $^{\Delta_4}$ filter in quarterly seasonal time series. This paper analyses the performance of the Hylleberg, Engle, Granger and Yoo (1990) (HEGY) procedure when the roots under the null are not all present. We exploit the Vector of Quarters representation and cointegration relationship between the quarters when factors $(1-L),(1+L),\bigg(1+L^2\bigg),\bigg(1-L^2\bigg) y \bigg(1+L+L^2+L^3\bigg)$ are a source of nonstationarity in a process in order to obtain the distribution of tests of the HEGY procedure when the underlying processes have a root at the zero, Nyquist frequency, two complex conjugates of frequency $^{\pi/2}$ and two combinations of the previous cases. We show both theoretically and through a Monte-Carlo analysis that the t-ratios $^{t_{{\hat\pi}_1}}$ and $^{t_{{\hat\pi}_2}}$ and the F-type tests used in the HEGY procedure have the same distribution as under the null of a seasonal random walk when the root(s) is/are present, although this is not the case for the t-ratio tests associated with unit roots at frequency $^{\pi/2}$.

Consumer Advisory Bulletin, Credit Card Offers: They’re Not All the Same, October 2012

The Attorney General’s Consumer Protection Division receives hundreds of calls and consumer complaints every year. Follow these tips to avoid unexpected expense and disappointments. This record is about: Credit Card Offers: They’re Not All the Same

Why not all young firms invest in R&D

This article aims to analyze the different impact that some factors may exert on the probability that a small young firm invests intensively in R&D. Recently, an increasing amount of the literature makes reference to the vital role played by a small number of young firms in generating jobs and increasing efficiency levels. However, not all new firms invest in R&D. Departing from the definition of YICs (firms younger than 6 years old, fewer than 250 employees and with more than 15% of their revenues invested in R&D activities), and with an extensive sample of the Spanish Community Innovation Survey between 2004- 2010, we try to determine: i) those factors that cause firms to become YICs (innovative young small firms) or YNICs (moderately innovative young small firms); ii) what is the difference in the impact of those factors between YICs and YNICs. Our results show that factors such as initial innovation capacity and cooperation in R&D projects enhance the probability of becoming a YIC. Nevertheless, factors such as export potential and market uncertainty may influence the decision to invest moderately and become a YNIC. Keywords: Innovation, Policy, YICs. JEL Classifications: O31, D21

Individual differences in some (but not all) medial prefrontal regions reflect cognitive demand while regulating unpleasant emotion.

The present study investigated the premise that individual differences in autonomic physiology could be used to specify the nature and consequences of information processing taking place in medial prefrontal regions during cognitive reappraisal of unpleasant pictures. Neural (blood oxygenation level-dependent functional magnetic resonance imaging) and autonomic (electrodermal [EDA], pupil diameter, cardiac acceleration) signals were recorded simultaneously as twenty-six older people (ages 64–66 years) used reappraisal to increase, maintain, or decrease their responses to unpleasant pictures. EDA was higher when increasing and lower when decreasing compared to maintaining. This suggested modulation of emotional arousal by reappraisal. By contrast, pupil diameter and cardiac acceleration were higher when increasing and decreasing compared to maintaining. This suggested modulation of cognitive demand. Importantly, reappraisal-related activation (increase, decrease > maintain) in two medial prefrontal regions (dorsal medial frontal gyrus and dorsal cingulate gyrus) was correlated with greater cardiac acceleration (increase, decrease > maintain) and monotonic changes in EDA (increase > maintain > decrease). These data indicate that these two medial prefrontal regions are involved in the allocation of cognitive resources to regulate unpleasant emotion, and that they modulate emotional arousal in accordance with the regulatory goal. The emotional arousal effects were mediated by the right amygdala. Reappraisal-related activation in a third medial prefrontal region (subgenual anterior cingulate cortex) was not associated with similar patterns of change in any of the autonomic measures, thus highlighting regional specificity in the degree to which cognitive demand is reflected in medial prefrontal activation during reappraisal.

Not all sigmodontine rodents in the sugarcane fields in costal Veracruz, Mexico, are pests

Rats and mice have traditionally been considered one of the most important pests of sugarcane. However, "control" campaigns are rarely specific to the target species, and can have an effect on local wildlife, in particular non-pest rodent species. The objective of this study was to distinguish between rodent species that are pests and those that are not, and to identify patterns of food utilization by the rodents in the sugarcane crop complex. Within the crop complex, subsistence crops like maize, sorghum, rice, and bananas, which are grown alongside the sugarcane, are also subject to rodent damage. Six native rodent species were trapped in the Papaloapan River Basin of the State of Veracruz; the cotton rat (Sigmodon hispidus), the rice rat (Oryzomys couesi), the small rice rat (O. chapmani), the white footed mouse (Peromyscus leucopus), the golden mouse (Reithrodontomys sumichrasti), and the pigmy mouse (Baiomys musculus). In a stomach content analysis, the major food components for the cotton rat, the rice rat and the small rice rat were sugarcane (4.9 to 30.1 %), seed (2.7 to 22.9%), and vegetation (0.9 to 29.8%); while for the golden mouse and the pigmy mouse the stomach content was almost exclusively seed (98 to 100%). The authors consider the first three species to be pests of the sugarcane crop complex, while the last two species are not.

Vocabulary is important for some, but not all reading skills

Although there is evidence for a close link between the development of oral vocabulary and reading comprehension, less clear is whether oral vocabulary skills relate to the development of word-level reading skills. This study investigated vocabulary and literacy in 81 children aged 8 to 10 years. In regression analyses, vocabulary accounted for unique variance in exception word reading and reading comprehension, but not text reading accuracy, decoding, or regular word reading. Consistent with these data, children with poor reading comprehension exhibited oral vocabulary weaknesses and read fewer exception words correctly. These findings demonstrate that oral vocabulary is associated with some, but not all, reading skills. Results are discussed in terms of current models of reading development.

Not all adolescents are sleep deprived: A study of rural populations

The objective of this study was to investigate the role of environmental factors in sleep duration among adolescents living in rural areas. A total of 1140 students (569 males), aged 10-19 years, and attending two schools in rural regions in southern Brazil, completed a questionnaire about their sleep habits. Demographic data were also obtained. Prevalence ratios (PR) were estimated for the cases of more than 9 h of sleep on weekdays. Sleep duration in adolescents with and without electric lighting at home was analyzed. Average sleep duration at night was 9.63 (1.64) h on school-going days and 10.14 (2.42) h on weekends. The prevalence of adolescents sleeping for more than 9 h at night on school-going days was 58.3%. Older adolescents showed a tendency to delay their sleep onset times, which is associated with a reduction of sleep duration. Adolescents without electric lighting at home slept longer on school-going days (P < 0.001) and on weekends (P = 0.013) when compared to those with electric lighting at home. From multivariate analysis, age (P < 0.001), school schedule (P = 0.007) and work (0.042) were factors affecting sleep duration. In contrast to the data previously reported for urban populations, we found a high prevalence of adolescents sleeping for more than 9 h on school nights. Data on populations living in less industrialized regions reinforce the idea that technological advances are associated with the negative impact of sleep phase delay in adolescents.