Evaluating weight gain with the initiation of antiretroviral therapy: A comparison of integrase strand transfer inhibitors to other antiretrovirals

Background: Existing research has observed a potential association between antiretroviral therapy (ART) exposed individuals and a high prevalence of weight gain and obesity. However, the impact of these metabolic changes imparted by integrase strand transfer inhibitor based regimens in particular remains unclear. The objective of this study is to evaluate weight change in treatment-naive patients with newly initiated ART in a Ryan White Clinic.Methods: This IRB-approved, retrospective chart review study utilized EMR records to identify patients aged 18 years or older with a diagnosis of HIV-1, who are treatment-naive or have been without ART for >6 months, initiated on ART between January 1, 2013 and January 1, 2018, maintained therapy for ≥24 months, had weight values recorded at least twice during the study period, and were initiated on any three-drug NNRTI, INSTI, or PI-based regimen. The following data was collected, recorded without patient identifiers, and maintained confidentially: patient regimen, age, gender, ethnicity, AIDS status, plasma HIV-1 RNA (viral load), CD4+ T-cell count, weight, BMI, and BMI categories. Patient weight, BMI, and BMI categories were evaluated at baseline, 6 months, and 18 months on ART.Results: Of the 3,054 patients identified, a total of 200 patients were included in the final analysis. The patient population consisted primarily of Caucasian (55.0%) males (81.0%) with an average age of 38.3 years. At initiation of treatment, the median CD4+ T-cell count = 356.2 cells/uL, HIV-1 RNA viral load = 481,801 copies/mL, weight = 80.8 kg, and BMI = 26.2 kg/m2. For all classes evaluated, the highest percentage of patients at baseline fell within BMI category indicating normal weight (18.5-24.9 kg/m2). A total of 42 (21.0%), 50 (25.0%), and 113 (56.5%) patients were initiated on NNRTI, PI, and INSTI-based regimens, respectively. Of the 113 patients who were initiated on an INSTI-based regimen, 82 (72.5%) patients began regimens containing doultegravir, 25 (22.1%) patients began regimens containing elvitegravir, and 6 (5.3%) patients began regimens containing raltegravir. All 6 patients who were initiated on raltegravir were also on concomitant darunavir. At 18 months of therapy, a median increase in weight of 2.2 kg and BMI of 0.5 kg/m2 was associated with NNRTI-based regimens, compared to a 3.9 kg and 1.3 kg/m2 increase associated with PI-based regimens. Of the INSTI-based regimens, use of dolutegravir was associated with a 4.3 kg and 1.7 kg/m2 increase, elvitegravir a 1.1 kg and 0.4 kg/m2 increase, and raltegravir a 7.7 kg and 2.5 kg/m2 increase in weight and BMI, respectively. At 18-months, 37.8% and 50.0% of patients initiated on dolutegravir and raltegravir-based therapy, respectively, were considered obese with an associated BMI of ≥ 30 kg/m2.Conclusions: Treatment naive patients with HIV-1 initiating therapy with dolutegravir-based regimens were associated with a higher incidence of increase in weight and BMI at 18-months than those initiating elvitegravir, NNRTI, and PI-based regimens. Those initiating raltegravir-based regimens, which also contained the PI darunavir, were associated with the highest incidence of increase in weight and BMI at 18-months compared to all other regimens. Further study is recommended

Report From Beeville Station (1.)

41 pgI. SOILS. II. CLIMATE. III. WTER SUPPLY. IV. IRRIGATION EQUIPMENT

Quantum statistical information contained in a semi-classical Fisher--Husimi measure

We study here the difference between quantum statistical treatments and semi-classical ones, using as the main research tool a semi-classical, shift-invariant Fisher information measure built up with Husimi distributions. Its semi-classical character notwithstanding, this measure also contains information of a purely quantal nature. Such a tool allows us to refine the celebrated Lieb bound for Wehrl entropies and to discover thermodynamic-like relations that involve the degree of delocalization. Fisher-related thermal uncertainty relations are developed and the degree of purity of canonical distributions, regarded as mixed states, is connected to this Fisher measure as well.Comment: 9 pages, 3 figures; chenged conten

Measurement of residual nucleus cross sections and recoil energies in p + Fe collisions at 300, 500, 750, 1000 and 1500 MeV

The production of residual nuclei in p + Fe collisions has been measured at GSI on the FRS facility by means of the reverse kinematic techniques at 300, 500, 750, 1000 and 1500 MeV/A. The cross-sections larger than 0.01 mb of all isotopes with Z larger than 8 have been obtained. Velocity distributions were also measured. Comparisons to models describing spallation reactions and some empirical formulae often used in astrophysics are presented. These data are directly used to calculate impurety production and DPAs in a thin window as foreseen in spallation sources or accelerator-driven systems

Yeasts and wine off-flavours: a technological perspective

Review article. Part of the special issue "Wine microbiology and safety: from the vineyard to the bottle (Microsafety Wine)", 19-20 Nov. 2009, ItalyIn wine production, yeasts have both beneficial and detrimental activities. Saccharomyces cerevisiae is the yeast mainly responsible for turning grape juice into wine but this species and several others may also show undesirable effects in wines. Among such effects, technologists are particularly concerned with the production of offflavours that may occur during all stages of winemaking. Typical spoiling activities include the production of ethyl acetate by apiculate yeasts before fermentation, hydrogen sulphide by S. cerevisiae during fermentation phases, acetaldehyde by film-forming yeasts during bulk storage, and volatile phenols by Dekkera bruxellensis during storage or after bottling. The occurrence of these hazards depends on the technological operations designed to obtain a given type of wine and most can be avoided by current preventive or curative measures. On the contrary, good manufacturing practices must be strengthened to deal with the problem of volatile phenol production in red wines. Appropriate monitoring of D. bruxellensis populations and quantification of 4-ethylphenol is advised during storage, particularly when oak barrels are used, and absence of viable cells must be guaranteed in bottled wines. This work, which is based on our experience at winery level, aims to provide information on appropriate technological strategies to deal with the problem of off-flavours produced by yeasts

Predicting Transitions in Low and High Levels of Risk Behavior from Early to Middle Adolescence: The TRAILS Study

The present study examined the joint development of substance use and externalizing problems in early and middle adolescence. First, it was tested whether the relevant groups found in previous studies i.e., those with an early onset, a late onset, and no onset or low levels of risk behavior could be identified, while using a developmental model of a single, underlying construct of risk behavior. Second, departing from Moffitt’s taxonomy of antisocial behavior, it was tested if early, but not late, onset risk behavior is predicted by a problematic risk profile in childhood. Data were used from TRAILS, a population based cohort study, starting at age 11 with two follow-ups at mean ages of 13.6 and 16.3 years. Latent transition analyses demonstrated that, both in early and middle adolescence, a single underlying construct of risk behavior, consisting of two classes (labeled as low and high risk behavior), adequately represented the data. Respondents could be clearly classified into four possible transition patterns from early to middle adolescence, with a transition from high to low being almost non-existent (2.5 %), low to low (39.4 %) and low to high (41.8 %) being the most prevalent, and high to high (16.2 %) substantial. As hypothesized, only the high-high group was characterized by a clear adverse predictor profile in late childhood, while the low-high group was not. This study demonstrates that the development of substance use is correlated with externalizing problems and underscores the theory that etiologies of early and later onset risk behavior are different

Risky choice in the limelight

This paper examines how risk behavior in the limelight differs from that in anonymity. In two separate experiments we find that subjects are more risk averse in the limelight. However, risky choices are similarly path dependent in the different treatments. Under both limelight and anonymous laboratory conditions, a simple prospect theory model with a path-dependent reference point provides a better explanation for subjects’ behavior than a flexible specification of expected utility theory. Additionally, our findings suggest that ambiguity aversion depends on being in the limelight, that passive experience has little effect on risk taking, and that reference points are determined by imperfectly updated expectations

Comparison of broad range 16S rDNA PCR and conventional blood culture for diagnosis of sepsis in the newborn: a case control study

<p>Abstract</p> <p>Background</p> <p>Early onset bacterial sepsis is a feared complication of the newborn. A large proportion of infants admitted to the Neonatal Intensive Care Unit (NICU) for suspected sepsis receive treatment with potent systemic antibiotics while a diagnostic workup is in progress. The gold standard for detecting bacterial sepsis is blood culture. However, as pathogens in blood cultures are only detected in approximately 25% of patients, the sensitivity of blood culture is suspected to be low. Therefore, the diagnosis of sepsis is often based on the development of clinical signs, in combination with laboratory tests such as a rise in C – reactive protein (CRP). Molecular assays for the detection of bacterial DNA in the blood represent possible new diagnostic tools for early identification of a bacterial cause.</p> <p>Methods</p> <p>A broad range 16S rDNA polymerase chain reaction (PCR) without preincubation was compared to conventional diagnostic work up for clinical sepsis, including BACTEC blood culture, for early determination of bacterial sepsis in the newborn. In addition, the relationship between known risk factors, clinical signs, and laboratory parameters considered in clinical sepsis in the newborn were explored.</p> <p>Results</p> <p>Forty-eight infants with suspected sepsis were included in this study. Thirty-one patients were diagnosed with sepsis, only 6 of these had a positive blood culture. 16S rDNA PCR analysis of blinded blood samples from the 48 infants revealed 10 samples positive for the presence of bacterial DNA. PCR failed to be positive in 2 samples from blood culture positive infants, and was positive in 1 sample where a diagnosis of a non-septic condition was established. Compared to blood culture the diagnosis of bacterial proven sepsis by PCR revealed a 66.7% sensitivity, 87.5% specificity, 95.4% positive and 75% negative predictive value. PCR combined with blood culture revealed bacteria in 35.1% of the patients diagnosed with sepsis. Irritability and feeding difficulties were the clinical signs most often observed in sepsis. CRP increased in the presence of bacterial infection.</p> <p>Conclusion</p> <p>There is a need for PCR as a method to quickly point out the infants with sepsis. However, uncertainty about a bacterial cause of sepsis was not reduced by the PCR result, reflecting that methodological improvements are required in order for DNA detection to replace or supplement traditional blood culture in diagnosis of bacterial sepsis.</p

1955: Abilene Christian College Bible Lectures - Full Text

Delivered in the Auditorium of Abilene Christian College, February, 1955 ABILENE, TEXAS PRICE, $3.00 FIRM FOUNDATION PUBLISHING HOUSE Box 77 Austin 61, Texa

Development of Motorized Slewing Mirror Stage for the UFFO Project

The Ultra-Fast Flash Observatory (UFFO) is a space observatory for optical follow-ups of gamma ray bursts (GRBs), aiming to explore the first 60 seconds of GRBs optical emission. UFFO is utilized to catch early optical emissions from GRBs within few sec after trigger using a Gimbal mirror which redirects the optical path rather than slewing entire spacecraft. We have developed a 15 cm two-axis Gimbal mirror stage for the UFFO-Pathfinder which is going to be on board the Lomonosov satellite which is to be launched in 2013. The stage is designed for fast and accurate motion with given budgets of 3 kg of mass and 3 Watt of power. By employing stepping motors, the slewing mirror can rotate faster than 15 deg/sec so that objects in the UFFO coverage (60 deg × 60 deg) can be targeted in ~1 sec. The obtained targeting resolution is better 2 arcmin using a close-loop control with high precision rotary encoder. In this presentation, we will discuss details of design, manufacturing, space qualification tests, as well as performance tests