Epstein-Barr Virus Coinfection in Cerebrospinal Fluid Is Associated With Increased Mortality in Malawian Adults With Bacterial Meningitis

Mortality from adult bacterial meningitis exceeds 50% in sub-Saharan Africa. We postulated that—particularly in individuals infected with human immunodeficiency virus (HIV)—herpes simplex virus, varicella zoster virus, Epstein-Barr virus (EBV), and cytomegalovirus (CMV) in the cerebrospinal fluid (CSF) contribute to poor outcome. CSF from 149 Malawian adults with bacterial meningitis and 39 controls were analyzed using polymerase chain reaction. EBV was detected in 79 of 149 bacterial meningitis patients. Mortality (54%) was associated with higher CSF EBV load when adjusted for HIV (P = .01). CMV was detected in 11 of 115 HIV-infected patients, 8 of whom died. The mechanisms by which EBV and CMV contribute to poor outcome require further investigation

The equivalence of four extensions of context-free grammars

There is currently considerable interest among computational linguists in grammatical formalisms with highly restricted generative power. This paper concerns the relationship between the class of string languages generated by several such formalisms, namely, combinatory categorial grammars, head grammars, linear indexed grammars, and tree adjoining grammars. Each of these formalisms is known to generate a larger class of languages than context-free grammars. The four formalisms under consideration were developed independently and appear superficially to be quite different from one another. The result presented in this paper is that all four of the formalisms under consideration generate exactly the same class of string languages

Deflection control for reinforced recycled aggregate concrete beams: Experimental database and extension of the fib Model Code 2010 model

Recycled aggregate concrete (RAC) has emerged as a viable solution for solving some of the environmental problems of concrete production. However, design guidelines for deflection control of reinforced RAC members have not yet been proposed. This study presents a comprehensive analysis of the applicability of the fib Model Code 2010 (MC2010) deflection control model to reinforced RAC beams. Three databases of long-term studies on natural aggregate concrete (NAC) and RAC beams were compiled and meta-analyses of deflection predictions by MC2010 were performed. First, the MC2010 deflection control model was tested against a large database of long-term tests on NAC beams. Second, a database of RAC and companion NAC beams was compiled and initial and long-term deflections were calculated using the MC2010 model. It was shown that deflections of RAC beams are significantly underestimated relative to NAC beams. Previously proposed modifications for MC2010 equations for shrinkage strain and creep coefficient were used, and new modifications for the modulus of elasticity and empirical coefficient β were proposed. The improved MC2010 deflection control model on RAC beams was shown to have equal performance to that on companion NAC beams. The proposals presented in this paper can help engineers to more reliably perform deflection control of reinforced RAC members.This is the peer-reviewed version of the article: N. Tošić, S. Marinković, and J. de Brito, ‘Deflection control for reinforced recycled aggregate concrete beams: Experimental database and extension of the fib Model Code 2010 model’, Structural Concrete, vol. 20, no. 6, pp. 2015–2029, 2019 [https://doi.org/10.1002/suco.201900035

Diffuse duodenal nodular lymphoid hyperplasia: a large cohort of patients etiologically related to Helicobacter pylori infection

Abstract Background Nodular lymphoid hyperplasia of gastrointestinal tract is a rare disorder, often associated with immunodeficiency syndromes. There are no published reports of its association with Helicobacter pylori infection. Methods From March 2005 till February 2010, we prospectively followed all patients with diffuse duodenal nodular lymphoid hyperplasia (DDNLH). Patients underwent esophagogastroduodenoscopy with targeted biopsies, colonoscopy, and small bowel video capsule endoscopy. Duodenal nodular lesions were graded from 0 to 4 based on their size and density. Patients were screened for celiac sprue (IgA endomysial antibody), immunoglobulin abnormalities (immunoglobulin levels & serum protein electrophoresis), small intestine bacterial overgrowth (lactulose hydrogen breath test), and Helicobacter pylori infection (rapid urease test, and histological examination of gastric biopsies). Patients infected with Helicobacter pylori received sequential antibiotic therapy and eradication of infection was evaluated by 14C urea breath test. Follow up duodenoscopies with biopsies were performed to ascertain resolution of nodular lesions. Results Forty patients (Males 23, females 17; mean age ± 1SD 35.6 ± 14.6 years) with DDNLH were studied. Patients presented with epigastric pain, vomiting, and weight loss. Esophagogastroduodenoscopy showed diffuse nodular lesions (size varying from 2 to 5 mm or more) of varying grades (mean score ± 1SD 2.70 ± 0.84) involving postbulbar duodenum. Video capsule endoscopies revealed nodular disease exclusively limited to duodenum. None of the patients had immunoglobulin deficiency or small intestine bacterial overgrowth or positive IgA endomysial antibodies. All patients were infected with Helicobacter pylori infection. Sequential antibiotic therapy eradicated Helicobacter pylori infection in 26 patients. Follow up duodenoscopies in these patients showed significant reduction of duodenal nodular lesions score (2.69 ± 0.79 to 1.50 ± 1.10; p Helicobacter pylori infection showed no significant reduction of nodular lesions score (2.71 ± 0.96 to 2.64 ± 1.15; p = 0.58). Nodules partially regressed in score in 2 patients, showed no interval change in 10 patients and progressed in 2 patients. Conclusions We report on a large cohort of patients with DDNLH, etiologically related to Helicobacter pylori infection.</p

A family study of coeliac disease.

Thirteen of 141 cases (9 percent) of overt, biopsy proven coeliac disease had a definitely affected relative. The pattern of inheritance in these families is compatible with an incompletely penetrant autosomal dominant gene. There was a female preponderance in the adults and the sporadic cases, but not in the children or the familial cases. The series included a pair of concordant and probably monozygotic twins. The authors believe that coeliac disease, as defined at present, is a heterogeneous condition

Fingerprint Changes in Coeliac Disease

Study of the fingerprints of 73 patients with coeliac disease, taken carefully, showed changes varying between moderate epidermal ridge atrophy and actual loss of fingerprint patterns. Of the patients 63 had these abnormalities, compared with 3 out of 485 controls. A high degree of correlation existed between ridge atrophy and changes in the clinical state of patients with coeliac disease