Nutrition and inflammation serum biomarkers are associated with 12-week mortality among malnourished adults initiating antiretroviral therapy in Zambia

<p>Abstract</p> <p>Background</p> <p>A low body mass index (BMI) at antiretroviral therapy (ART) initiation is a strong predictor of mortality among HIV-infected adults in resource-constrained settings. The relationship between nutrition and inflammation-related serum biomarkers and early treatment outcomes (e.g., less than 90 days) in this population is not well described.</p> <p>Methods</p> <p>An observational cohort of 142 HIV-infected adults in Lusaka, Zambia, with BMI under 16 kg/m²or CD4⁺lymphocyte counts of less than 50 cells/mm³, or both, was followed prospectively during the first 12 weeks of ART. Baseline and serial post-treatment phosphate, albumin, ferritin and highly sensitive C-reactive protein (hsCRP) serum levels were measured. The primary outcome was mortality.</p> <p>Results</p> <p>Lower baseline phosphate and albumin serum levels, and higher ferritin and hsCRP, were significantly associated with mortality prior to 12 weeks (p < 0.05 for all comparisons), independent of known risk factors for early ART-associated mortality in sub-Saharan Africa. The time-dependent interval change in albumin was associated with mortality after adjusting for the baseline value (AHR 0.62 [0.43, 0.89] per 5 g/L increase), but changes in the other biomarkers were not.</p> <p>Conclusions</p> <p>The predictive value of serum biomarkers for early mortality in a cohort of adults with malnutrition and advanced HIV in a resource-constrained setting was primarily driven by pre-treatment values, rather than post-ART changes. Interventions to promote earlier HIV diagnosis and treatment, address nutritional deficiencies, and identify the etiologies of increased systemic inflammation may improve ART outcomes in this vulnerable population.</p

Using a Modelling Language to Describe the Quality of Life Goals of People Living with Dementia

Although now well established, our information systems engineering theories and methods are applied only rarely in disciplines beyond systems development. This paper reports the application of the i* goal modelling language to describe the types of and relationships between quality of life goals of people living with dementia. Published social care frameworks to manage and improve the lives of people with dementia were reviewed to synthesize, for the first time, a comprehensive conceptual model of the types of goals of people living with dementia. Although the quality of life goal model was developed in order to construct automated reasoning capabilities in a new digital toolset that people with dementia can use for life planning, the multi-stage modelling exercise provided valuable insights into quality of life and dementia care practices of both researchers and experienced practitioners in the field

Tephrochronology

Tephrochronology is the use of primary, characterized tephras or cryptotephras as chronostratigraphic marker beds to connect and synchronize geological, paleoenvironmental, or archaeological sequences or events, or soils/paleosols, and, uniquely, to transfer relative or numerical ages or dates to them using stratigraphic and age information together with mineralogical and geochemical compositional data, especially from individual glass-shard analyses, obtained for the tephra/cryptotephra deposits. To function as an age-equivalent correlation and chronostratigraphic dating tool, tephrochronology may be undertaken in three steps: (i) mapping and describing tephras and determining their stratigraphic relationships, (ii) characterizing tephras or cryptotephras in the laboratory, and (iii) dating them using a wide range of geochronological methods. Tephrochronology is also an important tool in volcanology, informing studies on volcanic petrology, volcano eruption histories and hazards, and volcano-climate forcing. Although limitations and challenges remain, multidisciplinary applications of tephrochronology continue to grow markedly

Narrowing the Parameter Space of Collapse Models with Ultracold Layered Force Sensors

Despite the unquestionable empirical success of quantum theory, witnessed by the recent uprising of quantum technologies, the debate on how to reconcile the theory with the macroscopic classical world is still open. Spontaneous collapse models are one of the few testable solutions so far pro- posed. In particular, the continuous spontaneous localization (CSL) model has become subject of an intense experimental research. Experiments looking for the universal force noise predicted by CSL in ultrasensitive mechanical resonators have recently set the strongest unambiguous bounds on CSL; further improving these experiments by direct reduction of mechanical noise is technically challenging. Here, we implement a recently proposed alternative strategy, that aims at enhancing the CSL noise by exploiting a multilayer test mass attached on a high quality factor microcantilever. The test mass is specifically designed to enhance the effect of CSL noise at the characteristic length rC = 10 127 m. The measurements are in good agreement with pure thermal motion for temperatures down to 100 mK. From the absence of excess noise we infer a new bound on the collapse rate at the characteristic length rC = 10 127 m, which improves over previous mechanical experiments by more than one order of magnitude. Our results are explicitly challenging a well-motivated region of the CSL parameter space proposed by Adler

Up- and down-conversion in Yb3+–Pr3+ co-doped fluoride glasses and glass ceramics

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