Immune compromise in HIV-1/HTLV-1 coinfection with paradoxical resolution of CD4 lymphocytosis during antiretroviral therapy: a case report

Human immunodeficiency virus type-1 (HIV-1) and human T lymphotropic virus type-1 (HTLV-1) infections have complex effects on adaptive immunity, with specific tropism for, but contrasting effects on, CD4 T lymphocytes: depletion with HIV-1, proliferation with HTLV-1. Impaired T lymphocyte function occurs early in HIV-1 infection but opportunistic infections (OIs) rarely occur in the absence of CD4 lymphopenia. In the unusual case where a HIV-1 infected individual with a high CD4 count presents with recurrent OIs, a clinician is faced with the possibility of a second underlying comorbidity. We present a case of pseudo-adult T cell leukemia/lymphoma (ATLL) in HIV-1/HTLV-1 coinfection where the individual fulfilled Shimoyama criteria for chronic ATLL and had pulmonary Mycobacterium kansasii, despite a high CD4 lymphocyte count. However, there was no evidence of clonal T-cell proliferation by T-cell receptor gene rearrangement studies nor of monoclonal HTLV-1 integration by high-throughput sequencing. Mutually beneficial interplay between HIV-1 and HTLV-1, maintaining high level HIV-1 and HTLV-1 viremia and proliferation of poorly functional CD4 cells despite chronicity of infection is a postulated mechanism. Despite good microbiological response to antimycobacterial therapy, the patient remained systemically unwell with refractory anemia. Subsequent initiation of combined antiretroviral therapy led to paradoxical resolution of CD4 T lymphocytosis as well as HIV-1 viral suppression and decreased HTLV-1 proviral load. This is proposed to be the result of attenuation of immune activation post-HIV virological control. This case illustrates the importance of screening for HTLV-1 in HIV-1 patients with appropriate clinical presentation and epidemiological risk factors and explores mechanisms for the complex interactions on HIV-1/HTLV-1 adaptive immunity

DEVELOPMENT OF DESIGN PARAMETERS FOR AN INCLINED STEP-GRATE COMPOST VESSEL TO TREAT URBAN SOLID WASTES

There are several methods and systems of managing urban solid wastes. Aerobie systemsor managing wastes arc less expensive and the composition of wastes in most Sri Lankancities is conducive to compost making since the biodegradable component is high,The total quantity of organic matter generated in the urban centres if used as compost willstill not satisfy the demand for it. These basic problems could he solved by makingcompost [rom biodegradable urban wastes. facilitating the management of these wastes andalso providing organic matter for long awaited sustained and assured agriculturalproduction in Sri Lanka.The development of a feasible system or compost making was the challenge taken up by theDcpnruucnt or Agricultural Engineering. A series of studies were undertaken to determinesome of the major parameters to rcalise the concept of an inclined step-grate compostmakingvessel.The studies indicate that (l.'i% moisture content should be maintained for optimumconditions for compost making, The bulk density increases with time and It is inverselyproportional to mass, Within the first 20 days of degradation or mixed wastes. most of thevolatile solids react producing largely carbon dioxide and water, The generated heat fromthis reaction actuates the process or evaporating excess moisture. The reduction in massand increase in density can be expressed mathematically.A calculation or heat and mass balances was obtained for a 3-meter pile of wastes, Thesecalculations were based on data obtained from an Engineering Model. Several or the majorparameters such as the retention time. suction. heating and cooling system for moisturecontrol were developed to design a versatile bio-reactor to produce compost for treatingwastes aerobically.

Review on Photomicrography based Full Blood Count (FBC) Testing and Recent Advancements

With advancements in related sub-fields, research on photomicrography in life science is emerging and this is a review on its application towards human full blood count testing which is a primary test in medical practices. For a prolonged period of time, analysis of blood samples is the basis for bio medical observations of living creatures. Cell size, shape, constituents, count, ratios are few of the features identified using DIP based analysis and these features provide an overview of the state of human body which is important in identifying present medical conditions and indicating possible future complications. In addition, functionality of the immune system is observed using results of blood tests. In FBC tests, identification of different blood cell types and counting the number of cells of each type is required to obtain results. Literature discuss various techniques and methods and this article presents an insightful review on human blood cell morphology, photomicrography, digital image processing of photomicrographs, feature extraction and classification, and recent advances. Integration of emerging technologies such as microfluidics, micro-electromechanical systems, and artificial intelligence based image processing algorithms and classifiers with cell sensing have enabled exploration of novel research directions in blood testing applications.

Evaluation of EPAS1 variants for association with bovine congestive heart failure [version 1; peer review: 2 approved]

Background: Bovine congestive heart failure (BCHF) has become increasingly prevalent in feedlot cattle in the Western Great Plains of North America. BCHF is an untreatable complex condition involving pulmonary hypertension that culminates in right ventricular failure and death. A protein variant of hypoxia-inducible factor 2 alpha (HIF2α, encoded by the endothelial PAS domain-containing protein 1 gene, EPAS1) was previously reported to be associated with pulmonary hypertension at altitudes exceeding 2,000 m. Our aim was to evaluate EPAS1 haplotypes for association with BCHF in feedlot cattle raised at moderate altitudes (1,200 m). Methods: Paired samples of clinical cases and unaffected controls were collected at four feedlots in Nebraska and Wyoming. Each pair (n =102) was matched for source, pen, breed type, sex, arrival date, and management conditions. Cases were identified by animal caretakers, euthanized, and diagnosis was confirmed at necropsy. Cases were derived from 30 different ranch operations, with the largest source contributing 32. Animals were tested for eight EPAS1 haplotypes encoding 36 possible different diploid combinations. Results: The common, ancestral EPAS1 haplotype encoding HIF2α with alanine (A) at position 606 and glycine (G) at position 610 was equally frequent in cases and controls (0.67). The EPAS1 variant haplotype reported to be associated with disease (encoding threonine (T) at position 606 and serine (S) at position 610) was not enriched in cases compared with controls (0.21 and 0.25, respectively). Frequencies of other EPAS1 haplotypes (e.g., encoding Q270, L362, or G671) were each less than 0.05 overall. McNemar’s test with 45 discordant pairs showed the linked T606/S610 variant was not associated with BCHF (OR = 0.73, CI 0.38 -1.4, p-value = 0.37). Conclusions: HIF2α polypeptide variants were not significantly associated with BCHF in feedlot cattle at moderate altitudes. Thus, a wider search is needed to identify genetic risk factors underlying this disease

SNPs for Parentage Testing and Traceability in Globally Diverse Breeds of Sheep

DNA-based parentage determination accelerates genetic improvement in sheep by increasing pedigree accuracy. Single nucleotide polymorphism (SNP) markers can be used for determining parentage and to provide unique molecular identifiers for tracing sheep products to their source. However, the utility of a particular ‘‘parentage SNP’’ varies by breed depending on its minor allele frequency (MAF) and its sequence context. Our aims were to identify parentage SNPs with exceptional qualities for use in globally diverse breeds and to develop a subset for use in North American sheep. Starting with genotypes from 2,915 sheep and 74 breed groups provided by the International Sheep Genomics Consortium (ISGC), we analyzed 47,693 autosomal SNPs by multiple criteria and selected 163 with desirable properties for parentage testing. On average, each of the 163 SNPs was highly informative (MAF ≥ 0.3) in 48±5 breed groups. Nearby polymorphisms that could otherwise confound genetic testing were identified by whole genome and Sanger sequencing of 166 sheep from 54 breed groups. A genetic test with 109 of the 163 parentage SNPs was developed for matrix-assisted laser desorption/ionization– time-of-flight mass spectrometry. The scoring rates and accuracies for these 109 SNPs were greater than 99% in a panel of North American sheep. In a blinded set of 96 families (sire, dam, and non-identical twin lambs), each parent of every lamb was identified without using the other parent’s genotype. In 74 ISGC breed groups, the median estimates for probability of a coincidental match between two animals (PI), and the fraction of potential adults excluded from parentage (PE) were 1.1×10(−39) and 0.999987, respectively, for the 109 SNPs combined. The availability of a well-characterized set of 163 parentage SNPs facilitates the development of high-throughput genetic technologies for implementing accurate and economical parentage testing and traceability in many of the world’s sheep breeds

A bovine CD18 signal peptide variant with increased binding activity to Mannheimia hemolytica leukotoxin [version 1; referees: 2 approved]

Background: Mannheimia haemolytica is the major bacterial infectious agent of bovine respiratory disease complex and causes severe morbidity and mortality during lung infections. M. haemolytica secretes a protein leukotoxin (Lkt) that binds to the CD18 receptor on leukocytes, initiates lysis, induces inflammation, and causes acute fibrinous bronchopneumonia. Lkt binds the 22-amino acid CD18 signal peptide domain, which remains uncleaved in ruminant species. Our aim was to identify missense variation in the bovine CD18 signal peptide and measure the effects on Lkt binding. Methods: Missense variants in the integrin beta 2 gene (ITGB2) encoding CD18 were identified by whole genome sequencing of 96 cattle from 19 breeds, and targeted Sanger sequencing of 1238 cattle from 46 breeds. The ability of different CD18 signal peptide variants to bind Lkt was evaluated by preincubating the toxin with synthetic peptides and applying the mixture to susceptible bovine cell cultures in cytotoxicity-blocking assays. Results: We identified 14 missense variants encoded on 15 predicted haplotypes, including a rare signal peptide variant with a cysteine at position 5 (C5) instead of arginine (R5). Preincubating Lkt with synthetic signal peptides with C5 blocked cytotoxicity significantly better than those with R5. The most potent synthetic peptide (C5PQLLLLAGLLA) had 30-fold more binding activity compared to that with R5. Conclusions: The results suggest that missense variants in the CD18 signal peptide affect Lkt binding, and animals carrying the C5 allele may be more susceptible to the effects of Lkt. The results also identify a potent class of non-antibiotic Lkt inhibitors that could potentially protect cattle from cytotoxic effects during acute lung infections

Building local capacities in the operation and management of an integrated solid waste management programme; Experience of Ampara District, Eastern Sri Lanka

Open dumping and burning of wastes in the environmental sensitive areas were common practices in almost all the local authorities in Ampara district. It had become a big threat to public health, the beautiful natural environment and to the local economy. The Local Authorities of the District often faced severe difficulties in the management of solid waste in an environmentally, socially and economically feasible manner. The lack of technical and financial capacities to apply and practice the newly developed waste management guidelines and policies further aggravated this situation.Having identified the gravity  and the importance of this serious environmental issue, the Department of Assistant Commissioner of Local Government of Ampara District, with the financial assistance of the European Union and the technical assistance of the United Nations Office for Project Services (UNOPS), is currently implementing an Integrated Solid Waste Management Programme (ISWMP) in 12 local authorities of the District. This ISWMP is completely being operated with the full coordination of the District Office of the Central Environmental Authority, Ampara. The UNOPS, as part of its technical assistance, has constructed solid waste management facilities such as 7 engineered landfills, one Waste Transfer Station, 4 Recycling Centers, 5 compost yards, well developed collection systems  as well as provided with capability building/training assistance aiming to establish an effective and efficient solid waste management system for the District. These  facilities are now completed,  already in use and operational. With these facilities in place, and with the continued support from UNOPS in providing institutional and capacity building assistance to the LA officers and staff, haphazard dumping and littering of waste in certain areas of the LAs have now been stopped. Thus 45,000 urban households or 58% of the total urban population are benefitted under thisprogramme with a total collection of 137tonnes of wastes per day through this programme. Out of this 137tonnes of waste, 59 tonnes are collected from cluster systems involving five local authorities while the balance from the other non-clustered Local Authorities.The paper will also present the processes and methodologies to improve the landfill practices from the open dumping practices to controlled tipping and then to engineered landfills  among the implementing local authorities. It will also highlight interventions/strategies to ensure sustainability of the operation and their management through the introduction of a User Fee system/Service Charge which is currently being implemented in 04  Local Authorities. This collected User Fee covers about 80% of cost of collection of waste which would otherwise been spent through their normal budget.Key words: Integrated Solid Waste Management, Ampara, haphazard dumping, controlled tipping, engineered landfill

Proteomic analysis of urine in medication-overuse headache patients: possible relation with renal damages

Medication-overuse headache (MOH) is a chronic disorder associated with overuse of analgesic drugs, triptans, non-steroidal anti-inflammatory drugs (NSAIDs) or other acute headache compounds. Various epidemiologic investigations proved that different drug types could cause nephrotoxicity, particularly in chronic patients. The aim of the present work was to analyze, by a proteomic approach, the urinary protein profiles of MOH patients focusing on daily use of NSAIDs, mixtures and triptans that could reasonably be related to potential renal damage. We selected 43 MOH patients overusing triptans (n = 18), NSAIDs (n = 11), and mixtures (n = 14), for 2–30 years with a mean daily analgesic intake of 1.5 ± 0.9 doses, and a control group composed of 16 healthy volunteers. Urine proteins were analyzed by mono-dimensional gel electrophoresis and identified by mass spectrometry analysis. Comparing the proteomic profiles of patients and controls, we found a significantly different protein expression, especially in the NSAIDs group, in which seven proteins resulted over-secreted from kidney (OR = 49, 95% CI 2.53–948.67 vs. controls; OR = 11.6, 95% CI 0.92–147.57 vs. triptans and mixtures groups). Six of these proteins (uromodulin, α-1-microglobulin, zinc-α-2-glycoprotein, cystatin C, Ig-kappa-chain, and inter-α-trypsin heavy chain H4) were strongly correlated with various forms of kidney disorders. Otherwise, in mixtures and in triptans abusers, only three proteins were potentially associated to pathological conditions (OR = 4.2, 95% CI 0.33–53.12, vs. controls). In conclusion, this preliminary proteomic study allowed us to define the urinary protein pattern of MOH patients that is related to the abused drug. According with the obtained results, we believe that the risk of nephrotoxicity should be considered particularly in MOH patients who abuse of NSAIDs

Serum free light chain measurement aids the diagnosis of myeloma in patients with severe renal failure

<p>Abstract</p> <p>Background</p> <p>Monoclonal free light chains (FLCs) frequently cause rapidly progressive renal failure in patients with multiple myeloma. Immunoassays which provide quantitative measurement of FLCs in serum, have now been adopted into screening algorithms for multiple myeloma and other lymphoproliferative disorders. The assays indicate monoclonal FLC production by the presence of an abnormal κ to λ FLC ratio (reference range 0.26–1.65). Previous work, however, has demonstrated that in patients with renal failure the FLC ratio can be increased above normal with no other evidence of monoclonal proteins suggesting that in this population the range should be extended (reference range 0.37–3.1). This study evaluated the diagnostic sensitivity and specificity of the immunoassays in patients with severe renal failure.</p> <p>Methods</p> <p>Sera from 142 patients with new dialysis-dependent renal failure were assessed by serum protein electrophoresis (SPE), FLC immunoassays and immunofixation electrophoresis. The sensitivity and specificity of the FLC ratio's published reference range was compared with the modified renal reference range for identifying patients with multiple myeloma; by receiver operating characteristic curve analysis.</p> <p>Results</p> <p>Forty one patients had a clinical diagnosis of multiple myeloma; all of these patients had abnormal serum FLC ratios. The modified FLC ratio range increased the specificity of the assays (from 93% to 99%), with no loss of sensitivity. Monoclonal FLCs were identified in the urine from 23 of 24 patients assessed.</p> <p>Conclusion</p> <p>Measurement of serum FLC concentrations and calculation of the serum κ/λ ratio is a convenient, sensitive and specific method for identifying monoclonal FLC production in patients with multiple myeloma and acute renal failure. Rapid diagnosis in these patients will allow early initiation of disease specific treatment, such as chemotherapy plus or minus therapies for direct removal of FLCs.</p