High-altitude migration of Heteroptera in Britain

Heteroptera caught during day and night sampling at a height of 200 m above ground at Cardington, Bedfordshire, UK, during eight summers (1999, 2000, and 2002-2007) were compared to high-altitude catches made over the UK and North Sea from the 1930s to the 1950s. The height of these captures indicates that individuals were engaged in windborne migration over distances of at least several kilometres and probably tens of kilometres. This conclusion is generally supported by what is known of the species' ecologies, which reflect the view that the level of dispersiveness is associated with the exploitation of temporary habitats or resources. The seasonal timing of the heteropteran migrations is interpreted in terms of the breeding/overwintering cycles of the species concerned

The ideal job-seeker norm: unemployment and marital privileges in the professional middle-class

Objective: To understand how heterosexual US married parents interpret and respond to a spouse's unemployment and subsequent job-searching. Background: The pervasiveness of employment uncertainty, and unemployment, may propel families to embrace gender egalitarian norms. Quantitative research finds that this possibility is not borne out. Qualitative research has sought to illuminate mechanisms as to how gender norms persist even during a time that is optimal for dismantling them, but these mechanisms remain unclear. Method: Seventy-two in-depth interviews were conducted with a nonrandom sample of heterosexual, professional, dual-earner, married, unemployed women, men, and their spouses in the United States. Follow-up interviews were conducted with 35 participants. Intensive family observations were conducted with four families, two of unemployed men, and two of unemployed women. Results: Unemployed women, men, and spouses acknowledge that a set of time-intensive activities are key for reemployment (the ideal job-seeker norm). Couples with unemployed men direct resources such as time, space, and even money to facilitate unemployed men's compliance with the ideal job-seeker norm. Couples downplay the importance of women's reemployment and do not direct similar resources to help unemployed women job-search. Conclusion: Couples preserve a traditional gender status quo, often in defiance of material realities, by actively maintaining men's position at the helm of paid work and women's at unpaid work. Implications: Linking unemployment and job-seeking with the institution of heterosexual marriage reveals novel insights into social and marital processes shaping job-seeking

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

The rare British Shieldbug Carpocoris purpureipennis (Degeer) (Het.: Pentatomidae) from Portland Bill, Dorset

A recent record of Carpocoris purpureipennis (DeGeer) (Het.: Pentatomidae) from southern Britain is reported. Previous British records are discussed and pointers for the recognition of the species are given

The rare British Shieldbug Carpocoris purpureipennis (Degeer) (Het.: Pentatomidae) from Portland Bill, Dorset

A recent record of Carpocoris purpureipennis (DeGeer) (Het.: Pentatomidae) from southern Britain is reported. Previous British records are discussed and pointers for the recognition of the species are given

A Mathematical Analysis of Human Leukocyte Antigen Serology

This paper presents and explores a comprehensive mathematical model for human leukocyte antigen serology, based on a mathematical formalization of the concept of specificity. This model is general enough to take into account such factors as absorption, elution, cross-reactivity, and incomplete immunization. The paper includes a presentation of the relevant immunological background and a short discussion of the underlying computational difficulty of the basic problems. Upper and lower bounds are derived for the minimal number of specificities required to explain a given set of HLA reactions, and it is shown that the numbers of antibodies and antigens involved must be no less then this minimal number of specificities. Other techniques and theorems are also presented to aid in reducing and analyzing HLA reaction matrices