Risk factors for mortality among adult HIV/AIDS patients following antiretroviral therapy in Southwestern Ethiopia : an assessment through survival models

Introduction: Efforts have been made to reduce HIV/AIDS-related mortality by delivering antiretroviral therapy (ART) treatment. However, HIV patients in resource-poor settings are still dying, even if they are on ART treatment. This study aimed to explore the factors associated with HIV/AIDS-related mortality in Southwestern Ethiopia. Method: A non-concurrent retrospective cohort study which collected data from the clinical records of adult HIV/AIDS patients, who initiated ART treatment and were followed between January 2006 and December 2010, was conducted, to explore the factors associated with HIV/AIDS-related mortality at Jimma University Specialized Hospital (JUSH). Survival times (i. e., the time from the onset of ART treatment to the death or censoring) and different characteristics of patients were retrospectively examined. A best-fit model was chosen for the survival data, after the comparison between native semi-parametric Cox regression and parametric survival models (i. e., exponential, Weibull, and log-logistic). Result: A total of 456 HIV patients were included in the study, mostly females (312, 68.4%), with a median age of 30 years (inter-quartile range (IQR): 23-37 years). Estimated follow-up until December 2010 accounted for 1245 person-years at risk (PYAR) and resulted in 66 (14.5%) deaths and 390 censored individuals, representing a median survival time of 34.0 months (IQR: 22.8-42.0 months). The overall mortality rate was 5.3/100 PYAR: 6.5/100 PYAR for males and 4.8/100 PYAR for females. The Weibull survival model was the best model for fitting the data (lowest AIC). The main factors associated with mortality were: baseline age (> 35 years old, AHR = 3.8, 95% CI: 1.6-9.1), baseline weight (AHR = 0.93, 95% CI: 0.90-0.97), baseline WHO stage IV (AHR = 6.2, 95% CI: 2.2-14.2), and low adherence to ART treatment AHR = 4.2, 95% CI: 2.5-7.1). Conclusion: An effective reduction in HIV/AIDS mortality could be achieved through timely ART treatment onset and maintaining high levels of treatment adherence

Genome-wide association analyses identify new Brugada syndrome risk loci and highlight a new mechanism of sodium channel regulation in disease susceptibility.

Brugada syndrome (BrS) is a cardiac arrhythmia disorder associated with sudden death in young adults. With the exception of SCN5A, encoding the cardiac sodium channel Na1.5, susceptibility genes remain largely unknown. Here we performed a genome-wide association meta-analysis comprising 2,820 unrelated cases with BrS and 10,001 controls, and identified 21 association signals at 12 loci (10 new). Single nucleotide polymorphism (SNP)-heritability estimates indicate a strong polygenic influence. Polygenic risk score analyses based on the 21 susceptibility variants demonstrate varying cumulative contribution of common risk alleles among different patient subgroups, as well as genetic associations with cardiac electrical traits and disorders in the general population. The predominance of cardiac transcription factor loci indicates that transcriptional regulation is a key feature of BrS pathogenesis. Furthermore, functional studies conducted on MAPRE2, encoding the microtubule plus-end binding protein EB2, point to microtubule-related trafficking effects on Na1.5 expression as a new underlying molecular mechanism. Taken together, these findings broaden our understanding of the genetic architecture of BrS and provide new insights into its molecular underpinnings

Com optimitzar una matriu de dades? Utilitats bàsiques de l"SPSS

Una vegada es disposa de les dades introduïdes al paquet estadístic de l"SPSS (Statistical Package of Social Science) en una matriu de dades, és el moment de plantejar-se optimitzar aquesta matriu per poder extreure el màxim rendiment a les dades, segons el tipus d"anàlisi que es pretengui dur a terme. Per a això, el mateix SPSS té una sèrie d"utilitats que poden ser de gran utilitat. Aquestes utilitats bàsiques poden diferenciar-se segons la seva funcionalitat entre: les utilitats per a l"edició de dades, les utilitats per a la modificació de variables i les opcions d"ajuda que ens brinda. A continuació es presenten algunes d"aquestes utilitats

Void Fraction Influence on CICCs Coupling Losses: Analysis of Experimental Results With MPAS Model

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ASC2018-3LPo2A-03

International audienceIn spite of their complex geometry, CICCs have to be modelled with a rather simple description for coupling losses when operating in transient regime. Difficulties to predict AC losses in superconducting cable have already been shown in previous models such as the new analytical one developed at CEA named COLISEUM (after COupling Losses analytIcal Staged cablEs Unified Model) and CEA heuristic one MPAS. In this paper, we present a parametric analysis for coupling losses in superconducting strands and cables subjected to time-varying transverse magnetic field by using the recently developed COLISEUM. This analysis aims at understanding trends of the model in a broad domain of investigation and their associated limits of application. We show that for a wide range of parameters, it is possible to reduce this model of four time constants to a smaller subset. This reduction brings simplifications to the current COLISEUM and enables it to be consistent with the number of time constants considered in the MPAS model from CEA

Analytical Modelling of CICCs Coupling Losses: Broad Investigation of Two-Stage Model

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Analytical coupling losses modelling with COLISEUM: generalized approach upgraded to all stages

International audiencePredicting analytically the coupling losses generated in a cable for fusion magnets is still a significant challenge. Difficulties are related to the complex geometry of the system: several multi-strand stages embedded in one another with different twist pitches length, difficulty to model multiplets of strands, including compaction to the final shape. A two-stage analytical geometry based model (COLISEUM) has previously been developed at CEA. We try to extend it to any n-stage cables We detail here an iterative enhancement method to an n-stage model. We validated it against experimental data and shown that it is robust enough to fit our measured coupling losses. Finally, this upgraded model can be used to assess coupling losses in fusion n-stage cables in a particularly precise way from only geometrical information and analytical tools

Origin of the damage ring pattern in fused silica induced by multiple longitudinal modes laser pulses

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Corticosteroids increase blood interleukin-10 levels during cardiopulmonary bypass in men

Background. Interleukin (IL)-10 is a potent antiinflammatory cytokine inhibiting the release of tumor necrosis factor-α (TNF-α) and IL-8 by activated macrophages and polymorphonuclear leukocytes. Cardiopulmonary bypass (CPB) represents a unique situation where an inflammatory reaction is predictably induced. The present study examined the influence of CPB on the release of TNF-α, IL-1β, IL-8, and IL-10 and also defined the effects of pretreatment with corticosteroids on the release of these cytokines. Methods. The study included 22 patients undergoing coronary artery bypass graft operations, including eight control patients and seven patients who received dexamethasone, and seven patients who received methylprednisolone 4 hours before the operation. Cytokines were measured with the enzyme-linked immunosorbent assay technique before treatment, before anesthesia induction, immediately before heparin administration, before aorta declamping, 10 minutes and 90 minutes after aorta declamping, and 4 hours after the end of CPB. Results. In the control patients the TNF-α levels and especially the IL-8 levels increased during CPB and reached their maximal levels 4 hours after CPB. IL-10 levels rose moderately and transiently, reaching peak values 90 minutes after aorta declamping. Notably, administration of corticosteroids prevented IL-8 release but increased IL-10 levels, which were tenfold higher than in the control group 90 minutes after aorta declamping (dexamethasone, 271 ± 128 pg/ml; methylprednisolone, 312 ± 213 pg/ml; control, 17 ± 12 pg/ml, p < 0.05). IL-1β was not detected in any group of patients. Conclusions. The present data indicate that IL-10 is released together with proinflammatory cytokines during and after CPB and that pretreatment with corticosteroids markedly enhances this release. The release of IL-10 may play an important role in the antiinflammatory effects of corticosteroids.SCOPUS: ar.jinfo:eu-repo/semantics/publishe