Prevalence and impact of comorbid chronic pain and cigarette smoking among people living with HIV

Rates of chronic pain and cigarette smoking are each substantially higher among people living with HIV (PLWH) than in the general population. The goal of these analyses was to examine the prevalence and impact of comorbid chronic pain and cigarette smoking among PLWH. Participants included 3289 PLWH (83% male) who were recruited from five HIV clinics. As expected, the prevalence of smoking was higher among PLWH with chronic pain (41.9%), than PLWH without chronic pain (26.6%, p <.0001), and the prevalence of chronic pain was higher among current smokers (32.9%), than among former (23.6%) or never (17%) smokers (ps <.0001). PLWH who endorsed comorbid chronic pain and smoking (vs. nonsmokers without chronic pain) were more likely to report cocaine/crack and cannabis use, be prescribed long-term opioid therapy, and have virologic failure, even after controlling for relevant sociodemographic and substance-related variables (ps <.05). These results contribute to a growing empirical literature indicating that chronic pain and cigarette smoking frequently co-occur, and extend this work to a large sample of PLWH. Indeed, PLWH may benefit from interventions that are tailored to address bidirectional pain-smoking effects in the context of HIV

Perspectives of anaerobic decomposition of biomass for sustainable biogas production: A Review

Biogas production from biomass is an eco-friendly approach that offers renewable energy generation, waste recycling, biofertilizer production along with maintaining environmental quality. Anaerobic decomposition is a familiar practice used for biogas production in worldwide, whereas only few substrates were convenient for attaining desired methane concentration in biogas. Hence, further advancements are necessary for the exploration and utilization of various complex organic materials for the purpose. This article gives a clear outlook on potential of various biomass for biogas production, necessity of pretreatment, applicability of microbial/enzyme addition, maintenance of various process parameters, formulation of suitable digester designs and future scope of this area. The livestock wastes and agricultural wastes possess high energy generation potential (71%) and sustainable utilization of such wastes are admirable to commercialize biogas production in future. Hence, selection of biomass through biochemical methane potential (BMP) analysis and biomass pretreatment prior to anaerobic decomposition is adequate to improve the quality and quantity of generated biogas. Addition of effective microorganisms or respective enzymes along with the employment of suitable bioreactors, are other perspectives to enhance decomposition. The single-stage and multi-stage systems possess much attention than other types of reactors since that offers accurate process management at four different stages of decomposition. Moreover, the maintenances of optimum pH, temperature, volatile fatty acids, carbon/nitrogen ratio, etc. are crucial to evade system unsteadiness during decomposition. Since comprehensive mathematical models are appropriate to make the anaerobic decomposition process economically feasible and advancement with these forecasts are adequate to commercialize this technology in the future

Activated Phosphoinositide 3-Kinase δ Syndrome: Update from the ESID Registry and comparison with other autoimmune-lymphoproliferative inborn errors of immunity

Background Activated phosphoinositide-3-kinase (PI3K) δ Syndrome (APDS) is an inborn error of immunity (IEI) with infection susceptibility and immune dysregulation, clinically overlapping with other conditions. Management depends on disease evolution, but predictors of severe disease are lacking. Objectives Report the extended spectrum of disease manifestations in APDS1 versus APDS2, compare these to CTLA-4 deficiency, NFκB1 deficiency, and STAT3 gain-of-function (GOF) disease; identify predictors of severity in APDS. Methods Data collection with the European Society for Immunodeficiencies (ESID)-APDS registry. Comparison with published cohorts of the other IEIs. Results The analysis of 170 APDS patients outlines high penetrance and early-onset of APDS compared to the other IEIs. The large clinical heterogeneity even in individuals with the same PIK3CD variant E1021K illustrates how poorly the genotype predicts the disease phenotype and course. The high clinical overlap between APDS and the other investigated IEIs suggests relevant pathophysiological convergence of the affected pathways. Preferentially affected organ systems indicate specific pathophysiology: bronchiectasis is typical of APDS1; interstitial lung disease and enteropathy are more common in STAT3 GOF and CTLA-4 deficiency. Endocrinopathies are most frequent in STAT3 GOF, but growth impairment is also common particularly in APDS2. Early clinical presentation is a risk factor for severe disease in APDS. Conclusion APDS illustrates how a single genetic variant can result in a diverse autoimmune-lymphoproliferative phenotype. Overlap with other IEI is substantial. Some specific features distinguish APDS1 from APDS2. Early-onset is a risk factor for severe disease course calling for specific treatment studies in younger patients