14 research outputs found

    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

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    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

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    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

    On-machine and in-process surface metrology for precision manufacturing

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    On-machine and in-process surface metrology are important for quality control in manufacturing of precision surfaces. The classifications, requirements and tasks of on-machine and in-process surface metrology are addressed. The state-of-the-art on-machine and in-process measurement systems and sensor technologies are presented. Error separation algorithms for removing machine tool errors, which is specially required in on-machine and in-process surface metrology, are overviewed, followed by a discussion on calibration and traceability. Advanced techniques on sampling strategies, measurement systems-machine tools interface, data flow and analysis as well as feedbacks for compensation manufacturing are then demonstrated. Future challenges and developing trends are also discussed.status: publishe

    On-machine and in-process surface metrology for precision manufacturing

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    International audienceOn-machine and in-process surface metrology are important for quality control in manufacturing of precision surfaces. The classifications, requirements and tasks of on-machine and in-process surface metrology are addressed. The state-of-the-art on-machine and in-process measurement systems and sensor technologies are presented. Error separation algorithms for removing machine tool errors, which is specially required in on-machine and in-process surface metrology, are overviewed, followed by a discussion on calibration and traceability. Advanced techniques on sampling strategies, measurement systems-machine tools interface, data flow and analysis as well as feedbacks for compensation manufacturing are then demonstrated. Future challenges and developing trends are also discussed

    Clinical, virological, and biological parameters associated with outcomes of Ebola virus infection in Macenta, Guinea

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    International audienceBACKGROUND. The pathogenesis of Ebola virus (EBOV) disease (EVD) is poorly characterized. The establishment of well-equipped diagnostic laboratories close to Ebola treatment centers (ETCs) has made it possible to obtain relevant virological and biological data during the course of EVD and to assess their association with the clinical course and different outcomes of the disease. METHODS. We were responsible for diagnosing EBOV infection in patients admitted to two ETCs in forested areas of Guinea. The pattern of clinical signs was recorded, and an etiological diagnosis was established by RT-PCR for EBOV infection or a rapid test for malaria and typhoid fever. Biochemical analyses were also performed. RESULTS. We handled samples from 168 patients between November 29, 2014, and January 31, 2015; 97 patients were found to be infected with EBOV, with Plasmodium falciparum coinfection in 18%. Overall mortality for EVD cases was 58%, rising to 86% if P. falciparum was also present. Viral load was higher in fatal cases of EVD than in survivors, and fatal cases were associated with higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT), C-reactive protein (CRP), and IL-6 levels. Furthermore, regardless of outcome, EVD was characterized by higher creatine kinase (CPK), amylase, and creatinine levels than in febrile patients without EVD, with higher blood urea nitrogen (BUN) levels in fatal cases of EVD only. CONCLUSION. These findings suggest that a high viral load at admission is a marker of poor EVD prognosis. In addition, high AST, ALT, CRP, and IL-6 levels are associated with a fatal outcome of EVD. Damage to the liver and other tissues, with massive rhabdomyolysis and, probably, acute pancreatitis, is associated with EVD and correlated with disease severity. Finally, biochemical analyses provide substantial added value at ETCs, making it possible to improve supportive rehydration and symptomatic care for patients. FUNDING. The French Ministry of Foreign Affairs, the Agence Française de Développement, and Institut Pasteur

    On-machine and in-process surface metrology for precision manufacturing

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    The InCosmiCon Research Center and its activities in the field of SETI, Big History and interculturality

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    As announced at the IAC 2019 held in Washington, at the beginning of 2020 the University of Insubria (Italy), in collaboration with the UCSS of Lima (Peru), has created a new research center called InCosmiCon (Intelligence in the Cosmic Context), based at the Department of Human Sciences, Innovation and Territory (DISUIT). Its goal is to investigate the nature of intelligence in an interdisciplinary way and with a realistic approach, in the context of the history of humankind, of our planet and the whole universe, avoiding the specular errors of reductionism and dualism. InCosmiCon has already been joined by various illustrious scientists in the field of space sciences, as the former IAU Secretary General Piero Benvenuti, now Honorary President of InCosmiCon, and also by some members of the IAA SETI Committee, as Paolo Musso, Director of InCosmiCon, and the present Chairman of the IAA SETI Committee Claudio Maccone, who has been nominated Coordinator of the InCosmiCon SETI Section, whose aim is to support the implementation of SETI programs everywhere it is possible, especially in Italy and Latin America, and to participate in the interdisciplinary work about extraterrestrial intelligence promoted by the IAA SETI Committee. Other Sections of InCosmiCon are devoted to Big History and Intercultural Communication, especially focusing on the extraordinary experience of the UCSS Amazonian seat, the UCSS-Nopoki of Atalaya, which could be also a model for a positive interaction with a hypothetical extraterrestrial civilization. In the present paper some of the InCosmiCon members are going to present its structure, its first results, and its projects for the next future, while a separate paper will be specifically devoted to a Peruvian project about Astrobiology and Optical SETI

    Tolerancing: Managing uncertainty from conceptual design to final product

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    Risk for opportunistic disease and death after reinitiating continuous antiretroviral therapy in patients with HIV previously receiving episodic therapy: a randomized trial.

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    Collaboratore per la suddetta ricerca multicentrica in quanto membro di SMART Study Grou
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