1,724 research outputs found
Renal impairment in a rural African antiretroviral programme
Background:
There is little knowledge regarding the prevalence and nature of renal impairment in African populations initiating antiretroviral treatment, nor evidence to inform the most cost effective methods of screening for renal impairment. With the increasing availability of the potentially nephrotixic drug, tenofovir, such information is important for the planning of antiretroviral programmes
Methods:
(i) Retrospective review of the prevalence and risk factors for impaired renal function in 2189 individuals initiating antiretroviral treatment in a rural African setting between 2004 and 2007 (ii) A prospective study of 149 consecutive patients initiating antiretrovirals to assess the utility of urine analysis for the detection of impaired renal function. Severe renal and moderately impaired renal function were defined as an estimated GFR of ≤ 30 mls/min/1.73 m2 and 30–60 mls/min/1.73 m2 respectively. Logistic regression was used to determine odds ratio (OR) of significantly impaired renal function (combining severe and moderate impairment). Co-variates for analysis were age, sex and CD4 count at initiation.
Results:
(i) There was a low prevalence of severe renal impairment (29/2189, 1.3% 95% C.I. 0.8–1.8) whereas moderate renal impairment was more frequent (287/2189, 13.1% 95% C.I. 11.6–14.5) with many patients having advanced immunosuppression at treatment initiation (median CD4 120 cells/μl). In multivariable logistic regression age over 40 (aOR 4.65, 95% C.I. 3.54–6.1), male gender (aOR 1.89, 95% C.I. 1.39–2.56) and CD4<100 cells/ul (aOR 1.4, 95% C.I. 1.07–1.82) were associated with risk of significant renal impairment (ii) In 149 consecutive patients, urine analysis had poor sensitivity and specificity for detecting impaired renal function.
Conclusion:
In this rural African setting, significant renal impairment is uncommon in patients initiating antiretrovirals. Urine analysis alone may be inadequate for identification of those with impaired renal function where resources for biochemistry are limited
Conservation strategies for understanding and combating the primate bushmeat trade on Bioko Island, Equatorial Guinea
© 2017 Wiley Periodicals, Inc. Bioko Island, Equatorial Guinea is among the important places in Africa for the conservation of primates, but a cultural preference for bushmeat and a lack of effective law enforcement has encouraged commercial bushmeat hunting, threatening the survival of the remaining primate population. For over 13 years, we collected bushmeat market data in the Malabo market, recording over 35,000 primate carcasses, documenting “mardi gras” consumption patterns, seasonal carcass availability, and negative effects resulting from government intervention. We also conducted forest surveys throughout Bioko's two protected areas in order to localize and quantify primate populations and hunting pressure. Using these data, we were able to document the significant negative impact bushmeat hunting had on monkey populations, estimate which species are most vulnerable to hunting, and develop ecological niche models to approximate the distribution of each of Bioko's diurnal primate species. These results also have allowed for the identification of primate hotspots, such as the critically important southwest region of the Gran Caldera Scientific Reserve, and thus, priority areas for conservation on Bioko, leading to more comprehensive conservation recommendations. Current and future efforts now focus on bridging the gap between investigators and legislators in order to develop and effectively implement a management plan for Bioko's Gran Caldera Scientific Reserve and to develop a targeted educational campaign to reduce demand by changing consumer attitudes toward bushmeat. Using this multidisciplinary approach, informed by biological, socioeconomic, and cultural research, there may yet be a positive future for the primates of Bioko
Exploring the equity of GP practice prescribing rates for selected coronary heart disease drugs: a multiple regression analysis with proxies of healthcare need
Background
There is a small, but growing body of literature highlighting inequities in GP practice prescribing rates for many drug therapies. The aim of this paper is to further explore the equity of prescribing for five major CHD drug groups and to explain the amount of variation in GP practice prescribing rates that can be explained by a range of healthcare needs indicators (HCNIs).
Methods
The study involved a cross-sectional secondary analysis in four primary care trusts (PCTs 1–4) in the North West of England, including 132 GP practices. Prescribing rates (average daily quantities per registered patient aged over 35 years) and HCNIs were developed for all GP practices. Analysis was undertaken using multiple linear regression.
Results
Between 22–25% of the variation in prescribing rates for statins, beta-blockers and bendrofluazide was explained in the multiple regression models. Slightly more variation was explained for ACE inhibitors (31.6%) and considerably more for aspirin (51.2%). Prescribing rates were positively associated with CHD hospital diagnoses and procedures for all drug groups other than ACE inhibitors. The proportion of patients aged 55–74 years was positively related to all prescribing rates other than aspirin, where they were positively related to the proportion of patients aged >75 years. However, prescribing rates for statins and ACE inhibitors were negatively associated with the proportion of patients aged >75 years in addition to the proportion of patients from minority ethnic groups. Prescribing rates for aspirin, bendrofluazide and all CHD drugs combined were negatively associated with deprivation.
Conclusion
Although around 25–50% of the variation in prescribing rates was explained by HCNIs, this varied markedly between PCTs and drug groups. Prescribing rates were generally characterised by both positive and negative associations with HCNIs, suggesting possible inequities in prescribing rates on the basis of ethnicity, deprivation and the proportion of patients aged over 75 years (for statins and ACE inhibitors, but not for aspirin)
Ferritins: furnishing proteins with iron
Ferritins are a superfamily of iron oxidation, storage and mineralization proteins found throughout the animal, plant, and microbial kingdoms. The majority of ferritins consist of 24 subunits that individually fold into 4-α-helix bundles and assemble in a highly symmetric manner to form an approximately spherical protein coat around a central cavity into which an iron-containing mineral can be formed. Channels through the coat at inter-subunit contact points facilitate passage of iron ions to and from the central cavity, and intrasubunit catalytic sites, called ferroxidase centers, drive Fe2+ oxidation and O2 reduction. Though the different members of the superfamily share a common structure, there is often little amino acid sequence identity between them. Even where there is a high degree of sequence identity between two ferritins there can be major differences in how the proteins handle iron. In this review we describe some of the important structural features of ferritins and their mineralized iron cores and examine in detail how three selected ferritins oxidise Fe2+ in order to explore the mechanistic variations that exist amongst ferritins. We suggest that the mechanistic differences reflect differing evolutionary pressures on amino acid sequences, and that these differing pressures are a consequence of different primary functions for different ferritins
Molecular, morphological and acoustic identification of Eumops maurus and Eumops hansae (Chiroptera: Molossidae) with new reports from Central Amazonia
Eumops maurus and Eumops hansae are rarely captured Neotropical molossid bats for
which information on taxonomy, natural history, and spatial distribution are scarce.
This translates into a poor understanding of their ecology and limits the delimitation
of useful characters for their identification. Here, we describe records of these two
molossids from the Central Brazilian Amazon, providing data on their external and
craniodental morphology, DNA barcode (COI) sequences complemented by acoustic
data for the species. Morphological characters, DNA sequence data and phylogenetic
relationships within the genus Eumops were consistent with those previously described
for both species. Echolocation call characteristics did not differ significantly so as to be
useful for separating E. maurus and E. hansae from other congeners. Our records are,
respectively the first and the second for Central Amazonia as one individual previously
attributed to Eumops amazonicus from Manaus may be considered a junior synonym
for E. hansae. These new records increase the extent of the species’ known ranges,
partially filling in previous existing gaps in their distribution in central South America.
Our data further suggest that these molossid bats forage in a wider range of habitats
than previously thought
The Human Endogenous Circadian System Causes Greatest Platelet Activation during the Biological Morning Independent of Behaviors
Platelets are involved in the thromboses that are central to myocardial infarctions and ischemic strokes. Such adverse cardiovascular events have day/night patterns with peaks in the morning (~9 AM), potentially related to endogenous circadian clock control of platelet activation. The objective was to test if the human endogenous circadian system influences (1) platelet function and (2) platelet response to standardized behavioral stressors. We also aimed to compare the magnitude of any effects on platelet function caused by the circadian system with that caused by varied standardized behavioral stressors, including mental arithmetic, passive postural tilt and mild cycling exercise.We studied 12 healthy adults (6 female) who lived in individual laboratory suites in dim light for 240 h, with all behaviors scheduled on a 20-h recurring cycle to permit assessment of endogenous circadian function independent from environmental and behavioral effects including the sleep/wake cycle. Circadian phase was assessed from core body temperature. There were highly significant endogenous circadian rhythms in platelet surface activated glycoprotein (GP) IIb-IIIa, GPIb and P-selectin (6-17% peak-trough amplitudes; p ≤ 0.01). These circadian peaks occurred at a circadian phase corresponding to 8-9 AM. Platelet count, ATP release, aggregability, and plasma epinephrine also had significant circadian rhythms but with later peaks (corresponding to 3-8 PM). The circadian effects on the platelet activation markers were always larger than that of any of the three behavioral stressors.These data demonstrate robust effects of the endogenous circadian system on platelet activation in humans--independent of the sleep/wake cycle, other behavioral influences and the environment. The 9 AM timing of the circadian peaks of the three platelet surface markers, including platelet surface activated GPIIb-IIIa, the final common pathway of platelet aggregation, suggests that endogenous circadian influences on platelet function could contribute to the morning peak in adverse cardiovascular events as seen in many epidemiological studies
Oral health status and treatment needs of children and young adults attending a day centre for individuals with special health care needs
Genetic Analyses of Interactions among Gibberellin, Abscisic Acid, and Brassinosteroids in the Control of Flowering Time in Arabidopsis thaliana
Genetic interactions between phytohormones in the control of flowering time in Arabidopsis thaliana have not been extensively studied. Three phytohormones have been individually connected to the floral-timing program. The inductive function of gibberellins (GAs) is the most documented. Abscisic acid (ABA) has been demonstrated to delay flowering. Finally, the promotive role of brassinosteroids (BRs) has been established. It has been reported that for many physiological processes, hormone pathways interact to ensure an appropriate biological response.We tested possible genetic interactions between GA-, ABA-, and BR-dependent pathways in the control of the transition to flowering. For this, single and double mutants deficient in the biosynthesis of GAs, ABA, and BRs were used to assess the effect of hormone deficiency on the timing of floral transition. Also, plants that over-express genes encoding rate-limiting enzymes in each biosynthetic pathway were generated and the flowering time of these lines was investigated.Loss-of-function studies revealed a complex relationship between GAs and ABA, and between ABA and BRs, and suggested a cross-regulatory relation between GAs to BRs. Gain-of-function studies revealed that GAs were clearly limiting in their sufficiency of action, whereas increases in BRs and ABA led to a more modest phenotypic effect on floral timing. We conclude from our genetic tests that the effects of GA, ABA, and BR on timing of floral induction are only in partially coordinated action
An FPGA-based track finder for the L1 trigger of the CMS experiment at the high luminosity LHC
A new tracking system is under development for operation in the CMS experiment at the High Luminosity LHC. It includes an outer tracker which will construct stubs, built by correlating clusters in two closely spaced sensor layers for the rejection of hits from low transverse momentum tracks, and transmit them off-detector at 40 MHz. If tracker data is to contribute to keeping the Level-1 trigger rate at around 750 kHz under increased luminosity, a crucial component of the upgrade will be the ability to identify tracks with transverse momentum above 3 GeV/c by building tracks out of stubs. A concept for an FPGA-based track finder using a fully time-multiplexed architecture is presented, where track candidates are identified using a projective binning algorithm based on the Hough Transform. A hardware system based on the MP7 MicroTCA processing card has been assembled, demonstrating a realistic slice of the track finder in order to help gauge the performance and requirements for a full system. This paper outlines the system architecture and algorithms employed, highlighting some of the first results from the hardware demonstrator and discusses the prospects and performance of the completed track finder
Emulation of a prototype FPGA track finder for the CMS Phase-2 upgrade with the CIDAF emulation framework
The CMS collaboration is preparing a major upgrade of its detector, so it can operate during the high luminosity run of the LHC from 2026. The upgraded tracker electronics will reconstruct the trajectories of charged particles within a latency of a few microseconds, so that they can be used by the level-1 trigger. An emulation framework, CIDAF, has been developed to provide a reference for a proposed FPGA-based implementation of this track finder, which employs a Time-Multiplexed (TM) technique for data processing.The research leading to these results has received funding from the People Programme (Marie Curie Actions) of the European Unions Seventh Framework Programme FP7/2007- 2013/ under REA grant agreement n [317446] INFIERI “Intelligent Fast Interconnected and Efficient Devices for Frontier Exploitation in Research and Industry”. This work was supported in part by the the UK Science and Technology Facilities Council, we gratefully acknowledge their support
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