Randomized Controlled Trial of an Internet Application to Reduce HIV Transmission Behavior Among HIV Infected Men Who have Sex with Men.

We conducted a prospective, randomized controlled trial of an internet-based safer-sex intervention to reduce HIV transmission risk behaviors. HIV-infected men who have sex with men (n = 179) were randomized to receive a monthly internet survey alone or a monthly survey plus tailored risk reduction messages over 12 months. The primary outcome was the cumulative sexually transmitted infection (STI) incidence over 12 months. Secondary outcomes included self-reported unprotected sex with an at risk partner and disclosure of HIV status to partners. In a modified intent to treat analysis, there was no difference in 12-month STI incidence between the intervention and control arms (30 vs. 25 %, respectively; p = 0.5). Unprotected sex decreased and disclosure increased over time in both study arms. These improvements suggest that addition of the risk-reduction messages provided little benefit beyond the self-monitoring of risky behavior via regular self-report risk behavior assessments (as was done in both study arms)

Kearns-sayre syndrome with reduced plasma and cerebrospinal fluid folate

A young woman with Kearns-Sayre syndrome and progressive central nervous system deterioration over 15 years had decreased plasma and cerebrospinal fluid folate levels while receiving phenytoin for a seizure disorder. A muscle biopsy showed a “ragged red fiber” myopathy with reduced muscle carnitine and mitochondrial enzymes. Computed tomographic brain scans showed cerebral white matter hypodensities and bilateral calcification of the basal ganglia. The mechanism for the folate deficiency and altered ratio of plasma to cerebrospinal fluid folate is unknown, but the deficiency may be responsive to replacement therapy.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50301/1/410130620_ftp.pd

The 1991 version of the plume impingement computer program. Volume 2: User's input guide

The Plume Impingement Program (PLIMP) is a computer code used to predict impact pressures, forces, moments, heating rates, and contamination on surfaces due to direct impingement flowfields. Typically, it has been used to analyze the effects of rocket exhaust plumes on nearby structures from ground level to the vacuum of space. The program normally uses flowfields generated by the MOC, RAMP2, SPF/2, or SFPGEN computer programs. It is capable of analyzing gaseous and gas/particle flows. A number of simple subshapes are available to model the surfaces of any structure. The original PLIMP program has been modified many times of the last 20 years. The theoretical bases for the referenced major changes, and additional undocumented changes and enhancements since 1988 are summarized in volume 1 of this report. This volume is the User's Input Guide and should be substituted for all previous guides when running the latest version of the program. This version can operate on VAX and UNIX machines with NCAR graphics ability

The 1991 version of the plume impingement computer program. Volume 1: Description

The objective of this contract was to continue development of a vacuum plume impingement evaluator to provide an analyst with a capability for rapid assessment of thruster plume impingement scenarios. The research was divided into three areas: Plume Impingement Computer Program (PLIMP) modification/validation; graphics development; and documentation in the form of a Plume Handbook and PLIMP Input Guide

Randomized Trial of a Health Coaching Intervention to Enhance Retention in Care: California Collaborative Treatment Group 594.

Poor linkage, engagement and retention remain significant barriers in achieving HIV treatment goals in the US. HIV-infected persons entering or re-entering care across three Southern California academic HIV clinics, were randomized (1:1) to an Active, Linkage, Engagement, Retention and Treatment (ALERT) specialist for outreach and health coaching, or standard of care (SOC). The primary outcome of time to loss to follow up (LTFU) was compared using Cox proportional hazards regression modeling. No differences in the median time to LTFU (81.7 for ALERT versus 93.6 weeks for SOC; HR 1.27; p = 0.40), or time to ART initiation was observed (N = 116). Although, ALERT participants demonstrated worsening depressive symptomatology from baseline to week 48 compared to SOC (p = 0.02). The ALERT intervention did not improve engagement and retention in HIV care over SOC. Further studies are needed to determine how best to apply resources to improve retention and engagement

The Use of Biomonitoring Data in Exposure and Human Health Risk Assessments

Biomonitoring uses analytic methods that permit the accurate measurement of low levels of environmental chemicals in human tissues. However, depending on the intended use, biomonitoring, like all exposure tools, may not be a stand-alone exposure assessment tool for some of its environmental public health uses. Although biomonitoring data demonstrate that many environmental chemicals are absorbed in human tissues, uncertainty exists regarding if and at what concentrations many of these chemicals cause adverse health outcomes. Moreover, without exposure pathway information, it is difficult to relate biomonitoring results to sources and routes of exposure and develop effective health risk management strategies. In September 2004, the Health and Environmental Sciences Institute, U.S. Environmental Protection Agency, Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, and International Council of Chemical Associations co-sponsored the International Biomonitoring Workshop, which explored the processes and information needed for placing biomonitoring data into perspective for risk assessment purposes, with special emphasis on integrating biomarker measurements of exposure, internal dose, and potential health outcome. Scientists from international governments, academia, and industry recommended criteria for applying biomonitoring data for various uses. Six case studies, which are part of this mini-monograph, were examined: inorganic arsenic, methyl eugenol, organophosphorus pesticides, perfluorooctanesulfonate, phthalates, and polybrominated diphenyl ethers. Based on the workshop and follow-up discussions, this overview article summarizes lessons learned, identifies data gaps, outlines research needs, and offers guidance for designing and conducting biomonitoring studies, as well as interpreting biomonitoring data in the context of risk assessment and risk management

The Cold Peace: Russo-Western Relations as a Mimetic Cold War

In 1989–1991 the geo-ideological contestation between two blocs was swept away, together with the ideology of civil war and its concomitant Cold War played out on the larger stage. Paradoxically, while the domestic sources of Cold War confrontation have been transcended, its external manifestations remain in the form of a ‘legacy’ geopolitical contest between the dominant hegemonic power (the United States) and a number of potential rising great powers, of which Russia is one. The post-revolutionary era is thus one of a ‘cold peace’. A cold peace is a mimetic cold war. In other words, while a cold war accepts the logic of conflict in the international system and between certain protagonists in particular, a cold peace reproduces the behavioural patterns of a cold war but suppresses acceptance of the logic of behaviour. A cold peace is accompanied by a singular stress on notions of victimhood for some and undigested and bitter victory for others. The perceived victim status of one set of actors provides the seedbed for renewed conflict, while the ‘victory’ of the others cannot be consolidated in some sort of relatively unchallenged post-conflict order. The ‘universalism’ of the victors is now challenged by Russia's neo-revisionist policy, including not so much the defence of Westphalian notions of sovereignty but the espousal of an international system with room for multiple systems (the Schmittean pluriverse)

Fate of lesion-related side branches after coronary artery stenting

AbstractObjectives. The aim of this study was to assess the immediate and long-term patency of lesion-associated side branches after coronary artery stenting.Background. The possible adverse effects related to implantation of coronary stents are not completely known. An important potential complication of stenting is side branch occlusion due to mechanical obstruction or thrombosis.Methods. Serial coronary angiography was performed in 153 patients (167 lesions) at baseline, after conventional balloon angioplasty, immediately after Palmaz-Schatz stent placement and at 6 months. The patency of side branches, where present, was analysed at each of these points.Results. Of 167 lesions stented, 57 stent placements spanned 66 side branches with a diameter ≥1 mm. Twenty-seven (41%) of these side branches had ≥50% ostial stenosis before standard balloon angioplasty. Six side branches became occluded after standard balloon angioplasty and remained occluded after stenting. Of the 60 side branches patent after conventional angioplasty, 57 (95%) remained patent immediately after stenting. All three side branches that became occluded after stenting had ≥50% ostial stenosis at baseline. All 60 side branches, including the 3 initially occluded after stenting, were patent at 6-month follow-up.Conclusions. These findings demonstrate that 1) acute side branch occlusion due to coronary stenting occurs infrequently; 2) when side branch occlusion occurs, it is associated with intrinsic ostial disease; and 3) the patency of side branch ostia is well maintained at long-term follow-up

DLL4-Notch signaling mediates tumor resistance to anti-VEGF therapy in vivo.

Resistance to VEGF inhibitors is emerging as a major clinical problem. Notch signaling has been implicated in tumor angiogenesis. Therefore, to investigate mechanisms of resistance to angiogenesis inhibitors, we transduced human glioblastoma cells with retroviruses encoding Notch delta-like ligand 4 (DLL4), grew them as tumor xenografts and then treated the murine hosts with the VEGF-A inhibitor bevacizumab. We found that DLL4-mediated tumor resistance to bevacizumab in vivo. The large vessels induced by DLL4-Notch signaling increased tumor blood supply and were insensitive to bevacizumab. However, blockade of Notch signaling by dibenzazepine, a γ-secretase inhibitor, disrupted the large vessels and abolished the tumor resistance. Multiple molecular mechanisms of resistance were shown, including decreased levels of hypoxia-induced VEGF and increased levels of the VEGF receptor VEGFR1 in the tumor stroma, decreased levels of VEGFR2 in large blood vessels, and reduced levels of VEGFR3 overall. DLL4-expressing tumors were also resistant to a VEGFR targeting multikinase inhibitor. We also observed activation of other pathways of tumor resistance driven by DLL4-Notch signaling, including the FGF2-FGFR and EphB4-EprinB2 pathways, the inhibition of which reversed tumor resistance partially. Taken together, our findings show the importance of classifying mechanisms involved in angiogenesis in tumors, and how combination therapy to block DLL4-Notch signaling may enhance the efficacy of VEGF inhibitors, particularly in DLL4-upregulated tumors, and thus provide a rational base for the development of novel strategies to overcome antiangiogenic resistance in the clinic