6 research outputs found

    Evolution of the continental margin of south to central Vietnam and its relationship to opening of the South China Sea (East Vietnam Sea)

    Get PDF
    The continental margin of south to central Vietnam is notable for its high elevation plateaus many of which are covered by late Cenozoic basalt flows. It forms the westernmost margin of a wide continental rift of the South China Sea (East Vietnam Sea), and uplift has been considered a result of either rifting or younger intraplate basalt magmatism. To investigate margin development apatite thermochronometry was applied to a dense array of samples collected from across and along the margin of south to central Vietnam. Results, including thermal history models, identified a distinct regional episode of fast cooling between c. 37 and 30 Ma after which cooling rates remained low. The fast cooling coincides with a period of fast extension across the South China Sea (East Sea) region that preceded continental break-up recorded by Oligocene grabens onshore. A thermal model is used test different processes that might influence the inferred cooling including a distinct pulse of exhumation; a decrease in exhumation followed by an associated transient decrease in geothermal gradients and, underplating coincident with rifting. Thermal relaxation following Mesozoic arc magmatism is ruled out as geotherms returned to background rates within 20 Myrs of emplacement, well before the onset of fast cooling. Models support fast cooling attributed to accelerated erosion during early stages of rifting. Some additional heating from either underplating, and/or hot mantle upwellings is also possible. No evidence was found to support regional uplift associated with the intraplate magmatism, enhanced monsoon-driven erosion or seafloor spreading dynamics

    Autoantibodies against type I IFNs in patients with life-threatening COVID-19

    Get PDF
    Interindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-w (IFN-w) (13 patients), against the 13 types of IFN-a (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men

    A Trial of Itraconazole or Amphotericin B for HIV-Associated Talaromycosis

    No full text
    BACKGROUND: Talaromyces marneffei infection is a major cause of human immunodeficiency virus (HIV)-related death in South and Southeast Asia. Guidelines recommend initial treatment with amphotericin B deoxycholate, but this drug has substantial side effects, a high cost, and limited availability. Itraconazole is available in oral form, is associated with fewer unacceptable side effects than amphotericin, and is widely used in place of amphotericin; however, clinical trials comparing these two treatments are lacking. METHODS: In this open-label, noninferiority trial, we randomly assigned 440 HIV-infected adults who had talaromycosis, confirmed by either microscopy or culture, to receive either intravenous amphotericin B deoxycholate (amphotericin) (219 patients), at a dose of 0.7 to 1.0 mg per kilogram of body weight per day, or itraconazole capsules (221 patients), at a dose of 600 mg per day for 3 days, followed by 400 mg per day, for 11 days; thereafter, all the patients received maintenance therapy with itraconazole. The primary outcome was all-cause mortality at week 2. Secondary outcomes included all-cause mortality at week 24, the time to clinical resolution of talaromycosis, early fungicidal activity, relapse of talaromycosis, development of the immune reconstitution inflammatory syndrome (IRIS), and the side-effect profile. RESULTS: The risk of death at week 2 was 6.5% in the amphotericin group and 7.4% in the itraconazole group (absolute risk difference, 0.9 percentage points; 95% confidence interval [CI], -3.9 to 5.6; P<0.001 for noninferiority); however, the risk of death at week 24 was 11.3% in the amphotericin group and 21.0% in the itraconazole group (absolute risk difference, 9.7 percentage points; 95% CI, 2.8 to 16.6; P=0.006). Treatment with amphotericin was associated with significantly faster clinical resolution and fungal clearance and significantly lower rates of relapse and IRIS than itraconazole. The patients who received amphotericin had significantly higher rates of infusion-related reactions, renal failure, hypokalemia, hypomagnesemia, and anemia than patients in the itraconazole group. CONCLUSIONS: Amphotericin was superior to itraconazole as initial treatment for talaromycosis with respect to 6-month mortality, clinical response, and fungicidal activity. (Funded by the Medical Research Council and others; IVAP Current Controlled Trials number, ISRCTN59144167 .)
    corecore