The VITI program: Final Report

In this report we present our findings and results from the VITI program in 2000. The focus of the research work undertaken by VITI has been to provide electronic meeting environments that are easy to use and afford as natural a collaboration experience as possible. This final report is structured into three parts. Part one concerns the VITI infrastructure and consists of two sections. The first section describes the process of establishing the infrastructure, concentrating on how the work was done. The second section presents the actual infrastructure that is in place today, concentrating on what has been put in place. Part two examines the use the VITI infrastructure has been put to, giving examples of activities it has supported and discussing strengths and weaknesses that have emerged through this use. Finally part three considers the future of distributed electronic meeting environments. It is recommended that the report be read in the order in which it is presented. However, each section has been written as a standalone document and can be read independently of the others

Ledningens vilja och avsikt : säkerhetspolicyer vid svenska förvaltningsmyndigheter

Alla organisationers ledningar vill ha en verksamhet som når upp till det som deras styrdokumenten vill förmedla. Ledningen har med sina säkerhetspolicyer visat sin vilja och avsikt med säkerhetatsarbetet och förväntar sig att dessa styrdokument ger resultat. Är det så enkelt? Kan ledningarna bli framgångsrikare gällande efterlevnad? Genom att ta reda på vad säkerhetspolicyer innehåller och om innehållets utformning kan tänkas påverka efterlevnad och om det finns faktorer som kan användas för att nå en framgångsrikare efterlevnad. För att få en hanterbar nivå av säkerhetspolicyer, så behandlar avhandlingen innehållet i säkerhetspolicyer som kan kopplas till verksamhetsskydd vid svenska förvaltningsmyndigheter under regeringen. Målet med forskningen är i denna avhandling att få ökad kunskap om hur säkerhetsledningssystem i form av policy som styrdokument är uppbyggda vid svenska förvaltningsmyndigheter, identifiera generella utvecklingsbehov och utifrån dessa behov föreslå förbättringar. Säkerhetspolicyer behöver vara skrivna på ett sätt att det som skrivs skapar förståelse och acceptans och är begripligt för att uppnå målet med efterlevnad gällande säkerhetsarbetet. Då säkerhetspolicyer kan ses som en ledningsresurs för styrning av medarbetarnas förståelse och acceptans för hurarbetet med säkerhet ska genomföras, kan såväl ledning som medarbetare subjektifieras och subjektspositioneras med inspiration av Michel Foucaults teoretiska utgångspunkter

Serum apolipoprotein profile of patients with chronic renal failure

Serum apolipoprotein profile of patients with chronic renal failure. Serum concentrations of apolipoproteins A-I, A-II, B, C-I, C-II, C-III and E were determined by electroimmunoassay in 56 patients with chronic renal failure (CRF) in the predialytic phase. The results were compared with those obtained in asymptomatic normolipidemic subjects, patients with type IV hyperlipoproteinemia, and patients with type II diabetes mellitus. CRF patients had reduced concentrations of ApoA-I and Apo A-II, normal levels of ApoB and ApoC-I, and increased concentrations of ApoC-II and, in particular, of ApoC-III. There was a significant reduction in the levels of ApoE, especially in male patients. In comparison with type IV, hyperlipoproteinemic patients, CRF patients had lower concentrations of ApoA-I, Apo A-II, ApoB, ApoC-I and, particularly, ApoE; there was no difference in ApoC-III levels reflecting the hypertriglyceridemia common to both disorders. Similar but less marked differences were also found in comparison with type II diabetics. The findings suggest that in CRF, the accumulation of ApoC-III-enriched lipoprotein particles accompanied by a moderate hypertriglyceridemia may be caused more probably by an impaired catabolism than overproduction of triglyceride-rich lipoproteins. CRF patients with vascular disease tended to have higher serum concentrations of triglycerides, cholesterol and ApoB and lower ApoA-I/ApoC-III and ApoA-I/ApoB ratios than patients without vascular disease

Tuberculosis burden in an urban population: a cross sectional tuberculosis survey from Guinea Bissau

<p>Abstract</p> <p>Background</p> <p>Little is known about the prevalence of pulmonary tuberculosis (TB) in low income countries. We conducted a cross sectional survey for pulmonary TB and TB symptoms in Bissau, Guinea-Bissau, in an urban cohort with known HIV prevalence. TB surveillance in the area is routinely based on passive case finding.</p> <p>Methods</p> <p>Two cohorts were selected based on a previous HIV survey, but only 52.5% of those enrolled in the adult cohort had participated in the HIV survey. One cohort included all adults living in 384 randomly selected houses; in this cohort 8% (135/1687) were HIV infected. The other included individuals 50 years or older from all other houses in the study area; of these 11% (62/571) were HIV infected. Symptom screening was done through household visits using a standardised questionnaire. TB suspects were investigated with sputum smear microscopy and X-ray.</p> <p>Results</p> <p>In the adult cohort, we found 4 cases among 2989 individuals screened, giving a total TB prevalence of 134/100,000 (95% CI 36-342/100,000). In the >50 years cohort, we found 4 cases among 571 individuals screened, giving a total prevalence of 701/100,000 (191-1784/100.000). Two of the eight detected TB cases were unknown by the TB program. Of the total TB cases five were HIV uninfected while three had unknown HIV status. The prevalence of TB symptoms was 2.1% (63/2989) and 10.3% (59/571) in the two cohorts respectively.</p> <p>Conclusions</p> <p>In conclusion we found a moderately high prevalence of pulmonary TB and TB symptoms in the general population, higher among elderly individuals. By active case finding unknown cases were detected. Better awareness of TB and its symptoms needs to be promoted in low income settings.</p

Viral Findings in Adult Hematological Patients with Neutropenia

BACKGROUND: Until recently, viral infections in patients with hematological malignancies were concerns primarily in allogeneic hematopoietic stem cell transplant (HSCT) recipients. During the last years, changed treatment regimens for non-transplanted patients with hematological malignancies have had potential to increase the incidence of viral infections in this group. In this study, we have prospectively investigated the prevalence of a broad range of respiratory viruses in nasopharyngeal aspirate (NPA) as well as viruses that commonly reactivate after allogeneic HSCT. METHODOLOGY/PRINCIPAL FINDINGS: Patients with hematological malignancies and therapy induced neutropenia (n = 159) were screened regarding a broad range of common respiratory viruses in the nasopharynx and for viruses commonly detected in severely immunosuppressed patients in peripheral blood. Quantitative PCR was used for detection of viruses. A viral pathogen was detected in 35% of the patients. The detection rate was rather similar in blood (22%) and NPA (18%) with polyoma BK virus and rhinovirus as dominating pathogens in blood and NPA, respectively. Patients with chronic lymphocytic leukemia (CLL) (p<0.01) and patients with fever (p<0.001) were overrepresented in the virus-positive group. Furthermore, viral findings in NPA were associated with upper respiratory symptoms (URTS) (p<0.0001). CONCLUSIONS/SIGNIFICANCE: Both respiratory viral infections and low titers of viruses in blood from patients with neutropenia were common. Patients with CLL and patients with fever were independently associated to these infections, and viral findings in NPA were associated to URTS indicating active infection. These findings motivate further studies on viruses' impact on this patient category and their potential role as causative agents of fever during neutropenia

CD209 Genetic Polymorphism and Tuberculosis Disease

BACKGROUND: Tuberculosis causes significant morbidity and mortality worldwide, especially in sub-Saharan Africa. DC-SIGN, encoded by CD209, is a receptor capable of binding and internalizing Mycobacterium tuberculosis. Previous studies have reported that the CD209 promoter single nucleotide polymorphism (SNP)-336A/G exerts an effect on CD209 expression and is associated with human susceptibility to dengue, HIV-1 and tuberculosis in humans. The present study investigates the role of the CD209 -336A/G variant in susceptibility to tuberculosis in a large sample of individuals from sub-Saharan Africa. METHODS AND FINDINGS: A total of 2,176 individuals enrolled in tuberculosis case-control studies from four sub-Saharan Africa countries were genotyped for the CD209 -336A/G SNP (rs4804803). Significant overall protection against pulmonary tuberculosis was observed with the -336G allele when the study groups were combined (n = 914 controls vs. 1262 cases, Mantel-Haenszel 2 x 2 chi(2) = 7.47, P = 0.006, odds ratio = 0.86, 95%CI 0.77-0.96). In addition, the patients with -336GG were associated with a decreased risk of cavitory tuberculosis, a severe form of tuberculosis disease (n = 557, Pearson's 2x2 chi(2) = 17.34, P = 0.00003, odds ratio = 0.42, 95%CI 0.27-0.65). This direction of association is opposite to a previously observed result in a smaller study of susceptibility to tuberculosis in a South African Coloured population, but entirely in keeping with the previously observed protective effect of the -336G allele. CONCLUSION: This study finds that the CD209 -336G variant allele is associated with significant protection against tuberculosis in individuals from sub-Saharan Africa and, furthermore, cases with -336GG were significantly less likely to develop tuberculosis-induced lung cavitation. Previous in vitro work demonstrated that the promoter variant -336G allele causes down-regulation of CD209 mRNA expression. Our present work suggests that decreased levels of the DC-SIGN receptor may therefore be protective against both clinical tuberculosis in general and cavitory tuberculosis disease in particular. This is consistent with evidence that Mycobacteria can utilize DC-SIGN binding to suppress the protective pro-inflammatory immune response

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

Epidemiological aspects of tuberculosis in Guinea-Bissau, West Africa

Tuberculosis (TB) has plagued the humanity for several thousands of years. The bacteria causing TB is mainly spread from person to person as an aerosol transmission. It is estimated that one third of the world’s population is infected with the disease; about 10% of these will develop active TB during their lifetime. In year 2000, 8 million TB-cases were detected, of which 2 million died. Except for studies of the correlation between TB and HIV/AIDS, the epidemiology of TB in developing countries has been little investigated. The aims of this thesis have been to evaluate risk factors for positive tuberculin skin test (TST), which is the test for diagnosing TB infection, in the population and among TB-case household members, to assess incidence and risk factors for active TB, and to determine clinical predictors for death in TB patients. A study area in Bissau, the capital of Guinea-Bissau, with a population of about 43,000 has been followed through a demographic census system for over 25 years. In 1996, a TB surveillance system was set up in the area; all adults (age >15 years) with active TB within the chest were included. The background data from the census system allows analyses comparing TB-cases with the whole population. From 1996 to 2001 a total of 811 TB-cases were included and investigated. The risk of positive TST was closely related to previous or recent exposure to TB, and among the family members of the TB cases the extent of contact was important. BCG vaccination status did not confound the interpretation of the test. TST performed during the early rainy season, from June to August, resulted in smaller reactions, and testing during these months may confound the results. The incidence of active TB in the area was high; 471/100,000 for the adult population. Both HIV-1 and HIV-2 infection greatly increased the risk for TB, although the effect was considerably higher for HIV-1. Other independent risk factors for active TB corresponded well with factors believed to increase the risk also during the epidemic situation in Europe and USA during the 19th and the beginning of the 20th century: male sex, older age, poverty, less schooling and more adults in the family (adult crowding). Interestingly it seemed as if children had a protective influence; children in the household reduced the risk for TB among the adults. The mortality was increased for HIV-1-positive TB-cases, but also co-infection with HIV-2 increased the risk of death compared to HIV-negative. Signs of weakened immune function, such as oral candida infection, and malnutrition increased the risk of dying in both HIV-positive and HIV-negative patients. Estimating the degree of malnutrition using the mid-upper-arm circumference provided a good tool in the evaluation of increased risk for TB death. A civil war 1998-1999 caused involuntary treatment interruption among the patients which considerably increased the mortality, an effect that was most marked in HIV-positive. The increased mortality in HIV-positive TB-cases continued also after the war had ended