Cortisol patterns are associated with T cell activation in HIV.

ObjectiveThe level of T cell activation in untreated HIV disease is strongly and independently associated with risk of immunologic and clinical progression. The factors that influence the level of activation, however, are not fully defined. Since endogenous glucocorticoids are important in regulating inflammation, we sought to determine whether less optimal diurnal cortisol patterns are associated with greater T cell activation.MethodsWe studied 128 HIV-infected adults who were not on treatment and had a CD4(+) T cell count above 250 cells/µl. We assessed T cell activation by CD38 expression using flow cytometry, and diurnal cortisol was assessed with salivary measurements.ResultsLower waking cortisol levels correlated with greater T cell immune activation, measured by CD38 mean fluorescent intensity, on CD4(+) T cells (r = -0.26, p = 0.006). Participants with lower waking cortisol also showed a trend toward greater activation on CD8(+) T cells (r = -0.17, p = 0.08). A greater diurnal decline in cortisol, usually considered a healthy pattern, correlated with less CD4(+) (r = 0.24, p = 0.018) and CD8(+) (r = 0.24, p = 0.017) activation.ConclusionsThese data suggest that the hypothalamic-pituitary-adrenal (HPA) axis contributes to the regulation of T cell activation in HIV. This may represent an important pathway through which psychological states and the HPA axis influence progression of HIV

Human Immunodeficiency Virus (HIV)-Infected CCR6+ Rectal CD4+ T Cells and HIV Persistence On Antiretroviral Therapy.

BackgroundIdentifying where human immunodeficiency virus (HIV) persists in people living with HIV and receiving antiretroviral therapy is critical to develop cure strategies. We assessed the relationship of HIV persistence to expression of chemokine receptors and their chemokines in blood (n = 48) and in rectal (n = 20) and lymph node (LN; n = 8) tissue collected from people living with HIV who were receiving suppressive antiretroviral therapy.MethodsCell-associated integrated HIV DNA, unspliced HIV RNA, and chemokine messenger RNA were quantified by quantitative polymerase chain reaction. Chemokine receptor expression on CD4+ T cells was determined using flow cytometry.ResultsIntegrated HIV DNA levels in CD4+ T cells, CCR6+CXCR3+ memory CD4+ T-cell frequency, and CCL20 expression (ligand for CCR6) were highest in rectal tissue, where HIV-infected CCR6+ T cells accounted for nearly all infected cells (median, 89.7%). Conversely in LN tissue, CCR6+ T cells were infrequent, and there was a statistically significant association of cell-associated HIV DNA and RNA with CCL19, CCL21, and CXCL13 chemokines.ConclusionsHIV-infected CCR6+ CD4+ T cells accounted for the majority of infected cells in rectal tissue. The different relationships between HIV persistence and T-cell subsets and chemokines in rectal and LN tissue suggest that different tissue-specific strategies may be required to eliminate HIV persistence and that assessment of biomarkers for HIV persistence may not be generalizable between blood and other tissues

Cytomegalovirus-Specific T Cells Persist at Very High Levels during Long-Term Antiretroviral Treatment of HIV Disease

Background: In healthy, HIV seronegative, CMV seropositive adults, a large proportion of T cells are CMV-specific. High-level CMV-specific T cell responses are associated with accelerated immunologic aging (‘‘immunosenesence’’) in the elderly population. The impact of untreated and treated HIV infection on the frequency of these cells remains undefined. Methodology/Principal Findings: We measured the proportion of CD4+ and CD8+ T cells responding to CMV pp65 and IE proteins was measured using flow cytometry in 685 unique HIV seronegative and seropositive individuals. The proportion of CMV-specific CD8+ T cells was consistently higher in the HIV-seropositive subjects compared to the HIV-seronegative subjects. This HIV effect was observed even in patients who lacked measurable immunodeficiency. Among the HIV-seropositive subjects, CMV-specific CD8+ T cell responses were proportionately lower during recent infection, higher during chronic untreated infection and higher still during long-term antiretroviral treated infection. The CD8+ T cell response to just two CMV proteins (pp65 and IE) was approximately 6% during long-term therapy, which was over twice that seen in HIV-seronegative persons. CMV-specific CD4+ T cell responses followed the same trends, but the magnitude of the effect was smaller. Conclusions/Significance: Long-term successfully treated HIV infected patients have remarkably high levels of CMV-specific effector cells. These levels are similar to that observed in the elderly, but occur at much younger ages. Future studies should focus on defining the potential role of the CMV-specific inflammatory response in non-AIDS morbidity and mortality, including immunosenescence

MRI safety and devices: An update and expert consensus

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154533/1/jmri26909_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154533/2/jmri26909.pd

Hematopoietic Cell Transplant and Use of Massage for Improved Symptom Management: Results from a Pilot Randomized Control Trial

Background. Pediatric hematopoietic cell transplant (HCT) is a lifesaving treatment that often results in physical and psychological discomfort. An acupressure-massage intervention may improve symptom management in this setting. Methods. This randomized controlled pilot trial compared a combined massage-acupressure intervention to usual care. Children were offered three practitioner-provided sessions per week throughout hospitalization. Parents were trained to provide additional acupressure as needed. Symptoms were assessed using nurses' reports and two questionnaires, the behavioral affective and somatic experiences scale and the Peds quality of life cancer module. Results. We enrolled 23 children, ages 5 to 18. Children receiving the intervention reported fewer days of mucositis (Hedges' g effect size ES = 0.63), lower overall symptom burden (ES = 0.26), feeling less tired and run-down (ES = 0.86), having fewer moderate/severe symptoms of pain, nausea, and fatigue (ES = 0.62), and less pain (ES = 0.42). The intervention group showed trends toward increasing contentness/serenity (ES = +0.50) and decreasing depression (ES = −0.45), but not decreased anxiety (ES = +0.42). Differences were not statistically significant. Discussion. Feasibility of studying massage-acupressure was established in children undergoing HCT. Larger studies are needed to test the efficacy of such interventions in reducing HCT-associated symptoms in children

Novos catalisadores a base de argilas para a produção do biodiesel.

Nas últimas décadas uma quantidade substancial de pesquisas foi realizada a fim de encontrar novas fontes de energia renovável e sustentável para substituir o diesel de petróleo. Uma fonte alternativa promissora de energia é o biodiesel, que é um combustível renovável que pode ser produzido a partir dos óleos e gorduras animais/vegetais ou mesmo ácidos graxos reciclados da indústria de alimentos. Os catalisadores heterogêneos podem melhorar os métodos de síntese eliminando os custos adicionais associados aos catalisadores homogêneos e minimizando a produção de poluentes. As argilas ativadas têm atraído atenção como catalisadores para uma variedade de reações ácidas. O comportamento físico-químico dos minerais argilosos tem sido estudado devido a sua relação como adsorvente e/ou propriedades catalíticas. Diante do exposto verifica-se a necessidade de desenvolver estudos sobre a utilização de argilas como catalisador na produção do biodiesel, tornando-se, portanto, fundamental conhecer a estabilidade e propriedades do biodiesel produzido a partir desses catalisadores. Visando avaliar a eficiência das argilas como catalisadores no processo de transesterificação deste combustível, foram estudados nesse trabalho 27 tipos de argilas, fornecidas pela empresa BENTONISA- Bentonita do Nordeste S.A, para produção do biodiesel na rota etílica e metílica, utilizando óleo de soja. Inicialmente foi realizada uma pré-seleção das argilas, utilizando as análises de umidade e pH, onde foram escolhidos 15 tipos de amostras, as mesmas foram submetidas a ensaios nos sistemas reacionais S1 e S2 e utilizando as técnicas de cor do óleo (aspecto visual) e viscosidade, optou-se pelos dois melhores catalisadores argilosos (A23 e A24) a serem testados no sistema padrão para produção do biodiesel, denominado S3. Os catalisadores A23 e A24 foram caracterizados por : fluorescência de raios-X (FRX); difração de raios-X (DRX); espectroscopia de absorção no infravermelho (IV); microscopia eletrônica de varredura (MEV); energia dispersiva de raios-X (EDS) e área específica pelo método BET. O óleo de soja e o biodiesel formado foram caracterizados através das seguintes técnicas: composição química, umidade, acidez, densidade 20ºC, glicerol total e viscosidade 40ºC, teor de éster, teor de álcool e cromatografia gasosa. Os resultados mostraram que é possível obter o biodiesel a partir de catalisadores argilosos.In the last decades a substantial amount of research has been undertaken to find new sources of renewable and sustainable energy to replace Diesel. A promising alternative energy source is biodiesel, which is a renewable fuel produced from vegetable oils and animal fats or even from recycled fat from the food industry. Heterogeneous catalysts can improve the synthesis methods eliminating additional costs associated with the homogeneous catalysts and minimizing the production of pollutants. Activated clays have attracted attention as catalysts for a variety of acid reactions. The physical and chemical behavior of clay minerals has been studied because of their property as adsorbent and / or catalysts. Therefore the need to develop studies on the use of clays as a catalyst in the production of biodiesel, making it, therefore, necessary to know the stability and properties of biodiesel produced by these catalysts. To evaluate the efficiency of clays as catalysts in the transesterification process of this fuel, 27 types of clay supplied by the company BENTONISA- Bentonite Nordeste SA, were studied in this work. The biodiesel was produced on the ethyl and methyl route, using soybean oil as raw material. The initial preselection for the clays was carried out on moisture and pH analysis, whereby 15 samples were selected. These were submitted to the testing systems in the S1 and S2, using the techniques of oil color (visual aspect) and viscosity. The two best clay catalysts (A23 and A24) were chosen to be tested in the standard system for production of biodiesel called S3. The catalysts A23 and A24 were characterized by: FRX; XRD; IR, SEM, EDS and BET. The soybean oil and biodiesel were characterized by the following techniques: chemical composition, moisture, acidity, density 20ºC, viscosity 40ºC, total glycerol, ester content, alcohol content and gas chromatography. The results showed that it is possible to get biodiesel from clay catalysts

Machine learning in cardiovascular radiology:ESCR position statement on design requirements, quality assessment, current applications, opportunities, and challenges

Machine learning offers great opportunities to streamline and improve clinical care from the perspective of cardiac imagers, patients, and the industry and is a very active scientific research field. In light of these advances, the European Society of Cardiovascular Radiology (ESCR), a non-profit medical society dedicated to advancing cardiovascular radiology, has assembled a position statement regarding the use of machine learning (ML) in cardiovascular imaging. The purpose of this statement is to provide guidance on requirements for successful development and implementation of ML applications in cardiovascular imaging. In particular, recommendations on how to adequately design ML studies and how to report and interpret their results are provided. Finally, we identify opportunities and challenges ahead. While the focus of this position statement is ML development in cardiovascular imaging, most considerations are relevant to ML in radiology in general. KEY POINTS: • Development and clinical implementation of machine learning in cardiovascular imaging is a multidisciplinary pursuit. • Based on existing study quality standard frameworks such as SPIRIT and STARD, we propose a list of quality criteria for ML studies in radiology. • The cardiovascular imaging research community should strive for the compilation of multicenter datasets for the development, evaluation, and benchmarking of ML algorithms

Endometrial carcinoma, grossing and processing issues: recommendations of the International Society of Gynecologic Pathologists.

Endometrial cancer is the most common gynecologic neoplasm in developed countries; however, updated universal guidelines are currently not available to handle specimens obtained during the surgical treatment of patients affected by this disease. This article presents recommendations on how to gross and submit sections for microscopic examination of hysterectomy specimens and other tissues removed during the surgical management of endometrial cancer such as salpingo-oophorectomy, omentectomy, and lymph node dissection-including sentinel lymph nodes. In addition, the intraoperative assessment of some of these specimens is addressed. These recommendations are based on a review of the literature, grossing manuals from various institutions, and a collaborative effort by a subgroup of the Endometrial Cancer Task Force of the International Society of Gynecological Pathologists. The aim of these recommendations is to standardize the processing of endometrial cancer specimens which is vital for adequate pathological reporting and will ultimately improve our understanding of this disease