Outcomes of HIV-positive patients with renal insufficiency on treatment with HAART at Charlotte Maxeke Johannesburg Academic Hospital

MBBCH (Wits) FCP (SA)With the increasing use of HAART (Highly Active Antiretroviral Treatment), chronic kidney disease is becoming an increasingly important consideration for the clinician. In resource-limited settings like sub-Saharan Africa, predictors of outcome are important when deciding on the timing of HAART initiation. Methods The main objectives of this study included assessment of outcomes of HIV positive patients with chronic kidney disease (CKD) on HAART using mortality and changes in renal function and proteinuria over a one year period or longer; in addition, the impact of common co-morbid conditions and predictors of outcome were assessed. A retrospective study was done on 169 patients with CKD at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Group 1 (n = 87) were ART-naïve and had baseline pre-HAART initiation results available. Group 2 (n = 82) were on HAART prior to being referred to the HIV renal clinic. Results In Group 1, renal function improved from a median baseline eGFR of 20.8±SEM ml/min/1.73m² to 57.7±SEM ml/min/1.73m² (p<0.05) at 24 months. Median baseline proteinuria was 0.3±SEM g/mmol with a decrease to 0.08±SEM g/mmol at 24 months (p<0.05). In Group 2, the median time from initiation of HAART to presentation to HIV renal clinic was 25 months. Median baseline eGFR was 38.9±SEM ml/min/1.73m² with an increase to 47.3±SEM ml/min/1.73m² at 24 months (p=0.4256). Median baseline proteinuria was 3g±SEM g/mmol, with a decrease at 12 months to 1.1g±SEM g/mmol and subsequent increase to 0.21g±SEM g/mmol at 24 months. These findings suggest that renal function may plateau at around 24 months on HAART. HIV-associated nephropathy (HIVAN) and HIV immune complex disease (HIV-ICD) were the main histological findings and both improved with HAART. Factors associated with poor renal outcome were diabetes mellitus (OR 4.24, CI 1.02-17.5) (p 0.04) and lower starting eGFR (OR 1.01, CI 1-1.02) (p0.017). Conclusions Initiating HAART before severe renal dysfunction has developed improves renal outcomes and reduces the burden of HIV CKD

International Journal of Applied Behavioral Sciences (IJABS)volume 7number 3Summer2020. Journals. smbu.ac.ir/ijabs 47 Effect of Cognitive-Behavioral Therapy (CBT) and Transcranial Direct Current Stimulation (tDCS) on Body Mass Index and Self-Control in Ov

Introduction: Considering the growing trend of overweight and its risk, it is necessary to find useful solutions for weight loss. Usually overweight people are involved in several treatment programs that have decent short-term effects, but the symptoms might be relapsed in long term. The purpose of this study was to compare the effectiveness of Cognitive-Behavioral Therapy (CBT) and transcranial Direct Current Stimulation (tDCS) on reducing body mass index and increase self-control in overweight women.Methods: This is a quasi-experimental study with pretest- posttest design and follow-up. The statistical population of this study included all overweight women referring to the Nutrition Clinic of Shahid Beheshti University of Medical Sciences. The sample consisted of 30 females selected by purposeful sampling method and were randomly assigned to two experimental groups. In this study, BMI was used to assess overweight and Tangney self-control scale was used for self-control.Results: The findings indicated that the self-control in the participants in the cognitive-behavioral group were more improved in comparison to transcranial Direct Current Stimulation group (p,0.05), while tDCS was more effective than CBT on improving body mass index.Conclusion: In general, cognitive-behavioral therapy and transcranial Direct Current Stimulation with effect on the area of the brain that is associate with control perception lead to increased self-control, decreased craving and BMI

Application of Fluorescent Nuclear Track Detectors for Cellular Dosimetry in Ion Beam Radiotherapy

Ion beam radiotherapy (IBRT) offers a more conformal dose distribution and an enhanced relative biological effectiveness (RBE) in the Bragg peak region as compared to conventional photon therapy. This enhanced RBE is due to the highly localized energy deposition pattern of ion beams, which due to its stochastic nature, is subject to large fluctuations on cellular and sub-cellular scales, resulting in a large variation of biological response in cells exposed to the same beam.Therefore, a cell hybrid detector capable of quantifying local energy deposition at such microscopic scales and correlating it to a biological response is highly desirable. For this purpose, Fluorescent Nuclear Track Detectors (FNTDs) covered with cells have been shown to be an effective cell-hybrid detector, as they can provide information on individual cellular energy deposition with the ability to directly visualize cellular response. In this thesis, a new framework, referred to as the "Cell Dose" model, was established to define dosimetric quantities relevant for quantifying energy deposition at sub-cellular scales, that can be measured with FNTDs as a model detector: specific dose and specific LET. When energy deposition inside the cell nuclei is of interest, the "Cell Dose" quantities can complement the microdosimetric and macroscopic quantities as intermediate quantities between the two. The theoretical framework includes a sampling method that incorporates uncertainties due to five different sources of variations: cross-sectional area of the nuclei, number of particles entering the cell nucleus, the chord lengths of the particles inside the cell nucleus, the linear energy transfer (LET) of the individual particle, and the energy loss straggling of the particles inside the cell nucleus. The distribution of the new dosimetric terms specific dose and specific LET in the cell-wide population was studied for different ions and energies at different depths of their depth-dose profiles, and the individual contribution of these different sources was assessed. The results indicated that there is a great variation (24-55 %) in terms of energy deposition in the cell nuclei, with LET variation of the particles as the major contributor. It was shown that with the use of microscopy and FNTDs, the uncertainty in measurement can potentially be reduced down to only 4-14 %. Furthermore, these dosimetric quantities were compared to experimental results with FNTDs which indicated the possibility of correlating the physical parameters, obtained from FNTDs, to different biological response parameters. With additional improvements and studies, the new "Cell Dose" model may be a valuable tool in radiobiological studies with ion beams, as it can provide valuable information to better understand the underlying physical nature of ion beams in producing cellular response

Augmenting the performance of image similarity search through crowdsourcing

Crowdsourcing is defined as “outsourcing a task that is traditionally performed by an employee to a large group of people in the form of an open call” (Howe 2006). Many platforms designed to perform several types of crowdsourcing and studies have shown that results produced by crowds in crowdsourcing platforms are generally accurate and reliable. Crowdsourcing can provide a fast and efficient way to use the power of human computation to solve problems that are difficult for machines to perform. From several different microtasking crowdsourcing platforms available, we decided to perform our study using Amazon Mechanical Turk. In the context of our research we studied the effect of user interface design and its corresponding cognitive load on the performance of crowd-produced results. Our results highlighted the importance of a well-designed user interface on crowdsourcing performance. Using crowdsourcing platforms such as Amazon Mechanical Turk, we can utilize humans to solve problems that are difficult for computers, such as image similarity search. However, in tasks like image similarity search, it is more efficient to design a hybrid human–machine system. In the context of our research, we studied the effect of involving the crowd on the performance of an image similarity search system and proposed a hybrid human–machine image similarity search system. Our proposed system uses machine power to perform heavy computations and to search for similar images within the image dataset and uses crowdsourcing to refine results. We designed our content-based image retrieval (CBIR) system using SIFT, SURF, SURF128 and ORB feature detector/descriptors and compared the performance of the system using each feature detector/descriptor. Our experiment confirmed that crowdsourcing can dramatically improve the CBIR system performance

Network reconstruction of platelet metabolism identifies metabolic signature for aspirin resistance.

Recently there has not been a systematic, objective assessment of the metabolic capabilities of the human platelet. A manually curated, functionally tested, and validated biochemical reaction network of platelet metabolism, iAT-PLT-636, was reconstructed using 33 proteomic datasets and 354 literature references. The network contains enzymes mapping to 403 diseases and 231 FDA approved drugs, alluding to an expansive scope of biochemical transformations that may affect or be affected by disease processes in multiple organ systems. The effect of aspirin (ASA) resistance on platelet metabolism was evaluated using constraint-based modeling, which revealed a redirection of glycolytic, fatty acid, and nucleotide metabolism reaction fluxes in order to accommodate eicosanoid synthesis and reactive oxygen species stress. These results were confirmed with independent proteomic data. The construction and availability of iAT-PLT-636 should stimulate further data-driven, systems analysis of platelet metabolism towards the understanding of pathophysiological conditions including, but not strictly limited to, coagulopathies

γ-Ray Pre-Irradiated Grafting of Polytetrafluoroethylene Film Membrane

YesThe changes induced by γ-ray pre-irradiated grafting of polytetrafluoroethylene (PTFE) with alkalo-amines such as Monoethanolamine (MEA), Diethanolamine (DEA) and Methyldiethanolamine (MDEA) solvents were investigated. Samples of the commercially available fluoropolymer, i.e. PTFE film membranes were irradiated with 60Co source γ-radiation with absorbed doses of 30 to 90 kGy. Effects of the grafting conditions of the amines onto the pre-irradiated PTFE, such as grafting time, reaction temperature and pre-irradiation doses on the resulting grafting yield are reported. The grafted PTFE was characterized by the FT-IR spectroscopy and FESEM.The gravimeteric analysis showed that the maximum grafting yield obtained is 2.9% for the 30 kGy irradiated MDEA grafted PTFE (MDEA-g-PTFE) at 10 min grafting time. However, at 60 min grafting time the maximum grafting yield reduced to 1.05% for the same sample. Consequently, therefore, for the low dose γ-ray pre-irradiated samples, the effects of applied dose and grafting time were found to be remarkably insignificant