A Descriptive Exploratory Study of the Experience of Gay Partners of HIV-Positive Men

HIV disease/AIDS has been the focus of much research since its introduction in 1981 and continues to have profound implications for those living with the disease and for those who are in close social relationships with them. One group that has received minimal attention in the HIV/AIDS literature is gay partners of HIV infected men. The aim of this study was to explore and describe the experiences of gay men living with a life partner who has HIV disease/AIDS who were not primary caregivers. A qualitative study using an interpretive descriptive approach was employed to study the experiences of ten gay men whose partner had HIV disease/AIDS. The study was conducted in a large urban area in one of the western states within the USA, using a purposeful convenience sample. An unstructured interview process was utilized, the interviews transcribed verbatim, analyzed, and themes and patterns developed into a professional narrative conveying the most important findings focusing on clinical implications for nursing practice. Significant findings that emerged from analysis of the study data included: (a) issues of disclosure of HIV serostatus both within and outside of the relationship; (b) influences on daily life including the impact on day-to-day routines and plans, effective coping, perceptions of the future of the relationship, and ways in which the relationship had been enhanced; and (e) perceptions of the healthcare system including care by physicians and care by nurses. Implications for nursing practice included: (a) acknowledgement by the nurse of the role and importance of the participant in the lives of their HIV-positive partner is crucial in establishing rapport and developing a family-centered approach to care; (b) the need to combat the notions of homophobia and heterosexism by introducing the needs of this vulnerable population in early nursing curricula; (e) the ongoing need for education regarding HIV transmission; (d) assisting the study participants in identifying and implementing effective coping interventions by providing emotional support and by including them in their partner\u27s care; (e) assisting the participant in identifying and developing skills and behaviors that will better allow them to normalize their lives; and (f) recognition that these participants may need increased community resources to assist in coping as well as integrating into the community as a whole. The results of the study suggest that even though societal views on gay relationships are changing, issues regarding secondary stigma, disclosure, health, and support and education from the healthcare community continue to impact gay men and their partners

Left-right symmetry at LHC and precise 1-loop low energy data

Despite many tests, even the Minimal Manifest Left-Right Symmetric Model (MLRSM) has never been ultimately confirmed or falsified. LHC gives a new possibility to test directly the most conservative version of left-right symmetric models at so far not reachable energy scales. If we take into account precise limits on the model which come from low energy processes, like the muon decay, possible LHC signals are strongly limited through the correlations of parameters among heavy neutrinos, heavy gauge bosons and heavy Higgs particles. To illustrate the situation in the context of LHC, we consider the "golden" process $pp \to e^+ N$. For instance, in a case of degenerate heavy neutrinos and heavy Higgs masses at 15 TeV (in agreement with FCNC bounds) we get $\sigma(pp \to e^+ N)>10$ fb at $\sqrt{s}=14$ TeV which is consistent with muon decay data for a very limited $W_2$ masses in the range (3008 GeV, 3040 GeV). Without restrictions coming from the muon data, $W_2$ masses would be in the range (1.0 TeV, 3.5 TeV). Influence of heavy Higgs particles themselves on the considered LHC process is negligible (the same is true for the light, SM neutral Higgs scalar analog). In the paper decay modes of the right-handed heavy gauge bosons and heavy neutrinos are also discussed. Both scenarios with typical see-saw light-heavy neutrino mixings and the mixings which are independent of heavy neutrino masses are considered. In the second case heavy neutrino decays to the heavy charged gauge bosons not necessarily dominate over decay modes which include only light, SM-like particles.Comment: 16 pages, 10 figs, KL-KS and new ATLAS limits taken into accoun

Human Bocavirus NS1 and NS1-70 Proteins Inhibit TNF-α-Mediated Activation of NF-κB by targeting p65.

Human bocavirus (HBoV), a parvovirus, is a single-stranded DNA etiologic agent causing lower respiratory tract infections in young children worldwide. Nuclear factor kappa B (NF-κB) transcription factors play crucial roles in clearance of invading viruses through activation of many physiological processes. Previous investigation showed that HBoV infection could significantly upregulate the level of TNF-α which is a strong NF-κB stimulator. Here we investigated whether HBoV proteins modulate TNF-α-mediated activation of the NF-κB signaling pathway. We showed that HBoV NS1 and NS1-70 proteins blocked NF-κB activation in response to TNF-α. Overexpression of TNF receptor-associated factor 2 (TRAF2)-, IκB kinase alpha (IKKα)-, IκB kinase beta (IKKβ)-, constitutively active mutant of IKKβ (IKKβ SS/EE)-, or p65-induced NF-κB activation was inhibited by NS1 and NS1-70. Furthermore, NS1 and NS1-70 didn't interfere with TNF-α-mediated IκBα phosphorylation and degradation, nor p65 nuclear translocation. Coimmunoprecipitation assays confirmed the interaction of both NS1 and NS1-70 with p65. Of note, NS1 but not NS1-70 inhibited TNF-α-mediated p65 phosphorylation at ser536. Our findings together indicate that HBoV NS1 and NS1-70 inhibit NF-κB activation. This is the first time that HBoV has been shown to inhibit NF-κB activation, revealing a potential immune-evasion mechanism that is likely important for HBoV pathogenesis

Diagnostic difficulties of Lactobacillus casei bacteraemia in immunocompetent patients: A case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

A methodology for the risk assessment of climate variability and change under uncertainty

Existing methods for the assessment of the potential impacts of climate change in productive activities and sectors are usually limited to point estimates that do not consider the inherent variability and uncertainty of climatic and socioeconomic variables. This is a major drawback given that only a limited and potentially misleading estimation of risk can be expected when ignoring such determinant factors. In this paper, a new methodology is introduced that is capable of integrating the agent's beliefs and expert judgment into the assessment of the potential impacts of climate change in a quantitative manner by means of an objective procedure. The goal is to produce tailor-made information to assist decision-making under uncertainty in a way that is consistent with the current state of knowledge and the available subjective "expert" information. Time-charts of the evolution of different risk measures, that can be relevant for assisting decision-making and planning, can be constructed using this new methodology. This methodology is illustrated with a case study of coffee production in Mexico. Time-dependent probabilistic scenarios for coffee production and income, conditional on the agent's beliefs and expert judgment, are developed for the average producer under uncertain future conditions. It is shown that variability in production and income, generated by introducing climate variability and uncertainty are important factors affecting decision-making and the assessment of economic viability that are frequently ignored. The concept of Value at Risk, commonly applied in financial risk management, is introduced as a means for estimating the maximum expected loss for a previously chosen confidence level. Results are tailor-made for agents that have incomplete information and different beliefs. In this case study, the costs of climate change for coffee production in Veracruz are estimated to have a present value representing from 3 to 14 times the current annual value of coffee production in the state. © 2011 The Author(s)

Limitations of the MELD score in predicting mortality or need for removal from waiting list in patients awaiting liver transplantation

<p>Abstract</p> <p>Background</p> <p>Decompensated cirrhosis is associated with a poor prognosis and liver transplantation provides the only curative treatment option with excellent long-term results. The relative shortage of organ donors renders the allocation algorithms of organs essential. The optimal strategy based on scoring systems and/or waiting time is still under debate.</p> <p>Methods</p> <p>Data sets of 268 consecutive patients listed for single-organ liver transplantation for nonfulminant liver disease between 2003 and 2005 were included into the study. The Model for End-Stage Liver Disease (MELD) and Child-Turcotte-Pugh (CTP) scores of all patients at the time of listing were used for calculation. The predictive ability not only for mortality on the waiting list but also for the need for withdrawal from the waiting list was calculated for both scores. The Mann-Whitney-U Test was used for the univariate analysis and the AUC-Model for discrimination of the scores.</p> <p>Results</p> <p>In the univariate analysis comparing patients who are still on the waiting list and patients who died or were removed from the waiting list due to poor conditions, the serum albumin, bilirubin INR, and CTP and MELD scores as well as the presence of ascites and encephalopathy were significantly different between the groups (p < 0.05), whereas serum creatinine and urea showed no difference.</p> <p>Comparing the predictive abilities of CTP and MELD scores, the best discrimination between patients still alive on the waiting list and patients who died on or were removed from the waiting list was achieved at a CTP score of ≥9 and a MELD score of ≥14.4. The sensitivity and specificity to identify mortality or severe deterioration for CTP was 69.0% and 70.5%, respectively; for MELD, it was 62.1% and 72.7%, respectively. This result was supported by the AUC analysis showing a strong trend for superiority of CTP over MELD scores (AUROC 0.73 and 0.68, resp.; p = 0.091).</p> <p>Conclusion</p> <p>The long term prediction of mortality or removal from waiting list in patients awaiting liver transplantation might be better assessed by the CTP score than the MELD score. This might have implications for the development of new improved scoring systems.</p

Incentive or Habit Learning in Amphibians?

Toads (Rhinella arenarum) received training with a novel incentive procedure involving access to solutions of different NaCl concentrations. In Experiment 1, instrumental behavior and weight variation data confirmed that such solutions yield incentive values ranging from appetitive (deionized water, DW, leading to weight gain), to neutral (300 mM slightly hypertonic solution, leading to no net weight gain or loss), and aversive (800 mM highly hypertonic solution leading to weight loss). In Experiment 2, a downshift from DW to a 300 mM solution or an upshift from a 300 mM solution to DW led to a gradual adjustment in instrumental behavior. In Experiment 3, extinction was similar after acquisition with access to only DW or with a random mixture of DW and 300 mM. In Experiment 4, a downshift from DW to 225, 212, or 200 mM solutions led again to gradual adjustments. These findings add to a growing body of comparative evidence suggesting that amphibians adjust to incentive shifts on the basis of habit formation and reorganization

Physics, Astrophysics and Cosmology with Gravitational Waves

Gravitational wave detectors are already operating at interesting sensitivity levels, and they have an upgrade path that should result in secure detections by 2014. We review the physics of gravitational waves, how they interact with detectors (bars and interferometers), and how these detectors operate. We study the most likely sources of gravitational waves and review the data analysis methods that are used to extract their signals from detector noise. Then we consider the consequences of gravitational wave detections and observations for physics, astrophysics, and cosmology.Comment: 137 pages, 16 figures, Published version <http://www.livingreviews.org/lrr-2009-2