Damaged Intestinal Epithelial Integrity Linked to Microbial Translocation in Pathogenic Simian Immunodeficiency Virus Infections

The chronic phase of HIV infection is marked by pathological activation of the immune system, the extent of which better predicts disease progression than either plasma viral load or CD4+ T cell count. Recently, translocation of microbial products from the gastrointestinal tract has been proposed as an underlying cause of this immune activation, based on indirect evidence including the detection of microbial products and specific immune responses in the plasma of chronically HIV-infected humans or SIV-infected Asian macaques. We analyzed tissues from SIV-infected rhesus macaques (RMs) to provide direct in situ evidence for translocation of microbial constituents from the lumen of the intestine into the lamina propria and to draining and peripheral lymph nodes and liver, accompanied by local immune responses in affected tissues. In chronically SIV-infected RMs this translocation is associated with breakdown of the integrity of the epithelial barrier of the gastrointestinal (GI) tract and apparent inability of lamina propria macrophages to effectively phagocytose translocated microbial constituents. By contrast, in the chronic phase of SIV infection in sooty mangabeys, we found no evidence of epithelial barrier breakdown, no increased microbial translocation and no pathological immune activation. Because immune activation is characteristic of the chronic phase of progressive HIV/SIV infections, these findings suggest that increased microbial translocation from the GI tract, in excess of capacity to clear the translocated microbial constituents, helps drive pathological immune activation. Novel therapeutic approaches to inhibit microbial translocation and/or attenuate chronic immune activation in HIV-infected individuals may complement treatments aimed at direct suppression of viral replication

ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Writing Committee to revise the ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices)

This revision of the “ACC/AHA/NASPE Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices” updates the previous versions published in 1984, 1991, 1998, and 2002. Revision of the statement was deemed necessary for multiple reasons: 1) Major studies have been reported that have advanced our knowledge of the natural history of bradyarrhythmias and tachyarrhythmias, which may be treated optimally with device therapy; 2) there have been tremendous changes in the management of heart failure that involve both drug and device therapy; and 3) major advances in the technology of devices to treat, delay, and even prevent morbidity and mortality from bradyarrhythmias, tachyarrhythmias, and heart failure have occurred

U. S. Marines in Iraq, 2004-2005 : into the fray /

Almost as soon as Saddam Hussein's regime collapsed in 2003, it became apparent to U.S. commanders that a second deployment of Marines to Iraq would be necessary to conduct security and stability operations. This monograph recounts the first two years of this second deployment during which Marines were responsible for Iraq's cast al-Anbar Province. It focuses on I Marine's Expeditionary Force's deployment in 2004 and II Marine Expeditionary Force's deployment in 2005, and focuses on planning, counterinsurgency operations, and efforts to build civil-military relations with the Iraqi population. The first and second battles of Fallujah and the battle of an-Najaf are also highlighted.Shipping list no.: 2011-0371-P.Includes bibliographical references and index.Foreword -- Preface -- The return to Iraq -- The deployment -- Early operations in Al-Anbar Province -- The first Al-Fallujah battle and its aftermath -- The second Al-Fallujah battle -- Optimism and doubt -- The mission continues -- Into the fray -- Protecting self-rule -- Protecting the emerging Iraq -- Continuous operations -- Redeployment and relief -- Epilogue : new and old.Almost as soon as Saddam Hussein's regime collapsed in 2003, it became apparent to U.S. commanders that a second deployment of Marines to Iraq would be necessary to conduct security and stability operations. This monograph recounts the first two years of this second deployment during which Marines were responsible for Iraq's cast al-Anbar Province. It focuses on I Marine's Expeditionary Force's deployment in 2004 and II Marine Expeditionary Force's deployment in 2005, and focuses on planning, counterinsurgency operations, and efforts to build civil-military relations with the Iraqi population. The first and second battles of Fallujah and the battle of an-Najaf are also highlighted.Mode of access: Internet

The Influence of Averaging and Noisy Decision Strategies on the Recognition Memory ROC

Many single- and dual-process models of recognition memory predict that the ratings and remember-know receiver operating characteristics (ROCs) are the same, but Rotello, Macmillan, and Reeder (2004) reported that the slopes of the remember-know and ratingsz-transformed ROCs (zROCs) are different. The authors show that averaging introduces nonlinearities to the form of thezROC and that ratings and remember-knowzROCs are indistinguishable when constructed in a conventional manner. The authors show, further, that some nonoptimal decision strategies have a distinctive, nonlinear effect on the form of the single-process continuous-statezROC. The conclusion is that many factors having nothing to do with the nature of recognition memory can affect the shape ofzROCs, and that therefore, the shape of thezROC does not, alone, characterize different memory models