In-hospital outcomes of premature infants with severe bronchopulmonary dysplasia

To characterize in-hospital outcomes of premature infants diagnosed with severe bronchopulmonary dysplasia

Odyssey 2 : A mission toward Neptune and Triton to test General Relativity

Odyssey 2 will be proposed in December 2010 for the next call of M3 missions for Cosmic Vision 2015-2025. This mission, under a Phase 0 study performed by CNES, will aim at Neptune and Triton. Two sets of objectives will be pursued. The first one is to perform a set of gravitation experiments at the Solar System scale. Experimental tests of gravitation have always shown good agreement with General Relativity. There are however drivers to continue testing General Relativity, and to do so at the largest possible scales. From a theoretical point of view, Einstein's theory of gravitation shows inconsistencies with a quantum description of Nature and unified theories predict deviations from General Relativity. From an observational point of view, as long as dark matter and dark energy are not observed through other means than their gravitational effects, they can be considered as a manifestation of a modification of General Relativity at cosmic scales. The scientific objectives are to: (i) test the gravitation law at the Solar System scale; (ii) measure the Eddington parameter; and (iii) investigate the navigation anomalies during fly-bys. To fulfil these objectives, the following components are to be on board the spacecraft: (i) the Gravity Advanced Package (GAP), which is an electrostatic accelerometer to which a rotating stage is added; (ii) radio-science; (iii) laser ranging, to improve significantly the measure of the Eddington parameter. The second set of objectives is to enhance our knowledge of Neptune and Triton. Several instruments dedicated to planetology are foreseen: camera, spectrometer, dust and particle detectors, and magnetometer. Depending on the ones kept, the mission could provide information on the gravity field, the atmosphere and the magnetosphere of the two bodies as well as on the surface geology of Triton and on the nature of the planetary rings around Neptune.Comment: 61st International Astronautical Congress (Prague, Czech Republic - September 2010), 7 page

The Associations of Regional Adipose Tissue With Lipid and Lipoprotein Levels in HIV-Infected Men

HIV infection and antiretroviral therapy are associated with dyslipidemia, but the association between regional adipose tissue depots and lipid levels is not defined

Increasing JAK/STAT Signaling Function of Infant CD4+ T Cells during the First Year of Life

Most infant deaths occur in the first year of life. Yet, our knowledge of immune development during this period is scarce and derived from cord blood (CB) only. To more effectively combat pediatric diseases, a deeper understanding of the kinetics and the factors that regulate the maturation of immune functions in early life is needed. Increased disease susceptibility of infants is generally attributed to T helper 2-biased immune responses. The differentiation of CD4+ T cells along a specific T helper cell lineage is dependent on the pathogen type, and on costimulatory and cytokine signals provided by antigen-presenting cells. Cytokines also regulate many other aspects of the host immune response. Therefore, toward the goal of increasing our knowledge of early immune development, we defined the temporal development of the Janus kinase (JAK)/signal transducers and activators of transcription (STAT) signaling function of CD4+ T cells using cross-sectional blood samples from healthy infants ages 0 (birth) to 14 months. We specifically focused on cytokines important in T cell differentiation (IFN-γ, IL-12, and IL-4) or in T cell survival and expansion (IL-2 and IL-7) in infant CD4+ T cells. Independent of the cytokine tested, JAK/STAT signaling in infant compared to adult CD4+ T cells was impaired at birth, but increased during the first year, with the most pronounced changes occurring in the first 6 months. The relative change in JAK/STAT signaling of infant CD4+ T cells with age was distinct for each cytokine tested. Thus, while about 60% of CB CD4+ T cells could efficiently activate STAT6 in response to IL-4, less than 5% of CB CD4+ T cells were able to activate the JAK/STAT pathway in response to IFN-γ, IL-12 or IL-2. By 4–6 months of age, the activation of the cytokine-specific STAT molecules was comparable to adults in response to IL-4 and IFN-γ, while IL-2- and IL-12-induced STAT activation remained below adult levels even at 1 year. These results suggest that common developmental and cytokine-specific factors regulate the maturation of the JAK/STAT signaling function in CD4+ T cells during the first year of life

Controls and limits on bedrock channel geometry

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94837/1/jgrf728.pd

CMV retinitis in China and SE Asia: the way forward

AIDS-related CMV retinitis is a common clinical problem in patients with advanced HIV/AIDS in China and Southeast Asia. The disease is causing blindness, and current clinical management, commonly characterized by delayed diagnosis and inadequate treatment, results in poor clinical outcomes: 21% - 36% of eyes with CMV retinitis are already blind at the time the diagnosis is first established by an ophthalmologist. CMV retinitis also identifies a group of patients at extraordinary risk of mortality, and the direct or indirect contribution of extra-ocular CMV disease to AIDS-related morbidity and mortality is currently unmeasured and clinically often overlooked. The obvious way to improve clinical management of CMV retinitis is to screen all patients with CD4 counts < 100 cells/μL with indirect ophthalmoscopy at the time they first present for care, and to provide systemic treatment with oral valganciclovir when active CMV retinitis is detected. Treatment of opportunistic infections is an integral part of HIV management, and, with appropriate training and support, CMV retinitis screening and treatment can be managed by the HIV clinicians, like all other opportunistic infections. Access to ophthalmologist has been problematic for HIV patients in China, and although non-ophthalmologists can perform screening, sophisticated ophthalmological skills are required for the management of retinal detachment and immune recovery uveitis, the major complications of CMV retinitis. CMV retinitis has been clinically ignored, in part, because of the perceived complexity and expense of treatment, and this obstacle can be removed by making valganciclovir affordable and widely available. Valganciclovir is an essential drug for developing successful programs for management of CMV retinitis in China and throughout SE Asia

Quantifying the combined effects of multiple extreme floods on river channel geometry and on flood hazards

Effects of flood-induced bed elevation and channel geometry changes on flood hazards are largely unexplored, especially in the case of multiple floods from the same site. This study quantified the evolution of river channel and floodplain geometry during a repeated series of hypothetical extreme floods using a 2D full hydro-morphodynamic model (LHMM). These experiments were designed to examine the consequences of channel geometry changes on channel conveyance capacity and subsequent flood dynamics. Our results revealed that extreme floods play an important role in adjusting a river channel to become more efficient for subsequent propagation of floods, and that in-channel scour and sediment re-distribution can greatly improve the conveyance capacity of a channel for subsequent floods. In our hypothetical sequence of floods the response of bed elevation was of net degradation, and sediment transport successively weakened even with floods of the same magnitude. Changes in river channel geometry led to significant impact on flood hydraulics and thereby flood hazards. We found that flood-induced in-channel erosion can disconnect the channel from its floodplain resulting in a reduction of floodwater storage. Thus, the frequency and extent of subsequent overbank flows and floodplain inundation decreased, which reduced downstream flood attenuation and increased downstream flood hazard. In combination and in summary, these results suggest that changes in channel capacity due to extreme floods may drive changes in flood hazard. The assumption of unchanging of river morphology during inundation modelling should therefore be open to question for flood risk management

Cytomegalovirus Retinitis: The Neglected Disease of the AIDS Pandemic

The authors describe CMV retinitis in resource-poor settings and suggest possibilities for management

The social meaning of social indicators

While new modes of data processing have provided reams of data, there has been relatively less effort in seeking to comprehend the social meaning of results of empirical work. A set of previously developed indicators of urban social structure is here examined for its link to theory, and to the social structure of the city itself. The original indicators (size, social class, racial composition and community maturity) were empirically derived. In this paper, each is taken in turn, and explored with respect to several possible social meanings. Size, for example, is considered to be itself an indicator, and an imperfect one, for system complexity; percent non-white is seen to be itself an indicator for a slowdown in the mobility process, or a slower social metabolism. These and other results are suggestions, with illustrations, but not conclusive support, from other than the original data. While it is hoped that the theoretical suggestions may themselves be of interest, it is also hoped that approach itself can indicate the fertility and usefulness of going back to theory once empirical measures have been developed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43687/1/11205_2004_Article_BF00304121.pd

Does HAART Efficacy Translate to Effectiveness? Evidence for a Trial Effect

Background: Patients who participate in clinical trials may experience better clinical outcomes than patients who initiate similar therapy within clinical care (trial effect), but no published studies have evaluated a trial effect in HIV clinical trials. Methods: To examine a trial effect we compared virologic suppression (VS) among patients who initiated HAART in a clinical trial versus in routine clinical care. VS was defined as a plasma HIV RNA #400 copies/ml at six months after HAART initiation and was assessed within strata of early (1996–99) or current (2000–06) HAART periods. Risk ratios (RR) were estimated using binomial models. Results: Of 738 persons initiating HAART, 30.6 % were women, 61.7 % were black, 30 % initiated therapy in a clinical trial and 67 % (n = 496) had an evaluable six month HIV RNA result. HAART regimens differed between the early and current periods (p,0.001); unboosted PI regimens (55.6%) were more common in the early and NNRTI regimens (46.4%) were more common in the current period. Overall, 78 % (95%CI 74, 82%) of patients achieved VS and trial participants were 16 % more likely to achieve VS (unadjusted RR 1.16, 95%CI 1.06, 1.27). Comparing trial to non-trial participants, VS differed by study period. In the early period, trial participants initiating HAART were significantly more likely to achieve VS than non-trial participants (adjusted RR 1.33; 95%CI 1.15, 1.54), but not in the current period (adjusted RR 0.98; 95%CI 0.87, 1.11). Conclusions: A clear clinical trial effect on suppression of HIV replication was observed in the early HAART period but not i