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Meiyappan P, Dalton M, O’Neill BC, Jain AK. Spatial modeling of agricultural land use change at global scale. Ecol Modell 2014. [DOI: 10.1016/j.ecolmodel.2014.07.027] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Ackermann M, Ajello M, Albert A, Allafort A, Baldini L, Barbiellini G, Bastieri D, Bechtol K, Bellazzini R, Blandford RD, Bloom ED, Bonamente E, Bottacini E, Bouvier A, Brandt TJ, Brigida M, Bruel P, Buehler R, Buson S, Caliandro GA, Cameron RA, Caraveo PA, Cecchi C, Charles E, Chaves RCG, Chekhtman A, Chiang J, Chiaro G, Ciprini S, Claus R, Cohen-Tanugi J, Conrad J, Cutini S, Dalton M, D'Ammando F, de Angelis A, de Palma F, Dermer CD, Digel SW, Di Venere L, do Couto e Silva E, Drell PS, Drlica-Wagner A, Favuzzi C, Fegan SJ, Ferrara EC, Focke WB, Franckowiak A, Fukazawa Y, Funk S, Fusco P, Gargano F, Gasparrini D, Germani S, Giglietto N, Giordano F, Giroletti M, Glanzman T, Godfrey G, Gomez-Vargas GA, Grenier IA, Grove JE, Guiriec S, Gustafsson M, Hadasch D, Hanabata Y, Harding AK, Hayashida M, Hayashi K, Hewitt JW, Horan D, Hou X, Hughes RE, Inoue Y, Jackson MS, Jogler T, Jóhannesson G, Johnson AS, Kamae T, Kawano T, Knödlseder J, Kuss M, Lande J, Larsson S, Latronico L, Longo F, Loparco F, Lovellette MN, Lubrano P, Mayer M, Mazziotta MN, McEnery JE, Mehault J, Michelson PF, Mitthumsiri W, Mizuno T, Moiseev AA, Monte C, Monzani ME, Morselli A, Moskalenko IV, Murgia S, Nemmen R, Nuss E, Ohsugi T, Okumura A, Orienti M, Orlando E, Ormes JF, Paneque D, Panetta JH, Perkins JS, Pesce-Rollins M, Piron F, Pivato G, Porter TA, Rainò S, Rando R, Razzano M, Razzaque S, Reimer A, Reimer O, Ritz S, Roth M, Schaal M, Schulz A, Sgrò C, Siskind EJ, Spandre G, Spinelli P, Strong AW, Takahashi H, Takeuchi Y, Thayer JG, Thayer JB, Thompson DJ, Tibaldo L, Tinivella M, Torres DF, Tosti G, Troja E, Tronconi V, Usher TL, Vandenbroucke J, Vasileiou V, Vianello G, Vitale V, Werner M, Winer BL, Wood KS, Wood M, Yang Z. Inferred cosmic-ray spectrum from Fermi large area telescope γ-ray observations of Earth's limb. PHYSICAL REVIEW LETTERS 2014; 112:151103. [PMID: 24785023 DOI: 10.1103/physrevlett.112.151103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Indexed: 06/03/2023]
Abstract
Recent accurate measurements of cosmic-ray (CR) species by ATIC-2, CREAM, and PAMELA reveal an unexpected hardening in the proton and He spectra above a few hundred GeV, a gradual softening of the spectra just below a few hundred GeV, and a harder spectrum of He compared to that of protons. These newly discovered features may offer a clue to the origin of high-energy CRs. We use the Fermi Large Area Telescope observations of the γ-ray emission from Earth's limb for an indirect measurement of the local spectrum of CR protons in the energy range ∼90 GeV-6 TeV (derived from a photon energy range 15 GeV-1 TeV). Our analysis shows that single power law and broken power law spectra fit the data equally well and yield a proton spectrum with index 2.68±0.04 and 2.61±0.08 above ∼200 GeV, respectively.
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Abramowski A, Acero F, Aharonian F, Akhperjanian AG, Anton G, Balenderan S, Balzer A, Barnacka A, Becherini Y, Becker Tjus J, Bernlöhr K, Birsin E, Biteau J, Bochow A, Boisson C, Bolmont J, Bordas P, Brucker J, Brun F, Brun P, Bulik T, Carrigan S, Casanova S, Cerruti M, Chadwick PM, Chaves RCG, Cheesebrough A, Colafrancesco S, Cologna G, Conrad J, Couturier C, Dalton M, Daniel MK, Davids ID, Degrange B, Deil C, deWilt P, Dickinson HJ, Djannati-Ataï A, Domainko W, Drury LO, Dubus G, Dutson K, Dyks J, Dyrda M, Egberts K, Eger P, Espigat P, Fallon L, Farnier C, Fegan S, Feinstein F, Fernandes MV, Fernandez D, Fiasson A, Fontaine G, Förster A, Füßling M, Gajdus M, Gallant YA, Garrigoux T, Gast H, Giebels B, Glicenstein JF, Glück B, Göring D, Grondin MH, Häffner S, Hague JD, Hahn J, Hampf D, Harris J, Heinz S, Heinzelmann G, Henri G, Hermann G, Hillert A, Hinton JA, Hofmann W, Hofverberg P, Holler M, Horns D, Jacholkowska A, Jahn C, Jamrozy M, Jung I, Kastendieck MA, Katarzyński K, Katz U, Kaufmann S, Khélifi B, Klepser S, Klochkov D, Kluźniak W, Kneiske T, Komin N, Kosack K, Kossakowski R, Krayzel F, Krüger PP, Laffon H, Lamanna G, Lefaucheur J, Lemoine-Goumard M, Lenain JP, Lennarz D, Lohse T, Lopatin A, Lu CC, Marandon V, Marcowith A, Masbou J, Maurin G, Maxted N, Mayer M, McComb TJL, Medina MC, Méhault J, Menzler U, Moderski R, Mohamed M, Moulin E, Naumann CL, Naumann-Godo M, de Naurois M, Nedbal D, Nekrassov D, Nguyen N, Niemiec J, Nolan SJ, Ohm S, de Oña Wilhelmi E, Opitz B, Ostrowski M, Oya I, Panter M, Parsons RD, Paz Arribas M, Pekeur NW, Pelletier G, Perez J, Petrucci PO, Peyaud B, Pita S, Pühlhofer G, Punch M, Quirrenbach A, Raue M, Reimer A, Reimer O, Renaud M, de Los Reyes R, Rieger F, Ripken J, Rob L, Rosier-Lees S, Rowell G, Rudak B, Rulten CB, Sahakian V, Sanchez DA, Santangelo A, Schlickeiser R, Schulz A, Schwanke U, Schwarzburg S, Schwemmer S, Sheidaei F, Skilton JL, Sol H, Spengler G, Stawarz L, Steenkamp R, Stegmann C, Stinzing F, Stycz K, Sushch I, Szostek A, Tavernet JP, Terrier R, Tluczykont M, Trichard C, Valerius K, van Eldik C, Vasileiadis G, Venter C, Viana A, Vincent P, Völk HJ, Volpe F, Vorobiov S, Vorster M, Wagner SJ, Ward M, White R, Wierzcholska A, Wouters D, Zacharias M, Zajczyk A, Zdziarski AA, Zech A, Zechlin HS. Search for photon-linelike signatures from dark matter annihilations with H.E.S.S. PHYSICAL REVIEW LETTERS 2013; 110:041301. [PMID: 25166149 DOI: 10.1103/physrevlett.110.041301] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Indexed: 06/03/2023]
Abstract
Gamma-ray line signatures can be expected in the very-high-energy (E(γ)>100 GeV) domain due to self-annihilation or decay of dark matter (DM) particles in space. Such a signal would be readily distinguishable from astrophysical γ-ray sources that in most cases produce continuous spectra that span over several orders of magnitude in energy. Using data collected with the H.E.S.S. γ-ray instrument, upper limits on linelike emission are obtained in the energy range between ∼ 500 GeV and ∼ 25 TeV for the central part of the Milky Way halo and for extragalactic observations, complementing recent limits obtained with the Fermi-LAT instrument at lower energies. No statistically significant signal could be found. For monochromatic γ-ray line emission, flux limits of (2 × 10(-7) -2 × 10(-5)) m(-2) s(-1) sr(-1) and (1 × 10(-8) -2 × 10(-6)) m(-2) s(-1)sr(-1) are obtained for the central part of the Milky Way halo and extragalactic observations, respectively. For a DM particle mass of 1 TeV, limits on the velocity-averaged DM annihilation cross section ⟨σv⟩(χχ → γγ) reach ∼ 10(-27) cm(3)s(-1), based on the Einasto parametrization of the Galactic DM halo density profile.
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Abstract
Relations between demographic change and emissions of the major greenhouse gas carbon dioxide (CO(2)) have been studied from different perspectives, but most projections of future emissions only partly take demographic influences into account. We review two types of evidence for how CO(2) emissions from the use of fossil fuels are affected by demographic factors such as population growth or decline, ageing, urbanisation, and changes in household size. First, empirical analyses of historical trends tend to show that CO(2) emissions from energy use respond almost proportionately to changes in population size and that ageing and urbanisation have less than proportional but statistically significant effects. Second, scenario analyses show that alternative population growth paths could have substantial effects on global emissions of CO(2) several decades from now, and that ageing and urbanisation can have important effects in particular world regions. These results imply that policies that slow population growth would probably also have climate-related benefits.
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Ribeiro JT, Macedo LT, Curigliano G, Fumagalli L, Locatelli M, Dalton M, Quintela A, Carvalheira JBC, Manunta S, Mazzarella L, Brollo J, Goldhirsch A. Cytotoxic drugs for patients with breast cancer in the era of targeted treatment: back to the future? Ann Oncol 2012; 23:547-555. [PMID: 21896541 DOI: 10.1093/annonc/mdr382] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Despite current trend of targeted therapy development, cytotoxic agents are a mainstay of treatment of patients with breast cancer. We reviewed recent advances in cytotoxic therapy for patients with metastatic breast cancer (MBC). MATERIALS AND METHODS Medline searches were conducted for English language studies using the term 'MBC' and 'cytotoxic drugs'. The data search was restricted to the period 2000-2011. RESULTS Several novel cytotoxic compounds, all microtubule inhibitors, have been approved for clinical use in MBC: (i) nab-paclitaxel, reported to improve tumour response and decrease hypersensitivity reactions in comparison with other taxanes; (ii) ixabepilone, shown to have clinical benefit in taxane- and anthracycline-resistant disease and (iii) eribulin, shown to improve overall survival in heavily pre-treated patients, when compared with best available standard treatment. Agents, such as larotaxel, vinflunine, trabectidin and formulations, including cationic liposomal paclitaxel or paclitaxel poliglumex, are currently under evaluation in phase II/III trials. CONCLUSION Toxicity and chemotherapy resistance are still major limitations in the treatment of patients with MBC. Further research into new cytotoxic compounds is needed in order to maximise benefit, whilst minimising toxicity.
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Dalton M, Blundell J, Finlayson G. Implicit wanting is a marker of trait binge eating- A susceptible phenotype for overeating. Appetite 2011. [DOI: 10.1016/j.appet.2011.05.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Dalton M. Michael John Thomson Dalton. West J Med 2011. [DOI: 10.1136/bmj.d5982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abramowski A, Acero F, Aharonian F, Akhperjanian AG, Anton G, Barnacka A, de Almeida UB, Bazer-Bachi AR, Becherini Y, Becker J, Behera B, Bernlöhr K, Bochow A, Boisson C, Bolmont J, Bordas P, Borrel V, Brucker J, Brun F, Brun P, Bulik T, Büsching I, Carrigan S, Casanova S, Cerruti M, Chadwick PM, Charbonnier A, Chaves RCG, Cheesebrough A, Chounet LM, Clapson AC, Coignet G, Conrad J, Dalton M, Daniel MK, Davids ID, Degrange B, Deil C, Dickinson HJ, Djannati-Ataï A, Domainko W, Drury LO, Dubois F, Dubus G, Dyks J, Dyrda M, Egberts K, Eger P, Espigat P, Fallon L, Farnier C, Fegan S, Feinstein F, Fernandes MV, Fiasson A, Fontaine G, Förster A, Füssling M, Gallant YA, Gast H, Gérard L, Gerbig D, Giebels B, Glicenstein JF, Glück B, Goret P, Göring D, Hague JD, Hampf D, Hauser M, Heinz S, Heinzelmann G, Henri G, Hermann G, Hinton JA, Hoffmann A, Hofmann W, Hofverberg P, Horns D, Jacholkowska A, de Jager OC, Jahn C, Jamrozy M, Jung I, Kastendieck MA, Katarzyński K, Katz U, Kaufmann S, Keogh D, Kerschhaggl M, Khangulyan D, Khélifi B, Klochkov D, Kluźniak W, Kneiske T, Komin N, Kosack K, Kossakowski R, Laffon H, Lamanna G, Lennarz D, Lohse T, Lopatin A, Lu CC, Marandon V, Marcowith A, Masbou J, Maurin D, Maxted N, McComb TJL, Medina MC, Méhault J, Moderski R, Moulin E, Naumann CL, Naumann-Godo M, de Naurois M, Nedbal D, Nekrassov D, Nguyen N, Nicholas B, Niemiec J, Nolan SJ, Ohm S, Olive JF, Wilhelmi EDO, Opitz B, Ostrowski M, Panter M, Arribas MP, Pedaletti G, Pelletier G, Petrucci PO, Pita S, Pühlhofer G, Punch M, Quirrenbach A, Raue M, Rayner SM, Reimer A, Reimer O, Renaud M, de los Reyes R, Rieger F, Ripken J, Rob L, Rosier-Lees S, Rowell G, Rudak B, Rulten CB, Ruppel J, Ryde F, Sahakian V, Santangelo A, Schlickeiser R, Schöck FM, Schönwald A, Schwanke U, Schwarzburg S, Schwemmer S, Shalchi A, Sikora M, Skilton JL, Sol H, Spengler G, Stawarz Ł, Steenkamp R, Stegmann C, Stinzing F, Sushch I, Szostek A, Tavernet JP, Terrier R, Tibolla O, Tluczykont M, Valerius K, van Eldik C, Vasileiadis G, Venter C, Vialle JP, Viana A, Vincent P, Vivier M, Völk HJ, Volpe F, Vorobiov S, Vorster M, Wagner SJ, Ward M, Wierzcholska A, Zajczyk A, Zdziarski AA, Zech A, Zechlin HS. Search for a dark matter annihilation signal from the galactic center halo with H.E.S.S. PHYSICAL REVIEW LETTERS 2011; 106:161301. [PMID: 21599352 DOI: 10.1103/physrevlett.106.161301] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 01/12/2011] [Indexed: 05/30/2023]
Abstract
A search for a very-high-energy (VHE; ≥100 GeV) γ-ray signal from self-annihilating particle dark matter (DM) is performed towards a region of projected distance r∼45-150 pc from the Galactic center. The background-subtracted γ-ray spectrum measured with the High Energy Stereoscopic System (H.E.S.S.) γ-ray instrument in the energy range between 300 GeV and 30 TeV shows no hint of a residual γ-ray flux. Assuming conventional Navarro-Frenk-White and Einasto density profiles, limits are derived on the velocity-weighted annihilation cross section (σv) as a function of the DM particle mass. These are among the best reported so far for this energy range and in particular differ only little between the chosen density profile parametrizations. In particular, for the DM particle mass of ∼1 TeV, values for (σv) above 3×10(-25) cm(3) s(-1) are excluded for the Einasto density profile.
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O'Neill BC, Dalton M, Fuchs R, Jiang L, Pachauri S, Zigova K. Global demographic trends and future carbon emissions. Proc Natl Acad Sci U S A 2010; 107:17521-6. [PMID: 20937861 PMCID: PMC2955139 DOI: 10.1073/pnas.1004581107] [Citation(s) in RCA: 271] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Substantial changes in population size, age structure, and urbanization are expected in many parts of the world this century. Although such changes can affect energy use and greenhouse gas emissions, emissions scenario analyses have either left them out or treated them in a fragmentary or overly simplified manner. We carry out a comprehensive assessment of the implications of demographic change for global emissions of carbon dioxide. Using an energy-economic growth model that accounts for a range of demographic dynamics, we show that slowing population growth could provide 16-29% of the emissions reductions suggested to be necessary by 2050 to avoid dangerous climate change. We also find that aging and urbanization can substantially influence emissions in particular world regions.
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Acero F, Aharonian F, Akhperjanian AG, Anton G, Barres de Almeida U, Bazer-Bachi AR, Becherini Y, Behera B, Bernlöhr K, Bochow A, Boisson C, Bolmont J, Borrel V, Brucker J, Brun F, Brun P, Bühler R, Bulik T, Büsching I, Boutelier T, Chadwick PM, Charbonnier A, Chaves RCG, Cheesebrough A, Chounet LM, Clapson AC, Coignet G, Dalton M, Daniel MK, Davids ID, Degrange B, Deil C, Dickinson HJ, Djannati-Ataï A, Domainko W, Drury LO, Dubois F, Dubus G, Dyks J, Dyrda M, Egberts K, Emmanoulopoulos D, Espigat P, Farnier C, Fegan S, Feinstein F, Fiasson A, Förster A, Fontaine G, Füßling M, Gabici S, Gallant YA, Gérard L, Gerbig D, Giebels B, Glicenstein JF, Glück B, Goret P, Göring D, Hauser D, Hauser M, Heinz S, Heinzelmann G, Henri G, Hermann G, Hinton JA, Hoffmann A, Hofmann W, Hofverberg P, Hoppe S, Horns D, Jacholkowska A, de Jager OC, Jahn C, Jung I, Katarzyński K, Katz U, Kaufmann S, Kerschhaggl M, Khangulyan D, Khélifi B, Keogh D, Klochkov D, Kluźniak W, Kneiske T, Komin N, Kosack K, Kossakowski R, Lamanna G, Lenain JP, Lohse T, Marandon V, Martineau-Huynh O, Marcowith A, Masbou J, Maurin D, McComb TJL, Medina MC, Méhault J, Moderski R, Moulin E, Naumann-Godo M, de Naurois M, Nedbal D, Nekrassov D, Nicholas B, Niemiec J, Nolan SJ, Ohm S, Olive JF, Wilhelmi EDO, Orford KJ, Ostrowski M, Panter M, Arribas MP, Pedaletti G, Pelletier G, Petrucci PO, Pita S, Pühlhofer G, Punch M, Quirrenbach A, Raubenheimer BC, Raue M, Rayner SM, Reimer O, Renaud M, Rieger F, Ripken J, Rob L, Rosier-Lees S, Rowell G, Rudak B, Rulten CB, Ruppel J, Sahakian V, Santangelo A, Schlickeiser R, Schöck FM, Schwanke U, Schwarzburg S, Schwemmer S, Shalchi A, Sikora M, Skilton JL, Sol H, Stawarz Ł, Steenkamp R, Stegmann C, Stinzing F, Superina G, Szostek A, Tam PH, Tavernet JP, Terrier R, Tibolla O, Tluczykont M, van Eldik C, Vasileiadis G, Venter C, Venter L, Vialle JP, Vincent P, Vivier M, Völk HJ, Volpe F, Wagner SJ, Ward M, Zdziarski AA, Zech A. Detection of Gamma Rays from a Starburst Galaxy. Science 2009; 326:1080-2. [DOI: 10.1126/science.1178826] [Citation(s) in RCA: 151] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Khan A, Dalton M. P541 Chlamydia screening in gynaecology. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)62031-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Acciari VA, Aliu E, Arlen T, Bautista M, Beilicke M, Benbow W, Bradbury SM, Buckley JH, Bugaev V, Butt Y, Byrum K, Cannon A, Celik O, Cesarini A, Chow YC, Ciupik L, Cogan P, Cui W, Dickherber R, Fegan SJ, Finley JP, Fortin P, Fortson L, Furniss A, Gall D, Gillanders GH, Grube J, Guenette R, Gyuk G, Hanna D, Holder J, Horan D, Hui CM, Humensky TB, Imran A, Kaaret P, Karlsson N, Kieda D, Kildea J, Konopelko A, Krawczynski H, Krennrich F, Lang MJ, LeBohec S, Maier G, McCann A, McCutcheon M, Millis J, Moriarty P, Ong RA, Otte AN, Pandel D, Perkins JS, Petry D, Pohl M, Quinn J, Ragan K, Reyes LC, Reynolds PT, Roache E, Roache E, Rose HJ, Schroedter M, Sembroski GH, Smith AW, Swordy SP, Theiling M, Toner JA, Varlotta A, Vincent S, Wakely SP, Ward JE, Weekes TC, Weinstein A, Williams DA, Wissel S, Wood M, Walker RC, Davies F, Hardee PE, Junor W, Ly C, Aharonian F, Akhperjanian AG, Anton G, Barres de Almeida U, Bazer-Bachi AR, Becherini Y, Behera B, Bernlöhr K, Bochow A, Boisson C, Bolmont J, Borrel V, Brucker J, Brun F, Brun P, Bühler R, Bulik T, Büsching I, Boutelier T, Chadwick PM, Charbonnier A, Chaves RCG, Cheesebrough A, Chounet LM, Clapson AC, Coignet G, Dalton M, Daniel MK, Davids ID, Degrange B, Deil C, Dickinson HJ, Djannati-Ataï A, Domainko W, Drury LO, Dubois F, Dubus G, Dyks J, Dyrda M, Egberts K, Emmanoulopoulos D, Espigat P, Farnier C, Feinstein F, Fiasson A, Förster A, Fontaine G, Füssling M, Gabici S, Gallant YA, Gérard L, Gerbig D, Giebels B, Glicenstein JF, Glück B, Goret P, Göhring D, Hauser D, Hauser M, Heinz S, Heinzelmann G, Henri G, Hermann G, Hinton JA, Hoffmann A, Hofmann W, Holleran M, Hoppe S, Horns D, Jacholkowska A, de Jager OC, Jahn C, Jung I, Katarzyński K, Katz U, Kaufmann S, Kendziorra E, Kerschhaggl M, Khangulyan D, Khélifi B, Keogh D, Kluźniak W, Kneiske T, Komin N, Kosack K, Lamanna G, Lenain JP, Lohse T, Marandon V, Martin JM, Martineau-Huynh O, Marcowith A, Maurin D, McComb TJL, Medina MC, Moderski R, Moulin E, Naumann-Godo M, de Naurois M, Nedbal D, Nekrassov D, Nicholas B, Niemiec J, Nolan SJ, Ohm S, Olive JF, de Oña Wilhelmi E, Orford KJ, Ostrowski M, Panter M, Paz Arribas M, Pedaletti G, Pelletier G, Petrucci PO, Pita S, Pühlhofer G, Punch M, Quirrenbach A, Raubenheimer BC, Raue M, Rayner SM, Renaud M, Rieger F, Ripken J, Rob L, Rosier-Lees S, Rowell G, Rudak B, Rulten CB, Ruppel J, Sahakian V, Santangelo A, Schlickeiser R, Schöck FM, Schröder R, Schwanke U, Schwarzburg S, Schwemmer S, Shalchi A, Sikora M, Skilton JL, Sol H, Spangler D, Stawarz Ł, Steenkamp R, Stegmann C, Stinzing F, Superina G, Szostek A, Tam PH, Tavernet JP, Terrier R, Tibolla O, Tluczykont M, van Eldik C, Vasileiadis G, Venter C, Venter L, Vialle JP, Vincent P, Vivier M, Völk HJ, Volpe F, Wagner SJ, Ward M, Zdziarski AA, Zech A, Anderhub H, Antonelli LA, Antoranz P, Backes M, Baixeras C, Balestra S, Barrio JA, Bastieri D, Becerra González J, Becker JK, Bednarek W, Berger K, Bernardini E, Biland A, Bock RK, Bonnoli G, Bordas P, Borla Tridon D, Bosch-Ramon V, Bose D, Braun I, Bretz T, Britvitch I, Camara M, Carmona E, Commichau S, Contreras JL, Cortina J, Costado MT, Covino S, Curtef V, Dazzi F, De Angelis A, De Cea del Pozo E, Delgado Mendez C, De los Reyes R, De Lotto B, De Maria M, De Sabata F, Dominguez A, Dorner D, Doro M, Elsaesser D, Errando M, Ferenc D, Fernández E, Firpo R, Fonseca MV, Font L, Galante N, García López RJ, Garczarczyk M, Gaug M, Goebel F, Hadasch D, Hayashida M, Herrero A, Hildebrand D, Höhne-Mönch D, Hose J, Hsu CC, Jogler T, Kranich D, La Barbera A, Laille A, Leonardo E, Lindfors E, Lombardi S, Longo F, López M, Lorenz E, Majumdar P, Maneva G, Mankuzhiyil N, Mannheim K, Maraschi L, Mariotti M, Martínez M, Mazin D, Meucci M, Miranda JM, Mirzoyan R, Miyamoto H, Moldón J, Moles M, Moralejo A, Nieto D, Nilsson K, Ninkovic J, Oya I, Paoletti R, Paredes JM, Pasanen M, Pascoli D, Pauss F, Pegna RG, Perez-Torres MA, Persic M, Peruzzo L, Prada F, Prandini E, Puchades N, Reichardt I, Rhode W, Ribó M, Rico J, Rissi M, Robert A, Rügamer S, Saggion A, Saito TY, Salvati M, Sanchez-Conde M, Satalecka K, Scalzotto V, Scapin V, Schweizer T, Shayduk M, Shore SN, Sidro N, Sierpowska-Bartosik A, Sillanpää A, Sitarek J, Sobczynska D, Spanier F, Stamerra A, Stark LS, Takalo L, Tavecchio F, Temnikov P, Tescaro D, Teshima M, Torres DF, Turini N, Vankov H, Wagner RM, Zabalza V, Zandanel F, Zanin R, Zapatero J. Radio Imaging of the Very-High-Energy γ-Ray Emission Region in the Central Engine of a Radio Galaxy. Science 2009; 325:444-8. [PMID: 19574351 DOI: 10.1126/science.1175406] [Citation(s) in RCA: 157] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Aharonian F, Akhperjanian AG, Barres de Almeida U, Bazer-Bachi AR, Becherini Y, Behera B, Benbow W, Bernlöhr K, Boisson C, Bochow A, Borrel V, Braun I, Brion E, Brucker J, Brun P, Brucker R, Bulik T, Büsching I, Boutelier T, Carrigan S, Chadwick PM, Charbonnier A, Chaves RCG, Cheesebrough A, Chounet LM, Clapson AC, Coignet G, Costamante L, Dalton M, Degrange B, Deil C, Dickinson HJ, Djannati-Ataï A, Domainko W, Drury LO, Dubois F, Dubus G, Dyks J, Dyrda M, Egberts K, Emmanoulopoulos D, Espigat P, Farnier C, Feinstein F, Fiasson A, Fontaine G, Füsling M, Gabici S, Gallant YA, Gérard L, Giebels B, Glicenstein JF, Glück B, Goret P, Hadjichristidis C, Hauser D, Hauser M, Heinz S, Heinzelmann G, Henri G, Hermann G, Hinton JA, Hoffmann A, Hofmann W, Holleran M, Hoppe S, Horns D, Jacholkowska A, de Jager OC, Jung I, Katarzyński K, Kaufmann S, Kendziorra E, Kerschhaggl M, Khangulyan D, Khélifi B, Keogh D, Komin N, Kosack K, Lamanna G, Lenain JP, Lohse T, Marandon V, Martin JM, Martineau-Huynh O, Marcowith A, Maurin D, McComb TJL, Medina C, Moderski R, Moulin E, Naumann-Godo M, de Naurois M, Nedbal D, Nekrassov D, Niemiec J, Nolan SJ, Ohm S, Olive JF, de Oña Wilhelmi E, Orford KJ, Osborne JL, Ostrowski M, Panter M, Pedaletti G, Pelletier G, Petrucci PO, Pita S, Pühlhofer G, Punch M, Quirrenbach A, Raubenheimer BC, Raue M, Rayner SM, Renaud M, Rieger F, Ripken J, Rob L, Rosier-Lees S, Rowell G, Rudak B, Rulten CB, Ruppel J, Sahakian V, Santangelo A, Schlickeiser R, Schöck FM, Schröder R, Schwanke U, Schwarzburg S, Schwemmer S, Shalchi A, Skilton JL, Sol H, Spangler D, Stawarz Ł, Steenkamp R, Stegmann C, Superina G, Tam PH, Tavernet JP, Terrier R, Tibolla O, van Eldik C, Vasileiadis G, Venter C, Vialle JP, Vincent P, Vivier M, Völk HJ, Volpe F, Wagner SJ, Ward M, Zdziarski AA, Zech A. Energy spectrum of cosmic-ray electrons at TeV energies. PHYSICAL REVIEW LETTERS 2008; 101:261104. [PMID: 19437632 DOI: 10.1103/physrevlett.101.261104] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The very large collection area of ground-based gamma-ray telescopes gives them a substantial advantage over balloon or satellite based instruments in the detection of very-high-energy (>600 GeV) cosmic-ray electrons. Here we present the electron spectrum derived from data taken with the High Energy Stereoscopic System (H.E.S.S.) of imaging atmospheric Cherenkov telescopes. In this measurement, the first of this type, we are able to extend the measurement of the electron spectrum beyond the range accessible to direct measurements. We find evidence for a substantial steepening in the energy spectrum above 600 GeV compared to lower energies.
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Aharonian F, Akhperjanian AG, Barres de Almeida U, Bazer-Bachi AR, Becherini Y, Behera B, Beilicke M, Benbow W, Bernlöhr K, Boisson C, Bochow A, Borrel V, Braun I, Brion E, Brucker J, Brun P, Bühler R, Bulik T, Büsching I, Boutelier T, Carrigan S, Chadwick PM, Charbonnier A, Chaves RCG, Chounet LM, Clapson AC, Coignet G, Costamante L, Dalton M, Degrange B, Deil C, Dickinson HJ, Djannati-Ataï A, Domainko W, Drury LO, Dubois F, Dubus G, Dyks J, Egberts K, Emmanoulopoulos D, Espigat P, Farnier C, Feinstein F, Fiasson A, Förster A, Fontaine G, Füssling M, Gabici S, Gallant YA, Gérard L, Giebels B, Glicenstein JF, Glück B, Goret P, Hadjichristidis C, Hauser D, Hauser M, Heinz S, Heinzelmann G, Henri G, Hermann G, Hinton JA, Hoffmann A, Hofmann W, Holleran M, Hoppe S, Horns D, Jacholkowska A, de Jager OC, Jung I, Katarzyński K, Kaufmann S, Kendziorra E, Kerschhaggl M, Khangulyan D, Khélifi B, Keogh D, Komin N, Kosack K, Lamanna G, Lenain JP, Lohse T, Marandon V, Martin JM, Martineau-Huynh O, Marcowith A, Maurin D, McComb TJL, Medina C, Moderski R, Moulin E, Naumann-Godo M, de Naurois M, Nedbal D, Nekrassov D, Niemiec J, Nolan SJ, Ohm S, Olive JF, de Oña Wilhelmi E, Orford KJ, Osborne JL, Ostrowski M, Panter M, Pedaletti G, Pelletier G, Petrucci PO, Pita S, Pühlhofer G, Punch M, Quirrenbach A, Raubenheimer BC, Raue M, Rayner SM, Renaud M, Rieger F, Ripken J, Rob L, Rosier-Lees S, Rowell G, Rudak B, Ruppel J, Sahakian V, Santangelo A, Schlickeiser R, Schöck FM, Schröder R, Schwanke U, Schwarzburg S, Schwemmer S, Shalchi A, Skilton JL, Sol H, Spangler D, Stawarz Ł, Steenkamp R, Stegmann C, Superina G, Tam PH, Tavernet JP, Terrier R, Tibolla O, van Eldik C, Vasileiadis G, Venter C, Vialle JP, Vincent P, Vivier M, Völk HJ, Volpe F, Wagner SJ, Ward M, Zdziarski AA, Zech A. Limits on an energy dependence of the speed of light from a flare of the active galaxy PKS 2155-304. PHYSICAL REVIEW LETTERS 2008; 101:170402. [PMID: 18999724 DOI: 10.1103/physrevlett.101.170402] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Indexed: 05/27/2023]
Abstract
In the past few decades, several models have predicted an energy dependence of the speed of light in the context of quantum gravity. For cosmological sources such as active galaxies, this minuscule effect can add up to measurable photon-energy dependent time lags. In this Letter a search for such time lags during the High Energy Stereoscopic System observations of the exceptional very high energy flare of the active galaxy PKS 2155-304 on 28 July 2006 is presented. Since no significant time lag is found, lower limits on the energy scale of speed of light modifications are derived.
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Dunten PW, Little EJ, Gregory MT, Manohar VM, Dalton M, Hough D, Bitinaite J, Horton NC. The structure of SgrAI bound to DNA; recognition of an 8 base pair target. Nucleic Acids Res 2008; 36:5405-16. [PMID: 18701646 PMCID: PMC2532715 DOI: 10.1093/nar/gkn510] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2008] [Revised: 07/19/2008] [Accepted: 07/24/2008] [Indexed: 11/14/2022] Open
Abstract
The three-dimensional X-ray crystal structure of the 'rare cutting' type II restriction endonuclease SgrAI bound to cognate DNA is presented. SgrAI forms a dimer bound to one duplex of DNA. Two Ca(2+) bind in the enzyme active site, with one ion at the interface between the protein and DNA, and the second bound distal from the DNA. These sites are differentially occupied by Mn(2+), with strong binding at the protein-DNA interface, but only partial occupancy of the distal site. The DNA remains uncleaved in the structures from crystals grown in the presence of either divalent cation. The structure of the dimer of SgrAI is similar to those of Cfr10I, Bse634I and NgoMIV, however no tetrameric structure of SgrAI is observed. DNA contacts to the central CCGG base pairs of the SgrAI canonical target sequence (CR|CCGGYG, | marks the site of cleavage) are found to be very similar to those in the NgoMIV/DNA structure (target sequence G|CCGGC). Specificity at the degenerate YR base pairs of the SgrAI sequence may occur via indirect readout using DNA distortion. Recognition of the outer GC base pairs occurs through a single contact to the G from an arginine side chain located in a region unique to SgrAI.
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Fuentes S, Rogers G, Jobling J, Conroy J, Camus C, Dalton M, Mercenaro L. A SOIL-PLANT-ATMOSPHERE APPROACH TO EVALUATE THE EFFECT OF IRRIGATION/FERTIGATION STRATEGY ON GRAPEVINE WATER AND NUTRIENT UPTAKE, GRAPE QUALITY AND YIELD. ACTA ACUST UNITED AC 2008. [DOI: 10.17660/actahortic.2008.792.34] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Amato RJ, Jac J, Harris P, Dalton M, Saxena S, Monzon F, Zhai J, Brady J, Willis JP. A phase II trial of intra-patient dose escalated-sorafenib in patients (pts) with metastatic renal cell cancer (MRCC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5122] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Amato RJ, Harris P, Dalton M, Khan M, Alter R, Zhai Q, Brady JR, Jac J, Hauke R, Srinivas S. A phase II trial of intra-patient dose-escalated sorafenib in patients (pts) with metastatic renal cell cancer (MRCC). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5026] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5026 Background: Sorafenib has demonstrated activity with limited toxicity at a dose of 400 mg bid in MRCC pts. This presents an opportunity to explore a more intensive drug administration. This study allowed individual pt titration designed to evaluate the ability for pts to dose escalate. Response rate (RR), time to progression (TTP) and overall survival (OS) will be assessed. Methods: Eligibility included; pathologic diagnosis of a component of clear cell, progressive measurable MRCC, no more than 1 prior therapy, karnofsky performance status (KPS) = 70%, adequate organ/marrow function and no active CNS involvement. Initial dose 400 mg bid, daily. Dose escalation defined in the table below: Re-evaluation is performed every 8 weeks. RECIST criteria is utilized. Results: 46 patients have been enrolled. 44 are evaluable. 37 male/7 female, median age 50 years (43–79). 19 pts received prior therapy. 39 pts had a KPS of 100%, 5/90%. Sites of disease included; lung, nodal, liver, bone, adrenal, pancreas and kidney. 26 pts 1 metastatic site, 12 /2, 6/3 or more. 22 pts continue to receive sorafenib therapy; 2/800 mg, 7/1,200 mg, and 13/1,600 mg. 8 pts complete response (CR), 14 pts/partial response (PR) and 14 pts stable for 3+ months. Median duration of therapy is 6+ (range 0.2+ - 12+) months. 2 pts have not been reevaluated. Treatment related adverse events to-date; hand/foot syndrome, skin rash, diarrhea, alopecia, fatigue, hypertension, hypophosphatemia, and elevated amylase/lipase. Conclusion: 91% of pts were escalated to 1,200 mg or 1,600 mg per day. Dose escalated sorafenib has promising anti-tumor activity in pts with MRCC as demonstrated by a 52% CR/PR rate. Anti-tumor activity is further suggested by prolonged TTP = 3 months for 33% of pts. Independent radiology review is in progress. Intra-patient dose escalation data in association with anti-tumor activity and toxicity will be presented. [Table: see text] [Table: see text]
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Georgantopoulou C, Dalton M, Bignardi G. Screening for chickenpox in the UK: evaluation of a pre-conceptual screening program. J OBSTET GYNAECOL 2006; 26:138. [PMID: 16483971 DOI: 10.1080/01443610500443436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kenardy J, Mensch M, Bowen K, Green B, Walton J, Dalton M. Disordered eating behaviours in women with Type 2 diabetes mellitus. Eat Behav 2004; 2:183-92. [PMID: 15001045 DOI: 10.1016/s1471-0153(01)00028-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The aim of the article is to investigate the relationship between disordered eating, particularly binge eating, and Type 2 diabetes in women. Subjects included 215 women with Type 2 diabetes (mean age: 58.9 years, mean body mass index (BMI)=33.5 kg/m(2)). Measurements included a structured clinical interview for disordered eating (Eating Disorder Examination, EDE), self-report measures of psychological functioning, glycosylated haemoglobin A1c, BMI. A total of 20.9% of women was binge eating regularly. Binge eating was associated with poorer well being, earlier age of diagnosis, poorer self-efficacy for diet and exercise self-management, and higher BMI. Binge eating frequency predicted blood glucose control after controlling for BMI and exercise level. A history of binge eating independently predicted age of diagnosis of diabetes. Binge eating is relatively common in women with Type 2 diabetes. The relationship between binge eating severity and diabetic control is not explained by overweight. Binge eating may be an independent risk factor for Type 2 diabetes.
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Dalton M, Cameron AJ, Zimmet PZ, Shaw JE, Jolley D, Dunstan DW, Welborn TA. Waist circumference, waist-hip ratio and body mass index and their correlation with cardiovascular disease risk factors in Australian adults. J Intern Med 2003; 254:555-63. [PMID: 14641796 DOI: 10.1111/j.1365-2796.2003.01229.x] [Citation(s) in RCA: 373] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare body mass index (BMI), waist circumference and waist-hip ratio (WHR) as indices of obesity and assess the respective associations with type 2 diabetes, hypertension and dyslipidaemia. DESIGN AND SETTING A national sample of 11 247 Australians aged > or =25 years was examined in 2000 in a cross-sectional survey. MAIN OUTCOME MEASURES The examination included a fasting blood sample, standard 2-h 75-g oral glucose tolerance test, blood pressure measurements and questionnaires to assess treatment for dyslipidaemia and hypertension. BMI, waist circumference and WHR were measured to assess overweight and obesity. RESULTS The prevalence of obesity amongst Australian adults defined by BMI, waist circumference and WHR was 20.8, 30.5 and 15.8% respectively. The unadjusted odds ratio for the fourth vs. first quartile of each obesity measurement showed that WHR had the strongest relationship with type 2 diabetes, dyslipidaemia (women only) and hypertension. Following adjustment for age, however, there was little difference between the three measures of obesity, with the possible exceptions of hypertension in women, where BMI had a stronger association, and dyslipidaemia in women and type 2 diabetes in men, where WHR was marginally superior. CONCLUSIONS Waist circumference, BMI and WHR identified different proportions of the population, as measured by both prevalence of obesity and cardiovascular disease (CVD) risk factors. Whilst WHR had the strongest correlations with CVD risk factors before adjustment for age, the three obesity measures performed similarly after adjustment for age. Given the difficulty of using age-adjusted associations in the clinical setting, these results suggest that given appropriate cut-off points, WHR is the most useful measure of obesity to use to identify individuals with CVD risk factors.
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Ford J, Meaden ER, Hoggard PG, Dalton M, Newton P, Williams I, Khoo SH, Back DJ. Effect of protease inhibitor-containing regimens on lymphocyte multidrug resistance transporter expression. J Antimicrob Chemother 2003; 52:354-8. [PMID: 12917239 DOI: 10.1093/jac/dkg381] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Increased expression of multidrug resistance transporters, such as P-glycoprotein (P-gp), has been suggested as a potential mechanism for decreased protease inhibitor (PI) availability at certain intracellular sites and tissue compartments. OBJECTIVES To investigate the effect of PIs on the surface lymphocyte expression of P-gp in vitro and in vivo. PATIENTS AND METHODS Peripheral blood mononuclear cells (PBMCs) were isolated from healthy subjects (n = 15) and incubated (72 h) with 10 microM of each PI studied (saquinavir, ritonavir, nelfinavir, indinavir, amprenavir and lopinavir), or dimethyl sulphoxide (DMSO) control. PBMCs were also isolated from HIV-infected subjects (n = 50; viral load <50 copies/mL) on a PI- or a non-PI-containing combination antiretroviral regimen. P-gp expression was analysed by flow cytometry. RESULTS No differences in surface P-gp expression on lymphocytes, CD4+ or CD8+ lymphocyte subsets were observed following incubation with 10 microM saquinavir, ritonavir, indinavir, amprenavir or lopinavir in vitro. Nelfinavir, however, increased P-gp expression. In vivo, no difference in P-gp expression on total lymphocytes was observed between patients receiving a PI-containing regimen [saquinavir n = 9, ritonavir n = 6, nelfinavir n = 7, indinavir n = 7 and lopinavir/ritonavir n = 13, and two nucleoside reverse transcriptase inhibitors (NRTIs)] and patients receiving a control regimen of three NRTIs alone (n = 8). CONCLUSION This study suggests that, of the PIs, only nelfinavir increases P-gp expression in vitro, and in vivo the PI class of antiretrovirals do not increase P-gp expression on lymphocytes. It is clear that factors other than PI induction are important in the inter-individual variability in the lymphocyte expression of P-gp.
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Toelle BG, Li J, Dalton M, Devadason SG. Subject discomfort associated with the histamine challenge in a population study. Respir Med 2002; 96:990-2. [PMID: 12477213 DOI: 10.1053/rmed.2002.1395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Many review articles report the safety and lack of serious side-effects associated with the histamine challenge. Even though methacholine and hypertonic saline are more commonly used to measure airway responsiveness, histamine challenges are used in many countries around the world. Levels of subjects discomfort after a challenge have not been quantified. This study quantified the incidence, severity and duration of subject discomfort after histamine challenge. METHODS Ninety-nine subjects were recruited in an Australian multi-centre population-based study of the genetic epidemiology of asthma. Subjects completed a histamine challenge with final cumulative dose 3.2 micromol. Immediately, and 10 min, after challenge subjects rated their discomfort for cough, headache, throat irritation, hoarse voice and flushed. Research personnel also reported their perception of subjectdiscomfort. RESULTS Subjects and research personnel reported a small degree of subject discomfort for all symptoms immediately after the histamine challenge. Overall, median symptom scores were less than 1.5 out of 10. Discomfort scores improved 10 min after challenge and cough, throat irritation and flushed improved significantly CONCLUSIONS This study confirms the tolerability of the histamine challenge.
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Chadban SJ, Kerr P, Briganti E, Dunstan D, Dalton M, Zimmet P, Atkins RC. ACCURACY OF DIPSTICK TESTING FOR POPULATION SCREENING. Nephrology (Carlton) 2002. [DOI: 10.1046/j.1440-1797.2002.00007-1-95.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Walsh JC, Horne R, Dalton M, Burgess AP, Gazzard BG. Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes. AIDS Care 2001; 13:709-20. [PMID: 11720641 DOI: 10.1080/09540120120076878] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The objective of the study was to define common reasons for non-adherence (NA) to highly active antiretroviral therapy (HAART) and the number of reasons reported by non-adherent individuals. A confidential questionnaire was administered to HIV-seropositive patients taking proteinase inhibitor based HAART. Median self-reported adherence was 95% (n = 178, range = 60-100%). The most frequent reasons for at least 'sometimes' missing a dose were eating a meal at the wrong time (38.2%), oversleeping (36.3%), forgetting (35.0%) and being in a social situation (30.5%). The mean number of reasons occurring at least 'sometimes' was 3.2; 20% of patients gave six or more reasons; those reporting the lowest adherence reported a significantly greater numbers of reasons (rho = - 0.59; p < 0.001). Three factors were derived from the data by principal component analysis reflecting 'negative experiences of HAART', 'having a low priority for taking medication' and 'unintentionally missing doses', accounting for 53.8% of the variance. On multivariate analysis only the latter two factors were significantly related to NA (odds ratios 0.845 and 0.849, respectively). There was a wide spectrum of reasons for NA in our population. The number of reasons in an individual increased as adherence became less. A variety of modalities individualized for each patient are required to support patients with the lowest adherence.
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