Does use of antiretroviral therapy regimens with high central nervous system penetration improve survival in HIV-infected adults?

OBJECTIVES

The aim of the study was to determine whether combination antiretroviral therapy (cART) with high central nervous system penetration-effectiveness (CPE) rank (neurocART) is associated with increased survival benefit compared with non-neurocART.

METHODS

Prospective data were examined for HIV-positive patients in the Asia Pacific HIV Observational Database who had commenced cART. CPE rank was calculated using the 2010 rankings process. NeurocART status was assigned to regimens with a CPE rank of 8 or more. Survival was analysed using Cox proportional hazards models with covariates updated at changes in cART regimen and with deaths up to 90 days after regimen cessation attributed to that regimen. Sensitivity analyses were conducted to examine the robustness of analysis assumptions.

RESULTS

Among 5882 patients, 308 deaths occurred. The hazard ratio (HR) for neurocART use was 0.89 (P=0.35) when data were stratified by cohort and adjusted for age, mode of HIV exposure, hepatitis B virus coinfection, AIDS-defining illness, CD4 count (cells/μL) and regimen count. Sensitivity analyses showed similar nonsignificant results. We also examined a composite endpoint of AIDS-defining illness or death (HR=0.93; P=0.61), baseline regimen as neurocART (HR=0.95; P=0.69), CPE category (P=0.71) and prior neurocART duration (P=0.16). No association between CD4 cell count and neurocART use was observed (P=0.52).

CONCLUSIONS

Our findings do not show a significant overall survival benefit associated with neurocART compared with cART. The potential benefit associated with neurocART in terms of prevention of neurocognitive impairment did not translate into an improvement in overall survival in this population. These findings were limited by the low incidence of associated mortality. Further studies and more extensive data are needed to address these limitations.

A novel hybrid organic/inorganic photonic crystal slab showing a resonance action at the band edge

Here we propose and experimentally demonstrate a hybrid photonic crystal (PC) slab consisting of air rods in a nanocomposite prepared by incorporating CdSe/CdS core/shell NRs (NR) in a polymer. Since the styrene methyl acrylate based polymer (ZEP) is transparent in the visible spectral range and is an electron-sensitive material, it was chosen as the embedding matrix for the NRs. Scanning electron microscopy and luminance measurements were used to characterize the experimental structure. The vertical extraction of the light, by the coupling of the modes guided by the PC slab to the free radiation via Bragg scattering, consists of a narrow orange emission band at 592 nm with a full width at half-maximum (FWHM) of 17 nm. The original characteristics of hybrid materials based on polymers and colloidal NRs, able to combine the unique optical properties of the inorganic moiety with the processability of the host matrix, are extremely appealing in view of their technological impact on the development of new high performing optical devices such as organic light-emitting diodes, ultra-low threshold lasers and non-linear devices.

Elevated IgG autoantibody production in oligoarticular juvenile idiopathic arthritis may predict a refractory course

OBJECTIVES

Although oligoarticular juvenile idiopathic arthritis (oJIA) is considered to carry the best prognosis among the JIA subtypes, many children evolve to a chronic course. A few studies have identified clinical risk factors for disease extension, and recent studies have evaluated synovial fluid markers. However, the only biological marker from the serum studied to date is the anti-nuclear antibody (ANA), regarding which there is mixed data regarding prognosis. No studies have evaluated whether additional autoantibodies may affect the articular prognosis of oJIA.

METHODS

Microarrays containing candidate autoantigens were printed on slides, which were used to profile 36 children with oJIA and 18 controls. Unsupervised cluster analysis was used to identify distinct subgroups of JIA patients. Response to therapy after a mean interval of 4.9 months was evaluated.

RESULTS

Cluster analysis revealed two subgroups of oJIA patients, with identical clustering observed when children with onset over age six were excluded. Cluster 1 had higher levels of multiple autoantibodies compared to both cluster 2 as well as controls, including antibodies against several extracellular matrix (ECM) and nuclear antigens. Although the two patient clusters were similar with respect to clinical features and treatment decisions, children in cluster 1 were less likely to have attained remission by the follow-up visit.

CONCLUSIONS

Antibodies against ECM and possibly other antigens may identify a sub-group of children with oJIA who will require more aggressive therapy to attain control of the arthritis.

Observation of turbulence suppression after electron-cyclotron-resonance-heating switch-off on the HL-2A tokamak

The formation of a transient internal transport barrier (ITB) is observed after the electron-cyclotron-resonance-heating (ECRH) switch-off in the HL-2A plasmas, characterized by transient increase of central electron temperature. The newly developed correlation reflectometer provided direct measurements showing reduction of turbulence in the region of steepened gradients for the period of ITB formation triggered by the ECRH switch-off. Furthermore, the reduction of core turbulence is correlated in time with the appearance of a low-frequency mode with a spectrally broad poloidal structure that peaks near zero frequency in the core region. These structures have low poloidal mode number, high poloidal correlation, and short radial correlation and are strongly coupled with high-frequency ambient turbulence. Observation indicates that these structures play important roles in the reduction of the core turbulence and in improvements of the core transport after the off-axis ECRH is turned off.

Dual-negative refraction in photonic crystals with hexagonal lattices

We present a dual-negative refraction effect based on the overlapping bands in a two-dimensional triangular photonic crystal formed by holographic lithography. Under certain conditions, one incident plane wave launched into this photonic crystal can be dispersed into two negative refracted waves at the same frequency and the same perpendicular polarization state with different phase velocities and group velocities. We find that this dual-negative refraction behavior can be easily manipulated by adjusting the incident angle, the frequency of incident wave and the filling ratio of the PhC. This special effect can be applied to realize wave-front division and optical interference in optical holography. Based on this effect, a double focusing imaging phenomenon has been achieved by the PhC slab. These unique features may show great impacts on both fundamental physics and optical device applications.

Polymorphisms in the toll-like receptor 9 gene associated with sepsis and multiple organ dysfunction after major blunt trauma

BACKGROUND

Toll-like receptor (TLR) 9 is the pattern recognition receptor for microbial DNA. Genetic variation within pattern recognition receptors for bacterial endotoxin and exotoxin has been shown to be associated with the risk of sepsis and organ dysfunction in critical illness. However, little is known about the clinical relevance of TLR9 gene polymorphisms in critical illness.

METHODS

A total of 557 patients with major blunt trauma were included in the study. Genetic variation data for the entire TLR9 gene were obtained from the HapMap Project. The genotypes of TLR9 gene polymorphisms were determined using a pyrosequencing method. Whole peripheral blood samples obtained immediately after admission were stimulated with bacterial DNA and production of tumour necrosis factor (TNF) α was then determined. Sepsis morbidity rate and multiple organ dysfunction (MOD) scores were assessed.

RESULTS

Of five single-nucleotide polymorphisms (SNPs) genotyped, four (rs187084, rs352139, rs352140 and rs352162) existed as common SNPs and were in strong linkage disequilibrium. Both rs187084 and rs352162 were significantly associated with TNF-α production by peripheral blood leucocytes in response to bacterial DNA stimulation and a higher sepsis morbidity rate in patients with major trauma. In addition, the rs352162 polymorphism was significantly associated with MOD scores, whereas rs187084 showed a trend to be associated with MOD score.

CONCLUSION

TLR9 polymorphisms rs187084 and rs352162 might be used to provide relevant risk estimates for the development of sepsis and MOD in patients with major trauma.

Dihadron fragmentation functions for large invariant mass

Using perturbative quantum chromodynamics, we compute dihadron fragmentation functions for a large invariant mass of the dihadron pair. The main focus is on the interference fragmentation function H(1)(∢), which plays an important role in spin physics of the nucleon. Our calculation also reveals that H(1)(∢) and the Collins fragmentation function have closely related underlying dynamics. By considering semi-inclusive deep-inelastic scattering, we further show that collinear factorization in terms of dihadron fragmentation functions and collinear factorization in terms of single-hadron fragmentation functions provide the same result in the region of intermediate invariant mass.

Overtime and psychological well-being among Chinese office workers

BACKGROUND

Research on the relationship between overtime and psychological well-being, and workers' perceptions of the factors that determine overtime, has been conducted exclusively in the Western cultural context.

AIMS

To examine whether existing theory and evidence can be applied to a non-Western cultural setting by investigating the constructs among a sample of office workers drawn from a Chinese branch of an international information and communication technology company.

METHODS

Data were collected from 130 full-time employees on overtime hours worked, psychological well-being, and four variables identified by participants as being important determinants of overtime: job demands, intrinsic motivation, anticipated rewards, and overtime work culture. T-tests and multiple linear regression analyses were used to examine the relationship between variables.

RESULTS

All study participants had worked overtime in the previous 6 months period; the mean weekly overtime rate was 14.2 h. High overtime employees demonstrated significantly lower levels of psychological well-being than those who worked low levels of overtime. In combination, the four reasons for working overtime predicted approximately one-fifth of the variance in overtime hours worked, suggesting that knowledge of these variables could be used by practitioners to predict the amount of overtime in which workers are likely to engage.

CONCLUSIONS

The findings suggest that existing theory and evidence may apply beyond the individualist cultural context. The findings might usefully inform the organization of work in collectivist cultures and the implementation of multinational operations in these cultures.