49,635 research outputs found
Immunological failure of first-line and switch to second-line antiretroviral therapy among HIV-infected persons in Tanzania: analysis of routinely collected national data.
No full textOBJECTIVES: Rates of first-line treatment failure and switches to second-line therapy are key indicators for national HIV programmes. We assessed immunological treatment failure defined by WHO criteria in the Tanzanian national HIV programme. METHODS: We included adults initiating first-line therapy in 2004-2011 with a pre-treatment CD4 count, and ≥6-months of follow-up. We assessed subhazard ratios (SHR) for immunological treatment failure, and subsequent switch to second-line therapy, using competing risks methods to account for deaths. RESULTS: Of 121 308 adults, 7% experienced immunological treatment failure, and 2% died without observed immunological treatment failure, over a median 1.7 years. The 6-year cumulative probability of immunological treatment failure was 19.0% (95% CI 18.5, 19.7) and of death, 5.1% (4.8, 5.4). Immunological treatment failure predictors included earlier year of treatment initiation (P < 0.001), initiation in lower level facilities (SHR = 2.23 [2.03, 2.45] for dispensaries vs. hospitals), being male (1.27 [1.19, 1.33]) and initiation at low or high CD4 counts (for example, 1.78 [1.65, 1.92] and 5.33 [4.65, 6.10] for <50 and ≥500 vs. 200-349 cells/mm(3) , respectively). Of 7382 participants in the time-to-switch analysis, 6% switched and 5% died before switching. Four years after immunological treatment failure, the cumulative probability of switching was 7.3% (6.6, 8.0) and of death, 6.8% (6.0, 7.6). Those who immunologically failed in dispensaries, health centres and government facilities were least likely to switch. CONCLUSIONS: Immunological treatment failure rates and unmet need for second-line therapy are high in Tanzania; virological monitoring, at least for persons with immunological treatment failure, is required to minimise unnecessary switches to second-line therapy. Lower level government health facilities need more support to reduce treatment failure rates and improve second-line therapy uptake to sustain the benefits of increased coverage
The construction of Karen Karnak: The multi-author-function
No full textThis thesis is situated within the comparatively recent developments of Web 2.0 and the emergence of interactive WikiMedia, and explores the mode of authorship within a Read/Write culture compared to that of a Read/Only tradition. The hypothesis of this study is that the role of the audience has become merged with the author, and as such, represents new functions and attributes, distinct from a more conventional concept of authorship, in which the roles of audience and author are more separate. Read/Write and participatory culture, as defined by this study, is focused on collaboration, and includes the influences of D.I.Y. culture, Open-Source practices and the production of text by multiple authors. Multi-authorship presents a re-thinking of several concepts which support the notion of the individual author, since the focus of multi-authorship is not on attribution and ownership of a finished text, but on the continued malleability of a text. Modes of multi-authorship, demonstrated in the use of the pseudonyms Alan Smithee and Karen Eliot, represent declarative authors whose names signify multiple origins, whilst concurrently indicating a distinct body of work. The function of these names form an important context to this study, since primary research involves the construction of an experimental mode of multi-authorship utilising WikiMedia technology and the interaction of thirty nine participants, who are invited to create a body of work under the collective pseudonym Karen Karnak. The data generated by this experiment is analysed using aspects of Michel Foucault's author-function to identify and determine power structures inherent in the WikiMedia context. The interplay of power structures, including concepts such as identity, ownership and the body of work, affect the resulting mode of authorship and contribute to the construction of Karen Karnak, suggesting further areas of research into the emerging multi-author
Hospital-Wide SARS-CoV-2 Antibody Screening in 3056 Staff in a Tertiary Center in Belgium
No full textThis study characterizes the prevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among hospital staff of a Belgian tertiary care center tested over 1 week in April 2020, and risk factors for seropositivity.status: Publishe
Responding to lethal violence: RCMP use of deadly force
No full textNot peer reviewedContemporary police officers face the challenge of intervening in community crises while maintaining public and personal safety. Unfortunately, this sometimes includes precarious life and death encounters which require using deadly force.police; RCMP; use of force; deadly force; mental illness; crisis interventio
Tagging of Biomedical Articles on CiteULike: A Comparison of User, Author and Professional Indexing
No full textThis paper examines the context of online indexing from the viewpoint of three different groups: users, authors, and professional indexers. User tags, author keywords and descriptors were collected from academic journal articles, which were both indexed in Pubmed and tagged on CiteULike, and analysed. Descriptive statistics, informetric measures, and thesaural term comparison shows that there are important differences in the use of keywords between the three groups in addition to similarities which can be used to enhance support for search and browse. While tags and author keywords were found that matched descriptors exactly, other terms which did not match but provided important expansion to the indexing lexicon were found. These additional terms could be used to enhance support for searching and browsing in article databases as well as to provide invaluable data for entry vocabulary and emergent terminology for regular updates to indexing systems. Additionally, the study suggests that tags support organisation by association to task, projects and subject while making important connections to traditional systems which classify into subject categories
Predictors and Dynamics of the Humoral and Cellular Immune Response to SARS-CoV-2 mRNA Vaccines in Hemodialysis Patients: A Multicenter Observational Study
No full textBackground Preliminary evidence suggests patients on hemodialysis have a blunted early serological response to SARS-CoV-2 vaccination. Optimizing the vaccination strategy in this population requires a thorough understanding of predictors and dynamics of humoral and cellular immune responses to differentSARS-CoV-2 vaccines.Methods This prospective multicenter study of 543 patients on hemodialysis and 75 healthy volunteers evaluated the immune responses at 4 or 5 weeks and 8 or 9 weeks after administration of the BNT162b2or mRNA-1273 vaccine, respectively. We assessed antiSARS-CoV-2 spike antibodies and T cell responses by IFN-? secretion of peripheral blood lymphocytes upon SARS-CoV-2 glycoprotein stimulation (QuantiFERON assay) and evaluated potential predictors of the responses.Results Compared with healthy volunteers, patients on hemodialysis had an incomplete, delayed humoral immune response and a blunted cellular immune response. Geometric mean antibody titers at both timepoints were significantly greater in patients vaccinated with mRNA-1273 versus BNT162b2, and a larger proportion of them achieved the threshold of 4160 AU/ml, corresponding with high neutralizing antibody titers in vitro(53.6% versus 31.8% at 8 or 9 weeks, P Conclusions The mRNA-1273 vaccine's greater immunogenicity may be related to its higher mRNA dose. This suggests a high-dose vaccine might improve the impaired immune response to SARS-CoV-2 vaccination in patients on hemodialysis.This research was supported by Amgen (DONATION-331036).
A. De Vriese and J. Van Praet designed the study; R. Caluw e, A. De Bel, A. De Vriese, P. Doubel, L. Heylen, M. Schoutteten, J. Van Praet, B. Van Vlem, and L. Viaene provided study materials or patients; D. De Bacquer, A. De Vriese, M. Reynders, and J. Van Praet analyzed the data; D. De Bacquer and J. Van Praet made the figures; A. De Vriese drafted the paper; D. De Bacquer, M. Reynders, and J. Van Praet revised it critically for important intellectual content; all authors approved the final version
of the manuscript. The authors are indebted to Tessa Acke, Manuela Caster, Evelyne Deglorie, Mirjam Demesmaecker, Suzanne Driessens, Inne Hoebrekx, Annelien Leunen, Carine Lowis, Isabel Moyaert, Danny Pauwels, Joris Penders, Melissa Renders, Carmen Reynders, Sofie Tombeur, Katrien Uyttersprot, Femke Van Den Berg, Kristel Van Varenbergh, Tine Verheyen, Manon Verhulst, and Sophie Vleeschouwers for their invaluable help in the collection of the patient data and analysis of the samples
Second Author Affiliation / Address line 1 Affiliation / Address line 2
No full textThis document contains the instructions for preparing a camera-ready manuscript for the proceedings of ACL-2015. The document itself conforms to its own spec-ifications, and is therefore an example of what your manuscript should look like. These instructions should be used for both papers submitted for review and for final versions of accepted papers. Authors are asked to conform to all the directions re-ported in this document.
Ischemie tijdens niertransplantatie beïnvloedt de transplantoverleving en het epigenoom
No full textOrgan transplantation has become the treatment of choice for patients with organ failure. Novel and potent immunosuppressive drugs have become available, and have significantly reduced the incidence of acute rejection and improved short term organ survival. However, long-term graft survival hasn’t improved in parallel over the past decades and it is well established that ongoing destruction of the transplant by the recipient’s immune system continues to be a major contributor to graft loss. Immunosuppressants only provide aspecific suppression of the immune system and are also associated with significant side effects, among others damage of the renal transplant. Therefore, there is a continuing interest in transplantation without the need of long-term immunosuppression (or induction of transplantation tolerance) by using regulatory immune cells or influencing tolerogenic molecular pathways. In the last decade, several regulatory cell populations and tolerogenic pathways have been identified in murine models. In this project, we will describe the changes in immune cells and immune gene expression within the allograft using innovative techniques in a longitudinal manner, and the results will be correlated with changes seen in the peripheral blood and patient outcome. This will identify the relevant regulatory immune cell populations in organ transplantation and help us designing future tolerance-inducing studies in patients suffering from organ failure.status: Publishe
The influence of catheter locks on thrombin and fibrin generation assays in haemodialysis patients
No full textCell free DNA methylation analysis reveals cerebral cell death during hemodialysis
No full textcitation ID: gfae069.850 Background and Aims: Patients treated with hemodialysis demonstrate a significant cognitive decline, likely explained by cerebrovas-cular disease and hypoperfusion. Despite the significant morbidity and mortality associated, no method exists to detect subclinical cerebral injury. This prevents early diagnosis and precludes mitigation strategies. Following cell death, cell free DNA (cfDNA) is released into the peripheral blood. Since DNA methylation is cell-type specific, cfDNA methylation analysis can reveal the cellular origin of cfDNA and cell-type specific changes in cell death. Here, we evaluate if subclinical cerebral ischemia during hemodialysis is detectable through cfDNA methylome analyses
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