Background. The optimal time to initiate antiretroviral therapy (ART) in human immunodeficiency virus (HIV)—associated tuberculous meningitis is unknown. Methods. We conducted a randomized, ...double-blind, placebo-controlled trial of immediate versus deferred ART in patients with HIV-associated tuberculous meningitis to determine whether immediate ART reduced the risk of death. Antiretroviral drugs (zidovudine, lamivudine, and efavirenz) were started either at study entry or 2 months after randomization. All patients were treated with standard antituberculosis treatment, adjunctive dexamethasone, and prophylactic co-trimoxazole and were followed up for 12 months. We conducted intention-to-treat, perprotocol, and prespecified subgroup analyses. Results. A total of 253 patients were randomized, 127 in the immediate ART group and 126 in the deferred ART group; 76 and 70 patients died within 9 months in the immediate and deferred ART groups, respectively. Immediate ART was not significantly associated with 9-month mortality (hazard ratio HR, 1.12; 95% confidence interval CI,.81-1.55; P = .50) or the time to new AIDS events or death (HR, 1.16; 95% CI,.87-1.55; P = .31). The percentage of patients with severe (grade 3 or 4) adverse events was high in both arms (90% in the immediate ART group and 89% in the deferred ART group; P = .84), but there were significantly more grade 4 adverse events in the immediate ART arm (102 in the immediate ART group vs 87 in the deferred ART group; P = .04). Conclusions. Immediate ART initiation does not improve outcome in patients presenting with HIV-associated tuberculous meningitis. There were significantly more grade 4 adverse events in the immediate ART arm, supporting delayed initiation of ART in HIV-associated tuberculous meningitis.
Bacteriophage L522, which infects
Xanthomonas oryzae
pv.
oryzae
, was isolated from a paddy leaf sample collected in Long An province, Vietnam. The phage shows myovirus morphology based on ...transmission electron microscopy. It displays a latent period and burst size of approximately 3 h and 63 new virions per infected cell (PFU/infected cell), respectively. The genome of L522 is 44,497 bp in length, with 52% GC content. Of the 63 genes identified, functions were predicted for 26. No virulence or antibiotic-resistance genes were detected. The results of a BLASTn search showed similarity to a previously reported
Xanthomonas
phage, with 85% average nucleotide sequence identity and 87.15% query coverage. Thus, this L522 is a representative of a new species in the genus
Xipdecavirus
.
Poor household dietary diversity has been linked to malnutrition in individuals, households, and cumulatively in populations. High rates of malnutrition among Khmer ethnic children aged five years ...and younger have been reported in Tri Ton district, Vietnam. This paper aims to further investigate household dietary diversity and associated factors among Khmer ethnic minority populations in Vietnam. A cross sectional study was conducted from October 2018 to April 2019 in Tri Ton District, An Giang Province. By employing a multistage sampling technique, a total of 402 (99.8% response rate) participants were interviewed to measure household dietary diversity using a structured and validated questionnaire developed by FAO. Both bivariate and multivariate logistic regression analyses were carried out to identify factors associated with household dietary diversity. The results showed that the prevalence of low, medium and high dietary diversity scores were 21.4%, 70.4% and 8.2%, respectively. Male-headed households, literacy level, household income, exposure to mass media on nutrition and health information, and frequency of eating were positively associated with household dietary diversity (p < 0.05). However, owning a vegetable and rice farm was not statistically related to households’ dietary diversification. The paper concludes that the magnitude of household diversified dietary intakes was essentially low to medium in participants’ households. These findings have provided evidence to inform the development of the National Nutrition Strategy—2021−2030 in Vietnam, to be revised in 2045. This national strategy proposes appropriate interventions, programs and policies to improve socioeconomic status in ethnic groups and in mountainous areas to enhance populations’ health and well-being including controlling childhood malnutrition. In order to improve population health and wellbeing in Tri Ton District, further actions to address effective dietary practices including strengthening nutrition and health communication about the need to improve household dietary diversity to high levels are recommended.
Many clinical and imaging characteristics can influence the prognosis of multilevel cervical spondylotic myelopathy (M-CSM). This study investigated the factors that influence surgical outcomes among ...patients with M-CSM.
This prospective study included 30 patients who underwent surgical treatment for M-CSM from June 2019 to June 2021.
The average age was 62.29 years, and the average follow-up time was 13.13 months. Preoperative, postoperative, and follow-up Modified Japanese Orthopaedic Association (mJOA) scores were 10.17, 13.53, and 16.17, respectively. The average postoperative and follow-up recovery rates were 45.46% and 76.69%, respectively. Patients older than 60 years (p = 0.04), male patients (p = 0.023), and smokers (p = 0.027) had lower preoperative mJOA scores than other groups. Patients with symptoms duration longer than 6 months had lower recovery rates (p = 0.021) than those with shorter symptom duration. Patients with intramedullary hyperintensity in ≤ 2 vertebra (p = 0.041) or anterior surgery (p = 0.022) had better postoperative recovery rates than their counterparts. A shorter period of hyperintensity in the intramedullary region on sagittal T2-weighted magnetic resonance imaging (T2W MRI) was significantly associated with faster discharge (p = 0.044). Patients with type 3 (discrete focal) hyperintensity in the intramedullary region on axial T2W MRI had a 6.75-fold increase in experiencing less than 50% postoperative recovery compared with other groups (odds ratio: 6.75, 95% confidence interval: 2.73-16.67).
Good prognostic factors for a shorter recovery included hyperintensity in the intramedullary region for ≤ 2 levels, shorter period of hyperintensity in the intramedullary region on sagittal T2W MRI, and an anterior surgical approach. A duration of symptoms longer than 6 months and discrete hyperintensity in the intramedullary region on axial T2W MRI were poor prognostic indicators associated with a longer recovery period.
This paper investigates the benefits of applying fountain codes (FCs) in improving the transmission efficiency in broadcasting systems. Particularly, an exact expression of the transmission ...efficiency for wireless broadcast using FCs is derived. This derivation allows us to compare the transmission efficiency of the fountain code approach (FCA) and network coding approach (NCA) in wireless broadcast. The numerical results demonstrate that FCA achieves better performance than NCA when the number of users is large and vice versa when the number of users is small.
Let
n
≥
2
be an integer. The Grimaldi graph
G
(
n
) is defined by taking the elements of the set
{
0
,
…
,
n
-
1
}
as vertices. Two distinct vertices
x
and
y
are adjacent in
G
(
n
) if and only if
...gcd
(
x
+
y
,
n
)
=
1
. In this paper, we examine the Betti numbers of the edge ideals of these graphs and their complements.
The model alga Chlamydomonas reinhardtii has been used to pioneer genetic engineering techniques for high‐value protein and biofuel production from algae. To date, most studies of transgenic ...Chlamydomonas have utilized the chloroplast genome due to its ease of engineering, with a sizeable suite of reporters and well‐characterized expression constructs. The advanced manipulation of algal nuclear genomes has been hampered by limited strong expression cassettes, and a lack of high‐throughput reporters. We have improved upon an endogenous reporter gene – the ARS2 gene encoding an arylsulfatase enzyme – that was first cloned and characterized decades ago but has not been used extensively. The new construct, derived from ARS2 cDNA, expresses significantly higher levels of reporter protein and transforms more efficiently, allowing qualitative and quantitative screening using a rapid, inexpensive 96‐well assay. The improved arylsulfatase expression cassette was used to screen a new transgene promoter from the ARG7 gene, and found that the ARG7 promoter can express the ARS2 reporter as strongly as the HSP70‐RBCS2 chimeric promoter that currently ranks as the best available promoter, thus adding to the list of useful nuclear promoters. This enhanced arylsulfatase reporter construct improves the efficiency and ease of genetic engineering within the Chlamydomonas nuclear genome, with potential application to other algal strains.
Manipulation of algal nuclear genomes has been hampered by a lack of adequate molecular tools. In this study, the authors construct a new arylsulfatase reporter (ARS2) which is developed for transforming Chlamydomonas reinhardtii more efficiently, and can produce thousands of colonies per transformation that can be grown in deep 96‐well plates for downstream analysis. Furthermore, the improved reporter construct produces much higher expression, enabling rapid visual analysis using an inexpensive, high‐throughput chromogenic assay. The availability of this ARS2‐derived nuclear reporter improves the tractability of algal nuclear genome engineering.
Cholecystokinin (CCK) is well-known as a key hormone that inhibits stomach emptying and stimulates midgut motility in gastric species. However, the function of CCK related to gut motility in agastric ...fish, especially in fish with a short digestive tract such as ballan wrasse, remains unknown. Here we present a detailed description of the spatio-temporal quantification of intestinal motility activity
comprising the complete intestinal tract in ballan wrasse. We show that CCK modulates intestinal motility, having multiple effects on motility patterns depending on location in the gut and types of contractions. CCK reduced propagating contractions in the foregut, but it increased both non-propagating and propagating contractions in the hindgut. CCK also altered the direction of propagating contractions, as it reduced anterograde ripples and slow propagating contractions. The velocity of propagating contractions was slowed down by CCK. CCK also reduced the amplitude of standing contractions and ripples, but it did not alter the amplitude of slow propagating contractions. The presence of CCKA receptor antagonist modulated the motility responses of ballan wrasse intestines when exposed to CCK. We also showed that CCK reduced the intestinal length and stimulated motility to empty the gallbladder. Based on our findings we hypothesize that CCK, mainly through the CCKA receptor, modulates non-propagating and propagating contractions to optimize digestion and absorption and regulate the intestinal evacuation in ballan wrasse. We also found evidence that the modulation of intestinal motility by CCK is different in agastric fish from that in gastric vertebrates. We suggest that this is an evolutionary adaptation to optimize digestion without a stomach.
To assess risk factors for respiratory tract infection symptoms and signs in sheltered homeless people in Marseille during the winter season, including pathogen carriage.
Data on 479 male ...participants within two shelters who completed questionnaires and a total of 950 nasal and pharyngeal samples were collected during the winters of 2015–2017. Respiratory pathogen carriage including seven viruses and four bacteria was assessed by quantitative PCR.
The homeless population was characterized by a majority of individuals of North African origin (300/479, 62.6%) with a relatively high prevalence of chronic homelessness (175/465, 37.6%). We found a high prevalence of respiratory symptoms and signs (168/476, 35.3%), a very high prevalence of bacterial carriage (313/477, 65.6%), especially Haemophilus influenzae (280/477, 58.7%), and a lower prevalence of virus carriage (51/473, 10.8%) with human rhinovirus being the most frequent (25/473, 5.3%). Differences were observed between the microbial communities of the nose and throat. Duration of homelessness (odds ratio (OR) 1.77, p 0.017), chronic respiratory diseases (OR 5.27, p <0.0001) and visiting countries of origin for migrants (OR 1.68, p 0.035) were identified as independent risk factors for respiratory symptoms and signs. A strong association between virus (OR 2.40, p 0.012) or Streptococcus pneumoniae (OR 2.32, p 0.014) carriage and respiratory symptoms and signs was also found.
These findings allowed identification of the individuals at higher risk for contracting respiratory tract infections to better target preventive measures aimed at limiting the transmission of these diseases in this setting.
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