Has the HIV Epidemic Peaked? Bongaarts, John; Buettner, Thomas; Heilig, Gerhard ...
Population and development review,
June 2008, Letnik:
34, Številka:
2
Journal Article
Recenzirano
This study reviews the highly diverse regional and country patterns of HIV epidemics and discusses possible causes of the geographic variation in epidemic sizes. Past trends and projections of the ...epidemics are presented and the peak years of epidemics are estimated. The potential future impact of new prevention technologies is briefly assessed. A final section summarizes the future impact of the epidemic on key demographic variables. The main finding of this analysis is that the HIV epidemic reached a major turning point over the past decade. The peak years of HIV incidence rates are past for all regions, and the peaks of prevalence rates are mostly in the past except in Eastern Europe, where they are expected to peak in 2008. But owing in part to the life-prolonging effect of antiretroviral therapy and to sustained population growth, the absolute number of infected individuals is expected to keep growing slowly in sub-Saharan Africa and to remain near current levels worldwide, thus posing a continuing challenge to public health programs. No country is expected to see a decline in its population size between 2005 and 2050 that is attributable to high mortality related to AIDS.
Anti‐double‐stranded (ds)DNA antibodies are serological markers of systemic lupus erythematosus (SLE). Of all anti‐dsDNA antibody detection methods, the Crithidia luciliae immunofluorescence test ...(CLIFT) is thought to have the highest specificity for SLE. However, the clinical application is hampered by the low diagnostic sensitivity. A CLIFT with modified assay buffer (mCLIFT) was developed and compared with conventional CLIFT, using sera from 110 patients with SLE, 89 anti‐dsDNA ELISA‐positive patients with other diseases (non‐SLE group A), 157 non‐SLE patients with undetectable anti‐dsDNA antibodies by ELISA (non‐SLE group B), 77 disease controls (non‐SLE group C), and 50 healthy blood donors. Out of the 110 anti‐dsDNA antibody ELISA‐positive SLE patients, 84 (76.4%) demonstrated a positive kinetoplast staining, using the mCLIFT, compared to only 42.3%, using the conventional CLIFT. The diagnostic specificity of mCLIFT was 100% with healthy blood donors and 98.1% with the non‐SLE group C (anti‐nuclear antibodies negative; no signs or symptoms of an autoimmune disease) included. In the non‐SLE groups A and B with various other autoimmune diseases or symptoms of a possible autoimmune disease, positive mCLIFT results were obtained in 33.7% and 3.2%, respectively. In conclusion, by modification of the assay buffer, a significant increase in sensitivity of the CLIFT could be observed while retaining the high specificity for SLE. Further investigation is required to check whether the CLIFT‐positive non‐SLE patients develop SLE and whether anti‐dsDNA antibodies detected by the mCLIFT represent a pathogenetic and diagnostic subgroup of autoantibodies that may improve the early diagnosis of SLE or SLE‐overlap syndromes.
Abstract Spinocerebellar ataxia type 6 (SCA6), episodic ataxia type 2 (EA2) and familial hemiplegic migraine type 1 (FHM1) are allelic disorders of the gene CACNA1A encoding the P/Q subunit of a ...voltage gated calcium channel. While SCA6 is related to repeat expansions affecting the C-terminal part of the protein, EA2 and FHM phenotypes are usually associated with nonsense and missense mutations leading to impaired channel properties. In three unrelated families with dominant cerebellar ataxia, symptoms cosegregated with CACNA1A missense mutations of evolutionary highly conserved amino acids (exchanges p.E668K, p.R583Q and p.D302N). To evaluate pathogenic effects, in silico , protein modeling analyses were performed which indicate structural alterations of the novel mutation p.E668K within the homologous domain 2 affecting CACNA1A protein function. The phenotype is characterised by a very slowly progressive ataxia, while ataxic episodes or migraine are uncommon. These findings enlarge the phenotypic spectrum of CACNA1A mutations.
In 1998 the United Nations Population Division extended the age format of its estimates and projections of population dynamics for all countries and areas of the world from 80 years and above to 100 ...years and above. The paper is based on experiences made during the implementation of relevant mortality projection methodologies and their application in two rounds of global population projections.
The paper first briefly addresses the need for the explicit inclusion of very old population segments into the regular UN estimates and projections. It is argued that since population aging is an important issue for both developed and developing countries, the need for more information regarding the elderly, and the oldest-old in particular, is significant.
The paper then documents the methods that have been evaluated and implemented, namely, the relational mortality standard proposed by Himes, Preston, and Condran, the Coale-Kisker extrapolation method for extending empirical age patterns of mortality to very high ages, and the Carter-Lee projection method for projecting model patterns of mortality to very high levels of life expectancy at birth. The methods are critically reviewed, and possible improvements to the methods are discussed.
The paper concludes with a discussion of different views regarding the future evolution of mortality at older ages, their regional variability, and the necessity to improve the coverage and quality of data collected in this area.
In 2012-2013 the European Commission has had particularly prominent merger cases, with two prohibitions of transactions and several clearances with farreaching remedies. In these cases economic ...analysis has been tightly integrated into the general argument of the Commission and became central to the outcome of the cases. Based on economic theory and supporting data, the Commission has pursued novel economic theories of harm and challenged some economically dubious "common wisdom" in merger assessment. The second area in which economic analysis has had a major impact is in state aid modernization. The new regional aid guidelines of 2013 have moved the rules much closer to economic thinking about effective regional aid and introduced requirements for economic ex-post analysis. Finally, the decisions on the e-books case reflect close cross-Atlantic cooperation with respect to the economic analysis and the design of appropriate remedies. This article reports on a number of examples for the most important cases.
Demographic forecasts are inherently uncertain. Nevertheless, an appropriate description of this uncertainty is a key underpinning of informed decision making. In recent decades various methods have ...been developed to describe the uncertainty of future populations and their structures, but the uptake of such tools amongst the practitioners of official population statistics has been lagging behind. In this letter we revisit the arguments for the practical uses of uncertainty assessments in official population forecasts, and address their implications for decision making. We discuss essential challenges, both for the forecasters and forecast users, and make recommendations for the official statistics community.
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