Background. Lymphoma incidence is increased among human immunodeficiency virus (HIV)–infected individuals soon after antiretroviral therapy (ART), perhaps due to unmasking immune reconstitution ...inflammatory syndrome (IRIS). Clinical characteristics and survival for unmasking lymphoma IRIS have not been described. Methods. We studied lymphoma patients in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) from 1996 until 2011. Unmasking lymphoma IRIS was defined as lymphoma within 6 months after ART accompanied by a ≥0.5 log10 copies/mL HIV RNA reduction. Differences in presentation and survival were examined between IRIS and non-IRIS cases. Results. Of 482 lymphoma patients, 56 (12%) met criteria for unmasking lymphoma IRIS. Of these, 12 (21%) had Hodgkin lymphoma, 22 (39%) diffuse large B-cell lymphoma, 5 (9%) Burkitt lymphoma, 10 (18%) primary central nervous system lymphoma, and 7 (13%) other non-Hodgkin lymphoma. Median CD4 cell count at lymphoma diagnosis among IRIS cases was 173 cells/μL (interquartile range, 73–302), and 48% had suppressed HIV RNA <400 copies/mL. IRIS cases were similar overall to non-IRIS cases in histologic distribution and clinical characteristics, excepting more frequent hepatitis B and C (30% vs 19%, P = .05), and lower HIV RNA at lymphoma diagnosis resulting from the IRIS case definition. Overall survival at 5 years was similar between IRIS (49%; 95% confidence interval CI, 37%–64%) and non-IRIS (44%; 95% CI, 39%–50%), although increased early mortality was suggested among IRIS cases. Conclusions. In a large HIV-associated lymphoma cohort, 12% of patients met a uniformly applied unmasking lymphoma IRIS case definition. Detailed studies of lymphoma IRIS might identify immunologic mechanisms of lymphoma control.
Association and dissociation rate constants were measured for O2, CO, and alkyl isocyanide binding to a set of genetically engineered sperm whale myoglobins with site-specific mutations at residue 64 ...(the E7 helical position). Native His was replaced by Gly, Val, Leu, Met, Phe, Gln, Arg, and Asp using the synthetic gene and expression system developed by Springer and Sligar (Springer, B. A., and Sligar, S. G. (1987) Proc. Natl. Acad. Sci. U.S.A. 84, 8961-8965). The His64---Gly substitution produced a sterically unhindered myoglobin that exhibited ligand binding parameters similar to those of chelated protoheme suspended in soap micelles. The order of the association rate constants for isocyanide binding to the mutant myoglobins was Gly64 (approximately 10(7) M-1 s-1) much greater than Val64 approximately Leu64 (approximately 10(6) M-1 s-1) greater than Met64 greater than Phe64 approximately His64 approximately Gln64 (10(5)-10(3) M-1 s-1) and indicates that the barrier to isocyanide entry into the distal pocket is primarily steric in nature. The bimolecular rates of methyl, ethyl, n-propyl, and n-butyl isocyanide binding to the His64---Arg and His64---Asp mutants were abnormally high (1-5 x 10(6) M-1 s-1), suggesting that Arg64 and Asp64 adopt conformations with the charged side chains pointing out toward the solvent creating a less hindered pathway for ligand binding. In contrast to the isocyanide data, the association rate constants for O2 and CO binding exhibited little dependence on the size of the E7 side chain. The values for all the mutants except His64---Gln approached or were larger than those for chelated model heme (i.e. approximately 1 x 10(8) M-1 s-1 for O2 and approximately 1 x 10(7) M-1 s-1 for CO), whereas the corresponding rate parameters for myoglobin containing either Gln64 or His64 were 5- to 10-fold smaller. This result suggests that a major kinetic barrier for O2 and CO binding to native myoglobin may involve disruption of polar interactions between His64 and water molecules found in the distal pocket of deoxymyoglobin. Finally, the rate and equilibrium parameters for O2 and CO binding to the His64---Gln, His64---Val, and His64---Leu mutants were compared to those reported previously for Asian elephant myoglobin (Gln-E7), Aplysia limacina myoglobin (Val-E7), and monomeric Hb II from Glycera dibranchiata (Leu-E7).
We introduce a novel algorithm to recover sparse and low-rank matrices from noisy and undersampled measurements. We pose the reconstruction as an optimization problem, where we minimize a linear ...combination of data consistency error, nonconvex spectral penalty, and nonconvex sparsity penalty. We majorize the nondifferentiable spectral and sparsity penalties in the criterion by quadratic expressions to realize an iterative three-step alternating minimization scheme. Since each of these steps can be evaluated either analytically or using fast schemes, we obtain a computationally efficient algorithm. We demonstrate the utility of the algorithm in the context of dynamic magnetic resonance imaging (MRI) reconstruction from sub-Nyquist sampled measurements. The results show a significant improvement in signal-to-noise ratio and image quality compared with classical dynamic imaging algorithms. We expect the proposed scheme to be useful in a range of applications including video restoration and multidimensional MRI.
Sperm whale myoglobin mutants were constructed using site-directed mutagenesis to replace the highly conserved distal histidine residue (His(E7)-64). His-64 was substituted with Gly, Val, Phe, Cys, ...Met, Lys, Arg, Asp, Thr, and Tyr, and all 10 mutant proteins expressed to approximately 10% of the total soluble cell protein in Escherichia coli as heme containing myoglobin. With the exception of His-64---Tyr, which did not form a stable oxygen (O2) complex, all mutant proteins could be reduced and bound O2 and carbon monoxide (CO) reversibly. However, removal of the distal histidine increased the rate of autooxidation 40-350-fold. The His-64---Gly, Val, Phe, Met, and Arg mutants all showed markedly increased O2 dissociation rate constants which were approximately 50-1500-fold higher than those for wild-type myoglobin and increased O2 association rate constants which were approximately 5-15-fold higher than those for the native protein. All mutants studied (except His-64---Tyr) showed approximately 10-fold increased CO association rates and relatively unchanged CO dissociation rates. These altered O2 and CO association and dissociation rate constants resulted in 3-14-fold increased CO affinities, 10-200-fold decreased O2 affinities, and 50-380-fold greater M (KCO/KO2) values for the mutants compared to the wild-type protein. Thus, the distal histidine of myoglobin discriminates between CO and O2 binding by both sterically hindering bound CO and stabilizing bound O2 through hydrogen bonding. The increased autooxidation rates observed for the mutants appear to be due to a decrease in oxygen affinity and an increase in solvent anion accessibility to the distal pocket.
Organic complementary inverters and ring oscillators are fabricated using a unique combination of inkjet printing and evaporation of organic semiconductors. p-Type poly (3, ...3'''-didodecylquaterthiophene) (PQT) is inkjet printed, after which n-type copper hexadecafluorophthalocyanine (F 16 CuPc) is evaporated and patterned by shadow masking. A solution-processable bilayer gate dielectric with superior gate leakage characteristics and a simplified process stack is implemented. The inverters show a high noise margin, good gain characteristics, and a switching point close to V dd /2. A five-stage ring oscillator is also demonstrated.
The South African energy crisis harms the economy. Tax incentives are intended to help, but rules for incentives must be understood by all stakeholders for taxpayers to be encouraged to invest. ...Section 12L (S12L) is relatively new legislation that allows a tax deduction for verified year-on-year energy efficiency savings in South Africa. Concurrent benefits are excluded from this tax incentive, to prevent a double reward for the same activity. Although the prevention of double benefits is commonly addressed in the field of measurement and verification (M&V), non-technical guidelines are not available. This is a critical shortcoming since multiple professions (tax, audit and legal) need to understand the technical M&V requirements of S12L. This study reviews the current legislation and interpretations of concurrent benefits in terms of S12L. It shows that multiple energy-related incentives are utilised by industries and that, therefore, it must be determined if different programmes overlap, so as to create concurrent benefits with S12L. It is then critical to correctly apply M&V practice to ensure exclusion of concurrent benefits. This study also provides a simplified methodology to evaluate concurrency, based on the S12L regulatory requirements and standard M&V methods. Three case studies show how concurrency can occur and how M&V practice is applied to exclude double benefits. The test for concurrency is shown to reduce to the following question: Is the same energy saving funded twice? The tests must be done to ensure no double benefit occurs.
Inroduction: Nasal obstruction is the most common complaint in an average ENT practice, and a deviated nasal septum is the most common cause of nasal obstruction. The deformities of the septum are ...usually congenital, developmental, traumatic, or iatrogenic in nature with traumatic and iatrogenic being the most common. The aim of the study was to evaluate patient-based outcomes on subjective-based opinion in patients undergoing endoscopic septoplasty. Methods: This study was conducted in a tertiary care hospital setting in western Maharashtra. This was a prospective observational study.The present study was conducted on 50 patients who presented with signs and symptoms attributed to septal deviation who underwent endoscopic septoplasty and followed up in the department of otorhinolaryngology, head and neck surgery, tertiary care hospital, Mumbai, Maharashtra.The results of our study were analyzed on SPSS Software using "Paired t-test". Results: On the statistical analysis of the Nasal Obstruction Symptom Evaluation score of patients (n = 50) at baseline and at postoperative 3- and 6-month follow-up, mean + standard deviation was 61.2 ± 11.18, 9.1 ± 5.32, and 8.1 ± 4.51, respectively, with P < 0.0001 preoperative and 3-month postoperative follow-up which is highly significant and P > 0.05 for 3- and 6-month follow-up and hence insignificant. Conclusion: Endoscopic septoplasty results in significant improvement in disease-specific quality of life with high patient satisfaction.
We describe a technique of proximal hypospadias correction that involves freeing the proximal normal bulbar urethra from perineal attachments to lengthen the ventral penis and decrease chordee.
...Correction was performed in 9 patients with a mean age of 11.5 months who had proximal hypospadias and severe chordee that was perineal in 2, mid scrotal in 6 and penoscrotal in 1. After the penis was degloved the bulbar urethra was detethered to or beyond the perineal body without lifting the urethra from the corpora cavernosa. Any remaining penile chordee was corrected and the urethral plate was transected only when chordee persisted. When the urethral plate was intact and the penis straight, tubularized incised plate urethroplasty was done to correct hypospadias in 1 stage. Otherwise 2-stage repair was performed.
Using this maneuver penile straightening was achieved in 2 of the 9 patients, resulting in a glanular urethral or penoscrotal meatus. Dorsal plication sutures required in 4 cases resulted in a mid shaft and penoscrotal meatus in 1 and 3, respectively. Residual chordee in the remaining 3 patients necessitated division of the urethral plate and 2-stage repair despite aggressive mobilization of the proximal urethra. Simultaneous tubularized incised plate urethroplasty was then performed in the 4 penoscrotal and 1 mid shaft meatus. All 6 patients who underwent a successful 1-stage procedure have excellent cosmetic results, while 1 required meatotomy. No fistula or chordee was present at a mean of 13.8 months of followup (range 3.9 to 27.1).
This safe, rapid technique may compensate for significant penile tethering and chordee in a subpopulation of patients with proximal hypospadias, such as 6 of the 9 in our study. It also allows successful tubularized incised plate urethroplasty to be done simultaneously.
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