Orientation and morphology control in acid-catalyzed covalent organic framework thin films.

As thin films of semiconducting covalent organic frameworks (COFs) are demonstrating utility for ambipolar electronics, channel materials in organic electrochemical transistors (OECTs), and broadband photodetectors, control and modulation of their thin film properties is paramount. In this work, an interfacial growth technique is utilized to synthesize imine TAPB-PDA COF films at both the liquid-liquid interface as well as at the liquid-solid interface on a Si/SiO2 substrate. The concentration of acetic acid catalyst in the aqueous phase is shown to significantly influence the thin film morphology of the liquid-solid growth, with concentrations below 1 M resulting in no film nucleation, concentrations of 1-4 M enabling smooth film formation, and concentrations greater than 4 M resulting in films with a higher density of particulates on the surface. Importantly, while the films grown at the liquid-liquid interface are mixed-orientation, those grown directly at the liquid-solid interface on the Si/SiO2 surface have highly oriented COF layers aligned parallel to the substrate surface. Moreover, this liquid-solid growth process affords TAPB-PDA COF thin films with p-type charge transport having a transconductance of 10 µS at a gate voltage of -0.9 V in an OECT device structure.

Microwave Facilitated Covalent Organic Framework/Transition Metal Dichalcogenide Heterostructures.

Organic/inorganic heterostructures present a versatile platform for creating materials with new functionalities and hybrid properties. In particular, junctions between two dimensional materials have demonstrated utility in next generation electronic, optical, and optoelectronic devices. This work pioneers a microwave facilitated synthesis process to readily incorporate few-layer covalent organic framework (COF) films onto monolayer transition metal dichalcogenides (TMDC). Preferential microwave excitation of the monolayer TMDC flakes result in selective attachment of COFs onto the van der Waals surface with film thicknesses between 1 and 4 nm. The flexible process is extended to multiple TMDCs (MoS2, MoSe2, MoSSe) and several well-known COFs (TAPA-PDA COF, TPT-TFA-COF, and COF-5). Photoluminescence studies reveal a power-dependent defect formation in the TMDC layer, which facilitates electronic coupling between the materials at higher TMDC defect densities. This coupling results in a shift in the A-exciton peak location of MoSe2, with a red or blue shift of 50 or 19 meV, respectively, depending upon the electron donating character of the few-layer COF films. Moreover, optoelectronic devices fabricated from the COF-5/TMDC heterostructure present an opportunity to tune the PL intensity and control the interaction dynamics within inorganic/organic heterostructures.

Detection of Arterial Injuries in Blunt Abdominopelvic Trauma: The Value of Computed Tomography.

Background: This study aims to evaluate the value of computed tomography (CT) in detecting arterial injuries in abdominopelvic trauma compared with digital subtraction angiography (DSA). Methods: A retrospective study was performed on 83 patients (67 men, 16 women with a mean age of 38.2 years) who were hospitalized with abdominopelvic trauma and were diagnosed by CT with arterial injuries including active extravasation (AE), pseudoaneurysm (PA), and arteriovenous fistula (AVF). The findings on the CT images were interpreted and its value as a diagnostic modality was analyzed compared with images taken from patients who underwent DSA from June 2020 to November 2021. Results: A total of 94 arterial lesions were observed on CT (54 AE, 37 PA, and 3 AVF). The sensitivity (Se), specificity (Sp), positive predictive values (PPV), and negative predictive values (NPV) on the arterial phase when diagnosing AE were 88.9%, 90%, 92.3%, and 85.7%, respectively, and 86.1%, 91.4 %, 86.1%, and 91.4%, respectively, when diagnosing PA. On the portal venous phase, the Se, Sp, PPV, NPV for AE were 88.9%, 92.5%, 94.1%, and 86.0%, respectively, and 75%, 91.4%, 84.4%, and 85.5%, respectively, for PA. On the dual phase, the Se, Sp, PPV, and NPV for AE were 92.6%, 90%, 92.6%, and 90%, respectively, 88.9%, 91.4%. 86.5%, and 93%, respectively, for PA, and 75%, 100%, 100%, and 98.9%, respectively for AVF. Conclusions: Our study showed that CT is a useful, non-invasive modality for detecting arterial injuries in abdominopelvic trauma. A dual-phase scan combined with arterial and portal venous phases gives the optimal performance.

The systemic inflammatory response and clinicopathological characteristics in patients admitted to hospital with COVID-19 infection: Comparison of 2 consecutive cohorts.

BACKGROUND: In order to manage the COVID-19 systemic inflammatory response, it is important to identify clinicopathological characteristics across multiple cohorts. METHODS: The aim of the present study was to compare the 4C mortality score, other measures of the systemic inflammatory response and clinicopathological characteristics in two consecutive cohorts of patients on admission with COVID-19. Electronic patient records for 2 consecutive cohorts of patients admitted to two urban teaching hospitals with COVID-19 during two 7-week periods of the COVID-19 pandemic in Glasgow, U.K. (cohort 1: 17/3/2020-1/5/2020) and (cohort 2: 18/5/2020-6/7/2020) were examined for routine clinical, laboratory and clinical outcome data. RESULTS: Compared with cohort 1, cohort 2 were older (p<0.001), more likely to be female (p<0.05) and have less independent living circumstances (p<0.001). More patients in cohort 2 were PCR positive, CXR negative (both p<0.001) and had low serum albumin concentrations (p<0.001). 30-day mortality was similar between both cohorts (23% and 22%). In cohort 2, age >70 (p<0.05), male gender (p<0.05), COPD (p<0.05), cognitive impairment (p<0.05), frailty (p<0.001), delirium (p = 0.001), CRP>150mg/L (p<0.05), albumin <30 g/L (p<0.01), elevated perioperative Glasgow Prognostic Score (p<0.05), elevated neutrophil-lymphocyte ratio (p<0.001), low haematocrit (p<0.01), elevated PT (p<0.05), sodium <133 mmol/L (p<0.01) elevated urea (p<0.001), creatinine (p<0.001), glucose (p<0.05) and lactate (p<0.001) and the 4C score (p<0.001) were associated with 30-day mortality. In multivariate analysis, greater frailty (CFS>3) (OR 11.3, 95% C.I. 2.3-96.7, p<0.05), low albumin (<30g/L) (OR 2.5, 95% C.I. 1.0-6.2, p<0.05), high NLR (≥3) (OR 2.2, 95% C.I. 1.5-4.5, p<0.05) and the 4C score (OR 2.4, 95% C.I. 1.0-5.6, p<0.05) remained independently associated with 30-day mortality. CONCLUSION: In addition to the 4C mortality score, frailty score and a low albumin were strongly independently associated with 30-day mortality in two consecutive cohorts of patients admitted to hospital with COVID-19. TRIAL REGISTRATION: clinicaltrials.gov: NCT04484545.

Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection.

BACKGROUND: Severe COVID-19 infection results in a systemic inflammatory response (SIRS). This SIRS response shares similarities to the changes observed during the peri-operative period that are recognised to be associated with the development of multiple organ failure. METHODS: Electronic patient records for patients who were admitted to an urban teaching hospital during the initial 7-week period of the COVID-19 pandemic in Glasgow, U.K. (17th March 2020-1st May 2020) were examined for routine clinical, laboratory and clinical outcome data. Age, sex, BMI and documented evidence of COVID-19 infection at time of discharge or death certification were considered minimal criteria for inclusion. RESULTS: Of the 224 patients who fulfilled the criteria for inclusion, 52 (23%) had died at 30-days following admission. COVID-19 related respiratory failure (75%) and multiorgan failure (12%) were the commonest causes of death recorded. Age ≥ 70 years (p < 0.001), past medical history of cognitive impairment (p ≤ 0.001), previous delirium (p < 0.001), clinical frailty score > 3 (p < 0.001), hypertension (p < 0.05), heart failure (p < 0.01), national early warning score (NEWS) > 4 (p < 0.01), positive CXR (p < 0.01), and subsequent positive COVID-19 swab (p ≤ 0.001) were associated with 30-day mortality. CRP > 80 mg/L (p < 0.05), albumin < 35 g/L (p < 0.05), peri-operative Glasgow Prognostic Score (poGPS) (p < 0.05), lymphocytes < 1.5 109/l (p < 0.05), neutrophil lymphocyte ratio (p ≤ 0.001), haematocrit (< 0.40 L/L (male)/ < 0.37 L/L (female)) (p ≤ 0.01), urea > 7.5 mmol/L (p < 0.001), creatinine > 130 mmol/L (p < 0.05) and elevated urea: albumin ratio (< 0.001) were also associated with 30-day mortality. On multivariate analysis, age ≥ 70 years (O.R. 3.9, 95% C.I. 1.4-8.2, p < 0.001), past medical history of heart failure (O.R. 3.3, 95% C.I. 1.2-19.3, p < 0.05), NEWS > 4 (O.R. 2.4, 95% C.I. 1.1-4.4, p < 0.05), positive initial CXR (O.R. 0.4, 95% C.I. 0.2-0.9, p < 0.05) and poGPS (O.R. 2.3, 95% C.I. 1.1-4.4, p < 0.05) remained independently associated with 30-day mortality. Among those patients who tested PCR COVID-19 positive (n = 122), age ≥ 70 years (O.R. 4.7, 95% C.I. 2.0-11.3, p < 0.001), past medical history of heart failure (O.R. 4.4, 95% C.I. 1.2-20.5, p < 0.05) and poGPS (O.R. 2.4, 95% C.I. 1.1-5.1, p < 0.05) remained independently associated with 30-days mortality. CONCLUSION: Age ≥ 70 years and severe systemic inflammation as measured by the peri-operative Glasgow Prognostic Score are independently associated with 30-day mortality among patients admitted to hospital with COVID-19 infection.

[Knowledge, Attitudes And Practice Of The Pupils Of The High School Famolo Coulibaly Of Kolokani On The HIV And The AIDS (Mali)]. / Connaissances, Attitudes Et Pratiques Des Eleves Du Lycee Famolo Coulibaly De Kolokani Sur Le VIH Et Le Sida (Mali).

INTRODUCTION: The epidemic of the AIDS is global. No country or territory is saved. Mali takes into account the preventive education in the AIDS in the sectorial programs of the Ministry of Education and the courses of study. OBJECTIVE: to estimate the level of the Knowledge, Attitudes and Practice of the pupils regarding prevention of the HIV and the AIDS. METHODS: it was about an exhaustive, quantitative and transverse survey led to the high school of Kolokani. The survey concerned 515 pupils questioned from 2 till 7 March 2007. RESULTS: At the level of the knowledge the mode of transmission the most quoted by the pupils was the sexual intercourse with multiple partners (78.46 % for the boys and 71.22 % for the girls). Compared with the behavior, 62.89% of sexually active pupils used the condom in their last high-risk sexual intercourse. Only 25.05% of students reported having conducted a voluntary screening test. Attitudes of discrimination exist because 18.06 % of pupils have a feeling of fear towards the People Living with the HIV. CONCLUSION: These results show that there is a risk of transmission of the HIV and the AIDS in schools. This has to motivate the intensification of the activities of raising sensitization and prevention to improve the indicators of prevention of this pandemic.

INTRODUCTION: L'épidémie du SIDA est globale. Aucun pays ou territoire n'est épargné. Le Mali prend en compte l'éducation préventive au SIDA dans les programmes sectoriels du Ministère chargé de l'éducation et des programmes scolaires. OBJECTIF: Evaluer le niveau des Connaissances, Attitudes et Pratiques des élèves en matière de prévention du VIH et du SIDA. MÉTHODES: Il s'agissait d'une étude exhaustive, quantitative et transversale menée au lycée de Kolokani. L'enquête a porté sur 515 élèves interrogés du 2 au 7 Mars 2007. RÉSULTATS: Au niveau des connaissances le mode de transmission le plus cité par les élèves était le rapport sexuel avec les partenaires multiples (78,46% pour garçons et 71,22% pour les filles). Par rapport aux comportements 62,89% des élèves sexuellement actifs ont utilisé le préservatif lors de leur dernier rapport sexuel à haut risque. Seulement 25,05% des élèves ont déclaré avoir effectué un test de dépistage volontaire. Les attitudes de discrimination existent car 18,06% des élèves ont un sentiment de peur envers les Personnes Vivant avec le VIH. CONCLUSION: Ces résultats montrent qu'il y a un risque de transmission du VIH et du SIDA en milieu scolaire. Ceci doit motiver l'intensification des activités de sensibilisation et de prévention pour améliorer les indicateurs de prévention de cette pandémie.

Connaissances, attitudes et pratiques des élevés du lycée famolo coulibaly de Kolokani sur le VIH et le sida (Mali)

Introduction : L'épidémie du SIDA est globale. Aucun pays ou territoire n'est épargné. Le Mali prend en compte l'éducation préventive au SIDA dans les programmes sectoriels du Ministère chargé de l'éducation et des programmes scolaires. Objectif : Evaluer le niveau des Connaissances, Attitudes et Pratiques des élèves en matière de prévention du VIH et du SIDA. Méthodes : Il s'agissait d'une étude exhaustive, quantitative et transversale menée au lycée de Kolokani. L'enquête a porté sur 515 élèves interrogés du 2 au 7 Mars 2007. Résultats : Au niveau des connaissances le mode de transmission le plus cité par les élèves était le rapport sexuel avec les partenaires multiples (78,46% pour garçons et 71,22% pour les filles). Par rapport aux comportements 62,89% des élèves sexuellement actifs ont utilisé le préservatif lors de leur dernier rapport sexuel à haut risque. Seulement 25,05% des élèves ont déclaré avoir effectué un test de dépistage volontaire. Les attitudes de discrimination existent car 18,06% des élèves ont un sentiment de peur envers les Personnes Vivant avec le VIH. Conclusion : Ces résultats montrent qu'il y a un risque de transmission du VIH et du SIDA en milieu scolaire. Ceci doit motiver l'intensification des activités de sensibilisation et de prévention pour améliorer les indicateurs de prévention de cette pandémie

Infusion of ex-vivo expanded human TCR-αß+ double-negative regulatory T cells delays onset of xenogeneic graft-versus-host disease.

Despite the demonstration of potent immunosuppressive function of T cell receptor (TCR)-αß+ double-negative regulatory T cells (DN Tregs ), scarce numbers and lack of effective expansion method limit their clinical applications. Here we describe an approach that allows for ∼3500-fold ex-vivo expansion of human DN Tregs within 3 weeks with > 97% purity. Ex-vivo-expanded DN Tregs suppress proliferation of polyclonally stimulated autologous T and B cells in vitro through direct cell-to-cell contact. In vivo, we demonstrate for the first time that infusion of human DN Tregs delayed an onset of xenogeneic graft-versus-host disease (GVHD) significantly in a humanized mouse model. Furthermore, preincubation of ex-vivo-expanded DN Tregs with a mechanistic target of rapamycin (mTOR) inhibitor rapamycin enhanced their immune regulatory function further. Taken together, this study demonstrates that human DN Tregs can be expanded ex vivo to therapeutic numbers. The expanded DN Tregs can suppress proliferation of T and B cells and attenuate GVHD, highlighting the potential clinical use of DN Tregs to mitigate GVHD.

Scar satisfaction and body image in thyroidectomy patients: prospective study in a tertiary referral centre.

BACKGROUND: This study is the first to evaluate scar satisfaction and body image in thyroidectomy patients using validated assessment tools. METHODS: A total of 123 thyroidectomy patients were recruited over 8 months. Both patients and clinicians completed assessment tools that included: the Manchester Scar Scale (to measure scar perception), Dysmorphic Concern Questionnaire (to assess body image), Body Dysmorphic Concern Questionnaire (to screen for body dysmorphic disorder) and EQ-5D (to measure life quality). A separate image panel comprising experts and non-experts assessed 15 scar photographs. The results were analysed using non-parametric descriptive statistics. RESULTS: Poor body image was associated with poor scar perception (ρ = 0.178, p = 0.05). Poor life quality correlated with poor scar perception (ρ = -0.292, p = 0.001). Scar length did not affect scar perception. Prevalence of body dysmorphic disorder among patients was found to be 8.94 per cent, which is higher than general population rates. CONCLUSION: Negative body image and life quality impact negatively upon scar perception.

The P2X7 receptor antagonist Brilliant Blue G reduces serum human interferon-γ in a humanized mouse model of graft-versus-host disease.

Graft-versus-host disease (GVHD) remains a major problem after allogeneic haematopoietic stem cell transplantation, a curative therapy for haematological malignancies. Previous studies have demonstrated a role for the adenosine triphosphate (ATP)-gated P2X7 receptor channel in allogeneic mouse models of GVHD. In this study, injection of human peripheral blood mononuclear cells (PBMCs) into immunodeficient non-obese diabetic-severe combined immunodeficiency-interleukin (NOD-SCID-IL)-2Rγnull (NSG) mice established a humanized mouse model of GVHD. This model was used to study the effect of P2X7 blockade in this disease. From five weeks post-PBMC injection, humanized mice exhibited clinical signs and histopathology characteristic of GVHD. The P2X7 antagonist, Brilliant Blue G (BBG), blocked ATP-induced cation uptake into both murine and human cells in vitro. Injection of BBG (50 mg/kg) into NSG mice did not affect engraftment of human leucocytes (predominantly T cells), or the clinical score and survival of mice. In contrast, BBG injection reduced circulating human interferon (IFN)-γ significantly, which was produced by human CD4+ and CD8+ T cells. BBG also reduced human T cell infiltration and apoptosis in target organs of GVHD. In conclusion, the P2X7 antagonist BBG reduced circulating IFN-γ in a humanized mouse model of GVHD supporting a potential role for P2X7 to alter the pathology of this disease in humans.

A Perylene-Based Microporous Coordination Polymer Interacts Selectively with Electron-Poor Aromatics.

The design, synthesis, and properties of the new microporous coordination polymer UMCM-310 are described. The unique electronic character of the perylene-based linker enables selective interaction with electron-poor aromatics leading to efficient separation of nitroaromatics. UMCM-310 possesses high surface area and large pore size and thus permits the separation of large organic molecules based on adsorption rather than size exclusion.

Filling pore space in a microporous coordination polymer to improve methane storage performance.

A strategy that allows the tuning of pore size in microporous coordination polymers (MCPs) through modification of their organic linkers is presented. When large substituents are introduced onto the linker, these pendent groups partially occupy the pores, thus reducing pore size while serving as additional adsorption sites for gases. The approach takes advantage of the fact that, for methane storage materials, small pores (0.4-0.8 nm in diameter) are more desirable than large pores since small pores promote optimal volumetric capacity. This method was demonstrated with IRMOF-8, a MCP constructed from Zn4O metal clusters and 2,6-naphthalenedicarboxylate (NDC) linkers. The NDC was functionalized through the addition of substituents including tert-butylethynyl or phenylethynyl groups. High pressure methane uptake demonstrates that the IRMOF-8 derivatives have significantly better performance than the unfunctionalized material in terms of both excess volumetric uptake and deliverable capacity. Moreover, IRMOF-8 derivatives also give rise to stronger interactions with methane molecules as shown by higher heat of adsorption values.

Recurrent reactions to food among children at paediatric emergency departments: epidemiology of allergic disease.

BACKGROUND: Knowledge about repeated food reactions in paediatric emergency departments (ED) is sparse. OBJECTIVE: To investigate the incidence and potential risk factors for repeated ED visits for food-allergic reactions among children with a prior ED visit due to reactions to food. METHODS: A total of 358 children with ED visits at paediatric hospitals in Stockholm due to reactions to foods during 2007 (index-reaction) were investigated in relation to recurrent reactions until 30 June 2010. Adjusted Cox proportional hazard models were used to compute relative risks (RR) and 95% confidence intervals (CI). RESULTS: A total of 80 children had 116 ED revisits over a period of 873 patient-years, yielding an incidence rate of 9 per 100 patient-years. Known food allergy before the index ED visit in 2007 increased the risk for ED revisits (RR = 2.30, 95% CI 1.35-3.94). Likewise, prescription of adrenaline auto-injector before the index-reaction increased the risk (RR = 2.02, 95% CI 1.17-3.49). Twenty-one percent of the children had more severe reactions at the revisit, 38% less severe and 41% had reactions of comparable severity. However, among 44% of the children with comparable or less severe reaction at revisit, early treatment with adrenaline hampered the classification of change in severity. CONCLUSIONS AND CLINICAL RELEVANCE: Previously known food allergy and prior prescription of adrenaline are significant risk factors for ED revisits among children with a prior ED visit due to reactions to food. Our results indicate that the severity of the index-reaction cannot be used to predict the severity of the relapse.

CD44 is prognostic for overall survival in the NCI randomized trial on breast conservation with 25 year follow-up.

CD44 is a transmembrane glycoprotein involved in numerous cellular functions, including cell adhesion and extracellular matrix interactions. It is known to be functionally diverse, with alternative splice variants increasingly implicated as a marker for tumor-initiating stem cells associated with poor prognosis. Here, we evaluate CD44 as a potential marker of long-term breast cancer outcomes. Tissue specimens from patients treated on the National Cancer Institute 79-C-0111 randomized trial of breast conservation versus mastectomy between 1979 and 1987 were collected, and immunohistochemistry was performed using the standard isoform of CD44. Specimens were correlated with patient characteristics and outcomes. Survival analysis was performed using the log rank test. Fifty-one patients had evaluable tumor sections and available long-term clinical follow up data at a median follow up of 25.7 years. Significant predictors of OS were tumor size (median OFS 25.4 years for ≤2 cm vs. 7.5 years for >2 cm, p = 0.001), nodal status (median OS 17.2 years for node-negative patients vs. 6.7 years for node positive patients, p = 0.017), and CD44 expression (median OS 18.9 years for CD44 positive patients vs. 8.6 years for CD44 negative patients, p = 0.049). There was a trend toward increased PFS for patients with CD44 positive tumors (median PFS 17.9 vs. 4.3 years, p = 0.17), but this did not reach statistical significance. These findings illustrate the potential utility of CD44 as a prognostic marker for early stage breast cancer. Subgroup analysis in patients with lymph node involvement revealed CD44 positivity to be most strongly associated with increased survival, suggesting a potential role of CD44 in decision making for axillary management. As there is increasing interest in CD44 as a therapeutic target in ongoing clinical trials, the results of this study suggest additional investigation regarding the role CD44 in breast cancer is warranted.

Kinetic pathways of sphere-to-cylinder transition in diblock copolymer melt under electric field.

Phase transition from body-centered-cubic spheres to cylinders in a diblock copolymer melt under an external electric field is investigated by means of real-space dynamical self-consistent field theory. Different phase transition kinetic pathways and different cylindrical domains arrangements of the final phase are observed depending on the strength and direction of the applied electric field. Various transient states have been identified depending on the electric field being applied along [111], [100], and [110] directions. The electric field should be above a certain threshold value in order the transition to occur. A "dynamic critical exponent" of the transition is found to be about 3/2, consistent with other order-order transitions in diblock copolymers under electric field.

Anaphylaxis and reactions to foods in children--a population-based case study of emergency department visits.

BACKGROUND: Information about acute reactions to foods among children is limited. OBJECTIVE: To describe the overall incidence of anaphylaxis in a paediatric emergency department (ED) setting and to describe reactions to foods in relation to sex and age, clinical characteristics and management. METHODS: In a review of medical records, children with ED visits at any of three paediatric hospitals in Stockholm County during 2007 were targeted. Inclusion criteria were any adverse reaction to foods or anaphylaxis. RESULTS: 383 children fulfilled the inclusion criteria of which 371 had had reactions to foods. The incidence of anaphylaxis was 32 per 100 000 person years irrespective of cause and food was involved in 92%. Tree nuts, particular cashew, and peanut were the most common eliciting foods, and in children under 3 years, reactions to these two food allergens were as common as reactions to milk and egg. Pollen-allergic children seemed to be admitted due to food-induced anaphylaxis more often during the deciduous tree pollen season compared with the rest of the year (P = 0.015). Symptoms from the lower airways occurred in 49% of children with anaphylaxis but without underlying asthma compared with 72% of children with anaphylaxis and asthma, P < 0.01. CONCLUSIONS AND CLINICAL RELEVANCE: Reactions to peanut and tree nuts are as common as reactions to milk and egg in early life. Concomitant exposure to airborne allergens seems to increase the risk of anaphylaxis to foods. Among children with anaphylaxis, wheeze is prevalent even in children without asthma diagnosis.

An alpha-galactosylceramide C20:2 N-acyl variant enhances anti-inflammatory and regulatory T cell-independent responses that prevent type 1 diabetes.

Protection from type 1 diabetes (T1D), a T helper type 1 (Th1)-mediated disease, is achievable in non-obese diabetic (NOD) mice by treatment with alpha-galactosylceramide (alpha-GalCer) glycolipids that stimulate CD1d-restricted invariant natural killer T (iNK T) cells. While we have reported previously that the C20:2 N-acyl variant of alpha-GalCer elicits a Th2-biased cytokine response and protects NOD mice from T1D more effectively than a form of alpha-GalCer that induces mixed Th1 and Th2 responses, it remained to determine whether this protection is accompanied by heightened anti-inflammatory responses. We show that treatment of NOD mice with C20:2 diminished the activation of 'inflammatory' interleukin (IL)-12 producing CD11c(high)CD8+ myeloid dendritic cells (mDCs) and augmented the function of 'tolerogenic' DCs more effectively than treatment with the prototypical iNKT cell activator KRN7000 (alpha-GalCer C26:0) that induces Th1- and Th2-type responses. These findings correlate with a reduced capacity of C20:2 to sustain the early transactivation of T, B and NK cells. They may also explain our observation that C20:2 activated iNK T cells depend less than KRN7000 activated iNK T cells upon regulation by regulatory T cells for cytokine secretion and protection from T1D. The enhanced anti-inflammatory properties of C20:2 relative to KRN7000 suggest that C20:2 should be evaluated further as a drug to induce iNK T cell-mediated protection from T1D in humans.

[HIV/AIDS prevalence among the attendees at the Center for Voluntary Anonymous Detection and Support in Pikine/Guediawaye, Senegal]. / Prévalence du VIH/sida chez les clients du Centre de Dépistage Volontaire Anonyme et d'Accompagnement de Pikine/Guédiawaye, au Sénégal.

Within the framework of HIV/AIDS epidemic control, a Center for Voluntary Anonymous Detection and Support (CDVAA) was opened in March 2003 in Pikine/Guediawaye, Senegal. The purpose of this study was to analyze the prevalence of the HIV infection among attendees at the center over a one-year period as a basis for targeting the services of the CDVAA towards improving public health. This retrospective epidemiological study based on analysis of CDVAA attendee records was carried out from April 8, 2003 to April 7, 2004. The CDVAA in Pikine/Guediawaye shares premises with the Departmental Center for Popular and Sports Education. Sampling was exhaustive with inclusion of all people that attended the CDVAA during the study period. Study variables were age, sex, family status, educational level, ethnic group, religion, reason for detection, knowledge about HIV/AIDS prevention methods, results of the test, and, in case of infection, acceptance/refusal of referral to an appropriate management facility. Data were computed and analyzed using EpiInfo 6.04d software. The most common reason for detection was curiosity to know serologic status (69%). Test results were positive in 3% of cases. Infection was due to HIV1 in 65% of cases, HIV2 in 24%, and both (HIV1-HIV2 co-infection) in 11%. Ninety-one percent of attendees that underwent testing returned to pick-up their results. Sixty-eight percent of attendees that tested positive accepted referral to an appropriate management facility. HIV infection was significantly more frequent in attendees who were 24 years old, married, or illiterate and in attendees reporting risky behavior. To further encouraging progress already achieved, the CDVAA must improve the quality of its services and promote its activities as a means of familiarizing the target population on prevention of sexual transmitted diseases and HIV/AIDS, with a particular focus on safe behavior.

Prevalence du VIH/sida chez les clients du Centre de Depistage Volontaire Anonyme et d'Accompagnement de Pikine/Guediawaye; au Senegal

Dans le cadre de la lutte contre le VIH/SIDA; un Centre de Depistage Volontaire Anonyme et d'Accompagnement (CDVAA) a ete ouvert en mars 2003 a Pikine/Guediawaye; au Senegal. Cette etude cherche a analyser la prevalence de l'infection chez les clients durant une annee d'activite dans le but d'orienter les services du CDVAA pour une meilleure sante des populations. L'etude porte sur la periode allant du 08 avril 2003 au 07 avril 2004. Il s'agit d'une etude epidemiologique retrospective basee sur l'exploitation des fiches des clients du CDVAA qui; a Pikine/Guediawaye; etait abrite par le Centre Departemental d'Education Populaire et Sportive. Elle portait sur l'ensemble des personnes recues au CDVAA durant la periode consideree. Les variables etudiees portaient sur l'age; le sexe; le statut matrimonial; le niveau d'instruction; l'ethnie; la religion; les raisons du depistage; les connaissances concernant les modes de prevention; les resultats du test et; en cas de positivite; l'acceptation ou non de la reference vers une structure de prise en charge. Les donnees ont ete saisies et analysees sur Epiinfo 6.04dfr. Les raisons du depistage etaient dominees par la curiosite de connaitre le statut serologique (69). Le resultat du test etait positif dans 3des cas. L'infection etait due au VIH1 dans 65des cas; au VIH2 dans 24des cas; et a l'association VIH1+VIH2 dans 11des cas. Parmi ceux qui ont fait le test; 91sont venus retirer leurs resultats. Parmi les personnes infectees par le VIH/SIDA; 68ont accepte d'etre referees vers une structure de prise en charge. La seropositivite a ete significativement plus frequente chez les clients ages de plus de 24 ans; marie(e)s; non scolarise(e)s et assurer sa promotion pour mieux sensibiliser la population cible sur la prevention des IST/VIH/SIDA; avec un accent particulier sur le changement de comportement

TIPS versus paracentesis for cirrhotic patients with refractory ascites.

BACKGROUND: Ten per cent of cirrhotic patients develop refractory ascites, which carries substantial morbidity and has a one-year survival of less than 50 per cent. Patients with refractory ascites may benefit from transjugular intrahepatic portosystemic stent-shunts (TIPS). OBJECTIVES: To compare TIPS versus paracentesis standard treatment in patients with refractory ascites due to cirrhosis with regard to overall short- and long-term mortality, treatment efficacy, and complications. SEARCH STRATEGY: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register (July 2003), The Cochrane Central Register of Controlled Trials on The Cochrane Library (Issue 1, 2003), MEDLINE (1966 to July 2003), EMBASE (1980 to July 2003), and CINAHL (1982 to July 2003). We supplemented the searches with reading through scientific citations, review of citations in relevant primary articles, and hand-searched abstracts from national meetings. SELECTION CRITERIA: We included randomised clinical trials comparing TIPS and paracentesis with or without volume expanders for cirrhotic patients with refractory ascites. DATA COLLECTION AND ANALYSIS: We evaluated the methodological quality of the randomised clinical trials by the generation of the allocation section, allocation concealment, and follow-up. Two independent observers extracted data from each trial. We contacted trial authors for additional information. Dichotomous outcomes were reported as odds ratio (OR) with 95% confidence interval (CI). MAIN RESULTS: Four randomised clinical trials, including 264 patients, met the inclusion criteria. Methodological quality was moderate. Thirty-day mortality (OR 1.00, 95% CI 0.10 to 10.06, P = 1.0) and 24-month mortality (OR 1.17, 95% CI 0.52 to 2.66, P = 0.70) did not differ significantly between TIPS and paracentesis treatment. TIPS significantly reduced ascites re-accumulation at three months (OR 0.07, 95% CI 0.03 to 0.18, P < 0.00001) and at 12 months follow-up (OR 0.14, 95% CI 0.06 to 0.28, P < 0.00001). Hepatic encephalopathy occurred significantly more often in the TIPS group (OR 2.11, 95% CI 1.22 to 3.66, P = 0.008). Gastrointestinal bleeding (OR 0.82, 95% CI 0.36 to 1.84, P = 0.63), acute renal failure (OR 0.64, 95% CI 0.15 to 2.72, P = 0.55), septicemia/infection (OR 1.05, 95% CI 0.22 to 4.94, P = 0.96), and disseminated intravascular coagulation (OR 0.82, 95% CI 0.26 to 1.84, P = 0.63) did not differ significantly between groups. REVIEWERS' CONCLUSIONS: TIPS removed ascites more effectively than paracentesis. After 12 months, the beneficial effects of TIPS on ascites was still present. Mortality, gastrointestinal bleeding, septicemia/infection, acute renal failure, and disseminated intravascular coagulation did not differ significantly between the two groups. Hepatic encephalopathy occurred significantly more often in the TIPS group.