Early suppression of lymphoproliferative response in dogs with natural infection by Leishmania infantum.

Dogs are the domestic reservoirs of zoonotic visceral leishmaniasis caused by Leishmania infantum. Early detection of canine infections evolving to clinically patent disease may be important to leishmaniasis control. In this study we firstly investigated the peripheral blood mononuclear cell (PBMC) response to leishmanial antigens and to polyclonal activators concanavalin A, phytohemagglutinin and pokeweed mitogen, of mixed-breed dogs with natural L. infantum infection, either in presymptomatic or in patent disease condition, compared to healthy animals. Leishmania antigens did not induce a clear proliferative response in any of the animals examined. Furthermore, mitogen-induced lymphocyte proliferation was found strongly reduced not only in symptomatic, but also in presymptomatic dogs suggesting that the cell-mediated immunity is suppressed in progressive canine leishmaniasis. To test this finding, naive Beagle dogs were exposed to natural L. infantum infection in a highly endemic area of southern Italy. Two to 10 months after exposure all dogs were found to be infected by Leishmania, and on month 2 of exposure they all showed a significant reduction in PBMC activation by mitogens. Our results indicate that suppression of the lymphoproliferative response is a common occurrence in dogs already at the beginning of an established leishmanial infection. # 1999 Elsevier Science B.V. All rights reserved

Religion and Child Death in Ireland's Industrial Capital: Belfast 1911

Ireland is often seen as an outlier within the western world in terms of demographic behavior. As a society it has also been noted for its religious fervor, including religious division, at least until fairly recently. Might there be connections historically between these two spheres? One intriguing area of enquiry relates to possible links between religious denomination and child mortality. We explore this possibility using individual-level data from the household schedules of the Irish Census of 1911. The study area is Belfast, Ireland's leading industrial city, which allows for a wide range of occupational and social class differences. Combining regression techniques and the mortality index proposed by Preston and Haines (1991), we seek to tease out the relationship between child mortality and religious affiliation while controlling for a range of other explanatory variables. We show that religious identity is clearly associated with different infant and child mortality outcomes. Of the three major religious denominations, Catholics suffered the most from high infant mortality, Church of Ireland (Anglican) families were only a little better off, while the largest Protestant denomination, the Presbyterians, had the best infant mortality outcomes. These differences were related, in the main, to the varying socioeconomic composition of the three major religious denominations but religious affiliation also mattered in its own right

Asymmetric nuclear matter in a Hartree-Fock approach to non-linear QHD

The Equation of State (EOS) for asymmetric nuclear matter is discussed starting from a phenomenological hadronic field theory of Serot-Walecka type including exchange terms. In a model with self interactions of the scalar sigma-meson we show that the Fock terms naturally lead to isospin effects in the nuclear EOS. These effects are quite large and dominate over the contribution due to isovector mesons. We obtain a potential symmetry term of "stiff" type, i.e. increasing with baryon density and an interesting behaviour of neutron/proton effective masses of relevance for transport properties of asymmetric dense matter.Comment: 12 pages (LATEX), 3 Postscript figures, revised versio

Compliance, persistence, costs and quality of life in young patients treated with antipsychotic drugs: results from the COMETA study

BACKGROUND: Little data is available on the real-world socio-economic burden and outcomes in schizophrenia. This study aimed to assess persistence, compliance, costs and Health-Related Quality-of-Life (HRQoL) in young patients undergoing antipsychotic treatment according to clinical practice. METHODS: A naturalistic, longitudinal, multicentre cohort study was conducted: we involved 637 patients aged 18–40 years, with schizophrenia or schizophreniform disorder diagnosed ≤10 years before, enrolled in 86 Italian Mental Health Centres and followed-up for 1 year. Comparisons were conducted between naïve (i.e., patients visiting the centre for the first time and starting a new treatment regimen) and non naïve patients. RESULTS: At enrolment, 84% of patients were taking atypical drugs, 3.7% typical, 10% a combination of the two classes, and 2% were untreated. During follow-up, 23% of patients switched at least once to a different class of treatment, a combination or no treatment. The mean Drug-Attitude-Inventory score was 43.4, with 94.3% of the patients considered compliant by the clinicians. On average, medical costs at baseline were 390.93€/patient-month, mostly for drug treatment (29.5%), psychotherapy (29.2%), and hospitalizations (27.1%). Patients and caregivers lost 3.5 days/patient-month of productivity. During follow-up, attitude toward treatment remained fairly similar, medical costs were generally stable, while productivity, clinical statusand HRQoL significantly improved. While no significantly different overall direct costs trends were found between naïve and non naïve patients, naïve patients showed generally a significant mean higher improvement of clinical outcomes, HRQoL and indirect costs, compared to the others. CONCLUSIONS: Our results suggest how tailoring the treatment strategy according to the complex and specific patient needs make it possible to achieve benefits and to allocate more efficiently resources. This study can also provide information on the most relevant items to be considered when conducting cost-effectiveness studies comparing specific alternatives for the treatment of target patients

Asymmetric nuclear matter:the role of the isovector scalar channel

We try to single out some qualitative new effects of the coupling to the $\delta$-isovector-scalar meson introduced in a minimal way in a phenomenological hadronic field theory. Results for the equation of state ($EOS$) and the phase diagram of asymmetric nuclear matter ($ANM$) are discussed. We stress the consistency of the $\delta$-coupling introduction in a relativistic approach. New contributions to the slope and curvature of the symmetry energy and the neutron-proton effective mass splitting appear particularly interesting. A more repulsive $EOS$ for neutron matter at high baryon densities is expected. Effects on new critical properties of warm $ANM$, mixing of mechanical and chemical instabilities and isospin distillation, are also presented. The $\delta$ influence is mostly on the {\it isovectorlike} collective response. The results are largely analytical and this makes the physical meaning quite transparent. Implications for nuclear structure properties of drip-line nuclei and for reaction dynamics with Radioactive Beams are finally pointed out.Comment: 12 pages, 10 Postscript figure

Compliance, persistence, costs and quality of life in young patients treated with antipsychotic drugs: Results from the COMETA study

Background: Little data is available on the real-world socio-economic burden and outcomes in schizophrenia. This study aimed to assess persistence, compliance, costs and Health-Related Quality-of-Life (HRQoL) in young patients undergoing antipsychotic treatment according to clinical practice.Methods: A naturalistic, longitudinal, multicentre cohort study was conducted: we involved 637 patients aged 18-40 years, with schizophrenia or schizophreniform disorder diagnosed ≤10 years before, enrolled in 86 Italian Mental Health Centres and followed-up for 1 year. Comparisons were conducted between naïve (i.e., patients visiting the centre for the first time and starting a new treatment regimen) and non naïve patients.Results: At enrolment, 84% of patients were taking atypical drugs, 3.7% typical, 10% a combination of the two classes, and 2% were untreated. During follow-up, 23% of patients switched at least once to a different class of treatment, a combination or no treatment. The mean Drug-Attitude-Inventory score was 43.4, with 94.3% of the patients considered compliant by the clinicians. On average, medical costs at baseline were 390.93€/patient-month, mostly for drug treatment (29.5%), psychotherapy (29.2%), and hospitalizations (27.1%). Patients and caregivers lost 3.5 days/patient-month of productivity. During follow-up, attitude toward treatment remained fairly similar, medical costs were generally stable, while productivity, clinical statusand HRQoL significantly improved. While no significantly different overall direct costs trends were found between naïve and non naïve patients, naïve patients showed generally a significant mean higher improvement of clinical outcomes, HRQoL and indirect costs, compared to the others.Conclusions: Our results suggest how tailoring the treatment strategy according to the complex and specific patient needs make it possible to achieve benefits and to allocate more efficiently resources. This study can also provide information on the most relevant items to be considered when conducting cost-effectiveness studies comparing specific alternatives for the treatment of target patients

A new Differential Optical Absorption Spectroscopy instrument to study atmospheric chemistry from a high-altitude unmanned aircraft

Observations of atmospheric trace gases in the tropical upper troposphere (UT), tropical tropopause layer (TTL), and lower stratosphere (LS) require dedicated measurement platforms and instrumentation. Here we present a new limb-scanning Differential Optical Absorption Spectroscopy (DOAS) instrument developed for NASA's Global Hawk (GH) unmanned aerial system and deployed during the Airborne Tropical TRopopause EXperiment (ATTREX). The mini-DOAS system is designed for automatic operation under unpressurized and unheated conditions at 14–18 km altitude, collecting scattered sunlight in three wavelength windows: UV (301–387 nm), visible (410–525 nm), and near infrared (900–1700 nm). A telescope scanning unit allows selection of a viewing angle around the limb, as well as real-time correction of the aircraft pitch. Due to the high altitude, solar reference spectra are measured using diffusors and direct sunlight. The DOAS approach allows retrieval of slant column densities (SCDs) of O₃, O₄, NO₂, and BrO with relative errors similar to other aircraft DOAS systems. Radiative transfer considerations show that the retrieval of trace gas mixing ratios from the observed SCD based on O₄ observations, the most common approach for DOAS measurements, is inadequate for high-altitude observations. This is due to the frequent presence of low-altitude clouds, which shift the sensitivity of the O₄ SCD into the lower atmosphere and make it highly dependent on cloud coverage. A newly developed technique that constrains the radiative transfer by comparing in situ and DOAS O₃ observations overcomes this issue. Extensive sensitivity calculations show that the novel O₃-scaling technique allows the retrieval of BrO and NO₂ mixing ratios at high accuracies of 0.5 and 15 ppt, respectively. The BrO and NO₂ mixing ratios and vertical profiles observed during ATTREX thus provide new insights into ozone and halogen chemistry in the UT, TTL, and LS

Neutron-Proton Differential Flow as a Probe of Isospin-Dependence of Nuclear Equation of State

The neutron-proton differential flow is shown to be a very useful probe of the isospin-dependence of the nuclear equation of state (EOS). This novel approach utilizes constructively both the isospin fractionation and the nuclear collective flow as well as their sensitivities to the isospin-dependence of the nuclear EOS. It also avoids effectively uncertainties associated with other dynamical ingredients of heavy-ion reactions at intermediate energies.Comment: 10 pages + 3 figures. Phys. Rev. Lett. (2000) in pres

Evaluation of rK39 rapid diagnostic tests for canine visceral leishmaniasis : longitudinal study and meta-analysis

Canine visceral leishmaniasis is a vector-borne disease caused by the intracellular parasite Leishmania infantum. It is an important veterinary disease, and dogs are also the main animal reservoir for human infection. The disease is widespread in the Mediterranean area, and parts of Asia and South and Central America, and is potentially fatal in both dogs and humans unless treated. Diagnosis of canine infections requires serological or molecular tests. Detection of infection in dogs is important prior to treatment, and in epidemiological studies and control programmes, and a sensitive and specific rapid diagnostic test would be very useful. Rapid diagnostic tests (RDTs) have been developed, but their diagnostic performance has been reported to be variable. We evaluated the sensitivity of a RDT based on serological detection of the rK39 antigen in a cohort of naturally infected Brazilian dogs. The sensitivity of the test to detect infection was relatively low, but increased with time since infection and the severity of infection. We then carried out a meta-analysis of published studies of rK39 RDTs, evaluating the sensitivity to detect disease and infection. The results suggest that rK39 RDTs may be useful in a veterinary clinical setting, but the sensitivity to detect infection is too low for operational control programmes