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The impact of antiretroviral treatment (ART) on the occurrence of oral diseases among children and adolescents living with HIV (CALHIV) is poorly understood. The aim of this study was to determine the effect of ART timing on vitamin D levels and the prevalence of four oral diseases (dry mouth, dental caries, enamel hypoplasia, and non-herpes oral ulcer) among Kenyan CALHIV from two pediatric HIV cohorts. This nested cross-sectional study was conducted at the Kenyatta National Hospital, Nairobi, Kenya. CALHIV, 51 with early-ART initiated at <12 months of age and 27 with late-ART initiated between 18 months-12 years of age, were included. Demographics, HIV diagnosis, baseline CD4 and HIV RNA viral load data were extracted from the primary study databases. Community Oral Health Officers performed oral health examinations following standardized training. Among 78 CALHIV in the study, median age at the time of the oral examination was 11.4 years old and median ART duration at the time of oral examination was 11 years (IQR: 10.1, 13.4). Mean serum vitamin D level was significantly higher among the early-ART group than the late-ART group (29.5 versus 22.4 ng/mL, p = 0.0002). Children who received early-ART had a 70% reduction in risk of inadequate vitamin D level (<20 ng/mL), compared to those who received late-ART (p = 0.02). Although both groups had similar prevalence of oral diseases overall (early-ART 82.4%; late-ART 85.2%; p = 0.2), there was a trend for higher prevalence of dry mouth (p = 0.1) and dental caries (p = 0.1) in the early versus late ART groups. The prevalence of the four oral diseases was not associated with vitamin D levels (p = 0.583). After >10 years of ART, CALHIV with early-ART initiation had higher serum vitamin D levels compared to the late-ART group. The four oral diseases were not significantly associated with timing of ART initiation or serum vitamin D concentrations in this cohort. There was a trend for higher prevalence of dry mouth and dental caries in the early-ART group, probably as side-effects of ART.

ObjectivesThe impact of antiretroviral treatment (ART) on the occurrence of oral diseases among children and adolescents living with HIV (CALHIV) is poorly understood. The aim of this study was to determine the effect of ART timing on vitamin D levels and the prevalence of four oral diseases (dry mouth, dental caries, enamel hypoplasia, and non-herpes oral ulcer) among Kenyan CALHIV from two pediatric HIV cohorts.MethodsThis nested cross-sectional study was conducted at the Kenyatta National Hospital, Nairobi, Kenya. CALHIV, 51 with early-ART initiated at <12 months of age and 27 with late-ART initiated between 18 months-12 years of age, were included. Demographics, HIV diagnosis, baseline CD4 and HIV RNA viral load data were extracted from the primary study databases. Community Oral Health Officers performed oral health examinations following standardized training.ResultsAmong 78 CALHIV in the study, median age at the time of the oral examination was 11.4 years old and median ART duration at the time of oral examination was 11 years (IQR: 10.1, 13.4). Mean serum vitamin D level was significantly higher among the early-ART group than the late-ART group (29.5 versus 22.4 ng/mL, p = 0.0002). Children who received early-ART had a 70% reduction in risk of inadequate vitamin D level (<20 ng/mL), compared to those who received late-ART (p = 0.02). Although both groups had similar prevalence of oral diseases overall (early-ART 82.4%; late-ART 85.2%; p = 0.2), there was a trend for higher prevalence of dry mouth (p = 0.1) and dental caries (p = 0.1) in the early versus late ART groups. The prevalence of the four oral diseases was not associated with vitamin D levels (p = 0.583).ConclusionsAfter >10 years of ART, CALHIV with early-ART initiation had higher serum vitamin D levels compared to the late-ART group. The four oral diseases were not significantly associated with timing of ART initiation or serum vitamin D concentrations in this cohort. There was a trend for higher prevalence of dry mouth and dental caries in the early-ART group, probably as side-effects of ART.

Purpose: To determine the prevalence of HIV oral manifestations and oral comorbidities in ART treated children and adolescents, and its relationship with oral health status at the time initiation of ART. Methods: We utilized convenience sampling of a population nested into ongoing cohort studies of 78 Kenyan HIV-infected children who were enrolled and initiated antiretroviral therapy (ART) as part of two clinical trials. Oral health examinations were performed by Community Oral Health Officers (COHO’s) to determine oral health endpoints. Demographics, age at initiation of ART, HIV diagnosis, baseline CD4, and HIV RNA viral load data were extracted from the primary study databases. Fisher’s exact and two-sample t-tests were run to examine the significance of the differences observed between early and late ART initiation groups.Results: The majority of children and adolescents evaluated in this study were found to have at least one type of oral disease (83.3%). When compared to children with early art initiation, children with late art initiation showed decreased odds of having dental caries (OR:0.55 CI:0.20, 1.48; p=0.23), decreased odds of presenting with any HIV-associated oral lesion when compared to early ART initiation (OR: 0.57; CI:0.18, 1.62; p= 0.31) and the mean dmft/DMFT (adjusted model; ß:-1.23; CI:-7.7, 4.90; p=0.69).Conclusion: Oral disease is highly prevalent in Kenyan CALHIV despite having access to high quality medical care at the Kenyatta National Hospital. Oral disease prevalence varies by age at initiation of ART and should be investigated further on an individual basis. This study highlights the opportunity for integrating oral health in pediatric HIV medical, boosting interprofessional collaboration in the effort to improve the quality of life of CALHIV.

This study provides a critical analysis of four Chilean novels pub- lished between 1908 and 1923. These texts are examined in relation to the \"reformist\" ideology, a social, political and intellectual move- ment which consolidated a new model of domination during the 1920's. Chapter One characterizes the global historical situation in Chile during which this reformist movement was formed. It particularly focuses on the class and social sectors' contradictions as a basis for understanding the emergence of this movement, since its centrist posture was presented as an alternative to the retrogradation of the old oligarchy and the revolutionary position that appeared with the social and political organization of the working class. The ideologi- cal bases of this movement are analyzed in relation to its centrist discourse of \"social harmony\" and reformist attitude toward the popular sectors. It is maintained that the worldview of this centrist discourse had its roots in social evolutionarism. In this context, a parallel is demonstrated between the historical period in Chile and the emergence of positivism in Europe. This is presented through the discussion of pertinent ideas of Comtian positivism and their influence on the Chilean intellectuality which had identified with the reformist movement since the late nineteenth century. Chapters Two, Three and Four contain the textual analysis of El roto by Joaqu(')in Edwards Bello, El crisol and Robles, Blume y C(')ia by Fernando Santivan, and Casa Grande by Luis Orrego Luco. The four novels were selected and are discussed in terms of their relation to the ideas presented in Chapter One. Thus the texts are seen as literary representations inserted in the global historical situation, expressing within the framework of the period, a worldview homolo- gous to the class interests of the reformist movement. It is affirmed that only from this perspective the so-called \"social commitment\" of these naturalist novels as well as the narrative structures, conflicts, character configurations, and social sectors represented can be understood.

Around 30% of global food is produced by smallholder farmers, yet they constitute the most food-insecure group. In Mexico, food self-sufficiency is declining. Rural policies in the country have stimulated the production of cash crops to the detriment of the traditional intercropping system, the milpa . Such a decline may have negative consequences for the food security of subsistence farmers. This study aimed to assess changes in nutritional self-sufficiency over the last 30 years and the role of milpa systems in food security for two communities in the highlands of Oaxaca, Mexico. The study used satellite images, censuses, and field data to estimate food production. Three cropping systems, monoculture of maize, monoculture of common bean, and the milpa were compared in terms of nutrients and vitamins produced. Furthermore, a household typology was developed for each community to contrast nutritional self-sufficiency levels between the different household types. Results showed that the milpa produced more volume of food per area compared to the other systems. The milpa also produced all the nutrients and vitamins (except for B12) required to feed at least 2 persons ha -1 . Monocultures of maize lacked vitamins A, B9, B12, and C, and the common bean lacked vitamins A, B12, and C. While farmers recognized the importance of the milpa , they preferred monocultures due to the reduced labor demands of this system. Households that obtained most of their income from off-farm activities had the lowest nutritional self-sufficiency. Enhancing nutritional self-sufficiency through crop diversification has the potential to not only improve the nutrition of subsistence farmers, but also to enhance ecosystem service provision, promote biodiversity conservation and restoration, and improve resilience to climate change.

Uric acid has gained considerable attention as a potential neuroprotective agent in stroke during the last decades, however, its role in the pathophysiology of ischemic stroke remains poorly understood. A serial evaluation of uric acid levels during the acute phase of stroke and its association with infarct size on magnetic resonance imaging is lacking. We present a cohort study of 31 patients with ischemic stroke who were not candidates for thrombolysis according to current criteria at the time. We performed daily measurements of serum uric acid and total antioxidant capacity of plasma during the first week after symptoms onset and 30 days after. Infarct size was determined in the acute phase by a DWI sequence and the final infarct size with a control MRI (FLAIR) at day 30. Uric acid significantly decreases between days 2 to 6 compared to day 1, after adjustment by sex, age and DWI at diagnosis, with a nadir value at 72h. A mixed model analysis showed a negative association between DWI at diagnosis and uric acid evolution during the first week after stroke. Moreover, multivariable linear regression of uric acid values during follow up on DWI volumes demonstrated that DWI volume at diagnosis is negatively associated with uric acid levels at day 3 and 4. There were no significant associations between total antioxidant capacity of plasma and DWI at diagnosis, or FLAIR at any point. Patients with larger infarcts exhibited a significant decrease in serum uric acid levels, accounting for a more prominent reactive oxygen species scavenging activity with subsequent consumption and decay of this antioxidant. The different kinetics of total antioxidant capacity of plasma and serum uric acid levels suggests a specific role of uric acid in the antioxidant response in ischemic stroke.

Key molecular drivers that underlie transformation of colonic epithelium into colorectal adenocarcinoma (CRC) are well described. However, the mechanisms through which clinically targeted pathways are activated during CRC progression have yet to be elucidated. Here, we used an integrative genomics approach to examine CRC progression. We used laser capture microdissection to isolate colonic crypt cells, differentiated surface epithelium, adenomas, carcinomas and metastases, and used gene expression profiling to identify pathways that were differentially expressed between the different cell types. We identified a number of potentially important transcriptional changes in developmental and oncogenic pathways, and noted a marked upregulation of EREG in primary and metastatic cancer cells. We confirmed this pattern of gene expression by in situ hybridization and observed staining consistent with autocrine expression in the tumor cells. Upregulation of EREG during the adenoma–carcinoma transition was associated with demethylation of two key sites within its promoter, and this was accompanied by an increase in the levels of epidermal growth factor receptor (EGFR) phosphorylation, as assessed by reverse-phase protein analysis. In CRC cell lines, we demonstrated that EREG demethylation led to its transcriptional upregulation, higher levels of EGFR phosphorylation, and sensitization to EGFR inhibitors. Low levels of EREG methylation in patients who received cetuximab as part of a phase II study were associated with high expression of the ligand and a favorable response to therapy. Conversely, high levels of promoter methylation and low levels of EREG expression were observed in tumors that progressed after treatment. We also noted an inverse correlation between EREG methylation and expression levels in several other cancers, including those of the head and neck, lung and bladder. Therefore, we propose that upregulation of EREG expression through promoter demethylation might be an important means of activating the EGFR pathway during the genesis of CRC and potentially other cancers.

Hernández-Ledesma P., Berendsohn W. G., Borsch Th., Mering S. von, Akhani H., Arias S., Castañeda-Noa I., Eggli U., Eriksson R., Flores-Olvera H., Fuentes-Bazán S., Kadereit G., Klak C., Korotkova N., Nyffeler R., Ocampo G., Ochoterena H., Oxelman B., Rabeler R. K., Sanchez A., Schlumpberger B. O. & Uotila P.: A taxonomic backbone for the global synthesis of species diversity in the angiosperm order Caryophyllales. — Willdenowia 45: 281–383. 2015. — Version of record first published online on 11 September 2015 ahead of inclusion in December 2015 issue; ISSN 1868-6397; © 2015 BGBM Berlin. DOI: http://dx.doi.org/10.3372/wi.45.45301 The Caryophyllales constitute a major lineage of flowering plants with approximately 12500 species in 39 families. A taxonomic backbone at the genus level is provided that reflects the current state of knowledge and accepts 749 genera for the order. A detailed review of the literature of the past two decades shows that enormous progress has been made in understanding overall phylogenetic relationships in Caryophyllales. The process of re-circumscribing families in order to be monophyletic appears to be largely complete and has led to the recognition of eight new families (Anacampserotaceae, Kewaceae, Limeaceae, Lophiocarpaceae, Macarthuriaceae, Microteaceae, Montiaceae and Talinaceae), while the phylogenetic evaluation of generic concepts is still well underway. As a result of this, the number of genera has increased by more than ten percent in comparison to the last complete treatments in the Families and genera of vascular plants” series. A checklist with all currently accepted genus names in Caryophyllales, as well as nomenclatural references, type names and synonymy is presented. Notes indicate how extensively the respective genera have been studied in a phylogenetic context. The most diverse families at the generic level are Cactaceae and Aizoaceae, but 28 families comprise only one to six genera. This synopsis represents a first step towards the aim of creating a global synthesis of the species diversity in the angiosperm order Caryophyllales integrating the work of numerous specialists around the world.

In this paper, we report on the spectral detection of wustite, Fe(II) oxide (FeO), and magnetite, Fe(II, III) oxide (Fe3O4), molecular emissions during the combustion of pyrite (FeS2), in a laboratory-scale furnace operating at high temperatures. These species are typically generated by reactions occurring during the combustion (oxidation) of this iron sulfide mineral. Two detection schemes are addressed: the first consisting of measurements with a built-in developed spectrometer with a high sensitivity and a high spectral resolution. The second one consisting of spectra measured with a low spectral resolution and a low sensitivity commercial spectrometer, but enhanced and analyzed with post signal processing and multivariate data analysis such as principal component analysis (PCA) and a multivariate curve resolution—the alternating least squares method (MCR-ALS). A non-linear model is also proposed to reconstruct spectral signals measured during pyrite combustion. Different combustion conditions were studied to evaluate the capacity of the detection schemes to follow the spectral emissions of iron oxides. The results show a direct correlation between FeO and Fe3O4 spectral features intensity, and non-linear relations with key combustion variables such as flame temperature, and the combusted sulfide mineral particle size.