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Sustained heavy ethanol drinking is a common problem
globally and ethanol is one of the most abused drugs among individuals of
different socio-economic status including the HIV-infected patients on antiretroviral drugs. Ethanol is reward drug and a CNS depressant especially at high doses. The study determined the
effect of sustained heavy ethanol drinking by HIV-infected patients on
d4T/3TC/NVP regimen on CD4+ cell counts in Uganda using WHO AUDIT tool and chronic alcohol-use biomarkers. A case control study using repeated measures design with serial measurements model was used. The patients on stavudine (d4T) 30 mg, lamivudine
(3TC) 150 mg and nevirapine (NVP) 200 mg and chronic alcohol use were recruited. A
total of 41 patients (20 in alcohol group and 21 in control group) were
screened for chronic alcohol use by WHO AUDIT tool and chronic alcohol use biomarkers. They were followed up for 9 months with blood sampling done at 3 months
intervals. CD4+ cell count was determined using Facscalibur Flow Cytometer system. Results were then sorted by alcohol-use biomarkers (GGT, MCV and AST/ ALT ratio). Data were
analysed using SAS 2003 version 9.1 statistical package with repeated measures fixed
model and the means were compared using student t-test. The mean CD4+ cell counts in all the groups were lower
than the reference ranges
at baseline and gradually increased at 3, 6 and 9 months of follow-up. The mean
CD4+ cell counts were higher in the control
group as compared to the chronic alcohol use group
in both WHO AUDIT tool group and chronic alcohol-use biomarkers group though
there was no significant difference (p > 0.05). Chronic alcohol use slightly
lowers CD4+ cell count in HIV-infected patients on d4T/3TC/NVP
This article reviews selected neuroscience and psychoanalytic writings about respective concepts regarding unconscious processes. Two objectives are pursued. The first is the modification of an apparent dualistic view of the psychoanalytic, dynamic unconscious described by Freud and the implicit, automated unconscious described by neuroscientists into a unified unconscious process concept. Secondly, to examine the functional, structural theory of Freud and to connect it to neuroscience findings via neurodevelopment and the concomitant development of speech and language, an exclusive communicative capacity of the human species. The goal is to illustrate the application of the objectives into clinical settings.
Decisive modulatory systems of compromise and systems of dynamic turnover in lymphoid cells and macrophages are activated by repeated bursts of viremia and as promotional schemes of representation of subsequent spread and replication of HIV-1. In such operative systems of micro-environmental conditioning and reconditioning, a significant mechanism towards the turnover of specific cell-types occurs within context of sequestration within macrophages and circulating monocytes. Dendritic cells in germinal follicles and within specific organs such as the Langerhans cells of the skin are allied to dysfunctionality of such cellular subtypes as exemplified by the resident microglia of the central nervous system. Decisive perturbation in cell-type number and in dysfunctional activation indicate an exquisite modulatory role for HIV-1 in promoting homeostatic-related mechanisms within organs and tissues towards utilization in terms of viral dynamics and cytokine operability. In such manner, HIV-1 replication is itself a system of promotion in spread of viruses across cell-type and host cell specificities that tend to characterize and recharacterize systems of cytokine network operability in particular.
The object of this
paper is to determine whether there are economies or diseconomies of scale in
highway maintenance and whether higher concentration levels/greater market
power across the governments involved in highway maintenance results in higher
or lower cost levels. The data used come from New York State municipalities.
New York is divided into Towns and Cities that added together give the total
land area for the State. There are also Villages that are located in one or
more Towns. All of these government entities may own and manage/maintain
highways. The results are that 1) there are significantly U-shaped average cost
curves, but the differences in average costs between communities with lower
numbers or higher numbers of lane miles than the most efficient are not very
great and 2) there are both substantial and significant increases in average
costs when market power is greater. Thus, making the case for mergers of
communities is more difficult and such mergers would be more problematic.
The Laplace distribution is one of the oldest defined and studied distributions. In the one-parameter model (location parameter only), the sample median is the maximum likelihood estimator and is asymptotically efficient. Approximations for the variance of the sample median for small to moderate sample sizes have been studied, but no exact formula has been published. In this article, we provide an exact formula for the probability density function of the median and an exact formula for the variance of the median.