66 results on '"Barbour, A. D."'
Search Results
2. The expected degree distribution in transient duplication divergence models.
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Barbour, Andrew D. and Lo, Tiffany Y. Y.
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GEOMETRIC vertices , *GENERALIZATION , *CENTRAL limit theorem , *DISTRIBUTION (Probability theory) , *LOGARITHMS - Abstract
We study the degree distribution of a randomly chosen vertex in a duplication-divergence graph, under a variety of different generalizations of the basic model of Bhan et al. (2002) and Vázquez et al. (2003). We pay particular attention to what happens when a non-trivial proportion of the vertices have large degrees, establishing a central limit theorem for the logarithm of the degree distribution. Our approach, as in Jordan (2018) and Hermann and Pfaffelhuber (2021), relies heavily on the analysis of related birth-catastrophe processes, and couplings are used to show that a number of different formulations of the process have asymptotically similar expected degree distributions. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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3. Local approximation of a metapopulation’s equilibrium.
- Author
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Barbour, A. D., McVinish, R., and Pollett, P. K.
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METAPOPULATION (Ecology) , *APPROXIMATION theory , *BIOLOGICAL extinction , *MODULES (Algebra) , *PROBABILITY theory , *EQUILIBRIUM - Abstract
We consider the approximation of the equilibrium of a metapopulation model, in which a finite number of patches are randomly distributed over a bounded subset Ω
of Euclidean space. The approximation is good when a large number of patches contribute to the colonization pressure on any given unoccupied patch, and when the quality of the patches varies little over the length scale determined by the colonization radius. If this is the case, the equilibrium probability of a patch at z being occupied is shown to be close to q1(z) , the equilibrium occupation probability in Levins’s model, at any point z∈Ω not too close to the boundary, if the local colonization pressure and extinction rates appropriate to z are assumed. The approximation is justified by giving explicit upper and lower bounds for the occupation probabilities, expressed in terms of the model parameters. Since the patches are distributed randomly, the occupation probabilities are also random, and we complement our bounds with explicit bounds on the probability that they are satisfied at all patches simultaneously. [ABSTRACT FROM AUTHOR] - Published
- 2018
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4. DYNAMICS OF AN INSERTION SEQUENCE INFECTION IN A SPATIALLY STRUCTURED ENVIRONMENT.
- Author
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BICHSEL, MANUEL, BARBOUR, A. D., and WAGNER, ANDREAS
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DNA insertion elements , *BACTERIAL DNA , *PROKARYOTES , *INFECTION risk factors , *GENETIC transformation , *TRANSPOSONS - Abstract
Bacterial insertion sequences (ISs), the simplest form of autonomous mobile DNA, depend on their prokaryote hosts to spread in a spatially structured environment. We use a spatially explicit metapopulation model to simulate the spread of an IS that can have both detrimental and beneficial effects on its host cell. We find that, on the one hand, the spatial structure of the metapopulation and cell dispersal between subpopulations have no strong effect on the time to full infection of the metapopulation. On the other hand, factors that influence the IS infection dynamics within a subpopulation have a strong effect on that time. These factors are mainly the fitness benefit of an IS and the rate of horizontal gene transfer. We also find that the infection process of a metapopulation is very erratic in its early phase. Finally, we show that the infection's success depends critically on the initially infected subpopulation. [ABSTRACT FROM AUTHOR]
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- 2018
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5. “FOR THE GOOD OF OUR COUNTRY”: RUTH WATANABE AND THE “GOOD THAT IS IN MUSIC” AT THE SANTA ANITA DETENTION CENTER.
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BARBOUR, ALECIA D.
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JAPANESE Americans , *IMMIGRANTS , *MUSIC , *HUMANITIES - Abstract
Japanese Americans were involuntarily confined en masse during World War II. They were heavily scrutinized: their senses of belonging and identification were interrogated, contested, always fraught, and often ambiguous. During this tumultuous time, an American-born daughter of Japanese emigrants Ruth Watanabe (1916–2005), who would later become a notable and influential music librarian, head of the Sibley Music Library at the Eastman School of Music, corresponded extensively with a former teacher. In these letters, Watanabe provides an imaginative soundtrack for her daily life at the detention center at the Santa Anita Racetrack in California, while demonstrating ways that she drew on the European classical music tradition, in which she was highly trained, in order to maintain a sense of self and purpose amidst the confusion and indignity of mass confinement. This article briefly introduces some of Watanabe’s select activities at Santa Anita, contextualizing her work in the music department there against a backdrop of confusion and transience. The article includes large sections of text quoted directly from her letters in order to demonstrate that the sense of self and purpose expressed by Watanabe, and the resultant order and educational structures that she enacted in Santa Anita, can be understood to have been intrinsically aligned with her sense of belonging to her country—to “our country”—even as that very belonging was placed at risk by her involuntary confinement. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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6. Update on C3 glomerulopathy.
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Barbour, Thomas D., Ruseva, Marieta M., and Pickering, Matthew C.
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KIDNEY glomerulus diseases , *COMPLEMENT activation , *BASAL lamina , *COMPLEMENT factor H , *NEPHROLOGY , *MEDICAL research - Abstract
C3 glomerulopathy refers to a disease process in which abnormal control of complement activation, degradation or deposition results in predominant C3 fragment deposition within the glomerulus and glomerular damage. Recent studies have improved our understanding of its pathogenesis. The key abnormality is uncontrolled C3b amplification in the circulation and/or along the glomerular basement membrane. Family studies in which disease segregates with structurally abnormal complement factor H-related (CFHR) proteins demonstrate that abnormal CFHR proteins are important in some types of C3 glomerulopathy. This is currently thought to be due to the ability of these proteins to antagonize the major negative regulator of C3 activation, complement factor H (CFH), a process termed 'CFH de-regulation'. Recent clinicopathological cohort studies have led to further refinements in case definition, culminating in a 2013 consensus report, which provides recommendations regarding investigation and treatment. Early clinical experience with complement-targeted therapeutics, notably C5 inhibitors, has also now been published. Here, we summarize the latest developments in C3 glomerulopathy. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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7. 'Oh Events' for the Professor: Studies and Stories of Religious Studies Abroad.
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Barbour, John D.
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FOREIGN study , *RELIGIOUS studies , *TEACHING methods , *EDUCATIONAL objectives , *HIGHER education - Abstract
This response explains three ways in which the preceding essays are a significant contribution to the study of study abroad, explores three additional issues, and makes three suggestions for future work on religious studies and study abroad. This response is published alongside of six other essays, comprising a special section of the journal (see Teaching Theology and Religion 18:1, January 2015). [ABSTRACT FROM AUTHOR]
- Published
- 2015
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8. Antiphospholipid syndrome in renal transplantation.
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Barbour, Thomas D, Crosthwaite, Amy, Chow, Kevin, Finlay, Moira J, Better, Nathan, Hughes, Peter D, and Cohney, Solomon J
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ANTIPHOSPHOLIPID syndrome , *KIDNEY transplantation , *SYSTEMIC lupus erythematosus , *KIDNEY failure , *VENOUS thrombosis , *THROMBOTIC thrombocytopenic purpura , *CHRONIC kidney failure - Abstract
Antiphospholipid syndrome ( APS) may occur in isolation or in association with systemic lupus erythematosus ( SLE), with the potential to cause renal failure via several distinct pathologies. Renal transplantation in the presence of APS carries a risk of early graft loss from arterial or venous thrombosis, or thrombotic microangiopathy ( TMA). Whilst perioperative anticoagulation reduces the risk of large vessel thrombosis, it may result in significant haemorrhage, and its efficacy in preventing post-transplant TMA is uncertain. Here, we report a patient with end-stage kidney disease ( ESKD) due to lupus nephritis and APS, in whom allograft TMA developed soon after transplantation despite partial anticoagulation. TMA resolved with plasma exchange-based therapy albeit with some irreversible graft damage and renal impairment. We discuss the differential diagnosis of post-transplant TMA, and current treatment options. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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9. Reduced CD14 expression on classical monocytes and vascular endothelial adhesion markers independently associate with carotid artery intima media thickness in chronically HIV-1 infected adults on virologically suppressive anti-retroviral therapy.
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Barbour, Jason D., Jalbert, Emilie C., Chow, Dominic C., Gangcuangco, Louie Mar A., Norris, Philip J., Keating, Sheila M., Heitman, John, Nagamine, Lorna, Seto, Todd, Ndhlovu, Lishomwa C., Nakamoto, Beau K., Hodis, Howard N., Parikh, Nisha I., and Shikuma, Cecilia M.
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CD14 antigen , *MONOCYTES , *ENDOTHELIAL cells , *CELL adhesion , *CAROTID intima-media thickness , *HIV infections , *ANTIRETROVIRAL agents - Abstract
Abstract: HIV infection causes systemic immune inflammation, and increases the risk for cardiovascular (CVD) disease even among those on virologically suppressive anti-retroviral treatment (ART). We performed a biostatistical analysis and screen of candidate cellular and plasma biomarkers for association with carotid artery intima-media thickness (CIMT), independent of traditional CVD risk factors such as age, gender, systolic blood pressure (SBP), lipid levels, smoking and diabetes. We conducted a multi-stage analysis based on a cross-sectional study of CVD risk in HIV-infected subjects age >45 years on ART for >6 months. The goal of this analysis was to identify candidate cellular and plasma biomarkers of CIMT in HIV-1 infected adults. We further sought to determine if these candidate biomarkers were independent of traditional CVD risk factors previously identified in HIV negative adults. High-resolution B-mode ultrasound images of the right common carotid common artery (CCA) were obtained. Plasma soluble inflammatory mediators, cytokines and chemokines were detected. Monocytes were defined by CD14/CD16 expression, and CD8+ T-cell activation by CD38/HLA-DR expression. Subjects were a median of 49.5 years old, 87% male, had a CIMT of 0.73 mm, FRS of 6%, a median viral load of 48 copies/mL, and CD4+ T cell count of 479 cells/μL. Soluble VCAM-1, and expansion of CD14dimCD16− monocytes each associated with higher CIMT independently of age and SBP. These factors are distinct components of a shared atherogenic process; 1) vascular endothelial molecular expression and 2) vascular monocytes that enter into the vascular endothelium and promote atherosclerotic plaque. [Copyright &y& Elsevier]
- Published
- 2014
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10. Recent insights into C3 glomerulopathy.
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Barbour, Thomas D., Pickering, Matthew C., and Cook, H. Terence
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GLOMERULONEPHRITIS , *HISTOLOGY , *ETIOLOGY of diseases , *KIDNEY disease treatments , *AUTOANTIBODIES , *ECULIZUMAB , *MOLECULAR biology - Abstract
‘C3 glomerulopathy’ is a recent disease classification comprising several rare types of glomerulonephritis (GN), including dense deposit disease (DDD), C3 glomerulonephritis (C3GN) and CFHR5 nephropathy. These disorders share the key histological feature of isolated complement C3 deposits in the glomerulus. A common aetiology involving dysregulation of the alternative pathway (AP) of complement has been elucidated in the past decade, with genetic defects and/or autoantibodies able to be identified in a proportion of patients. We review the clinical and histological features of C3 glomerulopathy, relating these to underlying molecular mechanisms. The role of uncontrolled C3 activation in pathogenesis is emphasized, with important lessons from animal models. Methods, advantages and limitations of gene testing in the assessment of individuals or families with C3 glomerulopathy are discussed. While no therapy has yet been shown consistently effective, clinical evaluation of agents targeting specific components of the complement system is ongoing. However, limits to current knowledge regarding the natural history and the appropriate timing and duration of proposed therapies need to be addressed. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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11. Simultaneous necrotizing glomerulonephritis and Hodgkin’s lymphoma: a case report and review of the literature.
- Author
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Barbour, Thomas D., Haynes, Richard J., Roberts, Ian S. D., and Winearls, Christopher G.
- Abstract
Glomerulonephritis occurs in 1% of Hodgkin's lymphoma patients. In the even rarer setting of rapidly progressive glomerulonephritis, lymphoma may go unrecognized. We describe a case of necrotizing glomerulonephritis in which treatment with cyclophosphamide and steroids led to resolution of lymphadenopathy. Two years later, recrudescent lymphadenopathy was shown to be Hodgkin's lymphoma, but renal disease did not recur. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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12. The Consolations and Compensations of Exile: Memoirs by Said, Ahmed, and Eire.
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Barbour, John D.
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EXILES , *ORIENTATION (Religion) , *RELIGION , *SOCIAL history - Abstract
This article explores exile as a religious orientation, focusing on three recent memoirs by American university professors: Edward Said's Out of Place, Leila Ahmed's A Border Passage, and Carlos Eire's Waiting for Snow in Havana. These writers criticize the political conditions that led to their exile even as they find compensatory or consoling meaning in their experience. The ways in which Said, Ahmed, and Eire shape their memoirs reflect distinctive versions of an exilic worldview, each with a significant religious dimension. In dialogue with Thomas Tweed's understanding of exile, I argue that autobiographical writing provides insights that cannot be duplicated by other approaches to religious studies. This article suggests the value of autobiography for religious studies and the particular contributions of the recent turn to memoir by American humanities professors. [ABSTRACT FROM PUBLISHER]
- Published
- 2011
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13. The early phase of a bacterial insertion sequence infection
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Bichsel, Manuel, Barbour, Andrew D., and Wagner, Andreas
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DNA insertion elements , *BACTERIAL diseases , *MOBILE genetic elements , *BRANCHING processes , *GENETIC transformation , *BACTERIOLOGY - Abstract
Abstract: Bacterial insertion sequences are the simplest form of autonomous mobile DNA. It is unknown whether they need to have beneficial effects to infect and persist in bacterial populations, or whether horizontal gene transfer suffices for their persistence. We address this question by using branching process models to investigate the critical, early phase of an insertion sequence infection. We find that the probability of a successful infection is low and depends linearly on the difference between the rate of horizontal gene transfer and the fitness cost of the insertion sequences. Our models show that the median time to extinction of an insertion sequence that dies out is very short, while the median time for a successful infection to reach a modest population size is very long. We conclude that horizontal gene transfer is strong enough to allow the persistence of insertion sequences, although infection is an erratic and slow process. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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14. High CD8+ T Cell Activation Marks a Less Differentiated HIV-1 Specific CD8+ T Cell Response that Is Not Altered by Suppression of Viral Replication.
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Barbour, Jason D., Ndhlovu, Lishomwa C., Qi Xuan Tan, Ho, Terence, Epling, Lorrie, Bredt, Barry M., Levy, Jay A., Hecht, Frederick M., and Sinclair, Elizabeth
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T cells , *HIV infections , *VIRAL replication , *SUPPRESSOR cells , *IMMUNOSUPPRESSION , *ANTIRETROVIRAL agents , *CELL differentiation , *IMMUNODEFICIENCY , *CELL membranes - Abstract
Background: The relationship of elevated T cell activation to altered T cell differentiation profiles, each defining features of HIV-1 infection, has not been extensively explored. We hypothesized that anti-retroviral suppression of T cell activation levels would lead to alterations in the T cell differentiation of total and HIV-1 specific CD8+ T cell responses among recently HIV-1 infected adults. Methodology/Principal Findings: We performed a longitudinal study simultaneously measuring T cell activation and maturation markers on both total and antigen-specific T cells in recently infected adults: prior to treatment; after the initiation of HAART; and after treatment was halted. Prior to treatment, HIV-1 Gag-specific CD8+ T cells were predominantly of a highly activated, intermediate memory (CD27+CD282) phenotype, while CMV pp65-specific CD8+ T cells showed a late memory (CD272CD282), low activation phenotype. Participants with the highest fraction of late memory (CD272CD282) HIV-1-specific CD8+ T cells had higher CD4+ T cell counts (rho = +0.74, p = 0.004). In turn, those with the highest fraction of intermediate memory (CD27+ CD282) HIV-1 specific CD8+ T cells had high total CD8+ T cell activation (rho = +0.68, p = 0.01), indicating poorer long-term clinical outcomes. The HIV-1 specific T cell differentiation profile was not readily altered by suppression of T cell activation following HAART treatment. Conclusions/Significance: A more differentiated, less activated HIV-1 specific CD8+ T cell response may be clinically protective. Anti-retroviral treatment initiated two to four months after infection lowered T cell activation but had no effect on the differentiation profile of the HIV-1-specific response. Intervention during the first month of acute infection may be required to shift the differentiation phenotype of HIV-1 specific responses to a more clinically favorable profile. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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15. The Relation Between Symptoms, Viral Load, and Viral Load Set Point in Primary HIV Infection.
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Kelley, Colleen F., Barbour, Jason D., and Hecht, Frederick M
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HIV infections , *HIV , *HIV-positive persons , *SYMPTOMS , *IMMUNOGLOBULINS , *RNA - Abstract
The article evaluates the relation between viral load and primary HIV infection symptoms and the association of both of these factors with viral load set point in a cohort enrolled before or within approximately two months after HIV antibody seroconversion. According to the authors, the strong correlation between initial HIV-1 RNA viral load levels and viral load set point suggests that early interactions between the HIV-1 virus and a host are important in establishing viral load set point.
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- 2007
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16. Synergy or Independence? Deciphering the Interaction of HLA Class I and NK Cell KIR Alleles in Early HIV-1 Disease Progression.
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Barbour, Jason D., Sriram, Uma, Caillier, Stacy J., Levy, Jay A., Hecht, Frederick M., and Oksenberg, Jorge R.
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HLA histocompatibility antigens , *KILLER cells , *HIV , *DISEASES - Abstract
The article focuses on the interaction of human leukocyte antigen (HLA) Class I and natural killer (NK) cell killer immunoglobulin (Ig)-like receptor (KIR) alleles in early human immunodeficiency virus-1 (HIV-1) disease progression. It mentions the two groups of KIR receptor alleles. It provides a summary of observational studies on HLA and KIR on HIV-1 disease progression including one by M. P. Martin et al on an approach to a historical cohort with extended pre-treatment follow-up.
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- 2007
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17. Cuticular Hydrocarbons Mediate Mate Recognition in a Species of Longhorned Beetle (Coleoptera: Cerambycidae) of the Primitive Subfamily Prioninae.
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Barbour, James D., Lacey, Emerson S., and Hanks, Lawrence M.
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PHEROMONES , *SEX recognition (Zoology) , *ANIMAL sexual behavior , *CERAMBYCIDAE , *BEETLES , *INSECT behavior - Abstract
We tested the hypothesis that contact pheromones mediate mate recognition in Prionus californicus Motschulsky, a species of longhorned beetle (Coleoptera: Cerambycidae) in the primitive subfamily Prioninae. Males attempted to mate with live females only after contacting them with their antennae, and 80% of males showed an identical response to freshly killed females. Males did not attempt to mate with dead females that had been extracted with solvent, suggesting that mate recognition cues had been eliminated. When the solvent extract was applied to carcasses of the same dead females, however, 56% of the males again attempted to mate with them. A preliminary analysis of crude solvent extracts of adult beetles revealed that adults have at least 24 different cuticular hydrocarbons and that the sexes differ in relative proportions of some compounds that may serve as the contact pheromone. This report provides the first evidence that contact pheromones play an important role in mate recognition in the more primitive longhorned beetles. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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18. First report of Centrodera dayi Leech, 1963 and Phymatodes vulneratus (LeConte, 1857).
- Author
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Lyons-Yerion, Claudia D., Barbour, James D., Merickel, Frank W., and Cook, Stephen P.
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LEECHES , *CERAMBYCIDAE , *PONDEROSA pine , *MORACEAE , *DEAD trees , *DOUGLAS fir , *CONIFEROUS forests - Published
- 2020
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19. Higher Frequency of HIV-1--Specific T Cell Immune Responses in African American Children Vertically Infected with HIV-1.
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Sharp, Elizabeth R., Barbour, Jason D., Karlsson, R. Karl, Jordan, Kimberly A., Sandberg, Johan K., Wiznia, Andrew, Rosenberg, Michael G., and Nixon, Douglas F.
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HIV infections , *T cells , *LYMPHOCYTES , *HLA histocompatibility antigens , *ANTIVIRAL agents , *MULTIVARIATE analysis - Abstract
The progression of human immunodeficiency virus (HIV) disease and plasma levels of HIV may differ between racial groups. We compared HIV-specific T cell responses between vertically HIV-1-infected Hispanic and African American children. Subjects were matched for sex, age, viral load, and CD4+ cell count in 18 pairs; T cell responses were measured by cytokine-enhanced interferon-γ assay. Peripheral blood mononuclear cells were stimulated with HIV consensus peptides from Gag, Nef, and Tat. The influence of ethnicity, sex, age, viral load, and CD4+ cell count on T cell responses was determined through linear regression analyses. After adjustment for CD4+ count, age, and log10 viral load, African American children demonstrated significantly higher Gag responses (average, 486 spot-forming cells higher; P = .01) than Hispanic children; this was significantly driven by robust responses in African American girls near the age of puberty, many of whom carried the human leukocyte antigen class I B*58 allele. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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20. TESTING FOR EVOLUTIONARY RELATIONSHIP:: AN APPLICATION OF MATHEMATICS IN MOLECULAR BIOLOGY.
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BARBOUR, A. D.
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MOLECULAR biology , *MATHEMATICAL models , *NUCLEOTIDE sequence , *TREE graphs , *MOLECULAR evolution , *EVOLUTIONARY theories - Abstract
The paper illustrates some mathematical problems that are motivated by molecular biological applications and the techniques that are used to address them. The context is that of detecting evolutionary relationship on the basis of molecular sequence data and of measuring its strength. The Stein–Chen method is shown to play a central role in the theoretical analysis of many of the procedures used in practice. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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21. THE ETHICS OF INTERCULTURAL TRAVEL:THOMAS MERTON'S ASIAN PILGRIMAGE AND ORIENTALISM.
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Barbour, John D.
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PILGRIMS & pilgrimages , *TRAVEL writing , *VOYAGES & travels , *RELIGIOUS travel , *CROSS-cultural communication , *CULTURE - Abstract
This article focuses on the pilgrimage of U.S. monk and writer Thomas Merton to Asia. One of the most interesting issues raised by increasing global travel is the ethics of cross-cultural travel. Significant insights into cross-cultural travel is suggested by a work of autobiographical travel literature, "The Asian Journal of Thomas Merton." This book records the final journey of Merton's life, a two-month trip in 1968 to India, Nepal, Sri Lanka, and Thailand. The book is a posthumously edited version of a travel diary, containing descriptions of daily sightseeing and meetings, quotes from readings, dreams, poems, and reflections on religious matters.
- Published
- 2005
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22. Histology of the fascial-periosteal interface in lower limb chronic deep posterior compartment syndrome.
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Barbour, T. D. A., Briggs, C. A., Bell, S. N., Bradshaw, C. J., Venter, D. J., and Brukner, P. D.
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HISTOLOGY , *LEG , *MUSCLE diseases , *COLLAGEN , *FIBROBLASTS , *SYNDROMES - Abstract
Objective: To describe the histological features of the fascial-periosteal interface at the medial tibial border of patients surgically treated for chronic deep posterior compartment syndrome and to make statistical comparisons with control tissue. Methods: Nineteen subjects and 11 controls were recruited. Subject tissue was obtained at operation, and control tissue from autopsy cases. Tissue samples underwent histological preparation and then examination by an independent pathologist. Samples were analysed with regard to six histological variables: fibroblastic activity, chronic inflammatory cells, vascularity, collagen regularity, mononuclear cells, and ground substance. Collagen regularity was measured with respect to collagen density, fibre arrangement, orientation, and spacing. The observed changes were graded from 1 to 4 in terms of abnormality. Mann-Whitney U test, Spearman correlation coefficients, and intraobserver reliability scores were used. Results: With regard to collagen arrangement, control tissue showed greater degrees of irregularity than subject tissue (p = 0.01). Subjects with a symptom duration of greater than 12 months (as opposed to less than 12 months) showed greater degrees of collagen irregularity (p = 0.043). Vascular changes approached significance (p = 0.077). With regard to the amount of fibrocyte activity, chronic inflammatory cell activity, mononuclear cells, or ground substance, there were no significant differences between controls and subjects. Good correlation was seen in scores measuring chronic inflammatory cell activity and mononuclear cells (r = 0.649), and moderate correlation was seen between fibrocyte activity and vascular changes (r = 0.574). Intraobserver reliability scores were good for chronic inflammatory cell activity and moderate for vascular changes, but were poor for collagen and fibrocyte variables. Individual cases showed varying degrees of fibrocyte activity, chronic inflammatory cellular infiltration, vascular abnormalities, and collagen fibre disruption. Conclusions: Statistical analysis showed no histological differences at the fascial-periosteal interface in cases of chronic deep posterior compartment syndrome, except for collagen, which showed less irregularity in subject samples. The latter may indicate a remodelling process, and this is supported by greater collagen irregularity in subjects with longer duration of symptoms. [ABSTRACT FROM AUTHOR]
- Published
- 2004
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23. Relating HIV-1 Sequence Variation to Replication Capacity via Trees and Forests.
- Author
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Segal, Mark R., Barbour, Jason D., and Grant, Robert M.
- Abstract
The problem of relating genotype (as represented by amino acid sequence) to phenotypes is distinguished from standard regression problems by the nature of sequence data. Here we investigate an instance of such a problem where the phenotype of interest is HIV-1 replication capacity and contiguous segments of protease and reverse transcriptase sequence constitutes genotype. A variety of data analytic methods have been proposed in this context. Shortcomings of select techniques are contrasted with the advantages afforded by tree-structured methods. However, tree-structured methods, in turn, have been criticized on grounds of only enjoying modest predictive performance. A number of ensemble approaches (bagging, boosting, random forests) have recently emerged, devised to overcome this deficiency. We evaluate random forests as applied in this setting, and detail why prediction gains obtained in other situations are not realized. Other approaches including logic regression, support vector machines and neural networks are also applied. We interpret results in terms of HIV-1 reverse transcriptase structure and function. [ABSTRACT FROM AUTHOR]
- Published
- 2004
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24. The Duration of a Sequence of Epidemics
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Barbour, A. D. and Kälin, Roman
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EPIDEMICS , *POPULATION , *BEHAVIOR - Abstract
The typical duration of an epidemic in a sequence of linearly ordered populations shows a surprising nonmonotonic behaviour with respect to population size, which was noted by [Bull. Math. Biol., 60, 215–230]. This paper gives the sketch of a proof of the phenomenon. [Copyright &y& Elsevier]
- Published
- 2003
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25. Sustained CD4+ T Cell Response after Virologic Failure of Protease Inhibitor-Based Regimens in...
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Deeks, Steven G., Barbour, Jason D., Martin, Jeffrey N., Swanson, Melinda S., and Grant, Robert M.
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T cells , *HIV infections , *IMMUNOLOGY - Abstract
Studies sustained CD4[sup +] T cell response after virologic failure of protease inhibitor-based regimens in patients with HIV infection. HIV RNA and CD4[sup +] T cell change after initiation of a protease inhibitor-based regimen; Effect of virologic failure on the subsequent CD4[sup +] T cell response.
- Published
- 2000
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26. Reversal of Human Immunodeficiency Virus Type 1-Associated Hematosuppression by Effective Antiretroviral Therapy.
- Author
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Huang, Susan S., Barbour, Jason D., Deeks, Steven G., Huang, Jeannie S., Grant, Robert M., Ng, Valerie L., and McCune, Joseph M.
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HIV infections , *VIRUS-induced immunosuppression , *HEMATOPOIESIS , *T cells - Abstract
Examines the reversal of HIV type 1-associated hematosuppression by effective antiretroviral therapy. Effects of durable viral suppression on multilineage hematopoiesis in 66 HIV-1 seropositive patients; Increase in circulating CD4(sup +) T cell counts and circulating levels of other hematopoietic lineages; Location of a significant lesion in untreated HIV-1 disease.
- Published
- 2000
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27. Iterates of expanding maps.
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Barbour, A. D., Gerrard, R. M., and Reinert, G.
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STOCHASTIC processes , *ITERATIVE methods (Mathematics) , *GAUSSIAN distribution - Abstract
Abstract. The iterates of expanding maps of the unit interval into itself have many of the properties of a more conventional stochastic process, when the expanding map satisfies some regularity conditions and when the starting point is suitably chosen at random. In this paper, we show that the sequence of iterates can be closely tied to an m-dependent process. This enables us to prove good bounds on the accuracy of Gaussian approximations. Our main tools are coupling and Stein's method. [ABSTRACT FROM AUTHOR]
- Published
- 2000
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28. Aspects of Line-Fitting in Bivariate Allometric Analyses.
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Martin, Robert D. and Barbour, Andrew D.
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- 1989
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29. Ad Libitum Water Source for a Common Raven.
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Hanks, Lawrence M., Barbour, James D., Kratz, Kim, and Webb, William C.
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ANIMAL-water relationships , *CORVUS corax , *PREDATORY animals , *DESERT tortoise ,RAVEN behavior - Abstract
We report a Common Raven (Corvus corax) that learned to turn on a water faucet in a campground at Death Valley National Park, Inyo County, California, USA, and drink from it. Ad libitum availability of water has important implications for survival and reproductive success of desert birds. Ravens commonly exploit anthropogenic sources of water and food; these behaviors are of interest because ravens can be important predators of the federally-threatened desert tortoise (Gopherus agassizii). Our observation is further evidence of the resourcefulness of ravens and challenges involved in limiting access to anthropogenic resources for an intelligent, subsidized predator. Received 14 January 2008. Accepted 6 June 2008. [ABSTRACT FROM AUTHOR]
- Published
- 2009
- Full Text
- View/download PDF
30. Measurement of maternal functioning during pregnancy and postpartum: findings from the cross-sectional WHO pilot study in Jamaica, Kenya, and Malawi.
- Author
-
Cresswell, Jenny A., Barbour, Kelli D., Chou, Doris, McCaw-Binns, Affette, Filippi, Veronique, Cecatti, Jose Guilherme, Barreix, Maria, Petzold, Max, Kostanjsek, Nenad, Cottler-Casanova, Sara, and Say, Lale
- Subjects
- *
MATERNAL health services , *PREGNANCY , *CHILDBIRTH , *MEDICAL care - Abstract
Background: The World Health Organization's definition of maternal morbidity refers to "a negative impact on the woman's wellbeing and/or functioning". Many studies have documented the, mostly negative, effects of maternal ill-health on functioning. Although conceptually important, measurement of functioning remains underdeveloped, and the best way to measure functioning in pregnant and postpartum populations is unknown.Methods: A cross-sectional study among women presenting for antenatal (N = 750) and postpartum (N = 740) care in Jamaica, Kenya and Malawi took place in 2015-2016. Functioning was measured through the World Health Organization Disability Assessment Schedule (WHODAS-12). Data on health conditions and socio-demographic characteristics were collected through structured interview, medical record review, and clinical examination. This paper presents descriptive data on the distribution of functioning status among pregnant and postpartum women and examines the relationship between functioning and health conditions.Results: Women attending antenatal care had a lower level of functioning than those attending postpartum care. Women with a health condition or associated demographic risk factor were more likely to have a lower level of functioning than those with no health condition. However, the absolute difference in functioning scores typically remained modest.Conclusions: Functioning is an important concept which integrates a woman-centered approach to examining how a health condition affects her life, and ultimately her return to functioning after delivery. However, the WHODAS-12 may not be the optimal tool for use in this population and additional components to capture pregnancy-specific issues may be needed. Challenges remain in how to integrate functioning outcomes into routine maternal healthcare at-scale and across diverse settings. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
31. Toxic-Shock Syndrome Associated with Nasal Packing: Analogy to Tampon-Associated Illness.
- Author
-
Barbour, Stephen D., Shlaes, David M., and Guertin, Stephen R.
- Subjects
- *
HEMORRHAGIC diseases in children , *HYDROCEPHALUS in children , *JUVENILE diseases - Abstract
A pure culture of migmatoxin-producing Staphylococcus aureus was isolated from the purulent nasal packing removed from a 13-year-old premenarchal girl with toxic-shock syndrome after rhinoplasty. The similarities between this case and the tampon-associated illness are examined. An increased awareness of these similarities and the identification of predisposing factors may lead to ca:flier detection and treatment of toxicshock syndrome. [ABSTRACT FROM AUTHOR]
- Published
- 1984
- Full Text
- View/download PDF
32. Male Confessions: Intimate Revelations and the Religious Imagination.
- Author
-
Barbour, John D.
- Subjects
- *
CONFESSION (Law) , *NONFICTION - Abstract
The article presents a review of the book "Male Confessions: Intimate Revelations and the Religious Imagination," by Björn Krondorfer.
- Published
- 2010
- Full Text
- View/download PDF
33. The Odyssey Experience: Physical, Social, Psychological, and Spiritual Journeys. By Neil J. Smelser.
- Author
-
Barbour, John D.
- Subjects
- *
LIFE , *NONFICTION - Abstract
The article reviews the book "The Odyssey Experience: Physical, Social, Psychological, and Spiritual Journeys," by Neil J. Smelser.
- Published
- 2009
- Full Text
- View/download PDF
34. EDWARD SAID AND THE SPACE OF EXILE.
- Author
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Barbour, John D.
- Subjects
- *
EXILES , *NONFICTION - Abstract
The article reviews the book "Out of Place: A Memoir," by Edward Said.
- Published
- 2007
- Full Text
- View/download PDF
35. God and the American Writer (Book Review).
- Author
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Barbour, John D.
- Subjects
- GOD & the American Writer (Book)
- Abstract
Reviews the book 'God and the American Writer,' by Alfred Kazin.
- Published
- 2000
36. Correction: Synergy or Independence? Deciphering the Interaction of HLA Class I and NK Cell KIR Alleles in Early HIV-1 Disease Progression.
- Author
-
Barbour, Jason D, Sriram, Uma, Caillier, Stacy J, Levy, Jay A, Hecht, Frederick M, and Oksenberg, Jorge R
- Subjects
- *
RESEARCH grants - Abstract
A correction to the article "Synergy or Independence? Deciphering the Interaction of HLA Class I and NK Cell KIR Alleles in Early HIV-1 Disease Progression," by J. D. Barbour et al that was published in the 2007 issue is presented.
- Published
- 2007
- Full Text
- View/download PDF
37. Modes of Faith: Secular Surrogates for Lost Religious Belief.
- Author
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Barbour, John D.
- Subjects
- *
FAITH in literature , *NONFICTION - Abstract
The article reviews the book "Modes of Faith: Secular Surrogates for Lost Religious Belief," by Theodore Ziolkowski.
- Published
- 2008
- Full Text
- View/download PDF
38. Henry Fielding and the Narration of Providence (Book).
- Author
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Barbour, John D.
- Subjects
- *
GOOD & evil , *NONFICTION - Abstract
Reviews the book 'Henry Fielding and the Narration of Providence: Divine Design and the Incursions of Evil,' by Richard Rosengarten.
- Published
- 2002
- Full Text
- View/download PDF
39. Santa or Scrooge? DVMs debate holiday bonuses.
- Author
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Vadala-Barbour, Denise D.
- Subjects
- *
VETERINARIANS , *ANIMAL health technicians , *EMPLOYEE bonuses , *EMPLOYEE benefits , *MONETARY incentives - Abstract
The article focuses on the author's perspectives regarding the proper way of dealing with bonuses for employers and their staff in the U.S. She believes that it is important for employees to express their gratitude to their employers when they are given gifts. Moreover, she thinks that it would be best if their employers know that their actions are recognized.
- Published
- 2007
40. Tim-3 marks human natural killer cell maturation and suppresses cell-mediated cytotoxicity.
- Author
-
Ndhlovu, Lishomwa C., Lopez-Vergès, Sandra, Barbour, Jason D., Jones, R. Brad, Jha, Aashish R., Long, Brian R., Schoeffler, Eric C., Fujita, Tsuyoshi, Nixon, Douglas F., and Lanier, Lewis L.
- Subjects
- *
KILLER cells , *CELL-mediated cytotoxicity , *LYMPHOCYTES , *VIRUS diseases , *GENE expression , *IMMUNOGLOBULINS , *CELL physiology - Abstract
Natural killer (NK) cells are innate lymphocytes that play an important role against viral infections and cancer. This effect is achieved through a complex mosaic of inhibitory and activating receptors expressed by NK cells that ultimately determine the magnitude of the NK-cell response. The T-cell immunoglobulin- and mucin domain-containing (Tim)-3 receptor was initially identified as a T-helper 1-specific type I membrane protein involved in regulating T-cell responses. Human NK cells transcribe the highest amounts of Tim-3 among lymphocytes. Tim-3 protein is expressed on essentially all mature CD56dimCD16+ NK cells and is expressed heterogeneously in the immature CD56bright,CD16- NK-cell subset in blood from healthy adults and in cord blood. Tim-3 expression was induced on CD56bright CD16- NK ce||s after stimulation with IL-15 or IL-12 and IL-18 in vitro, suggesting that Tim-3 is a maturation marker on NK cells. Whereas Tim-3 has been used to identify dysfunctional Τ cells, NK cells expressing high amounts of Tim-3 are fully responsive with respect to cytokine production and cytotoxicity. However, when Tim-3 was cross-linked with antibodies it suppressed NK cellmediated cytotoxicity. These findings suggest that NK-cell responses may be negatively regulated when NK cells encounter target cells expressing cognate ligands of Tim-3. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
41. Effects of the insect growth regulator, novaluron on immature alfalfa leafcutting bees, Megachile rotundata.
- Author
-
Hodgson, Erin W., Pitts-Singer, Theresa L., and Barbour, James D.
- Subjects
- *
BEES , *ALFALFA leafcutting bee , *TOXICITY testing , *INSECT growth regulators , *NOVALURON , *MORTALITY - Abstract
The article focuses on a research conducted in order to evaluate the toxicity of the insect growth regulator, novaluron on immature alfalfa leafcutting bees, Megachile rotundata (M. rotundata). It discusses the determination of the immature mortality via treating nectar-pollen provisions and adults with novaluron. The study revealed that novaluron is toxic to progeny in nest cells of M. rotundata.
- Published
- 2011
- Full Text
- View/download PDF
42. Determination of the Relative and Absolute Configurations of the Female-produced Sex Pheromone of the Cerambycid Beetle Prionus californicus.
- Author
-
Rodstein, Joshua, Millar, Jocelyn G., Barbour, James D., McElfresh, J. Steven, Wright, Ian M., Barbour, Karen S., Ray, Ann M., and Hanks, Lawrence M.
- Subjects
- *
PHEROMONES , *BEETLES , *STEREOISOMERS , *BIOLOGICAL assay , *INSECTS , *OPTICAL isomers - Abstract
We previously identified the basic structure of the female-produced sex attractant pheromone of the cerambycid beetle, Prionus californicus Motschulsky (Cerambycidae: Prioninae), as 3,5-dimethyldodecanoic acid. A synthesized mixture of the four stereoisomers of 3,5-dimethyldodecanoic acid was highly attractive to male beetles. Here, we describe stereoselective syntheses of three of the four possible stereoisomers, and the results of laboratory and field bioassays showing that male beetles are attracted specifically to (3 R,5 S)-3,5-dimethyldodecanoic acid, but not to its enantiomer, (3 S,5 R)-3,5-dimethyldodecanoic acid, indicating that the (3 R,5 S)-enantiomer is the active pheromone component. The diastereomeric (3 R,5 R)- and (3 S,5 S)-enantiomers were excluded from consideration because their gas chromatographic retention times were different from that of the insect-produced compound. The mixture of the four stereoisomers of 3,5-dimethyldodecanoic acid was as attractive to male P. californicus as the (3 R,5 S)-enantiomer, indicating that none of the other three stereoisomers inhibited responses to the active enantiomer. Beetles responded to as little as 10 ng and 10 μg of synthetic 3,5-dimethyldodecanoic acid in laboratory and field studies, respectively. Field studies indicated that capture rate did not increase with dosages of 3,5-dimethyldodecanoic acid greater than 100 μg. In field bioassays, males of a congeneric species, P. lecontei Lameere, were captured in southern California but not in Idaho. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
43. Estimation of the transmission dynamics of Theileria equi and Babesia caballi in horses.
- Author
-
RÜEGG, S. R., HEINZMANN, D., BARBOUR, A. D., and TORGERSON, P. R.
- Subjects
- *
INFECTIOUS disease transmission , *BABESIA , *MONTE Carlo method , *THEILERIA , *EPIDEMIOLOGY , *MAXIMUM likelihood statistics - Abstract
SUMMARY: For the evaluation of the epidemiology of Theileria equi and Babesia caballi in a herd of 510 horses in SW Mongolia, several mathematical models of the transmission dynamics were constructed. Because the field data contain information on the presence of the parasite (determined by PCR) and the presence of antibodies (determined by IFAT), the models cater for maternal protection with antibodies, susceptible animals, infected animals and animals which have eliminated the parasite and also allow for age-dependent infection in susceptible animals. Maximum likelihood estimation procedures were used to estimate the model parameters and a Monte Carlo approach was applied to select the best fitting model. Overall, the results are in line with previous experimental work, and add evidence that the epidemiology of T. equi differs from that of Babesia spp. The presented modelling approach provides a useful tool for the investigation of some vector-borne diseases and the applied model selection procedure avoids asymptotical assumptions that may not be adequate for the analysis of epidemiological field data. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
44. Turning up the volume on mutational pressure: Is more of a good thing always better? (A case study of HIV-1 Vif and APOBEC3).
- Author
-
Pillai, Satish K., Wong, Joseph K., and Barbour, Jason D.
- Subjects
- *
GENETIC mutation , *HIV , *ANTIVIRAL agents , *VIRAL genomes - Abstract
APOBEC3G and APOBEC3F are human cytidine deaminases that serve as innate antiviral defense mechanisms primarily by introducing C-to-U changes in the minus strand DNA of retroviruses during replication (resulting in G-to-A mutations in the genomic sense strand sequence). The HIV-1 Vif protein counteracts this defense by promoting the proteolytic degradation of APOBEC3G and APOBEC3F in the host cell. In the absence of Vif expression, APOBEC3 is incorporated into HIV-1 virions and the viral genome undergoes extensive G-to-A mutation, or "hypermutation", typically rendering it non-viable within a single replicative cycle. Consequently, Vif is emerging as an attractive target for pharmacological intervention and therapeutic vaccination. Although a highly effective Vif inhibitor may result in mutational meltdown of the viral quasispecies, a partially effective Vif inhibitor may accelerate the evolution of drug resistance and immune escape due to the codon structure and recombinogenic nature of HIV-1. This hypothesis rests on two principal assumptions which are supported by experimental evidence: a) there is a dose response between intracellular APOBEC concentration and degree of viral hypermutation, and, b) HIV-1 can tolerate an elevated mutation rate, and a true error or extinction threshold is as yet undetermined. Rigorous testing of this hypothesis will have timely and critical implications for the therapeutic management of HIV/AIDS, and delve into the complexities underlying the induction of lethal mutagenesis in a viral pathogen. [ABSTRACT FROM AUTHOR]
- Published
- 2008
- Full Text
- View/download PDF
45. Human Immunodeficiency Virus Type 1 Superinfection Was Not Detected following 215 Years of Injection Drug User Exposure.
- Author
-
Tsui, Rose, Herring, Belinda L., Barbour, Jason D., Grant, Robert M., Bacchetti, Peter, Kral, Alex, edlin, Brian R., and Delwart, Eric L.
- Subjects
- *
HIV , *INTRAVENOUS drug abuse , *NUCLEOTIDE sequence , *SERUM , *INFECTION , *DISEASE risk factors - Abstract
Evidence for human immunodeficiency virus type 1 (HIV-1) superinfection was sought among 37 HIV-1 positive street-recruited active injection drug users (IDUs) from the San Francisco Bay area. HIV-1 sequences from pairs of samples collected 1 to 12 years apart, spanning a total of 215 years of exposure, were generated at p17 gag, the V3-V5 region of env, and/or the first exon of tat and phylogenetically analyzed. No evidence of HIV-1 superinfection was detected in which a highly divergent HIV-1 variant emerged at a frequency >20% of the serum viral quasispecies. Based on the reported risk behavior of the IDUs and the HIV-1 incidence in uninfected subjects in the same cohort, a total of 3.4 new infections would have been expected if existing infection conferred no protection from superinfection. Adjusted for risk behaviors, the estimated relative risk of superinfection compared with initial infection was therefore 0.0 (95% confidence interval, 0.00, 0.79; P = 0.02), indicating that existing infection conferred a statistically significant level of protection against superinfection with an HIV-1 strain of the same subtype, which was between 21 and 100%. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
- View/download PDF
46. Dual Pressure from Antiretroviral Therapy and Cell-Mediated Immune Response on the Human Immunodeficiency Virus Type 1 Protease Gene.
- Author
-
Karlsson, Annika C., Deeks, Steven G., Barbour, Jason D., Heiken, Brandon D., Younger, Sophie R., Hoh, Rebecca, Lane, Meghan, Sällberg, Matti, Ortiz, Gabriel M., Demarest, James F., Liegler, Teri, Grant, Robert M., Martin, Jeffrey N., and Nixon, Douglas F.
- Subjects
- *
HIV , *T cells , *ANTIRETROVIRAL agents - Abstract
Human immunodeficiency virus (HIV)-specific CD8[sup +] T-lymphocyte pressure can lead to the development of viral escape mutants, with consequent loss of immune control. Antiretroviral drugs also exert selection pressures on HIV, leading to the emergence of drug resistance mutations and increased levels of viral replication. We have determined a minimal epitope of HIV protease, amino acids 76 to 84, towards which a CD8[sup +] T-lymphocyte response is directed. This epitope, which is HLA-A2 restricted, includes two amino acids that commonly mutate (V82A and I84V) in the face of protease inhibitor therapy. Among 29 HIV-infected patients who were treated with protease inhibitors and who had developed resistance to these drugs, we show that the wild-type PR82V[sub 76.84] epitope is commonly recognized by cytotoxic T lymphocytes (CTL) in HLA-A2positive patients and that the CTL directed to this epitope are of high avidity. In contrast, the mutant PR82A[sub 76-84] epitope is generally not recognized by wild-type-specific CTL, or when recognized it is of low to moderate avidity, suggesting that the protease inhibitor-selected V82A mutation acts both as a CTL and protease inhibitor escape mutant. Paradoxically, the absence of a mutation at position 82 was associated with the presence of a high-avidity CD8[sup +] T-cell response to the wild-type virus sequence. Our results indicate that both HIV type 1-specific CD8[sup +] T cells and antiretroviral drugs provide complex pressures on the same amino acid sequence of the HIV protease gene and, thus, can influence viral sequence evolution. [ABSTRACT FROM AUTHOR]
- Published
- 2003
- Full Text
- View/download PDF
47. The Place of Personal Faith in the Classroom.
- Author
-
Barbour, John D.
- Subjects
- *
TEACHER attitudes , *ACADEMIC freedom , *COLLEGE student attitudes , *FREEDOM of teaching , *INTELLECTUAL freedom - Abstract
The author discusses his reasons and instances for giving his theology students his own interpretation of literary and sacred texts. The argument that college teachers should not discuss their personal views in the classroom is to prevent students from being influenced and therefore not think critically but the author believes that students want someone with whom they can discuss multiple points of view.
- Published
- 2008
48. Grading on the Guilty-Liberal Standard.
- Author
-
Barbour, John D.
- Subjects
- *
CHURCH & education , *RIGHT & left (Political science) , *STUDENTS , *PSYCHOLOGY of college teachers , *GRADING of students , *RELIGION in universities & colleges , *HIGHER education - Abstract
The article focuses on the perceptions of conservative students at colleges and universities in the United States. These conservative students argue that many universities suffer from liberal biases, and as such, it makes it more difficult for them to argue more conservative positions. Particular attention is given to conservative students and their opinions on religion. Article topics include the author's experiences teaching religious studies at a college, the fairness of his grading policies towards conservative students, and his interaction with a particular student named Rick.
- Published
- 2007
49. Coupling, Stationarity, and Regeneration.
- Author
-
Barbour, A. D.
- Subjects
- *
MATHEMATICS , *NONFICTION - Abstract
Reviews the book "Coupling, Stationarity and Regeneration," by Hermann Thorisson.
- Published
- 2001
- Full Text
- View/download PDF
50. Consensus opinion on diagnosis and management of thrombotic microangiopathy in Australia and New Zealand.
- Author
-
Fox, Lucy C., Blombery, Piers, Cohney, Solomon J., Wood, Erica M., Durkan, Anne, Hissaria, Pravin, Hughes, Peter D., Barbour, Thomas D., Kausman, Joshua Y., Shortt, Jake, Isbel, Nicole M., and de Malmanche, Theo
- Subjects
- *
THERAPEUTIC use of monoclonal antibodies , *THROMBOCYTOPENIA treatment , *HEMOLYTIC-uremic syndrome diagnosis , *ANEMIA , *ATTITUDE (Psychology) , *AUTOANTIBODIES , *CITRATES , *COMPLEMENT (Immunology) , *CONSENSUS (Social sciences) , *ESCHERICHIA coli diseases , *HEMOLYTIC-uremic syndrome , *GENETIC mutation , *PEPTIDES , *PLASMA exchange (Therapeutics) , *PROTEOLYTIC enzymes , *PUERPERIUM , *THERAPEUTICS , *THROMBOCYTOPENIA , *THROMBOTIC thrombocytopenic purpura , *TIME , *TOXINS , *DISEASE management , *GENETIC testing , *SYMPTOMS , *MALIGNANT hypertension , *PROTEIN kinase inhibitors , *DISEASE complications , *DIAGNOSIS - Abstract
Abstract: Thrombotic microangiopathy (TMA) arises in a variety of clinical circumstances with the potential to cause significant dysfunction of the kidneys, brain, gastrointestinal tract and heart. TMA should be considered in all patients with thrombocytopenia and anaemia, with an immediate request to the haematology laboratory to look for red cell fragments on a blood film. Although TMA of any aetiology generally demands prompt treatment, this is especially so in thrombotic thrombocytopenic purpura (TTP) and atypical haemolytic uraemic syndrome (aHUS), where organ failure may be precipitous, irreversible and fatal. In all adults, urgent, empirical plasma exchange (PE) should be started within 4–8 h of presentation for a possible diagnosis of TTP, pending a result for ADAMTS13 (a disintegrin and metalloprotease thrombospondin, number 13) activity. A sodium citrate plasma sample should be collected for ADAMTS13 testing prior to any plasma therapy. In children, Shiga toxin‐associated haemolytic uraemic syndrome due to infection with Escherichia coli (STEC‐HUS) is the commonest cause of TMA, and is managed supportively. If TTP and STEC‐HUS have been excluded, a diagnosis of aHUS should be considered, for which treatment is with the monoclonal complement C5 inhibitor, eculizumab. Although early confirmation of aHUS is often not possible, except in the minority of patients in whom auto‐antibodies against factor H are identified, genetic testing ultimately reveals a complement‐related mutation in a significant proportion of aHUS cases. The presence of other TMA‐associated conditions (e.g. infection, pregnancy/postpartum and malignant hypertension) does not exclude TTP or aHUS as the underlying cause of TMA. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
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