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People with HIV (PWH) have a >2‐fold greater risk for development of cardiovascular disease (CVD), which may be associated with abnormalities in 24‐h ambulatory blood pressure measurement (ABPM) profile. We conducted a nested case‐control study of ABPM in 137 PWH and HIV‐uninfected controls with normal and high clinic blood pressure (BP) in Tanzania. Nocturnal non‐dipping of heart rate (HR) was significantly more common among PWH than HIV‐uninfected controls (p =.01). Nocturnal non‐dipping of BP was significantly more common in PWH with normal clinic BP (p =.048). Clinical correlates of nocturnal non‐dipping were similar in PWH and HIV‐uninfected adults and included higher BMI, higher CD4+ cell count, and high C‐reactive protein for HR and markers of renal disease for BP. In conclusion, nocturnal non‐dipping of both BP and HR was more common in PWH but further research is needed to determine causes and consequences of this difference. [ABSTRACT FROM AUTHOR]

Cardiovascular disease is now a leading cause of mortality in people with HIV (PWH). High blood pressure is the major driver of cardiovascular disease. Despite this, little is known about blood pressure in PWH during the early years of antiretroviral therapy (ART). In this prospective cohort study in Tanzania, the authors conducted unobserved blood pressure measurements at enrollment, 3, 6, 12, 18, and 24 months in 500 PWH initiating ART and 504 HIV‐uninfected adults. The authors excluded measurements taken on antihypertensive medications. Although PWH had a significantly lower blood pressure before ART initiation, they had a significantly greater increase in blood pressure during the first 2 years of ART compared to HIV‐uninfected controls. Blood pressure correlates in PWH differed from HIV‐uninfected controls. In PWH, lower baseline CD4+ T‐cell counts were associated with lower blood pressure, and greater increases in CD4+ T‐cell counts on ART were associated with greater increases in blood pressure, both on average and within individuals. In addition, PWH with a systolic blood pressure (SBP) <90 mm Hg at the time of ART initiation had ~30% mortality in the following 3 months due to occult infections. These patients require careful investigation for occult infections, and those with tuberculosis may benefit from corticosteroids. [ABSTRACT FROM AUTHOR]

HIV infection is associated with increased risk and progression of cardiovascular disease (CVD), yet little is known about the prevalence of CVD risk factors among long-term AIDS survivors in resource-limited settings. Using routinely collected data, we conducted a retrospective study to describe the prevalence of CVD risk factors among a cohort of HIV-infected patients followed for over 10 years in Port-au Prince, Haiti. This cohort includes 910 adults who initiated antiretroviral therapy (ART) between 2003 and 2004 and remained in care between 2014 and 2016 when routine screening for CVD risk factors was implemented at a large clinic in Haiti. A total of 397 remained in care ≥10 years and received screening. At ART initiation, 59% were female, median age was 38 years (IQR 33-44), and median CD4 count was 117 cells/mm3 (IQR 34-201). Median follow-up time from ART initiation was 12.1 years (IQR 11.7-12.7). At screening, median CD4 count was 574 cells/mm3 (IQR 378-771), and 84% (282 of 336 screened) had HIV-1 RNA < 1000 copies/mL. Seventy-four percent of patients had at least 1 risk factor including 58% (224/385) with hypertension, 8% (24/297) diabetes, 43% (119/275) hypercholesterolemia, 8% (20/248) active smoking, and 10% (25/245) obesity. Factors associated with hypertension were age (adjusted OR 1.06, P < .001) and weight at screening (adjusted OR 1.02, P = .019). Long-term AIDS survivors have a high prevalence of CVD risk factors, primarily hypertension. Integration of cardiovascular screening and management into routine HIV care is needed to maximize health outcomes among aging HIV patients in resource-limited settings. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the skin anti‐inflammatory activity of rose petal extract (RPE) and the mechanisms underlying this phenomenon. Recently, flowers have been considered as dietary resources owing to their biological activities, such as inhibition of nephritis and hemorrhoids. The Rosa plant exerts various biological functions, including antioxidant and anti‐microbiological activities. Herein, we confirmed the skin anti‐inflammatory activity of RPE upon solar UV (sUV) exposure. RPE reduced sUV‐induced COX‐2 expression as well as expressions of several cytokines. Activation of MKK4‐JNK, MEK‐ERK, and MKK3‐p38 signaling pathways, which are associated with cytokine production, was also attenuated by RPE treatment. We hypothesized these RPE‐induced changes are because of its antioxidant activity, because RPE displayed drastic radical scavenging and oxygen radical absorbance capacity (ORAC). Furthermore, high anthocyanins, polyphenols, and flavonoids contents were found in RPE. Hence, these results indicated the skin anti‐inflammatory activity of RPE is because of antioxidant activity. Rose petal extract (RPE) exerts strong antioxidant effects through cytokine suppression in epidermal cell lines exposed to sUV. And RPE possesses high amounts of anthocyanin content. [ABSTRACT FROM AUTHOR]

HIV-positive adults with hypertension have increased risk of mortality but HIV clinics often do not provide hypertension care. The authors integrated hypertension management into existing HIV services at a large clinic in Haiti. Of 1729 documented HIV-positive adults presenting for care at the GHESKIO HIV clinic between March and July 2016, 551 screened positive for hypertension, with systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. A convenience sample of 100 patients from this group received integrated hypertension and HIV care for 6 months. At time of identification, patients were screened for proteinuria and initiated on antihypertensive medication. Hypertension and HIV visits coincided; medications were free. Outcomes were retention in care and change in blood pressure over 6 months. Average blood pressure over 6 months was described using linear mixed-effects model. Of 100 HIV-positive adults with hypertension referred for integrated care, three were ineligible due to comorbidities. Among 97 participants, 82% (N = 80) remained in care at 6 months from time of positive hypertension identification. 96% (N = 93) were on antiretroviral therapy with median CD4+ count of 442 cells/µL (IQR 257-640). Estimated average blood pressure over 6 months decreased from systolic 160 mmHg (CI 156, 165) to 146 mmHg (CI 141, 150), P-value <0.0001, and diastolic 105 mmHg (CI 102, 108) to 93 mmHg (CI 89, 96), P-value <0.0001. HIV and hypertension management were successfully integrated at a HIV clinic in Haiti. Integrated management is essential to combat the growing burden of cardiovascular disease among HIV-positive adults. [ABSTRACT FROM AUTHOR]

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Abstract: A precision matrix is an important parameter of interests because its elements describe useful association information among multiple variables, which has a wide variety of applications. For example, it is used for inferring gene regulation networks in genomic studies and stock association networks in financial studies. However, in many cases, the precision matrix needs to be robustly estimated due to the presence of outliers. We propose estimating a sparse scaled precision matrix via weighted median regression with regularization. Our weighted median regression approach is consistent under various distributional assumptions including multivariate t‐ or contaminated Gaussian distributions. This fact is illustrated with simulation studies and a real data analysis with monthly stock return data. The Canadian Journal of Statistics 46: 265–278; 2018 © 2018 Statistical Society of Canada [ABSTRACT FROM AUTHOR]

Mycobacterium tuberculosis (Mtb) can persist in the human host in a latent state for decades, in part because it has the ability to withstand numerous stresses imposed by host immunity. Prior studies have established the essentiality of the periplasmic protease MarP for Mtb to survive in acidified phagosomes and establish and maintain infection in mice. However, the proteolytic substrates of MarP that mediate these phenotypes were unknown. Here, we used biochemical methods coupled with supravital chemical probes that facilitate imaging of nascent peptidoglycan to demonstrate that during acid stress MarP cleaves the peptidoglycan hydrolase RipA, a process required for RipA's activation. Failure of RipA processing in MarP-deficient cells leads to cell elongation and chain formation, a hallmark of progeny cell separation arrest. Our results suggest that sustaining peptidoglycan hydrolysis, a process required for cell elongation, separation of progeny cells, and cell wall homeostasis in growing cells, may also be essential for Mtb's survival in acidic conditions. [ABSTRACT FROM AUTHOR]

Background and Aim: Biopsy specimens are taken during transnasal esophagogastroduodenoscopy with 1.8 mm forceps. The aims of this study were to compare the concordance of the Campylobacter-like organism (CLO) test and histological diagnoses between biopsies taken with 1.8 mm and 2.2 mm forceps and to determine whether the concordance of the CLO test could be improved by increasing the number of specimens using 1.8 mm forceps. Methods: A total of 200 patients were enrolled. We first performed the CLO test twice using each sample taken with both forceps in 100 patients. The CLO test was conducted three times again after confirming the difference in the CLO test between two forceps: (i) one sample with 1.8 mm forceps; (ii) two with 1.8 mm; and (iii) one with 2.2 mm in the other 100 patients. Additionally, each specimen was taken from the same gastric lesions in 200 patients for the histological diagnosis using both forceps types. Results: The concordance rate of the CLO test between each sample with 1.8 mm and 2.2 mm forceps was 83% (κ-value, 0.64), and that between two samples with 1.8 mm and one with 2.2 mm was 92% (κ-value, 0.83). The concordance rate of the histological diagnosis with 1.8 and 2.2 mm was 97% (κ-value, 0.84). Conclusions: At least two samples using 1.8 mm forceps might be needed to obtain similar results on the CLO test using 2.2 mm. But, the size difference between two forceps did not influence the histological diagnosis. [ABSTRACT FROM AUTHOR]

Background: Meridian Massage is a traditional practice that manually stimulates the body's meridian system - the same network of vital energy channels used in acupuncture. The present study was to assess the effect of Meridian Massage on physical growth and infants' health as perceived by mothers. Methods: A study was conducted in a community health center in Korea. A total of 169 healthy infant-mother dyads were assigned to the Meridian Massage group ( n= 89) or the gentle touch massage group ( n= 80), based on the mother's preference. All massages were conducted by the mothers for 15 min per session, one time daily over a course of 6 weeks. In each group, the infant's weights, heights, and the number of days with illness as perceived by mothers and related clinic visits were measured. Results: Significant differences were observed in weight and height after 6 weeks between the Meridian group and the gentle touch massage group ( P < 0.001). Infants in the Meridian Massage group showed a significantly different number of days with perceived clinic visits compared to those in the control group ( P < 0.001). Conclusions: Meridian Massage may facilitate physical growth and improve infants' health outcome as perceived by mothers. A randomized controlled trial is required to further explore the effects of Meridian Massage in early infancy. [ABSTRACT FROM AUTHOR]