Sample records for primary immunodeficiencies pid

  1. The German national registry for primary immunodeficiencies (PID)

    PubMed Central

    Gathmann, B; Goldacker, S; Klima, M; Belohradsky, B H; Notheis, G; Ehl, S; Ritterbusch, H; Baumann, U; Meyer-Bahlburg, A; Witte, T; Schmidt, R; Borte, M; Borte, S; Linde, R; Schubert, R; Bienemann, K; Laws, H-J; Dueckers, G; Roesler, J; Rothoeft, T; Krüger, R; Scharbatke, E C; Masjosthusmann, K; Wasmuth, J-C; Moser, O; Kaiser, P; Groß-Wieltsch, U; Classen, C F; Horneff, G; Reiser, V; Binder, N; El-Helou, S M; Klein, C; Grimbacher, B; Kindle, G

    2013-01-01

    In 2009, a federally funded clinical and research consortium (PID–NET, http://www.pid-net.org) established the first national registry for primary immunodeficiencies (PID) in Germany. The registry contains clinical and genetic information on PID patients and is set up within the framework of the existing European Database for Primary Immunodeficiencies, run by the European Society for Primary Immunodeficiencies. Following the example of other national registries, a central data entry clerk has been employed to support data entry at the participating centres. Regulations for ethics approvals have presented a major challenge for participation of individual centres and have led to a delay in data entry in some cases. Data on 630 patients, entered into the European registry between 2004 and 2009, were incorporated into the national registry. From April 2009 to March 2012, the number of contributing centres increased from seven to 21 and 738 additional patients were reported, leading to a total number of 1368 patients, of whom 1232 were alive. The age distribution of living patients differs significantly by gender, with twice as many males than females among children, but 15% more women than men in the age group 30 years and older. The diagnostic delay between onset of symptoms and diagnosis has decreased for some PID over the past 20 years, but remains particularly high at a median of 4 years in common variable immunodeficiency (CVID), the most prevalent PID. PMID:23607573

  2. Rapid Flow cytometric prenatal diagnosis of primary immunodeficiency (PID) disorders.

    PubMed

    Mishra, Anju; Gupta, Maya; Dalvi, Aparna; Ghosh, Kanjaksha; Madkaikar, Manisha

    2014-04-01

    Primary Immunodeficiency diseases (PID) are a heterogeneous group of inherited disorders of immune system. Immunophenotypic evaluation of PIDs using flowcytometry provides important clues for diagnosis of these disorders, though confirmation requires identification of underlying molecular defects. Prenatal diagnosis (PND) forms an important component of management in families affected with severe PID. However, molecular diagnostic facilities for each of these diseases are not available and may not be possible to perform in all cases. In such scenario we opted for phenotypic prenatal diagnosis by cordocentesis for families with index case having immunophenotypically well characterized PID. Normal reference ranges of lymphocyte subsets, CD 18/CD11 integrins on leukocytes, MHC class II expression and oxidative burst activity of fetal neutrophils at 18 weeks of gestation were previously established on 30 cord blood samples. PND was performed in 13 families with PIDs. Maternal contamination was ruled out by VNTR analysis. Out of 13 fetuses, nine were found to be unaffected (three cases with leukocyte adhesion deficiency (LAD-I), four cases with severe combined immunodeficiency diseases (SCID), one with X-linked agammaglobulinemia (XLA), and one with chronic granulomatous disease (CGD)] and three were found to be affected (one with T-B+NK-SCID, one with MHC class II deficiency and one with LAD-I). Diagnosis was confirmed by testing the cord blood samples after delivery and further follow-up of the children. In one family diagnosis could not be offered due to maternal contamination. No procedure related complications were observed. Flowcytometry offers rapid and sensitive method for prenatal diagnosis and genetic counseling for selected phenotypically well characterized PID in cases where molecular diagnostic facilities are not available.

  3. History of Primary Immunodeficiency Diseases in Iran

    PubMed Central

    Aghamohammadi, Asghar; Moin, Mostafa; Rezaei, Nima

    2010-01-01

    Pediatric immunology came into sight in the second half of 20th century, when pediatricians and basic immunologists began to give attention to diagnosis and treatment of children with primary immunodeficiency diseases (PIDs). Understanding the genetic and mechanistic basis of PIDs provides unique insight into the functioning of the immune system. By progress in basic and clinical immunology, many infrastructural organizations and academic centers have been established in many countries worldwide to focus on training and research on the immune system and related disorders. Along with progress in basic and clinical immunology in the world, pediatric immunology had a good progress in Iran during the last 33-year period. Now, patients with PIDs can benefit from multidisciplinary comprehensive care, which is provided by clinical immunologists in collaboration with other specialists. Patients with history of recurrent and/or chronic infections suggestive of PIDs are evaluated by standard and research-based testing and receive appropriate treatment. The progress in PIDs can be described in three periods. Development of training program for clinical fellowship in allergy and immunology, multidisciplinary and international collaborative projects, primary immunodeficiency diseases textbooks, meetings on immunodeficiency disorders, improvement in diagnosis and treatment, and construction of Iranian primary immunodeficiency association, Students' research group for immunodeficiencies, Iranian primary immunodeficiency registry, and the immunological societies and centers were the main activities on PIDs during these years. In this article, we review the growth of modern pediatric immunology and PIDs status in Iran. PMID:23056678

  4. Current Perspectives on Primary Immunodeficiency Diseases

    PubMed Central

    Kumar, Arvind; Teuber, Suzanne S.; Gershwin, M. Eric

    2006-01-01

    Since the original description of X-linked agammaglobulinemia in 1952, the number of independent primary immunodeficiency diseases (PIDs) has expanded to more than 100 entities. By definition, a PID is a genetically determined disorder resulting in enhanced susceptibility to infectious disease. Despite the heritable nature of these diseases, some PIDs are clinically manifested only after prerequisite environmental exposures but they often have associated malignant, allergic, or autoimmune manifestations. PIDs must be distinguished from secondary or acquired immunodeficiencies, which are far more common. In this review, we will place these immunodeficiencies in the context of both clinical and laboratory presentations as well as highlight the known genetic basis. PMID:17162365

  5. Clinical features that identify children with primary immunodeficiency diseases.

    PubMed

    Subbarayan, Anbezhil; Colarusso, Gloria; Hughes, Stephen M; Gennery, Andrew R; Slatter, Mary; Cant, Andrew J; Arkwright, Peter D

    2011-05-01

    The 10 warning signs of primary immunodeficiency diseases (PID) have been promoted by various organizations in Europe and the United States to predict PID. However, the ability of these warning signs to identify children with PID has not been rigorously tested. The main goal of this study was to determine the effectiveness of these 10 warning signs in predicting defined PID among children who presented to 2 tertiary pediatric immunodeficiency centers in the north of England. A retrospective survey of 563 children who presented to 2 pediatric immunodeficiency centers was undertaken. The clinical records of 430 patients with a defined PID and 133 patients for whom detailed investigations failed to establish a specific PID were reviewed. Overall, 96% of the children with PID were referred by hospital clinicians. The strongest identifiers of PID were a family history of immunodeficiency disease in addition to use of intravenous antibiotics for sepsis in children with neutrophil PID and failure to thrive in children with T-lymphocyte PID. With these 3 signs, 96% of patients with neutrophil and complement deficiencies and 89% of children with T-lymphocyte immunodeficiencies could be identified correctly. Family history was the only warning sign that identified children with B-lymphocyte PID. PID awareness initiatives should be targeted at hospital pediatricians and families with a history of PID rather than the general public. Our results provide the general pediatrician with a simple refinement of 10 warning signs for identifying children with underlying immunodeficiency diseases.

  6. Primary immunodeficiency diseases: a 30-year patient registry from the referral center for primary immunodeficiencies in Greece.

    PubMed

    Michos, Athanasios; Raptaki, Maria; Tantou, Sofia; Tzanoudaki, Marianna; Spanou, Kleopatra; Liatsis, Manolis; Constantinidou, Nikki; Paschali, Evangelia; Varela, Ioanna; Moraloglou, Olga; Bakoula, Chryssa; Kanariou, Maria

    2014-10-01

    Primary Immunodeficiencies (PID) represent a group of heterogeneous immune diseases with important biological significance. We reviewed the records of children diagnosed with PID in the Referral Center for PID in our country in order to describe the epidemiological, clinical and laboratory characteristics of immunodeficient patients. During a 30-year period, 147 patients (101 males, 68.7 %), with a mean age of 6.5 years at the time of diagnosis, were diagnosed with PID. The most prevalent diagnoses of PID were: "Combined Immunodeficiency" in 46 (31.3 %) patients, "Well-defined immunodeficiency syndrome" in 35 (23.1 %) patients, "Predominantly antibody deficiency" in 30 (20.4 %) patients and "Congenital defect of phagocyte function or both" in 28 (19 %) patients. There was a higher prevalence of males with "Combined immunodeficiency" (p < 0.033) and "Predominantly antibody deficiency" (p < 0.02) compared to females. The median age of children at the onset of symptoms and at the time of diagnosis was 0.5y (IQR: 0.1-2.5) and 2y (IQR: 0.6-7.2), respectively. The median diagnostic delay was 0.9y (IQR: 0.2-4.8). This period was shorter for patients with "Combined immunodeficiency" [median 0.3y (IQR: 0.1-1)], and longer for those with "Predominantly antibody deficiency" [median 3.2y (IQR: 0.2-5.9) or "Disease of immune dysregulation" [median 3.2y (IQR: 0.1-6.6)]. Comparing the rates in our population with those of the European Registry (ESID), the rates of "Combined immunodeficiencies", "Well-defined syndromes" and "Congenital birth defects and/or function of phagocytes" were significantly higher in this study (p <0,001). PID registry analysis improves knowledge in the field of Immunology and enhances awareness, early detection, diagnosis, and management of this rare but significant group of diseases.

  7. Prevalence of Primary Immunodeficiency in Korea

    PubMed Central

    Rhim, Jung Woo; Kim, Kyung Hyo; Kim, Dong Soo; Kim, Bong Seong; Kim, Jung Soo; Kim, Chang Hwi; Kim, Hwang Min; Park, Hee Ju; Pai, Ki Soo; Son, Byong Kwan; Shin, Kyung Sue; Oh, Moo Young; Woo, Young Jong; Yoo, Young; Lee, Kun Soo; Lee, Kyung Yil; Lee, Chong Guk; Lee, Joon Sung; Chung, Eun Hee; Choi, Eun Hwa; Hahn, Youn Soo; Park, Hyun Young

    2012-01-01

    This study represents the first epidemiological study based on the national registry of primary immunodeficiencies (PID) in Korea. Patient data were collected from 23 major hospitals. A total of 152 patients with PID (under 19 yr of age), who were observed from 2001 to 2005, have been entered in this registry. The period prevalence of PID in Korea in 2005 is 11.25 per million children. The following frequencies were found: antibody deficiencies, 53.3% (n = 81), phagocytic disorders, 28.9% (n = 44); combined immunodeficiencies, 13.2% (n = 20); and T cell deficiencies, 4.6% (n = 7). Congenital agammaglobulinemia (n = 21) and selective IgA deficiency (n = 21) were the most frequently reported antibody deficiency. Other reported deficiencies were common variable immunodeficiencies (n = 16), X-linked agammaglobulinemia (n = 15), IgG subclass deficiency (n = 4). Phagocytic disorder was mostly chronic granulomatous disease. A small number of patients with Wiskott-Aldrich syndrome, hyper-IgE syndrome, and severe combined immunodeficiency were also registered. Overall, the most common first manifestation was pneumonia. This study provides data that permit a more accurate estimation PID patients in Korea. PMID:22787376

  8. How effective are the 6 European Society of Immunodeficiency warning signs for primary immunodeficiency disease?

    PubMed

    Arslan, Sevket; Ucar, Ramazan; Caliskaner, Ahmet Zafer; Reisli, Ismail; Guner, Sukru Nail; Sayar, Esra Hazar; Baloglu, Ismail

    2016-02-01

    The European Society of Immunodeficiency (ESID) developed 6 warning signs to promote the awareness of adult primary immunodeficiency disease (PID). To screen adult patients for the presence of PID using these 6 warning signs to determine the effectiveness of this protocol. Questions related to the ESID warning signs for adult PID were added to the standard outpatient clinic file system and asked of 3,510 patients who were admitted to our clinic for any reason. Patients with signs and/or suspicion of PID based on their medical history underwent immunologic investigation. In total, 24 patients were diagnosed as having a PID. The most common reason that patients with PID were admitted was frequent infection (n=18 [75%]), and the most common PID subgroup was common variable immunodeficiency (n=12 [50%]). Twenty patients with PID had at least one positive finding according to the ESID warning signs. Two patients with gastrointestinal concerns and 2 with dermatologic symptoms were also diagnosed as having a PID, although they did not have any of the ESID warning signs. The ESID warning signs do not specify the need for symptoms to diagnose a PIDs and do not include a comprehensive list of all signs and symptoms of PIDs. As a result, more than infection-centric questions are needed to identify adult patients with immunodeficiencies. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  9. Attentiveness of pediatricians to primary immunodeficiency disorders

    PubMed Central

    2012-01-01

    Background Primary immunodeficiency (PID) is a cluster of serious disorders that requires special alertness on the part of the medical staff for prompt diagnosis and management of the patient. This study explored PID knowledge and experience among pediatricians of wide educational backgrounds, practicing in the United Arab Emirates (UAE). Method A self-administered questionnaire was used to determine the competency of pediatricians in their knowledge of PID disorders. This study questionnaire included questions on PID signs and symptoms, syndromes associated with immunodeficiency, screening tests, interpreting laboratory tests and case management. The participants were 263 pediatricians of diverse education working in the 27 governmental hospitals in all regions of UAE. Results The overall performance of the pediatricians did not differ based on their age, gender, origin of certification, rank, or years of experience. Of the 50 questions, 20% of pediatricians answered correctly <60% of the questions, 76% answered correctly 60 to 79% of the questions, and 4% answered correctly ≥80% of the questions. Seventeen of the 19 PID signs and symptoms were identified by 55 to 97%. Four of 5 syndromes associated with immunodeficiency were identified by 50 to 90%. Appropriate screening tests were chosen by 64 to 96%. Attention to the laboratory reference range values as function of patient age was notably limited. Conclusions There was a noteworthy deficiency in PID work-up. Therefore, implementing effective educational strategies is needed to improve the competency of pediatricians to diagnose and manage PID disorders. PMID:22846098

  10. Poliovirus Excretion in Children with Primary Immunodeficiency Disorders, India

    PubMed Central

    Madkaikar, Manisha Rajan; Desai, Mukesh; Taur, Prasad; Nalavade, Uma Prajwal; Sharma, Deepa Kailash; Gupta, Maya; Dalvi, Aparna; Shabrish, Snehal; Kulkarni, Manasi; Aluri, Jahnavi; Deshpande, Jagadish Mohanrao

    2017-01-01

    Prolonged excretion of poliovirus can occur in immunodeficient patients who receive oral polio vaccine, which may lead to propagation of highly divergent vaccine-derived polioviruses (VDPVs), posing a concern for global polio eradication. This study aimed to estimate the proportion of primary immunodeficient children with enterovirus infection and to identify the long-term polio/nonpolio enterovirus excreters in a tertiary care unit in Mumbai, India. During September 2014–April 2017, 151 patients received diagnoses of primary immunodeficiency (PID). We isolated 8 enteroviruses (3 polioviruses and 5 nonpolio enteroviruses) in cell culture of 105 fecal samples collected from 42 patients. Only 1 patient with severe combined immunodeficiency was identified as a long-term VDPV3 excreter (for 2 years after identification of infection). Our results show that the risk of enterovirus excretion among children in India with PID is low; however, systematic screening is necessary to identify long-term poliovirus excreters until the use of oral polio vaccine is stopped. PMID:28930011

  11. Poliovirus Excretion in Children with Primary Immunodeficiency Disorders, India.

    PubMed

    Mohanty, Madhu Chhanda; Madkaikar, Manisha Rajan; Desai, Mukesh; Taur, Prasad; Nalavade, Uma Prajwal; Sharma, Deepa Kailash; Gupta, Maya; Dalvi, Aparna; Shabrish, Snehal; Kulkarni, Manasi; Aluri, Jahnavi; Deshpande, Jagadish Mohanrao

    2017-10-01

    Prolonged excretion of poliovirus can occur in immunodeficient patients who receive oral polio vaccine, which may lead to propagation of highly divergent vaccine-derived polioviruses (VDPVs), posing a concern for global polio eradication. This study aimed to estimate the proportion of primary immunodeficient children with enterovirus infection and to identify the long-term polio/nonpolio enterovirus excreters in a tertiary care unit in Mumbai, India. During September 2014-April 2017, 151 patients received diagnoses of primary immunodeficiency (PID). We isolated 8 enteroviruses (3 polioviruses and 5 nonpolio enteroviruses) in cell culture of 105 fecal samples collected from 42 patients. Only 1 patient with severe combined immunodeficiency was identified as a long-term VDPV3 excreter (for 2 years after identification of infection). Our results show that the risk of enterovirus excretion among children in India with PID is low; however, systematic screening is necessary to identify long-term poliovirus excreters until the use of oral polio vaccine is stopped.

  12. Primary Immunodeficiencies: “New” Disease in an Old Country

    PubMed Central

    Lee, Pamela P W; Lau, Yu-Lung

    2009-01-01

    Primary immunodeficiency disorders (PIDs) are rare inborn errors of the immune system. Patients with PIDs are unique models that exemplify the functional and phenotypic consequences of various immune defects underlying infections, autoimmunity, lymphoproliferation, allergy and cancer. Over 150 PID syndromes were characterized in the past 60 years, with an ever growing list of new entities being discovered. Because of their rarity, multi-center collaboration for pooled data analysis and molecular studies is important to gain meaningful insights into the phenotypic and genetic diversities of PIDs. In this article, we summarize our research findings on PIDs in Chinese population in the past 20 years. Close collaboration among various immunology centers, cross-referrals and systematic data analysis constitute the foundation for research on PIDs. Future directions include establishment of a national PID registry, raising awareness of PIDs and securing sufficient resources for patient care and scientific research. PMID:20003815

  13. Prevention of infection in children and adolescents with primary immunodeficiency disorders.

    PubMed

    Papadopoulou-Alataki, Efimia; Hassan, Amel; Davies, E Graham

    2012-12-01

    Primary Immunodeficiency diseases (PIDs) are a heterogenous group of inherited disorders that may involve one or multiple components of the immune system. PIDs are uncommon, chronic and severe disorders, in which patients cannot mount a sufficiently protective immune response, leading to an increased susceptibility to infections. This review addresses the current practices for the prevention of infection in children and adolescents with PIDs, particular covering immunisations and antimicrobial prophylaxis. Over recent years, there have been major advances in molecular and cellular understanding in the field of PIDs. Many different disorders are recognised with variable spectra of infection susceptibility depending on the particular aspects of the immune response that are affected. Immunoglobulin prophylaxis is the mainstay of treatment for PIDs and provides passive protection. Prophylactic antimicrobials are efficacious in children and adolescents with predominant defects in primary T cell immunodeficiency diseases and phagocytic disorders, and also with predominant defects in antibody production. Prophylactic antibiotics are suggested for patients with antibody deficiency diseases if recurrent infections exceed three per year, if severe infections occur despite adequate immunoglobulin replacement and in hypogammaglobulinaemic patients who have bronchiectasis. Certain immunisations are effective in antibody deficiencies, T cell deficiencies, complement deficiencies and phagocytic disorders. There are remarkably few published data relating to clinical management aimed at preventing infectious complications in children and adolescents with PIDs. The cornerstones of the prevention of infection in most PID patients are: antimicrobial prophylaxis, appropriate vaccination, immunoglobulin replacement, for the more severe cases, and regular ongoing follow-up.

  14. Consanguinity and primary immunodeficiencies.

    PubMed

    Al-Herz, Waleed; Aldhekri, Hasan; Barbouche, Mohamed-Ridha; Rezaei, Nima

    2014-01-01

    Primary immunodeficiencies (PIDs) are a heterogeneous group of genetic disorders caused by defects in the immune system that predispose patients to infections, autoimmune diseases, lymphoproliferation and malignancies. Most PIDs are inherited in an autosomal recessive pattern; therefore, they are more common in areas with high rates of consanguineous marriage. Reports about PIDs from these areas have demonstrated a peculiar prevalence of more severe forms of diseases compared to other regions, and patients born to consanguineous parents have increased rates of morbidity and mortality compared to other patients. Individuals at high risk of having a child with a PID who wish to have a healthy child have limited options, these include prenatal diagnosis and pre-implantation genetic diagnosis. However, these options require a collaborative team of specialists and may not always be implemented due to geographic, religious, financial or social factors. The recent introduction of newborn-screening programs for a number of T and B lymphocyte deficiencies will facilitate early diagnosis and therapeutic interventions, which may include hematopoietic stem cell transplantation and intravenous immunoglobulin treatment. There is a need for the implementation of strategies to increase public awareness of the health risks associated with consanguineous marriage. It should be stressed that genetic counseling should be an important component of the care of patients with PIDs as well as their families. © 2014 S. Karger AG, Basel.

  15. Survival and predictors of death among primary immunodeficient patients: a registry-based study.

    PubMed

    Al-Herz, Waleed; Moussa, Mohamed A A

    2012-06-01

    The aims of this study were to investigate survival among patients with primary immunodeficiency disorders (PID) in Kuwait and to determine whether certain variables were associated with increased risk of death. The data of 176 patients (98 males and 78 females) were extracted from the Kuwait National Primary Immunodeficiency Disorders Registry and the observation period was from January 2004 to July 2011. The distribution of the reported patients was combined T- and B-cell immunodeficiencies (30.1%), predominantly antibody immunodeficiency (19.9%), other well-defined immunodeficiencies (25%), diseases of immune dysregulation (14.8%), congenital defects of phagocyte number, function or both (6.25%), and complement deficiencies (4.0%). In a total of 619.1 patient-years at risk, 48 patients died (mortality incidence rate 77.53 per 1,000 person-years). The overall survival in the studied cohort was 72.7% (72.4% for males and 73.1% for females). The most common cause of death was sepsis (46%) followed by pneumonia (29%). The probabilities that a patient survived 2, 4, and 6 years after onset of symptoms were 76%, 73%, and 69%, respectively. The variables that were found to be predictors for death are parental consanguinity, sepsis, adenovirus and CMV infections, failure to thrive, PID category, and onset age <6 months. Patients with PID have decreased probabilities of survival that are variable between PID categories. Early diagnosis and aggressive therapeutic interventions specifically of patients with history of the variables associated with increased risk of death may help increase their chance of survival.

  16. Patient-centred screening for primary immunodeficiency, a multi-stage diagnostic protocol designed for non-immunologists: 2011 update

    PubMed Central

    de Vries, E

    2012-01-01

    Members of the European Society for Immunodeficiencies (ESID) and other colleagues have updated the multi-stage expert-opinion-based diagnostic protocol for non-immunologists incorporating newly defined primary immunodeficiency diseases (PIDs). The protocol presented here aims to increase the awareness of PIDs among doctors working in different fields. Prompt identification of PID is important for prognosis, but this may not be an easy task. The protocol therefore starts from the clinical presentation of the patient. Because PIDs may present at all ages, this protocol is aimed at both adult and paediatric physicians. The multi-stage design allows cost-effective screening for PID of the large number of potential cases in the early phases, with more expensive tests reserved for definitive classification in collaboration with a specialist in the field of immunodeficiency at a later stage. PMID:22132890

  17. Primary Immunodeficiency Diseases in Oman: 10-Year Experience in a Tertiary Care Hospital.

    PubMed

    Al-Tamemi, Salem; Naseem, Shafiq Ur Rehman; Al-Siyabi, Nabila; El-Nour, Ibtisam; Al-Rawas, Abdulhakim; Dennison, David

    2016-11-01

    Primary immunodeficiency (PID) diseases are rare, complex medical disorders that often are overlooked in clinical settings. There are emerging reports of PID from Middle Eastern populations. This study describes the features of PID patients in a tertiary care setting in Oman and compares them with regional and worldwide reports. Sultan Qaboos University Hospital (SQUH) is an academic tertiary care-level hospital for specialized healthcare, including PID patients. At the time of diagnosis, patients' sociodemographics, clinical features, laboratory investigations, and management were entered in electronic form. This study included patients seen between August 2005 and July 2015. One hundred forty patients were registered with a minimum estimated population prevalence of 7.0/100,000. The male/female ratio was 1.6:1, the median age of onset of symptoms was 8 months, and diagnosis was 21 months with a delay of 13 months. Family history was positive in 44 %, consanguinity was present in 76 %, death of a previous sibling was present in 36 %, and there was an overall mortality in 18 %, with an 85 % probability of survival 10 years following diagnosis. The most common type of immunodeficiency was phagocytic disorders (35.0 %), followed by predominantly antibody disorders (20.7 %), combined immunodeficiency (17.8 %), other well-defined PID syndromes (15.0 %), immune dysregulation syndromes (3.5 %), complement deficiencies (3.5 %), and unclassified immunodeficiency (4.2 %). The commonest presenting infection was pneumonia (47.1 %). PID is not a rare condition in Oman. The prevalence is in concordance with reports from the region but higher than in Western populations. The findings of the current study would help to improve the awareness and management of, and policy making for PID.

  18. Increased Incidence of Fatigue in Patients with Primary Immunodeficiency Disorders: Prevalence and Associations Within the US Immunodeficiency Network Registry.

    PubMed

    Hajjar, Joud; Guffey, Danielle; Minard, Charles G; Orange, Jordan S

    2017-02-01

    Patients with primary immunodeficiency (PID) often report fatigue, yet this symptom has not been studied in PID. Fatigue affects 6-7.5% of healthy adults. The goal of this study is to estimate the prevalence of fatigue in patients with PID and investigate its associated factors. We analyzed 2537 PID patients registered in USIDNET to determine responses to the field "fatigue" in the core registry form. Demographics, immune phenotypes, and comorbid conditions were compared between fatigued and non-fatigued patients to identify relevant associations and potential drivers. A focused analysis was performed for patients with predominantly antibody deficiency disorders (PADs). Fatigue was reported in 25.9% (95% CI 23.7-28.3) of PAD patients, compared to 6.4% (95% CI 4.9-8.2) of non-PAD. Patients with common variable immunodeficiency (CVID) had the highest prevalence of fatigue (p < 0.001) among all PID diagnoses. Other factors that were associated with a higher rate of fatigue among PAD patients included female sex, higher BMI, depression, bronchiectasis, and autoimmunity. Additionally, fatigued PAD patients had lower absolute lymphocyte, CD3, CD4, and CD8 counts compared to non-fatigued patients. Our findings suggest that fatigue is overrepresented in PAD patients. Prospective studies to estimate prevalence, risk factors, and fatigue etiology in PID are warranted, so therapeutic interventions can be considered.

  19. Increased Incidence of Fatigue in Patients with Primary Immunodeficiency Disorders: Prevalence and Associations Within the US Immunodeficiency Network Registry

    PubMed Central

    Guffey, Danielle; Minard, Charles G.; Orange, Jordan S.

    2017-01-01

    Introduction Patients with primary immunodeficiency (PID) often report fatigue, yet this symptom has not been studied in PID. Fatigue affects 6–7.5% of healthy adults. The goal of this study is to estimate the prevalence of fatigue in patients with PID and investigate its associated factors. Methods We analyzed 2537 PID patients registered in USIDNET to determine responses to the field “fatigue” in the core registry form. Demographics, immune phenotypes, and comorbid conditions were compared between fatigued and non-fatigued patients to identify relevant associations and potential drivers. A focused analysis was performed for patients with predominantly antibody deficiency disorders (PADs). Results Fatigue was reported in 25.9%(95% CI 23.7–28.3) of PAD patients, compared to 6.4% (95% CI 4.9–8.2) of non-PAD. Patients with common variable immunodeficiency (CVID) had the highest prevalence of fatigue (p < 0.001) among all PID diagnoses. Other factors that were associated with a higher rate of fatigue among PAD patients included female sex, higher BMI, depression, bronchiectasis, and autoimmunity. Additionally, fatigued PAD patients had lower absolute lymphocyte, CD3, CD4, and CD8 counts compared to non-fatigued patients. Conclusion Our findings suggest that fatigue is overrepresented in PAD patients. Prospective studies to estimate prevalence, risk factors, and fatigue etiology in PID are warranted, so therapeutic interventions can be considered. PMID:28124237

  20. Primary Immunodeficiency Diseases in Aguascalientes, Mexico: Results from an Educational Program.

    PubMed

    Alvarez-Cardona, Aristoteles; Espinosa-Padilla, Sara Elva; Reyes, Saul Oswaldo Lugo; Ventura-Juarez, Javier; Lopez-Valdez, Jaime Asael; Martínez-Medina, Lucila; Santillan-Artolozaga, Alberto; Cajero-Avelar, Adriana; De Luna-Sosa, Alma R; Torres-Bernal, Luis F; Espinosa-Rosales, Francisco J

    2016-04-01

    Primary immunodeficiencies (PIDs) are a heterogeneous group of disorders characterized mainly by recurrent infections. Late diagnosis remains as one of the main issues to solve. We aimed to increase PID diagnosis in Aguascalientes, a 1.3 million inhabitants state in the center of Mexico, and to describe the clinical features of such patients. We developed an educational program for health personnel and general public; patients with possible PID were referred to a State University clinical center from December 2011 to December 2012. The patients were evaluated at the clinic and their definitive diagnosis pursued through laboratory, molecular and genetic assays. We describe the findings of those patients and analyze the impact of the program in terms of number of referrals. After 41 talks and 12 media appearances 151 patients were referred for evaluation. Fifteen (9.9%) were diagnosed with PID: five (33%) had antibody deficiencies, seven (47%) Well-defined syndromes, two (13%) Severe combined Immunodeficiency (SCID) and one case (7%) of an innate immune deficiency. All of the 15 PID patients had been referred by physicians, as opposed to the public. We estimated a "number needed to teach" of 75 physicians to get one PID patient referral. Educational programs are a fundamental part of the global efforts to increase PID diagnosis and care. To be successful, such programs should include public relations, reach for first-contact physicians, and aim to develop an efficient referral network with molecular diagnostic capability. Enhancing medical knowledge on PID is a successful strategy to improve early diagnosis and treatment.

  1. Mechanism-based strategies for the management of autoimmunity and immune dysregulation in primary immunodeficiencies

    PubMed Central

    Walter, Jolan E; Farmer, Jocelyn R; Foldvari, Zsofia; Torgerson, Troy R; Cooper, Megan A

    2016-01-01

    A broad spectrum of autoimmunity is now well described in patients with primary immunodeficiencies (PIDs). Management of autoimmune disease in the background of PID is particularly challenging given the seemingly discordant goals of immune support and immune suppression. Our growing ability to define the molecular underpinnings of immune dysregulation has facilitated novel targeted therapeutics. This review focuses on mechanism-based treatment strategies for the most common autoimmune and inflammatory complications of PID including autoimmune cytopenias, rheumatologic disease, and gastrointestinal disease. We aim to provide guidance regarding the rational use of these agents in the complex PID patient population. PMID:27836058

  2. Skin signs of primary immunodeficiencies: how to find the genes to check.

    PubMed

    Ettinger, M; Schreml, J; Wirsching, K; Berneburg, M; Schreml, S

    2018-02-01

    Primary immunodeficiencies (PIDs) are a heterogeneous group of rare diseases that result from defects in immune system development and/or function. The clinical manifestations of PIDs are highly variable, but most disorders involve at least an increased susceptibility to infection. Furthermore, cutaneous manifestations are very common in PIDs. As an easily accessible organ, the skin can be crucial for early diagnosis and treatment. This is relevant for preventing significant disease-associated morbidity and mortality. We provide a table that enables the reader to find the possible diseases and corresponding gene defects based on the skin manifestations of the suspected PIDs. To our knowledge, this is the first review that allows the reader to find relevant PIDs and the respective gene defects through solitary or combined skin signs. © 2017 British Association of Dermatologists.

  3. Adoptive T Cell Immunotherapy for Patients with Primary Immunodeficiency Disorders.

    PubMed

    McLaughlin, Lauren P; Bollard, Catherine M; Keller, Michael

    2017-01-01

    Primary immunodeficiency disorders (PID) are a group of inborn errors of immunity with a broad range of clinical severity but often associated with recurrent and serious infections. While hematopoietic stem cell transplantation (HSCT) can be curative for some forms of PID, chronic and/or refractory viral infections remain a cause of morbidity and mortality both before and after HSCT. Although antiviral pharmacologic agents exist for many viral pathogens, these are associated with significant costs and toxicities and may not be effective for increasingly drug-resistant pathogens. Thus, the emergence of adoptive immunotherapy with virus-specific T lymphocytes (VSTs) is an attractive option for addressing the underlying impaired T cell immunity in many PID patients. VSTs have been utilized for PID patients following HSCT in many prior phase I trials, and may potentially be beneficial before HSCT in patients with chronic viral infections. We review the various methods of generating VSTs, clinical experience using VSTs for PID patients, and current limitations as well as potential ways to broaden the clinical applicability of adoptive immunotherapy for PID patients.

  4. Primary Immunodeficiency Diseases in Highly Consanguineous Populations from Middle East and North Africa: Epidemiology, Diagnosis, and Care

    PubMed Central

    Al-Mousa, Hamoud; Al-Saud, Bandar

    2017-01-01

    Middle East and North Africa region (MENA)1 populations are of different ethnic origins. Consanguineous marriages are common practice with an overall incidence ranging between 20 and 50%. Primary immunodeficiency diseases (PIDs) are a group of heterogeneous genetic disorders caused by defects in the immune system that predisposes patients to recurrent infections, autoimmune diseases, and malignancies. PIDs are more common in areas with high rates of consanguineous marriage since most have an autosomal recessive mode of inheritance. Studies of PIDs in the region had contributed into the discovery and the understanding of several novel immunodeficiency disorders. Few MENA countries have established national registries that helped in estimating the prevalence and defining common PID phenotypes. Available reports from those registries suggest a predominance of combined immunodeficiency disorders in comparison to antibody deficiencies seen in other populations. Access to a comprehensive clinical immunology management services is limited in most MENA countries. Few countries had established advanced clinical immunology service, capable to provide extensive genetic testing and stem cell transplantation for various immunodeficiency disorders. Newborn screening for PIDs is an essential need in this population considering the high incidence of illness and can be implemented and incorporated into existing newborn screening programs in some MENA countries. Increased awareness, subspecialty training in clinical immunology, and establishing collaborating research centers are necessary to improve patient care. In this review, we highlight some of the available epidemiological data, challenges in establishing diagnosis, and available therapy for PID patients in the region. PMID:28694805

  5. Primary immunodeficiency diseases in children: 15 year experience in a tertiary care medical center in Qatar.

    PubMed

    Ehlayel, Mohammad S; Bener, Abdulbari; Laban, Mohammad Abu

    2013-02-01

    Primary immunodeficiency diseases (PID) are a group of heterogeneous, rare, genetic, mainly childhood disorders that affect specific components of immune system leading to serious complications. This study is aimed at describing the prevalence and the categories of PID, the ages of onset and the diagnosis, the clinical presentations, the treatment modalities and the overall outcome of affected patients. A retrospective study was conducted on 131 pediatric patients (aged 0-14 years) diagnosed with PID at Hamad General Hospital during a 15-year period (1998-2012). Data of 131 patients (75 males & 56 females) was analyzed with an estimated prevalence of 4.7 PID patients per 100,000 children younger than 14 years of age. The most common type of PID was predominantly antibody deficiency (23.7 %), followed by other well-defined immunodeficiency syndromes (22.9 %), 19.1 % combined T and B cell immunodeficiency, but rare CVID, and no cases of complement deficiency. The mean onset age was 24.01 months and diagnosis age was 42.2 months. Recurrent infections, particularly pneumonia (48.9 %), failure to thrive (34.4 %), otitis media (26 %), sepsis (23.7 %), and chronic diarrhoea (21.4 %) were commonest presenting conditions. P. aeruginosa (15.7 %), Salmonella species (13.2 %), and Non-TB mycobacteria (13.2 %) were the most common bacterial isolates. The overall mortality rate was 21.4 % with combined immunodeficiency's accounting for 53.4 % of deaths. This study reveals that PIDs are not rare in children in Qatar; and like other studies predominantly antibody deficiencies are the most common. Strategies that reinforce awareness and education of practicing physicians, bone marrow transplantation, and establishing PID national registry should be adopted to reduce mortality and morbidity of PID patients in Qatar.

  6. Patient-centred screening for primary immunodeficiency: a multi-stage diagnostic protocol designed for non-immunologists

    PubMed Central

    de Vries, E

    2006-01-01

    Efficient early identification of primary immunodeficiency disease (PID) is important for prognosis, but is not an easy task for non-immunologists. The Clinical Working Party of the European Society for Immunodeficiencies (ESID) has composed a multi-stage diagnostic protocol that is based on expert opinion, in order to increase the awareness of PID among doctors working in different fields. The protocol starts from the clinical presentation of the patient; immunological skills are not needed for its use. The multi-stage design allows cost-effective screening for PID within the large pool of potential cases in all hospitals in the early phases, while more expensive tests are reserved for definitive classification in collaboration with an immunologist at a later stage. Although many PIDs present in childhood, others may present at any age. The protocols presented here are therefore aimed at both adult physicians and paediatricians. While designed for use throughout Europe, there will be national differences which may make modification of this generic algorithm necessary. PMID:16879238

  7. Use of Genetic Testing for Primary Immunodeficiency Patients.

    PubMed

    Heimall, Jennifer R; Hagin, David; Hajjar, Joud; Henrickson, Sarah E; Hernandez-Trujillo, Hillary S; Tan, Yuval; Kobrynski, Lisa; Paris, Kenneth; Torgerson, Troy R; Verbsky, James W; Wasserman, Richard L; Hsieh, Elena W Y; Blessing, Jack J; Chou, Janet S; Lawrence, Monica G; Marsh, Rebecca A; Rosenzweig, Sergio D; Orange, Jordan S; Abraham, Roshini S

    2018-04-01

    Genetic testing plays a critical role in diagnosis for many primary immunodeficiency diseases. The goals of this report are to outline some of the challenges that clinical immunologists face routinely in the use of genetic testing for patient care. In addition, we provide a review of the types of genetic testing used in the diagnosis of PID, including their strengths and limitations. We describe the strengths and limitations of different genetic testing approaches for specific clinical contexts that raise concern for specific PID disorders in light of the challenges reported by the clinical immunologist members of the CIS in a recent membership survey. Finally, we delineate the CIS's recommendations for the use of genetic testing in light of these issues.

  8. Mismatched related hematopoietic stem cell transplantation in primary immunodeficiency.

    PubMed

    Wahadneh, Adel M; Bin Dahman, Haifa A; Abu Shukear, Mohammed E; Habahbeh, Zeyad M; Ajarmeh, Mohammad A; Zyood, Raed M; Habashneh, Mueen S

    2013-11-01

    Hematopoietic stem cell transplantation (HSCT) is the definitive therapy for a variety of primary immunodeficiency syndromes (PIDs). However, no more than 30% of the patients will have a human leukocyte antigen (HLA)-identical sibling. We retrospectively analyzed our results of ten patients with PID; severe combined immunodeficiency (SCID) (n = 7), hyper IgM (HIgM) (n = 1) and combined immunodeficiency (CID) (n = 2), who lacked a fully matched donor and underwent mismatched related HSCT during the period from 2008 to 2010. The median age at the time of transplantation ranged between 3 and 84 months (median 6.5 months). Peripheral blood stem cells (PBSC) were used in all HSCTs. The mean value of the peripheral CD34+ cells infused was 9.19 × 10 (6) /kg recipient weight. Patients received different conditioning protocols. All patients received anti graft versus host disease (GVHD) prophylaxis and all were engrafted. Mixed chimerism (5-55%) was noticed. GVHD was observed in 50% of the patients. Post-transplant follow-up ranged from 3 weeks to 36 months (median 15 months). Five patients are still alive while one patient developed engraftment syndrome followed by graft slippage for which a second transplant with CD34+ stem cells 5.8 × 10 (6) /kg recipient's weight was infused. The others died from sepsis and transplant-related complications. Immune reconstitution was noticed in four patients. In conclusion, HLA-haploidentical stem cell transplantation may be feasible, with appropriate GVHD prophylaxis, for patients with PID who lack a fully matched donor.

  9. Distribution, clinical features and molecular analysis of primary immunodeficiency diseases in Chinese children: a single-center study from 2005 to 2011.

    PubMed

    Zhang, Zhi-Yong; An, Yun-Fei; Jiang, Li-Ping; Liu, Wei; Liu, Da-Wei; Xie, Jing-Wen; Tang, Xue-Mei; Wang, Mo; Yang, Xi-Qiang; Zhao, Xiao-Dong

    2013-10-01

    Two hundred three children with genetically proven primary immunodeficiency diseases (PIDs) from 197 unrelated families were enrolled from January 2005 to December 2011. On the basis of criteria developed by the International Union of Immunological Societies, 79 patients were diagnosed as "other well-defined immunodeficiency syndromes" (38.9%), 62 (30.6%) with "predominant antibody deficiencies," 26 (12.8%) with "congenital defects of phagocyte," 25 (12.3%) with "T- and B-cell immunodeficiency" and 11 (5.4%) with "diseases of immune dysregulation." The median time to the diagnosis was 27.9 months and the patients had a wide range of clinical presentations. In addition, a total of 23 pathogenic genes were identified and 213 mutations were detected, including 42 novel mutations. With the increase in the awareness of PIDs and diagnostic competence, more PID patients will be diagnosed and we will be able to more accurately identify the frequency and the distribution of PIDs in the most populous country in the world.

  10. Early-Onset Autoimmune Disease as a Manifestation of Primary Immunodeficiency

    PubMed Central

    Carneiro-Sampaio, Magda; Coutinho, Antonio

    2015-01-01

    Autoimmune disorders (AID) have been increasingly observed in association with primary immunodeficiencies (PIDs). Here, we discuss the interface between PID and AID, focusing on autoimmune manifestations early in life, which can be diagnostic clues for underlying PIDs. Inflammatory bowel disease in infants and children has been associated with IL-10 and IL-10R deficiencies, chronic granulomatous disease, immunedysregulation-polyendocrinopathy-enteropathy-X-linked syndrome (IPEX), autoinflammatory disorders, and others. Some PIDs have been identified as underlying defects in juvenile systemic lupus erythematosus: C1q-, IgA-, IgM deficiencies, alterations of the IFN-α pathway (in Aicardi–Goutières syndrome due to TREX1 mutation). IPEX (due to FOXP3 mutation leading to Treg cell deficiency), usually appearing in the first months of life, was recently observed in miscarried fetuses with hydrops who presented with CD3+ infiltrating lymphocytes in the pancreas. Hemophagocytic lymphohistiocytosis due to perforin deficiency was also identified as a cause of fetal hydrops. In conclusion, PID should be suspected in any infant with signs of autoimmunity after excluding transferred maternal effects, or in children with multiple and/or severe AID. PMID:25999944

  11. [Discriminant analysis to predict the clinical diagnosis of primary immunodeficiencies: a preliminary report].

    PubMed

    Murata, Chiharu; Ramírez, Ana Belén; Ramírez, Guadalupe; Cruz, Alonso; Morales, José Luis; Lugo-Reyes, Saul Oswaldo

    2015-01-01

    The features in a clinical history from a patient with suspected primary immunodeficiency (PID) direct the differential diagnosis through pattern recognition. PIDs are a heterogeneous group of more than 250 congenital diseases with increased susceptibility to infection, inflammation, autoimmunity, allergy and malignancy. Linear discriminant analysis (LDA) is a multivariate supervised classification method to sort objects of study into groups by finding linear combinations of a number of variables. To identify the features that best explain membership of pediatric PID patients to a group of defect or disease. An analytic cross-sectional study was done with a pre-existing database with clinical and laboratory records from 168 patients with PID, followed at the National Institute of Pediatrics during 1991-2012, it was used to build linear discriminant models that would explain membership of each patient to the different group defects and to the most prevalent PIDs in our registry. After a preliminary run only 30 features were included (4 demographic, 10 clinical, 10 laboratory, 6 germs), with which the training models were developed through a stepwise regression algorithm. We compared the automatic feature selection with a selection made by a human expert, and then assessed the diagnostic usefulness of the resulting models (sensitivity, specificity, prediction accuracy and kappa coefficient), with 95% confidence intervals. The models incorporated 6 to 14 features to explain membership of PID patients to the five most abundant defect groups (combined, antibody, well-defined, dysregulation and phagocytosis), and to the four most prevalent PID diseases (X-linked agammaglobulinemia, chronic granulomatous disease, common variable immunodeficiency and ataxiatelangiectasia). In practically all cases of feature selection the machine outperformed the human expert. Diagnosis prediction using the equations created had a global accuracy of 83 to 94%, with sensitivity of 60 to 100

  12. The European internet-based patient and research database for primary immunodeficiencies: update 2011

    PubMed Central

    Gathmann, B; Binder, N; Ehl, S; Kindle, G

    2012-01-01

    In order to build a common data pool and estimate the disease burden of primary immunodeficiencies (PID) in Europe, the European Society for Immunodeficiencies (ESID) has developed an internet-based database for clinical and research data on patients with PID. This database is a platform for epidemiological analyses as well as the development of new diagnostic and therapeutic strategies and the identification of novel disease-associated genes. Since its start in 2004, 13 708 patients from 41 countries have been documented in the ESID database. Common variable immunodeficiency (CVID) represents the most common entity with 2880 patients or 21% of all entries, followed by selective immunoglobulin A (sIgA) deficiency (1424 patients, 10·4%). The total documented prevalence of PID is highest in France, with five patients per 100 000 inhabitants. The highest documented prevalence for a single disease is 1·3 per 100 000 inhabitants for sIgA deficiency in Hungary. The highest reported incidence of PID per 100 000 live births was 16·2 for the period 1999–2002 in France. The highest reported incidence rate for a single disease was 6·7 for sIgA deficiency in Spain for the period 1999–2002. The genetic cause was known in 36·2% of all registered patients. Consanguinity was reported in 8·8%, and 18·5% of patients were reported to be familial cases; 27·9% of patients were diagnosed after the age of 16. We did not observe a significant decrease in the diagnostic delay for most diseases between 1987 and 2010. The most frequently reported long-term medication is immunoglobulin replacement. PMID:22288591

  13. Haematopoietic stem cell transplantation for primary immunodeficiency syndromes: A 5-year single-centre experience.

    PubMed

    Norman, Melissa; David, Clementine; Wainstein, Brynn; Ziegler, John B; Cohn, Richard; Mitchell, Richard; O'Brien, Tracey; Russell, Susan; Trahair, Toby; Trickett, Annette; Frith, Katie; Gray, Paul

    2017-10-01

    Haematopoietic stem cell transplantation (HSCT) is a central therapy in the treatment of primary immunodeficiency diseases (PIDs). Over the past 5 years, outcomes have been greatly improved due to earlier diagnosis, improved donor availability, advancements in graft manipulation and the use of less toxic preparative regimens. We present a 5-year audit of HSCT for PID at a single Australian tertiary hospital. Retrospective case note review identified diagnosis, pre-transplant medical morbidity, transplant protocol, engraftment, adverse events, post-transplant immune reconstitution and general health. A total of 22 patients with PID underwent 24 HSCTs at our institution between 2012 and 2016. The most common indications were severe combined immunodeficiency, chronic granulomatous disease and familial haemophagocytic lymphohistiocytosis, with a genetic diagnosis in all but two patients. Reduced intensity or reduced toxicity conditioning was used in 91% of cases, and 75% of the donors were unrelated. Transplant-related mortality at day +100 was 9.5%, and cumulative overall survival was 86%. There were three mortalities, all secondary to viral infection, one of which occurred in the context of graft failure. Two patients remained on immune support, with the remainder achieving adequate immune reconstitution. The outcomes for HSCT for PIDs performed at Sydney Children's Hospital were in line with the world's best practice. HSCT should be considered a potential therapeutic option for all Australian PID patients with a valid disease indication. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  14. Primary immunodeficiencies predisposed to Epstein-Barr virus-driven haematological diseases.

    PubMed

    Parvaneh, Nima; Filipovich, Alexandra H; Borkhardt, Arndt

    2013-09-01

    Epstein-Barr virus (EBV), a ubiquitous human herpesvirus, maintains lifelong subclinical persistent infections in humans. In the circulation, EBV primarily infects the B cells, and protective immunity is mediated by EBV-specific cytotoxic T cells (CTLs) and natural killer (NK) cells. However, EBV has been linked to several devastating diseases, such as haemophagocytic lymphohistiocytosis (HLH) and lymphoproliferative diseases in the immunocompromised host. Some types of primary immunodeficiencies (PIDs) are characterized by the development of EBV-associated complications as their predominant clinical feature. The study of such genetic diseases presents an ideal opportunity for a better understanding of the biology of the immune responses against EBV. Here, we summarize the range of PIDs that are predisposed to EBV-associated haematological diseases, describing their clinical picture and pathogenetic mechanisms. © 2013 John Wiley & Sons Ltd.

  15. Clinical comparison between patients with selective immunoglobulin A deficiency and other primary immunodeficiencies.

    PubMed

    Lozano, Natalia A; Lozano, Alejandro; Sasia, Laura V; Saranz, Ricardo J; Agresta, María Fernanda; del Pilar Bovina Martijena, María; Ianiero, Luciano; Grenat, Andrés R

    2015-04-01

    Primary immunodeficiencies (PID) are low-prevalence diseases. There are warning signs that may raise clinical suspicion. The objectives of this study were to describe the clinical characteristics and warning signs of patients with PID and to compare the clinical differences between selective immunoglobulin A (IgA) deficiency and other PIDs. Eighty-nine patients were studied; their median age at the time of diagnosis was 6 years old (4.08-11.67). Fifty-three (59.5%) patients were male. Fifty-four (60.7%) patients had selective IgA deficiency, and 35 (39.3%) had other PIDs. The main clinical manifestations were rhinopharyngitis in 65 (73.03%) patients and atopy in 39 (43.82%). Twenty- four (26.97%) patients showed warning signs, and none had selective IgA deficiency. Patients with other PIDs had a higher incidence of lower respiratory tract infection, sepsis, skin infections, mucocutaneous candidiasis, dental alterations, cardiovascular malformations, angioedema, hospitalizations and death. Ten (28.57%) patients received intravenous gammaglobulin, 15 (42.85%) antibiotic prophylaxis, and 2 (2.24%) antifungal prophylaxis.

  16. Exome Sequencing Reveals Primary Immunodeficiencies in Children with Community-Acquired Pseudomonas aeruginosa Sepsis.

    PubMed

    Asgari, Samira; McLaren, Paul J; Peake, Jane; Wong, Melanie; Wong, Richard; Bartha, Istvan; Francis, Joshua R; Abarca, Katia; Gelderman, Kyra A; Agyeman, Philipp; Aebi, Christoph; Berger, Christoph; Fellay, Jacques; Schlapbach, Luregn J

    2016-01-01

    One out of three pediatric sepsis deaths in high income countries occur in previously healthy children. Primary immunodeficiencies (PIDs) have been postulated to underlie fulminant sepsis, but this concept remains to be confirmed in clinical practice. Pseudomonas aeruginosa ( P. aeruginosa ) is a common bacterium mostly associated with health care-related infections in immunocompromised individuals. However, in rare cases, it can cause sepsis in previously healthy children. We used exome sequencing and bioinformatic analysis to systematically search for genetic factors underpinning severe P. aeruginosa infection in the pediatric population. We collected blood samples from 11 previously healthy children, with no family history of immunodeficiency, who presented with severe sepsis due to community-acquired P. aeruginosa bacteremia. Genomic DNA was extracted from blood or tissue samples obtained intravitam or postmortem. We obtained high-coverage exome sequencing data and searched for rare loss-of-function variants. After rigorous filtrations, 12 potentially causal variants were identified. Two out of eight (25%) fatal cases were found to carry novel pathogenic variants in PID genes, including BTK and DNMT3B . This study demonstrates that exome sequencing allows to identify rare, deleterious human genetic variants responsible for fulminant sepsis in apparently healthy children. Diagnosing PIDs in such patients is of high relevance to survivors and affected families. We propose that unusually severe and fatal sepsis cases in previously healthy children should be considered for exome/genome sequencing to search for underlying PIDs.

  17. Exome Sequencing Reveals Primary Immunodeficiencies in Children with Community-Acquired Pseudomonas aeruginosa Sepsis

    PubMed Central

    Asgari, Samira; McLaren, Paul J.; Peake, Jane; Wong, Melanie; Wong, Richard; Bartha, Istvan; Francis, Joshua R.; Abarca, Katia; Gelderman, Kyra A.; Agyeman, Philipp; Aebi, Christoph; Berger, Christoph; Fellay, Jacques; Schlapbach, Luregn J.; Posfay-Barbe, Klara

    2016-01-01

    One out of three pediatric sepsis deaths in high income countries occur in previously healthy children. Primary immunodeficiencies (PIDs) have been postulated to underlie fulminant sepsis, but this concept remains to be confirmed in clinical practice. Pseudomonas aeruginosa (P. aeruginosa) is a common bacterium mostly associated with health care-related infections in immunocompromised individuals. However, in rare cases, it can cause sepsis in previously healthy children. We used exome sequencing and bioinformatic analysis to systematically search for genetic factors underpinning severe P. aeruginosa infection in the pediatric population. We collected blood samples from 11 previously healthy children, with no family history of immunodeficiency, who presented with severe sepsis due to community-acquired P. aeruginosa bacteremia. Genomic DNA was extracted from blood or tissue samples obtained intravitam or postmortem. We obtained high-coverage exome sequencing data and searched for rare loss-of-function variants. After rigorous filtrations, 12 potentially causal variants were identified. Two out of eight (25%) fatal cases were found to carry novel pathogenic variants in PID genes, including BTK and DNMT3B. This study demonstrates that exome sequencing allows to identify rare, deleterious human genetic variants responsible for fulminant sepsis in apparently healthy children. Diagnosing PIDs in such patients is of high relevance to survivors and affected families. We propose that unusually severe and fatal sepsis cases in previously healthy children should be considered for exome/genome sequencing to search for underlying PIDs. PMID:27703454

  18. Distribution and clinical aspects of primary immunodeficiencies in a Taiwan pediatric tertiary hospital during a 20-year period.

    PubMed

    Lee, Wen-I; Kuo, Ming-Ling; Huang, Jing-Long; Lin, Syh-Jae; Wu, Cheng-Jang

    2005-03-01

    Recent advances in immunologic techniques have lead to increased recognition of primary immunodeficiencies. A review of patients with suspected immunodeficiencies in a Taiwan tertiary hospital from January 1985 to October 2004 and molecular/genetic analyses done on some patients were investigated. Of the 403 patients selected based on the International Classification of Disease, Ninth Revision, 37 patients with PID (8 females and 29 males) were identified: 17 (46%) with antibody production deficiencies, nine (24%) with defective phagocyte function, four (11%) with combined B and T cell immunodeficiencies, seven (19%) with T cell deficiencies, but none with primary complement deficiencies. Those with secondary immunodeficiencies were excluded from the study. Recurrent sinopulmonary infections (62%) were the most common clinical manifestation, followed by sepsis (57%), severe skin infection (40%), splenomegaly/hepatomegaly (27%), central nervous system dysfunction (22%), chronic diarrhea (22%), and failure to thrive (19%). Seven (19%) patients died, five of infections, one of disseminated intravascular coagulopathy and one of hepatocellular carcinoma. Six novel mutations were found from 11 agreed patients. This is the first report on primary immunodeficiencies in Taiwan covering a 20-year period.

  19. Adoptive Immunotherapy for Primary Immunodeficiency Disorders with Virus-Specific T-lymphocytes

    PubMed Central

    Naik, Swati; Nicholas, Sarah K; Martinez, Caridad A; Leen, Ann M; Hanley, Patrick J; Gottschalk, Steven M; Rooney, Cliona M; Hanson, I Celine; Krance, Robert A; Cruz, Conrad R; Amrolia, Persis; Lucchini, Giovanna; Bunin, Nancy; Heimall, Jennifer; Klein, Orly R; Gennery, Andrew R; Slatter, Mary A; Vickers, Mark A; Orange, Jordan S; Heslop, Helen E; Bollard, Catherine M; Keller, Michael D

    2016-01-01

    Background Viral infections are a leading fatal complication for patients with primary immunodeficiency (PID) who require hematopoietic stem cell transplantation (HSCT). Use of virus-specific T-lymphocytes (VST) has been successful for treatment and prevention of viral infections after HSCT for malignant and non-malignant conditions. Here, we describe the clinical use of VST in PID at four centers. Objective To evaluate the safety and efficacy of VST for treatment of viral infections in patients with PID. Methods Patients with PID who have received VST therapy on previous or current protocols were reviewed in aggregate. Clinical information including transplantation details, viral infections, and use of antiviral and immunosuppressive pharmacotherapy were evaluated. Data regarding VST production, infusions, and adverse reactions were compared. Results Thirty-six patients with twelve classes of PID diagnoses received 37 VST products before or after HSCT. Twenty-six patients (72%) had been diagnosed with infections with cytomegalovirus, Epstein-Barr virus, adenovirus, BK virus, and/or human herpesvirus 6 (HHV6). Two patients were treated prior to HSCT due to EBV-associated lymphoproliferative disease (LPD). Partial or complete responses against targeted viruses occurred in 81% of patients overall. Time to response varied from two weeks to three months (median 28 days). Overall survival at six months after therapy was 80%. Four patients developed graft versus host disease (GVHD) in the 45 days following VST infusion, which in most cases was therapy-responsive. Interpretation VST derived from either stem cell donors or third-party donors are likely safe and effective for treatment of viral infections in patients with PID. PMID:26920464

  20. XMEN disease: a new primary immunodeficiency affecting Mg2+ regulation of immunity against Epstein-Barr virus.

    PubMed

    Li, Feng-Yen; Chaigne-Delalande, Benjamin; Su, Helen; Uzel, Gulbu; Matthews, Helen; Lenardo, Michael J

    2014-04-03

    Epstein-Barr virus (EBV) is an oncogenic gammaherpesvirus that infects and persists in 95% of adults worldwide and has the potential to cause fatal disease, especially lymphoma, in immunocompromised hosts. Primary immunodeficiencies (PIDs) that predispose to EBV-associated malignancies have provided novel insights into the molecular mechanisms of immune defense against EBV. We have recently characterized a novel PID now named "X-linked immunodeficiency with magnesium defect, EBV infection, and neoplasia" (XMEN) disease characterized by loss-of-function mutations in the gene encoding magnesium transporter 1 (MAGT1), chronic high-level EBV with increased EBV-infected B cells, and heightened susceptibility to EBV-associated lymphomas. The genetic etiology of XMEN disease has revealed an unexpected quantitative role for intracellular free magnesium in immune functions and has led to novel diagnostic and therapeutic strategies. Here, we review the clinical presentation, genetic mutation spectrum, molecular mechanisms of pathogenesis, and diagnostic and therapeutic considerations for this previously unrecognized disease.

  1. Primary immunodeficiency investigation in patients during and after hospitalization in a pediatric Intensive Care Unit

    PubMed Central

    Suavinho, Érica; de Nápolis, Ana Carolina R.; Segundo, Gesmar Rodrigues S.

    2014-01-01

    Objective: To analyze whether the patients with severe infections, admitted in the Pediatric Intensive Care Unit of the Hospital de Clínicas of the Universidade Federal de Uberlândia, underwent the active screening for primary immunodeficiencies (PID). Methods: Retrospective study that assessed the data records of patients with any severe infections admitted in the Pediatric Intensive Care Unit, covering a period from January 2011 to January 2012, in order to confirm if they performed an initial investigation for PID with blood count and immunoglobulin dosage. Results: In the studied period, 53 children were hospitalized with severe infections in the Pediatric Intensive Care Unit, and only in seven (13.2%) the initial investigation of PID was performed. Among these patients, 3/7 (42.8%) showed quantitative alterations in immunoglobulin G (IgG) levels, 1/7 (14.3%) had the diagnosis of cyclic neutropenia, and 1/7 (14.3%) presented thrombocytopenia and a final diagnosis of Wiskott-Aldrich syndrome. Therefore, the PID diagnosis was confirmed in 5/7 (71.4%) of the patients. Conclusions: The investigation of PID in patients with severe infections has not been routinely performed in the Pediatric Intensive Care Unit. Our findings suggest the necessity of performing PID investigation in this group of patients. PMID:24676187

  2. Adoptive immunotherapy for primary immunodeficiency disorders with virus-specific T lymphocytes.

    PubMed

    Naik, Swati; Nicholas, Sarah K; Martinez, Caridad A; Leen, Ann M; Hanley, Patrick J; Gottschalk, Steven M; Rooney, Cliona M; Hanson, I Celine; Krance, Robert A; Shpall, Elizabeth J; Cruz, Conrad R; Amrolia, Persis; Lucchini, Giovanna; Bunin, Nancy; Heimall, Jennifer; Klein, Orly R; Gennery, Andrew R; Slatter, Mary A; Vickers, Mark A; Orange, Jordan S; Heslop, Helen E; Bollard, Catherine M; Keller, Michael D

    2016-05-01

    Viral infections are a leading fatal complication for patients with primary immunodeficiencies (PIDs) who require hematopoietic stem cell transplantation (HSCT). Use of virus-specific T lymphocytes (VSTs) has been successful for the treatment and prevention of viral infections after HSCT for malignant and nonmalignant conditions. Here we describe the clinical use of VSTs in patients with PIDs at 4 centers. We sought to evaluate the safety and efficacy of VSTs for treatment of viral infections in patients with PIDs. Patients with PIDs who have received VST therapy on previous or current protocols were reviewed in aggregate. Clinical information, including transplantation details, viral infections, and use of antiviral and immunosuppressive pharmacotherapy, were evaluated. Data regarding VST production, infusions, and adverse reactions were compared. Thirty-six patients with 12 classes of PID diagnoses received 37 VST products before or after HSCT. Twenty-six (72%) patients had received a diagnosis of infection with cytomegalovirus, EBV, adenovirus, BK virus, and/or human herpesvirus 6. Two patients were treated before HSCT because of EBV-associated lymphoproliferative disease. Partial or complete responses against targeted viruses occurred in 81% of patients overall. Time to response varied from 2 weeks to 3 months (median, 28 days). Overall survival at 6 months after therapy was 80%. Four patients had graft-versus-host disease in the 45 days after VST infusion, which in most cases was therapy responsive. VSTs derived from either stem cell donors or third-party donors are likely safe and effective for the treatment of viral infections in patients with PIDs. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  3. Successful treatment of lymphoproliferative disease complicating primary immunodeficiency/immunodysregulatory disorders with reduced-intensity allogeneic stem-cell transplantation.

    PubMed

    Cohen, Jonathan M; Sebire, Neil J; Harvey, Julia; Gaspar, H Bobby; Cathy, Cale; Jones, Alison; Rao, Kanchan; Cubitt, David; Amrolia, Persis J; Davies, E Graham; Veys, Paul

    2007-09-15

    Lymphoproliferative disease (LPD) is a recognized complication of primary immunodeficiency (PID) and immunodysregulatory syndromes. Historically, it has a very poor outcome. For patients surviving LPD, myeloablative hematopoietic stem cell transplantation (SCT) was the only cure for the underlying PID, with a high risk of developing posttransplantation complications, including recurrent lymphoproliferative disease. We describe 8 patients with a range of PID and immunodysregulatory syndromes complicated by LPD. After initial treatment of the LPD (including the use of anti-CD20 monoclonal antibody, rituximab, in 6 of the patients), all patients underwent reduced-intensity conditioning (RIC) SCT with prospective monitoring for Epstein-Barr virus (EBV) viremia. After transplantation, 3 patients received rituximab, and 3 patients received prophylactic EBV-specific cytotoxic T-lymphocytes. Only 1 patient developed recurrent LPD posttransplantation, which responded to rituximab. All patients who underwent transplantation survive free of LPD and are cured of their PID at a median follow-up of 4 years (range, 1-7 years). With careful monitoring and pre-emptive therapy, we advocate this RIC SCT approach to patients with PID who have pre-existing EBV-LPD.

  4. Spectrum of primary immunodeficiency disorders in Sri Lanka

    PubMed Central

    2013-01-01

    Background While primary immunodeficiencies (PID has been recognized in the west for decades, recognition has been delayed in the third world. This study attempts to detail the spectrum of PID, the therapy provided, and constraints in the diagnosis and treatment in a middle income country such as Sri Lanka. Methods Nine hundred and forty two patients with recurrent infections and features suggestive of immune deficiency, referred from the entire country in a 4 year period, to the sole immunology unit in Sri Lanka were included. The following tests were performed. Full blood counts, serum Immunoglobulin and complement C3 and C4 levels, functional antibody levels, enumeration of lymphocyte subsets, in vitro and in vivo T cell functional assays,, nitroblue tetrazolium assay to diagnose chronic granulomatous disease, hair shaft assay to diagnose Griscelli syndrome. Sequencing of the common gamma chain to identify x linked severe combined immune deficiency, and X linked agammaglobulinemia was confirmed by assaying for Btk mutations by single sequence conformation polymorphism. HIV/AIDS was excluded in all patients. Results Seventy three patients were diagnosed with a primary immune deficiency. The majority (60.27%) had antibody deficiency. Common variable immune deficiency was the commonest (28.76%), followed by X linked agammaglobulinemia (XLA) (20.54%). Five patients had possible hyper IgM syndrome. Ten patients had severe combined immune deficiency (SCID), including 2 with x linked SCID, in addition to DiGeorge syndrome (2), ataxia telangiectasia (6), autosomal dominant hyper IgE syndrome (2), chronic granulomatous disease (4), leucocyte adhesion deficiency type 1 (2) and Griscelli syndrome (3). Patients with autoinflammatory, innate immune and complement defects could not be identified due to lack of facilities. Conclusions Antibody deficiency is the commonest PID, as in the west.IgA deficiency is rare. Autoinflammatory diseases, innate immune and complement

  5. [Spectrum of primary immunodeficiencies in a tertiary hospital over a period of 10 years].

    PubMed

    Martín-Nalda, A; Soler-Palacín, P; Español Borén, T; Caragol Urgelles, I; Díaz de Heredia Rubio, C; Figueras Nadal, C

    2011-02-01

    More than 200 primary immunodeficiencies (PID) have been described and about 60% present during childhood. Early diagnosis and treatment have been shown to improve patient outcome. Analysis of patients with a PID diagnosed in a paediatric tertiary care hospital-referral centre over a period of 10 years. Medical records of all paediatric patients followed up in our unit were retrospectively reviewed. Clinical and epidemiological features, laboratory tests, therapy and outcome were analysed. One hundred and eighty nine patients were followed up in this period of time. Antibody disorders were the most common diagnosis. In our series, clinical presentation at diagnosis were: recurrent respiratory infections in selective IgA deficiency and common variable immunodeficiency (CVID) patients, failure to thrive and opportunistic infections (mainly viral infections) in patients with severe combined immunodeficiency (SCID), skin abscesses (Staphylococcus aureus, Serratia spp.) and complicated pneumonia (Aspergillus spp., Rhodococcus equi) in chronic granulomatous disease, congenital heart disease and consistent phenotype in 22q11 deletion syndrome, skin abscesses and ecthyma gangrenosum in severe congenital neutropenia and opportunistic infections and sepsis (Pseudomonas aeruginosa) in children with X-linked agammaglobulinaemia (XLA). Lymphoproliferative disorders were common in CVID. No malignancies were observed during this period. One patient with XLA developed chronic encephalitis. All patients with CVID and XLA were receiving immunoglobulin replacement therapy (8 intravenous and 14 (since 2006) subcutaneous route) and in all but two SCID patients, stem cell transplantation was performed. Outcome was good in most of them except 8 SCID (2 prior and 6 after transplantation), 3 Wiskott-Aldrich syndrome, 1 complete DiGeorge, 1 chronic granulomatous disease and 1 ataxia-telangiectasia patients who died during follow-up. The vast majority of patients included in this series

  6. Placental Transfer of Maternally-Derived IgA Precludes the Use of Guthrie Card Eluates as a Screening Tool for Primary Immunodeficiency Diseases

    PubMed Central

    Borte, Stephan; Janzi, Magdalena; Pan-Hammarström, Qiang; von Döbeln, Ulrika; Nordvall, Lennart; Winiarski, Jacek; Fasth, Anders; Hammarström, Lennart

    2012-01-01

    There is a need for neonatal screening tools to improve the long-term clinical outcome of patients with primary immunodeficiency diseases (PID). Recently, a PCR-based screening method for both TRECs and KRECs using Guthrie card samples has been developed. However, the applicability of these excision circle assays is limited to patients with severe T or B cell lymphopenia (SCID, XLA and A-T), whereas the most common forms of PID are not detected. Absence of serum IgA is seen in a major fraction of patients with immunological defects. As serum IgA in newborns is considered to be of fetal origin, eluates from routinely collected dried blood spot samples might thus be suitable for identification of children with PID. To assess the applicability of such screening assays, stored Guthrie card samples were obtained from 47 patients with various forms of primary immunodeficiency diseases (SCID, XLA, A-T, HIGM and IgAD), 20 individuals with normal serum IgA levels born to IgA-deficient mothers and 51 matched healthy newborns. Surprisingly, normal serum IgA levels were found in all SCID, XLA, A-T and HIGM patients and, additionally, in all those IgAD patients born to IgA-sufficient mothers. Conversely, no serum IgA was found in any of the 16 IgAD patients born by IgA-deficient mothers. Moreover, half of the IgA-sufficient individuals born by IgA-deficient mothers also lacked IgA at birth whereas no IgA-deficient individuals were found among the controls. IgA in neonatal dried blood samples thus appears to be of both maternal and fetal origin and precludes its use as a reliable marker for neonatal screening of primary immunodeficiency diseases. PMID:22916257

  7. Placental transfer of maternally-derived IgA precludes the use of guthrie card eluates as a screening tool for primary immunodeficiency diseases.

    PubMed

    Borte, Stephan; Janzi, Magdalena; Pan-Hammarström, Qiang; von Döbeln, Ulrika; Nordvall, Lennart; Winiarski, Jacek; Fasth, Anders; Hammarström, Lennart

    2012-01-01

    There is a need for neonatal screening tools to improve the long-term clinical outcome of patients with primary immunodeficiency diseases (PID). Recently, a PCR-based screening method for both TRECs and KRECs using Guthrie card samples has been developed. However, the applicability of these excision circle assays is limited to patients with severe T or B cell lymphopenia (SCID, XLA and A-T), whereas the most common forms of PID are not detected. Absence of serum IgA is seen in a major fraction of patients with immunological defects. As serum IgA in newborns is considered to be of fetal origin, eluates from routinely collected dried blood spot samples might thus be suitable for identification of children with PID. To assess the applicability of such screening assays, stored Guthrie card samples were obtained from 47 patients with various forms of primary immunodeficiency diseases (SCID, XLA, A-T, HIGM and IgAD), 20 individuals with normal serum IgA levels born to IgA-deficient mothers and 51 matched healthy newborns. Surprisingly, normal serum IgA levels were found in all SCID, XLA, A-T and HIGM patients and, additionally, in all those IgAD patients born to IgA-sufficient mothers. Conversely, no serum IgA was found in any of the 16 IgAD patients born by IgA-deficient mothers. Moreover, half of the IgA-sufficient individuals born by IgA-deficient mothers also lacked IgA at birth whereas no IgA-deficient individuals were found among the controls. IgA in neonatal dried blood samples thus appears to be of both maternal and fetal origin and precludes its use as a reliable marker for neonatal screening of primary immunodeficiency diseases.

  8. Screening protocols to monitor respiratory status in primary immunodeficiency disease: findings from a European survey and subclinical infection working group

    PubMed Central

    Sánchez‐Ramón, S.; Quinti, I.; Soler‐Palacín, P.; Agostini, C.; Florkin, B.; Couderc, L.‐J.; Brodszki, N.; Jones, A.; Longhurst, H.; Warnatz, K.; Haerynck, F.; Matucci, A.; de Vries, E.

    2017-01-01

    Summary Many patients with primary immunodeficiency (PID) who have antibody deficiency develop progressive lung disease due to underlying subclinical infection and inflammation. To understand how these patients are monitored we conducted a retrospective survey based on patient records of 13 PID centres across Europe, regarding the care of 1061 adult and 178 paediatric patients with PID on immunoglobulin (Ig) G replacement. The most common diagnosis was common variable immunodeficiency in adults (75%) and hypogammaglobulinaemia in children (39%). The frequency of clinic visits varied both within and between centres: every 1–12 months for adult patients and every 3–6 months for paediatric patients. Patients diagnosed with lung diseases were more likely to receive pharmaceutical therapies and received a wider range of therapies than patients without lung disease. Variation existed between centres in the frequency with which some clinical and laboratory monitoring tests are performed, including exercise tests, laboratory testing for IgG subclass levels and specific antibodies, and lung function tests such as spirometry. Some tests were carried out more frequently in adults than in children, probably due to difficulties conducting these tests in younger children. The percentage of patients seen regularly by a chest physician, or who had microbiology tests performed following chest and sinus exacerbations, also varied widely between centres. Our survey revealed a great deal of variation across Europe in how frequently patients with PID visit the clinic and how frequently some monitoring tests are carried out. These results highlight the urgent need for consensus guidelines on how to monitor lung complications in PID patients. PMID:28708268

  9. Primary immunodeficiency association with systemic lupus erythematosus: review of literature and lessons learned by the Rheumatology Division of a tertiary university hospital at São Paulo, Brazil.

    PubMed

    Errante, Paolo Ruggero; Perazzio, Sandro Félix; Frazão, Josias Brito; da Silva, Neusa Pereira; Andrade, Luis Eduardo Coelho

    2016-01-01

    Primary immunodeficiency disorders (PID) represent a heterogeneous group of diseases resulting from inherited defects in the development, maturation and normal function of immune cells; thus, turning individuals susceptible to recurrent infections, allergy, autoimmunity, and malignancies. In this retrospective study, autoimmune diseases (AIDs), in special systemic lupus erythematosus (SLE) which arose associated to the course of PID, are described. Classically, the literature describes three groups of PID associated with SLE: (1) deficiency of Complement pathway components, (2) defects in immunoglobulin synthesis, and (3) chronic granulomatous disease (CGD). Currently, other PID have been described with clinical manifestation of SLE, such as Wiskott-Aldrich syndrome (WAS), autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED), autoimmune lymphoproliferative syndrome (ALPS) and idiopathic CD4(+) lymphocytopenia. Also we present findings from an adult cohort from the outpatient clinic of the Rheumatology Division of Universidade Federal de São Paulo. The PID manifestations found by our study group were considered mild in terms of severity of infections and mortality in early life. Thus, it is possible that some immunodeficiency states are compatible with survival regarding infectious susceptibility; however these states might represent a strong predisposing factor for the development of immune disorders like those observed in SLE. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  10. Screening protocols to monitor respiratory status in primary immunodeficiency disease: findings from a European survey and subclinical infection working group.

    PubMed

    Jolles, S; Sánchez-Ramón, S; Quinti, I; Soler-Palacín, P; Agostini, C; Florkin, B; Couderc, L-J; Brodszki, N; Jones, A; Longhurst, H; Warnatz, K; Haerynck, F; Matucci, A; de Vries, E

    2017-11-01

    Many patients with primary immunodeficiency (PID) who have antibody deficiency develop progressive lung disease due to underlying subclinical infection and inflammation. To understand how these patients are monitored we conducted a retrospective survey based on patient records of 13 PID centres across Europe, regarding the care of 1061 adult and 178 paediatric patients with PID on immunoglobulin (Ig) G replacement. The most common diagnosis was common variable immunodeficiency in adults (75%) and hypogammaglobulinaemia in children (39%). The frequency of clinic visits varied both within and between centres: every 1-12 months for adult patients and every 3-6 months for paediatric patients. Patients diagnosed with lung diseases were more likely to receive pharmaceutical therapies and received a wider range of therapies than patients without lung disease. Variation existed between centres in the frequency with which some clinical and laboratory monitoring tests are performed, including exercise tests, laboratory testing for IgG subclass levels and specific antibodies, and lung function tests such as spirometry. Some tests were carried out more frequently in adults than in children, probably due to difficulties conducting these tests in younger children. The percentage of patients seen regularly by a chest physician, or who had microbiology tests performed following chest and sinus exacerbations, also varied widely between centres. Our survey revealed a great deal of variation across Europe in how frequently patients with PID visit the clinic and how frequently some monitoring tests are carried out. These results highlight the urgent need for consensus guidelines on how to monitor lung complications in PID patients. © 2017 The Authors. Clinical and Experimental Immunology published by John Wiley & Sons Ltd on behalf of British Society for Immunology.

  11. Evaluation of the Safety, Tolerability, and Pharmacokinetics of Gammaplex® 10% Versus Gammaplex® 5% in Subjects with Primary Immunodeficiency.

    PubMed

    Wasserman, Richard L; Melamed, Isaac R; Stein, Mark R; Jolles, Stephen; Norton, Miranda; Moy, James N

    2017-04-01

    This phase 3, multicenter, open-label, randomized, two-period, crossover bioequivalence trial evaluated the safety, tolerability, and pharmacokinetics of intravenous immunoglobulins (IVIGs) Gammaplex 5% and Gammaplex 10% in 33 adults and 15 children with primary immunodeficiency diseases (PIDs). Eligible adults received five Gammaplex 5% infusions followed by five Gammaplex 10% infusions, or vice versa, stratified by a 21- or 28-day dosing regimen. Pediatric subjects received five Gammaplex 10% infusions only. The primary objective, to demonstrate the bioequivalence of Gammaplex 10% and Gammaplex 5% at the 28-day dosing interval, was met based on the Gammaplex 10%/Gammaplex 5% ratio of area under the concentration versus time curve (AUC 0-28 ) values. Throughout the study, total immunoglobulin G trough levels were well maintained, with total values generally ≥600 mg/dL (minimum level for study inclusion). At the dosing schedules and infusion rates used in this study, safety and tolerability were comparable and acceptable in adult and pediatric PID subjects treated with Gammaplex 10% and 5%. In this study, the first direct comparison of 5% IVIG and 10% IVIG products in PID subjects, the pharmacokinetic analysis demonstrated bioequivalence of Gammaplex 10% and Gammaplex 5% at the 28-day dosing interval. The Gammaplex 10% formulation was safe and well tolerated in pediatric and adult PID subjects. Based on the results from this bridging study in PID subjects, Gammaplex 10% could be expected to have a therapeutic effect similar to the licensed Gammaplex 5%, which has demonstrated efficacy and tolerability in patients with PID and idiopathic thrombocytopenic purpura.

  12. Mannose-Binding Lectin Protein Deficiency Among Patients with Primary Immunodeficiency Disease Receiving IVIG Therapy.

    PubMed

    Azizi, Gholamreza; Kiaee, Fatemeh; Yaslianifard, Somaye; Rafiemanesh, Hosein; Mohammadikhajehdehi, Sara; Mohammadi, Hamed; Miresmaeeli, Seyed Sakineh; Pour, Leila H; Poor Heravi, Sina Abdolrahim; Sharifi, Laleh; Yazdani, Reza; Abolhassani, Hassan; Aghamohammadi, Asghar

    2018-02-13

    Primary immunodeficiencies (PIDs) are inherited disorders in which one or several components of the immune system are defective. Immunoglobulin replacement therapy is the mainstay of treatment for patients with impaired antibody production. However, recurrent infections would continue to occur in some patients due to the other high frequent concomitant defects, such as mannose-binding lectin (MBL) deficiency. A total of 51 PID patients participated in this cross-sectional study. A detailed questionnaire was completed by interviewing patients in order to record demographic, clinical and laboratory data. The levels of MBL were determined in the serums of patients by a sandwich enzyme-linked immunosorbent assay (ELISA) technique. MBL deficiency was found in 29.4% of cases; 11.8% patients had mild, 3.9% patients had moderate and 13.7% patients had severe MBL deficiency. In patients with MBL deficiency, the rate of meningitis, sepsis, pneumonia, and otitis media was higher than patients with normal MBL levels. Immunoglobulin replacement therapy reduced the rate of infectious complications in PID patients; however, these reductions were more apparent in patients with normal MBL levels than patients with MBL deficiency. Antibody deficient patients with a concomitant immune defect in MBL production have higher rates of recurrent infections despite receiving Immunoglobulin replacement therapy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  13. Immunodeficiencies

    PubMed Central

    Ballow, M; Notarangelo, L; Grimbacher, B; Cunningham-Rundles, C; Stein, M; Helbert, M; Gathmann, B; Kindle, G; Knight, A K; Ochs, H D; Sullivan, K; Franco, J L

    2009-01-01

    Primary immunodeficiencies (PIDs) are uncommon, chronic and severe disorders of the immune system in which patients cannot mount a sufficiently protective immune response, leading to an increased susceptibility to infections. The treatment of choice for PID patients with predominant antibody deficiency is intravenous immunoglobulin (Ig) replacement therapy. Despite major advances over the last 20 years in the molecular characterization of PIDs, many patients remain undiagnosed or are diagnosed too late, with severe consequences. Various strategies to ensure timely diagnosis of PIDs are in place, and novel approaches are being developed. In recent years, several patient registries have been established. Such registries shed light on the pathology and natural history of these varied disorders. Analyses of the registry data may also reveal which patients are likely to respond well to higher Ig infusion rates and may help to determine the optimal dosing of Ig products. Faster infusion rates may lead to improved convenience for patients and thus increase patient compliance, and may reduce nursing time and the need for hospital resources. Data from two recent studies suggest that Gamunex® and Privigen® are well tolerated at high infusion rates. Nevertheless, careful selection of patients for high infusion rates, based on co-morbid conditions and tolerance of the current infusion rate, is advisable. Based on the available data, intravenous Ig offers broad protection against encapsulated organisms. As vaccine trends change, careful monitoring of specific antibody levels in the general population, such as those against pneumococcal and meningococcal bacteria, should be implemented. PMID:19883420

  14. Autoimmunity and primary immunodeficiency: two sides of the same coin?

    PubMed

    Schmidt, Reinhold E; Grimbacher, Bodo; Witte, Torsten

    2017-12-19

    Autoimmunity and immunodeficiency were previously considered to be mutually exclusive conditions; however, increased understanding of the complex immune regulatory and signalling mechanisms involved, coupled with the application of genetic analysis, is revealing the complex relationships between primary immunodeficiency syndromes and autoimmune diseases. Single-gene defects can cause rare diseases that predominantly present with autoimmune symptoms. Such genetic defects also predispose individuals to recurrent infections (a hallmark of immunodeficiency) and can cause primary immunodeficiencies, which can also lead to immune dysregulation and autoimmunity. Moreover, risk factors for polygenic rheumatic diseases often exist in the same genes as the mutations that give rise to primary immunodeficiency syndromes. In this Review, various primary immunodeficiency syndromes are presented, along with their pathogenetic mechanisms and relationship to autoimmune diseases, in an effort to increase awareness of immunodeficiencies that occur concurrently with autoimmune diseases and to highlight the need to initiate appropriate genetic tests. The growing knowledge of various genetically determined pathologic mechanisms in patients with immunodeficiencies who have autoimmune symptoms opens up new avenues for personalized molecular therapies that could potentially treat immunodeficiency and autoimmunity at the same time, and that could be further explored in the context of autoimmune rheumatic diseases.

  15. Infectious complications of the primary immunodeficiencies.

    PubMed

    Stiehm, E R; Chin, T W; Haas, A; Peerless, A G

    1986-07-01

    The primary manifestation of the immunodeficiencies is undue susceptibility to infection. This means too many, too severe, too prolonged, too complicated and too unusual infections. Infections in immunodeficiency have a characteristic cause depending on the nature of the immune deficiency. Antibody deficiencies are associated with infections with gram-positive infections. Cellular immune deficiencies are associated with mycobacterial, protozoan, fungus, virus, and opportunistic bacterial infection. Phagocytic disorders are associated with staphylococcal, fungal, and gram-negative organisms. Complement disorders are associated by neisserial infections. Infections have also been implicated in the pathogenesis of some immunodeficiencies in some circumstances. These include human T lymphotropic virus type III (HTLV-III), rubella virus, cytomegalovirus, and Epstein-Barr virus. Several infectious syndromes in specific immunodeficiencies have been identified. Examples include enteric cytopathic human orphan (ECHO) virus encephalitis in agammaglobulinemia, and meningococcal meningitis in C6 deficiency. Infections can also be induced by live vaccines given in immunodeficiency (e.g., paralytic polio in agammaglobulinemia.) Unusual infectious syndromes will be illustrated including parainfluenza infection in severe combined and immunodeficiency, Legionella pneumonia in chronic granulomatous disease, and Cryptosporidium infection in hyper-IgM immunodeficiency.

  16. Warts and All: HPV in Primary Immunodeficiencies

    PubMed Central

    Leiding, Jennifer W.; Holland, Steven M.

    2012-01-01

    Infection with human papilloma virus (HPV) is almost universal and eventually asymptomatic, but pathologic infection with HPV is severe, recurrent, and recalcitrant to therapy. It is also an underappreciated manifestation of primary immunodeficiency. Mutations in EVER1, EVER2, GATA2, CXCR4, and DOCK8 are typically associated with extensive HPV infections, whereas several other primary immune defects have severe HPV much less frequently. We review immunodeficiencies with severe HPV infections and the mechanisms underlying them. PMID:23036745

  17. Long-term outcomes of fludarabine, melphalan and antithymocyte globulin as reduced-intensity conditioning regimen for allogeneic hematopoietic stem cell transplantation in children with primary immunodeficiency disorders: a prospective single center study.

    PubMed

    Hamidieh, A A; Behfar, M; Pourpak, Z; Faghihi-Kashani, S; Fazlollahi, M R; Hosseini, A S; Movahedi, M; Mozafari, M; Moin, M; Ghavamzadeh, A

    2016-02-01

    Reduced-intensity conditioning (RIC) has offered many primary immunodeficiency disorder (PID) patients who are ineligible for myeloablative regimens a chance of cure. However, the beneficial role of RIC was questioned following reports suggesting higher chance of rejection and lower symptom resolution rate in mixed chimerism settings. Forty-five children affected by PIDs with a median age of 21 months underwent allogeneic hematopoietic stem cell transplantation in our institute from 2007 to 2013. All patients received an identical RIC regimen. Forty-one patients had successful primary engraftment (91%). Of the successful engraftments, 80% (n=33) had stable full donor chimerism at last contact. Overall, eleven transplant-related mortalities were reported including five patients due to sepsis, three children due to grade IV acute GvHD, two due to chronic GvHD and one patient due to sepsis after primary graft failure. The median post-transplantation follow-up of deceased patients was 55 days. Five-year overall survival and disease-free survival was 75.6% and 68.89%, respectively. All surviving patients with successful engraftment became disease free, regardless of having full or mixed chimerism. Our study suggests that RIC regimen provides satisfactory rates of successful engraftment and full chimerism. Furthermore, patients with mixed chimerism were stable in long-term follow-up and this chimerism status offered the potential to resolve symptoms of immunodeficiency.

  18. An evaluation of the budget impact of a new 20% subcutaneous immunoglobulin (Ig20Gly) for the management of primary immunodeficiency diseases in Switzerland.

    PubMed

    Pollock, Richard F; Meckley, Lisa M

    2018-01-01

    While most individual primary immunodeficiency diseases (PID) are rare, the collective prevalence of PID results in a substantial economic and clinical burden. The aim of this study was to evaluate the budgetary implications of Ig20Gly (Immune Globulin Subcutaneous [human] 20% solution; CUVITRU ® , Baxalta US Inc, now part of Shire Plc, Westlake Village, CA, USA) as a treatment for PID relative to intravenous immunoglobulin (IVIG) and other subcutaneous immunoglobulin (SCIG) formulations in the Swiss health care setting. A budget impact model was developed in Microsoft Excel to capture the estimated prevalence of PID in Switzerland, the proportion of patients treated in different health care settings, and the costs of administering SCIG and IVIG in each setting. Unit costs were based on a recent cost-minimization analysis of SCIG in Lausanne, and drug costs were taken from the Spezialitätenliste. All costs were reported in 2016 Swiss Francs (CHF), and future costs were not discounted. The total cost of treating PID in Switzerland was estimated to be CHF 11.16 m over 3 years, comprising CHF 9.28 m of drug costs and CHF 1.87 m of ancillary costs, including health care professional time and other administration costs, such as pumps and needle sets. The analysis showed that using Ig20Gly in place of other SCIG formulations would be cost neutral, while using Ig20Gly in place of IVIG would result in savings of 4.0%. Ig20Gly would be cost neutral relative to existing SCIG products and would result in cost savings relative to IVIG in patients with PID in Switzerland, even with modest uptake.

  19. Gene therapy for PIDs: progress, pitfalls and prospects.

    PubMed

    Mukherjee, Sayandip; Thrasher, Adrian J

    2013-08-10

    Substantial progress has been made in the past decade in treating several primary immunodeficiency disorders (PIDs) with gene therapy. Current approaches are based on ex-vivo transfer of therapeutic transgene via viral vectors to patient-derived autologous hematopoietic stem cells (HSCs) followed by transplantation back to the patient with or without conditioning. The overall outcome from all the clinical trials targeting different PIDs has been extremely encouraging but not without caveats. Malignant outcomes from insertional mutagenesis have featured prominently in the adverse events associated with these trials and have warranted intense pre-clinical investigation into defining the tendencies of different viral vectors for genomic integration. Coupled with issues pertaining to transgene expression, the therapeutic landscape has undergone a paradigm shift in determining safety, stability and efficacy of gene therapy approaches. In this review, we aim to summarize the progress made in the gene therapy trials targeting ADA-SCID, SCID-X1, CGD and WAS, review the pitfalls, and outline the recent advancements which are expected to further enhance favourable risk benefit ratios for gene therapeutic approaches in the future. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. Diagnosis and Treatment of Gastrointestinal Disorders in Patients With Primary Immunodeficiency

    PubMed Central

    AGARWAL, SHRADHA; MAYER, LLOYD

    2013-01-01

    Gastrointestinal disorders such as chronic or acute diarrhea, malabsorption, abdominal pain, and inflammatory bowel diseases can indicate immune deficiency. The gastrointestinal tract is the largest lymphoid organ in the body, so it is not surprising that intestinal diseases are common among immunodeficient patients. Gastroenterologists therefore must be able to diagnose and treat patients with primary immunodeficiency. Immune-related gastrointestinal diseases can be classified as those that develop primarily via autoimmunity, infection, an inflammatory response, or malignancy. Immunodeficient and immunocompetent patients with gastrointestinal diseases present with similar symptoms. However, intestinal biopsy specimens from immunodeficient patients often have distinct histologic features, and these patients often fail to respond to conventional therapies. Therefore, early recognition of symptoms and referral to an immunologist for a basic immune evaluation is required to select appropriate treatments. Therapies for primary immunodeficiency comprise immunoglobulin replacement, antibiotics, and, in severe cases, bone marrow transplantation. Treatment of immunodeficient patients with concomitant gastrointestinal disease can be challenging, and therapy with immunomodulators often is required for severe disease. This review aims to guide gastroenterologists in the diagnosis and treatment of patients with primary immunodeficiency. PMID:23501398

  1. Comprehensive genetic testing for primary immunodeficiency disorders in a tertiary hospital: 10-year experience in Auckland, New Zealand.

    PubMed

    Woon, See-Tarn; Ameratunga, Rohan

    2016-01-01

    New Zealand is a developed geographically isolated country in the South Pacific with a population of 4.4 million. Genetic diagnosis is the standard of care for most patients with primary immunodeficiency disorders (PIDs). Since 2005, we have offered a comprehensive genetic testing service for PIDs and other immune-related disorders with a published sequence. Here we present results for this program, over the first decade, between 2005 and 2014. We undertook testing in 228 index cases and 32 carriers during this time. The three most common test requests were for X-linked lymphoproliferative (XLP), tumour necrosis factor receptor associated periodic syndrome (TRAPS) and haemophagocytic lymphohistiocytosis (HLH). Of the 32 suspected XLP cases, positive diagnoses were established in only 2 patients. In contrast, genetic defects in 8 of 11 patients with suspected X-linked agammaglobulinemia (XLA) were confirmed. Most XLA patients were initially identified from absence of B cells. Overall, positive diagnoses were made in about 23% of all tests requested. The diagnostic rate was lowest for several conditions with locus heterogeneity. Thorough clinical characterisation of patients can assist in prioritising which genes should be tested. The clinician-driven customised comprehensive genetic service has worked effectively for New Zealand. Next generation sequencing will play an increasing role in disorders with locus heterogeneity.

  2. Inflammatory Bowel Disease in Primary Immunodeficiencies.

    PubMed

    Kelsen, Judith R; Sullivan, Kathleen E

    2017-08-01

    Inflammatory bowel disease is most often a polygenic disorder with contributions from the intestinal microbiome, defects in barrier function, and dysregulated host responses to microbial stimulation. There is, however, increasing recognition of single gene defects that underlie a subset of patients with inflammatory bowel disease, particularly those with early-onset disease, and this review focuses on the primary immunodeficiencies associated with early-onset inflammatory bowel disease. The advent of next-generation sequencing has led to an improved recognition of single gene defects underlying some cases of inflammatory bowel disease. Among single gene defects, immune response genes are the most frequent category identified. This is also true of common genetic variants associated with inflammatory bowel disease, supporting a pivotal role for host responses in the pathogenesis. This review focuses on practical aspects related to diagnosis and management of children with inflammatory bowel disease who have underlying primary immunodeficiencies.

  3. [Interdisciplinary AWMF guideline for the diagnostics of primary immunodeficiency].

    PubMed

    Farmand, S; Baumann, U; von Bernuth, H; Borte, M; Foerster-Waldl, E; Franke, K; Habermehl, P; Kapaun, P; Klock, G; Liese, J; Marks, R; Müller, R; Nebe, T; Niehues, T; Schuster, V; Warnatz, K; Witte, T; Ehl, S; Schulze, I

    2011-11-01

    Primary immunodeficiencies are potentially life-threatening diseases. Over the last years, the clinical phenotype and the molecular basis of an increasing number of immunological defects have been characterized. However, in daily practice primary immunodeficiencies are still often diagnosed too late. Considering that an early diagnosis may reduce morbidity and mortality of affected patients, an interdisciplinary guideline for the diagnosis of primary immunodeficiencies was developed on behalf of the Arbeitsgemeinschaft Pädiatrische Immunologie (API) and the Deutsche Gesellschaft für Immunologie (DGfI). The guideline is based on expert opinion and on knowledge from other guidelines and recommendations from Germany and other countries, supplemented by data from studies that support the postulated key messages (level of evidence III). With the contribution of 20 representatives, belonging to 14 different medical societies and associations, a consensus-based guideline with a representative group of developers and a structured consensus process was created (S2k). Under the moderation of a representative of the Association of the Scientific Medical Societies in Germany (AWMF) the nominal group process took place in April 2011. The postulated key messages were discussed and voted on following a structured consensus procedure. In particular, modified warning signs for primary immunodeficiencies were formulated and immunological emergency situations were defined. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Doctors' awareness concerning primary immunodeficiencies in Brazil.

    PubMed

    Dantas, E O; Aranda, C S; Rêgo Silva, A M; Tavares, F S; Severo Ferreira, J F; de Quadros Coelho, M A; de Siqueira Kovalhuk, L C; Roxo Júnior, P; Toledo, E C; Porto Neto, A C; de Sousa Vieira, H M C; Takano, O A; Nobre, F A; Sano, F; Nudelman, V; de Farias Sales, V S; Silva Segundo, G R; Villar Guedes, H T; Félix, E; Marques, S M B; Mazzucchelli, J T L; Wandalsen, N F; Pinto, J A; Paes Barreto, I C D; Silva, M R; Rullo, V E V; Franco, J M; Damasceno, E; Fahl, K; de Moraes-Pinto, M I; Del Nero, D L; Moraes, L S L; Condino-Neto, A; Vilela, M M; Góes, H; Schisler, K L; Miranda, E; Goudouris, E S; Costa Carvalho, B T

    2015-01-01

    PIDs are a heterogeneous group of genetic illnesses, and delay in their diagnosis is thought to be caused by a lack of awareness among physicians concerning PIDs. The latter is what we aimed to evaluate in Brazil. Physicians working at general hospitals all over the country were asked to complete a 14-item questionnaire. One of the questions described 25 clinical situations that could be associated with PIDs and a score was created based on percentages of appropriate answers. A total of 4026 physicians participated in the study: 1628 paediatricians (40.4%), 1436 clinicians (35.7%), and 962 surgeons (23.9%). About 67% of the physicians had learned about PIDs in medical school or residency training, 84.6% evaluated patients who frequently took antibiotics, but only 40.3% of them participated in the immunological evaluation of these patients. Seventy-seven percent of the participating physicians were not familiar with the warning signs for PIDs. The mean score of correct answers for the 25 clinical situations was 48.08% (±16.06). Only 18.3% of the paediatricians, 7.4% of the clinicians, and 5.8% of the surgeons answered at least 2/3 of these situations appropriately. There is a lack of medical awareness concerning PIDs, even among paediatricians, who have been targeted with PID educational programmes in recent years in Brazil. An increase in awareness with regard to these disorders within the medical community is an important step towards improving recognition and treatment of PIDs. Copyright © 2014 SEICAP. Published by Elsevier Espana. All rights reserved.

  5. An update on gain-of-function mutations in primary immunodeficiency diseases.

    PubMed

    Jhamnani, Rekha D; Rosenzweig, Sergio D

    2017-12-01

    Most primary immunodeficiencies described since 1952 were associated with loss-of-function defects. With the advent and popularization of unbiased next-generation sequencing diagnostic approaches followed by functional validation techniques, many gain-of-function mutations leading to immunodeficiency have also been identified. This review highlights the updates on pathophysiology mechanisms and new therapeutic approaches involving primary immunodeficiencies because of gain-of-function mutations. The more recent developments related to gain-of-function primary immunodeficiencies mostly involving increased infection susceptibility but also immune dysregulation and autoimmunity, were reviewed. Updates regarding pathophysiology mechanisms, different mutation types, clinical features, laboratory markers, current and potential new treatments on patients with caspase recruitment domain family member 11, signal transducer and activator of transcription 1, signal transducer and activator of transcription 3, phosphatidylinositol-4,5-biphosphate 3-kinase catalytic 110, phosphatidylinositol-4,5-biphosphate 3-kinase regulatory subunit 1, chemokine C-X-C motif receptor 4, sterile α motif domain containing 9-like, and nuclear factor κ-B subunit 2 gain-of-function mutations are reviewed for each disease. With the identification of gain-of-function mutations as a cause of immunodeficiency, new genetic pathophysiology mechanisms unveiled and new-targeted therapeutic approaches can be explored as potential rescue treatments for these diseases.

  6. Diagnosis of primary antibody and complement deficiencies in young adults after a first invasive bacterial infection.

    PubMed

    Sanges, S; Wallet, F; Blondiaux, N; Theis, D; Vérin, I; Vachée, A; Dessein, R; Faure, K; Viget, N; Senneville, E; Leroy, O; Maury, F; Just, N; Poissy, J; Mathieu, D; Prévotat, A; Chenivesse, C; Scherpereel, A; Smith, G; Lopez, B; Rosain, J; Frémeaux-Bacchi, V; Hachulla, E; Hatron, P-Y; Bahuaud, M; Batteux, F; Launay, D; Labalette, M; Lefèvre, G

    2017-08-01

    Screening for primary immunodeficiencies (PIDs) in adults is recommended after two severe bacterial infections. We aimed to evaluate if screening should be performed after the first invasive infection in young adults. Eligible patients were retrospectively identified using hospital discharge and bacteriology databases in three centres during a 3-year period. Eighteen to 40-year-old patients were included if they had experienced an invasive infection with encapsulated bacteria commonly encountered in PIDs (Streptococcus pneumoniae (SP), Neisseria meningitidis (NM), Neisseria gonorrhoeae (NG), Haemophilus influenzae (HI), or group A Streptococcus (GAS)). They were excluded in case of general or local predisposing factors. Immunological explorations and PIDs diagnoses were retrieved from medical records. Serum complement and IgG/A/M testings were systematically proposed at the time of study to patients with previously incomplete PID screening. The study population comprised 38 patients. Thirty-six had experienced a first invasive episode and a PID was diagnosed in seven (19%): two cases of common variable immunodeficiency revealed by SP bacteraemia, one case of idiopathic primary hypogammaglobulinaemia, and two cases of complement (C6 and C7) deficiency revealed by NM meningitis, one case of IgG2/IgG4 subclasses deficiency revealed by GAS bacteraemia, and one case of specific polysaccharide antibody deficiency revealed by HI meningitis. Two patients had previously experienced an invasive infection before the study period: in both cases, a complement deficiency was diagnosed after a second NM meningitis and a second NG bacteraemia, respectively. PID screening should be considered after a first unexplained invasive encapsulated-bacterial infection in young adults. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  7. Prevalence of atopic disorders and immunodeficiency in patients with ectodermal dysplasia syndromes

    PubMed Central

    Mark, Barry J.; Becker, Bradley A.; Halloran, Donna R.; Bree, Alanna F.; Sindwani, Raj; Fete, Mary D.; Motil, Kathleen J.; Srun, Sopheak W.; Fete, Timothy J.

    2013-01-01

    Background Ectodermal dysplasia (ED) syndromes are a diverse group of disorders that affect multiple ectodermally derived tissues. Small studies and case reports suggest an increase in atopy and primary immunodeficiencies (PIDs) among patients with ED syndromes. Objective To determine the prevalence of clinical symptoms suggestive of atopy or immunodeficiency among a large cohort of children with ED syndromes. Methods A 9-page questionnaire was mailed to families who were members of the National Foundation for Ectodermal Dysplasias. The surveys were completed by parents of children younger than 18 years with a diagnosis of an ED syndrome or carrier state. Portions of the questionnaire were adapted from previously validated questionnaires developed by the International Study of Asthma and Allergies in Childhood (ISAAC). Results We received 347 completed questionnaires (41%). When compared with the 13- to 14-year-old children surveyed by ISAAC, we found both all-aged and age-matched children with ED syndromes, respectively, had significantly higher rates of asthma (32.2% and 37.2% vs 16.4%), rhinitis symptoms (76.1% and 78.3% vs 38.9%), and eczema (58.9% and 48.9% vs 8.2%). The prevalence of physician-diagnosed food allergies (20.7%) and PIDs (6.1%) in these ED patients also exceeded known rates in the general pediatric population. Conclusion This large-scale, retrospective study demonstrates a greater reported prevalence of symptoms suggestive of atopic disorders and PIDs among children with ED syndromes than the general pediatric population. A combination of genetic and environmental factors in ED syndromes may contribute to breaches of skin and mucosal barriers, permitting enhanced transmission and sensitization to irritants, allergens, and pathogens. PMID:22626597

  8. T cell-B cell interactions in primary immunodeficiencies.

    PubMed

    Tangye, Stuart G; Deenick, Elissa K; Palendira, Umaimainthan; Ma, Cindy S

    2012-02-01

    Regulated interactions between cells of the immune system facilitate the generation of successful immune responses, thereby enabling efficient neutralization and clearance of pathogens and the establishment of both cell- and humoral-mediated immunological memory. The corollary of this is that impediments to efficient cell-cell interactions, normally necessary for differentiation and effector functions of immune cells, underly the clinical features and disease pathogenesis of primary immunodeficiencies. In affected individuals, these defects manifest as impaired long-term humoral immunity and susceptibility to infection by specific pathogens. In this review, we discuss the importance of, and requirements for, effective interactions between B cells and T cells during the formation of CD4(+) T follicular helper cells and the elicitation of cytotoxic function of virus-specific CD8(+) T cells, as well as how these processes are abrogated in primary immunodeficiencies due to loss-of-function mutations in defined genes. © 2012 New York Academy of Sciences.

  9. Clinical Features, Non-Infectious Manifestations and Survival Analysis of 161 Children with Primary Immunodeficiency in Mexico: A Single Center Experience Over two Decades.

    PubMed

    Lugo Reyes, Saul Oswaldo; Ramirez-Vazquez, Guadalupe; Cruz Hernández, Alonso; Medina-Torres, Edgar A; Ramirez-Lopez, Ana Belen; España-Cabrera, Corín; Hernandez-Lopez, Citlali A; Yamazaki-Nakashimada, Marco A; Espinosa-Rosales, Francisco J; Espinosa-Padilla, Sara E; Murata, Chiharu

    2016-01-01

    The hallmark of Primary immunodeficiencies (PID) is unusual infection, although other immunological non-infectious manifestations such as autoimmunity, allergy and cancer are often present. Most published reports focus on one disease or defect groups, so that a global prevalence of non-infectious manifestations of PID is hard to find. We aimed to describe the clinical features of our pediatric patients with PID, as well as the frequency and evolution of allergy, cancer and autoimmunity. We reviewed all the available charts of patients being followed for PID from 1991 to the spring of 2012 at the National Institute of Pediatrics, Mexico City, to describe their demographic, clinical and laboratory features. Their diagnoses were established by pediatric immunologists in accordance to ESID criteria, including routine immunological workup and specialized diagnostic assays. We divided patients by decade of diagnosis to analyze their survival curves. There were 168 charts available, from which we excluded one duplicate and six equivocal diagnoses. We studied the charts of 161 PID patients (68% male, 86% alive), mostly from the center of the country, with a positive family history in 27% and known consanguinity in 11%. Eighty percent of the patients were diagnosed during the last decade. Current median age was 124 months; median age at onset of infections, 12 months; median age at diagnosis, 52 months; median age at death, 67.5 months. Severe infection and bleeding were the cause of 22 deaths. Eighty-six percent of all patients had at least one infection, while non-infectious manifestations had a global prevalence of 36%, namely: autoimmunity 19%, allergies 17%, and cancer 2.4%. Survival curves were not significantly different when compared by decade of diagnosis. Compared to other registry reports, we found a lower prevalence of antibody defects, and of associated allergy and cancer. We could only locate two isolated IgA deficiencies and four cases of cancer among our PID

  10. Neutropenia in primary immunodeficiency

    PubMed Central

    Sokolic, Robert

    2016-01-01

    Purpose of review Neutropenia is a feature of several primary immunodeficiency diseases (PIDDs). Because of the diverse pathophysiologies of the PIDDs and the rarity of each disorder, data are often lacking, leading to the necessity of empiric treatment. Recent developments in the understanding of neutropenia in several of the PIDDs make a review of the data timely. Recent findings The category of severe congenital neutropenia continues to expand. Mutations in G6PC3 have been identified as the cause of neutropenia in a minority of previously molecularly undefined cases. Recent advances have broadened our understanding of the pathophysiology and the clinical expression of this disorder. A possible function of the C16orf57 gene has been hypothesized that may explain the clinical overlap between Clerucuzio-type poikiloderma with neutropenia and other marrow diseases. Plerixafor has been shown to be a potentially useful treatment in the warts, hypogammaglobulinemia, infection, and myelokathexis syndrome. Investigations of patients with adenosine deaminase deficient severe combined immunodeficiency have identified neutropenia, and particularly susceptibility to myelotoxins, as a feature of this disorder. Granulocyte-colony stimulating factor is the treatment of choice for neutropenia in PIDD, whereas hematopoietic cell transplantation is the only curative option. Summary The number of PIDDs associated with neutropenia has increased, as has our understanding of the range of phenotypes. Additional data and hypotheses have been generated helping to explain the diversity of presentations of neutropenia in PIDDs. PMID:23196894

  11. Epstein–Barr Virus Susceptibility in Activated PI3Kδ Syndrome (APDS) Immunodeficiency

    PubMed Central

    Carpier, Jean-Marie; Lucas, Carrie L.

    2018-01-01

    Activated PI3Kδ Syndrome (APDS) is an inherited immune disorder caused by heterozygous, gain-of-function mutations in the genes encoding the phosphoinositide 3-kinase delta (PI3Kδ) subunits p110δ or p85δ. This recently described primary immunodeficiency disease (PID) is characterized by recurrent sinopulmonary infections, lymphoproliferation, and susceptibility to herpesviruses, with Epstein–Barr virus (EBV) infection being most notable. A broad range of PIDs having disparate, molecularly defined genetic etiology can cause susceptibility to EBV, lymphoproliferative disease, and lymphoma. Historically, PID patients with loss-of-function mutations causing defective cell-mediated cytotoxicity or antigen receptor signaling were found to be highly susceptible to pathological EBV infection. By contrast, the gain of function in PI3K signaling observed in APDS patients paradoxically renders these patients susceptible to EBV, though the underlying mechanisms are incompletely understood. At a cellular level, APDS patients exhibit deranged B lymphocyte development and defects in class switch recombination, which generally lead to defective immunoglobulin production. Moreover, APDS patients also demonstrate an abnormal skewing of T cells toward terminal effectors with short telomeres and senescence markers. Here, we review APDS with a particular focus on how the altered lymphocyte biology in these patients may confer EBV susceptibility. PMID:29387064

  12. Recurrent and Sustained Viral Infections in Primary Immunodeficiencies

    PubMed Central

    Ruffner, Melanie A.; Sullivan, Kathleen E.; Henrickson, Sarah E.

    2017-01-01

    Viral infections are commonplace and often innocuous. Nevertheless, within the population of patients with primary immunodeficiencies (PIDDs), viral infections can be the feature that drives a diagnostic evaluation or can be the most significant morbidity for the patient. This review is focused on the viral complications of PIDDs. It will focus on respiratory viruses, the most common type of viral infection in the general population. Children and adults with an increased frequency or severity of respiratory viral infections are often referred for an immunologic evaluation. The classic teaching is to investigate humoral function in people with recurrent sinopulmonary infections, but this is often interpreted to mean recurrent bacterial infections. Recurrent or very severe viral infections may also be a harbinger of a primary immunodeficiency as well. This review will also cover persistent cutaneous viral infections, systemic infections, central nervous system infections, and gastrointestinal infections. In each case, the specific viral infections may drive a diagnostic evaluation that is specific for that type of virus. This review also discusses the management of these infections, which can become problematic in patients with PIDDs. PMID:28674531

  13. Primary immunodeficiencies appearing as combined lymphopenia, neutropenia, and monocytopenia.

    PubMed

    Dotta, Laura; Badolato, Raffaele

    2014-10-01

    Recurrent or prolonged severe infections associated to panleukopenia strongly suggest primary immune disorders. In recent years, new immunodeficiency syndromes turned up: besides the importance of continuous clinical characterization throughout added reports, the phenotype can easily lead to diagnosis of known rare entities. Our purpose is to review main emerging genetic syndromes featuring lymphopenia combined to neutropenia and/or monocytopenia in order to facilitate diagnosis of rare primary immune deficiencies. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Primary Immunodeficiency Diseases: An Update on the Classification from the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency

    PubMed Central

    Al-Herz, Waleed; Bousfiha, Aziz; Casanova, Jean-Laurent; Chapel, Helen; Conley, Mary Ellen; Cunningham-Rundles, Charlotte; Etzioni, Amos; Fischer, Alain; Franco, Jose Luis; Geha, Raif S.; Hammarström, Lennart; Nonoyama, Shigeaki; Notarangelo, Luigi Daniele; Ochs, Hans Dieter; Puck, Jennifer M.; Roifman, Chaim M.; Seger, Reinhard; Tang, Mimi L. K.

    2011-01-01

    We report the updated classification of primary immunodeficiency diseases, compiled by the ad hoc Expert Committee of the International Union of Immunological Societies. As compared to the previous edition, more than 15 novel disease entities have been added in the updated version. For each disorders, the key clinical and laboratory features are provided. This updated classification is meant to help in the diagnostic approach to patients with these diseases. PMID:22566844

  15. Hematopoietic Stem Cell Transplantation in Primary Immunodeficiency Patients in the Black Sea Region of Turkey.

    PubMed

    Yıldıran, Alişan; Çeliksoy, Mehmet Halil; Borte, Stephan; Güner, Şükrü Nail; Elli, Murat; Fışgın, Tunç; Özyürek, Emel; Sancak, Recep; Oğur, Gönül

    2017-12-01

    Hematopoietic stem cell transplantation is a promising curative therapy for many combined primary immunodeficiencies and phagocytic disorders. We retrospectively reviewed pediatric cases of patients diagnosed with primary immunodeficiencies and scheduled for hematopoietic stem cell transplantation. We identified 22 patients (median age, 6 months; age range, 1 month to 10 years) with various diagnoses who received hematopoietic stem cell transplantation. The patient diagnoses included severe combined immunodeficiency (n=11), Chediak-Higashi syndrome (n=2), leukocyte adhesion deficiency (n=2), MHC class 2 deficiency (n=2), chronic granulomatous syndrome (n=2), hemophagocytic lymphohistiocytosis (n=1), Wiskott-Aldrich syndrome (n=1), and Omenn syndrome (n=1). Of the 22 patients, 7 received human leukocyte antigen-matched related hematopoietic stem cell transplantation, 12 received haploidentical hematopoietic stem cell transplantation, and 2 received matched unrelated hematopoietic stem cell transplantation. The results showed that 5 patients had graft failure. Fourteen patients survived, yielding an overall survival rate of 67%. Screening newborn infants for primary immunodeficiency diseases may result in timely administration of hematopoietic stem cell transplantation.

  16. The United Kingdom Primary Immune Deficiency (UKPID) registry 2012 to 2017.

    PubMed

    Shillitoe, B; Bangs, C; Guzman, D; Gennery, A R; Longhurst, H J; Slatter, M; Edgar, D M; Thomas, M; Worth, A; Huissoon, A; Arkwright, P D; Jolles, S; Bourne, H; Alachkar, H; Savic, S; Kumararatne, D S; Patel, S; Baxendale, H; Noorani, S; Yong, P F K; Waruiru, C; Pavaladurai, V; Kelleher, P; Herriot, R; Bernatonienne, J; Bhole, M; Steele, C; Hayman, G; Richter, A; Gompels, M; Chopra, C; Garcez, T; Buckland, M

    2018-06-01

    This is the second report of the United Kingdom Primary Immunodeficiency (UKPID) registry. The registry will be a decade old in 2018 and, as of August 2017, had recruited 4758 patients encompassing 97% of immunology centres within the United Kingdom. This represents a doubling of recruitment into the registry since we reported on 2229 patients included in our first report of 2013. Minimum PID prevalence in the United Kingdom is currently 5·90/100 000 and an average incidence of PID between 1980 and 2000 of 7·6 cases per 100 000 UK live births. Data are presented on the frequency of diseases recorded, disease prevalence, diagnostic delay and treatment modality, including haematopoietic stem cell transplantation (HSCT) and gene therapy. The registry provides valuable information to clinicians, researchers, service commissioners and industry alike on PID within the United Kingdom, which may not otherwise be available without the existence of a well-established registry. © 2018 British Society for Immunology.

  17. A 10% liquid immunoglobulin preparation for intravenous use (Privigen®) in paediatric patients with primary immunodeficiencies and hypersensitivity to IVIG.

    PubMed

    Lozano-Blasco, J; Martín-Mateos, M A; Alsina, L; Domínguez, O; Giner, M T; Piquer, M; Alvaro, M; Plaza, A M

    2014-01-01

    The objective of this study was to evaluate safety and efficacy of Privigen®, a 10% intravenous immunoglobulin (IVIG), in a particular group of paediatric patients (highly sensitive to previous IVIG infusion) affected with Primary Immunodeficiencies (PID). Patients (n=8) from 3 to 17 years old diagnosed of PID who often suffered from adverse events related to the infusion to previous IVIG were switched to Privigen® in an open protocol. Data were prospectively collected regarding Privigen® administration: infusion, safety and efficacy. In parallel, data on safety and tolerance were retrospectively collected from medical charts regarding the previous 10% IVIG product used. 50% of the patients required premedication with previous IVIG. At the end of the study none required premedication with Privigen®. The infusion rate was lower than that recommended by the manufacturer. All patients had suffered through adverse events during previous IVIG infusion being severe in three patients and recurrent in the rest. With Privigen® only three patients suffered from an adverse event (all cases were milder than previous related). Trough levels of IgG remained stable. None suffer from any episode of bacterial infection. The present work shows that Privigen® was safe in a group of hypersensitive paediatric patients who did not tolerate the administration of a previous 10% liquid IVIG by using a particular infusion protocol slower than recommended. The number of adverse effects was smaller than published, and all cases were mild. No premedication was needed. Privigen® was also effective in this small group. Copyright © 2012 SEICAP. Published by Elsevier Espana. All rights reserved.

  18. Rheumatologic complications in a cohort of 227 patients with common variable immunodeficiency.

    PubMed

    Azizi, G; Kiaee, F; Hedayat, E; Yazdani, R; Dolatshahi, E; Alinia, T; Sharifi, L; Mohammadi, H; Kavosi, H; Jadidi-Niaragh, F; Ziaee, V; Abolhassani, H; Aghamohammadi, A

    2018-05-01

    Common variable immunodeficiency (CVID) is the most prevalent symptomatic type of human primary immunodeficiency diseases (PID). Clinically, CVID is characterized by increased susceptibility to infections and a wide variety of autoimmune and rheumatologic disorders. All patients with CVID registered in Iranian PID Registry (IPIDR) were enrolled in this retrospective cohort study. We investigated the frequency of rheumatologic diseases and its association with immunological and clinical phenotypes in patients with CVID. A total of 227 patients with CVID were enrolled in this study. The prevalence of rheumatologic disorders was 10.1% with a higher frequency in women than men. Most common rheumatologic manifestations were juvenile idiopathic arthritis (JIA) and adult rheumatoid arthritis (RA) followed by juvenile spondyloarthritis (JSpA) and undifferentiated inflammatory arthritis (UIA). Septic arthritis in patients with CVID with a history of RA and JIA was higher than patients without rheumatologic complication. Patients with CVID with a history of autoimmunity (both rheumatologic and non-rheumatologic autoimmunity) had lower regulatory T cells counts in comparison with patients without autoimmune disorders. There was an association between defect in specific antibody responses and negative serologic test results in patients with rheumatologic manifestations. JIA, RA, JSpA and UIA are the most frequent rheumatologic disorders in patients with CVID. Due to antibody deficiency, serologic tests may be negative in these patients. Therefore, these conditions pose significant diagnostic and therapeutic challenges for immunologists and rheumatologists in charge of the care for these patients. © 2018 The Foundation for the Scandinavian Journal of Immunology.

  19. Cascade control of superheated steam temperature with neuro-PID controller.

    PubMed

    Zhang, Jianhua; Zhang, Fenfang; Ren, Mifeng; Hou, Guolian; Fang, Fang

    2012-11-01

    In this paper, an improved cascade control methodology for superheated processes is developed, in which the primary PID controller is implemented by neural networks trained by minimizing error entropy criterion. The entropy of the tracking error can be estimated recursively by utilizing receding horizon window technique. The measurable disturbances in superheated processes are input to the neuro-PID controller besides the sequences of tracking error in outer loop control system, hence, feedback control is combined with feedforward control in the proposed neuro-PID controller. The convergent condition of the neural networks is analyzed. The implementation procedures of the proposed cascade control approach are summarized. Compared with the neuro-PID controller using minimizing squared error criterion, the proposed neuro-PID controller using minimizing error entropy criterion may decrease fluctuations of the superheated steam temperature. A simulation example shows the advantages of the proposed method. Copyright © 2012 ISA. Published by Elsevier Ltd. All rights reserved.

  20. Pneumococcal vaccine failure: can it be a primary immunodeficiency?

    PubMed

    Moinho, Rita; Brett, Ana; Ferreira, Gisela; Lemos, Sónia

    2014-06-12

    Vaccine failure is a rare condition and the need to investigate a primary immunodeficiency is controversial. We present the case of a 4-year-old boy, with complete antipneumococcal vaccination, who had necrotising pneumonia with pleural effusion and severe pancytopaenia with need for transfusion. A vaccine-serotype Streptococcus pneumoniae was isolated in the blood culture. On follow-up, detailed medical history, laboratory and genetic investigation led to the diagnosis of X linked dyskeratosis congenita. Dyskeratosis congenita is an inherited disorder that causes shortening or dysfunction of telomeres, affecting mainly rapidly dividing cells (particularly in the skin and haematopoietic system). It leads to bone marrow failure, combined immunodeficiency and predisposition to cancer. The confirmation of this diagnosis allows genetic counselling and medical monitoring of these patients, in order to detect early complications such as bone marrow aplasia or malignancies. 2014 BMJ Publishing Group Ltd.

  1. New insights in the use of immunoglobulins for the management of immune deficiency (PID) patients

    PubMed Central

    Krivan, Gergely; Jolles, Stephen; Granados, Eduardo Lopes; Paolantonacci, Phillipe; Ouaja, Rabye; Cissé, Ousmane Alfa; Bernatowska, Ewa

    2017-01-01

    Immunoglobulin replacement therapy (IRT) is standard treatment for patients with primary immunodeficiency (PID). Because most of the patients with PID will require long life-time immunoglobulin replacement therapy, the quality of the prescribed products is of utmost importance. The IRT is generally administered either intravenously (abbreviated IVIG), or subcutaneously (abbreviated SCIG). Both routes have been demonstrated to be effective. The preferred route may vary at different times during a given patient’s life. Options are therefore not fixed and the choice of route for immunoglobulin therapy will depend on several factors, including patient characteristics, clinical indication, venous access, side effects, rural or remote location, treatment compliance and patient preference. Many years ago, immunoglobulin therapy was associated with side effects which may compromise patient’s compliance and quality of life of the patients. Most of the side effects were related to impurities. Recently, major advances in the manufacturing process have been made and new processes, such as the Quality by design (QbD) approach were added into the manufacturing steps to ensure patients tolerability and safety. Due to the improved purity of the immunoglobulin products obtained by these processes, the incidence of side effects is lower, while the ways of administration of Ig therapy and the choice of the regimen has widened to suit patient’s preference and needs. PMID:29181272

  2. Newborn Screening for Severe Primary Immunodeficiency Diseases in Sweden-a 2-Year Pilot TREC and KREC Screening Study.

    PubMed

    Barbaro, Michela; Ohlsson, Annika; Borte, Stephan; Jonsson, Susanne; Zetterström, Rolf H; King, Jovanka; Winiarski, Jacek; von Döbeln, Ulrika; Hammarström, Lennart

    2017-01-01

    Newborn screening for severe primary immunodeficiencies (PID), characterized by T and/or B cell lymphopenia, was carried out in a pilot program in the Stockholm County, Sweden, over a 2-year period, encompassing 58,834 children. T cell receptor excision circles (TREC) and kappa-deleting recombination excision circles (KREC) were measured simultaneously using a quantitative PCR-based method on DNA extracted from dried blood spots (DBS), with beta-actin serving as a quality control for DNA quantity. Diagnostic cutoff levels enabling identification of newborns with milder and reversible T and/or B cell lymphopenia were also evaluated. Sixty-four children were recalled for follow-up due to low TREC and/or KREC levels, and three patients with immunodeficiency (Artemis-SCID, ATM, and an as yet unclassified T cell lymphopenia/hypogammaglobulinemia) were identified. Of the positive samples, 24 were associated with prematurity. Thirteen children born to mothers treated with immunosuppressive agents during pregnancy (azathioprine (n = 9), mercaptopurine (n = 1), azathioprine and tacrolimus (n = 3)) showed low KREC levels at birth, which spontaneously normalized. Twenty-nine newborns had no apparent cause identified for their abnormal results, but normalized with time. Children with trisomy 21 (n = 43) showed a lower median number of both TREC (104 vs. 174 copies/μL blood) and KREC (45 vs. 100 copies/3.2 mm blood spot), but only one, born prematurely, fell below the cutoff level. Two children diagnosed with DiGeorge syndrome were found to have low TREC levels, but these were still above the cutoff level. This is the first large-scale screening study with a simultaneous detection of both TREC and KREC, allowing identification of newborns with both T and B cell defects.

  3. In-depth interviews of patients with primary immunodeficiency who have experienced pump and rapid push subcutaneous infusions of immunoglobulins reveal new insights on their preference and expectations.

    PubMed

    Cozon, Grégoire Jacques Noël; Clerson, Pierre; Dokhan, Annaïk; Fardini, Yann; Sala, Taylor Pindi; Crave, Jean-Charles

    2018-01-01

    Patients with primary immunodeficiency (PID) often receive immunoglobulin replacement therapy (IgRT). Physicians and patients have the choice between various methods of administration. For subcutaneous immunoglobulin infusions, patients may use an automated pump (P) or push the plunger of a syringe (rapid push [RP]). P infusions are performed once a week and last around 1 hour. RP decreases the duration of administration, but requires more frequent infusions. Eight out of 30 patients (coming from a single center) who had participated in the cross-over, randomized, open-label trial comparing P and RP participated in a focus group or underwent in-depth interviews. Patients had a long history of home-based subcutaneous immunoglobulin using P. The trial suggested that RP had slightly greater interference on daily life than P, but similar efficacy and better cost-effectiveness. When asked about the delivery method they had preferred, around one-third of patients pointed out RP rather than P. In-depth interviews may reveal unforeseen reasons for patients' preferences. Interviews underlined the complexity of the relationship that the patients maintain with their disease and IgRT. Even if they recognized the genetic nature of the disease and claimed PID was a part of them, patients tried not to be overwhelmed by the disease. IgRT by P was well integrated in patients' routine. By contrast, RP too frequently reminded the patients of their disease. In addition, some patients pointed out the difficulty of pushing the plunger due to the viscosity of the product. Coming back too frequently, RP was not perceived as time saving over a week. Long-lasting use of P could partly explain patients' reasonable reluctance to change to RP. In-depth interviews of PID patients highlighted unforeseen reasons for patients' preference that the physician needs to explore during the shared medical decision-making process.

  4. Fibromyalgia in 300 adult index patients with primary immunodeficiency.

    PubMed

    Barton, James C; Bertoli, Luigi F; Barton, Jackson C; Acton, Ronald T

    2017-01-01

    We sought to determine the prevalence and clinical and laboratory associations of fibromyalgia in adults with primary immunodeficiency (immunoglobulin (Ig) G subclass deficiency (IgGSD) and common variable immunodeficiency (CVID). We performed a retrospective analysis of these observations in 300 non-Hispanic white adult index patients with recurrent/severe respiratory tract infections and IgGSD or CVID: age; sex; IgGSD; fibromyalgia; chronic fatigue; autoimmune conditions (ACs); interstitial cystitis (IC); diabetes; body mass index; serum Ig isotypes; blood lymphocytes and subsets; and human leukocyte antigen (HLA)-A and -B types and haplotypes. We performed univariate comparisons, logistic multivariable regressions, and an analysis of covariance. Mean age was 49 ± 12 (standard deviation) y. There were 246 women (82.0%). IgGSD was diagnosed in 276 patients (92.0%). Fifty-six patients had fibromyalgia (18.7%; female:male 13:1). Other characteristics included: chronic fatigue, 63.0%; aggregate ACs, 35.3%; Sjögren's syndrome, 8.0%; IC, 3.0%; diabetes, 10.3%; and HLA-A*29, B*44 positivity, 9.7%. Prevalences of female sex; chronic fatigue; IC; and HLA-A*29, B*44 positivity were greater in patients with fibromyalgia. Logistic regression on fibromyalgia revealed three positive associations: chronic fatigue (p=0.0149; odds ratio 2.6 [95% confidence interval 1.2, 5.6]); Sjögren's syndrome (p=0.0004; 5.2 [2.1, 13.2]); and IC (p=0.0232; 5.7 [1.3, 25.7]). In an analysis of covariance, there were significant interactions of chronic fatigue, Sjögren's syndrome, and interstitial cystitis on fibromyalgia. Fibromyalgia is common in non-Hispanic white adult index patients with primary immunodeficiency, especially women. Chronic fatigue, Sjögren's syndrome, and IC are significantly associated with fibromyalgia after adjustment for other independent variables.

  5. Pelvic Inflammatory Disease (PID)

    MedlinePlus

    ... a serious condition, in women. 1 in 8 women with a history of PID experience difficulties getting pregnant. You can prevent PID if you know how to protect yourself. What is PID? Pelvic inflammatory disease is an infection of a woman’s reproductive organs. It is a complication often caused ...

  6. Immune Dysregulation, Polyendocrinopathy, Enteropathy, X-Linked Syndrome: A Paradigm of Immunodeficiency with Autoimmunity

    PubMed Central

    Barzaghi, Federica; Passerini, Laura; Bacchetta, Rosa

    2012-01-01

    Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is a rare monogenic primary immunodeficiency (PID) due to mutations of FOXP3, a key transcription factor for naturally occurring (n) regulatory T (Treg) cells. The dysfunction of Treg cells is the main pathogenic event leading to the multi-organ autoimmunity that characterizes IPEX syndrome, a paradigm of genetically determined PID with autoimmunity. IPEX has a severe early onset and can become rapidly fatal within the first year of life regardless of the type and site of the mutation. The initial presenting symptoms are severe enteritis and/or type-1 diabetes mellitus, alone or in combination with eczema and elevated serum IgE. Other autoimmune symptoms, such as hypothyroidism, cytopenia, hepatitis, nephropathy, arthritis, and alopecia can develop in patients who survive the initial acute phase. The current therapeutic options for IPEX patients are limited. Supportive and replacement therapies combined with pharmacological immunosuppression are required to control symptoms at onset. However, these procedures can allow only a reduction of the clinical manifestations without a permanent control of the disease. The only known effective cure for IPEX syndrome is hematopoietic stem cell transplantation, but it is always limited by the availability of a suitable donor and the lack of specific guidelines for bone marrow transplant in the context of this disease. This review aims to summarize the clinical histories and genomic mutations of the IPEX patients described in the literature to date. We will focus on the clinical and immunological features that allow differential diagnosis of IPEX syndrome and distinguish it from other PID with autoimmunity. The efficacy of the current therapies will be reviewed, and possible innovative approaches, based on the latest highlights of the pathogenesis to treat this severe primary autoimmune disease of childhood, will be discussed. PMID:23060872

  7. Gain of Function Mutations of PIK3CD as a Cause of Primary Sclerosing Cholangitis.

    PubMed

    Hartman, Heather N; Niemela, Julie; Hintermeyer, Mary K; Garofalo, Mary; Stoddard, Jennifer; Verbsky, James W; Rosenzweig, Sergio D; Routes, John M

    2015-01-01

    Gain of function (GOF) mutation in the p110δ catalytic subunit of the phosphatidylinositol-3-OH kinase (PIK3CD) is the cause of a primary immunodeficiency (PID) characterized by recurrent sinopulmonary infections and lymphoproliferation. We describe a family of two adults and three children with GOF mutation in PIK3CD, all with recurrent sinopulmonary infections and varied infectious and non-infectious complications. The two adults have Primary Sclerosing Cholangitis (PSC) without evidence of Cryptosporidium parvum infection and have required liver transplantation. PSC is a novel phenotype of GOF mutation in PIK3CD.

  8. Primary immunodeficiency diseases in children treated in the Children's Memorial Hospital, Poland.

    PubMed

    Bernatowska, E; Madalinski, K; Michalkiewicz, J; Gregorek, H

    1988-04-01

    One hundred and three cases of primary immunodeficiency diseases were diagnosed among children suffering mainly from chronic and severe infections in the period 1980-1987. Predominantly antibody defects were recognized in 48 patients (46.6%), combined immunodeficiencies in 36 patients (35%), phagocytic disorders in 12 patients (11.6%), complement defects in 6 patients (5.8%), and cell-mediated disease (Di George syndrome) in 1 patient. Allergic complications were observed in 25 patients (24.2%) and malignancy-in 3 patients (2.9%). More detailed immunological studies were performed in children with X-linked agammaglobulinemia in the course of intravenous immunoglobulin therapy and in children with ataxia telangiectasia.

  9. TOXIRAE PRO PID

    EPA Science Inventory

    The ToxiRAE Pro PID measures total volatile organic compounds (VOCs) using a photoionization detector (PID). This sensor can be programmed to measure concentrations of a specified compound automatically and has a real time reading of VOC concentrations in parts per million (ppm) ...

  10. Induced Pluripotent Stem Cells: A novel frontier in the study of human primary immunodeficiencies

    PubMed Central

    Pessach, Itai M.; Ordovas-Montanes, Jose; Zhang, Shen-Ying; Casanova, Jean-Laurent; Giliani, Silvia; Gennery, Andrew R.; Al-Herz, Waleed; Manos, Philip D.; Schlaeger, Thorsten M.; Park, In-Hyun; Rucci, Francesca; Agarwal, Suneet; Mostoslavsky, Gustavo; Daley, George Q.; Notarangelo, Luigi D.

    2010-01-01

    Background The novel ability to epigenetically reprogram somatic cells into induced pluripotent stem cells through the exogenous expression of transcription promises to revolutionize the study of human diseases. Objective Here we report on the generation of 25 induced pluripotent stem cell lines from 6 patients with various forms of Primary Immunodeficiencies, affecting adaptive and/or innate immunity. Methods Patients’ dermal fibroblasts were reprogrammed by expression of four transcription factors, OCT4, SOX2, KLF4, and c-MYC using a single excisable polycistronic lentiviral vector. Results Induced pluripotent stem cells derived from patients with primary immunodeficiencies show a stemness profile that is comparable to that observed in human embryonic stem cells. Following in vitro differentiation into embryoid bodies, pluripotency of the patient-derived indiced pluripotent stem cells lines was demonstrated by expression of genes characteristic of each of the three embryonic layers. We have confirmed the patient-specific origin of the induced pluripotent stem cell lines, and ascertained maintenance of karyotypic integrity. Conclusion By providing a limitless source of diseased stem cells that can be differentiated into various cell types in vitro, the repository of induced pluripotent stem cell lines from patients with primary immunodeficiencies represents a unique resource to investigate the pathophysiology of hematopoietic and extra-hematopoietic manifestations of these diseases, and may assist in the development of novel therapeutic approaches based on gene correction. PMID:21185069

  11. Allogeneic hematopoietic stem cell transplantation in children with primary immunodeficiencies: Hospital Israelita Albert Einstein experience.

    PubMed

    Fernandes, Juliana Folloni; Kerbauy, Fabio Rodrigues; Ribeiro, Andreza Alice Feitosa; Kutner, Jose Mauro; Camargo, Luis Fernando Aranha; Stape, Adalberto; Troster, Eduardo Juan; Zamperlini-Netto, Gabriele; Azambuja, Alessandra Milani Prandini de; Carvalho, Bruna; Dorna, Mayra de Barros; Vilela, Marluce Dos Santos; Jacob, Cristina Miuki Abe; Costa-Carvalho, Beatriz Tavares; Cunha, Jose Marcos; Carneiro-Sampaio, Magda Maria; Hamerschlak, Nelson

    2011-06-01

    To report the experience of a tertiary care hospital with allogeneic hematopoietic stem cell transplantation in children with primary immunodeficiencies. Seven pediatric patients with primary immunodeficiencies (severe combined immunodeficiency: n = 2; combined immunodeficiency: n = 1; chronic granulomatous disease: n = 1; hyper-IgM syndrome: n = 2; and IPEX syndrome: n = 1) who underwent eight hematopoietic stem cell transplants in a single center, from 2007 to 2010, were studied. Two patients received transplants from HLA-identical siblings; the other six transplants were done with unrelated donors (bone marrow: n = 1; cord blood: n = 5). All patients had pre-existing infections before hematopoietic stem cell transplants. One patient received only anti-thymocyte globulin prior to transplant, three transplants were done with reduced intensity conditioning regimens and four transplants were done after myeloablative therapy. Two patients were not evaluated for engraftment due to early death. Three patients engrafted, two had primary graft failure and one received a second transplant with posterior engraftment. Two patients died of regimen related toxicity (hepatic sinusoidal obstruction syndrome); one patient died of progressive respiratory failure due to Parainfluenza infection present prior to transplant. Four patients are alive and well from 60 days to 14 months after transplant. Patients' status prior to transplant is the most important risk factor on the outcome of hematopoietic stem cell transplants in the treatment of these diseases. Early diagnosis and the possibility of a faster referral of these patients for treatment in reference centers may substantially improve their survival and quality of life.

  12. II Brazilian Consensus on the use of human immunoglobulin in patients with primary immunodeficiencies.

    PubMed

    Goudouris, Ekaterini Simões; Rego Silva, Almerinda Maria do; Ouricuri, Aluce Loureiro; Grumach, Anete Sevciovic; Condino-Neto, Antonio; Costa-Carvalho, Beatriz Tavares; Prando, Carolina Cardoso; Kokron, Cristina Maria; Vasconcelos, Dewton de Moraes; Tavares, Fabíola Scancetti; Silva Segundo, Gesmar Rodrigues; Barreto, Irma Cecília; Dorna, Mayra de Barros; Barros, Myrthes Anna; Forte, Wilma Carvalho Neves

    2017-01-01

    In the last few years, new primary immunodeficiencies and genetic defects have been described. Recently, immunoglobulin products with improved compositions and for subcutaneous use have become available in Brazil. In order to guide physicians on the use of human immunoglobulin to treat primary immunodeficiencies, based on a narrative literature review and their professional experience, the members of the Primary Immunodeficiency Group of the Brazilian Society of Allergy and Immunology prepared an updated document of the 1st Brazilian Consensus, published in 2010. The document presents new knowledge about the indications and efficacy of immunoglobulin therapy in primary immunodeficiencies, relevant production-related aspects, mode of use (routes of administration, pharmacokinetics, doses and intervals), adverse events (major, prevention, treatment and reporting), patient monitoring, presentations available and how to have access to this therapeutic resource in Brazil. RESUMO Nos últimos anos, novas imunodeficiências primárias e defeitos genéticos têm sido descritos. Recentemente, produtos de imunoglobulina, com aprimoramento em sua composição e para uso por via subcutânea, tornaram-se disponíveis em nosso meio. Com o objetivo de orientar o médico no uso da imunoglobulina humana para o tratamento das imunodeficiências primárias, os membros do Grupo de Assessoria em Imunodeficiências da Associação Brasileira de Alergia e Imunologia produziram um documento que teve por base uma revisão narrativa da literatura e sua experiência profissional, atualizando o I Consenso Brasileiro publicado em 2010. Apresentam-se novos conhecimentos sobre indicações e eficácia do tratamento com imunoglobulina nas imunodeficiências primárias, aspectos relevantes sobre a produção, forma de utilização (vias de administração, farmacocinética, doses e intervalos), efeitos adversos (principais efeitos, prevenção, tratamento e notificação), monitorização do

  13. Human IL-21 and IL-21R deficiencies: two novel entities of primary immunodeficiency.

    PubMed

    Kotlarz, Daniel; Ziętara, Natalia; Milner, Joshua D; Klein, Christoph

    2014-12-01

    This review highlights the recent identification of human interleukin-21 (IL-21) and interleukin-21 receptor (IL-21R) deficiencies as novel entities of primary immunodeficiency. We recently described the first patients with IL-21R deficiency who had cryptosporidial infections associated with chronic cholangitis and liver disease. All IL-21R-deficient patients suffered from recurrent respiratory tract infections. Immunological work-up revealed impaired B cell proliferation and immunoglobulin class-switch, reduced T cell effector functions, and variable natural killer cell dysfunctions. Recently, these findings have been extended by the discovery of one patient with a mutation in the IL21 gene. This patient predominantly manifested with very early onset inflammatory bowel disease and recurrent respiratory infections. Laboratory examination showed reduced circulating B cells and impaired B cell class-switch. Human IL-21 and IL-21R deficiencies cause severe, primary immunodeficiency reminiscent of common variable immunodeficiency. Early diagnosis is critical to prevent life-threatening complications, such as secondary liver failure. In view of the critical role of IL-21 in controlling immune homeostasis, early hematopoietic stem cell transplantation might be considered as therapeutic intervention in affected children.

  14. Severe Epstein-Barr virus infection in primary immunodeficiency and the normal host.

    PubMed

    Worth, Austen J J; Houldcroft, Charlotte J; Booth, Claire

    2016-11-01

    Epstein-Barr virus (EBV) infection is ubiquitous in humans, but the majority of infections have an asymptomatic or self-limiting clinical course. Rarely, individuals may develop a pathological EBV infection with a variety of life threatening complications (including haemophagocytosis and malignancy) and others develop asymptomatic chronic EBV viraemia. Although an impaired ability to control EBV infection has long been recognised as a hallmark of severe T-cell immunodeficiency, the advent of next generation sequencing has identified a series of Primary Immunodeficiencies in which EBV-related pathology is the dominant feature. Chronic active EBV infection is defined as chronic EBV viraemia associated with systemic lymphoproliferative disease, in the absence of immunodeficiency. Descriptions of larger cohorts of patients with chronic active EBV in recent years have significantly advanced our understanding of this clinical syndrome. In this review we summarise the current understanding of the pathophysiology and natural history of these diseases and clinical syndromes, and discuss approaches to the investigation and treatment of severe or atypical EBV infection. © 2016 John Wiley & Sons Ltd.

  15. PID Tuning Using Extremum Seeking

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Killingsworth, N; Krstic, M

    2005-11-15

    Although proportional-integral-derivative (PID) controllers are widely used in the process industry, their effectiveness is often limited due to poor tuning. Manual tuning of PID controllers, which requires optimization of three parameters, is a time-consuming task. To remedy this difficulty, much effort has been invested in developing systematic tuning methods. Many of these methods rely on knowledge of the plant model or require special experiments to identify a suitable plant model. Reviews of these methods are given in [1] and the survey paper [2]. However, in many situations a plant model is not known, and it is not desirable to openmore » the process loop for system identification. Thus a method for tuning PID parameters within a closed-loop setting is advantageous. In relay feedback tuning [3]-[5], the feedback controller is temporarily replaced by a relay. Relay feedback causes most systems to oscillate, thus determining one point on the Nyquist diagram. Based on the location of this point, PID parameters can be chosen to give the closed-loop system a desired phase and gain margin. An alternative tuning method, which does not require either a modification of the system or a system model, is unfalsified control [6], [7]. This method uses input-output data to determine whether a set of PID parameters meets performance specifications. An adaptive algorithm is used to update the PID controller based on whether or not the controller falsifies a given criterion. The method requires a finite set of candidate PID controllers that must be initially specified [6]. Unfalsified control for an infinite set of PID controllers has been developed in [7]; this approach requires a carefully chosen input signal [8]. Yet another model-free PID tuning method that does not require opening of the loop is iterative feedback tuning (IFT). IFT iteratively optimizes the controller parameters with respect to a cost function derived from the output signal of the closed-loop system

  16. Pelvic Inflammatory Disease (PID)

    MedlinePlus

    ... Education FAQs Pelvic Inflammatory Disease (PID) Patient Education Pamphlets - Spanish Pelvic Inflammatory Disease (PID) FAQ077, September 2015 ... on Patient Safety For Patients Patient FAQs Spanish Pamphlets Teen Health About ACOG About Us Leadership & Governance ...

  17. Update on gene therapy for immunodeficiencies.

    PubMed

    Kohn, Donald B

    2010-05-01

    Primary immune deficiencies (PID) are due to blood cell defects and can be treated with transplantation of normal hematopoietic stem cells (HSC) from another person (allogeneic). Gene therapy in which a patient's autologous HSC are genetically corrected represents an alternative treatment for patients with PID, which could avoid the immunologic risks of allogeneic HSCT and confer similar benefits. Recent clinical trials using gene therapy have led to immune restoration in patients with X-linked severe combined immune deficiency (XSCID), adenosine deaminase (ADA)-deficient SCID and chronic granulomatous disease (CGD). However, severe complications arose in several of the patients in whom the integrated retroviral vectors led to leukoproliferative disorders. New approaches using safer integrating vectors or direct correction of the defective gene underlying the PID are being developed and may lead to safer and effective gene therapy for PID. Copyright 2009 Elsevier Inc. All rights reserved.

  18. Community-Acquired Poliovirus Infection in Children with Primary Immunodeficiencies in Tunisia

    PubMed Central

    Triki, Hinda; Barbouche, Mohamed Ridha; Bahri, Olfa; Bejaoui, Mohamed; Dellagi, Koussay

    2003-01-01

    The global polio eradication program recommends the use of massive vaccination campaigns with live vaccine through National Immunization Days (NIDs) to displace the wild virus from the community. Immunodeficient patients may be indirectly infected and become chronic excretors and potential reservoirs of polioviruses, a concern for the posteradication era. This prospective study aimed to assess the risk of community-acquired infection of immunodeficient patients following NIDs, the dynamics of viral excretion and the genetic variation of excreted viruses. Sixteen children with various primary immunodeficiencies, who did not receive the vaccine during the campaign, were investigated. Stool samples were collected weekly, shortly after the NIDs, during at least 3 months, and were processed for viral isolation. Isolates were characterized by three intratypic differentiation methods and partial sequencing of the VP1/2A region. Polioviruses were detected in 4 out of 16 patients (serotype 1 in 3 patients and serotype 3 in 1 patient). Sequencing revealed more than 99% homology with homotypic Sabin strains, suggesting recent infection. Duration of viral excretion ranged from 1 to 7 weeks. Nine out of eleven isolates from the three poliovirus serotype 1-infected patients disclosed a non-Sabin-like phenotype by enzyme-linked immunosorbent assay and had recurrent mutations within or close to the neutralizing antigenic sites. In summary, the risk of secondary infection in immunodeficient patients is within the range previously reported for the general population. Although none of the four infected patients developed prolonged viral excretion, particular viral variants were selected and may be of epidemiological significance. PMID:12624052

  19. Loss-of-function nuclear factor κB subunit 1 (NFKB1) variants are the most common monogenic cause of common variable immunodeficiency in Europeans.

    PubMed

    Tuijnenburg, Paul; Lango Allen, Hana; Burns, Siobhan O; Greene, Daniel; Jansen, Machiel H; Staples, Emily; Stephens, Jonathan; Carss, Keren J; Biasci, Daniele; Baxendale, Helen; Thomas, Moira; Chandra, Anita; Kiani-Alikhan, Sorena; Longhurst, Hilary J; Seneviratne, Suranjith L; Oksenhendler, Eric; Simeoni, Ilenia; de Bree, Godelieve J; Tool, Anton T J; van Leeuwen, Ester M M; Ebberink, Eduard H T M; Meijer, Alexander B; Tuna, Salih; Whitehorn, Deborah; Brown, Matthew; Turro, Ernest; Thrasher, Adrian J; Smith, Kenneth G C; Thaventhiran, James E; Kuijpers, Taco W

    2018-03-02

    The genetic cause of primary immunodeficiency disease (PID) carries prognostic information. We conducted a whole-genome sequencing study assessing a large proportion of the NIHR BioResource-Rare Diseases cohort. In the predominantly European study population of principally sporadic unrelated PID cases (n = 846), a novel Bayesian method identified nuclear factor κB subunit 1 (NFKB1) as one of the genes most strongly associated with PID, and the association was explained by 16 novel heterozygous truncating, missense, and gene deletion variants. This accounted for 4% of common variable immunodeficiency (CVID) cases (n = 390) in the cohort. Amino acid substitutions predicted to be pathogenic were assessed by means of analysis of structural protein data. Immunophenotyping, immunoblotting, and ex vivo stimulation of lymphocytes determined the functional effects of these variants. Detailed clinical and pedigree information was collected for genotype-phenotype cosegregation analyses. Both sporadic and familial cases demonstrated evidence of the noninfective complications of CVID, including massive lymphadenopathy (24%), unexplained splenomegaly (48%), and autoimmune disease (48%), features prior studies correlated with worse clinical prognosis. Although partial penetrance of clinical symptoms was noted in certain pedigrees, all carriers have a deficiency in B-lymphocyte differentiation. Detailed assessment of B-lymphocyte numbers, phenotype, and function identifies the presence of an increased CD21 low B-cell population. Combined with identification of the disease-causing variant, this distinguishes between healthy subjects, asymptomatic carriers, and clinically affected cases. We show that heterozygous loss-of-function variants in NFKB1 are the most common known monogenic cause of CVID, which results in a temporally progressive defect in the formation of immunoglobulin-producing B cells. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Poliovirus excretion among persons with primary immune deficiency disorders: summary of a seven-country study series.

    PubMed

    Li, Li; Ivanova, Olga; Driss, Nadia; Tiongco-Recto, Marysia; da Silva, Rajiva; Shahmahmoodi, Shohreh; Sazzad, Hossain M S; Mach, Ondrej; Kahn, Anna-Lea; Sutter, Roland W

    2014-11-01

    Persons with primary immune deficiency disorders (PID), especially those disorders affecting the B-cell system, are at substantially increased risk of paralytic poliomyelitis and can excrete poliovirus chronically. However, the risk of prolonged or chronic excretion is not well characterized in developing countries. We present a summary of a country study series on poliovirus excretion among PID cases. Cases with PID from participating institutions were enrolled during the first year and after obtaining informed consent were tested for polioviruses in stool samples. Those cases excreting poliovirus were followed on a monthly basis during the second year until 2 negative stool samples were obtained. A total of 562 cases were enrolled in Bangladesh, China, Iran, Philippines, Russia, Sri Lanka, and Tunisia during 2008-2013. Of these, 17 (3%) shed poliovirus, including 2 cases with immunodeficient vaccine-derived poliovirus. Poliovirus was detected in a single sample from 5/17 (29%) cases. One case excreted for more than 6 months. None of the cases developed paralysis during the study period. Chronic polioviruses excretion remains a rare event even among individuals with PID. Nevertheless, because these individuals were not paralyzed they would have been missed by current surveillance; therefore, surveillance for polioviruses among PID should be established. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  1. Does the route of immunoglobin replacement therapy impact quality of life and satisfaction in patients with primary immunodeficiency? Insights from the French cohort "Visages".

    PubMed

    Bienvenu, B; Cozon, G; Hoarau, C; Pasquet, M; Cherin, P; Clerson, P; Hachulla, E; Crave, J C; Delain, J C; Jaussaud, R

    2016-06-22

    IgG replacement therapy (IgRT) in primary immunodeficiencies (PID) is a lifelong treatment which may be administered intravenously (IVIg) or subcutaneously (SCIg), at hospital or at home. The objective of the VISAGE study was to investigate if route and/or place for IgRT impact patients' satisfaction regarding IgRT and quality of life (QoL) in real-life conditions. The study enrolled PID patients at least 15 years old receiving IgRT for at least 3 months. Satisfaction and QoL were evaluated at enrollment and over a 12-month follow-up period by Life Quality Index (LQI) which measures 3 dimensions of satisfaction: treatment interference, therapy related problems and therapy settings (factors I, II and III) and SF-36 v2 questionnaire. The study included 116 PID patients (mean age 42 ± 18 years, 44 % males, 58 % with scholar or professional occupation) receiving IgRT for a mean of 8.5 ± 8.4 years. At enrollment they were receiving either home-based SCIg (51 %), hospital-based IVIg (40 %) or home-based IVIg (9 %). Patients exhibited a high degree of satisfaction regarding IgRT whatever the route and place for administration. LQI factor I was higher for home-based SCIg (86 ± 2) than for hospital-based IVIg (81 ± 3) and home-based IVIg (73 ± 5; p = 0.02 versus home-based SCIg); no difference was found for LQI factor II; LQI factor III was higher for home-based SCIg (92 ± 2) than for hospital-based IVIg (87 ± 5) and hospital-based IVIg (82 ± 3; p = 0.005 versus home-based SCIg). By contrast, every dimension of QoL was impaired. Over the follow-up period, 10 patients switched from hospital-based IVIg to home-based SCIg and improved LQI factor I (p = 0.004) and factor III (p = 0.02), while no change was noticed in LQI factors II and QoL. Meanwhile, no change in satisfaction or QoL was found in patients with stable route of IgRT. When asked on their preferred place of treatment all but one patient with home

  2. Exploiting Fractional Order PID Controller Methods in Improving the Performance of Integer Order PID Controllers: A GA Based Approach

    NASA Astrophysics Data System (ADS)

    Mukherjee, Bijoy K.; Metia, Santanu

    2009-10-01

    The paper is divided into three parts. The first part gives a brief introduction to the overall paper, to fractional order PID (PIλDμ) controllers and to Genetic Algorithm (GA). In the second part, first it has been studied how the performance of an integer order PID controller deteriorates when implemented with lossy capacitors in its analog realization. Thereafter it has been shown that the lossy capacitors can be effectively modeled by fractional order terms. Then, a novel GA based method has been proposed to tune the controller parameters such that the original performance is retained even though realized with the same lossy capacitors. Simulation results have been presented to validate the usefulness of the method. Some Ziegler-Nichols type tuning rules for design of fractional order PID controllers have been proposed in the literature [11]. In the third part, a novel GA based method has been proposed which shows how equivalent integer order PID controllers can be obtained which will give performance level similar to those of the fractional order PID controllers thereby removing the complexity involved in the implementation of the latter. It has been shown with extensive simulation results that the equivalent integer order PID controllers more or less retain the robustness and iso-damping properties of the original fractional order PID controllers. Simulation results also show that the equivalent integer order PID controllers are more robust than the normal Ziegler-Nichols tuned PID controllers.

  3. Intravenous Immunoglobulin in the Treatment of Primary Immunodeficiency Diseases.

    PubMed

    De Ranieri, Deirdre; Fenny, Nana Sarkoah

    2017-01-01

    Intravenous immunoglobulin (IVIG) has been used as antibody replacement therapy in primary immunodeficiency diseases (PIDDs) for more than 50 years. Its role as a therapeutic agent has expanded over the past couple of decades as its anti-inflammatory and immune-modulatory mechanisms of action have been elucidated. It is now used "off-label" to treat other autoimmune diseases. This article focuses on the role of IVIG in the treatment of PIDDs characterized by absent or deficient antibody production. Replacement doses are given on a monthly basis in these conditions as a prophylactic measure to prevent acute and serious bacterial infections. [Pediatr Ann. 2017;46(1):e8-e12.]. Copyright 2017, SLACK Incorporated.

  4. PIDs, Types and the Semantic Web

    NASA Astrophysics Data System (ADS)

    Schwardmann, Ulrich

    2017-04-01

    PID Information Types are becoming a crucial role in scientific data management because they can provide state (what) and binding (where) information about digital objects as attributes of the PID. This is a similar but much more flexible approach than the well known mime type characterization, because both of these types concepts allow to decide about preconditions for processes in advance and before touching the data. One aspect of this is the need for standards and correctness of the used types to ensure reliability for the processes operating on the digital objects. This requires registries and schemas for PID InfoTypes and suggests an automated schema generation process. Such a process in combination with data type registries will be described in more detail in the intended talk. Another aspect of PID InfoTypes is its intrinsic grammar as subject-predicate-object triple, with the PID as subject, the type as predicate and its value (often again a PID) as object in this relation. Given the registration of types and the proposed syntactical rigidness of the value, guaranteed by the schema, together with the use of PIDs in subject and predicate, the type concept has the ability to overcome the fuzziness and lack of reliability of semantic web categories with its URL references and possibly changing locations and content. The intended talk will also describe this approach in more detail, discusses the differences to linked data and describes some necessary technological developments for the type concept to keep up with the possibilities currently provided by the semantic web.

  5. Allogeneic Bone Marrow Transplantation in Patients With Primary Immunodeficiencies

    ClinicalTrials.gov

    2009-10-14

    Immunologic Deficiency Syndromes; Chediak-Higashi Syndrome; Common Variable Immunodeficiency; Graft Versus Host Disease; X-Linked Lymphoproliferative Syndrome; Familial Erythrophagocytic Lymphohistiocytosis; Hemophagocytic Lymphohistiocytosis; X-linked Agammaglobulinemia; Wiskott-Aldrich Syndrome; Chronic Granulomatous Disease; X-linked Hyper IgM Syndrome; Severe Combined Immunodeficiency; Leukocyte Adhesion Deficiency Syndrome; Virus-Associated Hemophagocytic Syndrome

  6. Impact of PID on industrial rooftop PV-installations

    NASA Astrophysics Data System (ADS)

    Buerhop, Claudia; Fecher, Frank W.; Pickel, Tobias; Patel, Tirth; Zetzmann, Cornelia; Camus, Christian; Hauch, Jens; Brabec, Christoph J.

    2017-08-01

    Potential induced degradation (PID) causes severe damage and financial losses even in modern PV-installations. In Germany, approximately 19% of PV-installations suffer from PID and resulting power loss. This paper focuses on the impact of PID in real installations and how different evaluated time intervals influence the performance ratio (PR) and the determined degradation rate. The analysis focuses exemplarily on a 314 kWp PV-system in the Atlantic coastal climate. IR-imaging is used for identifying PID without operation interruption. Historic electric performance data are available from a monitoring system for several years on system level, string level as well as punctually measured module string IV- curves. The data sets are combined for understanding the PID behavior of this PV plant. The number of PID affected cells within a string varies strongly between 1 to 22% with the string position on the building complex. With increasing number of PID-affected cells the performance ratio decreases down to 60% for daily and monthly periods. Local differences in PID evolution rates are identified. An average PR-reduction of -3.65% per year is found for the PV-plant. On the string level the degradation rate varied up to 8.8% per year depending on the string position and the time period. The analysis reveals that PID generation and evolution in roof-top installations on industrial buildings with locally varying operation conditions can be fairly complex. The results yield that local operating conditions, e.g. ambient weather conditions as well as surrounding conditions on an industrial building, seem to have a dominating impact on the PID evolution rate.

  7. Advances in Understanding the Pathogenesis of Epstein-Barr Virus-Associated Lymphoproliferative Disorders.

    PubMed

    Yang, Xi; Nishida, Naonori; Zhao, Xiaodong; Kanegane, Hirokazu

    2015-10-01

    Epstein-Barr virus (EBV) was discovered 50 years ago from an african Burkitt lymphoma cell line. EBV-associated lymphoproliferative disorders (LPDs) are life- threatening diseases, especially in children. In this article, we review EBV-associated LPDs, especially in the area of primary immunodeficiency disease (PID). We searched PubMed for publications with key words including EBV infection, lymphoma, LPDs and PID, and selected the manuscripts written in English that we judged to be relevant to the topic of this review.On the basis of the data in the literature, we grouped the EBV-associated LPDs into four categories: nonmalignant disease, malignant disease, acquired immunodeficiency disease and PID. Each category has its own risk factor for LPD development. EBV-associated LPD is a complex disease, creating new challenges for diagnosis and treatment.

  8. Soft Real-Time PID Control on a VME Computer

    NASA Technical Reports Server (NTRS)

    Karayan, Vahag; Sander, Stanley; Cageao, Richard

    2007-01-01

    microPID (uPID) is a computer program for real-time proportional + integral + derivative (PID) control of a translation stage in a Fourier-transform ultraviolet spectrometer. microPID implements a PID control loop over a position profile at sampling rate of 8 kHz (sampling period 125microseconds). The software runs in a strippeddown Linux operating system on a VersaModule Eurocard (VME) computer operating in real-time priority queue using an embedded controller, a 16-bit digital-to-analog converter (D/A) board, and a laser-positioning board (LPB). microPID consists of three main parts: (1) VME device-driver routines, (2) software that administers a custom protocol for serial communication with a control computer, and (3) a loop section that obtains the current position from an LPB-driver routine, calculates the ideal position from the profile, and calculates a new voltage command by use of an embedded PID routine all within each sampling period. The voltage command is sent to the D/A board to control the stage. microPID uses special kernel headers to obtain microsecond timing resolution. Inasmuch as microPID implements a single-threaded process and all other processes are disabled, the Linux operating system acts as a soft real-time system.

  9. Compound heterozygous TYK2 mutations underlie primary immunodeficiency with T-cell lymphopenia.

    PubMed

    Nemoto, Michiko; Hattori, Hiroyoshi; Maeda, Naoko; Akita, Nobuhiro; Muramatsu, Hideki; Moritani, Suzuko; Kawasaki, Tomonori; Maejima, Masami; Ode, Hirotaka; Hachiya, Atsuko; Sugiura, Wataru; Yokomaku, Yoshiyuki; Horibe, Keizo; Iwatani, Yasumasa

    2018-05-03

    Complete tyrosine kinase 2 (TYK2) deficiency has been previously described in patients with primary immunodeficiency diseases. The patients were infected with various pathogens, including mycobacteria and/or viruses, and one of the patients developed hyper-IgE syndrome. A detailed immunological investigation of these patients revealed impaired responses to type I IFN, IL-10, IL-12 and IL-23, which are associated with increased susceptibility to mycobacterial and/or viral infections. Herein, we report a recessive partial TYK2 deficiency in two siblings who presented with T-cell lymphopenia characterized by low naïve CD4 + T-cell counts and who developed Epstein-Barr virus (EBV)-associated B-cell lymphoma. Targeted exome-sequencing of the siblings' genomes demonstrated that both patients carried novel compound heterozygous mutations (c.209_212delGCTT/c.691C > T, p.Cys70Serfs*21/p.Arg231Trp) in the TYK2. The TYK2 protein levels were reduced by 35% in the T cells of the patient. Unlike the response under complete TYK2 deficiency, the patient's T cells responded normally to type I IFN, IL-6, IL-10 and IL-12, whereas the cells displayed an impaired response to IL-23. Furthermore, the level of STAT1 was low in the cells of the patient. These studies reveal a new clinical entity of a primary immunodeficiency with T-cell lymphopenia that is associated with compound heterozygous TYK2 mutations in the patients.

  10. Primary human immunodeficiency virus infection presenting as elevated aminotransferases.

    PubMed

    Chen, Yi-Jan; Tsai, Hung-Chin; Cheng, Ming-Fang; Lee, Susan Shin-Jung; Chen, Yao-Shen

    2010-06-01

    Primary human immunodeficiency virus type 1 (HIV-1) infection is often under-diagnosed because of its nonspecific presentations. Elevated aminotransferase levels is one of its clinical manifestations, but is infrequently reported in the literature. The objective of this study was to investigate cases of elevated aminotransferases as a manifestation of primary HIV-1 infection. A retrospective chart review from October 1990 to May 2009 of HIV-1 infected patients in a registered database at a tertiary hospital was conducted to identify patients diagnosed with primary HIV-1 infection. An elevated aminotransferase level was broadly defined as above-normal values of alanine or aspartate aminotransferases. Acute hepatitis markers were determined using stored serum samples. Twenty-three of the 827 (2.8%) patients were identified as having a primary HIV-1 infection. All were male, with a median age of 26 years (range, 19-77 years), and the majority were men who had sex with men (19/23, 82.6%). The most common clinical manifestations were fever (95.7%), elevated aminotransferases (65.2%), fatigue (47.8%), and pharyngitis (47.8%). The median CD4 lymphocyte count was 374/μL (range, 109-674/μL) and the median log HIV viral load was 5.0 (range, 4.3-5.9). For the 15 patients with abnormal liver function tests, the median aspartate aminotransferase level was 112 U/L (range, 62-969 U/L) and the median alanine aminotransferase level was 146 U/L (range, 42-1,110 U/L). Elevated aminotransferases may be an initial manifestation of primary HIV infection and is more common than expected. Primary HIV-1 infection should be one of the differential diagnoses considered in young men presenting with unexplained, new-onset liver function impairment. Copyright © 2010 Taiwan Society of Microbiology. Published by Elsevier B.V. All rights reserved.

  11. Kiovig for primary immunodeficiency: reduced infusion and decreased costs per infusion.

    PubMed

    Connolly, Mark; Simoens, Steven

    2011-09-01

    Kiovig is a ready-to-use 10% liquid immunoglobulin preparation that is medically indicated for the treatment of primary immunodeficiency. This study aims to conduct an economic evaluation which compares the intravenous immunoglobulin (IVIg) preparations Kiovig, Multigam, and Sandoglobulin from the Belgian societal perspective. As three prospective studies have observed no difference in outcomes, a cost-minimization analysis is considered appropriate to evaluate differences in treatment costs that can arise from IVIgs. A decision-analytic model simulated treatment costs attributed to one infusion. Resource use data were derived from a Dutch costing study. Cost items included immunoglobulin costs, pharmacy administration and nursing costs, mini-forfait for hospital infusion, costs of adverse events, and lost productivity with 2009 as base year. Cost data were identified from published sources and Belgian hospital administrators. A probabilistic sensitivity analysis explored the impact of parameter uncertainty on cost results. Costs per infusion cycle in adult primary immunodeficiency patients were €1,046 (95% confidence interval: €1,006-1,093) with Kiovig; €1,102 (€1,064-1,147) with Multigam; and €1,147 (€1,108-1,193) with Sandoglobulin. The average cost savings per infusion with Kiovig as compared to Multigam and Sandoglobulin amounted to €56 and €101 per infusion. In conclusion, treatment costs with Kiovig were shown to be lower as compared to other IVIgs in Belgium. Reduced costs per infusion were attributed to lower costs associated with treating adverse events and the opportunity cost of nursing time and time off work for working adults. Copyright © 2011 Elsevier B.V. All rights reserved.

  12. Rapid molecular diagnostics of severe primary immunodeficiency determined by using targeted next-generation sequencing.

    PubMed

    Yu, Hui; Zhang, Victor Wei; Stray-Pedersen, Asbjørg; Hanson, Imelda Celine; Forbes, Lisa R; de la Morena, M Teresa; Chinn, Ivan K; Gorman, Elizabeth; Mendelsohn, Nancy J; Pozos, Tamara; Wiszniewski, Wojciech; Nicholas, Sarah K; Yates, Anne B; Moore, Lindsey E; Berge, Knut Erik; Sorte, Hanne; Bayer, Diana K; ALZahrani, Daifulah; Geha, Raif S; Feng, Yanming; Wang, Guoli; Orange, Jordan S; Lupski, James R; Wang, Jing; Wong, Lee-Jun

    2016-10-01

    Primary immunodeficiency diseases (PIDDs) are inherited disorders of the immune system. The most severe form, severe combined immunodeficiency (SCID), presents with profound deficiencies of T cells, B cells, or both at birth. If not treated promptly, affected patients usually do not live beyond infancy because of infections. Genetic heterogeneity of SCID frequently delays the diagnosis; a specific diagnosis is crucial for life-saving treatment and optimal management. We developed a next-generation sequencing (NGS)-based multigene-targeted panel for SCID and other severe PIDDs requiring rapid therapeutic actions in a clinical laboratory setting. The target gene capture/NGS assay provides an average read depth of approximately 1000×. The deep coverage facilitates simultaneous detection of single nucleotide variants and exonic copy number variants in one comprehensive assessment. Exons with insufficient coverage (<20× read depth) or high sequence homology (pseudogenes) are complemented by amplicon-based sequencing with specific primers to ensure 100% coverage of all targeted regions. Analysis of 20 patient samples with low T-cell receptor excision circle numbers on newborn screening or a positive family history or clinical suspicion of SCID or other severe PIDD identified deleterious mutations in 14 of them. Identified pathogenic variants included both single nucleotide variants and exonic copy number variants, such as hemizygous nonsense, frameshift, and missense changes in IL2RG; compound heterozygous changes in ATM, RAG1, and CIITA; homozygous changes in DCLRE1C and IL7R; and a heterozygous nonsense mutation in CHD7. High-throughput deep sequencing analysis with complete clinical validation greatly increases the diagnostic yield of severe primary immunodeficiency. Establishing a molecular diagnosis enables early immune reconstitution through prompt therapeutic intervention and guides management for improved long-term quality of life. Copyright © 2016 American

  13. Improved fuzzy PID controller design using predictive functional control structure.

    PubMed

    Wang, Yuzhong; Jin, Qibing; Zhang, Ridong

    2017-11-01

    In conventional PID scheme, the ensemble control performance may be unsatisfactory due to limited degrees of freedom under various kinds of uncertainty. To overcome this disadvantage, a novel PID control method that inherits the advantages of fuzzy PID control and the predictive functional control (PFC) is presented and further verified on the temperature model of a coke furnace. Based on the framework of PFC, the prediction of the future process behavior is first obtained using the current process input signal. Then, the fuzzy PID control based on the multi-step prediction is introduced to acquire the optimal control law. Finally, the case study on a temperature model of a coke furnace shows the effectiveness of the fuzzy PID control scheme when compared with conventional PID control and fuzzy self-adaptive PID control. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  14. Common variable immunodeficiency: experience in Puerto Rico.

    PubMed

    Santaella, María L; Font, Ivonne; Disdier, Orville

    2005-03-01

    Common variable immunodeficiency (CVI) is a primary immunodeficiency characterized by hypogammaglobulinemia and an increased susceptibility to infections. The degree and the type of deficiency of serum immunoglobulins, as well as, the clinical course vary from patient to patient, hence the term "variable". The aim of this report is to describe the clinical characteristics and the response to gammaglobulin therapy of a group of patients with CVI followed at the University Hospital of the Puerto Rico Medical Center. To our knowledge, no data on primary immunodeficiencies in Puerto Rico has been reported in the literature. The study group exhibits specific characteristics as compared to other reported series.

  15. X-linked primary immunodeficiency associated with hemizygous mutations in the moesin (MSN) gene.

    PubMed

    Lagresle-Peyrou, Chantal; Luce, Sonia; Ouchani, Farid; Soheili, Tayebeh Shabi; Sadek, Hanem; Chouteau, Myriam; Durand, Amandine; Pic, Isabelle; Majewski, Jacek; Brouzes, Chantal; Lambert, Nathalie; Bohineust, Armelle; Verhoeyen, Els; Cosset, François-Loïc; Magerus-Chatinet, Aude; Rieux-Laucat, Frédéric; Gandemer, Virginie; Monnier, Delphine; Heijmans, Catherine; van Gijn, Marielle; Dalm, Virgil A; Mahlaoui, Nizar; Stephan, Jean-Louis; Picard, Capucine; Durandy, Anne; Kracker, Sven; Hivroz, Claire; Jabado, Nada; de Saint Basile, Geneviève; Fischer, Alain; Cavazzana, Marina; André-Schmutz, Isabelle

    2016-12-01

    We investigated 7 male patients (from 5 different families) presenting with profound lymphopenia, hypogammaglobulinemia, fluctuating monocytopenia and neutropenia, a poor immune response to vaccine antigens, and increased susceptibility to bacterial and varicella zoster virus infections. We sought to characterize the genetic defect involved in a new form of X-linked immunodeficiency. We performed genetic analyses and an exhaustive phenotypic and functional characterization of the lymphocyte compartment. We observed hemizygous mutations in the moesin (MSN) gene (located on the X chromosome and coding for MSN) in all 7 patients. Six of the latter had the same missense mutation, which led to an amino acid substitution (R171W) in the MSN four-point-one, ezrin, radixin, moesin domain. The seventh patient had a nonsense mutation leading to a premature stop codon mutation (R533X). The naive T-cell counts were particularly low for age, and most CD8 + T cells expressed the senescence marker CD57. This phenotype was associated with impaired T-cell proliferation, which was rescued by expression of wild-type MSN. MSN-deficient T cells also displayed poor chemokine receptor expression, increased adhesion molecule expression, and altered migration and adhesion capacities. Our observations establish a causal link between an ezrin-radixin-moesin protein mutation and a primary immunodeficiency that could be referred to as X-linked moesin-associated immunodeficiency. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  16. Quantum Efficiency Loss after PID Stress: Wavelength Dependence on Cell Surface and Cell Edge

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Oh, Jaewon; Bowden, Stuart; TamizhMani, GovindaSamy

    2015-06-14

    It is known that the potential induced degradation (PID) stress of conventional p-base solar cells affects power, shunt resistance, junction recombination, and quantum efficiency (QE). One of the primary solutions to address the PID issue is a modification of chemical and physical properties of antireflection coating (ARC) on the cell surface. Depending on the edge isolation method used during cell processing, the ARC layer near the edges may be uniformly or non-uniformly damaged. Therefore, the pathway for sodium migration from glass to the cell junction could be either through all of the ARC surface if surface and edge ARC havemore » low quality or through the cell edge if surface ARC has high quality but edge ARC is defective due to certain edge isolation process. In this study, two PID susceptible cells from two different manufacturers have been investigated. The QE measurements of these cells before and after PID stress were performed at both surface and edge. We observed the wavelength dependent QE loss only in the first manufacturer's cell but not in the second manufacturer's cell. The first manufacturer's cell appeared to have low quality ARC whereas the second manufacturer's cell appeared to have high quality ARC with defective edge. To rapidly screen a large number of cells for PID stress testing, a new but simple test setup that does not require laminated cell coupon has been developed and is used in this investigation.« less

  17. Educational paper

    PubMed Central

    de Vries, Esther

    2010-01-01

    Primary immunodeficiencies (PIDs) are characterized by an increased susceptibility to infections due to defects in one ore more components of the immune system. Although most PIDs are relatively rare, they are more frequent than generally acknowledged. Early diagnosis and treatment of PIDs save lives, prevent morbidity, and improve quality of life. This early diagnosis is the task of the pediatrician who encounters the child for the first time: he/she should suspect potential PID in time and perform the appropriate diagnostic tests. In this educational paper, the first in a series of five, we will describe the most common clinical presentations of PIDs and offer guidelines for the diagnostic process, as well as a brief overview of therapeutic possibilities and prognosis. PMID:21170549

  18. Dynamic PID loop control

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pei, L.; Klebaner, A.; Theilacker, J.

    2011-06-01

    The Horizontal Test Stand (HTS) SRF Cavity and Cryomodule 1 (CM1) of eight 9-cell, 1.3GHz SRF cavities are operating at Fermilab. For the cryogenic control system, how to hold liquid level constant in the cryostat by regulation of its Joule-Thompson JT-valve is very important after cryostat cool down to 2.0 K. The 72-cell cryostat liquid level response generally takes a long time delay after regulating its JT-valve; therefore, typical PID control loop should result in some cryostat parameter oscillations. This paper presents a type of PID parameter self-optimal and Time-Delay control method used to reduce cryogenic system parameters oscillation.

  19. Research on fuzzy PID control to electronic speed regulator

    NASA Astrophysics Data System (ADS)

    Xu, Xiao-gang; Chen, Xue-hui; Zheng, Sheng-guo

    2007-12-01

    As an important part of diesel engine, the speed regulator plays an important role in stabilizing speed and improving engine's performance. Because there are so many model parameters of diesel-engine considered in traditional PID control and these parameters present non-linear characteristic.The method to adjust engine speed using traditional PID is not considered as a best way. Especially for the diesel-engine generator set. In this paper, the Fuzzy PID control strategy is proposed. Some problems about its utilization in electronic speed regulator are discussed. A mathematical model of electric control system for diesel-engine generator set is established and the way of the PID parameters in the model to affect the function of system is analyzed. And then it is proposed the differential coefficient must be applied in control design for reducing dynamic deviation of system and adjusting time. Based on the control theory, a study combined control with PID calculation together for turning fuzzy PID parameter is implemented. And also a simulation experiment about electronic speed regulator system was conducted using Matlab/Simulink and the Fuzzy-Toolbox. Compared with the traditional PID Algorithm, the simulated results presented obvious improvements in the instantaneous speed governing rate and steady state speed governing rate of diesel-engine generator set when the fuzzy logic control strategy used.

  20. Parameters-tuning of PID controller for automatic voltage regulators using the African buffalo optimization.

    PubMed

    Odili, Julius Beneoluchi; Mohmad Kahar, Mohd Nizam; Noraziah, A

    2017-01-01

    In this paper, an attempt is made to apply the African Buffalo Optimization (ABO) to tune the parameters of a PID controller for an effective Automatic Voltage Regulator (AVR). Existing metaheuristic tuning methods have been proven to be quite successful but there were observable areas that need improvements especially in terms of the system's gain overshoot and steady steady state errors. Using the ABO algorithm where each buffalo location in the herd is a candidate solution to the Proportional-Integral-Derivative parameters was very helpful in addressing these two areas of concern. The encouraging results obtained from the simulation of the PID Controller parameters-tuning using the ABO when compared with the performance of Genetic Algorithm PID (GA-PID), Particle-Swarm Optimization PID (PSO-PID), Ant Colony Optimization PID (ACO-PID), PID, Bacteria-Foraging Optimization PID (BFO-PID) etc makes ABO-PID a good addition to solving PID Controller tuning problems using metaheuristics.

  1. Randomized Crossover Comparison of Personalized MPC and PID Control Algorithms for the Artificial Pancreas

    PubMed Central

    Pinsker, Jordan E.; Lee, Joon Bok; Dassau, Eyal; Seborg, Dale E.; Bradley, Paige K.; Gondhalekar, Ravi; Bevier, Wendy C.; Huyett, Lauren; Zisser, Howard C.; Doyle, Francis J.

    2016-01-01

    OBJECTIVE To evaluate two widely used control algorithms for an artificial pancreas (AP) under nonideal but comparable clinical conditions. RESEARCH DESIGN AND METHODS After a pilot safety and feasibility study (n = 10), closed-loop control (CLC) was evaluated in a randomized, crossover trial of 20 additional adults with type 1 diabetes. Personalized model predictive control (MPC) and proportional integral derivative (PID) algorithms were compared in supervised 27.5-h CLC sessions. Challenges included overnight control after a 65-g dinner, response to a 50-g breakfast, and response to an unannounced 65-g lunch. Boluses of announced dinner and breakfast meals were given at mealtime. The primary outcome was time in glucose range 70–180 mg/dL. RESULTS Mean time in range 70–180 mg/dL was greater for MPC than for PID (74.4 vs. 63.7%, P = 0.020). Mean glucose was also lower for MPC than PID during the entire trial duration (138 vs. 160 mg/dL, P = 0.012) and 5 h after the unannounced 65-g meal (181 vs. 220 mg/dL, P = 0.019). There was no significant difference in time with glucose <70 mg/dL throughout the trial period. CONCLUSIONS This first comprehensive study to compare MPC and PID control for the AP indicates that MPC performed particularly well, achieving nearly 75% time in the target range, including the unannounced meal. Although both forms of CLC provided safe and effective glucose management, MPC performed as well or better than PID in all metrics. PMID:27289127

  2. A novel primary immunodeficiency with specific natural-killer cell deficiency maps to the centromeric region of chromosome 8.

    PubMed

    Eidenschenk, Celine; Dunne, Jean; Jouanguy, Emmanuelle; Fourlinnie, Claire; Gineau, Laure; Bacq, Delphine; McMahon, Corrina; Smith, Owen; Casanova, Jean-Laurent; Abel, Laurent; Feighery, Conleth

    2006-04-01

    We describe four children with a novel primary immunodeficiency consisting of specific natural-killer (NK) cell deficiency and susceptibility to viral diseases. One child developed an Epstein-Barr virus-driven lymphoproliferative disorder; two others developed severe respiratory illnesses of probable viral etiology. The four patients are related and belong to a large inbred kindred of Irish nomadic descent, which suggests autosomal recessive inheritance of this defect. A genomewide scan identified a single 12-Mb region on chromosome 8p11.23-q11.21 that was linked to this immunodeficiency (maximum LOD score 4.51). The mapping of the disease-causing genomic region paves the way for the identification of a novel pathway governing NK cell differentiation in humans.

  3. Pelvic inflammatory disease (PID)

    MedlinePlus

    ... Names PID; Oophoritis; Salpingitis; Salpingo - oophoritis; Salpingo - peritonitis Images Pelvic laparoscopy Female reproductive anatomy Endometritis Uterus References McKinzie J. Sexually transmitted diseases. In: Walls RM, Hockberger RS, ...

  4. Model Free iPID Control for Glycemia Regulation of Type-1 Diabetes.

    PubMed

    MohammadRidha, Taghreed; Ait-Ahmed, Mourad; Chaillous, Lucy; Krempf, Michel; Guilhem, Isabelle; Poirier, Jean-Yves; Moog, Claude H

    2018-01-01

    The objective is to design a fully automated glycemia controller of Type-1 Diabetes (T1D) in both fasting and postprandial phases on a large number of virtual patients. A model-free intelligent proportional-integral-derivative (iPID) is used to infuse insulin. The feasibility of iPID is tested in silico on two simulators with and without measurement noise. The first simulator is derived from a long-term linear time-invariant model. The controller is also validated on the UVa/Padova metabolic simulator on 10 adults under 25 runs/subject for noise robustness test. It was shown that without measurement noise, iPID mimicked the normal pancreatic secretion with a relatively fast reaction to meals as compared to a standard PID. With the UVa/Padova simulator, the robustness against CGM noise was tested. A higher percentage of time in target was obtained with iPID as compared to standard PID with reduced time spent in hyperglycemia. Two different T1D simulators tests showed that iPID detects meals and reacts faster to meal perturbations as compared to a classic PID. The intelligent part turns the controller to be more aggressive immediately after meals without neglecting safety. Further research is suggested to improve the computation of the intelligent part of iPID for such systems under actuator constraints. Any improvement can impact the overall performance of the model-free controller. The simple structure iPID is a step for PID-like controllers since it combines the classic PID nice properties with new adaptive features.

  5. An Update on the Use of Immunomodulators in Primary Immunodeficiencies.

    PubMed

    Vignesh, Pandiarajan; Rawat, Amit; Singh, Surjit

    2017-04-01

    The genomic revolution in the past decade fuelled by breathtaking advances in sequencing technologies has defined several new genetic diseases of the immune system. Many of these newly characterized diseases are a result of defects in genes involved in immune regulation. The discovery of these diseases has opened a vista of new therapeutic possibilities. Immunomodulatory agents, a hitherto unexplored therapeutic option in primary immunodeficiency diseases have been tried in a host of these newly described maladies. These agents have been shown conclusively to favorably modulate immune responses, resulting in abatement of clinical manifestations both in experimental models and patients. While some of the treatment options have been approved for therapeutic use or have been shown to be of merit in open-label trials, others have been shown to be efficacious in a handful of clinical cases, animal models, and cell lines. Interferon γ is approved for use in chronic granulomatous disease (CGD) to reduce the burden of infection and and has a good long-term efficacy. Recombinant human IL7 therapy has been shown increase the peripheral CD4 and CD8 T cell counts in patients with idiopathic CD4. Anti-IL1 agents are approved for the management of cryopyrin-related autoinflammatory syndrome, and their therapeutic efficacy is being increasingly recognized in other autoinflammatory syndromes and CGD. Mammalian target of rapamycin (mTOR) inhibitors have been proven useful in autoimmune lymphoproliferative syndrome (ALPS) and in IPEX syndrome. Therapies reported to be potential use in case reports include abatacept in CTLA4 haploinsufficiency and LRBA deficiency, ruxolitinib in gain-of-function STAT1, tocilizumab in gain-of-function STAT3 defect, mTOR inhibitors in PIK3CD activation, magnesium in XMEN syndrome, and pioglitazone in CGD. Treatment options of merit in human cell lines include interferon α and interferon β in TLR3 and UNC-93B deficiencies, anti-interferon therapy in

  6. Mutation particle swarm optimization of the BP-PID controller for piezoelectric ceramics

    NASA Astrophysics Data System (ADS)

    Zheng, Huaqing; Jiang, Minlan

    2016-01-01

    PID control is the most common used method in industrial control because its structure is simple and it is easy to implement. PID controller has good control effect, now it has been widely used. However, PID method has a few limitations. The overshoot of the PID controller is very big. The adjustment time is long. When the parameters of controlled plant are changing over time, the parameters of controller could hardly change automatically to adjust to changing environment. Thus, it can't meet the demand of control quality in the process of controlling piezoelectric ceramic. In order to effectively control the piezoelectric ceramic and improve the control accuracy, this paper replaced the learning algorithm of the BP with the mutation particle swarm optimization algorithm(MPSO) on the process of the parameters setting of BP-PID. That designed a better self-adaptive controller which is combing the BP neural network based on mutation particle swarm optimization with the conventional PID control theory. This combination is called the MPSO-BP-PID. In the mechanism of the MPSO, the mutation operation is carried out with the fitness variance and the global best fitness value as the standard. That can overcome the precocious of the PSO and strengthen its global search ability. As a result, the MPSO-BP-PID can complete controlling the controlled plant with higher speed and accuracy. Therefore, the MPSO-BP-PID is applied to the piezoelectric ceramic. It can effectively overcome the hysteresis, nonlinearity of the piezoelectric ceramic. In the experiment, compared with BP-PID and PSO-BP-PID, it proved that MPSO is effective and the MPSO-BP-PID has stronger adaptability and robustness.

  7. Evaluation of the severe combined immunodeficient (SCID) mouse as an animal model for dengue viral infection.

    PubMed

    Wu, S J; Hayes, C G; Dubois, D R; Windheuser, M G; Kang, Y H; Watts, D M; Sieckmann, D G

    1995-05-01

    Severe combined immunodeficient (SCID) mice reconstituted with human peripheral blood lymphocytes (hu-PBL) were evaluated as an animal model for demonstrating dengue (DEN) viral infection. Reconstituted mice (hu-PBL-SCID) that demonstrated successful engraftment by the presence of serum titers of human immunoglobulin (Ig) were inoculated intraperitoneally with DEN virus serotype 1 (DEN-1). Serial blood samples were taken postinoculation and assayed for virus in C6/36 cells. The identity of all viral isolates was confirmed by an immunofluorescence antibody assay using DEN-1 monoclonal antibody. A total of six experiments were performed using different procedures of reconstitution and infection, and in three of these experiments, DEN-1 virus was recovered from the hu-PBL-SCID mice. In the first successful experiment, DEN-1 virus was recovered on postinoculation day (PID) 24 from blood, spleen, thymus, and lung tissues of one of eight hu-PBL-SCID mice. A second group of eight hu-PBL-SCID mice were inoculated with human monocytes infected in vitro with DEN-1 virus. Virus was recovered from the blood of mice between PID 15 and 23, and from lung tissue of one of these mice. In a third experiment, seven SCID mice were treated initially with anti-asialo GM1 antibody to eliminate natural killer cells, and then were injected simultaneously with a mixture of hu-PBL and DEN-1 virus. Virus was demonstrated in the blood of one mouse on PID 38, and in another mouse on PID 8, 12, 20, 24, and 36.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Primary simian immunodeficiency virus SIVmnd-2 infection in mandrills (Mandrillus sphinx).

    PubMed

    Onanga, Richard; Souquière, Sandrine; Makuwa, Maria; Mouinga-Ondeme, Augustin; Simon, François; Apetrei, Cristian; Roques, Pierre

    2006-04-01

    Mandrills are the only nonhuman primate (NHP) naturally infected by two types of simian immunodeficiency virus (SIV): SIVmnd-1 and SIVmnd-2. We have already reported that the high SIVmnd-1 replication during primary infection contrasts with only transient changes in CD4+ and CD8+ cell counts. Since early virus-host interactions predict viral control and disease progression in human immunodeficiency virus-infected patients, we investigated the dynamics of SIVmnd-2 primary infection in mandrills to examine the impact on immune effectors in blood and lymph nodes (LNs). To avoid in vitro strain selection, all mandrills in this study received plasma from SIVmnd-2-infected mandrills. SIVmnd-2 plasma viremia peaked at 10(7) to 10(8) RNA copies/ml between days 7 and 10. This peak was followed in all four monkeys by a decline in virus replication, with a set point level of 10(5) to 10(6) RNA copies/ml at day 42 postinfection (p.i.). Viral DNA load in PBMC and LNs also peaked between days 7 and 10 (10(5) to 10(6) DNA copies/10(6) cells) and stabilized at 10(3) to 10(4) DNA copies/10(6) cells during the chronic phase. Anti-SIVmnd-2 antibodies were detected starting from days 28 to 32. A transitory decline of CD3+ CD4+ cells in the LNs occurred in animals with high peak VLs. CD4+ and CD8+ T-cell activation in blood and LNs was noted between days 5 and 17 p.i., surrounding the peak of viral replication. This was most significant in the LNs. Activation markers then returned to preinfection values despite continuous and active viral replication during the chronic infection. The dynamics of SIVmnd-2 infection in mandrills showed a pattern similar to that of SIVmnd-1 infection. This might be a general feature of nonpathogenic SIV natural African NHP models.

  9. A Novel Primary Immunodeficiency with Specific Natural-Killer Cell Deficiency Maps to the Centromeric Region of Chromosome 8

    PubMed Central

    Eidenschenk, Céline; Dunne, Jean; Jouanguy, Emmanuelle; Fourlinnie, Claire; Gineau, Laure; Bacq, Delphine; McMahon, Corrina; Smith, Owen; Casanova, Jean-Laurent; Abel, Laurent; Feighery, Conleth

    2006-01-01

    We describe four children with a novel primary immunodeficiency consisting of specific natural-killer (NK) cell deficiency and susceptibility to viral diseases. One child developed an Epstein-Barr virus–driven lymphoproliferative disorder; two others developed severe respiratory illnesses of probable viral etiology. The four patients are related and belong to a large inbred kindred of Irish nomadic descent, which suggests autosomal recessive inheritance of this defect. A genomewide scan identified a single 12-Mb region on chromosome 8p11.23-q11.21 that was linked to this immunodeficiency (maximum LOD score 4.51). The mapping of the disease-causing genomic region paves the way for the identification of a novel pathway governing NK cell differentiation in humans. PMID:16532402

  10. Malaysia’s First Transplanted Case of Chronic Granulomatous Disease: The Journey of Overcoming Obstacles

    PubMed Central

    Ismail, Intan Hakimah; Jamli, Faizah Mohamed; Othman, Ida Shahnaz; Noh, Lokman Mohd; Abdul Latiff, Amir Hamzah

    2016-01-01

    The awareness of primary immunodeficiency (PID) in Malaysia is still not forthcoming. Certain practical issues such as lack of clinical immunologists and specialized laboratory diagnostic facilities remain to be addressed. However, great efforts taken by passionate clinicians and scientists in the immunology networking have ascertained some prevalence. Despite the limitation, all suspected cases of PID are being properly investigated and competently managed. In this case report we highlighted the obstacles we faced in managing PID patients, particularly preparing for bone marrow transplant. This is the first transplanted case of chronic granulomatous disease in Malaysia, which emphasizes the importance of collaborative work to ensure further morbidities or mortalities are prevented. PMID:27417247

  11. Malaysia's First Transplanted Case of Chronic Granulomatous Disease: The Journey of Overcoming Obstacles.

    PubMed

    Ismail, Intan Hakimah; Jamli, Faizah Mohamed; Othman, Ida Shahnaz; Noh, Lokman Mohd; Abdul Latiff, Amir Hamzah

    2016-05-17

    The awareness of primary immunodeficiency (PID) in Malaysia is still not forthcoming. Certain practical issues such as lack of clinical immunologists and specialized laboratory diagnostic facilities remain to be addressed. However, great efforts taken by passionate clinicians and scientists in the immunology networking have ascertained some prevalence. Despite the limitation, all suspected cases of PID are being properly investigated and competently managed. In this case report we highlighted the obstacles we faced in managing PID patients, particularly preparing for bone marrow transplant. This is the first transplanted case of chronic granulomatous disease in Malaysia, which emphasizes the importance of collaborative work to ensure further morbidities or mortalities are prevented.

  12. Thermostatic system of sensor in NIR spectrometer based on PID control

    NASA Astrophysics Data System (ADS)

    Wang, Zhihong; Qiao, Liwei; Ji, Xufei

    2016-11-01

    Aiming at the shortcomings of the primary sensor thermostatic control system in the near infrared (NIR) spectrometer, a novel thermostatic control system based on proportional-integral-derivative (PID) control technology was developed to improve the detection precision of the NIR spectrometer. There were five parts including bridge amplifier circuit, analog-digital conversion (ADC) circuit, microcontroller, digital-analog conversion (DAC) circuit and drive circuit in the system. The five parts formed a closed-loop control system based on PID algorithm that was used to control the error between the temperature calculated by the sampling data of ADC and the designed temperature to ensure the stability of the spectrometer's sensor. The experimental results show that, when the operating temperature of sensor is -11°, compared with the original system, the temperature control precision of the new control system is improved from ±0.64° to ±0.04° and the spectrum signal to noise ratio (SNR) is improved from 4891 to 5967.

  13. A novel auto-tuning PID control mechanism for nonlinear systems.

    PubMed

    Cetin, Meric; Iplikci, Serdar

    2015-09-01

    In this paper, a novel Runge-Kutta (RK) discretization-based model-predictive auto-tuning proportional-integral-derivative controller (RK-PID) is introduced for the control of continuous-time nonlinear systems. The parameters of the PID controller are tuned using RK model of the system through prediction error-square minimization where the predicted information of tracking error provides an enhanced tuning of the parameters. Based on the model-predictive control (MPC) approach, the proposed mechanism provides necessary PID parameter adaptations while generating additive correction terms to assist the initially inadequate PID controller. Efficiency of the proposed mechanism has been tested on two experimental real-time systems: an unstable single-input single-output (SISO) nonlinear magnetic-levitation system and a nonlinear multi-input multi-output (MIMO) liquid-level system. RK-PID has been compared to standard PID, standard nonlinear MPC (NMPC), RK-MPC and conventional sliding-mode control (SMC) methods in terms of control performance, robustness, computational complexity and design issue. The proposed mechanism exhibits acceptable tuning and control performance with very small steady-state tracking errors, and provides very short settling time for parameter convergence. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

  14. Interval type-2 fuzzy PID controller for uncertain nonlinear inverted pendulum system.

    PubMed

    El-Bardini, Mohammad; El-Nagar, Ahmad M

    2014-05-01

    In this paper, the interval type-2 fuzzy proportional-integral-derivative controller (IT2F-PID) is proposed for controlling an inverted pendulum on a cart system with an uncertain model. The proposed controller is designed using a new method of type-reduction that we have proposed, which is called the simplified type-reduction method. The proposed IT2F-PID controller is able to handle the effect of structure uncertainties due to the structure of the interval type-2 fuzzy logic system (IT2-FLS). The results of the proposed IT2F-PID controller using a new method of type-reduction are compared with the other proposed IT2F-PID controller using the uncertainty bound method and the type-1 fuzzy PID controller (T1F-PID). The simulation and practical results show that the performance of the proposed controller is significantly improved compared with the T1F-PID controller. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

  15. Longitudinal control of aircraft dynamics based on optimization of PID parameters

    NASA Astrophysics Data System (ADS)

    Deepa, S. N.; Sudha, G.

    2016-03-01

    Recent years many flight control systems and industries are employing PID controllers to improve the dynamic behavior of the characteristics. In this paper, PID controller is developed to improve the stability and performance of general aviation aircraft system. Designing the optimum PID controller parameters for a pitch control aircraft is important in expanding the flight safety envelope. Mathematical model is developed to describe the longitudinal pitch control of an aircraft. The PID controller is designed based on the dynamic modeling of an aircraft system. Different tuning methods namely Zeigler-Nichols method (ZN), Modified Zeigler-Nichols method, Tyreus-Luyben tuning, Astrom-Hagglund tuning methods are employed. The time domain specifications of different tuning methods are compared to obtain the optimum parameters value. The results prove that PID controller tuned by Zeigler-Nichols for aircraft pitch control dynamics is better in stability and performance in all conditions. Future research work of obtaining optimum PID controller parameters using artificial intelligence techniques should be carried out.

  16. Bidirectional active control of structures with type-2 fuzzy PD and PID

    NASA Astrophysics Data System (ADS)

    Paul, Satyam; Yu, Wen; Li, Xiaoou

    2018-03-01

    Proportional-derivative and proportional-integral-derivative (PD/PID) controllers are popular algorithms in structure vibration control. In order to maintain minimum regulation error, the PD/PID control require big proportional and derivative gains. The control performances are not satisfied because of the big uncertainties in the buildings. In this paper, type-2 fuzzy system is applied to compensate the unknown uncertainties, and is combined with the PD/PID control. We prove the stability of these fuzzy PD and PID controllers. The sufficient conditions can be used for choosing the gains of PD/PID. The theory results are verified by a two-storey building prototype. The experimental results validate our analysis.

  17. The ESID Online Database network.

    PubMed

    Guzman, D; Veit, D; Knerr, V; Kindle, G; Gathmann, B; Eades-Perner, A M; Grimbacher, B

    2007-03-01

    Primary immunodeficiencies (PIDs) belong to the group of rare diseases. The European Society for Immunodeficiencies (ESID), is establishing an innovative European patient and research database network for continuous long-term documentation of patients, in order to improve the diagnosis, classification, prognosis and therapy of PIDs. The ESID Online Database is a web-based system aimed at data storage, data entry, reporting and the import of pre-existing data sources in an enterprise business-to-business integration (B2B). The online database is based on Java 2 Enterprise System (J2EE) with high-standard security features, which comply with data protection laws and the demands of a modern research platform. The ESID Online Database is accessible via the official website (http://www.esid.org/). Supplementary data are available at Bioinformatics online.

  18. ? PID output-feedback control under event-triggered protocol

    NASA Astrophysics Data System (ADS)

    Zhao, Di; Wang, Zidong; Ding, Derui; Wei, Guoliang; Alsaadi, Fuad E.

    2018-07-01

    This paper is concerned with the ? proportional-integral-derivative (PID) output-feedback control problem for a class of linear discrete-time systems under event-triggered protocols. The controller and the actuators are connected through a communication network of limited bandwidth, and an event-triggered communication mechanism is adopted to decide when a certain control signal should be transmitted to the respective actuator. Furthermore, a novel PID output-feedback controller is designed where the accumulative sum-loop (the counterpart to the integral-loop in the continues-time setting) operates on a limited time-window with hope to mitigate the effect from the past measurement data. The main objective of the problem under consideration is to design a desired PID controller such that the closed-loop system is exponentially stable and the prescribed ? disturbance rejection attenuation level is guaranteed under event-triggered protocols. By means of the Lyapunov stability theory combined with the orthogonal decomposition, sufficient conditions are established under which the addressed PID controller design problem is recast into a linear convex optimization one that can be easily solved via available software packages. Finally, a simulation example is exploited to illustrate the usefulness and effectiveness of the established control scheme.

  19. Fuzzy PID control algorithm based on PSO and application in BLDC motor

    NASA Astrophysics Data System (ADS)

    Lin, Sen; Wang, Guanglong

    2017-06-01

    A fuzzy PID control algorithm is studied based on improved particle swarm optimization (PSO) to perform Brushless DC (BLDC) motor control which has high accuracy, good anti-jamming capability and steady state accuracy compared with traditional PID control. The mathematical and simulation model is established for BLDC motor by simulink software, and the speed loop of the fuzzy PID controller is designed. The simulation results show that the fuzzy PID control algorithm based on PSO has higher stability, high control precision and faster dynamic response speed.

  20. LMI designmethod for networked-based PID control

    NASA Astrophysics Data System (ADS)

    Souza, Fernando de Oliveira; Mozelli, Leonardo Amaral; de Oliveira, Maurício Carvalho; Palhares, Reinaldo Martinez

    2016-10-01

    In this paper, we propose a methodology for the design of networked PID controllers for second-order delayed processes using linear matrix inequalities. The proposed procedure takes into account time-varying delay on the plant, time-varying delays induced by the network and packed dropouts. The design is carried on entirely using a continuous-time model of the closed-loop system where time-varying delays are used to represent sampling and holding occurring in a discrete-time digital PID controller.

  1. Variable Structure PID Control to Prevent Integrator Windup

    NASA Technical Reports Server (NTRS)

    Hall, C. E.; Hodel, A. S.; Hung, J. Y.

    1999-01-01

    PID controllers are frequently used to control systems requiring zero steady-state error while maintaining requirements for settling time and robustness (gain/phase margins). PID controllers suffer significant loss of performance due to short-term integrator wind-up when used in systems with actuator saturation. We examine several existing and proposed methods for the prevention of integrator wind-up in both continuous and discrete time implementations.

  2. Droplet Digital PCR-Based Chimerism Analysis for Primary Immunodeficiency Diseases.

    PubMed

    Okano, Tsubasa; Tsujita, Yuki; Kanegane, Hirokazu; Mitsui-Sekinaka, Kanako; Tanita, Kay; Miyamoto, Satoshi; Yeh, Tzu-Wen; Yamashita, Motoi; Terada, Naomi; Ogura, Yumi; Takagi, Masatoshi; Imai, Kohsuke; Nonoyama, Shigeaki; Morio, Tomohiro

    2018-04-01

    In the current study, we aimed to accurately evaluate donor/recipient or male/female chimerism in samples from patients who underwent hematopoietic stem cell transplantation (HSCT). We designed the droplet digital polymerase chain reaction (ddPCR) for SRY and RPP30 to detect the male/female chimerism. We also developed mutation-specific ddPCR for four primary immunodeficiency diseases. The accuracy of the male/female chimerism analysis using ddPCR was confirmed by comparing the results with those of conventional methods (fluorescence in situ hybridization and short tandem repeat-PCR) and evaluating dilution assays. In particular, we found that this method was useful for analyzing small samples. Thus, this method could be used with patient samples, especially to sorted leukocyte subpopulations, during the early post-transplant period. Four mutation-specific ddPCR accurately detected post-transplant chimerism. ddPCR-based male/female chimerism analysis and mutation-specific ddPCR were useful for all HSCT, and these simple methods contribute to following the post-transplant chimerism, especially in disease-specific small leukocyte fractions.

  3. Non-fragile multivariable PID controller design via system augmentation

    NASA Astrophysics Data System (ADS)

    Liu, Jinrong; Lam, James; Shen, Mouquan; Shu, Zhan

    2017-07-01

    In this paper, the issue of designing non-fragile H∞ multivariable proportional-integral-derivative (PID) controllers with derivative filters is investigated. In order to obtain the controller gains, the original system is associated with an extended system such that the PID controller design can be formulated as a static output-feedback control problem. By taking the system augmentation approach, the conditions with slack matrices for solving the non-fragile H∞ multivariable PID controller gains are established. Based on the results, linear matrix inequality -based iterative algorithms are provided to compute the controller gains. Simulations are conducted to verify the effectiveness of the proposed approaches.

  4. Nonlethal, attenuated, transfusion-associated graft-versus-host disease in an immunocompromised child: case report and review of the literature.

    PubMed

    Neves, João F; Marques, António; Valente, Rosalina; Barata, Deolinda

    2010-11-01

    Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare complication of transfusion of nonirradiated blood components. It usually affects children in high-risk groups, including those who have primary immunodeficiencies (PIDs). It usually presents with skin, hepatic, digestive, and hematologic involvement and is normally fatal. We report the case of a nonlethal, attenuated, TA-GVHD in a 7-month-old boy. The disease was marked by the presence of a severe rash but lacked all the other usual manifestations. We speculate that the unusually benign course of this disease, which has normally a fulminant course, was due to the fact that this child was under high-dose corticotherapy at the time of the engraftment. This fortunate coincidence led to the survival of this child and allowed the diagnosis of a combined immunodeficiency. A high index of suspicion is required for the diagnosis and proper management of PID. The administration of nonirradiated blood components in the first year of life, sometimes before the clinical suspicion of a PID, is of great concern. TA-GVHD may be more prevalent than reported in the literature and it is possibly a nonidentified cause of death in recipients with unexplained death and nondiagnosed PID. © 2010 American Association of Blood Banks.

  5. Immunodeficiency-associated vaccine-derived poliovirus type 3 in infant, South Africa, 2011.

    PubMed

    Gumede, Nicksy; Muthambi, Vongani; Schoub, Barry D

    2012-06-01

    Patients with primary immunodeficiency are prone to persistently excrete Sabin-like virus after administration of live-attenuated oral polio vaccine and have an increased risk for vaccine-derived paralytic polio. We report a case of type 3 immunodeficiency-associated vaccine-derived poliovirus in a child in South Africa who was born with X-linked immunodeficiency syndrome.

  6. Investigating PID shunting in polycrystalline silicon modules via multiscale, multitechnique characterization

    DOE PAGES

    Harvey, Steven P.; Moseley, John; Norman, Andrew; ...

    2018-02-27

    We investigated the potential-induced degradation (PID) shunting mechanism in multicrystalline-silicon photovoltaic modules by using a multiscale, multitechnique characterization approach. Both field-stressed modules and laboratory-stressed mini modules were studied. We used photoluminescence, electroluminescence, and dark lock-in thermography imaging to identify degraded areas at the module scale. Small samples were then removed from degraded areas, laser marked, and imaged by scanning electron microscopy. We used simultaneous electron-beam induced current imaging and focused ion beam milling to mark around PID shunts for chemical analysis by time-of-flight secondary-ion mass spectrometry or to isolate individual shunt defects for transmission electron microscopy and atom-probe tomography analysis.more » By spanning a range of 10 orders of magnitude in size, this approach enabled us to investigate the root-cause mechanisms for PID shunting. We observed a direct correlation between recombination active shunts and sodium content. The sodium content in shunted areas peaks at the SiNX/Si interface and is consistently observed at a concentration of 0.1% to 2% in shunted areas. Analysis of samples subjected to PID recovery, either activated by electron beam or thermal effects only, reveals that recovery of isolated shunts correlates with diffusion of sodium out of the structural defects to the silicon surface. We observed the role of oxygen and chlorine in PID shunting and found that those species - although sometimes present in structural defects where PID shunting was observed - do not play a consistent role in PID shunting.« less

  7. A Novel Technique for Performing PID Susceptibility Screening during the Solar Cell Fabrication Process

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Oh, Jaewon; Dahal, Som; Dauksher, Bill

    2016-11-21

    Various characterization techniques have historically been developed in order to screen potential induced degradation (PID)-susceptible cells, but those techniques require final solar cells. We present a new characterization technique for screening PID-susceptible cells during the cell fabrication process. Illuminated Lock-In Thermography (ILIT) was used to image PID shunting of the cell without metallization and clearly showed PID-affected areas. PID-susceptible cells can be screened by ILIT, and the sample structure can advantageously be simplified as long as the sample has the silicon nitride antireflection coating and an aluminum back surface field.

  8. Design of sewage treatment system by applying fuzzy adaptive PID controller

    NASA Astrophysics Data System (ADS)

    Jin, Liang-Ping; Li, Hong-Chan

    2013-03-01

    In the sewage treatment system, the dissolved oxygen concentration control, due to its nonlinear, time-varying, large time delay and uncertainty, is difficult to establish the exact mathematical model. While the conventional PID controller only works with good linear not far from its operating point, it is difficult to realize the system control when the operating point far off. In order to solve the above problems, the paper proposed a method which combine fuzzy control with PID methods and designed a fuzzy adaptive PID controller based on S7-300 PLC .It employs fuzzy inference method to achieve the online tuning for PID parameters. The control algorithm by simulation and practical application show that the system has stronger robustness and better adaptability.

  9. PID-based error signal modeling

    NASA Astrophysics Data System (ADS)

    Yohannes, Tesfay

    1997-10-01

    This paper introduces a PID based signal error modeling. The error modeling is based on the betterment process. The resulting iterative learning algorithm is introduced and a detailed proof is provided for both linear and nonlinear systems.

  10. PID1 (NYGGF4), a new growth-inhibitory gene in embryonal brain tumors and gliomas

    PubMed Central

    Erdreich-Epstein, Anat; Robison, Nathan; Ren, Xiuhai; Zhou, Hong; Xu, Jingying; Davidson, Tom B.; Schur, Mathew; Gilles, Floyd H.; Ji, Lingyun; Malvar, Jemily; Shackleford, Gregory M.; Margol, Ashley S.; Krieger, Mark D.; Judkins, Alexander R.; Jones, David T.W.; Pfister, Stefan; Kool, Marcel; Sposto, Richard; Asgharazadeh, Shahab

    2014-01-01

    Purpose We present here the first report of PID1 (Phosphotyrosine Interaction Domain containing 1; NYGGF4) in cancer. PID1 was identified in 2006 as a gene that modulates insulin signaling and mitochondrial function in adipocytes and muscle cells. Experimental Design and Results Using four independent medulloblastoma datasets, we show that mean PID1 mRNA levels were lower in unfavorable medulloblastomas (Groups 3 and 4, and anaplastic histology) compared with favorable medulloblastomas (SHH and WNT groups, and desmoplastic/nodular histology) and with fetal cerebellum. In two large independent glioma datasets PID1 mRNA was lower in glioblastomas (GBMs), the most malignant gliomas, compared to other astrocytomas, oligodendrogliomas and non-tumor brains. Neural and proneural GBM subtypes had higher PID1 mRNA compared to classical and mesenchymal GBM. Importantly, overall survival and radiation-free progression-free survival were longer in medulloblastoma patients with higher PID1 mRNA (univariate and multivariate analyses). Higher PID1 mRNA also correlated with longer overall survival in glioma and GBM patients. In cell culture, overexpression of PID1 inhibited colony formation in medulloblastoma, atypical teratoid rhabdoid tumor (ATRT) and GBM cell lines. Increasing PID1 also increased cell death and apoptosis, inhibited proliferation, induced mitochondrial depolarization, and decreased serum-mediated phosphorylation of AKT and ERK in medulloblastoma, ATRT and/or GBM cell lines, whereas siRNA to PID1 diminished mitochondrial depolarization. Conclusions These data are the first to link PID1 to cancer and suggest that PID1 may have a tumor inhibitory function in these pediatric and adult brain tumors. PMID:24300787

  11. Management of first-episode pelvic inflammatory disease in primary care: results from a large UK primary care database.

    PubMed

    Nicholson, Amanda; Rait, Greta; Murray-Thomas, Tarita; Hughes, Gwenda; Mercer, Catherine H; Cassell, Jackie

    2010-10-01

    Prompt and effective treatment of pelvic inflammatory disease (PID) may help prevent long-term complications. Many PID cases are seen in primary care but it is not known how well management follows recommended guidelines. To estimate the incidence of first-episode PID cases seen in UK general practice, describe their management, and assess its adequacy in relation to existing guidelines. Cohort study. UK general practices contributing to the General Practice Research Database (GPRD). Women aged 15 to 40 years, consulting with a first episode of PID occurring between 30 June 2003 and 30 June 2008 were identified, based on the presence of a diagnostic code. The records within 28 days either side of the diagnosis date were analysed to describe management. A total of 3797 women with a first-ever coded diagnosis of PID were identified. Incidence fell during the study period from 19.3 to 8.9/10 000 person-years. Thirty-four per cent of cases had evidence of care elsewhere, while 2064 (56%) appeared to have been managed wholly within the practice. Of these 2064 women, 34% received recommended treatment including metronidazole, and 54% had had a Chlamydia trachomatis test, but only 16% received both. Management was more likely to follow guidelines in women in their 20s, and later in the study period. These analyses suggest that the management of PID in UK primary care, although improving, does not follow recommended guidelines for the majority of women. Further research is needed to understand the delivery of care in general practice and the coding of such complex syndromic conditions.

  12. Research on Potential Induced Degradation (PID) of PV Modules in Different Typical Climate Regions

    NASA Astrophysics Data System (ADS)

    Daoren, Gong; Yingnan, Chen; Gang, Sun; Wenjing, Wang; Zhenshuang, Ji

    2018-03-01

    Potential Induced Degradation (PID) is one of the most important factors effecting the performances of Photovoltaic (PV) modules and PV systems in recent years. In this paper the PID phenomena of the PV power plant in different typical climate regions were studied and some experimental PID simulations were carried out in order to find out the factors effecting the performance by PID. The results show that the typical PID phenomena are easy to occur in cells close to the border of the PV module. PID phenomena can appear in PV power plants under different climate conditions, but the effecting degrees on module performance are different depending on temperature, humidity and other parameters. We also find the maximum power would recover in some degree after positive-bias voltage duration.

  13. Design and implementation of a 2-DOF PID compensation for magnetic levitation systems.

    PubMed

    Ghosh, Arun; Rakesh Krishnan, T; Tejaswy, Pailla; Mandal, Abhisek; Pradhan, Jatin K; Ranasingh, Subhakant

    2014-07-01

    This paper employs a 2-DOF (degree of freedom) PID controller for compensating a physical magnetic levitation system. It is shown that because of having a feedforward gain in the proposed 2-DOF PID control, the transient performance of the compensated system can be changed in a desired manner unlike the conventional 1-DOF PID control. It is also shown that for a choice of PID parameters, although the theoretical loop robustness is the same for both the compensated systems, in real-time, 2-DOF PID control may provide superior robustness if a suitable choice of the feedforward parameter is made. The results are verified through simulations and experiments. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

  14. Epstein-Barr virus-associated primary central nervous system lymphoma in a child with the acquired immunodeficiency syndrome. A case report and review of the literature.

    PubMed

    Rodriguez, M M; Delgado, P I; Petito, C K

    1997-12-01

    A 34-month-old black boy who had contracted acquired immunodeficiency syndrome from his mother presented with fever, vomiting, and cough. He was cachectic, hypertonic, and developmentally delayed. A brain computed tomography scan revealed masses in the left frontal horn, subependymal, and periventricular regions; secondary edema; and hydrocephalus. The differential diagnosis was cerebral lymphoma versus toxoplasmosis. The patient had disseminated Mycobacterium avium-intracellulare infection, lymphoid interstitial pneumonitis, as well as Pseudomonas and Klebsiella pneumonia. He died of respiratory insufficiency 53 days after admission. The autopsy confirmed a primary cerebral B-cell lymphoma, large cell type, which was positive for Epstein-Barr virus, latent phase, by in situ hybridization. Primary central nervous system lymphomas are rare in children, in contrast to adults. To our knowledge, only five well-documented cases of primary cerebral lymphomas in infants and children with acquired immunodeficiency syndrome have been reported previously. The current study shows that these childhood lymphomas are associated with and presumably caused by Epstein-Barr virus and thus have a pathogenesis similar to that of primary central nervous system lymphomas in adults.

  15. The application of neural network PID controller to control the light gasoline etherification

    NASA Astrophysics Data System (ADS)

    Cheng, Huanxin; Zhang, Yimin; Kong, Lingling; Meng, Xiangyong

    2017-06-01

    Light gasoline etherification technology can effectively improve the quality of gasoline, which is environmental- friendly and economical. By combining BP neural network and PID control and using BP neural network self-learning ability for online parameter tuning, this method optimizes the parameters of PID controller and applies this to the Fcc gas flow control to achieve the control of the final product- heavy oil concentration. Finally, through MATLAB simulation, it is found that the PID control based on BP neural network has better controlling effect than traditional PID control.

  16. Optimization of PID Parameters Utilizing Variable Weight Grey-Taguchi Method and Particle Swarm Optimization

    NASA Astrophysics Data System (ADS)

    Azmi, Nur Iffah Mohamed; Arifin Mat Piah, Kamal; Yusoff, Wan Azhar Wan; Romlay, Fadhlur Rahman Mohd

    2018-03-01

    Controller that uses PID parameters requires a good tuning method in order to improve the control system performance. Tuning PID control method is divided into two namely the classical methods and the methods of artificial intelligence. Particle swarm optimization algorithm (PSO) is one of the artificial intelligence methods. Previously, researchers had integrated PSO algorithms in the PID parameter tuning process. This research aims to improve the PSO-PID tuning algorithms by integrating the tuning process with the Variable Weight Grey- Taguchi Design of Experiment (DOE) method. This is done by conducting the DOE on the two PSO optimizing parameters: the particle velocity limit and the weight distribution factor. Computer simulations and physical experiments were conducted by using the proposed PSO- PID with the Variable Weight Grey-Taguchi DOE and the classical Ziegler-Nichols methods. They are implemented on the hydraulic positioning system. Simulation results show that the proposed PSO-PID with the Variable Weight Grey-Taguchi DOE has reduced the rise time by 48.13% and settling time by 48.57% compared to the Ziegler-Nichols method. Furthermore, the physical experiment results also show that the proposed PSO-PID with the Variable Weight Grey-Taguchi DOE tuning method responds better than Ziegler-Nichols tuning. In conclusion, this research has improved the PSO-PID parameter by applying the PSO-PID algorithm together with the Variable Weight Grey-Taguchi DOE method as a tuning method in the hydraulic positioning system.

  17. Intelligent tuning method of PID parameters based on iterative learning control for atomic force microscopy.

    PubMed

    Liu, Hui; Li, Yingzi; Zhang, Yingxu; Chen, Yifu; Song, Zihang; Wang, Zhenyu; Zhang, Suoxin; Qian, Jianqiang

    2018-01-01

    Proportional-integral-derivative (PID) parameters play a vital role in the imaging process of an atomic force microscope (AFM). Traditional parameter tuning methods require a lot of manpower and it is difficult to set PID parameters in unattended working environments. In this manuscript, an intelligent tuning method of PID parameters based on iterative learning control is proposed to self-adjust PID parameters of the AFM according to the sample topography. This method gets enough information about the output signals of PID controller and tracking error, which will be used to calculate the proper PID parameters, by repeated line scanning until convergence before normal scanning to learn the topography. Subsequently, the appropriate PID parameters are obtained by fitting method and then applied to the normal scanning process. The feasibility of the method is demonstrated by the convergence analysis. Simulations and experimental results indicate that the proposed method can intelligently tune PID parameters of the AFM for imaging different topographies and thus achieve good tracking performance. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Neural Network-Based Self-Tuning PID Control for Underwater Vehicles

    PubMed Central

    Hernández-Alvarado, Rodrigo; García-Valdovinos, Luis Govinda; Salgado-Jiménez, Tomás; Gómez-Espinosa, Alfonso; Fonseca-Navarro, Fernando

    2016-01-01

    For decades, PID (Proportional + Integral + Derivative)-like controllers have been successfully used in academia and industry for many kinds of plants. This is thanks to its simplicity and suitable performance in linear or linearized plants, and under certain conditions, in nonlinear ones. A number of PID controller gains tuning approaches have been proposed in the literature in the last decades; most of them off-line techniques. However, in those cases wherein plants are subject to continuous parametric changes or external disturbances, online gains tuning is a desirable choice. This is the case of modular underwater ROVs (Remotely Operated Vehicles) where parameters (weight, buoyancy, added mass, among others) change according to the tool it is fitted with. In practice, some amount of time is dedicated to tune the PID gains of a ROV. Once the best set of gains has been achieved the ROV is ready to work. However, when the vehicle changes its tool or it is subject to ocean currents, its performance deteriorates since the fixed set of gains is no longer valid for the new conditions. Thus, an online PID gains tuning algorithm should be implemented to overcome this problem. In this paper, an auto-tune PID-like controller based on Neural Networks (NN) is proposed. The NN plays the role of automatically estimating the suitable set of PID gains that achieves stability of the system. The NN adjusts online the controller gains that attain the smaller position tracking error. Simulation results are given considering an underactuated 6 DOF (degrees of freedom) underwater ROV. Real time experiments on an underactuated mini ROV are conducted to show the effectiveness of the proposed scheme. PMID:27608018

  19. Neural Network-Based Self-Tuning PID Control for Underwater Vehicles.

    PubMed

    Hernández-Alvarado, Rodrigo; García-Valdovinos, Luis Govinda; Salgado-Jiménez, Tomás; Gómez-Espinosa, Alfonso; Fonseca-Navarro, Fernando

    2016-09-05

    For decades, PID (Proportional + Integral + Derivative)-like controllers have been successfully used in academia and industry for many kinds of plants. This is thanks to its simplicity and suitable performance in linear or linearized plants, and under certain conditions, in nonlinear ones. A number of PID controller gains tuning approaches have been proposed in the literature in the last decades; most of them off-line techniques. However, in those cases wherein plants are subject to continuous parametric changes or external disturbances, online gains tuning is a desirable choice. This is the case of modular underwater ROVs (Remotely Operated Vehicles) where parameters (weight, buoyancy, added mass, among others) change according to the tool it is fitted with. In practice, some amount of time is dedicated to tune the PID gains of a ROV. Once the best set of gains has been achieved the ROV is ready to work. However, when the vehicle changes its tool or it is subject to ocean currents, its performance deteriorates since the fixed set of gains is no longer valid for the new conditions. Thus, an online PID gains tuning algorithm should be implemented to overcome this problem. In this paper, an auto-tune PID-like controller based on Neural Networks (NN) is proposed. The NN plays the role of automatically estimating the suitable set of PID gains that achieves stability of the system. The NN adjusts online the controller gains that attain the smaller position tracking error. Simulation results are given considering an underactuated 6 DOF (degrees of freedom) underwater ROV. Real time experiments on an underactuated mini ROV are conducted to show the effectiveness of the proposed scheme.

  20. Attempted reconstitution of a foal with primary severe combined immunodeficiency.

    PubMed

    Campbell, T M; Studdert, M J; Ellis, W M; Paton, C M

    1983-07-01

    A foal with primary severe combined immunodeficiency, diagnosed within the first two weeks of life, was maintained with its dam in semi-isolation. The foal received continuous prophylactic antibiotic therapy, plasma from a sibling hyperimmunised with equine adenovirus vaccine, and intensive general nursing care. A full sibling female was selected as a bone marrow donor on the basis of red blood cell cross-matching and mixed lymphocyte reactions. Cyclophosphamide was given before two bone marrow transfusions at 35 and 73 days of age. To prevent graft versus host disease graft versus host disease the foal was maintained on methotrexate therapy. Reconstitution was not achieved nor were there signs of graft versus host disease. The foal died suddenly four days after the second bone marrow transfer when 77 days old. It had remained clinically free of any life threatening infectious disease and at necropsy a remarkable degree of freedom from infectious disease was confirmed. The most notable necropsy findings were bilateral nephrosis and myocardial degeneration and fibrosis. The likely cause of death was an electrolyte imbalance, particularly hypokalaemia, which secondarily affected the myocardium. Renal toxicity caused by the cytotoxic drugs, especially cyclophosphamide, may have contributed to the electrolyte imbalance.

  1. Monitoring System and Temperature Controlling on PID Based Poultry Hatching Incubator

    NASA Astrophysics Data System (ADS)

    Shafiudin, S.; Kholis, N.

    2018-04-01

    Poultry hatching cultivation is essential to be observed in terms of temperature stability by using artificial penetration incubator which applies On/Off control. The On/Off control produces relatively long response time to reach steady-state conditions. Moreover, how the system works makes the component worn out because the lamp is on-off periodically. Besides, the cultivation in the market is less suitable to be used in an environment which has fluctuating temperature because it may influence plant’s temperature stability. The study aims to design automatic poultry hatching cultivation that can repair the temperature’s response of plant incubator to keep stable and in line with the intended set-point temperature value by using PID controller. The method used in PID controlling is designed to identify plant using ARX (Auto Regressive eXogenous) MATLAB which is dynamic/non-linear to obtain mathematical model and PID constants value that is appropriate to system. The hardware design for PID-based egg incubator uses Arduino Uno R3, as the main controller that includes PID source, and PWM, to keep plant temperature stability, which is integrated with incandescent light actuators and sensors where DHTI 1 sensor as the reader as temperature condition and plant humidity. The result of the study showed that PID constants value of each plant is different. For parallel 15 Watt plant, Kp = 3.9956, Ki = 0.361, Kd = 0, while for parallel 25 Watt plant, the value of Kp = 5.714, Ki = 0.351, Kd = 0. The PID constants value were capable to produce stable system response which is based on set-point with steady state error’s value is around 5%, that is 2.7%. With hatching percentage of 70-80%, the hatching process is successful in air-conditioned environment (changeable).

  2. Robotic excavator trajectory control using an improved GA based PID controller

    NASA Astrophysics Data System (ADS)

    Feng, Hao; Yin, Chen-Bo; Weng, Wen-wen; Ma, Wei; Zhou, Jun-jing; Jia, Wen-hua; Zhang, Zi-li

    2018-05-01

    In order to achieve excellent trajectory tracking performances, an improved genetic algorithm (IGA) is presented to search for the optimal proportional-integral-derivative (PID) controller parameters for the robotic excavator. Firstly, the mathematical model of kinematic and electro-hydraulic proportional control system of the excavator are analyzed based on the mechanism modeling method. On this basis, the actual model of the electro-hydraulic proportional system are established by the identification experiment. Furthermore, the population, the fitness function, the crossover probability and mutation probability of the SGA are improved: the initial PID parameters are calculated by the Ziegler-Nichols (Z-N) tuning method and the initial population is generated near it; the fitness function is transformed to maintain the diversity of the population; the probability of crossover and mutation are adjusted automatically to avoid premature convergence. Moreover, a simulation study is carried out to evaluate the time response performance of the proposed controller, i.e., IGA based PID against the SGA and Z-N based PID controllers with a step signal. It was shown from the simulation study that the proposed controller provides the least rise time and settling time of 1.23 s and 1.81 s, respectively against the other tested controllers. Finally, two types of trajectories are designed to validate the performances of the control algorithms, and experiments are performed on the excavator trajectory control experimental platform. It was demonstrated from the experimental work that the proposed IGA based PID controller improves the trajectory accuracy of the horizontal line and slope line trajectories by 23.98% and 23.64%, respectively in comparison to the SGA tuned PID controller. The results further indicate that the proposed IGA tuning based PID controller is effective for improving the tracking accuracy, which may be employed in the trajectory control of an actual excavator.

  3. Fault tolerant control of multivariable processes using auto-tuning PID controller.

    PubMed

    Yu, Ding-Li; Chang, T K; Yu, Ding-Wen

    2005-02-01

    Fault tolerant control of dynamic processes is investigated in this paper using an auto-tuning PID controller. A fault tolerant control scheme is proposed composing an auto-tuning PID controller based on an adaptive neural network model. The model is trained online using the extended Kalman filter (EKF) algorithm to learn system post-fault dynamics. Based on this model, the PID controller adjusts its parameters to compensate the effects of the faults, so that the control performance is recovered from degradation. The auto-tuning algorithm for the PID controller is derived with the Lyapunov method and therefore, the model predicted tracking error is guaranteed to converge asymptotically. The method is applied to a simulated two-input two-output continuous stirred tank reactor (CSTR) with various faults, which demonstrate the applicability of the developed scheme to industrial processes.

  4. Total OH reactivity measurements using a new fast Gas Chromatographic Photo-Ionization Detector (GC-PID)

    NASA Astrophysics Data System (ADS)

    Nölscher, A. C.; Sinha, V.; Bockisch, S.; Klüpfel, T.; Williams, J.

    2012-12-01

    The primary and most important oxidant in the atmosphere is the hydroxyl radical (OH). Currently OH sinks, particularly gas phase reactions, are poorly constrained. One way to characterize the overall sink of OH is to measure directly the ambient loss rate of OH, the total OH reactivity. To date, direct measurements of total OH reactivity have been either performed using a Laser-Induced Fluorescence (LIF) system ("pump-and-probe" or "flow reactor") or the Comparative Reactivity Method (CRM) with a Proton-Transfer-Reaction Mass Spectrometer (PTR-MS). Both techniques require large, complex and expensive detection systems. This study presents a feasibility assessment for CRM total OH reactivity measurements using a new detector, a Gas Chromatographic Photoionization Detector (GC-PID). Such a system is smaller, more portable, less power consuming and less expensive than other total OH reactivity measurement techniques. Total OH reactivity is measured by the CRM using a competitive reaction between a reagent (here pyrrole) with OH alone and in the presence of atmospheric reactive molecules. The new CRM method for total OH reactivity has been tested with parallel measurements of the GC-PID and the previously validated PTR-MS as detector for the reagent pyrrole during laboratory experiments, plant chamber and boreal field studies. Excellent agreement of both detectors was found when the GC-PID was operated under optimum conditions. Time resolution (60-70 s), sensitivity (LOD 3-6 s-1) and overall uncertainty (25% in optimum conditions) for total OH reactivity were similar to PTR-MS based total OH reactivity measurements. One drawback of the GC-PID system was the steady loss of sensitivity and accuracy during intensive measurements lasting several weeks, and a possible toluene interference. Generally, the GC-PID system has been shown to produce closely comparable results to the PTR-MS and thus in suitable environments (e.g. forests) it presents a viably economical

  5. Evaluating the Genetics of Common Variable Immunodeficiency: Monogenetic Model and Beyond.

    PubMed

    de Valles-Ibáñez, Guillem; Esteve-Solé, Ana; Piquer, Mònica; González-Navarro, E Azucena; Hernandez-Rodriguez, Jessica; Laayouni, Hafid; González-Roca, Eva; Plaza-Martin, Ana María; Deyà-Martínez, Ángela; Martín-Nalda, Andrea; Martínez-Gallo, Mónica; García-Prat, Marina; Del Pino-Molina, Lucía; Cuscó, Ivón; Codina-Solà, Marta; Batlle-Masó, Laura; Solís-Moruno, Manuel; Marquès-Bonet, Tomàs; Bosch, Elena; López-Granados, Eduardo; Aróstegui, Juan Ignacio; Soler-Palacín, Pere; Colobran, Roger; Yagüe, Jordi; Alsina, Laia; Juan, Manel; Casals, Ferran

    2018-01-01

    Common variable immunodeficiency (CVID) is the most frequent symptomatic primary immunodeficiency characterized by recurrent infections, hypogammaglobulinemia and poor response to vaccines. Its diagnosis is made based on clinical and immunological criteria, after exclusion of other diseases that can cause similar phenotypes. Currently, less than 20% of cases of CVID have a known underlying genetic cause. We have analyzed whole-exome sequencing and copy number variants data of 36 children and adolescents diagnosed with CVID and healthy relatives to estimate the proportion of monogenic cases. We have replicated an association of CVID to p.C104R in TNFRSF13B and reported the second case of homozygous patient to date. Our results also identify five causative genetic variants in LRBA, CTLA4, NFKB1 , and PIK3R1 , as well as other very likely causative variants in PRKCD, MAPK8 , or DOCK8 among others. We experimentally validate the effect of the LRBA stop-gain mutation which abolishes protein production and downregulates the expression of CTLA4, and of the frameshift indel in CTLA4 producing expression downregulation of the protein. Our results indicate a monogenic origin of at least 15-24% of the CVID cases included in the study. The proportion of monogenic patients seems to be lower in CVID than in other PID that have also been analyzed by whole exome or targeted gene panels sequencing. Regardless of the exact proportion of CVID monogenic cases, other genetic models have to be considered for CVID. We propose that because of its prevalence and other features as intermediate penetrancies and phenotypic variation within families, CVID could fit with other more complex genetic scenarios. In particular, in this work, we explore the possibility of CVID being originated by an oligogenic model with the presence of heterozygous mutations in interacting proteins or by the accumulation of detrimental variants in particular immunological pathways, as well as perform association

  6. PSO-based PID Speed Control of Traveling Wave Ultrasonic Motor under Temperature Disturbance

    NASA Astrophysics Data System (ADS)

    Arifin Mat Piah, Kamal; Yusoff, Wan Azhar Wan; Azmi, Nur Iffah Mohamed; Romlay, Fadhlur Rahman Mohd

    2018-03-01

    Traveling wave ultrasonic motors (TWUSMs) have a time varying dynamics characteristics. Temperature rise in TWUSMs remains a problem particularly in sustaining optimum speed performance. In this study, a PID controller is used to control the speed of TWUSM under temperature disturbance. Prior to developing the controller, a linear approximation model which relates the speed to the temperature is developed based on the experimental data. Two tuning methods are used to determine PID parameters: conventional Ziegler-Nichols(ZN) and particle swarm optimization (PSO). The comparison of speed control performance between PSO-PID and ZN-PID is presented. Modelling, simulation and experimental work is carried out utilizing Fukoku-Shinsei USR60 as the chosen TWUSM. The results of the analyses and experimental work reveal that PID tuning using PSO-based optimization has the advantage over the conventional Ziegler-Nichols method.

  7. Quadrotor trajectory tracking using PID cascade control

    NASA Astrophysics Data System (ADS)

    Idres, M.; Mustapha, O.; Okasha, M.

    2017-12-01

    Quadrotors have been applied to collect information for traffic, weather monitoring, surveillance and aerial photography. In order to accomplish their mission, quadrotors have to follow specific trajectories. This paper presents proportional-integral-derivative (PID) cascade control of a quadrotor for path tracking problem when velocity and acceleration are small. It is based on near hover controller for small attitude angles. The integral of time-weighted absolute error (ITAE) criterion is used to determine the PID gains as a function of quadrotor modeling parameters. The controller is evaluated in three-dimensional environment in Simulink. Overall, the tracking performance is found to be excellent for small velocity condition.

  8. Enhanced pid vs model predictive control applied to bldc motor

    NASA Astrophysics Data System (ADS)

    Gaya, M. S.; Muhammad, Auwal; Aliyu Abdulkadir, Rabiu; Salim, S. N. S.; Madugu, I. S.; Tijjani, Aminu; Aminu Yusuf, Lukman; Dauda Umar, Ibrahim; Khairi, M. T. M.

    2018-01-01

    BrushLess Direct Current (BLDC) motor is a multivariable and highly complex nonlinear system. Variation of internal parameter values with environment or reference signal increases the difficulty in controlling the BLDC effectively. Advanced control strategies (like model predictive control) often have to be integrated to satisfy the control desires. Enhancing or proper tuning of a conventional algorithm results in achieving the desired performance. This paper presents a performance comparison of Enhanced PID and Model Predictive Control (MPC) applied to brushless direct current motor. The simulation results demonstrated that the PSO-PID is slightly better than the PID and MPC in tracking the trajectory of the reference signal. The proposed scheme could be useful algorithms for the system.

  9. Primary Immune Deficiencies – Principles of Care

    PubMed Central

    Chapel, Helen; Prevot, Johan; Gaspar, Hubert Bobby; Español, Teresa; Bonilla, Francisco A.; Solis, Leire; Drabwell, Josina

    2014-01-01

    Primary immune deficiencies (PIDs) are a growing group of over 230 different disorders caused by ineffective, absent or an increasing number of gain of function mutations in immune components, mainly cells and proteins. Once recognized, these rare disorders are treatable and in some cases curable. Otherwise untreated PIDs are often chronic, serious, or even fatal. The diagnosis of PIDs can be difficult due to lack of awareness or facilities for diagnosis, and management of PIDs is complex. This document was prepared by a worldwide multi-disciplinary team of specialists; it aims to set out comprehensive principles of care for PIDs. These include the role of specialized centers, the importance of registries, the need for multinational research, the role of patient organizations, management and treatment options, the requirement for sustained access to all treatments including immunoglobulin therapies and hematopoietic stem cell transplantation, important considerations for developing countries and suggestions for implementation. A range of healthcare policies and services have to be put into place by government agencies and healthcare providers, to ensure that PID patients worldwide have access to appropriate and sustainable medical and support services. PMID:25566243

  10. Cystic fibrosis, common variable immunodeficiency and Aspergers syndrome: an immunological and behavioural challenge.

    PubMed

    Chotirmall, S H; Low, T B; Hassan, T; Branagan, P; Kernekamp, C; Flynn, M G; Gunaratnam, C; McElvaney, N G

    2011-06-01

    Cystic fibrosis (CF) is of particular importance in Ireland as the Irish population has both the highest incidence (2.98/10,000) and the highest carrier rate (1 in 19) in the world. Primary immunodeficiency has not been previously reported as co-existing with CF. We report a unique case of CF associated with a primary immunodeficiency syndrome--common variable immunodeficiency (CVID). Our patient has CF, CVID and the additional comorbidity of Aspergers syndrome. The challenges inherent in diagnosing and treating such a case are outlined herein and the successful management of this case is evidenced by the well-preserved lung function of our patient.

  11. Exome sequencing analysis reveals variants in primary immunodeficiency genes in patients with very early onset inflammatory bowel disease.

    PubMed

    Kelsen, Judith R; Dawany, Noor; Moran, Christopher J; Petersen, Britt-Sabina; Sarmady, Mahdi; Sasson, Ariella; Pauly-Hubbard, Helen; Martinez, Alejandro; Maurer, Kelly; Soong, Joanne; Rappaport, Eric; Franke, Andre; Keller, Andreas; Winter, Harland S; Mamula, Petar; Piccoli, David; Artis, David; Sonnenberg, Gregory F; Daly, Mark; Sullivan, Kathleen E; Baldassano, Robert N; Devoto, Marcella

    2015-11-01

    Very early onset inflammatory bowel disease (VEO-IBD), IBD diagnosed at 5 years of age or younger, frequently presents with a different and more severe phenotype than older-onset IBD. We investigated whether patients with VEO-IBD carry rare or novel variants in genes associated with immunodeficiencies that might contribute to disease development. Patients with VEO-IBD and parents (when available) were recruited from the Children's Hospital of Philadelphia from March 2013 through July 2014. We analyzed DNA from 125 patients with VEO-IBD (age, 3 wk to 4 y) and 19 parents, 4 of whom also had IBD. Exome capture was performed by Agilent SureSelect V4, and sequencing was performed using the Illumina HiSeq platform. Alignment to human genome GRCh37 was achieved followed by postprocessing and variant calling. After functional annotation, candidate variants were analyzed for change in protein function, minor allele frequency less than 0.1%, and scaled combined annotation-dependent depletion scores of 10 or less. We focused on genes associated with primary immunodeficiencies and related pathways. An additional 210 exome samples from patients with pediatric IBD (n = 45) or adult-onset Crohn's disease (n = 20) and healthy individuals (controls, n = 145) were obtained from the University of Kiel, Germany, and used as control groups. Four hundred genes and regions associated with primary immunodeficiency, covering approximately 6500 coding exons totaling more than 1 Mbp of coding sequence, were selected from the whole-exome data. Our analysis showed novel and rare variants within these genes that could contribute to the development of VEO-IBD, including rare heterozygous missense variants in IL10RA and previously unidentified variants in MSH5 and CD19. In an exome sequence analysis of patients with VEO-IBD and their parents, we identified variants in genes that regulate B- and T-cell functions and could contribute to pathogenesis. Our analysis could lead to the

  12. Exome Sequencing Analysis Reveals Variants in Primary Immunodeficiency Genes in Patients With Very Early Onset Inflammatory Bowel Disease

    PubMed Central

    Kelsen, Judith R.; Dawany, Noor; Moran, Christopher J.; Petersen, Britt-Sabina; Sarmady, Mahdi; Sasson, Ariella; Pauly-Hubbard, Helen; Martinez, Alejandro; Maurer, Kelly; Soong, Joanne; Rappaport, Eric; Franke, Andre; Keller, Andreas; Winter, Harland S.; Mamula, Petar; Piccoli, David; Artis, David; Sonnenberg, Gregory F.; Daly, Mark; Sullivan, Kathleen E.; Baldassano, Robert N.; Devoto, Marcella

    2016-01-01

    Background & Aims Very early onset inflammatory bowel disease (VEO-IBD), IBD diagnosed ≤5 y of age, frequently presents with a different and more severe phenotype than older-onset IBD. We investigated whether patients with VEO-IBD carry rare or novel variants in genes associated with immunodeficiencies that might contribute to disease development. Methods Patients with VEO-IBD and parents (when available) were recruited from the Children's Hospital of Philadelphia from March 2013 through July 2014. We analyzed DNA from 125 patients with VEO-IBD (ages 3 weeks to 4 y) and 19 parents, 4 of whom also had IBD. Exome capture was performed by Agilent SureSelect V4, and sequencing was performed using the Illumina HiSeq platform. Alignment to human genome GRCh37 was achieved followed by post-processing and variant calling. Following functional annotation, candidate variants were analyzed for change in protein function, minor allele frequency <0.1%, and scaled combined annotation dependent depletion scores ≤10. We focused on genes associated with primary immunodeficiencies and related pathways. An additional 210 exome samples from patients with pediatric IBD (n=45) or adult-onset Crohn's disease (n=20) and healthy individuals (controls, n=145) were obtained from the University of Kiel, Germany and used as control groups. Results Four-hundred genes and regions associated with primary immunodeficiency, covering approximately 6500 coding exons totaling > 1 Mbp of coding sequence, were selected from the whole exome data. Our analysis revealed novel and rare variants within these genes that could contribute to the development of VEO-IBD, including rare heterozygous missense variants in IL10RA and previously unidentified variants in MSH5 and CD19. Conclusions In an exome sequence analysis of patients with VEO-IBD and their parents, we identified variants in genes that regulate B- and T-cell functions and could contribute to pathogenesis. Our analysis could lead to the

  13. Method study on fuzzy-PID adaptive control of electric-hydraulic hitch system

    NASA Astrophysics Data System (ADS)

    Li, Mingsheng; Wang, Liubu; Liu, Jian; Ye, Jin

    2017-03-01

    In this paper, fuzzy-PID adaptive control method is applied to the control of tractor electric-hydraulic hitch system. According to the characteristics of the system, a fuzzy-PID adaptive controller is designed and the electric-hydraulic hitch system model is established. Traction control and position control performance simulation are carried out with the common PID control method. A field test rig was set up to test the electric-hydraulic hitch system. The test results showed that, after the fuzzy-PID adaptive control is adopted, when the tillage depth steps from 0.1m to 0.3m, the system transition process time is 4s, without overshoot, and when the tractive force steps from 3000N to 7000N, the system transition process time is 5s, the system overshoot is 25%.

  14. PID techniques: Alternatives to RICH methods

    DOE PAGES

    Va’vra, J.

    2017-07-05

    Here, in this review article we discuss new updates on PID techniques, other than the Cherenkov method. In particular, we discuss recent efforts to develop high resolution timing, placing an emphasis on small scale test results.

  15. Mitigation of PID in commercial PV modules using current interruption method

    NASA Astrophysics Data System (ADS)

    Bora, Birinchi; Oh, Jaewon; Tatapudi, Sai; Sastry, Oruganty S.; Kumar, Rajesh; Prasad, Basudev; Tamizhmani, Govindasamy

    2017-08-01

    Potential-induced degradation (PID) is known to have a very severe effect on the reliability of PV modules. PID is caused due to the leakage of current from the cell circuit to the grounded frame under humid conditions of high voltage photovoltaic (PV) systems. There are multiple paths for the current leakage. The most dominant leakage path is from the cell to the frame through encapsulant, glass bulk and glass surface. This dominant path can be prevented by interrupting the electrical conductivity at the glass surface. In our previous works related to this topic, we demonstrated the effectiveness of glass surface conductivity interruption technique using one-cell PV coupons. In this work, we demonstrate the effectiveness of this technique using a full size commercial module susceptible to PID. The interruption of surface conductivity of the commercial module was achieved by attaching a narrow, thin flexible glass strips, from Corning, called Willow Glass on the glass surface along the inner edges of the frame. The flexible glass strip was attached to the module glass surface by heating the glass strip with an ionomer adhesive underneath using a handheld heat gun. The PID stress test was performed at 60°C and 85% RH for 96 hours at -600 V. Pre- and post-PID characterizations including I-V and electroluminescence were carried out to determine the performance loss and affected cell areas. This work demonstrates that the PID issue can be effectively addressed by using this current interruption technique. An important benefit of this approach is that this interruption technique can be applied after manufacturing the modules and after installing the modules in the field as well.

  16. A uniform LMI formulation for tuning PID, multi-term fractional-order PID, and Tilt-Integral-Derivative (TID) for integer and fractional-order processes.

    PubMed

    Merrikh-Bayat, Farshad

    2017-05-01

    In this paper first the Multi-term Fractional-Order PID (MFOPID) whose transfer function is equal to [Formula: see text] , where k j and α j are unknown and known real parameters respectively, is introduced. Without any loss of generality, a special form of MFOPID with transfer function k p +k i /s+k d1 s+k d2 s μ where k p , k i , k d1 , and k d2 are unknown real and μ is a known positive real parameter, is considered. Similar to PID and TID, MFOPID is also linear in its parameters which makes it possible to study all of them in a same framework. Tuning the parameters of PID, TID, and MFOPID based on loop shaping using Linear Matrix Inequalities (LMIs) is discussed. For this purpose separate LMIs for closed-loop stability (of sufficient type) and adjusting different aspects of the open-loop frequency response are developed. The proposed LMIs for stability are obtained based on the Nyquist stability theorem and can be applied to both integer and fractional-order (not necessarily commensurate) processes which are either stable or have one unstable pole. Numerical simulations show that the performance of the four-variable MFOPID can compete the trivial five-variable FOPID and often excels PID and TID. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  17. IUD users may have higher risk of contracting PID, studies find; pill may have protective effect.

    PubMed

    1980-01-01

    The incidence of pelvic inflammatory disease (PID), which can lead to serious reproductive impairment, infertility, or ectopic pregnancy, is increasing worldwide. About 500,000 women in their childbearing years contract PID for the first time each year in the U.S., and the incidence among young women appears to be increasing. Sexually transmitted diseases are responsible for many PID cases worldwide, while in developing countries postpartum and postabortion sepsis and endemic diseases such as filariasis and schistosomiasis may also be implicated. Some increase of PID is associated with legal abortion and IUD insertion, while pill use appears to protect women from PID. A worldwide review of medical literature indicates that the risk of PID is 3.5 times greater for IUD users than for nonusers, although several variables other than IUD use affect PID risk, such as age, race, socioeconomic status, and sexual activity. The risk for never pregnant IUD users in a Swedish study was 11.8 per 100 woman years, compared to 3.4 for ever-pregnant IUD users. There was no difference in relative risk for users of the pill or barrier methods, or for non-contraceptors. Another study reported a higher relative risk of PID related to duration of IUD use.

  18. A Method for Precision Closed-Loop Irrigation Using a Modified PID Control Algorithm

    NASA Astrophysics Data System (ADS)

    Goodchild, Martin; Kühn, Karl; Jenkins, Malcolm; Burek, Kazimierz; Dutton, Andrew

    2016-04-01

    The benefits of closed-loop irrigation control have been demonstrated in grower trials which show the potential for improved crop yields and resource usage. Managing water use by controlling irrigation in response to soil moisture changes to meet crop water demands is a popular approach but requires knowledge of closed-loop control practice. In theory, to obtain precise closed-loop control of a system it is necessary to characterise every component in the control loop to derive the appropriate controller parameters, i.e. proportional, integral & derivative (PID) parameters in a classic PID controller. In practice this is often difficult to achieve. Empirical methods are employed to estimate the PID parameters by observing how the system performs under open-loop conditions. In this paper we present a modified PID controller, with a constrained integral function, that delivers excellent regulation of soil moisture by supplying the appropriate amount of water to meet the needs of the plant during the diurnal cycle. Furthermore, the modified PID controller responds quickly to changes in environmental conditions, including rainfall events which can result in: controller windup, under-watering and plant stress conditions. The experimental work successfully demonstrates the functionality of a constrained integral PID controller that delivers robust and precise irrigation control. Coir substrate strawberry growing trial data is also presented illustrating soil moisture control and the ability to match water deliver to solar radiation.

  19. Design and development of the Macpherson Proton Preve Magneto rheological damper with PID controller

    NASA Astrophysics Data System (ADS)

    Amiruddin, I. M.; Pauziah, M.; Aminudin, A.; Unuh, M. H.

    2017-10-01

    Since the creation of the first petrol-fuelled vehicle by Karl Benz in the late nineteenth century, car industry has grown considerably to meet the industrial demands. Luxurious looks and agreeable rides are the primary needs of drivers. The Magneto-rheological damper balanced their damping trademark progressively by applying the damping coefficient depending on the control system. In this research, the control calculations are assessed by utilizing the MR damper. The capacity and reliably of the target force for the damper speed is investigated from control algorithm. This is imperative to defeat the damper limitation. In this study, the simulation results of the semi-dynamic MR damper with the PID controller shows better performance in sprung mass acceleration, unsprung mass acceleration and suspension dislodging with permitting over the top tyre acceleration. The altered model of the MR damper is specially designed for Proton Preve specifications and semi-active PID control. The procedure for the advancement incorporates the numerical model to graphically recreate and break down the dynamic framework by utilizing Matlab.

  20. Comparative study of a learning fuzzy PID controller and a self-tuning controller.

    PubMed

    Kazemian, H B

    2001-01-01

    The self-organising fuzzy controller is an extension of the rule-based fuzzy controller with an additional learning capability. The self-organising fuzzy (SOF) is used as a master controller to readjust conventional PID gains at the actuator level during the system operation, copying the experience of a human operator. The application of the self-organising fuzzy PID (SOF-PID) controller to a 2-link non-linear revolute-joint robot-arm is studied using path tracking trajectories at the setpoint. For the purpose of comparison, the same experiments are repeated by using the self-tuning controller subject to the same data supplied at the setpoint. For the path tracking experiments, the output trajectories of the SOF-PID controller followed the specified path closer and smoother than the self-tuning controller.

  1. Design of a self-adaptive fuzzy PID controller for piezoelectric ceramics micro-displacement system

    NASA Astrophysics Data System (ADS)

    Zhang, Shuang; Zhong, Yuning; Xu, Zhongbao

    2008-12-01

    In order to improve control precision of the piezoelectric ceramics (PZT) micro-displacement system, a self-adaptive fuzzy Proportional Integration Differential (PID) controller is designed based on the traditional digital PID controller combining with fuzzy control. The arithmetic gives a fuzzy control rule table with the fuzzy control rule and fuzzy reasoning, through this table, the PID parameters can be adjusted online in real time control. Furthermore, the automatic selective control is achieved according to the change of the error. The controller combines the good dynamic capability of the fuzzy control and the high stable precision of the PID control, adopts the method of using fuzzy control and PID control in different segments of time. In the initial and middle stage of the transition process of system, that is, when the error is larger than the value, fuzzy control is used to adjust control variable. It makes full use of the fast response of the fuzzy control. And when the error is smaller than the value, the system is about to be in the steady state, PID control is adopted to eliminate static error. The problems of PZT existing in the field of precise positioning are overcome. The results of the experiments prove that the project is correct and practicable.

  2. Adaptive PID formation control of nonholonomic robots without leader's velocity information.

    PubMed

    Shen, Dongbin; Sun, Weijie; Sun, Zhendong

    2014-03-01

    This paper proposes an adaptive proportional integral derivative (PID) algorithm to solve a formation control problem in the leader-follower framework where the leader robot's velocities are unknown for the follower robots. The main idea is first to design some proper ideal control law for the formation system to obtain a required performance, and then to propose the adaptive PID methodology to approach the ideal controller. As a result, the formation is achieved with much more enhanced robust formation performance. The stability of the closed-loop system is theoretically proved by Lyapunov method. Both numerical simulations and physical vehicle experiments are presented to verify the effectiveness of the proposed adaptive PID algorithm. Copyright © 2013 ISA. Published by Elsevier Ltd. All rights reserved.

  3. Primary intestinal lymphangiectasia in an elderly female patient: A case report on a rare cause of secondary immunodeficiency.

    PubMed

    Huber, Xaver; Degen, Lukas; Muenst, Simone; Trendelenburg, Marten

    2017-08-01

    Protein loss via the gut can be caused by a number of gastrointestinal disorders, among which intestinal lymphangiectasia has been described to not only lead to a loss of proteins but also to a loss of lymphocytes, resembling secondary immunodeficiency. We are reporting on a 75-year-old female patient who came to our hospital because of a minor stroke. She had no history of serious infections. During the diagnostic work-up, we detected an apparent immunodeficiency syndrome associated with primary intestinal lymphangiectasia. Trying to characterize the alterations of the immune system, we not only found hypogammaglobulinemia and lymphopenia primarily affecting CD4+, and also CD8+ T cells, but also marked hypocomplementemia affecting levels of complement C4, C2, and C3. The loss of components of the immune system most likely was due to a chronic loss of immune cells and proteins via the intestinal lymphangiectasia, with levels of complement components following the pattern of protein electrophoresis. Thus, intestinal lymphangiectasia should not only be considered as a potential cause of secondary immune defects in an elderly patient, but can also be associated with additional hypocomplementemia.

  4. Simultaneous gains tuning in boiler/turbine PID-based controller clusters using iterative feedback tuning methodology.

    PubMed

    Zhang, Shu; Taft, Cyrus W; Bentsman, Joseph; Hussey, Aaron; Petrus, Bryan

    2012-09-01

    Tuning a complex multi-loop PID based control system requires considerable experience. In today's power industry the number of available qualified tuners is dwindling and there is a great need for better tuning tools to maintain and improve the performance of complex multivariable processes. Multi-loop PID tuning is the procedure for the online tuning of a cluster of PID controllers operating in a closed loop with a multivariable process. This paper presents the first application of the simultaneous tuning technique to the multi-input-multi-output (MIMO) PID based nonlinear controller in the power plant control context, with the closed-loop system consisting of a MIMO nonlinear boiler/turbine model and a nonlinear cluster of six PID-type controllers. Although simplified, the dynamics and cross-coupling of the process and the PID cluster are similar to those used in a real power plant. The particular technique selected, iterative feedback tuning (IFT), utilizes the linearized version of the PID cluster for signal conditioning, but the data collection and tuning is carried out on the full nonlinear closed-loop system. Based on the figure of merit for the control system performance, the IFT is shown to deliver performance favorably comparable to that attained through the empirical tuning carried out by an experienced control engineer. Copyright © 2012 ISA. Published by Elsevier Ltd. All rights reserved.

  5. Chronic active Epstein-Barr virus infection as the initial symptom in a Janus kinase 3 deficiency child: Case report and literature review.

    PubMed

    Zhong, Linqing; Wang, Wei; Ma, Mingsheng; Gou, Lijuan; Tang, Xiaoyan; Song, Hongmei

    2017-10-01

    With the progress of sequencing technology, an increasing number of atypical primary immunodeficiency (PID) patients have been discovered, including Janus kinase 3 (JAK3) gene deficiency. We report a patient who presented with chronic active Epstein-Barr virus (CAEBV) infection but responded poorly to treatment with ganciclovir. Next-generation sequencing (NGS) was performed, including all known PID genes, after which Sanger sequencing was performed to verify the results. Genetic analysis revealed that our patient had 2 novel compound heterozygous mutations of JAK3, a gene previously reported to cause a rare form of autosomal recessive severe combined immunodeficiency with recurrent infections. The p.H27Q mutation came from his father, while p. R222H from his mother. Thus, his diagnosis was corrected for JAK3-deficiency PID and CAEBV. Maintenance treatment of subcutaneous injection of recombinant human interferon α-2a was given to our patient with 2 MU, 3 times a week. Interferon alpha was applied and the EBV infection was gradually controlled and his symptoms ameliorated remarkably. Our patient is in good health now and did not have relapses. The diagnoses of PID should be taken into consideration when CAEBV patients respond poorly to conventional treatments. Good results of our patient indicate that interferon α-2a may be an alternative treatment for those who are unwilling to accept hematopoietic stem cell transplantation (HSCT) like our patient. Literature review identified 59 additional cases of JAK3 deficiency with various infections.

  6. Fractional order PID controller for improvement of PMSM speed control in aerospace applications

    NASA Astrophysics Data System (ADS)

    Saraji, Ali Motalebi; Ghanbari, Mahmood

    2014-12-01

    Because of the benefits reduced size, cost and maintenance, noise, CO2 emissions and increased control flexibility and precision, to meet these expectations, electrical equipment increasingly utilize in modern aircraft systems and aerospace industry rather than conventional mechanic, hydraulic, and pneumatic power systems. Electric motor drives are capable of converting electrical power to drive actuators, pumps, compressors, and other subsystems at variable speeds. In the past decades, permanent magnet synchronous motor (PMSM) and brushless dc (BLDC) motor were investigated for aerospace applications such as aircraft actuators. In this paper, the fractional-order PID controller is used in the design of speed loop of PMSM speed control system. Having more parameters for tuning fractional order PID controller lead to good performance ratio to integer order. This good performance is shown by comparison fractional order PID controller with the conventional PI and tuned PID controller by Genetic algorithm in MATLAB soft wear.

  7. A new method for total OH reactivity measurements using a fast Gas Chromatographic Photo-Ionization Detector (GC-PID)

    NASA Astrophysics Data System (ADS)

    Nölscher, A. C.; Sinha, V.; Bockisch, S.; Klüpfel, T.; Williams, J.

    2012-05-01

    The primary and most important oxidant in the atmosphere is the hydroxyl radical (OH). Currently OH sinks, particularly gas phase reactions, are poorly constrained. One way to characterize the overall sink of OH is to measure directly the ambient loss rate of OH, the total OH reactivity. To date direct measurements of total OH reactivity have been either performed using a Laser Induced Fluorescence (LIF) system ("pump-and-probe" or "flow reactor") or the Comparative Reactivity Method (CRM) with a Proton Transfer Reaction Mass Spectrometer (PTR-MS). Both techniques require large, complex and expensive detection systems. This study presents a feasibility assessment for CRM total OH reactivity measurements using a new detector, a Gas Chromatographic Photo-Ionization Detector (GC-PID). Such a system is smaller, more portable, less power consuming and less expensive than other total OH reactivity measurement techniques. Total OH reactivity is measured by the CRM using a competitive reaction between a reagent (here pyrrole) with OH alone and in the presence of atmospheric reactive molecules. The new CRM method for total OH reactivity has been tested with parallel measurements of the GC-PID and the previously validated PTR-MS as detector for the reagent pyrrole during laboratory experiments, plant chamber and boreal field studies. Excellent agreement of both detectors was found when the GC-PID was operated under optimum conditions. Time resolution (60-70 s), sensitivity (LOD 3-6 s-1) and overall uncertainty (25% in optimum conditions) for total OH reactivity were equivalent to PTR-MS based total OH reactivity measurements. One drawback of the GC-PID system was the steady loss of sensitivity and accuracy during intensive measurements lasting several weeks, and a possible toluene interference. Generally, the GC-PID system has been shown to produce closely comparable results to the PTR-MS and thus in suitable environments (e.g. forests) it presents a viably economical

  8. Recursion-based depletion of human immunodeficiency virus-specific naive CD4(+) T cells may facilitate persistent viral replication and chronic viraemia leading to acquired immunodeficiency syndrome.

    PubMed

    Tsukamoto, Tetsuo; Yamamoto, Hiroyuki; Okada, Seiji; Matano, Tetsuro

    2016-09-01

    Although antiretroviral therapy has made human immunodeficiency virus (HIV) infection a controllable disease, it is still unclear how viral replication persists in untreated patients and causes CD4(+) T-cell depletion leading to acquired immunodeficiency syndrome (AIDS) in several years. Theorists tried to explain it with the diversity threshold theory in which accumulated mutations in the HIV genome make the virus so diverse that the immune system will no longer be able to recognize all the variants and fail to control the viraemia. Although the theory could apply to a number of cases, macaque AIDS models using simian immunodeficiency virus (SIV) have shown that failed viral control at the set point is not always associated with T-cell escape mutations. Moreover, even monkeys without a protective major histocompatibility complex (MHC) allele can contain replication of a super infected SIV following immunization with a live-attenuated SIV vaccine, while those animals are not capable of fighting primary SIV infection. Here we propose a recursion-based virus-specific naive CD4(+) T-cell depletion hypothesis through thinking on what may happen in individuals experiencing primary immunodeficiency virus infection. This could explain the mechanism for impairment of virus-specific immune response in the course of HIV infection. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Single-Particle Tracking of Human Immunodeficiency Virus Type 1 Productive Entry into Human Primary Macrophages.

    PubMed

    Li, Qin; Li, Wei; Yin, Wen; Guo, Jia; Zhang, Zhi-Ping; Zeng, Dejun; Zhang, Xiaowei; Wu, Yuntao; Zhang, Xian-En; Cui, Zongqiang

    2017-04-25

    Macrophages are one of the major targets of human immunodeficiency virus (HIV-1), but the viral entry pathway remains poorly understood in these cells. Noninvasive virus labeling and single-virus tracking are effective tools for studying virus entry. Here, we constructed a quantum dot (QD)-encapsulated infectious HIV-1 particle to track viral entry at a single-particle level in live human primary macrophages. QDs were encapsulated in HIV-1 virions by incorporating viral accessory protein Vpr-conjugated QDs during virus assembly. With the HIV-1 particles encapsulating QDs, we monitored the early phase of viral infection in real time and observed that, during infection, HIV-1 was endocytosed in a clathrin-mediated manner; the particles were translocated into Rab5A-positive endosomes, and the core was released into the cytoplasm by viral envelope-mediated endosomal fusion. Drug inhibition assays verified that endosome fusion contributes to HIV-1 productive infection in primary macrophages. Additionally, we observed that a dynamic actin cytoskeleton is critical for HIV-1 entry and intracellular migration in primary macrophages. HIV-1 dynamics and infection could be blocked by multiple different actin inhibitors. Our study revealed a productive entry pathway in macrophages that requires both endosomal function and actin dynamics, which may assist in the development of inhibitors to block the HIV entry in macrophages.

  10. Fractional order PID controller for improvement of PMSM speed control in aerospace applications

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Saraji, Ali Motalebi; Ghanbari, Mahmood

    Because of the benefits reduced size, cost and maintenance, noise, CO2 emissions and increased control flexibility and precision, to meet these expectations, electrical equipment increasingly utilize in modern aircraft systems and aerospace industry rather than conventional mechanic, hydraulic, and pneumatic power systems. Electric motor drives are capable of converting electrical power to drive actuators, pumps, compressors, and other subsystems at variable speeds. In the past decades, permanent magnet synchronous motor (PMSM) and brushless dc (BLDC) motor were investigated for aerospace applications such as aircraft actuators. In this paper, the fractional-order PID controller is used in the design of speed loopmore » of PMSM speed control system. Having more parameters for tuning fractional order PID controller lead to good performance ratio to integer order. This good performance is shown by comparison fractional order PID controller with the conventional PI and tuned PID controller by Genetic algorithm in MATLAB soft wear.« less

  11. Tunning PID controller using particle swarm optimization algorithm on automatic voltage regulator system

    NASA Astrophysics Data System (ADS)

    Aranza, M. F.; Kustija, J.; Trisno, B.; Hakim, D. L.

    2016-04-01

    PID Controller (Proportional Integral Derivative) was invented since 1910, but till today still is used in industries, even though there are many kind of modern controllers like fuzz controller and neural network controller are being developed. Performance of PID controller is depend on on Proportional Gain (Kp), Integral Gain (Ki) and Derivative Gain (Kd). These gains can be got by using method Ziegler-Nichols (ZN), gain-phase margin, Root Locus, Minimum Variance dan Gain Scheduling however these methods are not optimal to control systems that nonlinear and have high-orde, in addition, some methods relative hard. To solve those obstacles, particle swarm optimization (PSO) algorithm is proposed to get optimal Kp, Ki and Kd. PSO is proposed because PSO has convergent result and not require many iterations. On this research, PID controller is applied on AVR (Automatic Voltage Regulator). Based on result of analyzing transient, stability Root Locus and frequency response, performance of PID controller is better than Ziegler-Nichols.

  12. Development and validation of an Overreporting Scale for the Personality Inventory for DSM-5 (PID-5).

    PubMed

    Sellbom, Martin; Dhillon, Sonya; Bagby, R Michael

    2018-05-01

    Our aim in the current study was to develop a validity scale for the Personality Inventory for DSM-5 (PID-5) to detect noncredible overreported responding. To this end, we used a rare symptoms approach and identified extreme response options on PID-5 items that were infrequently endorsed by students in 3 different university samples (N = 1,370) and in a psychiatric patient sample (N = 194). The resulting 10-item scale (the PID-5-ORS) produced adequate-to-good estimates of internal reliability and was significantly correlated with the Minnesota Multiphasic Personality Inventory-2 Restructued Form (MMPI-2-RF) overreporting validity scales, providing evidence of concurrent validity. The criterion validity of the PID-5-ORS was demonstrated in an analog simulation design study. More specifically, university students instructed to overreport (n = 80) scored substantially higher on the PID-5-ORS relative to both a group of genuine psychiatric patients and students instructed to complete the PID-5 under standard (honest) instructions (n = 161); the effect size magnitudes associated with these differences were large. Classification accuracy analyses further revealed that high scores on the PID-5-ORS were associated with high specificity (and thus, low rates of false positive classifications) in differentiating overreporters from genuine patients, with sensitivity being somewhat weaker. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Research on Environmental Adjustment of Cloud Ranch Based on BP Neural Network PID Control

    NASA Astrophysics Data System (ADS)

    Ren, Jinzhi; Xiang, Wei; Zhao, Lin; Wu, Jianbo; Huang, Lianzhen; Tu, Qinggang; Zhao, Heming

    2018-01-01

    In order to make the intelligent ranch management mode replace the traditional artificial one gradually, this paper proposes a pasture environment control system based on cloud server, and puts forward the PID control algorithm based on BP neural network to control temperature and humidity better in the pasture environment. First, to model the temperature and humidity (controlled object) of the pasture, we can get the transfer function. Then the traditional PID control algorithm and the PID one based on BP neural network are applied to the transfer function. The obtained step tracking curves can be seen that the PID controller based on BP neural network has obvious superiority in adjusting time and error, etc. This algorithm, calculating reasonable control parameters of the temperature and humidity to control environment, can be better used in the cloud service platform.

  14. Fatal EBV infection and variable clinical manifestations in an XLP-1 pedigree - rapid diagnosis of primary immunodeficiencies may save lives.

    PubMed

    Sperl, D; Benesch, M; Urban, C; Lackner, H; Sovinz, P; Speicher, M R; Uhrig, S; Schwarzbraun, T; Schwinger, W; zur Stadt, U; Beutel, K; Janka, G; Scarpatetti, M; Seidel, M G

    2012-10-01

    Two related boys who died from fulminant infectious mononucleosis were diagnosed with X-linked lymphoproliferative disease type 1 (XLP-1). Family screening (n=17) identified 6 female mutation carriers and 2 more XLP-1 patients in whom, despite recurrent infections, agammaglobulinemia, and Hodgkin's Disease, the genetic basis had been unknown; demonstrating that awareness and early genetic testing are crucial to reveal underlying primary immunodeficiencies and improve outcome. Furthermore, XLP should be included routinely in the differential diagnosis of severe hypogammaglobulinemia and/or lymphoma in males. © Georg Thieme Verlag KG Stuttgart · New York.

  15. PID feedback controller used as a tactical asset allocation technique: The G.A.M. model

    NASA Astrophysics Data System (ADS)

    Gandolfi, G.; Sabatini, A.; Rossolini, M.

    2007-09-01

    The objective of this paper is to illustrate a tactical asset allocation technique utilizing the PID controller. The proportional-integral-derivative (PID) controller is widely applied in most industrial processes; it has been successfully used for over 50 years and it is used by more than 95% of the plants processes. It is a robust and easily understood algorithm that can provide excellent control performance in spite of the diverse dynamic characteristics of the process plant. In finance, the process plant, controlled by the PID controller, can be represented by financial market assets forming a portfolio. More specifically, in the present work, the plant is represented by a risk-adjusted return variable. Money and portfolio managers’ main target is to achieve a relevant risk-adjusted return in their managing activities. In literature and in the financial industry business, numerous kinds of return/risk ratios are commonly studied and used. The aim of this work is to perform a tactical asset allocation technique consisting in the optimization of risk adjusted return by means of asset allocation methodologies based on the PID model-free feedback control modeling procedure. The process plant does not need to be mathematically modeled: the PID control action lies in altering the portfolio asset weights, according to the PID algorithm and its parameters, Ziegler-and-Nichols-tuned, in order to approach the desired portfolio risk-adjusted return efficiently.

  16. Kunkel Lecture: Fundamental immunodeficiency and its correction

    PubMed Central

    2017-01-01

    “Fundamental immunodeficiency” is the inability of the encoded immune system to protect an otherwise healthy host from every infection that could threaten its life. In contrast to primary immunodeficiencies, fundamental immunodeficiency is not rare but nearly universal. It results not from variation in a given host gene but from the rate and extent of variation in the genes of other organisms. The remedy for fundamental immunodeficiency is “adopted immunity,” not to be confused with adaptive or adoptive immunity. Adopted immunity arises from four critical societal contributions to the survival of the human species: sanitation, nutrition, vaccines, and antimicrobial agents. Immunologists have a great deal to contribute to the development of vaccines and antimicrobial agents, but they have focused chiefly on vaccines, and vaccinology is thriving. In contrast, the effect of antimicrobial agents in adopted immunity, although fundamental, is fragile and failing. Immunologists can aid the development of sorely needed antimicrobial agents, and the study of antimicrobial agents can help immunologists discover targets and mechanisms of host immunity. PMID:28701368

  17. [Primary Intracranial Malignant Lymphoma Associated with Acquired Immunodeficiency Syndrome(AIDS):A Case Report].

    PubMed

    Inaka, Yasufumi; Otani, Naoki; Nishida, Sho; Fujii, Kazuya; Ueno, Hideaki; Tomura, Satoshi; Tomiyama, Arata; Osada, Hideo; Wada, Kojiro; Maeda, Takuya; Mori, Kentaro

    2017-11-01

    The spread of human immunodeficiency virus(HIV)infection may result in an increased likelihood of surgery in patients with HIV infection. We treated a patient with intracranial malignant lymphoma associated with acquired immunodeficiency syndrome(AIDS)caused by HIV infection. The recommendations of the countermeasure manual for AIDS were followed. Only surgical staff without finger injury or inflammation were permitted to be involved in the operation. All staff were dressed in a waterproof, full-body surgical gown, and wore double gloves, double foot covers, and an N95 mask. The surgery could be performed safely with such infection control measures. Histological examination revealed a diffuse large B-cell lymphoma. The patient was referred to the Division of Infectious Diseases and Respiratory Medicine for chemotherapy.

  18. Update on Vaccine-Derived Polioviruses - Worldwide, January 2015-May 2016.

    PubMed

    Jorba, Jaume; Diop, Ousmane M; Iber, Jane; Sutter, Roland W; Wassilak, Steven G; Burns, Cara C

    2016-08-05

    In 1988, the World Health Assembly resolved to eradicate poliomyelitis worldwide (1). One of the main tools used in polio eradication efforts has been the live, attenuated, oral poliovirus vaccine (OPV) (2), an inexpensive vaccine easily administered by trained volunteers. OPV might require several doses to induce immunity, but provides long-term protection against paralytic disease. Through effective use of OPV, the Global Polio Eradication Initiative (GPEI) has brought wild polioviruses to the threshold of eradication (1). However, OPV use, particularly in areas with low routine vaccination coverage, is associated with the emergence of genetically divergent vaccine-derived polioviruses (VDPVs) whose genetic drift from the parental OPV strains indicates prolonged replication or circulation (3). VDPVs can emerge among immunologically normal vaccine recipients and their contacts as well as among persons with primary immunodeficiencies (PIDs). Immunodeficiency-associated VDPVs (iVDPVs) can replicate for years in some persons with PIDs. In addition, circulating vaccine-derived polioviruses (cVDPVs) (3) can emerge in areas with low OPV coverage and can cause outbreaks of paralytic polio. This report updates previous summaries regarding VDPVs (4).

  19. Anti-windup adaptive PID control design for a class of uncertain chaotic systems with input saturation.

    PubMed

    Tahoun, A H

    2017-01-01

    In this paper, the stabilization problem of actuators saturation in uncertain chaotic systems is investigated via an adaptive PID control method. The PID control parameters are auto-tuned adaptively via adaptive control laws. A multi-level augmented error is designed to account for the extra terms appearing due to the use of PID and saturation. The proposed control technique uses both the state-feedback and the output-feedback methodologies. Based on Lyapunov׳s stability theory, new anti-windup adaptive controllers are proposed. Demonstrative examples with MATLAB simulations are studied. The simulation results show the efficiency of the proposed adaptive PID controllers. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

  20. Promoting Cardiovascular Health in Patients Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome.

    PubMed

    Harris, Robin

    2018-03-01

    Patients living with human immunodeficiency virus/acquired immunodeficiency syndrome (PLWHA) are at increased risk of cardiovascular disease because of advances in human immunodeficiency virus/acquired immunodeficiency syndrome treatment and increased life expectancy. Cardiovascular health promotion in PLWHA includes strategies for risk factor reduction, disease prevention, early detection, and treatment of cardiovascular disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Nonlinear Adaptive PID Control for Greenhouse Environment Based on RBF Network

    PubMed Central

    Zeng, Songwei; Hu, Haigen; Xu, Lihong; Li, Guanghui

    2012-01-01

    This paper presents a hybrid control strategy, combining Radial Basis Function (RBF) network with conventional proportional, integral, and derivative (PID) controllers, for the greenhouse climate control. A model of nonlinear conservation laws of enthalpy and matter between numerous system variables affecting the greenhouse climate is formulated. RBF network is used to tune and identify all PID gain parameters online and adaptively. The presented Neuro-PID control scheme is validated through simulations of set-point tracking and disturbance rejection. We compare the proposed adaptive online tuning method with the offline tuning scheme that employs Genetic Algorithm (GA) to search the optimal gain parameters. The results show that the proposed strategy has good adaptability, strong robustness and real-time performance while achieving satisfactory control performance for the complex and nonlinear greenhouse climate control system, and it may provide a valuable reference to formulate environmental control strategies for actual application in greenhouse production. PMID:22778587

  2. Effects of a PID Control System on Electromagnetic Fields in an nEDM Experiment

    NASA Astrophysics Data System (ADS)

    Molina, Daniel

    2017-09-01

    The Kellogg Radiation Laboratory is currently testing a prototype for an experiment that hopes to identify the electric dipole moment of the neutron. As part of this testing, we have developed a PID (proportional, integral, derivative) feedback system that uses large coils to fix the value of local external magnetic fields, up to linear gradients. PID algorithms compare the current value to a set-point and use the integral and derivative of the field with respect to the set-point to maintain constant fields. We have also developed a method for zeroing linear gradients within the experimental apparatus. In order to determine the performance of the PID algorithm, measurements of both the internal and external fields were obtained with and without the algorithm running, and these results were compared for noise and time stability. We have seen that the PID algorithm can reduce the effect of disturbance to the field by a factor of 10.

  3. The Construct Validity of the Dutch Personality Inventory for DSM-5 Personality Disorders (PID-5) in a Clinical Sample.

    PubMed

    Bastiaens, Tim; Claes, Laurence; Smits, Dirk; De Clercq, Barbara; De Fruyt, Filip; Rossi, Gina; Vanwalleghem, Dominique; Vermote, Rudi; Lowyck, Benedicte; Claes, Stephan; De Hert, Marc

    2016-02-01

    The factor structure and the convergent validity of the Personality Inventory for DSM-5 (PID-5), a self-report questionnaire designed to measure personality pathology as advocated in the fifth edition, Section III of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), are already demonstrated in general population samples, but need replication in clinical samples. In 240 Flemish inpatients, we examined the factor structure of the PID-5 by means of exploratory structural equation modeling. Additionally, we investigated differences in PID-5 higher order domain scores according to gender, age and educational level, and explored convergent and discriminant validity by relating the PID-5 with the Dimensional Assessment of Personality Pathology-Basic Questionnaire and by comparing PID-5 scores of inpatients with and without a DSM-IV categorical personality disorder diagnosis. Our results confirmed the original five-factor structure of the PID-5. The reliability and the convergent and discriminant validity of the PID-5 proved to be adequate. Implications for future research are discussed. © The Author(s) 2015.

  4. Mutations in CsPID encoding a Ser/Thr protein kinase are responsible for round leaf shape in cucumber (Cucumis sativus L.).

    PubMed

    Zhang, Chaowen; Chen, Feifan; Zhao, Ziyao; Hu, Liangliang; Liu, Hanqiang; Cheng, Zhihui; Weng, Yiqun; Chen, Peng; Li, Yuhong

    2018-06-01

    Two round-leaf mutants, rl-1 and rl-2, were identified from EMS-induced mutagenesis. High throughput sequencing and map-based cloning suggested CsPID encoding a Ser/Thr protein kinase as the most possible candidate for rl-1. Rl-2 was allelic to Rl-1. Leaf shape is an important plant architecture trait that is affected by plant hormones, especially auxin. In Arabidopsis, PINOID (PID), a regulator for the auxin polar transporter PIN (PIN-FORMED) affects leaf shape formation, but this function of PID in crop plants has not been well studied. From an EMS mutagenesis population, we identified two round-leaf (rl) mutants, C356 and C949. Segregation analysis suggested that both mutations were controlled by single recessive genes, rl-1 and rl-2, respectively. With map-based cloning, we show that CsPID as the candidate gene of rl-1; a non-synonymous SNP in the second exon of CsPID resulted in an amino acid substitution and the round leaf phenotype. As compared in the wild type plant, CsPID had significantly lower expression in the root, leaf and female flowers in C356, which may result in the less developed roots, round leaves and abnormal female flowers, respectively in the rl-1 mutant. Among the three copies of PID genes, CsPID, CsPID2 and CSPID2L (CsPID2-like) in the cucumber genome, CsPID was the only one with significantly differential expression in adult leaves between WT and C356 suggesting CsPID plays a main role in leaf shape formation. The rl-2 mutation in C949 was also cloned, which was due to another SNP in a nearby location of rl-1 in the same CsPID gene. The two round leaf mutants and the work presented herein provide a good foundation for understanding the molecular mechanisms of CsPID in cucumber leaf development.

  5. Chronic active Epstein–Barr virus infection as the initial symptom in a Janus kinase 3 deficiency child

    PubMed Central

    Zhong, Linqing; Wang, Wei; Ma, Mingsheng; Gou, Lijuan; Tang, Xiaoyan; Song, Hongmei

    2017-01-01

    Abstract Rationale: With the progress of sequencing technology, an increasing number of atypical primary immunodeficiency (PID) patients have been discovered, including Janus kinase 3 (JAK3) gene deficiency. Patient concerns: We report a patient who presented with chronic active Epstein–Barr virus (CAEBV) infection but responded poorly to treatment with ganciclovir. Diagnoses: Next-generation sequencing (NGS) was performed, including all known PID genes, after which Sanger sequencing was performed to verify the results. Genetic analysis revealed that our patient had 2 novel compound heterozygous mutations of JAK3, a gene previously reported to cause a rare form of autosomal recessive severe combined immunodeficiency with recurrent infections. The p.H27Q mutation came from his father, while p. R222H from his mother. Thus, his diagnosis was corrected for JAK3-deficiency PID and CAEBV. Interventions: Maintenance treatment of subcutaneous injection of recombinant human interferon α-2a was given to our patient with 2 MU, 3 times a week. Outcomes: Interferon alpha was applied and the EBV infection was gradually controlled and his symptoms ameliorated remarkably. Our patient is in good health now and did not have relapses. Lessons: The diagnoses of PID should be taken into consideration when CAEBV patients respond poorly to conventional treatments. Good results of our patient indicate that interferon α-2a may be an alternative treatment for those who are unwilling to accept hematopoietic stem cell transplantation (HSCT) like our patient. Literature review identified 59 additional cases of JAK3 deficiency with various infections. PMID:29049190

  6. BROJA-2PID: A Robust Estimator for Bivariate Partial Information Decomposition

    NASA Astrophysics Data System (ADS)

    Makkeh, Abdullah; Theis, Dirk; Vicente, Raul

    2018-04-01

    Makkeh, Theis, and Vicente found in [8] that Cone Programming model is the most robust to compute the Bertschinger et al. partial information decompostion (BROJA PID) measure [1]. We developed a production-quality robust software that computes the BROJA PID measure based on the Cone Programming model. In this paper, we prove the important property of strong duality for the Cone Program and prove an equivalence between the Cone Program and the original Convex problem. Then describe in detail our software and how to use it.\

  7. Inverse optimal self-tuning PID control design for an autonomous underwater vehicle

    NASA Astrophysics Data System (ADS)

    Rout, Raja; Subudhi, Bidyadhar

    2017-01-01

    This paper presents a new approach to path following control design for an autonomous underwater vehicle (AUV). A NARMAX model of the AUV is derived first and then its parameters are adapted online using the recursive extended least square algorithm. An adaptive Propotional-Integral-Derivative (PID) controller is developed using the derived parameters to accomplish the path following task of an AUV. The gain parameters of the PID controller are tuned using an inverse optimal control technique, which alleviates the problem of solving Hamilton-Jacobian equation and also satisfies an error cost function. Simulation studies were pursued to verify the efficacy of the proposed control algorithm. From the obtained results, it is envisaged that the proposed NARMAX model-based self-tuning adaptive PID control provides good path following performance even in the presence of uncertainty arising due to ocean current or hydrodynamic parameter.

  8. Systematic review of vestibular disorders related to human immunodeficiency virus and acquired immunodeficiency syndrome.

    PubMed

    Heinze, B; Swanepoel, D W; Hofmeyr, L M

    2011-09-01

    Disorders of the auditory and vestibular system are often associated with human immunodeficiency virus infection and acquired immunodeficiency syndrome. However, the extent and nature of these vestibular manifestations are unclear. To systematically review the current peer-reviewed literature on vestibular manifestations and pathology related to human immunodeficiency virus and acquired immunodeficiency syndrome. Systematic review of peer-reviewed articles related to vestibular findings in individuals with human immunodeficiency virus infection and acquired immunodeficiency syndrome. Several electronic databases were searched. We identified 442 records, reduced to 210 after excluding duplicates and reviews. These were reviewed for relevance to the scope of the study. We identified only 13 reports investigating vestibular functioning and pathology in individuals affected by human immunodeficiency virus and acquired immunodeficiency syndrome. This condition can affect both the peripheral and central vestibular system, irrespective of age and viral disease stage. Peripheral vestibular involvement may affect up to 50 per cent of patients, and central vestibular involvement may be even more prevalent. Post-mortem studies suggest direct involvement of the entire vestibular system, while opportunistic infections such as oto- and neurosyphilis and encephalitis cause secondary vestibular dysfunction resulting in vertigo, dizziness and imbalance. Patients with human immunodeficiency virus and acquired immunodeficiency syndrome should routinely be monitored for vestibular involvement, to minimise functional limitations of quality of life.

  9. An Aggressive Plasmablastic Lymphoma of the Oral Cavity as Primary Manifestation of Acquired Immunodeficiency Syndrome: Case Report and Literature Review

    PubMed Central

    Corti, Marcelo; Minué, Gonzalo; Campitelli, Ana; Narbaitz, Marina; Gilardi, Leonardo

    2015-01-01

    Introduction Plasmablastic lymphoma is a rare entity that was first described in the jaws and the oral cavity of patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Plasmablastic lymphoma is considered as a diffuse, large, B-cell lymphoma with a unique phenotype and a predilection for the oral cavity. Objective The authors describe a case of an aggressive plasmablastic lymphoma of the oral cavity as the primary manifestation of AIDS. Resumed Report We report a case of plasmablastic lymphoma involving only the oral cavity as the first manifestation of AIDS. Diagnosis was confirmed by the oral lesion biopsy and the histopathologic examination that showed a dense infiltrate composed of atypical lymphocytes with numerous plasmocytes that expressed the plasma cell markers MUM-1 and CD138 and that were negative for the B-cell markers CD3, CD20, and CD45. Immunohistochemical and in situ hybridization revealed the Epstein-Barr virus genome in the atypical cells. Polymerase chain reaction was also positive for human herpesvirus-8 RNA. Conclusion The HIV serologic status should be evaluated in all patients with plasmablastic lymphoma of the oral cavity or extraoral sites. PMID:26491484

  10. Designing of new structure PID controller of boost converter for solar photovoltaic stability

    NASA Astrophysics Data System (ADS)

    Shabrina, Hanifati Nur; Setiawan, Eko Adhi; Sabirin, Chip Rinaldi

    2017-03-01

    Nowadays, the utilization of renewable energy as the source on distributed generation system is increasing. It aims to reduce reliance and power losses from utility grid and improve power stability in near loads. One example of renewable energy technology that have been highly proven on the market is solar photovoltaic (PV). This technology converts photon from sunlight into electricity. However, the fluctuation of solar radiation that often occurs become the main problem for this system. Due to this condition, the power conversion is needed to convert the change frequently in photovoltaic panel into a stable voltage to the system. Developing control of boost converter has important role to keep ability of system stabilization. A conventional PID (Proportional, Integral, Derivative) control is mostly used to achieve this goal. In this research, a design of new structure PID controller of boost converter is offered to better optimize system stability comparing to the conventional PID. Parameters obtained from this PID structure have been successfully yield a stable boost converter output at 200 V with 10% overshoot, 1.5 seconds of settling time, and 1.5% of steady-state error.

  11. Design And Implementation Of PID Controller Using Relay Feedback On TRMS (Twin Rotor MIMO System)

    NASA Astrophysics Data System (ADS)

    Shah, Dipesh H.

    2011-12-01

    Today, many process control problems can be adequately and routinely solved by conventional PID control strategies. The overriding reason that the PID controller is so widely accepted is its simple structure which has proved to be very robust with regard to many commonly met process control problems as for instance disturbances and nonlinearities. Relay feedback methods have been widely used in tuning proportional-integral-derivative controllers due to its closed loop nature. In this work, Relay based PID controller is designed and successfully implemented on TRMS (Twin Rotor MIMO System) in SISO and MIMO configurations. The performance of a Relay based PID controller for control of TRMS is investigated and performed satisfactorily. The system shares some features with a helicopter, such as important interactions between the vertical and horizontal motions. The RTWT toolbox in the MATLAB environment is used to perform real-time experiments.

  12. A severe combined immunodeficient-hu in vivo mouse model of human primary mantle cell lymphoma.

    PubMed

    Wang, Michael; Zhang, Liang; Han, Xiaohong; Yang, Jing; Qian, Jianfei; Hong, Sungyoul; Lin, Pei; Shi, Yuankai; Romaguera, Jorge; Kwak, Larry W; Yi, Qing

    2008-04-01

    To establish a severe combined immunodeficient (SCID)-hu in vivo mouse model of human primary mantle cell lymphoma (MCL) for the study of the biology and novel therapy of human MCL. Primary MCL cells were isolated from spleen, lymph node, bone marrow aspirates, or peripheral blood of six different patients and injected respectively into human bone chips, which had been s.c. implanted in SCID-hu. Circulating human beta(2)-microglobulin in mouse serum was used to monitor the engraftment and growth of patient's MCL cells. H&E staining and immunohistochemical staining with anti-human CD20 and cyclin D1 antibodies were used to confirm the tumor growth and migration. Increasing levels of circulating human beta(2)-microglobulin in mouse serum indicated that the patient's MCL cells were engrafted successfully into human bone chip of SCID-hu mice. The engraftment and growth of patient's MCL cells were dependent on human bone marrow microenvironment. Immunohistochemical staining with anti-human CD20 and cyclin D1 antibodies confirmed that patient's MCL cells were able to not only survive and propagate in the bone marrow microenvironment of the human fetal bone chips, but also similar to the human disease, migrate to lymph nodes, spleen, bone marrow, and gastrointestinal tract of host mice. Treatment of MCL-bearing SCID-hu mice with atiprimod, a novel antitumor compound against the protection of bone marrow stromal cells, induced tumor regression. This is the first human primary MCL animal model that should be useful for the biological and therapeutic research on MCL.

  13. Primary immunodeficiency disease: a model for case management of chronic diseases.

    PubMed

    Burton, Janet; Murphy, Elyse; Riley, Patty

    2010-01-01

    Patient-centered chronic care management is a new model for the management of rare chronic diseases such as primary immunodeficiency disease (PIDD). This approach emphasizes helping patients become experts on the management of their disease as informed, involved, and interactive partners in healthcare decisions with providers. Because only a few patients are affected by rare illnesses, these patients are forced to become knowledgeable about their disease and therapies and to seek treatment from a healthcare team, which includes physicians and nurse specialists who are equipped to manage the complexity of the disease and its comorbidities. Importantly, therapy for PIDD can be self-administered at home, which has encouraged the transition toward a proactive stance that is at the heart of patient-centered chronic care management. We discuss the evolution of therapy, the issues with the disease, and challenges with its management within the framework of other chronic disease management programs. Suggestions and rationale to move case management of PIDD forward are presented with the intent that sharing our experiences will improve process and better manage outcomes in this patient population. The patient-centered model for the management of PIDD is applicable to the primary care settings, where nurse case managers assist patients through education, support them and their families, and facilitate access to community resources in an approach, which has been described as "guided care." The model also applies specifically to immunology centers where patients receive treatment or instruction on its self-administration at home. Patient-centered management of PIDD, with its emphasis on full involvement of patients in their treatment, has the potential to improve compliance with treatment, and thus patient outcomes, as well as patients' quality of life. The patient-centered model expands the traditional model of chronic disease management, which relies on evidence

  14. Changes in B cell immunophenotype in common variable immunodeficiency: cause or effect – is bronchiectasis indicative of undiagnosed immunodeficiency?

    PubMed Central

    Bright, P; Grigoriadou, S; Kamperidis, P; Buckland, M; Hickey, A; Longhurst, H J

    2013-01-01

    Common variable immunodeficiency (CVID) is the most common severe primary immunodeficiency, but the pathology of this condition is poorly understood. CVID involves a defect in the production of immunoglobulin from B cells, with a subsequent predisposition to infections. Approximately 10–20% of cases are inherited, but even in families with a genetic defect the penetrance is far from complete. A classification system for CVID has been suggested (EUROclass) based on B cell immunophenotyping, but it has not been shown that altered B cell immunophenotype is not a consequence of the complications and treatment of CVID. This study compares the EUROclass B cell immunophenotype of CVID patients (n = 30) with suitable disease controls with bronchiectasis (n = 11), granulomatous disease (Crohn's disease) (n = 9) and neurological patients on immunoglobulin treatment (n = 6). The results of this study correlate with previous literature, that alterations in B cell immunophenotype are associated strongly with CVID. Interestingly, three of the 11 bronchiectasis patients without known immunodeficiency had an altered B cell immunophenotype, suggesting the possibility of undiagnosed immunodeficiency, or that bronchiectasis may cause a secondary alteration in B cell immunophenotype. This study showed a significant difference in B cell immunophenotype between CVID patients compared to disease control groups of granulomatous disease and immunoglobulin treatment. This suggests that granulomatous disease (in Crohn's disease) and immunoglobulin treatment (for chronic neurological conditions) are not causal of an altered B cell immunophenotype in these control populations. PMID:23286946

  15. Wireless Sensor Network Congestion Control Based on Standard Particle Swarm Optimization and Single Neuron PID

    PubMed Central

    Yang, Xiaoping; Chen, Xueying; Xia, Riting; Qian, Zhihong

    2018-01-01

    Aiming at the problem of network congestion caused by the large number of data transmissions in wireless routing nodes of wireless sensor network (WSN), this paper puts forward an algorithm based on standard particle swarm–neural PID congestion control (PNPID). Firstly, PID control theory was applied to the queue management of wireless sensor nodes. Then, the self-learning and self-organizing ability of neurons was used to achieve online adjustment of weights to adjust the proportion, integral and differential parameters of the PID controller. Finally, the standard particle swarm optimization to neural PID (NPID) algorithm of initial values of proportion, integral and differential parameters and neuron learning rates were used for online optimization. This paper describes experiments and simulations which show that the PNPID algorithm effectively stabilized queue length near the expected value. At the same time, network performance, such as throughput and packet loss rate, was greatly improved, which alleviated network congestion and improved network QoS. PMID:29671822

  16. Wireless Sensor Network Congestion Control Based on Standard Particle Swarm Optimization and Single Neuron PID.

    PubMed

    Yang, Xiaoping; Chen, Xueying; Xia, Riting; Qian, Zhihong

    2018-04-19

    Aiming at the problem of network congestion caused by the large number of data transmissions in wireless routing nodes of wireless sensor network (WSN), this paper puts forward an algorithm based on standard particle swarm⁻neural PID congestion control (PNPID). Firstly, PID control theory was applied to the queue management of wireless sensor nodes. Then, the self-learning and self-organizing ability of neurons was used to achieve online adjustment of weights to adjust the proportion, integral and differential parameters of the PID controller. Finally, the standard particle swarm optimization to neural PID (NPID) algorithm of initial values of proportion, integral and differential parameters and neuron learning rates were used for online optimization. This paper describes experiments and simulations which show that the PNPID algorithm effectively stabilized queue length near the expected value. At the same time, network performance, such as throughput and packet loss rate, was greatly improved, which alleviated network congestion and improved network QoS.

  17. Evaluation of Severe Combined Immunodeficiency and Combined Immunodeficiency Pediatric Patients on the Basis of Cellular Radiosensitivity

    PubMed Central

    Lobachevsky, Pavel; Woodbine, Lisa; Hsiao, Kuang-Chih; Choo, Sharon; Fraser, Chris; Gray, Paul; Smith, Jai; Best, Nickala; Munforte, Laura; Korneeva, Elena; Martin, Roger F.; Jeggo, Penny A.; Martin, Olga A.

    2016-01-01

    Pediatric patients with severe or nonsevere combined immunodeficiency have increased susceptibility to severe, life-threatening infections and, without hematopoietic stem cell transplantation, may fail to thrive. A subset of these patients have the radiosensitive (RS) phenotype, which may necessitate conditioning before hematopoietic stem cell transplantation, and this conditioning includes radiomimetic drugs, which may significantly affect treatment response. To provide statistical criteria for classifying cellular response to ionizing radiation as the measure of functional RS screening, we analyzed the repair capacity and survival of ex vivo irradiated primary skin fibroblasts from five dysmorphic and/or developmentally delayed pediatric patients with severe combined immunodeficiency and combined immunodeficiency. We developed a mathematical framework for the analysis of γ histone 2A isoform X foci kinetics to quantitate DNA-repair capacity, thus establishing crucial criteria for identifying RS. The results, presented in a diagram showing each patient as a point in a 2D RS map, were in agreement with findings from the assessment of cellular RS by clonogenic survival and from the genetic analysis of factors involved in the nonhomologous end-joining repair pathway. We provide recommendations for incorporating into clinical practice the functional assays and genetic analysis used for establishing RS status before conditioning. This knowledge would enable the selection of the most appropriate treatment regimen, reducing the risk for severe therapy-related adverse effects. PMID:26151233

  18. Utility of the Personality Inventory for DSM-5-Brief Form (PID-5-BF) in the Measurement of Maladaptive Personality and Psychopathology.

    PubMed

    Anderson, Jaime L; Sellbom, Martin; Salekin, Randall T

    2018-07-01

    The Diagnostic and Statistical Manual of Mental Disorders-Fifth edition ( DSM-5) Personality and Personality Disorders workgroup developed the Personality Inventory for the DSM-5 (PID-5) for the assessment of the alternative trait model for DSM-5. Along with this measure, the American Psychiatric Association published an abbreviated version, the PID-5-Brief form (PID-5-BF). Although this measure is available on the DSM-5 website for use, only two studies have evaluated its psychometric properties and validity and no studies have examined the U.S. version of this measure. The current study evaluated the reliability, factor structure, and construct validity of PID-5-BF scale scores. This included an evaluation of the scales' associations with Section II PDs, a well-validated dimensional measure of personality psychopathology, and broad externalizing and internalizing psychopathology measures. We found support for the reliability of PID-5-BF scales as well as for the factor structure of the measure. Furthermore, a series of correlation and regression analyses showed conceptually expected associations between PID-5-BF and external criterion variables. Finally, we compared the correlations with external criterion measures to those of the full-length PID-5 and PID-5-Short form. Intraclass correlation analyses revealed a comparable pattern of correlations across all three measures, thereby supporting the use of the PID-5-BF as a screening measure of dimensional maladaptive personality traits.

  19. Design of nonlinear PID controller and nonlinear model predictive controller for a continuous stirred tank reactor.

    PubMed

    Prakash, J; Srinivasan, K

    2009-07-01

    In this paper, the authors have represented the nonlinear system as a family of local linear state space models, local PID controllers have been designed on the basis of linear models, and the weighted sum of the output from the local PID controllers (Nonlinear PID controller) has been used to control the nonlinear process. Further, Nonlinear Model Predictive Controller using the family of local linear state space models (F-NMPC) has been developed. The effectiveness of the proposed control schemes has been demonstrated on a CSTR process, which exhibits dynamic nonlinearity.

  20. The application of immune genetic algorithm in main steam temperature of PID control of BP network

    NASA Astrophysics Data System (ADS)

    Li, Han; Zhen-yu, Zhang

    In order to overcome the uncertainties, large delay, large inertia and nonlinear property of the main steam temperature controlled object in the power plant, a neural network intelligent PID control system based on immune genetic algorithm and BP neural network is designed. Using the immune genetic algorithm global search optimization ability and good convergence, optimize the weights of the neural network, meanwhile adjusting PID parameters using BP network. The simulation result shows that the system is superior to conventional PID control system in the control of quality and robustness.

  1. A design of LED adaptive dimming lighting system based on incremental PID controller

    NASA Astrophysics Data System (ADS)

    He, Xiangyan; Xiao, Zexin; He, Shaojia

    2010-11-01

    As a new generation energy-saving lighting source, LED is applied widely in various technology and industry fields. The requirement of its adaptive lighting technology is more and more rigorous, especially in the automatic on-line detecting system. In this paper, a closed loop feedback LED adaptive dimming lighting system based on incremental PID controller is designed, which consists of MEGA16 chip as a Micro-controller Unit (MCU), the ambient light sensor BH1750 chip with Inter-Integrated Circuit (I2C), and constant-current driving circuit. A given value of light intensity required for the on-line detecting environment need to be saved to the register of MCU. The optical intensity, detected by BH1750 chip in real time, is converted to digital signal by AD converter of the BH1750 chip, and then transmitted to MEGA16 chip through I2C serial bus. Since the variation law of light intensity in the on-line detecting environment is usually not easy to be established, incremental Proportional-Integral-Differential (PID) algorithm is applied in this system. Control variable obtained by the incremental PID determines duty cycle of Pulse-Width Modulation (PWM). Consequently, LED's forward current is adjusted by PWM, and the luminous intensity of the detection environment is stabilized by self-adaptation. The coefficients of incremental PID are obtained respectively after experiments. Compared with the traditional LED dimming system, it has advantages of anti-interference, simple construction, fast response, and high stability by the use of incremental PID algorithm and BH1750 chip with I2C serial bus. Therefore, it is suitable for the adaptive on-line detecting applications.

  2. Predictors of human immunodeficiency virus (HIV) infection in primary care: a systematic review protocol.

    PubMed

    Rumbwere Dube, Benhildah N; Marshall, Tom P; Ryan, Ronan P

    2016-09-20

    Antiretroviral therapies for human immunodeficiency virus are more effective if infected individuals are diagnosed early, before they have irreversible immunologic damage. A large proportion of patients that are diagnosed with HIV, in United Kingdom, would have seen a general practitioner (GP) within the previous year. Determining the demographic and clinical characteristics of HIV-infected patients prior to diagnosis of HIV may be useful in identifying patients likely to be HIV positive in primary care. This could help inform a strategy of early HIV testing in primary care. This systematic review aims to identify characteristics of HIV-infected adults prior to diagnosis that could be used in a prediction model for early detection of HIV in primary care. The systematic review will search for literature, mainly observational (cohort and case-control) studies, with human participants aged 18 years and over. The exposures are demographic, socio-economic or clinical risk factors or characteristics associated with HIV infection. The comparison group will be patients with no risk factors or no comparison group. The outcome is laboratory-confirmed HIV/AIDS infection. Evidence will be identified from electronic searches of online databases of EMBASE, MEDLINE, The Cochrane Library and grey literature search engines of Open Grey, Web of Science Conference Proceedings Citation Index and examination of reference lists from selected studies (reference searching). Two reviewers will be involved in quality assessment and data extraction of the review. A data extraction form will be developed to collate data from selected studies. A checklist for quality assessment will be adapted from the Scottish Intercollegiate Guidelines Network (SIGN). This systematic review will identify and consolidate existing scientific evidence on characteristics of HIV infected individuals that could be used to inform decision-making in prognostic model development. PROSPERO CRD42016042427.

  3. Abnormal liver function in common variable immunodeficiency disorders due to nodular regenerative hyperplasia.

    PubMed

    Ward, C; Lucas, M; Piris, J; Collier, J; Chapel, H

    2008-09-01

    Patients with common variable immunodeficiency disorders are monitored for liver function test abnormalities. A proportion of patients develop deranged liver function and some also develop hepatomegaly. We investigated the prevalence of abnormalities and types of liver disease, aiming to identify those at risk and determine outcomes. The local primary immunodeficiency database was searched for patients with a common variable immunodeficiency disorder and abnormal liver function and/or a liver biopsy. Patterns of liver dysfunction were determined and biopsies reviewed. A total of 47 of 108 patients had deranged liver function, most commonly raised alkaline phosphatase levels. Twenty-three patients had liver biopsies. Nodular regenerative hyperplasia was found in 13 of 16 with unexplained pathology. These patients were more likely to have other disease-related complications of common variable immunodeficiency disorders, in particular non-coeliac (gluten insensitive) lymphocytic enteropathy. However, five had no symptoms of liver disease and only one died of liver complications. Nodular regenerative hyperplasia is a common complication of common variable immunodeficiency disorders but was rarely complicated by portal hypertension.

  4. Design and implementation of EP-based PID controller for chaos synchronization of Rikitake circuit systems.

    PubMed

    Hou, Yi-You

    2017-09-01

    This article addresses an evolutionary programming (EP) algorithm technique-based and proportional-integral-derivative (PID) control methods are established to guarantee synchronization of the master and slave Rikitake chaotic systems. For PID synchronous control, the evolutionary programming (EP) algorithm is used to find the optimal PID controller parameters k p , k i , k d by integrated absolute error (IAE) method for the convergence conditions. In order to verify the system performance, the basic electronic components containing operational amplifiers (OPAs), resistors, and capacitors are used to implement the proposed chaotic Rikitake systems. Finally, the experimental results validate the proposed Rikitake chaotic synchronization approach. Copyright © 2017. Published by Elsevier Ltd.

  5. An adaptive PID like controller using mix locally recurrent neural network for robotic manipulator with variable payload.

    PubMed

    Sharma, Richa; Kumar, Vikas; Gaur, Prerna; Mittal, A P

    2016-05-01

    Being complex, non-linear and coupled system, the robotic manipulator cannot be effectively controlled using classical proportional-integral-derivative (PID) controller. To enhance the effectiveness of the conventional PID controller for the nonlinear and uncertain systems, gains of the PID controller should be conservatively tuned and should adapt to the process parameter variations. In this work, a mix locally recurrent neural network (MLRNN) architecture is investigated to mimic a conventional PID controller which consists of at most three hidden nodes which act as proportional, integral and derivative node. The gains of the mix locally recurrent neural network based PID (MLRNNPID) controller scheme are initialized with a newly developed cuckoo search algorithm (CSA) based optimization method rather than assuming randomly. A sequential learning based least square algorithm is then investigated for the on-line adaptation of the gains of MLRNNPID controller. The performance of the proposed controller scheme is tested against the plant parameters uncertainties and external disturbances for both links of the two link robotic manipulator with variable payload (TL-RMWVP). The stability of the proposed controller is analyzed using Lyapunov stability criteria. A performance comparison is carried out among MLRNNPID controller, CSA optimized NNPID (OPTNNPID) controller and CSA optimized conventional PID (OPTPID) controller in order to establish the effectiveness of the MLRNNPID controller. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

  6. PID self tuning control based on Mamdani fuzzy logic control for quadrotor stabilization

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Priyambodo, Tri Kuntoro, E-mail: mastri@ugm.ac.id; Putra, Agfianto Eko; Department of Computer Science and Electronics, Universitas Gadjah Mada, Yogyakarta

    Quadrotor as one type of UAV have the ability to perform Vertical Take Off and Landing (VTOL). It allows the Quadrotor to be stationary hovering in the air. PID (Proportional Integral Derivative) control system is one of the control methods that are commonly used. It is usually used to optimize the Quadrotor stabilization at least based on the three Eulerian angles (roll, pitch, and yaw) as input parameters for the control system. The three constants of PID can be obtained in various methods. The simplest method is tuning manually. This method has several weaknesses. For example if the three constantsmore » are not exact, the resulting response will deviate from the desired result. By combining the methods of PID with fuzzy logic systems where human expertise is implemented into the machine language is expected to further optimize the control system.« less

  7. PID controller tuning using metaheuristic optimization algorithms for benchmark problems

    NASA Astrophysics Data System (ADS)

    Gholap, Vishal; Naik Dessai, Chaitali; Bagyaveereswaran, V.

    2017-11-01

    This paper contributes to find the optimal PID controller parameters using particle swarm optimization (PSO), Genetic Algorithm (GA) and Simulated Annealing (SA) algorithm. The algorithms were developed through simulation of chemical process and electrical system and the PID controller is tuned. Here, two different fitness functions such as Integral Time Absolute Error and Time domain Specifications were chosen and applied on PSO, GA and SA while tuning the controller. The proposed Algorithms are implemented on two benchmark problems of coupled tank system and DC motor. Finally, comparative study has been done with different algorithms based on best cost, number of iterations and different objective functions. The closed loop process response for each set of tuned parameters is plotted for each system with each fitness function.

  8. Newborn screening using TREC/KREC assay for severe T and B cell lymphopenia in Iran.

    PubMed

    Nourizadeh, Maryam; Shakerian, Leila; Borte, Stephan; Fazlollahi, Mohammadreza; Badalzadeh, Mohsen; Houshmand, Massoud; Alizadeh, Zahra; Dalili, Hossein; Rashidi-Nezhad, Ali; Kazemnejad, Anoshirvan; Moin, Mostafa; Hammarström, Lennart; Pourpak, Zahra

    2018-06-26

    T-cell receptor excision circles (TRECs) and κ-deleting recombination excision circles (KRECs) are recently used for detection of T or B cell lymphopenia in neonates based on region-specific cutoff levels. Here, we report cutoffs for TREC and KREC copies useful for newborn screening and/or diagnosis of primary immunodeficiency diseases (PID) in Iran. DNA was extracted from a single 3.2 mm punch of dried blood spots collected from 2160 anonymized newborns referred to two major referral health centers between 2014 and 2016. For refinement of the cutoffs, 51 patients with a definite diagnosis of severe combined immunodeficiency, X-linked agammaglobulinaemia and combined immunodeficiency, including ataxia telangiectasia, human phosphoglucomutase 3 and Janus kinase-3 deficiency, as well as 47 healthy controls were included. Samples from patients with an X-linked hyper-IgM-syndrome, Wiskott-Aldrich syndrome and DNA ligase 4 deficiency were considered as disease controls. Triplex-quantitative real-time PCR was used. Cutoffs were calculated as TRECs < 11 and KRECs < 6 copies with an ACTB > 700 copies with sensitivity of 100% for TREC and 97% for KREC. Among thirty anonymized newborn samples (1.5%) with abnormal results for TREC and/or KREC, only twenty one available cases were retested and shown to be in the normal range except for three samples (0.15%). All of the patients with a definitive diagnosis were correctly identified based on our established TREC/KREC copy numbers. Determining cutoffs for TREC/KREC is essential for correctly identifying children with PID in newborn screening. Early diagnosis of PID patients enables appropriate measures and therapies like stem cell transplantation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. The development and psychometric properties of an informant-report form of the personality inventory for DSM-5 (PID-5).

    PubMed

    Markon, Kristian E; Quilty, Lena C; Bagby, R Michael; Krueger, Robert F

    2013-06-01

    The current article reports on the development, psychometric properties, and external validity of an informant-report form of the Personality Inventory for DSM-5 (the PID-5-IRF). Using data from two nationally representative samples, as well as an elevated-risk community sample, we report on the PID-5-IRF item characteristics, scale properties, superordinate factor structure, and correlations with other measures. The PID-5-IRF replicates the factor structure of the self-report form and has relationships with other measures (including the PID-5 self-report form and a widely used Big Five measure) that are consistent with previous research and theory. We believe that the PID-5-IRF is a useful measure for a number of scenarios, such as when additional sources of information are desired, where informant measures are expected to provide incremental validity over self-report, where relationships or social perception is a focal interest, or when response bias is a salient concern. Areas for future research are also discussed.

  10. Using PIDs to Support the Full Research Data Publishing Lifecycle

    NASA Astrophysics Data System (ADS)

    Waard, A. D.

    2016-12-01

    Persistent identifiers can help support scientific research, track scientific impact and let researchers achieve recognition for their work. We discuss a number of ways in which Elsevier utilizes PIDs to support the scholarly lifecycle: To improve the process of storing and sharing data, Mendeley Data (http://data.mendeley.com) makes use of persistent identifiers to support the dynamic nature of data and software, by tracking and recording the provenance and versioning of datasets. This system now allows the comparison of different versions of a dataset, to see precisely what was changed during a versioning update. To present research data in context for the reader, we include PIDs in research articles as hyperlinks: https://www.elsevier.com/books-and-journals/content-innovation/data-base-linking. In some cases, PIDs fetch data files from the repositories provide that allow the embedding of visualizations, e.g. with PANGAEA and PubChem: https://www.elsevier.com/books-and-journals/content-innovation/protein-viewer; https://www.elsevier.com/books-and-journals/content-innovation/pubchem. To normalize referenced data elements, the Resource Identification Initiative - which we developed together with members of the Force11 RRID group - introduces a unified standard for resource identifiers (RRIDs) that can easily be interpreted by both humans and text mining tools. https://www.force11.org/group/resource-identification-initiative/update-resource-identification-initiative, as can be seen in our Antibody Data app: https://www.elsevier.com/books-and-journals/content-innovation/antibody-data To enable better citation practices and support robust metrics system for sharing research data, we have helped develop, and are early adopters of the Force11 Data Citation Principles and Implementation groups (https://www.force11.org/group/dcip) Lastly, through our work with the Research Data Alliance Publishing Data Services group, we helped create a set of guidelines (http

  11. Immunodeficiency with thymoma: failure to induce Ig production in immunodeficient lymphocytes cocultured with normal T cells. [X radiation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Litwin, S.D.

    Blood mononuclear cells of two individuals having immunodeficiency with thymoma (ID-THY) were cocultured with normal mononuclear cells or treated mononuclear cell fractions in an attempt to correct an imbalance of regulatory cells postulated to be responsible for the failure of pokeweed mitogen-induced Ig synthesis in vitro. Treatment included abrogation of suppressor cell activity by irradiation or incubation with prednisolone in vitro. T cell help was provided by cocultivating lymphocytes of related and unrelated persons, and in some cases autologous treated cells. Ig secretion failed to be induced by any experimental maneuver suggesting that the primary problem in the above ID-THYmore » cells was related to defective or deficient B cells rather than an imbalance of T regulatory cells. Prednisolone treatment in vitro decreased suppressor cell activity in allogeneic cocultures of two ID-THY persons (S1 and S2) but not of an individual (S3) with variable immunodeficiency suggesting heterogeneity of suppressor cells.« less

  12. Multivariable PID controller design tuning using bat algorithm for activated sludge process

    NASA Astrophysics Data System (ADS)

    Atikah Nor’Azlan, Nur; Asmiza Selamat, Nur; Mat Yahya, Nafrizuan

    2018-04-01

    The designing of a multivariable PID control for multi input multi output is being concerned with this project by applying four multivariable PID control tuning which is Davison, Penttinen-Koivo, Maciejowski and Proposed Combined method. The determination of this study is to investigate the performance of selected optimization technique to tune the parameter of MPID controller. The selected optimization technique is Bat Algorithm (BA). All the MPID-BA tuning result will be compared and analyzed. Later, the best MPID-BA will be chosen in order to determine which techniques are better based on the system performances in terms of transient response.

  13. An improved PID switching control strategy for type 1 diabetes.

    PubMed

    Marchetti, Gianni; Barolo, Massimiliano; Jovanovic, Lois; Zisser, Howard; Seborg, Dale E

    2006-01-01

    In order for an "artificial pancreas" to become a reality for ambulatory use, a practical closed-loop control strategy must be developed and critically evaluated. In this paper, an improved PID control strategy for blood glucose control is proposed and evaluated in silico using a physiologic model of Hovorka et al. The key features of the proposed control strategy are: (i) a switching strategy for initiating PID control after a meal and insulin bolus; (ii) a novel time-varying setpoint trajectory, (iii) noise and derivative filters to reduce sensitivity to sensor noise, and (iv) a systematic controller tuning strategy. Simulation results demonstrate that the proposed control strategy compares favorably to alternatives for realistic conditions that include meal challenges, incorrect carbohydrate meal estimates, changes in insulin sensitivity, and measurement noise.

  14. Data Publication Process for CMIP5 Data and the Role of PIDs within Federated Earth System Science Projects

    NASA Astrophysics Data System (ADS)

    Stockhause, M.; Höck, H.; Toussaint, F.; Weigel, T.; Lautenschlager, M.

    2012-12-01

    We present the publication process for the CMIP5 (Coupled Model Intercomparison Project Phase 5) data with special emphasis on the current role of identifiers and the potential future role of PIDs in such distributed technical infrastructures. The DataCite data publication with DOI assignment finalizes the 3 levels quality control procedure for CMIP5 data (Stockhause et al., 2012). WDCC utilizes the Assistant System Atarrabi to support the publication process. Atarrabi is a web-based workflow system for metadata reviews of data creators and Publication Agents (PAs). Within the quality checks for level 3 all available information in the different infrastructure components is cross-checked for consistency by the DataCite PA. This information includes: metadata on data, metadata in the long-term archive of the Publication Agency, quality information, and external metadata on model and simulation (CIM). For these consistency checks metadata related to the data publication has to be identified. The Data Reference Syntax (DRS) convention functions as global identifier for data. Since the DRS structures the data, hierarchically, it can be used to identify data collections like DataCite publication units, i.e. all data belonging to a CMIP5 simulation. Every technical component of the infrastructure uses DRS or maps to it, but there is no central repository storing DRS_ids. Thus they have to be mapped, occasionally. Additional local identifiers are used within the different technical infrastructure components. Identification of related pieces of information in their repositories is cumbersome and tricky for the PA. How could PIDs improve the situation? To establish a reliable distributed data and metadata infrastructure, PIDs for all objects are needed as well as relations between them. An ideal data publication scenario for federated community projects within Earth System Sciences, e.g. CMIP, would be: 1. Data creators at the modeling centers define their simulation

  15. Is Graves' disease a primary immunodeficiency? New immunological perspectives on an endocrine disease.

    PubMed

    Struja, Tristan; Kutz, Alexander; Fischli, Stefan; Meier, Christian; Mueller, Beat; Recher, Mike; Schuetz, Philipp

    2017-09-25

    Uncertainty about factors influencing the susceptibility and triggers for Graves' disease persists, along with a wide variation in the response to anti-thyroid drugs, currently at approximately 50% of non-responders. The aim of this narrative review is to summarize immunological concepts, with a combined endocrine and immunological perspective, to highlight potential new areas of research. Relevant studies were identified through a systematic literature search using the PubMed and EMBASE databases in March 2016. No cut-offs regarding dates were imposed. We used the terms "Graves' Disease" or "Basedow" or "thyrotoxicosis" together with the terms "etiology", "pathophysiology", "immunodeficiency", "causality", and "autoimmunity". The terms "orbitopathy", "ophthalmopathy", and "amiodarone" were excluded. Articles in English, French, German, Croatian, Spanish, and Italian were eligible for inclusion. While concepts such as the impact of iodine, smoking, human leucocyte antigen, infections, and ethnicity are established, new ideas have emerged. Pertaining evidence suggests the involvement of autoimmunity and immunodeficiency in the pathophysiology of Graves' disease. Recent studies point to specific immunological mechanisms triggering the onset of disease, which may also serve as targets for more specific therapies.

  16. PID tuning rules for SOPDT systems: review and some new results.

    PubMed

    Panda, Rames C; Yu, Cheng-Ching; Huang, Hsiao-Ping

    2004-04-01

    PID controllers are widely used in industries and so many tuning rules have been proposed over the past 50 years that users are often lost in the jungle of tuning formulas. Moreover, unlike PI control, different control laws and structures of implementation further complicate the use of the PID controller. In this work, five different tuning rules are taken for study to control second-order plus dead time systems with wide ranges of damping coefficients and dead time to time constant ratios (D/tau). Four of them are based on IMC design with different types of approximations on dead time and the other on desired closed-loop specifications (i.e., specified forward transfer function). The method of handling dead time in the IMC type of design is important especially for systems with large D/tau ratios. A systematic approach was followed to evaluate the performance of controllers. The regions of applicability of suitable tuning rules are highlighted and recommendations are also given. It turns out that IMC designed with the Maclaurin series expansion type PID is a better choice for both set point and load changes for systems with D/tau greater than 1. For systems with D/tau less than 1, the desired closed-loop specification approach is favored.

  17. Simulated Annealing-based Optimal Proportional-Integral-Derivative (PID) Controller Design: A Case Study on Nonlinear Quadcopter Dynamics

    NASA Astrophysics Data System (ADS)

    Nemirsky, Kristofer Kevin

    In this thesis, the history and evolution of rotor aircraft with simulated annealing-based PID application were reviewed and quadcopter dynamics are presented. The dynamics of a quadcopter were then modeled, analyzed, and linearized. A cascaded loop architecture with PID controllers was used to stabilize the plant dynamics, which was improved upon through the application of simulated annealing (SA). A Simulink model was developed to test the controllers and verify the functionality of the proposed control system design. In addition, the data that the Simulink model provided were compared with flight data to present the validity of derived dynamics as a proper mathematical model representing the true dynamics of the quadcopter system. Then, the SA-based global optimization procedure was applied to obtain optimized PID parameters. It was observed that the tuned gains through the SA algorithm produced a better performing PID controller than the original manually tuned one. Next, we investigated the uncertain dynamics of the quadcopter setup. After adding uncertainty to the gyroscopic effects associated with pitch-and-roll rate dynamics, the controllers were shown to be robust against the added uncertainty. A discussion follows to summarize SA-based algorithm PID controller design and performance outcomes. Lastly, future work on SA application on multi-input-multi-output (MIMO) systems is briefly discussed.

  18. Regulation of flow through a T-Shaped open cavity by temperature dependent P, PI, and PID controllers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Saha, Sourav, E-mail: ssaha09@me.buet.ac.bd; Mojumder, Satyajit, E-mail: satyajit@me.buet.ac.bd; Saha, Sumon, E-mail: sumonsaha@me.buet.ac.bd

    P (proportional), PI (proportional-integral), and PID (proportional-integral-derivative) controllers are popular means of controlling industrial processes. Due to superior response, accuracy, and stable performance, PID controllers are mostly used in control systems. This paper presents a mathematical model and subsequent response analysis regarding regulation of flow in mixed convection through a T-shaped open cavity by temperature dependent controllers. The T-shaped cavity has cold top and hot bottom walls, while air is flowing through the inlet at surrounding temperature. The inflow is regulated by a controlled gate which operates according to the signal received from the controller. Values of proportional gain (k{submore » p}), integral gain (k{sub i}), and derivative gain (k{sub d}) are varied to obtain the desired system response and to ensure a stable system with fastest response. At first, only P controller is used and eventually PI and finally PID control scheme is applied for controller tuning. Tuning of different controllers (P, PI, and PID) are carried out systematically based on the reference temperature which is continuously monitored at a certain location inside the cavity. It is found that PID controller performs better than P or PI controller.« less

  19. Classification of deaths in women with human immunodeficiency virus/acquired immunodeficiency syndrome in pregnancy and childbirth.

    PubMed

    Brayner, Manuella Coutinho; Alves, Sandra Valongueiro

    2017-01-01

    To reclassify deaths of women infected with the human immunodeficiency virus/acquired immunodeficiency syndrome in pregnancy and childbirth in the State of Pernambuco, Brazil, from 2000 to 2010. A descriptive exploratory study, developed from the following steps: translation to Portuguese of the item "HIV and aids" of the United Nations document "The WHO application of ICD-10 to deaths during pregnancy, childbirth and the puerperium: DCI MM 2012"; development of a classification algorithm of deaths of women living with the human immunodeficiency virus/acquired immunodeficiency syndrome in pregnancy and childbirth; and reclassification of deaths by a group of experts. Among the 25 reclassified deaths, 12 were due to human immunodeficiency virus/acquired immunodeficiency syndrome, and pregnancy condition was coexisting; 9 were reclassified as indirect maternal death, with O98.7 code, proposed by the World Health Organization; 2 as direct/indirect maternal death; and 2 were considered indeterminate. The reclassification showed a possible pattern of change in maternal mortality, since most of the deaths were attributed to the virus and may lead to a reduction in deaths from maternal causes. The algorithm will subsidize the use of the new classification of maternal death and human immunodeficiency virus/acquired immunodeficiency syndrome.

  20. Development of a novel direct X-ray detector using photoinduced discharge (PID) readout for digital radiography

    NASA Astrophysics Data System (ADS)

    Heo, D.; Jeon, S.; Kim, J.-S.; Kim, R. K.; Cha, B. K.; Moon, B. J.; Yoon, J.

    2013-02-01

    We developed a novel direct X-ray detector using photoinduced discharge (PID) readout for digital radiography. The pixel resolution is 512 × 512 with 200 μm pixel and the overall active dimensions of the X-ray imaging panel is 10.24 cm × 10.24 cm. The detector consists of an X-ray absorption layer of amorphous selenium, a charge accumulation layer of metal, and a PID readout layer of amorphous silicon. In particular, the charge accumulation is pixelated because image charges generated by X-ray should be stored pixel by pixel. Here the image charges, or holes, are recombined with electrons generated by the PID method. We used a 405 nm laser diode and cylindrical lens to make a line beam source with a width of 50 μm for PID readout, which generates charges for each pixel lines during the scan. We obtained spatial frequencies of about 1.0 lp/mm for the X-direction (lateral direction) and 0.9 lp/mm for the Y-direction (scanning direction) at 50% modulation transfer function.

  1. Adaptive fuzzy PID control of hydraulic servo control system for large axial flow compressor

    NASA Astrophysics Data System (ADS)

    Wang, Yannian; Wu, Peizhi; Liu, Chengtao

    2017-09-01

    To improve the stability of the large axial compressor, an efficient and special intelligent hydraulic servo control system is designed and implemented. The adaptive fuzzy PID control algorithm is used to control the position of the hydraulic servo cylinder steadily, which overcomes the drawback that the PID parameters should be adjusted based on the different applications. The simulation and the test results show that the system has a better dynamic property and a stable state performance.

  2. Trait Variance and Response Style Variance in the Scales of the Personality Inventory for DSM-5 (PID-5).

    PubMed

    Ashton, Michael C; de Vries, Reinout E; Lee, Kibeom

    2017-01-01

    Using self- and observer reports on the Personality Inventory for DSM-5 (PID-5) and the HEXACO Personality Inventory-Revised (HEXACO-PI-R), we identified for each inventory several trait dimensions (each defined by both self- and observer reports on the facet-level scales belonging to the same domain) and 2 source dimensions (each defined by self-reports or by observer reports, respectively, on all facet-level scales). Results (N = 217) showed that the source dimensions of the PID-5 were very large (much larger than those of the HEXACO-PI-R), and suggest that self-report (or observer report) response styles substantially inflate the intercorrelations and the alpha reliabilities of the PID-5 scales. We discuss the meaning and the implications of the large PID-5 source components, and we suggest some methods of controlling their influence.

  3. Design of distributed PID-type dynamic matrix controller for fractional-order systems

    NASA Astrophysics Data System (ADS)

    Wang, Dawei; Zhang, Ridong

    2018-01-01

    With the continuous requirements for product quality and safety operation in industrial production, it is difficult to describe the complex large-scale processes with integer-order differential equations. However, the fractional differential equations may precisely represent the intrinsic characteristics of such systems. In this paper, a distributed PID-type dynamic matrix control method based on fractional-order systems is proposed. First, the high-order approximate model of integer order is obtained by utilising the Oustaloup method. Then, the step response model vectors of the plant is obtained on the basis of the high-order model, and the online optimisation for multivariable processes is transformed into the optimisation of each small-scale subsystem that is regarded as a sub-plant controlled in the distributed framework. Furthermore, the PID operator is introduced into the performance index of each subsystem and the fractional-order PID-type dynamic matrix controller is designed based on Nash optimisation strategy. The information exchange among the subsystems is realised through the distributed control structure so as to complete the optimisation task of the whole large-scale system. Finally, the control performance of the designed controller in this paper is verified by an example.

  4. An Implementation Method of the Fractional-Order PID Control System Considering the Memory Constraint and its Application to the Temperature Control of Heat Plate

    NASA Astrophysics Data System (ADS)

    Sasano, Koji; Okajima, Hiroshi; Matsunaga, Nobutomo

    Recently, the fractional order PID (FO-PID) control, which is the extension of the PID control, has been focused on. Even though the FO-PID requires the high-order filter, it is difficult to realize the high-order filter due to the memory limitation of digital computer. For implementation of FO-PID, approximation of the fractional integrator and differentiator are required. Short memory principle (SMP) is one of the effective approximation methods. However, there is a disadvantage that the approximated filter with SMP cannot eliminate the steady-state error. For this problem, we introduce the distributed implementation of the integrator and the dynamic quantizer to make the efficient use of permissible memory. The objective of this study is to clarify how to implement the accurate FO-PID with limited memories. In this paper, we propose the implementation method of FO-PID with memory constraint using dynamic quantizer. And the trade off between approximation of fractional elements and quantized data size are examined so as to close to the ideal FO-PID responses. The effectiveness of proposed method is evaluated by numerical example and experiment in the temperature control of heat plate.

  5. Continuous Firefly Algorithm for Optimal Tuning of Pid Controller in Avr System

    NASA Astrophysics Data System (ADS)

    Bendjeghaba, Omar

    2014-01-01

    This paper presents a tuning approach based on Continuous firefly algorithm (CFA) to obtain the proportional-integral- derivative (PID) controller parameters in Automatic Voltage Regulator system (AVR). In the tuning processes the CFA is iterated to reach the optimal or the near optimal of PID controller parameters when the main goal is to improve the AVR step response characteristics. Conducted simulations show the effectiveness and the efficiency of the proposed approach. Furthermore the proposed approach can improve the dynamic of the AVR system. Compared with particle swarm optimization (PSO), the new CFA tuning method has better control system performance in terms of time domain specifications and set-point tracking.

  6. Reliability and validity of the personality inventory for DSM-5 (PID-5): predicting DSM-IV personality disorders and psychopathy in community-dwelling Italian adults.

    PubMed

    Fossati, Andrea; Krueger, Robert F; Markon, Kristian E; Borroni, Serena; Maffei, Cesare

    2013-12-01

    In order to assess the internal consistency, factor structure, and ability to recover DSM-IV personality disorders (PDs) of the Personality Inventory for DSM-5 (PID-5) scales, 710 Italian adult community dwelling volunteers were administered the Italian translation of the PID-5, as well as the Italian translation of the Personality Diagnostic Questionnaire-4+ (PDQ-4+). Cronbach's alpha values were >.70 for all PID-5 facet scales and greater than .90 for all PID-5 domain scales. Parallel analysis and confirmatory factor analysis supported the theoretical five-factor model of the PID-5 trait scales. Regression analyses showed that both PID-5 trait and domain scales explained a substantial amount of variance in the PDQ-4+ PD scales, with the exception of the Passive-Aggressive PD scale. When the PID-5 was administered to a second independent sample of 389 Italian adult community dwelling volunteers, the basic psychometric properties of the scale were replicated. In this second sample, the PID-5 trait and domain scales proved to be significant predictors of psychopathy measures. As a whole, the results of the present study support the hypothesis that the PID-5 is a reliable instrument which is able to recover DSM-IV PDs, as well as to capture personality pathology that is not included in the DSM-IV (namely, psychopathy).

  7. A conformal mapping based fractional order approach for sub-optimal tuning of PID controllers with guaranteed dominant pole placement

    NASA Astrophysics Data System (ADS)

    Saha, Suman; Das, Saptarshi; Das, Shantanu; Gupta, Amitava

    2012-09-01

    A novel conformal mapping based fractional order (FO) methodology is developed in this paper for tuning existing classical (Integer Order) Proportional Integral Derivative (PID) controllers especially for sluggish and oscillatory second order systems. The conventional pole placement tuning via Linear Quadratic Regulator (LQR) method is extended for open loop oscillatory systems as well. The locations of the open loop zeros of a fractional order PID (FOPID or PIλDμ) controller have been approximated in this paper vis-à-vis a LQR tuned conventional integer order PID controller, to achieve equivalent integer order PID control system. This approach eases the implementation of analog/digital realization of a FOPID controller with its integer order counterpart along with the advantages of fractional order controller preserved. It is shown here in the paper that decrease in the integro-differential operators of the FOPID/PIλDμ controller pushes the open loop zeros of the equivalent PID controller towards greater damping regions which gives a trajectory of the controller zeros and dominant closed loop poles. This trajectory is termed as "M-curve". This phenomena is used to design a two-stage tuning algorithm which reduces the existing PID controller's effort in a significant manner compared to that with a single stage LQR based pole placement method at a desired closed loop damping and frequency.

  8. Borderline Personality Disorder and Personality Inventory for DSM-5 (PID-5): Dimensional personality assessment with DSM-5.

    PubMed

    Calvo, Natalia; Valero, Sergi; Sáez-Francàs, Naia; Gutiérrez, Fernando; Casas, Miguel; Ferrer, Marc

    2016-10-01

    Borderline personality disorder (BPD) diagnosis has been considered highly controversial. The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) proposes an alternative hybrid diagnostic model for personality disorders (PD), and the Personality Inventory for DSM-5 (PID-5) has adequate psychometric properties and has been widely used for the assessment of the dimensional component. Our aim was to analyze the utility of the personality traits presented in Section III of the DSM-5 for BPD diagnosis in an outpatient clinical sample, using the Spanish version of the PID-5. Two clinical samples were studied: BPD sample (n=84) and non-BPD sample (n=45). Between-sample differences in PID-5 scores were analyzed. The BPD sample obtained significantly higher scores in most PID-5 trait facets and domains. Specifically and after regression logistic analyses, in BPD patients, the domains of Negative Affectivity and Disinhibition, and the trait facets of emotional lability, [lack of] restricted affectivity, and impulsivity were more significantly associated with BPD. Although our findings are only partially consistent with the algorithm proposed by DSM-5, we consider that the combination of the PID-5 trait domains and facets could be useful for BPD dimensional diagnosis, and could further our understanding of BPD diagnosis complexity. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. The maladaptive personality traits of the Personality Inventory for DSM-5 (PID-5) in relation to the HEXACO personality factors and schizotypy/dissociation.

    PubMed

    Ashton, Michael C; Lee, Kibeom; de Vries, Reinout E; Hendrickse, Joshua; Born, Marise Ph

    2012-10-01

    The Personality Inventory for DSM-5 (PID-5), a new measure of maladaptive personality traits, has recently been developed by the DSM-5 Personality and Personality Disorders Workgroup. The PID-5 variables were examined within the seven-factor space defined by the six HEXACO factors and the Schizotypy/Dissociation factor (Ashton & Lee, 2012) using participant samples from Canada (N = 378) and the Netherlands (N = 476). Extension analyses showed that several PID-5 facet-level scales represented each of the Honesty-Humility, Emotionality, Extraversion, Conscientiousness, and Schizotypy/Dissociation factors. In contrast, only one PID-5 scale loaded strongly on HEXACO Agreeableness, and no PID-5 scales loaded strongly on Openness to Experience. In addition, a joint factor analysis involving the PID-5 variables and facets of the Five-Factor Model was conducted in the Canadian sample and recovered a set of seven factors corresponding rather closely to the HEXACO factors plus Schizotypy/Dissociation. The authors discuss implications for the assessment and structure of normal and abnormal personality.

  10. Design of Intelligent Hydraulic Excavator Control System Based on PID Method

    NASA Astrophysics Data System (ADS)

    Zhang, Jun; Jiao, Shengjie; Liao, Xiaoming; Yin, Penglong; Wang, Yulin; Si, Kuimao; Zhang, Yi; Gu, Hairong

    Most of the domestic designed hydraulic excavators adopt the constant power design method and set 85%~90% of engine power as the hydraulic system adoption power, it causes high energy loss due to mismatching of power between the engine and the pump. While the variation of the rotational speed of engine could sense the power shift of the load, it provides a new method to adjust the power matching between engine and pump through engine speed. Based on negative flux hydraulic system, an intelligent hydraulic excavator control system was designed based on rotational speed sensing method to improve energy efficiency. The control system was consisted of engine control module, pump power adjusted module, engine idle module and system fault diagnosis module. Special PLC with CAN bus was used to acquired the sensors and adjusts the pump absorption power according to load variation. Four energy saving control strategies with constant power method were employed to improve the fuel utilization. Three power modes (H, S and L mode) were designed to meet different working status; Auto idle function was employed to save energy through two work status detected pressure switches, 1300rpm was setting as the idle speed according to the engine consumption fuel curve. Transient overload function was designed for deep digging within short time without spending extra fuel. An increasing PID method was employed to realize power matching between engine and pump, the rotational speed's variation was taken as the PID algorithm's input; the current of proportional valve of variable displacement pump was the PID's output. The result indicated that the auto idle could decrease fuel consumption by 33.33% compared to work in maximum speed of H mode, the PID control method could take full use of maximum engine power at each power mode and keep the engine speed at stable range. Application of rotational speed sensing method provides a reliable method to improve the excavator's energy efficiency and

  11. Tuning of PID controllers for boiler-turbine units.

    PubMed

    Tan, Wen; Liu, Jizhen; Fang, Fang; Chen, Yanqiao

    2004-10-01

    A simple two-by-two model for a boiler-turbine unit is demonstrated in this paper. The model can capture the essential dynamics of a unit. The design of a coordinated controller is discussed based on this model. A PID control structure is derived, and a tuning procedure is proposed. The examples show that the method is easy to apply and can achieve acceptable performance.

  12. Performance and robustness of optimal fractional fuzzy PID controllers for pitch control of a wind turbine using chaotic optimization algorithms.

    PubMed

    Asgharnia, Amirhossein; Shahnazi, Reza; Jamali, Ali

    2018-05-11

    The most studied controller for pitch control of wind turbines is proportional-integral-derivative (PID) controller. However, due to uncertainties in wind turbine modeling and wind speed profiles, the need for more effective controllers is inevitable. On the other hand, the parameters of PID controller usually are unknown and should be selected by the designer which is neither a straightforward task nor optimal. To cope with these drawbacks, in this paper, two advanced controllers called fuzzy PID (FPID) and fractional-order fuzzy PID (FOFPID) are proposed to improve the pitch control performance. Meanwhile, to find the parameters of the controllers the chaotic evolutionary optimization methods are used. Using evolutionary optimization methods not only gives us the unknown parameters of the controllers but also guarantees the optimality based on the chosen objective function. To improve the performance of the evolutionary algorithms chaotic maps are used. All the optimization procedures are applied to the 2-mass model of 5-MW wind turbine model. The proposed optimal controllers are validated using simulator FAST developed by NREL. Simulation results demonstrate that the FOFPID controller can reach to better performance and robustness while guaranteeing fewer fatigue damages in different wind speeds in comparison to FPID, fractional-order PID (FOPID) and gain-scheduling PID (GSPID) controllers. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

  13. All About PID - Testing and Avoidance in the Field

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hacke, Peter; Johnston, Steve

    2016-09-01

    Potential-induced degradation can cause significant power loss in modules if the appropriate precautions are not taken. In the first part of a new series in PV Tech Power on module failure, Peter Hacke and Steve Johnston assess the current state-of-the-art in detecting, avoiding and mitigating the worst effects of PID.

  14. Control of force during rapid visuomotor force-matching tasks can be described by discrete time PID control algorithms.

    PubMed

    Dideriksen, Jakob Lund; Feeney, Daniel F; Almuklass, Awad M; Enoka, Roger M

    2017-08-01

    Force trajectories during isometric force-matching tasks involving isometric contractions vary substantially across individuals. In this study, we investigated if this variability can be explained by discrete time proportional, integral, derivative (PID) control algorithms with varying model parameters. To this end, we analyzed the pinch force trajectories of 24 subjects performing two rapid force-matching tasks with visual feedback. Both tasks involved isometric contractions to a target force of 10% maximal voluntary contraction. One task involved a single action (pinch) and the other required a double action (concurrent pinch and wrist extension). 50,000 force trajectories were simulated with a computational neuromuscular model whose input was determined by a PID controller with different PID gains and frequencies at which the controller adjusted muscle commands. The goal was to find the best match between each experimental force trajectory and all simulated trajectories. It was possible to identify one realization of the PID controller that matched the experimental force produced during each task for most subjects (average index of similarity: 0.87 ± 0.12; 1 = perfect similarity). The similarities for both tasks were significantly greater than that would be expected by chance (single action: p = 0.01; double action: p = 0.04). Furthermore, the identified control frequencies in the simulated PID controller with the greatest similarities decreased as task difficulty increased (single action: 4.0 ± 1.8 Hz; double action: 3.1 ± 1.3 Hz). Overall, the results indicate that discrete time PID controllers are realistic models for the neural control of force in rapid force-matching tasks involving isometric contractions.

  15. vif-negative human immunodeficiency virus type 1 persistently replicates in primary macrophages, producing attenuated progeny virus.

    PubMed Central

    Chowdhury, I H; Chao, W; Potash, M J; Sova, P; Gendelman, H E; Volsky, D J

    1996-01-01

    The vif gene of human immunodeficiency virus type 1 (HIV-1) is required for efficient infection of primary T lymphocytes. In this study, we investigated in detail the role of vif in productive infection of primary monocyte-derived macrophages (MDM). Viruses carrying missense or deletion mutations in vif were constructed on the background of the monocytotropic recombinant NLHXADA-GP. Using MDM from multiple donors, we found that vif mutants produced in complementing or partially complementing cell lines were approximately 10% as infectious as wild-type virus when assayed for incomplete, complete, and circularized viral DNA molecules by quantitative PCR amplification or for viral core antigen p24 production by enzyme-linked immunosorbent assay. We then determined the structure and infectivity of vif mutant HIV-1 by using MDM exclusively both for virus production and as targets for infection. Biosynthetic labeling and immunoprecipitation analysis of sucrose cushion-purified vif-negative HIV-1 made in MDM revealed that the virus had reduced p24 content compared with wild-type HIV-1. Cell-free MDM-derived vif mutant HIV-1 was infectious in macrophages as determined by the synthesis and maintenance of full-length viral DNA and by the produc- tion of particle-associated viral RNA, but its infectivity was approximately 2,500-fold lower than that of wild-type virus whose titer was determined in parallel by measurement of the viral DNA burden. MDM infected with MDM-derived vif-negative HIV-1 were able to transmit the virus to uninfected MDM by cocultivation, confirming the infectiousness of this virus. We conclude that mutations in vif significantly reduce but do not eliminate the capacity of HIV-1 to replicate and produce infectious progeny virus in primary human macrophages. PMID:8764044

  16. vif-negative human immunodeficiency virus type 1 persistently replicates in primary macrophages, producing attenuated progeny virus.

    PubMed

    Chowdhury, I H; Chao, W; Potash, M J; Sova, P; Gendelman, H E; Volsky, D J

    1996-08-01

    The vif gene of human immunodeficiency virus type 1 (HIV-1) is required for efficient infection of primary T lymphocytes. In this study, we investigated in detail the role of vif in productive infection of primary monocyte-derived macrophages (MDM). Viruses carrying missense or deletion mutations in vif were constructed on the background of the monocytotropic recombinant NLHXADA-GP. Using MDM from multiple donors, we found that vif mutants produced in complementing or partially complementing cell lines were approximately 10% as infectious as wild-type virus when assayed for incomplete, complete, and circularized viral DNA molecules by quantitative PCR amplification or for viral core antigen p24 production by enzyme-linked immunosorbent assay. We then determined the structure and infectivity of vif mutant HIV-1 by using MDM exclusively both for virus production and as targets for infection. Biosynthetic labeling and immunoprecipitation analysis of sucrose cushion-purified vif-negative HIV-1 made in MDM revealed that the virus had reduced p24 content compared with wild-type HIV-1. Cell-free MDM-derived vif mutant HIV-1 was infectious in macrophages as determined by the synthesis and maintenance of full-length viral DNA and by the produc- tion of particle-associated viral RNA, but its infectivity was approximately 2,500-fold lower than that of wild-type virus whose titer was determined in parallel by measurement of the viral DNA burden. MDM infected with MDM-derived vif-negative HIV-1 were able to transmit the virus to uninfected MDM by cocultivation, confirming the infectiousness of this virus. We conclude that mutations in vif significantly reduce but do not eliminate the capacity of HIV-1 to replicate and produce infectious progeny virus in primary human macrophages.

  17. Prevalence and variables associated with an abnormal ankle-brachial index among patients with human immunodeficiency virus/acquired immunodeficiency syndrome.

    PubMed

    Hinojosa, Carlos A; Nunez-Salgado, Ana E; Anaya-Ayala, Javier E; Laparra-Escareno, Hugo; Ortiz-Lopez, Laura J; Herrera-Caceres, Jaime O; Crabtree-Ramirez, Brenda E; Sierra-Madero, Juan G

    2018-01-01

    Objectives The longer survival of patients with human immunodeficiency virus/acquired immunodeficiency syndrome and the introduction of the highly active antiretroviral therapy have increased the number of chronic conditions; among these, cardiovascular diseases. The aim of this study is to determine patient, disease, and factors associated with peripheral arterial disease in a population of patients with human immunodeficiency virus/acquired immunodeficiency syndrome. Methods A prospective nested case-control study of a cohort of patients with human immunodeficiency virus/acquired immunodeficiency syndrome was conducted in a tertiary medical center in Mexico City. A sample size of 206 patients was calculated. Medical history, relevant laboratory data, peripheral arterial exam, and screening ankle-brachial index tests were obtained. Results The prevalence of abnormal ankle-brachial indexes was 20% (42 patients). Patient's mean age was 44 years ±13. The majority (98.5%) were actively receiving highly active antiretroviral therapy; active smoking was reported in 55 (27%), arterial hypertension and type 2 diabetes mellitus were found in 24 (12%) and 22 (11%) patients. Median time from the human immunodeficiency virus diagnosis was eight years (Interquartile range ±11); the mean CD4 count was 481, with a mean viral load of 13,557 copies (SD ± 69025.27) and 1889.18 (SD ± 9052.77) for patients with normal and abnormal ankle-brachial index and a median of 40 (IQ ± 2). Viral load ( p = 0.04) and number of years with human immunodeficiency virus/acquired immunodeficiency syndrome ( p = 0.04) were significantly associated with abnormal ankle-brachial indexes. Conclusions Abnormal ankle-brachial index seems to be more frequent in Mexican patients with human immunodeficiency virus/acquired immunodeficiency syndrome when compared with the general population at the same age. The most important factors associated with arterial disease were the viral

  18. Optimized linear motor and digital PID controller setup used in Mössbauer spectrometer

    NASA Astrophysics Data System (ADS)

    Kohout, Pavel; Kouřil, Lukáš; Navařík, Jakub; Novák, Petr; Pechoušek, Jiří

    2014-10-01

    Optimization of a linear motor and digital PID controller setup used in a Mössbauer spectrometer is presented. Velocity driving system with a digital PID feedback subsystem was developed in the LabVIEW graphical environment and deployed on the sbRIO real-time hardware device (National Instruments). The most important data acquisition processes are performed as real-time deterministic tasks on an FPGA chip. Velocity transducer of a double loudspeaker type with a power amplifier circuit is driven by the system. Series of calibration measurements were proceeded to find the optimal setup of the P, I, D parameters together with velocity error signal analysis. The shape and given signal characteristics of the velocity error signal are analyzed in details. Remote applications for controlling and monitoring the PID system from computer or smart phone, respectively, were also developed. The best setup and P, I, D parameters were set and calibration spectrum of α-Fe sample with an average nonlinearity of the velocity scale below 0.08% was collected. Furthermore, the width of the spectral line below 0.30 mm/s was observed. Powerful and complex velocity driving system was designed.

  19. Barriers and facilitators to primary care or human immunodeficiency virus clinics providing methadone or buprenorphine for the management of opioid dependence.

    PubMed

    Turner, Barbara J; Laine, Christine; Lin, Yi-Ting; Lynch, Kevin

    Federal initiatives aim to increase office-based treatment of opioid dependence, but, to our knowledge, factors associated with willingness to deliver this care have not been defined. The objective of this study was to describe clinics' willingness to provide methadone hydrochloride or buprenorphine hydrochloride for opioid dependence. The design of the study was a survey conducted in New York State. Two hundred sixty-one directors of primary care and/or human immunodeficiency virus specialty clinics (response rate, 61.1%) that serve Medicaid enrollees were questioned. Outcomes were willingness to provide methadone and buprenorphine. Predictors included clinic characteristics, attitudes about drug users and their treatment, and reported barriers and facilitators to treatment. Clinics were more willing to provide buprenorphine than methadone treatment (59.8% vs 32.6%; P < .001). Clinics offering human immunodeficiency virus specialty care (adjusted odds ratio [AOR], 2.16; 95% confidence interval [CI], 1.18-3.95) or a safe location to store narcotics (AOR, 2.99; 95% CI, 1.57-5.70) were more willing to prescribe buprenorphine and more willing to provide methadone. Willingness was positively associated with continuing medical education credits for training, but negatively associated with greater concern about medication abuse. Immediate telephone access to an addiction expert was associated with willingness to provide buprenorphine (AOR, 2.08; 95% CI, 1.15-3.76). Greater willingness to provide methadone was associated with a belief that methadone-treated patients should be seen along with other patients (AOR, 6.20; 95% CI, 1.78-21.64), methadone program affiliation (AOR, 4.76; 95% CI, 1.64-13.82), and having more patients with chronic pain in the clinic (AOR, 2.80; 95% CI, 1.44-5.44). These clinics serving Medicaid enrollees were more receptive to buprenorphine than methadone treatment. Willingness to provide this care was greater in clinics offering human

  20. Design and Simulation of a PID Controller for Motion Control Systems

    NASA Astrophysics Data System (ADS)

    Hassan Abdullahi, Zakariyya; Danzomo, Bashir Ahmed; Suleiman Abdullahi, Zainab

    2018-04-01

    Motion control system plays important role in many industrial applications among which are in robot system, missile launching, positioning systems etc. However, the performance requirement for these applications in terms of high accuracy, high speed, insignificant or no overshoot and robustness have generated continuous challenges in the field of motion control system design and implementation. To compensate this challenge, a PID controller was design using mathematical model of a DC motor based on classical root-locus approach. The reason for adopting root locus design is to remodel the closed-loop response by putting the closed-loop poles of the system at desired points. Adding poles and zeros to the initial open-loop transfer function through the controller provide a way to transform the root locus in order to place the closed-loop poles at the required points. This process can also be used for discrete-time models. The Advantages of root locus over other methods is that, it gives the better way of pinpointing the parameters and can easily predict the fulfilment of the whole system. The controller performance was simulated using MATLAB code and a reasonable degree of accuracy was obtained. Implementation of the proposed model was conducted using-Simulink and the result obtained shows that the PID controller met the transient performance specifications with both settling time and overshoot less than 0.1s and 5% respectively. In terms of steady state error, the PID controller gave good response for both step input and ramp.

  1. System-wide hybrid MPC-PID control of a continuous pharmaceutical tablet manufacturing process via direct compaction.

    PubMed

    Singh, Ravendra; Ierapetritou, Marianthi; Ramachandran, Rohit

    2013-11-01

    The next generation of QbD based pharmaceutical products will be manufactured through continuous processing. This will allow the integration of online/inline monitoring tools, coupled with an efficient advanced model-based feedback control systems, to achieve precise control of process variables, so that the predefined product quality can be achieved consistently. The direct compaction process considered in this study is highly interactive and involves time delays for a number of process variables due to sensor placements, process equipment dimensions, and the flow characteristics of the solid material. A simple feedback regulatory control system (e.g., PI(D)) by itself may not be sufficient to achieve the tight process control that is mandated by regulatory authorities. The process presented herein comprises of coupled dynamics involving slow and fast responses, indicating the requirement of a hybrid control scheme such as a combined MPC-PID control scheme. In this manuscript, an efficient system-wide hybrid control strategy for an integrated continuous pharmaceutical tablet manufacturing process via direct compaction has been designed. The designed control system is a hybrid scheme of MPC-PID control. An effective controller parameter tuning strategy involving an ITAE method coupled with an optimization strategy has been used for tuning of both MPC and PID parameters. The designed hybrid control system has been implemented in a first-principles model-based flowsheet that was simulated in gPROMS (Process System Enterprise). Results demonstrate enhanced performance of critical quality attributes (CQAs) under the hybrid control scheme compared to only PID or MPC control schemes, illustrating the potential of a hybrid control scheme in improving pharmaceutical manufacturing operations. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. The Personality Inventory for DSM-5 Short Form (PID-5-SF): psychometric properties and association with big five traits and pathological beliefs in a Norwegian population.

    PubMed

    Thimm, Jens C; Jordan, Stian; Bach, Bo

    2016-12-07

    With the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), an alternative model for personality disorders based on personality dysfunction and pathological personality traits was introduced. The Personality Inventory for DSM-5 (PID-5) is a 220-item self-report inventory designed to assess the personality traits of this model. Recently, a short 100-item version of the PID-5 (PID-5-SF) has been developed. The aim of this study was to investigate the score reliability and structure of the Norwegian PID-5-SF. Further, criterion validity with the five factor model of personality (FFM) and pathological personality beliefs was examined. A derivation sample of university students (N = 503) completed the PID-5, the Big Five Inventory (BFI), and the Personality Beliefs Questionnaire - Short Form (PBQ-SF), whereas a replication sample of 127 students completed the PID-5-SF along with the aforementioned measures. The short PID-5 showed overall good score reliability and structural validity. The associations with FFM traits and pathological personality beliefs were conceptually coherent and similar for the two forms of the PID-5. The results suggest that the Norwegian PID-5 short form is a reliable and efficient measure of the trait criterion of the alternative model for personality disorders in DSM-5.

  3. Optimal Self-Tuning PID Controller Based on Low Power Consumption for a Server Fan Cooling System.

    PubMed

    Lee, Chengming; Chen, Rongshun

    2015-05-20

    Recently, saving the cooling power in servers by controlling the fan speed has attracted considerable attention because of the increasing demand for high-density servers. This paper presents an optimal self-tuning proportional-integral-derivative (PID) controller, combining a PID neural network (PIDNN) with fan-power-based optimization in the transient-state temperature response in the time domain, for a server fan cooling system. Because the thermal model of the cooling system is nonlinear and complex, a server mockup system simulating a 1U rack server was constructed and a fan power model was created using a third-order nonlinear curve fit to determine the cooling power consumption by the fan speed control. PIDNN with a time domain criterion is used to tune all online and optimized PID gains. The proposed controller was validated through experiments of step response when the server operated from the low to high power state. The results show that up to 14% of a server's fan cooling power can be saved if the fan control permits a slight temperature response overshoot in the electronic components, which may provide a time-saving strategy for tuning the PID controller to control the server fan speed during low fan power consumption.

  4. Natural variation of rice blast resistance gene Pi-d2

    USDA-ARS?s Scientific Manuscript database

    Studying natural variation of rice resistance (R) genes in cultivated and wild rice relatives can predict resistance stability to rice blast fungus. In the present study, the protein coding regions of rice R gene Pi-d2 in 35 rice accessions of subgroups, aus (AUS), indica (IND), temperate japonica (...

  5. Design of a PID Controller for a PCR Micro Reactor

    ERIC Educational Resources Information Center

    Dinca, M. P.; Gheorghe, M.; Galvin, P.

    2009-01-01

    Proportional-integral-derivative (PID) controllers are widely used in process control, and consequently they are described in most of the textbooks on automatic control. However, rather than presenting the overall design process, the examples given in such textbooks are intended to illuminate specific focused aspects of selection, tuning and…

  6. Inherited and acquired immunodeficiencies underlying tuberculosis in childhood

    PubMed Central

    Boisson-Dupuis, Stéphanie; Bustamante, Jacinta; El-Baghdadi, Jamila; Camcioglu, Yildiz; Parvaneh, Nima; Azbaoui, Safaa El; Agader, Aomar; Hassani, Amal; Hafidi, Naima El; Mrani, Nidal Alaoui; Jouhadi, Zineb; Ailal, Fatima; Najib, Jilali; Reisli, Ismail; Zamani, Adil; Yosunkaya, Sebnem; Gulle-Girit, Saniye; Yildiran, Alisan; Cipe, Funda Erol; Torun, Selda Hancerli; Metin, Ayse; Atikan, Basak Yildiz; Hatipoglu, Nevin; Aydogmus, Cigdem; Kilic, Sara Sebnem; Dogu, Figen; Karaca, Neslihan; Aksu, Guzide; Kutukculer, Necil; Keser-Emiroglu, Melike; Somer, Ayper; Tanir, Gonul; Aytekin, Caner; Adimi, Parisa; Mahdaviani, Seyed Alireza; Mamishi, Setareh; Bousfiha, Aziz; Sanal, Ozden; Mansouri, Davood; Casanova, Jean-Laurent; Abel, Laurent

    2015-01-01

    Summary Tuberculosis (TB), caused by Mycobacterium tuberculosis (M.tb) and a few related mycobacteria, is a devastating disease, killing more than a million individuals per year worldwide. However, its pathogenesis remains largely elusive, as only a small proportion of infected individuals develop clinical disease either during primary infection or during reactivation from latency or secondary infection. Subacute, hematogenous, and extrapulmonary disease tends to be more frequent in infants, children, and teenagers than in adults. Life-threatening primary TB of childhood can result from known acquired or inherited immunodeficiencies, although the vast majority of cases remain unexplained. We review here the conditions conferring a predisposition to childhood clinical diseases caused by mycobacteria, including not only M.tb but also weakly virulent mycobacteria, such as BCG vaccines and environmental mycobacteria. Infections with weakly virulent mycobacteria are much rarer than TB, but the inherited and acquired immunodeficiencies underlying these infections are much better known. Their study has also provided genetic and immunological insights into childhood TB, as illustrated by the discovery of single-gene inborn errors of IFN-γ immunity underlying severe cases of TB. Novel findings are expected from ongoing and future human genetic studies of childhood TB in countries that combine a high proportion of consanguineous marriages, a high incidence of TB, and an excellent clinical care, such as Iran, Morocco, and Turkey. PMID:25703555

  7. FoxP3+ CD25+ CD8+ T-Cell Induction during Primary Simian Immunodeficiency Virus Infection in Cynomolgus Macaques Correlates with Low CD4+ T-Cell Activation and High Viral Load▿

    PubMed Central

    Karlsson, Ingrid; Malleret, Benoît; Brochard, Patricia; Delache, Benoît; Calvo, Julien; Le Grand, Roger; Vaslin, Bruno

    2007-01-01

    The early immune response fails to prevent the establishment of chronic human immunodeficiency virus (HIV) infection but may influence viremia during primary infection, thereby possibly affecting long-term disease progression. CD25+ FoxP3+ regulatory T cells may contribute to HIV/simian immunodeficiency virus (SIV) pathogenesis by suppressing efficient antiviral responses during primary infection, favoring high levels of viral replication and the establishment of chronic infection. In contrast, they may decrease immune activation during chronic infection. CD4+ regulatory T cells have been studied in the most detail, but CD8+ CD25+ FoxP3+ T cells also have regulatory properties. We monitored the dynamics of CD25+ FoxP3+ T cells during primary and chronic SIVmac251 infection in cynomolgus macaques. The number of peripheral CD4+ CD25+ FoxP3+ T cells paralleled that of memory CD4+ T cells, with a rapid decline during primary infection followed by a rebound to levels just below baseline and gradual depletion during the course of infection. No change in the proportion of CD25+ FoxP3+ T cells was observed in peripheral lymph nodes. A small number of CD4+ CD25+ FoxP3+ T cells at set point was associated with a high plasma viral load. In contrast, peripheral CD8+ CD25+ FoxP3+ T cells were induced a few days after peak plasma viral load during primary infection. The number of these cells was positively correlated with viral load and negatively correlated with CD4+ T-cell activation, SIV antigen-specific proliferative responses during primary infection, and plasma viral load at set point, with large numbers of CD8+ CD25+ FoxP3+ T cells being indicative of a poor prognosis. PMID:17898053

  8. Glioblastoma multiforme of the brain stem in a patient with acquired immunodeficiency syndrome.

    PubMed

    Wolff, R; Zimmermann, M; Marquardt, Gerhard; Lanfermann, H; Nafe, R; Seifert, V

    2002-09-01

    Glioblastoma of the brain stem is rare and there is no description of such a lesion in patients suffering from acquired immunodeficiency syndrome. The majority of intracerebral mass lesions are due either to toxoplasmosis or primary central nervous system lymphomas so that it is usually not included in the differential diagnosis of enhancing lesions of the central nervous system in these patients. A 31-year-old human immunodeficiency virus (HIV) infected man presented with a four months history of slowly progressive deterioration of brainstem associated symptoms despite antitoxoplasmic therapy. Magnetic resonance imaging revealed a large ring enhancing lesion in the brainstem. Clinical and neuroradiological data could not establish a proper diagnosis and a stereotactic serial biopsy was undertaken. Histological examination of the specimen showed a glioblastoma multiforme (GBM) as the first reported case of GBM located in the brainstem in an acquired immunodeficiency syndrome (AIDS) patient. Patient management and effectiveness of stereotactic serial biopsy are discussed.

  9. Combined immunodeficiency presenting with vaccine-associated paralytic poliomyelitis: a case report and narrative review of literature.

    PubMed

    Shaghaghi, Mohammadreza; Parvaneh, Nima; Ostad-Rahimi, Pouya; Fathi, Seyed Mohammad; Shahmahmoodi, Shohreh; Abolhassani, Hassan; Aghamohammadi, Asghar

    2014-01-01

    Neurologic abnormalities compatible with vaccine-related poliovirus infection (VAPP) may be a first presentation of some primary immunodeficient patients. The risk of VAPP rises from 1 case per 750 000 in normal population to 1 per 7000 times higher, particularly for persons with agammaglobulinemia and hypogammaglobulinemia. However, there is no appropriate estimation for VAPP occurrence in patients with cellular immunity defects. Herein we report a case of combined immunodeficiency with paralytic complication due to oral polio vaccine and we present a literature review on this topic.

  10. Research on frequency control strategy of interconnected region based on fuzzy PID

    NASA Astrophysics Data System (ADS)

    Zhang, Yan; Li, Chunlan

    2018-05-01

    In order to improve the frequency control performance of the interconnected power grid, overcome the problems of poor robustness and slow adjustment of traditional regulation, the paper puts forward a frequency control method based on fuzzy PID. The method takes the frequency deviation and tie-line deviation of each area as the control objective, takes the regional frequency deviation and its deviation as input, and uses fuzzy mathematics theory, adjusts PID control parameters online. By establishing the regional frequency control model of water-fire complementary power generation in MATLAB, the regional frequency control strategy is given, and three control modes (TBC-FTC, FTC-FTC, FFC-FTC) are simulated and analyzed. The simulation and experimental results show that, this method has better control performance compared with the traditional regional frequency regulation.

  11. Active vibration and noise control of vibro-acoustic system by using PID controller

    NASA Astrophysics Data System (ADS)

    Li, Yunlong; Wang, Xiaojun; Huang, Ren; Qiu, Zhiping

    2015-07-01

    Active control simulation of the acoustic and vibration response of a vibro-acoustic cavity of an airplane based on a PID controller is presented. A full numerical vibro-acoustic model is developed by using an Eulerian model, which is a coupled model based on the finite element formulation. The reduced order model, which is used to design the closed-loop control system, is obtained by the combination of modal expansion and variable substitution. Some physical experiments are made to validate and update the full-order and the reduced-order numerical models. Optimization of the actuator placement is employed in order to get an effective closed-loop control system. For the controller design, an iterative method is used to determine the optimal parameters of the PID controller. The process is illustrated by the design of an active noise and vibration control system for a cavity structure. The numerical and experimental results show that a PID-based active control system can effectively suppress the noise inside the cavity using a sound pressure signal as the controller input. It is also possible to control the noise by suppressing the vibration of the structure using the structural displacement signal as the controller input. For an airplane cavity structure, considering the issue of space-saving, the latter is more suitable.

  12. Selective Downregulation of Rhesus Macaque and Sooty Mangabey Major Histocompatibility Complex Class I Molecules by Nef Alleles of Simian Immunodeficiency Virus and Human Immunodeficiency Virus Type 2▿

    PubMed Central

    DeGottardi, M. Quinn; Specht, Anke; Metcalf, Benjamin; Kaur, Amitinder; Kirchhoff, Frank; Evans, David T.

    2008-01-01

    Human immunodeficiency virus type 1 (HIV-1) Nef downregulates HLA-A and -B molecules, but not HLA-C or -E molecules, based on amino acid differences in their cytoplasmic domains to simultaneously evade cytotoxic T lymphocyte (CTL) and natural killer cell surveillance. Rhesus macaques and sooty mangabeys express orthologues of HLA-A, -B, and -E, but not HLA-C, and many of these molecules have unique amino acid differences in their cytoplasmic tails. We found that these differences also resulted in differential downregulation by primary simian immunodeficiency virus (SIV) SIVsmm/mac and HIV-2 Nef alleles. Thus, selective major histocompatibility complex class I downregulation is a conserved mechanism of immune evasion for pathogenic SIV infection of rhesus macaques and nonpathogenic SIV infection of sooty mangabeys. PMID:18199657

  13. The Effect of Response Bias on the Personality Inventory for DSM-5 (PID-5).

    PubMed

    McGee Ng, Sarah A; Bagby, R Michael; Goodwin, Brandee E; Burchett, Danielle; Sellbom, Martin; Ayearst, Lindsay E; Dhillon, Sonya; Yiu, Shirley; Ben-Porath, Yossef S; Baker, Spencer

    2016-01-01

    Valid self-report assessment of psychopathology relies on accurate and credible responses to test questions. There are some individuals who, in certain assessment contexts, cannot or choose not to answer in a manner typically representative of their traits or symptoms. This is referred to, most broadly, as test response bias. In this investigation, we explore the effect of response bias on the Personality Inventory for DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2013 ), a self-report instrument designed to assess the pathological personality traits used to inform diagnosis of the personality disorders in Section III of DSM-5. A set of Minnesota Multiphasic Personality Inventory Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008 / 2011 ) validity scales, which are used to assess and identify response bias, were employed to identify individuals who engaged in either noncredible overreporting (OR) or underreporting (UR), or who were deemed to be reporting or responding to the items in a "credible" manner-credible responding (CR). A total of 2,022 research participants (1,587 students, 435 psychiatric patients) completed the MMPI-2-RF and PID-5; following protocol screening, these participants were classified into OR, UR, or CR response groups based on MMPI-2-RF validity scale scores. Groups of students and patients in the OR group scored significantly higher on the PID-5 than those students and patients in the CR group, whereas those in the UR group scored significantly lower than those in the CR group. Although future research is needed to explore the effects of response bias on the PID-5, results from this investigation provide initial evidence suggesting that response bias influences scale elevations on this instrument.

  14. PID temperature controller in pig nursery: improvements in performance, thermal comfort, and electricity use.

    PubMed

    de Souza Granja Barros, Juliana; Rossi, Luiz Antonio; Sartor, Karina

    2016-08-01

    The use of smarter temperature control technologies in heating systems can optimize the use of electric power and performance of piglets. Two control technologies of a resistive heating system were assessed in a pig nursery: a PID (proportional, integral, and derivative) controller and a thermostat. The systems were evaluated regarding thermal environment, piglet performance, and use of electric power for 99 days. The heating system with PID controller improved the thermal environment conditions and was significantly (P < 0.001) more efficient in terms of electricity use to produce 1 kg of body weight (2.88 kWh kg(-1)), specific cost (0.75 R$ kg(-1)), weight gain (7.3 kg), daily weight gain (0.21 kg day(-1)), and feed conversion (1.71) than the system with thermostat (3.98 kWh kg(-1); 1.03 R$ kg(-1); 5.2 kg; 0.15 kg day(-1), and 2.62, respectively). The results indicate that the PID-controlled heating system is more efficient in electricity use and provides better conditions for thermal comfort and animal performance than heating with thermostat.

  15. Digitally controlled analog proportional-integral-derivative (PID) controller for high-speed scanning probe microscopy

    NASA Astrophysics Data System (ADS)

    Dukic, Maja; Todorov, Vencislav; Andany, Santiago; Nievergelt, Adrian P.; Yang, Chen; Hosseini, Nahid; Fantner, Georg E.

    2017-12-01

    Nearly all scanning probe microscopes (SPMs) contain a feedback controller, which is used to move the scanner in the direction of the z-axis in order to maintain a constant setpoint based on the tip-sample interaction. The most frequently used feedback controller in SPMs is the proportional-integral (PI) controller. The bandwidth of the PI controller presents one of the speed limiting factors in high-speed SPMs, where higher bandwidths enable faster scanning speeds and higher imaging resolution. Most SPM systems use digital signal processor-based PI feedback controllers, which require analog-to-digital and digital-to-analog converters. These converters introduce additional feedback delays which limit the achievable imaging speed and resolution. In this paper, we present a digitally controlled analog proportional-integral-derivative (PID) controller. The controller implementation allows tunability of the PID gains over a large amplification and frequency range, while also providing precise control of the system and reproducibility of the gain parameters. By using the analog PID controller, we were able to perform successful atomic force microscopy imaging of a standard silicon calibration grating at line rates up to several kHz.

  16. Digitally controlled analog proportional-integral-derivative (PID) controller for high-speed scanning probe microscopy.

    PubMed

    Dukic, Maja; Todorov, Vencislav; Andany, Santiago; Nievergelt, Adrian P; Yang, Chen; Hosseini, Nahid; Fantner, Georg E

    2017-12-01

    Nearly all scanning probe microscopes (SPMs) contain a feedback controller, which is used to move the scanner in the direction of the z-axis in order to maintain a constant setpoint based on the tip-sample interaction. The most frequently used feedback controller in SPMs is the proportional-integral (PI) controller. The bandwidth of the PI controller presents one of the speed limiting factors in high-speed SPMs, where higher bandwidths enable faster scanning speeds and higher imaging resolution. Most SPM systems use digital signal processor-based PI feedback controllers, which require analog-to-digital and digital-to-analog converters. These converters introduce additional feedback delays which limit the achievable imaging speed and resolution. In this paper, we present a digitally controlled analog proportional-integral-derivative (PID) controller. The controller implementation allows tunability of the PID gains over a large amplification and frequency range, while also providing precise control of the system and reproducibility of the gain parameters. By using the analog PID controller, we were able to perform successful atomic force microscopy imaging of a standard silicon calibration grating at line rates up to several kHz.

  17. Coordinating IMC-PID and adaptive SMC controllers for a PEMFC.

    PubMed

    Wang, Guo-Liang; Wang, Yong; Shi, Jun-Hai; Shao, Hui-He

    2010-01-01

    For a Proton Exchange Membrane Fuel Cell (PEMFC) power plant with a methanol reformer, the process parameters and power output are considered simultaneously to avoid violation of the constraints and to keep the fuel cell power plant safe and effective. In this paper, a novel coordinating scheme is proposed by combining an Internal Model Control (IMC) based PID Control and adaptive Sliding Mode Control (SMC). The IMC-PID controller is designed for the reformer of the fuel flow rate according to the expected first-order dynamic properties. The adaptive SMC controller of the fuel cell current has been designed using the constant plus proportional rate reaching law. The parameters of the SMC controller are adaptively tuned according to the response of the fuel flow rate control system. When the power output controller feeds back the current references to these two controllers, the coordinating controllers system works in a system-wide way. The simulation results of the PEMFC power plant demonstrate the effectiveness of the proposed method. 2009 ISA. Published by Elsevier Ltd. All rights reserved.

  18. A novel interval type-2 fractional order fuzzy PID controller: Design, performance evaluation, and its optimal time domain tuning.

    PubMed

    Kumar, Anupam; Kumar, Vijay

    2017-05-01

    In this paper, a novel concept of an interval type-2 fractional order fuzzy PID (IT2FO-FPID) controller, which requires fractional order integrator and fractional order differentiator, is proposed. The incorporation of Takagi-Sugeno-Kang (TSK) type interval type-2 fuzzy logic controller (IT2FLC) with fractional controller of PID-type is investigated for time response measure due to both unit step response and unit load disturbance. The resulting IT2FO-FPID controller is examined on different delayed linear and nonlinear benchmark plants followed by robustness analysis. In order to design this controller, fractional order integrator-differentiator operators are considered as design variables including input-output scaling factors. A new hybridized algorithm named as artificial bee colony-genetic algorithm (ABC-GA) is used to optimize the parameters of the controller while minimizing weighted sum of integral of time absolute error (ITAE) and integral of square of control output (ISCO). To assess the comparative performance of the IT2FO-FPID, authors compared it against existing controllers, i.e., interval type-2 fuzzy PID (IT2-FPID), type-1 fractional order fuzzy PID (T1FO-FPID), type-1 fuzzy PID (T1-FPID), and conventional PID controllers. Furthermore, to show the effectiveness of the proposed controller, the perturbed processes along with the larger dead time are tested. Moreover, the proposed controllers are also implemented on multi input multi output (MIMO), coupled, and highly complex nonlinear two-link robot manipulator system in presence of un-modeled dynamics. Finally, the simulation results explicitly indicate that the performance of the proposed IT2FO-FPID controller is superior to its conventional counterparts in most of the cases. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  19. PID techniques: Alternatives to RICH Methods

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vavra, J.; /SLAC

    2011-03-01

    In this review article we discuss the recent progress in PID techniques other than the RICH methods. In particular we mention the recent progress in the Transition Radiation Detector (TRD), dE/dx cluster counting, and Time Of Flight (TOF) techniques. The TRD technique is mature and has been tried in many hadron colliders. It needs space though, about 20cm of detector radial space for every factor of 10 in the {pi}/e rejection power, and this tends to make such detectors large. Although the cluster counting technique is an old idea, it was never tried in a real physics experiment. Recently, theremore » are efforts to revive it for the SuperB experiment using He-based gases and waveform digitizing electronics. A factor of almost 2 improvement, compared to the classical dE/dx performance, is possible in principle. However, the complexity of the data analysis will be substantial. The TOF technique is well established, but introduction of new fast MCP-PMT and G-APD detectors creates new possibilities. It seems that resolutions below 20-30ps may be possible at some point in the future with relatively small systems, and perhaps this could be pushed down to 10-15ps with very small systems, assuming that one can solve many systematic issues. However, the cost, rate limitation, aging and cross-talk in multi-anode devices at high BW are problems. There are several groups working on these issues, so progress is likely. Table 6 summarizes the author's opinion of pros and cons of various detectors presented in this paper based on their operational capabilities. We refer the reader to Ref.40 for discussion of other more general limits from the PID point of view.« less

  20. PID temperature controller in pig nursery: spatial characterization of thermal environment

    NASA Astrophysics Data System (ADS)

    de Souza Granja Barros, Juliana; Rossi, Luiz Antonio; Menezes de Souza, Zigomar

    2018-05-01

    The use of enhanced technologies of temperature control can improve the thermal conditions in environments of livestock facilities. The objective of this study was to evaluate the spatial distribution of the thermal environment variables in a pig nursery with a heating system with two temperature control technologies based on the geostatistical analysis. The following systems were evaluated: overhead electrical resistance with Proportional, Integral, and Derivative (PID) controller and overhead electrical resistance with a thermostat. We evaluated the climatic variables: dry bulb temperature (Tbs), air relative humidity (RH), temperature and humidity index (THI), and enthalpy in the winter, at 7:00, 12:00, and 18:00 h. The spatial distribution of these variables was mapped by kriging. The results showed that the resistance heating system with PID controllers improved the thermal comfort conditions in the pig nursery in the coldest hours, maintaining the spatial distribution of the air temperature more homogeneous in the pen. During the hottest weather, neither system provided comfort.

  1. PID temperature controller in pig nursery: spatial characterization of thermal environment

    NASA Astrophysics Data System (ADS)

    de Souza Granja Barros, Juliana; Rossi, Luiz Antonio; Menezes de Souza, Zigomar

    2017-11-01

    The use of enhanced technologies of temperature control can improve the thermal conditions in environments of livestock facilities. The objective of this study was to evaluate the spatial distribution of the thermal environment variables in a pig nursery with a heating system with two temperature control technologies based on the geostatistical analysis. The following systems were evaluated: overhead electrical resistance with Proportional, Integral, and Derivative (PID) controller and overhead electrical resistance with a thermostat. We evaluated the climatic variables: dry bulb temperature (Tbs), air relative humidity (RH), temperature and humidity index (THI), and enthalpy in the winter, at 7:00, 12:00, and 18:00 h. The spatial distribution of these variables was mapped by kriging. The results showed that the resistance heating system with PID controllers improved the thermal comfort conditions in the pig nursery in the coldest hours, maintaining the spatial distribution of the air temperature more homogeneous in the pen. During the hottest weather, neither system provided comfort.

  2. The hierarchical expert tuning of PID controllers using tools of soft computing.

    PubMed

    Karray, F; Gueaieb, W; Al-Sharhan, S

    2002-01-01

    We present soft computing-based results pertaining to the hierarchical tuning process of PID controllers located within the control loop of a class of nonlinear systems. The results are compared with PID controllers implemented either in a stand alone scheme or as a part of conventional gain scheduling structure. This work is motivated by the increasing need in the industry to design highly reliable and efficient controllers for dealing with regulation and tracking capabilities of complex processes characterized by nonlinearities and possibly time varying parameters. The soft computing-based controllers proposed are hybrid in nature in that they integrate within a well-defined hierarchical structure the benefits of hard algorithmic controllers with those having supervisory capabilities. The controllers proposed also have the distinct features of learning and auto-tuning without the need for tedious and computationally extensive online systems identification schemes.

  3. Memory feedback PID control for exponential synchronisation of chaotic Lur'e systems

    NASA Astrophysics Data System (ADS)

    Zhang, Ruimei; Zeng, Deqiang; Zhong, Shouming; Shi, Kaibo

    2017-09-01

    This paper studies the problem of exponential synchronisation of chaotic Lur'e systems (CLSs) via memory feedback proportional-integral-derivative (PID) control scheme. First, a novel augmented Lyapunov-Krasovskii functional (LKF) is constructed, which can make full use of the information on time delay and activation function. Second, improved synchronisation criteria are obtained by using new integral inequalities, which can provide much tighter bounds than what the existing integral inequalities can produce. In comparison with existing results, in which only proportional control or proportional derivative (PD) control is used, less conservative results are derived for CLSs by PID control. Third, the desired memory feedback controllers are designed in terms of the solution to linear matrix inequalities. Finally, numerical simulations of Chua's circuit and neural network are provided to show the effectiveness and advantages of the proposed results.

  4. Concept for Future Data Services at the Long-Term Archive of WDCC combining DOIs with common PIDs

    NASA Astrophysics Data System (ADS)

    Stockhause, Martina; Weigel, Tobias; Toussaint, Frank; Höck, Heinke; Thiemann, Hannes; Lautenschlager, Michael

    2013-04-01

    The World Data Center for Climate (WDCC) hosted at the German Climate Computing Center (DKRZ) maintains a long-term archive (LTA) of climate model data as well as observational data. WDCC distinguishes between two types of LTA data: Structured data: Data output of an instrument or of a climate model run consists of numerous, highly structured individual datasets in a uniform format. Part of these data is also published on an ESGF (Earth System Grid Federation) data node. Detailed metadata is available allowing for fine-grained user-defined data access. Unstructured data: LTA data of finished scientific projects are in general unstructured and consist of datasets of different formats, different sizes, and different contents. For these data compact metadata is available as content information. The structured data is suitable for WDCC's DataCite DOI process, the project data only in exceptional cases. The DOI process includes a thorough quality control process of technical as well as scientific aspects by the publication agent and the data creator. DOIs are assigned to data collections appropriate to be cited in scientific publications, like a simulation run. The data collection is defined in agreement with the data creator. At the moment there is no possibility to identify and cite individual datasets within this DOI data collection analogous to the citation of chapters in a book. Also missing is a compact citation regulation for a user-specified collection of data. WDCC therefore complements its existing LTA/DOI concept by Persistent Identifier (PID) assignment to datasets using Handles. In addition to data identification for internal and external use, the concept of PIDs allows to define relations among PIDs. Such structural information is stored as key-value pair directly in the handles. Thus, relations provide basic provenance or lineage information, even if part of the data like intermediate results are lost. WDCC intends to use additional PIDs on metadata

  5. Sequential immunization with V3 peptides from primary human immunodeficiency virus type 1 produces cross-neutralizing antibodies against primary isolates with a matching narrow-neutralization sequence motif.

    PubMed

    Eda, Yasuyuki; Takizawa, Mari; Murakami, Toshio; Maeda, Hiroaki; Kimachi, Kazuhiko; Yonemura, Hiroshi; Koyanagi, Satoshi; Shiosaki, Kouichi; Higuchi, Hirofumi; Makizumi, Keiichi; Nakashima, Toshihiro; Osatomi, Kiyoshi; Tokiyoshi, Sachio; Matsushita, Shuzo; Yamamoto, Naoki; Honda, Mitsuo

    2006-06-01

    An antibody response capable of neutralizing not only homologous but also heterologous forms of the CXCR4-tropic human immunodeficiency virus type 1 (HIV-1) MNp and CCR5-tropic primary isolate HIV-1 JR-CSF was achieved through sequential immunization with a combination of synthetic peptides representing HIV-1 Env V3 sequences from field and laboratory HIV-1 clade B isolates. In contrast, repeated immunization with a single V3 peptide generated antibodies that neutralized only type-specific laboratory-adapted homologous viruses. To determine whether the cross-neutralization response could be attributed to a cross-reactive antibody in the immunized animals, we isolated a monoclonal antibody, C25, which neutralized the heterologous primary viruses of HIV-1 clade B. Furthermore, we generated a humanized monoclonal antibody, KD-247, by transferring the genes of the complementary determining region of C25 into genes of the human V region of the antibody. KD-247 bound with high affinity to the "PGR" motif within the HIV-1 Env V3 tip region, and, among the established reference antibodies, it most effectively neutralized primary HIV-1 field isolates possessing the matching neutralization sequence motif, suggesting its promise for clinical applications involving passive immunizations. These results demonstrate that sequential immunization with B-cell epitope peptides may contribute to a humoral immune-based HIV vaccine strategy. Indeed, they help lay the groundwork for the development of HIV-1 vaccine strategies that use sequential immunization with biologically relevant peptides to overcome difficulties associated with otherwise poorly immunogenic epitopes.

  6. Sequential Immunization with V3 Peptides from Primary Human Immunodeficiency Virus Type 1 Produces Cross-Neutralizing Antibodies against Primary Isolates with a Matching Narrow-Neutralization Sequence Motif

    PubMed Central

    Eda, Yasuyuki; Takizawa, Mari; Murakami, Toshio; Maeda, Hiroaki; Kimachi, Kazuhiko; Yonemura, Hiroshi; Koyanagi, Satoshi; Shiosaki, Kouichi; Higuchi, Hirofumi; Makizumi, Keiichi; Nakashima, Toshihiro; Osatomi, Kiyoshi; Tokiyoshi, Sachio; Matsushita, Shuzo; Yamamoto, Naoki; Honda, Mitsuo

    2006-01-01

    An antibody response capable of neutralizing not only homologous but also heterologous forms of the CXCR4-tropic human immunodeficiency virus type 1 (HIV-1) MNp and CCR5-tropic primary isolate HIV-1 JR-CSF was achieved through sequential immunization with a combination of synthetic peptides representing HIV-1 Env V3 sequences from field and laboratory HIV-1 clade B isolates. In contrast, repeated immunization with a single V3 peptide generated antibodies that neutralized only type-specific laboratory-adapted homologous viruses. To determine whether the cross-neutralization response could be attributed to a cross-reactive antibody in the immunized animals, we isolated a monoclonal antibody, C25, which neutralized the heterologous primary viruses of HIV-1 clade B. Furthermore, we generated a humanized monoclonal antibody, KD-247, by transferring the genes of the complementary determining region of C25 into genes of the human V region of the antibody. KD-247 bound with high affinity to the “PGR” motif within the HIV-1 Env V3 tip region, and, among the established reference antibodies, it most effectively neutralized primary HIV-1 field isolates possessing the matching neutralization sequence motif, suggesting its promise for clinical applications involving passive immunizations. These results demonstrate that sequential immunization with B-cell epitope peptides may contribute to a humoral immune-based HIV vaccine strategy. Indeed, they help lay the groundwork for the development of HIV-1 vaccine strategies that use sequential immunization with biologically relevant peptides to overcome difficulties associated with otherwise poorly immunogenic epitopes. PMID:16699036

  7. Two degree of freedom internal model control-PID design for LFC of power systems via logarithmic approximations.

    PubMed

    Singh, Jay; Chattterjee, Kalyan; Vishwakarma, C B

    2018-01-01

    Load frequency controller has been designed for reduced order model of single area and two-area reheat hydro-thermal power system through internal model control - proportional integral derivative (IMC-PID) control techniques. The controller design method is based on two degree of freedom (2DOF) internal model control which combines with model order reduction technique. Here, in spite of taking full order system model a reduced order model has been considered for 2DOF-IMC-PID design and the designed controller is directly applied to full order system model. The Logarithmic based model order reduction technique is proposed to reduce the single and two-area high order power systems for the application of controller design.The proposed IMC-PID design of reduced order model achieves good dynamic response and robustness against load disturbance with the original high order system. Copyright © 2018 ISA. Published by Elsevier Ltd. All rights reserved.

  8. Evaluation of PD/PID controller for insulin control on blood glucose regulation in a Type-I diabetes

    NASA Astrophysics Data System (ADS)

    Mahmud, Farhanahani; Isse, Nadir Hussien; Daud, Nur Atikah Mohd; Morsin, Marlia

    2017-01-01

    This project introduces a simulation of Proportional-Derivative (PD) and Proportional-Integral-Derivative (PID) controller based on a virtual Type 1 Diabetes Mellitus (T1DM) patient: Hovorka diabetic model using MATLAB-Simulink software. The results of these simulations are based on three tuning responses for each controller which are fast, slow and oscillation responses. The main purpose of this simulation is to achieve an acceptable stability and fastness response towards the regulation of glucose concentration using PD and PID controller response with insulin infusion rate. Therefore, in order to analyze and compare the responses of both controller performances, one-day simulations of the insulin-glucose dynamic have been conducted using a typical day meal plan that contains five meals of different bolus size. It is found that the PID closed-loop control with a short rise time is required to retrieve a satisfactory glucose regulation.

  9. Two-degree-of-freedom fractional order-PID controllers design for fractional order processes with dead-time.

    PubMed

    Li, Mingjie; Zhou, Ping; Zhao, Zhicheng; Zhang, Jinggang

    2016-03-01

    Recently, fractional order (FO) processes with dead-time have attracted more and more attention of many researchers in control field, but FO-PID controllers design techniques available for the FO processes with dead-time suffer from lack of direct systematic approaches. In this paper, a simple design and parameters tuning approach of two-degree-of-freedom (2-DOF) FO-PID controller based on internal model control (IMC) is proposed for FO processes with dead-time, conventional one-degree-of-freedom control exhibited the shortcoming of coupling of robustness and dynamic response performance. 2-DOF control can overcome the above weakness which means it realizes decoupling of robustness and dynamic performance from each other. The adjustable parameter η2 of FO-PID controller is directly related to the robustness of closed-loop system, and the analytical expression is given between the maximum sensitivity specification Ms and parameters η2. In addition, according to the dynamic performance requirement of the practical system, the parameters η1 can also be selected easily. By approximating the dead-time term of the process model with the first-order Padé or Taylor series, the expressions for 2-DOF FO-PID controller parameters are derived for three classes of FO processes with dead-time. Moreover, compared with other methods, the proposed method is simple and easy to implement. Finally, the simulation results are given to illustrate the effectiveness of this method. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

  10. New genetic discoveries and primary immune deficiencies.

    PubMed

    Hernandez-Trujillo, Vivian

    2014-04-01

    The field of immunology has undergone recent discoveries of genetic causes for many primary immunodeficiency diseases (PIDD). The ever-expanding knowledge has led to increased understanding behind the pathophysiology of these diseases. Since these diseases are rare, the patients are frequently misdiagnosed early in the presentation of their illnesses. The identification of new genes has increased our opportunities for recognizing and making the diagnosis in patients with PIDD before they succumb to infections that may result secondary to their PIDD. Some mutations lead to a variety of presentations of severe combined immunodeficiency (SCID). The myriad and ever-growing genetic mutations which lead to SCID phenotypes have been identified in recent years. Other mutations associated with some genetic syndromes have associated immunodeficiency and are important for making the diagnosis of primary immunodeficiency in patients with some syndromes, who may otherwise be missed within the larger context of their syndromes. A variety of mutations also lead to increased susceptibility to infections due to particular organisms. These patterns of infections due to specific organisms are important keys in properly identifying the part of the immune system which is affected in these patients. This review will discuss recent genetic discoveries that enhance our understanding of these complex diseases.

  11. Laser therapy in women genital Chlamydia trachomatis infection complicated with PID and infertility

    NASA Astrophysics Data System (ADS)

    Brinzan, Daniela; Paiusan, Lucian; Smeu, Claudia-Ramona

    2018-04-01

    Genital Chlamydia Trachomatis infection is one of the most common sexually transmitted infections with more than 50 million new cases occurred globally every year. Underdiagnosed and untreated, it can generate long term severe complications including PID, infertility, ectopic pregnancy and chronic pelvic pain. Among 20 patients diagnosed with PID and infertility in our medical office during one year, we selected a study group of 10 patients with genital Chlamydia Trachomatis infection. The diagnostic methods used were anamnesis, clinical examination, Pap smear, bacteriological and serological tests, ultra sound examination. The group of patients selected was monitored for one year. The treatment took into account general measures for both partners and specific measures (antibiotic treatment and focused laser therapy). The initial group was split in two, group A treated only with antibiotics and group B treated with both antibiotics and laser therapy. All the 5 patients of group B presented an improvement of the clinical manifestations and 3 of them ended up with pregnancy. On the other hand, in group B, only one patient manifested total disappearance of pains and the infertility persisted for all. It is noteworthy that the association of laser therapy in the treatment of Chlamydia Trachomatis infection has brought significant improvement in the inflammatory processes of internal genitalia (PID) and in the fertility of the couple.

  12. Genetic and Functional Diversity of Human Immunodeficiency Virus Type 1 Subtype B Nef Primary Isolates

    PubMed Central

    Foster, John L.; Molina, Rene P.; Luo, Tianci; Arora, Vivek K.; Huang, Yaoxing; Ho, David D.; Garcia, J. Victor

    2001-01-01

    We have characterized the functional integrity of seven primary Nef isolates: five from a long-term nonprogressing human immunodeficiency virus (HIV)-infected individual and one each from two patients with AIDS. One of the seven Nefs was defective for CD4 downregulation, two others were defective for PAK-2 activation, and one Nef was defective for PAK-2 activation and major histocompatibility complex (MHC) class I downregulation. Five of the Nefs were tested and found to be functional for the enhancement of virus particle infectivity. The structural basis for each of the functional defects has been analyzed by constructing a consensus nef, followed by mutational analysis of the variant amino acid residues. Mutations A29V and F193I were deleterious to CD4 downregulation and PAK-2 activation, respectively, while S189R rendered Nef defective for both MHC class I downregulation and PAK-2 activation. A search of the literature identified HIVs from five patients with Nefs predominantly mutated at F193 and from one patient with Nefs predominantly mutated at A29. A29 is highly conserved in all HIV subtypes except for subtype E. F193 is conserved in subtype B (and possibly in the closely related subtype D), but none of the other HIV group M subtypes. Our results suggest that functional distinctions may exist between HIV subtypes. PMID:11160665

  13. Elucidating PID Degradation Mechanisms and In Situ Dark I–V Monitoring for Modeling Degradation Rate in CdTe Thin-Film Modules

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hacke, Peter; Spataru, Sergiu; Johnston, Steve

    A progression of potential-induced degradation (PID) mechanisms are observed in CdTe modules, including shunting/junction degradation and two different manifestations of series resistance depending on the stress level and water ingress. The dark I-V method for in-situ characterization of Pmax based on superposition was adapted for the thin-film modules undergoing PID in view of the degradation mechanisms observed. An exponential model based on module temperature and relative humidity was fit to the PID rate for multiple stress levels in chamber tests and validated by predicting the observed degradation of the module type in the field.

  14. Chicken barn climate and hazardous volatile compounds control using simple linear regression and PID

    NASA Astrophysics Data System (ADS)

    Abdullah, A. H.; Bakar, M. A. A.; Shukor, S. A. A.; Saad, F. S. A.; Kamis, M. S.; Mustafa, M. H.; Khalid, N. S.

    2016-07-01

    The hazardous volatile compounds from chicken manure in chicken barn are potentially to be a health threat to the farm animals and workers. Ammonia (NH3) and hydrogen sulphide (H2S) produced in chicken barn are influenced by climate changes. The Electronic Nose (e-nose) is used for the barn's air, temperature and humidity data sampling. Simple Linear Regression is used to identify the correlation between temperature-humidity, humidity-ammonia and ammonia-hydrogen sulphide. MATLAB Simulink software was used for the sample data analysis using PID controller. Results shows that the performance of PID controller using the Ziegler-Nichols technique can improve the system controller to control climate in chicken barn.

  15. Immunodeficiency disorders

    MedlinePlus

    ... that affect T cells may cause repeated Candida (yeast) infections. Inherited combined immunodeficiency affects both T cells ... infections (including some forms of pneumonia or repeated yeast infections) Symptoms depend on the disorder. For example, ...

  16. [Validation of a French translation of Krueger's personality inventory for DSM-5 in its brief form (PID-5 BF)].

    PubMed

    Combaluzier, S; Gouvernet, B; Menant, F; Rezrazi, A

    2018-02-01

    Since the publication of the DSM-5 (APA, 2013), the dimensional conception of the personality disorders is co-existing with the classical categorical paradigm. Tools have been proposed for the evaluations of five big pathological factors to be explored further according to the APA (negative affectivity, detachment, antagonism, disinhibition, psychoticism). Despite numerous works using these questionnaires (30 works in 3 years according to Al-Adjani et al., 2015), none of them have yet been translated into French. Also, the main objective of the paper is to present a French translation of the Personality Inventory for DSM -5 by Kruegger et al. (2013) in its brief form of 25 items (PID-5 BF). To reach this goal, we have employed the classic translation-retranslation method (Vallerand, 1989) and tested the consistence and the validity of this French version among a non-clinical sample (n=216) of young adults (age=31.4, SD=4.8), in joining some other questionnaires in their short forms to study the external validity of the PID-5 about the psychological distress (SCL-10, Nguyen, 1983), the categorical diagnosis of personality disorders (SAPAS, Moran et al., 2003) and the classical Big Five dimensions of the personality (BDI 10, Ramamstedt and John, 2007). The internal consistency of this translation has been studied through the classical outcomes on factor analysis for the dimensional repartitions of the items in 5 scales and Cronbach's alpha for the consistency of each found dimensions. The external validity has been explored by studying Pearson's correlations between the outcomes on each dimension of the PID-5 BF and both the clinical dimensions of SCL-10, personality dimensions of the BFI-10 or personality disorders (SAPAS). Factor analysis led to the same repartition of the 25 items as the original versions. Each of the dimensions is consistent enough (α>.65) to be taken into account as clinically significant. The items of the French version of the PID-5 BF follow

  17. Demonstrative fractional order - PID controller based DC motor drive on digital platform.

    PubMed

    Khubalkar, Swapnil W; Junghare, Anjali S; Aware, Mohan V; Chopade, Amit S; Das, Shantanu

    2017-09-21

    In industrial drives applications, fractional order controllers can exhibit phenomenal impact due to realization through digital implementation. Digital fractional order controllers have created wide scope as it possess the inherent advantages like robustness against the plant parameter variation. This paper provides brief design procedure of fractional order proportional-integral-derivative (FO-PID) controller through the indirect approach of approximation using constant phase technique. The new modified dynamic particle swarm optimization (IdPSO) technique is proposed to find controller parameters. The FO-PID controller is implemented using floating point digital signal processor. The building blocks are designed and assembled with all peripheral components for the 1.5kW industrial DC motor drive. The robust operation for parametric variation is ascertained by testing the controller with two separately excited DC motors with the same rating but different parameters. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  18. Primary antibody deficiencies at Queen Rania Children Hospital in Jordan: single center experience.

    PubMed

    Habahbeh, Zeyad M; Abu-Shukair, Mohammad E; Almutereen, Mohammad A; Alzyoud, Raed M; Wahadneh, Adel M

    2014-03-01

    Primary antibody deficiency, the most common primary immunodeficiency disorder, represents a heterogeneous spectrum of conditions caused by a defect in any critical stage of B cell development and is characterized by impaired production of normal amounts of antigen-specific antibodies. This retrospective study aimed at description and analysis of demographic, clinical, immunological features and complications of subjects diagnosed with primary antibody deficiency at a referral center in Jordan. The medical records of pediatric patients who were diagnosed as primary antibody deficiency (PAD) during the period from January 2006 to June 2013 were reviewed. Patients were diagnosed as PADs based on the Pan-American Group for Immunodeficiency (PAGID) and the European Society for Immunodeficiency (ESID) diagnostic criteria. A total number of 53 patients with PAD were identified; 37(70%) males and 16(30%) females, 16(30%) patients with congenital agammaglobulinemia, 16(30%) patients with common variable immunodeficiency, 4(7.5%) patients with IgG subclass deficiency, 10(19%) cases with transient hypogammaglobulinemia of infancy and 7(13.5%) patients as undefined PAD. The most common infection among patients was pneumonia (62%); followed by suppurative otitis media in 49% of patients. Cytopenia was the most noted autoimmune association and was found at prevalence of 22 %, other autoimmune associations (17%) including inflammatory arthritis, discoid lupus, inflammatory bowel disease, vasculitis and celiac disease. The prevalence of long-term complications was 58%, the most frequent ones were; stunted growth in 13%, bronchiectasis and lymphoproliferation in 11% for each. Our results indicated that congenital agammaglobulinemia and common variable immunodeficiency are the most frequent primary antibody deficiency in our patients. The awareness of families, general population as well as primary health physicians is crucial in the establishment of early diagnosis and prompt

  19. Mutations in CsPID encoding a Ser/Thr protein kinase are responsible for round leaf shape in cucumber (Cucumis sativus L.)

    USDA-ARS?s Scientific Manuscript database

    Leaf shape is an important plant architecture trait that is affected by plant hormones, especially auxin. In Arabidopsis, PINOID (PID), a regulator for the auxin polar transporter PIN (PIN-FORMED) affects leaf shape formation, but this function of PID in crop plants has not been well studied. From a...

  20. A comparative study of stabilizing control of a planer electromagnetic levitation using PID and LQR controllers

    NASA Astrophysics Data System (ADS)

    Yaseen, Mundher H. A.

    Magnetic levitation is a technique to suspend an object without any mechanical support. The main objective of this study is to demonstrate stabilized closed loop control of 1-DOF Maglev experimentally using real-time control simulink feature of (SIMLAB) microcontroller. Proportional Integral Derivative (PID) and Linear Quadratic Regulator (LQR) controllers are employed to examine the stability performance of the Maglev control system under effect of unbalanced change of load and wave signal on Maglev plane. The effect of unbalanced change of applied load on single point, line and plane are presented. Furthermore, in order to study the effect of sudden change in input signal, the input of wave signal has been applied on all points of the prototype maglev plate simultaneously. The results of pulse width modulation (PWM) reveal that the control system using LQR controller provides faster response to adjust the levitated plane comparing to PID controller. Moreover, the air gap distance that controlled using PID controller is rather stable with little oscillation. Meanwhile, LQR controller provided more stability and homogeneous response.

  1. Human immunodeficiency virus infection and pneumothorax

    PubMed Central

    Terzi, Eirini; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Tsiouda, Theodora; Madesis, Athanasios; Karaiskos, Theodoros

    2014-01-01

    Pneumothorax is a serious and relatively frequent complication of human immunodeficiency virus (HIV) infection that may associate with increased morbidity and mortality and may prove difficult to manage, especially in patients with acquired immunodeficiency syndrome (AIDS). PMID:25337392

  2. Design of PID temperature control system based on STM32

    NASA Astrophysics Data System (ADS)

    Zhang, Jianxin; Li, Hailin; Ma, Kai; Xue, Liang; Han, Bianhua; Dong, Yuemeng; Tan, Yue; Gu, Chengru

    2018-03-01

    A rapid and high-accuracy temperature control system was designed using proportional-integral-derivative (PID) control algorithm with STM32 as micro-controller unit (MCU). The temperature control system can be applied in the fields which have high requirements on the response speed and accuracy of temperature control. The temperature acquisition circuit in system adopted Pt1000 resistance thermometer as temperature sensor. Through this acquisition circuit, the monitoring actual temperature signal could be converted into voltage signal and transmitted into MCU. A TLP521-1 photoelectric coupler was matched with BD237 power transistor to drive the thermoelectric cooler (TEC) in FTA951 module. The effective electric power of TEC was controlled by the pulse width modulation (PWM) signals which generated by MCU. The PWM signal parameters could be adjusted timely by PID algorithm according to the difference between monitoring actual temperature and set temperature. The upper computer was used to input the set temperature and monitor the system running state via serial port. The application experiment results show that the temperature control system is featured by simple structure, rapid response speed, good stability and high temperature control accuracy with the error less than ±0.5°C.

  3. Primary Immune Deficiency Treatment Consortium (PIDTC) report.

    PubMed

    Griffith, Linda M; Cowan, Morton J; Notarangelo, Luigi D; Kohn, Donald B; Puck, Jennifer M; Pai, Sung-Yun; Ballard, Barbara; Bauer, Sarah C; Bleesing, Jack J H; Boyle, Marcia; Brower, Amy; Buckley, Rebecca H; van der Burg, Mirjam; Burroughs, Lauri M; Candotti, Fabio; Cant, Andrew J; Chatila, Talal; Cunningham-Rundles, Charlotte; Dinauer, Mary C; Dvorak, Christopher C; Filipovich, Alexandra H; Fleisher, Thomas A; Bobby Gaspar, Hubert; Gungor, Tayfun; Haddad, Elie; Hovermale, Emily; Huang, Faith; Hurley, Alan; Hurley, Mary; Iyengar, Sumathi; Kang, Elizabeth M; Logan, Brent R; Long-Boyle, Janel R; Malech, Harry L; McGhee, Sean A; Modell, Fred; Modell, Vicki; Ochs, Hans D; O'Reilly, Richard J; Parkman, Robertson; Rawlings, David J; Routes, John M; Shearer, William T; Small, Trudy N; Smith, Heather; Sullivan, Kathleen E; Szabolcs, Paul; Thrasher, Adrian; Torgerson, Troy R; Veys, Paul; Weinberg, Kenneth; Zuniga-Pflucker, Juan Carlos

    2014-02-01

    The Primary Immune Deficiency Treatment Consortium (PIDTC) is a network of 33 centers in North America that study the treatment of rare and severe primary immunodeficiency diseases. Current protocols address the natural history of patients treated for severe combined immunodeficiency (SCID), Wiskott-Aldrich syndrome, and chronic granulomatous disease through retrospective, prospective, and cross-sectional studies. The PIDTC additionally seeks to encourage training of junior investigators, establish partnerships with European and other International colleagues, work with patient advocacy groups to promote community awareness, and conduct pilot demonstration projects. Future goals include the conduct of prospective treatment studies to determine optimal therapies for primary immunodeficiency diseases. To date, the PIDTC has funded 2 pilot projects: newborn screening for SCID in Navajo Native Americans and B-cell reconstitution in patients with SCID after hematopoietic stem cell transplantation. Ten junior investigators have received grant awards. The PIDTC Annual Scientific Workshop has brought together consortium members, outside speakers, patient advocacy groups, and young investigators and trainees to report progress of the protocols and discuss common interests and goals, including new scientific developments and future directions of clinical research. Here we report the progress of the PIDTC to date, highlights of the first 2 PIDTC workshops, and consideration of future consortium objectives. Published by Mosby, Inc.

  4. Pediatric patients with common variable immunodeficiency: long-term follow-up.

    PubMed

    Mohammadinejad, P; Aghamohammadi, A; Abolhassani, H; Sadaghiani, M S; Abdollahzade, S; Sadeghi, B; Soheili, H; Tavassoli, M; Fathi, S M; Tavakol, M; Behniafard, N; Darabi, B; Pourhamdi, S; Rezaei, N

    2012-01-01

    Common variable immunodeficiency (CVID) is the most common form of symptomatic primary immunodeficiency disease. It is characterized by hypogammaglobulinemia, increased predisposition to infections, autoimmunity, and cancer. This study was performed to evaluate the clinical and immunological features of a group of pediatric patients with CVID. The study population comprised 69 individuals with CVID diagnosed during childhood. The patients were followed up for a mean (SD) period of 5.2 (4.3) years. The mean diagnostic delay was 4.4 (3.6) years, which was significantly lower in patients who were diagnosed recently. Children were classified according to 5 clinical phenotypes: infections only (n=39), polyclonal lymphocytic infiltration (n=17), autoimmunity (n=12), malignancy (n=7), and enteropathy (n=3). Postdiagnosis survival (10-year) was 71%. The high percentages of pediatric patients with CVID in Iran may be due to the considerable prevalence of parental consanguinity in the region and an underlying genetic background.

  5. Efficient Transduction of Human and Rhesus Macaque Primary T Cells by a Modified Human Immunodeficiency Virus Type 1-Based Lentiviral Vector.

    PubMed

    He, Huan; Xue, Jing; Wang, Weiming; Liu, Lihong; Ye, Chaobaihui; Cong, Zhe; Kimata, Jason T; Qin, Chuan; Zhou, Paul

    2017-03-01

    Human immunodeficiency virus type 1 (HIV-1)-based lentiviral vectors efficiently transduce genes to human, but not rhesus, primary T cells and hematopoietic stem cells (HSCs). The poor transduction of HIV-1 vectors to rhesus cells is mainly due to species-specific restriction factors such as rhesus TRIM5α. Previously, several strategies to modify HIV-1 vectors were developed to overcome rhesus TRIM5α restriction. While the modified HIV-1 vectors efficiently transduce rhesus HSCs, they remain suboptimal for rhesus primary T cells. Recently, HIV-1 variants that encode combinations of LNEIE mutations in capsid (CA) protein and SIVmac239 Vif were found to replicate efficiently in rhesus primary T cells. Thus, the present study tested whether HIV-1 vectors packaged by a packaging construct containing these CA substitutions could efficiently transduce both human and rhesus primary CD4 T cells. To accomplish this, LNEIE mutations were made in the packaging construct CEMΔ8.9, and recombinant HIV-1 vectors packaged by Δ8.9 WT or Δ8.9 LNEIE were generated. Transduction rates, CA stability, and vector integration in CEMss-CCR5 and CEMss-CCR5-rhTRIM5α/green fluorescent protein cells, as well as transduction rates in human and rhesus primary CD4 T cells by Δ8.9 WT or Δ8.9 LNEIE-packaged HIV-1 vectors, were compared. Finally, the influence of rhesus TRIM5α variations in transduction rates to primary CD4 T cells from a cohort of 37 Chinese rhesus macaques was studied. While it maintains efficient transduction for human T-cell line and primary CD4 T cells, Δ8.9 LNEIE-packaged HIV-1 vector overcomes rhesus TRIM5α-mediated CA degradation, resulting in significantly higher transduction efficiency of rhesus primary CD4 T cells than Δ8.9 WT-packaged HIV-1 vector. Rhesus TRIM5α variations strongly influence transduction efficiency of rhesus primary CD4 T cells by both Δ8.9 WT or Δ8.9 LNEIE-packaged HIV-1 vectors. Thus, it is concluded that Δ8.9 LNEIE-packaged HIV-1

  6. The impact of underreporting and overreporting on the validity of the Personality Inventory for DSM-5 (PID-5): A simulation analog design investigation.

    PubMed

    Dhillon, Sonya; Bagby, R Michael; Kushner, Shauna C; Burchett, Danielle

    2017-04-01

    The Personality Inventory for DSM-5 (PID-5) is a 220-item self-report instrument that assesses the alternative model of personality psychopathology in Section III (Emerging Measures and Models) of DSM-5 . Despite its relatively recent introduction, the PID-5 has generated an impressive accumulation of studies examining its psychometric properties, and the instrument is also already widely and frequently used in research studies. Although the PID-5 is psychometrically sound overall, reviews of this instrument express concern that this scale does not possess validity scales to detect invalidating levels of response bias, such as underreporting and overreporting. McGee Ng et al. (2016), using a "known-groups" (partial) criterion design, demonstrated that both underreporting and overreporting grossly affect mean scores on PID-5 scales. In the current investigation, we replicate these findings using an analog simulation design. An important extension to this replication study was the finding that the construct validity of the PID-5 was also significantly compromised by response bias, with statistically significant attenuation noted in validity coefficients of the PID-5 domain scales with scales from other instruments measuring congruent constructs. This attenuation was found for underreporting and overreporting bias. We believe there is a need to develop validity scales to screen for data-distorting response bias in research contexts and in clinical assessments where response bias is likely or otherwise suspected. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. Slip control design of electric vehicle using indirect Dahlin Adaptive Pid

    NASA Astrophysics Data System (ADS)

    Fauzi, I. R.; Koko, F.; Kirom, M. R.

    2016-11-01

    In this paper the problem to be solved is to build a slip control on a wheel that may occur in an electric car wheel. Slip is the difference in vehicle velocity and wheel tangential velocity and to be enlarged when the torque given growing. Slip can be reduced by controlling the torque of the wheel so that the wheel tangential speed does not exceed the vehicle speed. The experiment in this paper is a simulation using MATLAB Simulink and using Adaptive control. The response adaptive PID control more quickly 1.5 s than PID control and can controlled wheel tangential speed close to the vehicle velocity on a dry asphalt, wet asphalt, snow and ice surface sequent at time 2s, 4s, 10s, and 50s. The maximum acceleration of the vehicle (V) on the surface of the dry asphalt, wet asphalt, snow, and ice surface sequent at 8.9 m/s2, 6.2 m/s2, 2.75 m/s2, and 0.34 m/s2.

  8. Progress on Development of the New FDIRC PID Detector

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vavra, Jerry

    2012-08-03

    We present a progress status of a new concept of PID detector called FDIRC, intended to be used at the SuperB experiment, which requires {pi}/K separation up to a few GeV/c. The new photon camera is made of the solid fused-silica optics with a volume 25x smaller and speed increased by a factor of ten compared to the BaBar DIRC, and therefore will be much less sensitive to electromagnetic and neutron background

  9. PRIMARY IMMUNE DEFICIENCY TREATMENT CONSORTIUM (PIDTC) UPDATE

    PubMed Central

    Griffith, Linda M.; Cowan, Morton J.; Notarangelo, Luigi D.; Kohn, Donald B.; Puck, Jennifer M.; Shearer, William T.; Burroughs, Lauri M.; Torgerson, Troy R.; Decaluwe, Hélène; Haddad, Elie

    2016-01-01

    The Primary Immune Deficiency Treatment Consortium (PIDTC) is a collaboration of 41 North American centers studying therapy for rare primary immune deficiency diseases (PID) including Severe Combined Immune Deficiency (SCID), Wiskott-Aldrich syndrome (WAS) and chronic granulomatous disease (CGD). An additional 3 European centers have partnered with the PIDTC to study CGD. Natural history protocols of the PIDTC analyze outcomes of treatment for rare PID in multicenter longitudinal retrospective, prospective and cross-sectional studies. Since 2009, participating centers have enrolled over 800 subjects on PIDTC protocols for SCID, and enrollment on the studies in WAS and CGD is underway. Four pilot projects have been funded and 12 junior investigators have received fellowship awards. Important publications of the consortium describe outcomes of hematopoietic cell transplantation (HCT) for SCID during 2000–2009, diagnostic criteria for SCID, and the pilot project of newborn screening (NBS) for SCID in the Navajo Nation. The PIDTC Annual Scientific Workshops provide an opportunity to strengthen collaborations with junior investigators, patient advocacy groups and international colleagues. Funded by the NIAID and ORDR, NCATS, the PIDTC has recently received renewal for another 5 years. Here, we review accomplishments of the group, projects underway, highlights of recent workshops and challenges for the future. PMID:27262745

  10. A Family Study of the DSM-5 Section III Personality Pathology Model Using the Personality Inventory for the DSM-5 (PID-5).

    PubMed

    Katz, Andrea C; Hee, Danelle; Hooker, Christine I; Shankman, Stewart A

    2017-10-03

    In Section III of the DSM-5, the American Psychiatric Association (APA) proposes a pathological personality trait model of personality disorders. The recommended assessment instrument is the Personality Inventory for the DSM-5 (PID-5), an empirically derived scale that assesses personality pathology along five domains and 25 facets. Although the PID-5 demonstrates strong convergent validity with other personality measures, no study has examined whether it identifies traits that run in families, another important step toward validating the DSM-5's dimensional model. Using a family study method, we investigated familial associations of PID-5 domain and facet scores in 195 families, examining associations between parents and offspring and across siblings. The Psychoticism, Antagonism, and Detachment domains showed significant familial aggregation, as did facets of Negative Affect and Disinhibition. Results are discussed in the context of personality pathology and family study methodology. The results also help validate the PID-5, given the familial nature of personality traits.

  11. Altered Virome and Bacterial Microbiome in Human Immunodeficiency Virus-Associated Acquired Immunodeficiency Syndrome

    PubMed Central

    Monaco, Cynthia L.; Gootenberg, David B.; Zhao, Guoyan; Handley, Scott A.; Ghebremichael, Musie S.; Lim, Efrem S.; Lankowski, Alex; Baldridge, Megan T.; Wilen, Craig B.; Flagg, Meaghan; Norman, Jason M.; Keller, Brian C.; Luévano, Jesús Mario; Wang, David; Boum, Yap; Martin, Jeffrey N.; Hunt, Peter W.; Bangsberg, David R.; Siedner, Mark J.; Kwon, Douglas S.; Virgin, Herbert W.

    2016-01-01

    SUMMARY Human immunodeficiency virus (HIV) infection is associated with increased intestinal translocation of microbial products and enteropathy as well as alterations in gut bacterial communities. However, whether the enteric virome contributes to this infection and resulting immunodeficiency remains unknown. We characterized the enteric virome and bacterial microbiome in a cohort of Ugandan patients, including HIV-uninfected or HIV-infected subjects and those either treated with anti-retroviral therapy (ART) or untreated. Low peripheral CD4 T cell counts were associated with an expansion of enteric adenovirus sequences and this increase was independent of ART treatment. Additionally, the enteric bacterial microbiome of patients with lower CD4 T counts exhibited reduced phylogenetic diversity and richness with specific bacteria showing differential abundance, including increases in Enterobacteriaceae, which have been associated with inflammation. Thus, immunodeficiency in progressive HIV infection is associated with alterations in the enteric virome and bacterial microbiome, which may contribute to AIDS-associated enteropathy and disease progression. PMID:26962942

  12. Altered Virome and Bacterial Microbiome in Human Immunodeficiency Virus-Associated Acquired Immunodeficiency Syndrome.

    PubMed

    Monaco, Cynthia L; Gootenberg, David B; Zhao, Guoyan; Handley, Scott A; Ghebremichael, Musie S; Lim, Efrem S; Lankowski, Alex; Baldridge, Megan T; Wilen, Craig B; Flagg, Meaghan; Norman, Jason M; Keller, Brian C; Luévano, Jesús Mario; Wang, David; Boum, Yap; Martin, Jeffrey N; Hunt, Peter W; Bangsberg, David R; Siedner, Mark J; Kwon, Douglas S; Virgin, Herbert W

    2016-03-09

    Human immunodeficiency virus (HIV) infection is associated with increased intestinal translocation of microbial products and enteropathy as well as alterations in gut bacterial communities. However, whether the enteric virome contributes to this infection and resulting immunodeficiency remains unknown. We characterized the enteric virome and bacterial microbiome in a cohort of Ugandan patients, including HIV-uninfected or HIV-infected subjects and those either treated with anti-retroviral therapy (ART) or untreated. Low peripheral CD4 T cell counts were associated with an expansion of enteric adenovirus sequences and this increase was independent of ART treatment. Additionally, the enteric bacterial microbiome of patients with lower CD4 T counts exhibited reduced phylogenetic diversity and richness with specific bacteria showing differential abundance, including increases in Enterobacteriaceae, which have been associated with inflammation. Thus, immunodeficiency in progressive HIV infection is associated with alterations in the enteric virome and bacterial microbiome, which may contribute to AIDS-associated enteropathy and disease progression. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. On the convergence between PSY-5 domains and PID-5 domains and facets: implications for assessment of DSM-5 personality traits.

    PubMed

    Anderson, Jaime L; Sellbom, Martin; Bagby, R Michael; Quilty, Lena C; Veltri, Carlo O C; Markon, Kristian E; Krueger, Robert F

    2013-06-01

    The DSM-5 Personality and Personality Disorders workgroup and their consultants have developed the 220-item, self-report Personality Inventory for the DSM-5 (PID-5) for direct assessment of the proposed personality trait system for DSM-5; however, most practicing clinical psychologists will likely continue to rely on separate omnibus measures to index symptoms and traits associated with psychopathology. The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) is one such measure and assesses the Personality Psychopathology Five (PSY-5) domains, which are conceptual cognates of the DSM-5 trait domains. The current study examined the associations between the MMPI-2-RF PSY-5 scales and the DSM-5 trait domains and facets indexed by the PID-5. A clear pattern of convergence was found indicating that each of the PSY-5 scales was most highly correlated with its conceptually expected PID-5 counterpart (rs = .44-.67; Mdn r = .53) and facet correlations generally showed the same pattern. Similarly, when each of the PSY-5 scales was regressed onto the PID-5 domains, the conceptually expected pattern of associations emerged even more clearly. Finally, a joint exploratory factor analysis with the PSY-5 and PID-5 trait facet scales indicated a five-factor solution that clearly resembled both of the PSY-5/DSM-5 trait domains. These results show clear evidence that the MMPI-2-RF has utility in the assessment of dimensional personality traits proposed for the upcoming DSM-5.

  14. Performance analysis of two-degree of freedom fractional order PID controllers for robotic manipulator with payload.

    PubMed

    Sharma, Richa; Gaur, Prerna; Mittal, A P

    2015-09-01

    The robotic manipulators are multi-input multi-output (MIMO), coupled and highly nonlinear systems. The presence of external disturbances and time-varying parameters adversely affects the performance of these systems. Therefore, the controller designed for these systems should effectively deal with such complexities, and it is an intriguing task for control engineers. This paper presents two-degree of freedom fractional order proportional-integral-derivative (2-DOF FOPID) controller scheme for a two-link planar rigid robotic manipulator with payload for trajectory tracking task. The tuning of all controller parameters is done using cuckoo search algorithm (CSA). The performance of proposed 2-DOF FOPID controllers is compared with those of their integer order designs, i.e., 2-DOF PID controllers, and with the traditional PID controllers. In order to show effectiveness of proposed scheme, the robustness testing is carried out for model uncertainties, payload variations with time, external disturbance and random noise. Numerical simulation results indicate that the 2-DOF FOPID controllers are superior to their integer order counterparts and the traditional PID controllers. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

  15. The High Momentum Particle IDentification (HMPID) detector PID performance and its contribution to the ALICE physics program

    NASA Astrophysics Data System (ADS)

    Volpe, Giacomo; ALICE Collaboration

    2017-12-01

    The ALICE apparatus is dedicated to study the properties of strongly interacting matter under extremely high temperature and energy density conditions. For this, enhanced particle identification (PID) capabilities are required. Among the PID ALICE detectors, the ALICE-HMPID (High Momentum Particle IDentification) detector is devoted to the identification of charged hadrons, exploiting the Cherenkov effect. It consists of seven identical RICH modules, with liquid C6F14 as Cherenkov radiator (n ≈1.298 at λ=175 nm). Photon and charged particle detection is performed by a MWPC, coupled with a pad segmented CsI coated photo-cathode. The total CsI active area is 10.3 m2. The HMPID provides 3 sigma separation for pions and kaons up to pT = 3 GeV / c and for kaons and (anti-)protons up to pT = 5 GeV / c . A review of the HMPID PID performance, in particular in the challenging central Pb-Pb collisions, and its contribution to the ALICE physics program, using the LHC RUN1 (2010-2013) and RUN2 (2015) data, are presented.

  16. Preferential Use of CXCR4 by R5X4 Human Immunodeficiency Virus Type 1 Isolates for Infection of Primary Lymphocytes

    PubMed Central

    Yi, Yanjie; Shaheen, Farida; Collman, Ronald G.

    2005-01-01

    Coreceptor specificity of human immunodeficiency virus type 1 (HIV-1) strains is generally defined in vitro in cell lines expressing CCR5 or CXCR4, but lymphocytes and macrophages are the principal targets in vivo. CCR5-using (R5) variants dominate early in infection, but strains that use CXCR4 emerge later in a substantial minority of subjects. Many or most CXCR4-using variants can use both CXCR4 and CCR5 (R5X4), but the pathways that are actually used to cause infection in primary cells and in vivo are unknown. We examined several R5X4 prototype and primary isolates and found that they all were largely or completely restricted to CXCR4-mediated entry in primary lymphocytes, even though lymphocytes are permissive for CCR5-mediated entry by R5 strains. In contrast, in primary macrophages R5X4 isolates used both CCR5 and CXCR4. The R5X4 strains were also more sensitive than R5 strains to CCR5 blocking, suggesting that interactions between the R5X4 strains and CCR5 are less efficient. These results indicate that coreceptor phenotyping in transformed cells does not necessarily predict utilization in primary cells, that variability exists among HIV-1 isolates in the ability to use CCR5 expressed on lymphocytes, and that many or most strains characterized as R5X4 are functionally X4 in primary lymphocytes. Less efficient interactions between R5X4 strains and CCR5 may be responsible for the inability to use CCR5 on lymphocytes, which express relatively low CCR5 levels. Since isolates that acquire CXCR4 utilization retain the capacity to use CCR5 on macrophages despite their inability to use it on lymphocytes, these results also raise the possibility that a CCR5-mediated macrophage reservoir is required for sustained infection in vivo. PMID:15650174

  17. Explicit analytical tuning rules for digital PID controllers via the magnitude optimum criterion.

    PubMed

    Papadopoulos, Konstantinos G; Yadav, Praveen K; Margaris, Nikolaos I

    2017-09-01

    Analytical tuning rules for digital PID type-I controllers are presented regardless of the process complexity. This explicit solution allows control engineers 1) to make an accurate examination of the effect of the controller's sampling time to the control loop's performance both in the time and frequency domain 2) to decide when the control has to be I, PI and when the derivative, D, term has to be added or omitted 3) apply this control action to a series of stable benchmark processes regardless of their complexity. The former advantages are considered critical in industry applications, since 1) most of the times the choice of the digital controller's sampling time is based on heuristics and past criteria, 2) there is little a-priori knowledge of the controlled process making the choice of the type of the controller a trial and error exercise 3) model parameters change often depending on the control loop's operating point making in this way, the problem of retuning the controller's parameter a much challenging issue. Basis of the proposed control law is the principle of the PID tuning via the Magnitude Optimum criterion. The final control law involves the controller's sampling time T s within the explicit solution of the controller's parameters. Finally, the potential of the proposed method is justified by comparing its performance with the conventional PID tuning when controlling the same process. Further investigation regarding the choice of the controller's sampling time T s is also presented and useful conclusions for control engineers are derived. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  18. Efficient Transduction of Human and Rhesus Macaque Primary T Cells by a Modified Human Immunodeficiency Virus Type 1–Based Lentiviral Vector

    PubMed Central

    He, Huan; Xue, Jing; Wang, Weiming; Liu, Lihong; Ye, Chaobaihui; Cong, Zhe; Kimata, Jason T.; Qin, Chuan; Zhou, Paul

    2017-01-01

    Human immunodeficiency virus type 1 (HIV-1)-based lentiviral vectors efficiently transduce genes to human, but not rhesus, primary T cells and hematopoietic stem cells (HSCs). The poor transduction of HIV-1 vectors to rhesus cells is mainly due to species-specific restriction factors such as rhesus TRIM5α. Previously, several strategies to modify HIV-1 vectors were developed to overcome rhesus TRIM5α restriction. While the modified HIV-1 vectors efficiently transduce rhesus HSCs, they remain suboptimal for rhesus primary T cells. Recently, HIV-1 variants that encode combinations of LNEIE mutations in capsid (CA) protein and SIVmac239 Vif were found to replicate efficiently in rhesus primary T cells. Thus, the present study tested whether HIV-1 vectors packaged by a packaging construct containing these CA substitutions could efficiently transduce both human and rhesus primary CD4 T cells. To accomplish this, LNEIE mutations were made in the packaging construct CEMΔ8.9, and recombinant HIV-1 vectors packaged by Δ8.9 WT or Δ8.9 LNEIE were generated. Transduction rates, CA stability, and vector integration in CEMss-CCR5 and CEMss-CCR5-rhTRIM5α/green fluorescent protein cells, as well as transduction rates in human and rhesus primary CD4 T cells by Δ8.9 WT or Δ8.9 LNEIE-packaged HIV-1 vectors, were compared. Finally, the influence of rhesus TRIM5α variations in transduction rates to primary CD4 T cells from a cohort of 37 Chinese rhesus macaques was studied. While it maintains efficient transduction for human T-cell line and primary CD4 T cells, Δ8.9 LNEIE-packaged HIV-1 vector overcomes rhesus TRIM5α-mediated CA degradation, resulting in significantly higher transduction efficiency of rhesus primary CD4 T cells than Δ8.9 WT-packaged HIV-1 vector. Rhesus TRIM5α variations strongly influence transduction efficiency of rhesus primary CD4 T cells by both Δ8.9 WT or Δ8.9 LNEIE-packaged HIV-1 vectors. Thus, it is concluded that Δ8.9 LNEIE-packaged HIV-1

  19. [Skin symptoms associated with human immunodeficiency virus infection].

    PubMed

    Tamási, Béla; Marschalkó, Márta; Kárpáti, Sarolta

    2015-01-04

    The recently observed accelerated increase of human immunodeficiency virus infection in Hungary poses a major public concern for the healthcare system. Given the effective only but not the curative therapy, prevention should be emphasized. Current statistics estimate that about 50% of the infected persons are not aware of their human immunodeficiency virus-positivity. Thus, early diagnosis of the infection by serological screening and timely recognition of the disease-associated symptoms are crucial. The authors' intention is to facilitate early infection detection with this review on human immunodeficiency virus-associated skin symptoms, and highlight the significance of human immunodeficiency virus care in the everyday medical practice.

  20. A novel memristive multilayer feedforward small-world neural network with its applications in PID control.

    PubMed

    Dong, Zhekang; Duan, Shukai; Hu, Xiaofang; Wang, Lidan; Li, Hai

    2014-01-01

    In this paper, we present an implementation scheme of memristor-based multilayer feedforward small-world neural network (MFSNN) inspirited by the lack of the hardware realization of the MFSNN on account of the need of a large number of electronic neurons and synapses. More specially, a mathematical closed-form charge-governed memristor model is presented with derivation procedures and the corresponding Simulink model is presented, which is an essential block for realizing the memristive synapse and the activation function in electronic neurons. Furthermore, we investigate a more intelligent memristive PID controller by incorporating the proposed MFSNN into intelligent PID control based on the advantages of the memristive MFSNN on computation speed and accuracy. Finally, numerical simulations have demonstrated the effectiveness of the proposed scheme.

  1. A Novel Memristive Multilayer Feedforward Small-World Neural Network with Its Applications in PID Control

    PubMed Central

    Dong, Zhekang; Duan, Shukai; Hu, Xiaofang; Wang, Lidan

    2014-01-01

    In this paper, we present an implementation scheme of memristor-based multilayer feedforward small-world neural network (MFSNN) inspirited by the lack of the hardware realization of the MFSNN on account of the need of a large number of electronic neurons and synapses. More specially, a mathematical closed-form charge-governed memristor model is presented with derivation procedures and the corresponding Simulink model is presented, which is an essential block for realizing the memristive synapse and the activation function in electronic neurons. Furthermore, we investigate a more intelligent memristive PID controller by incorporating the proposed MFSNN into intelligent PID control based on the advantages of the memristive MFSNN on computation speed and accuracy. Finally, numerical simulations have demonstrated the effectiveness of the proposed scheme. PMID:25202723

  2. Application of multi-objective controller to optimal tuning of PID gains for a hydraulic turbine regulating system using adaptive grid particle swam optimization.

    PubMed

    Chen, Zhihuan; Yuan, Yanbin; Yuan, Xiaohui; Huang, Yuehua; Li, Xianshan; Li, Wenwu

    2015-05-01

    A hydraulic turbine regulating system (HTRS) is one of the most important components of hydropower plant, which plays a key role in maintaining safety, stability and economical operation of hydro-electrical installations. At present, the conventional PID controller is widely applied in the HTRS system for its practicability and robustness, and the primary problem with respect to this control law is how to optimally tune the parameters, i.e. the determination of PID controller gains for satisfactory performance. In this paper, a kind of multi-objective evolutionary algorithms, named adaptive grid particle swarm optimization (AGPSO) is applied to solve the PID gains tuning problem of the HTRS system. This newly AGPSO optimized method, which differs from a traditional one-single objective optimization method, is designed to take care of settling time and overshoot level simultaneously, in which a set of non-inferior alternatives solutions (i.e. Pareto solution) is generated. Furthermore, a fuzzy-based membership value assignment method is employed to choose the best compromise solution from the obtained Pareto set. An illustrative example associated with the best compromise solution for parameter tuning of the nonlinear HTRS system is introduced to verify the feasibility and the effectiveness of the proposed AGPSO-based optimization approach, as compared with two another prominent multi-objective algorithms, i.e. Non-dominated Sorting Genetic Algorithm II (NSGAII) and Strength Pareto Evolutionary Algorithm II (SPEAII), for the quality and diversity of obtained Pareto solutions set. Consequently, simulation results show that this AGPSO optimized approach outperforms than compared methods with higher efficiency and better quality no matter whether the HTRS system works under unload or load conditions. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

  3. Behaviors Influencing Human Immunodeficiency Virus Transmission in the Context of Positive Prevention among People Living with HIV/Acquired Immunodeficiency Syndrome in Iran: A Qualitative Study.

    PubMed

    Radfar, Seyed Ramin; Sedaghat, Abbas; Banihashemi, Arash Tehrani; Gouya, Mohammadmehdi; Rawson, Richard A

    2014-08-01

    Identifying factors, which influence health behaviors is critical to designing appropriate and effective preventive programs. Human immunodeficiency virus (HIV) transmission is highly related to people behaviors and understanding factors influencing healthy behaviors among Iranian people living with HIVs (PLHIVs)/acquired immunodeficiency syndrome (AIDS) is very important to tailor an effective response to HIV/AIDS epidemic. This study was conducted as a qualitative study by methods of focus group discussion and in-depth interview in six provinces of Iran with 64 PLHIVs to determine factors influence engagement in positive prevention. Knowledge and education, feelings of responsibility and positive prevention practices were identified as the primary domains of engagement. These domains were found to be influenced by feelings of ostracism and frustration, poverty, barriers to disclosure of HIV status, access to and utilization of drug abuse treatment services and antiretroviral therapy, adherence to treatment, age, religiousness, sex work, singleness, and incarceration. Designing new interventions and updating current interventions directed toward the aforementioned factors should be addressed by responsible Iranian authorities in order to have a national effective response on the HIV/AIDS epidemic.

  4. Skin problems in immunodeficient patients.

    PubMed

    Itin, Peter H; Battegay, Manuel

    2012-01-01

    The most important function of the skin besides social communication is active protection against mechanical, chemical and microbial threat. The epidermis has biochemical, physical, immunological and anti-infective properties, and is the most important shield against aggressors. Chronic immunosuppression impairs this cutaneous quality and therefore numerous mucocutaneous complications can occur. The physiological colonization of commensal microbes helps to limit the expansion of pathogenic bacteria, viruses and fungi by a continuous release of antimicrobial peptides from keratinocytes. Genetic or acquired immunodeficiency influences these factors. Malignant neoplastic diseases such as leukemia or lymphomas can also lead to severe immunodeficiency. Drug-induced immunodeficiency is common in organ-transplanted patients with the aim to prevent organ rejection. Such patients with prolonged immunodeficiency often develop atypical presentations of mucocutaneous infections. This is the reason why such patients should be biopsied liberally. In addition to the conventional histology, a part of the biopsy should be used for microbiological cultures. Long-term complications of oncogenic viruses have to be considered leading to epithelial cancers (HPV), Kaposi sarcomas (HHV8), lymphomas (EBV) and Merkel cell tumor (polyomavirus) apart from more known acute infections of the skin. Important mucocutaneous markers of immunosuppression such as oral hairy leukoplakia, oral candidiasis and eczema molluscatum exist. This work reviews the pathophysiology of skin protection and describes typical mucocutaneous problems in immunosuppressed patients. Copyright © 2012 S. Karger AG, Basel.

  5. PID Controller Design for FES Applied to Ankle Muscles in Neuroprosthesis for Standing Balance

    PubMed Central

    Rouhani, Hossein; Same, Michael; Masani, Kei; Li, Ya Qi; Popovic, Milos R.

    2017-01-01

    Closed-loop controlled functional electrical stimulation (FES) applied to the lower limb muscles can be used as a neuroprosthesis for standing balance in neurologically impaired individuals. The objective of this study was to propose a methodology for designing a proportional-integral-derivative (PID) controller for FES applied to the ankle muscles toward maintaining standing balance for several minutes and in the presence of perturbations. First, a model of the physiological control strategy for standing balance was developed. Second, the parameters of a PID controller that mimicked the physiological balance control strategy were determined to stabilize the human body when modeled as an inverted pendulum. Third, this PID controller was implemented using a custom-made Inverted Pendulum Standing Apparatus that eliminated the effect of visual and vestibular sensory information on voluntary balance control. Using this setup, the individual-specific FES controllers were tested in able-bodied individuals and compared with disrupted voluntary control conditions in four experimental paradigms: (i) quiet-standing; (ii) sudden change of targeted pendulum angle (step response); (iii) balance perturbations that simulate arm movements; and (iv) sudden change of targeted angle of a pendulum with individual-specific body-weight (step response). In paradigms (i) to (iii), a standard 39.5-kg pendulum was used, and 12 subjects were involved. In paradigm (iv) 9 subjects were involved. Across the different experimental paradigms and subjects, the FES-controlled and disrupted voluntarily-controlled pendulum angle showed root mean square errors of <1.2 and 2.3 deg, respectively. The root mean square error (all paradigms), rise time, settle time, and overshoot [paradigms (ii) and (iv)] in FES-controlled balance were significantly smaller or tended to be smaller than those observed with voluntarily-controlled balance, implying improved steady-state and transient responses of FES

  6. Performance comparison of optimal fractional order hybrid fuzzy PID controllers for handling oscillatory fractional order processes with dead time.

    PubMed

    Das, Saptarshi; Pan, Indranil; Das, Shantanu

    2013-07-01

    Fuzzy logic based PID controllers have been studied in this paper, considering several combinations of hybrid controllers by grouping the proportional, integral and derivative actions with fuzzy inferencing in different forms. Fractional order (FO) rate of error signal and FO integral of control signal have been used in the design of a family of decomposed hybrid FO fuzzy PID controllers. The input and output scaling factors (SF) along with the integro-differential operators are tuned with real coded genetic algorithm (GA) to produce optimum closed loop performance by simultaneous consideration of the control loop error index and the control signal. Three different classes of fractional order oscillatory processes with various levels of relative dominance between time constant and time delay have been used to test the comparative merits of the proposed family of hybrid fractional order fuzzy PID controllers. Performance comparison of the different FO fuzzy PID controller structures has been done in terms of optimal set-point tracking, load disturbance rejection and minimal variation of manipulated variable or smaller actuator requirement etc. In addition, multi-objective Non-dominated Sorting Genetic Algorithm (NSGA-II) has been used to study the Pareto optimal trade-offs between the set point tracking and control signal, and the set point tracking and load disturbance performance for each of the controller structure to handle the three different types of processes. Copyright © 2013 ISA. Published by Elsevier Ltd. All rights reserved.

  7. Natural killer cell biology illuminated by primary immunodeficiency syndromes in humans.

    PubMed

    Voss, Matthias; Bryceson, Yenan T

    2017-04-01

    Natural killer (NK) cells are innate immune cytotoxic effector cells well known for their role in antiviral immunity and tumor immunosurveillance. In parts, this knowledge stems from rare inherited immunodeficiency disorders in humans that abrogate NK cell function leading to immune impairments, most notably associated with a high susceptibility to viral infections. Phenotypically, these disorders range from deficiencies selectively affecting NK cells to complex general immune defects that affect NK cells but also other immune cell subsets. Moreover, deficiencies may be associated with reduced NK cell numbers or rather impair specific NK cell effector functions. In recent years, genetic defects underlying the various NK cell deficiencies have been uncovered and have triggered investigative efforts to decipher the molecular mechanisms underlying these disorders. Here we review the associations between inherited human diseases and NK cell development as well as function, with a particular focus on defects in NK cell exocytosis and cytotoxicity. Furthermore we outline how reports of diverse genetic defects have shaped our understanding of NK cell biology. Copyright © 2015. Published by Elsevier Inc.

  8. Monitoring of piglets' open field activity and choice behaviour during the replay of maternal vocalization: a comparison between Observer and PID technique.

    PubMed

    Puppe, B; Schön, P C; Wendland, K

    1999-07-01

    The paper presents a new system for the automatic monitoring of open field activity and choice behaviour of medium-sized animals. Passive infrared motion detectors (PID) were linked on-line via a digital I/O interface to a personal computer provided with self-developed analysis software based on LabVIEW (PID technique). The set up was used for testing 18 one-week-old piglets (Sus scrofa) for their approach to their mother's nursing vocalization replayed through loudspeakers. The results were validated by comparison with a conventional Observer technique, a computer-aided direct observation. In most of the cases, no differences were seen between the Observer and PID technique regarding the percentage of stay in previously defined open field segments, the locomotor open field activity, and the choice behaviour. The results revealed that piglets are clearly attracted by their mother's nursing vocalization. The monitoring system presented in this study is thus suitable for detailed behavioural investigations of individual acoustic recognition. In general, the PID technique is a useful tool for research into the behaviour of individual animals in a restricted open field which does not rely on subjective analysis by a human observer.

  9. Eruptive dysplastic nevi associated with human immunodeficiency virus infection.

    PubMed

    Duvic, M; Lowe, L; Rapini, R P; Rodriguez, S; Levy, M L

    1989-03-01

    The cutaneous manifestations of the acquired immunodeficiency syndrome include infections and neoplasms resulting from the immunodeficient state. Seven patients presenting with the symptom of new eruptive nevi with dysplastic histologic findings are described. These patients noted multiple new moles, which occurred in crops and in individuals without the dysplastic nevus syndrome (familial melanomas). This symptom occurred as the patients became symptomatic from their human immunodeficiency virus infection, developing acquired immunodeficiency syndrome or its related complex. Further confirmation and study of this phenomenon could lead to a better understanding of the pathogenesis of melanocytic dysplasia and its relationship to the immune system.

  10. Genetics Home Reference: X-linked severe combined immunodeficiency

    MedlinePlus

    ... Facebook Twitter Home Health Conditions X-linked SCID X-linked severe combined immunodeficiency Printable PDF Open All ... Javascript to view the expand/collapse boxes. Description X-linked severe combined immunodeficiency (SCID) is an inherited ...

  11. PIDs for digital content: Are they used as they should be? The example of DOI and ORCID, told from a research library perspective

    NASA Astrophysics Data System (ADS)

    Kraft, Angelina; Dreyer, Britta; Löwe, Peter

    2017-04-01

    For finding, linking and citing research content, persistent digital identifiers are the key, as a persistent identifier is a long-lasting reference to a resource. But are PIDs really used as they should be? With respect to the obstacles of the PID systems, we face a diverse landscape of stakeholders, legacy systems, competing interests and often incomprehensible messaging filled with technical jargon around PIDs. Insufficient metadata quality is another major challenge for these systems. While the principal task for service providers lies in collaborating to provide a shared and easy to use PID infrastructure, it is the key responsibility for data centers to provide rich metadata and structured access to research content. Especially metadata and structured access are imperative for the most basic services such as search, citation tracking and reuse. And of course all needs to be human- and machine interoperable, as we want our machines to be able to interpret PIDs depended on a specific use case. Since 2004, the German National Library of Science and Technology (TIB) has been providing DOI services to data centers in Germany. Recent developments make clear that requirements for PIDs have changed. Science has developed a need for PIDs at multiple content levels: In addition to DOIs for journal articles and research data, PIDs for people, physical objects, collections, software, funders, organizations, expeditions, resources, instruments and even for data management plans are required to enable different platforms to exchange information consistently and unambiguously. In this work we want to emphasize on the distinct increases of total DOI registrations for research data and other research output such as images, videos or software in Germany within the past decade and how research institutes and universities differ in their DOI registration workflows. We present use cases which illustrate the deployment of DOIs e.g. for dynamic data, and demonstrate the need of

  12. [Management of the esophageal candidiasis by the primary care physician].

    PubMed

    Behrens, Garance; Bocherens, Astrid; Senn, Nicolas

    2014-05-14

    Esophageal candidiasis is one of the most common opportunistic infections in patients infected by human immunodeficiency virus (HIV). This pathology is also found in patients without overt immunodeficiency. Other risk factors are known to be associated with this disease like inhaled or systemic corticosteroid treatment or proton-pump inhibitors and H2 receptor antagonists. In the absence of identified risk factors, a primary immune deficiency should be sought. Prevention of esophageal candidiasis is based primarily on the identification of risk factors, and a better control of them. This article presents a review of the physiopathology, clinical presentation and management of esophageal candidiasis by primary care physicians. We will also discuss ways of preventing esophageal candidiasis when necessary.

  13. Spinal cord toxoplasmosis in human immunodeficiency virus infection/acquired immunodeficiency syndrome.

    PubMed

    García-García, Concepción; Castillo-Álvarez, Federico; Azcona-Gutiérrez, José M; Herraiz, María J; Ibarra, Valvanera; Oteo, José A

    2015-05-01

    Neurological complications in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) are still common, even in the era of highly active antiretroviral therapy. Opportunistic infections, immune reconstitution, the virus itself, antiretroviral drugs and neurocognitive disorders have to be considered when establishing the differential diagnosis. Toxoplasmic encephalitis remains the major cause of space-occupying lesions in the brain of patients with HIV/AIDS; however, spinal cord involvement has been reported infrequently. Here, we review spinal cord toxoplasmosis in HIV infection and illustrate the condition with a recent case from our hospital. We suggest that most patients with HIV/AIDS and myelitis with enhanced spine lesions, multiple brain lesions and positive serology for Toxoplasma gondii should receive immediate empirical treatment for toxoplasmosis, and a biopsy should be performed in those cases without clinical improvement or with deterioration.

  14. PID position regulation in one-degree-of-freedom Euler-Lagrange systems actuated by a PMSM

    NASA Astrophysics Data System (ADS)

    Verastegui-Galván, J.; Hernández-Guzmán, V. M.; Orrante-Sakanassi, J.

    2018-02-01

    This paper is concerned with position regulation in one-degree-of-freedom Euler-Lagrange Systems. We consider that the mechanical subsystem is actuated by a permanent magnet synchronous motor (PMSM). Our proposal consists of a Proportional-Integral-Derivative (PID) controller for the mechanical subsystem and a slight variation of field oriented control for the PMSM. We take into account the motor electric dynamics during the stability analysis. We present, for the first time, a global asymptotic stability proof for such a control scheme without requiring the mechanical subsystem to naturally possess viscous friction. Finally, as a corollary of our main result we prove global asymptotic stability for output feedback PID regulation of one-degree-of-freedom Euler-Lagrange systems when generated torque is considered as the system input, i.e. when the electric dynamics of PMSM's is not taken into account.

  15. FFMPD scales: Comparisons with the FFM, PID-5, and CAT-PD-SF.

    PubMed

    Crego, Cristina; Oltmanns, Joshua R; Widiger, Thomas A

    2018-01-01

    A series of 8 Five Factor Model Personality Disorder (FFMPD) scales have been developed to assess, from the perspective of the Five Factor Model (FFM), the maladaptive traits included within DSM-5 Section II personality disorders. An extensive body of FFMPD research has accumulated. However, for the most part, each study has been confined to the scales within 1 particular FFMPD Inventory. The current study considered 36 FFMPD scales, at least 1 from each of the 8 FFMPD inventories, including 8 scales considered to be from neuroticism, 8 from extraversion, 5 from openness, 8 from agreeableness, and 7 from conscientiousness. Their convergent, discriminant, and structural relationship with the FFM was considered, and compared with the structural relationship with the FFM obtained by the Personality Inventory for DSM-5 (PID-5) and the Computerized Adaptive Test-Personality Disorder-Static Form (CAT-PD-SF). Support for an FFM structure was obtained (albeit with agreeableness defining 1 factor and antagonism a separate factor). Similarities and differences across the FFMPD, PID-5, and CAT-PD-SF scales were highlighted. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  16. Simulation and analysis of vertical displacement characteristics of three wheels reverse trike vehicle with PID controller application

    NASA Astrophysics Data System (ADS)

    Wibowo, Lambang, Lullus; Erick Chandra, N.; Muhayat, Nurul; Jaka S., B.

    2017-08-01

    The purpose of this research is to obtain a mathematical model (Full Vehicle Model) and compare the performance of passive and active suspension systems of a Three-Wheels Reverse Trike vehicle. Vehicle suspension system should able to provide good steering handling and passenger comfort. Vehicle suspension system generally only uses passive suspension components with fix spring and damper coefficients. An active suspension developed from the traditional (passive) suspension design can directly control the actuator force in the suspension system. In this paper, modeling and simulation of passive and active suspension system for a Full Vehicle Model is performed using Simulink-MATLAB software. Ziegler & Nichols tuning method is used to obtain controller parameters of Proportional Integral Derivative (PID) controller. Comparison between passive and active suspension with PID controller is conducted for disturbances input of single bump road surface profile 0.1 meters. The results are the displacement and acceleration of the vehicle body in the vertical direction of active suspension system with PID control is better in providing handling capabilities and comfort for the driver than of passive suspension system. The acceleration of 1,8G with the down time of 2.5 seconds is smaller than the acceleration of 2.5G with down time of 5.5 seconds.

  17. A Psychometric Review of the Personality Inventory for DSM-5 (PID-5): Current Status and Future Directions.

    PubMed

    Al-Dajani, Nadia; Gralnick, Tara M; Bagby, R Michael

    2016-01-01

    The paradigm of personality psychopathology is shifting from one that is purely categorical in nature to one grounded in dimensional individual differences. Section III (Emerging Measures and Models) of the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013), for example, includes a hybrid categorical/dimensional model of personality disorder classification. To inform the hybrid model, the DSM-5 Personality and Personality Disorders Work Group developed a self-report instrument to assess pathological personality traits-the Personality Inventory for the DSM-5 (PID-5). Since its recent introduction, 30 papers (39 samples) have been published examining various aspects of its psychometric properties. In this article, we review the psychometric characteristics of the PID-5 using the Standards for Educational and Psychological Testing as our framework. The PID-5 demonstrates adequate psychometric properties, including a replicable factor structure, convergence with existing personality instruments, and expected associations with broadly conceptualized clinical constructs. More research is needed with specific consideration to clinical utility, additional forms of reliability and validity, relations with psychopathological personality traits using clinical samples, alternative methods of criterion validation, effective employment of cut scores, and the inclusion of validity scales to propel this movement forward.

  18. A fast elitism Gaussian estimation of distribution algorithm and application for PID optimization.

    PubMed

    Xu, Qingyang; Zhang, Chengjin; Zhang, Li

    2014-01-01

    Estimation of distribution algorithm (EDA) is an intelligent optimization algorithm based on the probability statistics theory. A fast elitism Gaussian estimation of distribution algorithm (FEGEDA) is proposed in this paper. The Gaussian probability model is used to model the solution distribution. The parameters of Gaussian come from the statistical information of the best individuals by fast learning rule. A fast learning rule is used to enhance the efficiency of the algorithm, and an elitism strategy is used to maintain the convergent performance. The performances of the algorithm are examined based upon several benchmarks. In the simulations, a one-dimensional benchmark is used to visualize the optimization process and probability model learning process during the evolution, and several two-dimensional and higher dimensional benchmarks are used to testify the performance of FEGEDA. The experimental results indicate the capability of FEGEDA, especially in the higher dimensional problems, and the FEGEDA exhibits a better performance than some other algorithms and EDAs. Finally, FEGEDA is used in PID controller optimization of PMSM and compared with the classical-PID and GA.

  19. A Fast Elitism Gaussian Estimation of Distribution Algorithm and Application for PID Optimization

    PubMed Central

    Xu, Qingyang; Zhang, Chengjin; Zhang, Li

    2014-01-01

    Estimation of distribution algorithm (EDA) is an intelligent optimization algorithm based on the probability statistics theory. A fast elitism Gaussian estimation of distribution algorithm (FEGEDA) is proposed in this paper. The Gaussian probability model is used to model the solution distribution. The parameters of Gaussian come from the statistical information of the best individuals by fast learning rule. A fast learning rule is used to enhance the efficiency of the algorithm, and an elitism strategy is used to maintain the convergent performance. The performances of the algorithm are examined based upon several benchmarks. In the simulations, a one-dimensional benchmark is used to visualize the optimization process and probability model learning process during the evolution, and several two-dimensional and higher dimensional benchmarks are used to testify the performance of FEGEDA. The experimental results indicate the capability of FEGEDA, especially in the higher dimensional problems, and the FEGEDA exhibits a better performance than some other algorithms and EDAs. Finally, FEGEDA is used in PID controller optimization of PMSM and compared with the classical-PID and GA. PMID:24892059

  20. PSO-tuned PID controller for coupled tank system via priority-based fitness scheme

    NASA Astrophysics Data System (ADS)

    Jaafar, Hazriq Izzuan; Hussien, Sharifah Yuslinda Syed; Selamat, Nur Asmiza; Abidin, Amar Faiz Zainal; Aras, Mohd Shahrieel Mohd; Nasir, Mohamad Na'im Mohd; Bohari, Zul Hasrizal

    2015-05-01

    The industrial applications of Coupled Tank System (CTS) are widely used especially in chemical process industries. The overall process is require liquids to be pumped, stored in the tank and pumped again to another tank. Nevertheless, the level of liquid in tank need to be controlled and flow between two tanks must be regulated. This paper presents development of an optimal PID controller for controlling the desired liquid level of the CTS. Two method of Particle Swarm Optimization (PSO) algorithm will be tested in optimizing the PID controller parameters. These two methods of PSO are standard Particle Swarm Optimization (PSO) and Priority-based Fitness Scheme in Particle Swarm Optimization (PFPSO). Simulation is conducted within Matlab environment to verify the performance of the system in terms of settling time (Ts), steady state error (SSE) and overshoot (OS). It has been demonstrated that implementation of PSO via Priority-based Fitness Scheme (PFPSO) for this system is potential technique to control the desired liquid level and improve the system performances compared with standard PSO.

  1. Autoimmunity and dysmetabolism of human acquired immunodeficiency syndrome.

    PubMed

    Huang, Yan-Mei; Hong, Xue-Zhi; Xu, Jia-Hua; Luo, Jiang-Xi; Mo, Han-You; Zhao, Hai-Lu

    2016-06-01

    Acquired immunodeficiency syndrome (AIDS) remains ill-defined by lists of symptoms, infections, tumors, and disorders in metabolism and immunity. Low CD4 cell count, severe loss of body weight, pneumocystis pneumonia, and Kaposi's sarcoma are the major disease indicators. Lines of evidence indicate that patients living with AIDS have both immunodeficiency and autoimmunity. Immunodeficiency is attributed to deficits in the skin- and mucosa-defined innate immunity, CD4 T cells and regulatory T cells, presumably relating human immunodeficiency virus (HIV) infection. The autoimmunity in AIDS is evident by: (1) overproduction of autoantibodies, (2) impaired response of CD4 cells and CD8 cells, (3) failure of clinical trials of HIV vaccines, and (4) therapeutic benefits of immunosuppression following solid organ transplantation and bone marrow transplantation in patients at risk of AIDS. Autoantibodies are generated in response to antigens such as debris and molecules de novo released from dead cells, infectious agents, and catabolic events. Disturbances in metabolic homeostasis occur at the interface of immunodeficiency and autoimmunity in the development of AIDS. Optimal treatments favor therapeutics targeting on the regulation of metabolism to restore immune homeostasis.

  2. Common Variable Immunodeficiency Caused by FANC Mutations.

    PubMed

    Sekinaka, Yujin; Mitsuiki, Noriko; Imai, Kohsuke; Yabe, Miharu; Yabe, Hiromasa; Mitsui-Sekinaka, Kanako; Honma, Kenichi; Takagi, Masatoshi; Arai, Ayako; Yoshida, Kenichi; Okuno, Yusuke; Shiraishi, Yuichi; Chiba, Kenichi; Tanaka, Hiroko; Miyano, Satoru; Muramatsu, Hideki; Kojima, Seiji; Hira, Asuka; Takata, Minoru; Ohara, Osamu; Ogawa, Seishi; Morio, Tomohiro; Nonoyama, Shigeaki

    2017-07-01

    Common variable immunodeficiency (CVID) is the most common adult-onset primary antibody deficiency disease due to various causative genes. Several genes, which are known to be the cause of different diseases, have recently been reported as the cause of CVID in patients by performing whole exome sequencing (WES) analysis. Here, we found FANC gene mutations as a cause of adult-onset CVID in two patients. B cells were absent and CD4 + T cells were skewed toward CD45RO + memory T cells. T-cell receptor excision circles (TRECs) and signal joint kappa-deleting recombination excision circles (sjKRECs) were undetectable in both patients. Both patients had no anemia, neutropenia, or thrombocytopenia. Using WES, we identified compound heterozygous mutations of FANCE in one patient and homozygous mutation of FANCA in another patient. The impaired function of FANC protein complex was confirmed by a monoubiquitination assay and by chromosome fragility test. We then performed several immunological evaluations including quantitative lymphocyte analysis and TRECs/sjKRECs analysis for 32 individuals with Fanconi anemia (FA). In total, 22 FA patients (68.8%) were found to have immunological abnormalities, suggesting that such immunological findings may be common in FA patients. These data indicate that FANC mutations are involved in impaired lymphogenesis probably by the accumulation of DNA replication stress, leading to CVID. It is important to diagnose FA because it drastically changes clinical management. We propose that FANC mutations can cause isolated immunodeficiency in addition to bone marrow failure and malignancy.

  3. Amyloidosis in association with spontaneous feline immunodeficiency virus infection.

    PubMed

    Asproni, Pietro; Abramo, Francesca; Millanta, Francesca; Lorenzi, Davide; Poli, Alessandro

    2013-04-01

    Tissues from 34 naturally feline immunodeficiency virus (FIV)-infected cats, 13 asymptomatic cats and 21 cats with signs of feline acquired immunodeficiency syndrome (F-AIDS), and 35 FIV-seronegative subjects were examined to determine the presence of amyloid deposits. Twenty experimentally FIV-infected cats and five specific pathogen-free (SPF) control cats were also included in the study. Paraffin-embedded sections from kidney and other organs were submitted to histological and histochemical analysis. Amyloid deposits were identified by a modified Congo red stain and confirmed by electron microscopy to demonstrate the presence of amyloid fibrils in amyloid positive glomeruli. In all positive cases, secondary amyloidosis was identified with potassium permanganate pretreatment and amyloid type was further characterised by immunohistochemistry using primary antibodies against human AA and feline AL amyloids. Amyloid deposits were present in different tissues of 12/34 (35%) naturally FIV-infected cats (seven presenting F-AIDS and five in asymptomatic phase) and in 1/30 FIV-seronegative cats. All the experimentally FIV-infected and SPF subjects showed no amyloid deposits. Amyloidosis has been reported in human lentiviral infections, and the data reported here demonstrate the need, in naturally FIV-infected cats, to consider the presence of amyloidosis in differential diagnosis of hepatic and renal disorders to better assess the prognosis of the disease.

  4. Association of CLEC16A with human common variable immunodeficiency disorder and role in murine B cells.

    PubMed

    Li, Jin; Jørgensen, Silje F; Maggadottir, S Melkorka; Bakay, Marina; Warnatz, Klaus; Glessner, Joseph; Pandey, Rahul; Salzer, Ulrich; Schmidt, Reinhold E; Perez, Elena; Resnick, Elena; Goldacker, Sigune; Buchta, Mary; Witte, Torsten; Padyukov, Leonid; Videm, Vibeke; Folseraas, Trine; Atschekzei, Faranaz; Elder, James T; Nair, Rajan P; Winkelmann, Juliane; Gieger, Christian; Nöthen, Markus M; Büning, Carsten; Brand, Stephan; Sullivan, Kathleen E; Orange, Jordan S; Fevang, Børre; Schreiber, Stefan; Lieb, Wolfgang; Aukrust, Pål; Chapel, Helen; Cunningham-Rundles, Charlotte; Franke, Andre; Karlsen, Tom H; Grimbacher, Bodo; Hakonarson, Hakon; Hammarström, Lennart; Ellinghaus, Eva

    2015-04-20

    Common variable immunodeficiency disorder (CVID) is the most common symptomatic primary immunodeficiency in adults, characterized by B-cell abnormalities and inadequate antibody response. CVID patients have considerable autoimmune comorbidity and we therefore hypothesized that genetic susceptibility to CVID may overlap with autoimmune disorders. Here, in the largest genetic study performed in CVID to date, we compare 778 CVID cases with 10,999 controls across 123,127 single-nucleotide polymorphisms (SNPs) on the Immunochip. We identify the first non-HLA genome-wide significant risk locus at CLEC16A (rs17806056, P=2.0 × 10(-9)) and confirm the previously reported human leukocyte antigen (HLA) associations on chromosome 6p21 (rs1049225, P=4.8 × 10(-16)). Clec16a knockdown (KD) mice showed reduced number of B cells and elevated IgM levels compared with controls, suggesting that CLEC16A may be involved in immune regulatory pathways of relevance to CVID. In conclusion, the CLEC16A associations in CVID represent the first robust evidence of non-HLA associations in this immunodeficiency condition.

  5. A Low Cost Mobile Robot Based on Proportional Integral Derivative (PID) Control System and Odometer for Education

    NASA Astrophysics Data System (ADS)

    Haq, R.; Prayitno, H.; Dzulkiflih; Sucahyo, I.; Rahmawati, E.

    2018-03-01

    In this article, the development of a low cost mobile robot based on PID controller and odometer for education is presented. PID controller and odometer is applied for controlling mobile robot position. Two-dimensional position vector in cartesian coordinate system have been inserted to robot controller as an initial and final position. Mobile robot has been made based on differential drive and sensor magnetic rotary encoder which measured robot position from a number of wheel rotation. Odometry methode use data from actuator movements for predicting change of position over time. The mobile robot is examined to get final position with three different heading angle 30°, 45° and 60° by applying various value of KP, KD and KI constant.

  6. Space Flight Immunodeficiency

    NASA Technical Reports Server (NTRS)

    Shearer, William T.

    1999-01-01

    The National Aeronautics and Space Administration (NASA) has had sufficient concern for the well-being of astronauts traveling in space to create the National Space Biomedical Research Institute (NSBRI), which is investigating several areas of biomedical research including those of immunology. As part of the Immunology, Infection, and Hematology Team, the co-investigators of the Space Flight Immunodeficiency Project began their research projects on April 1, 1998 and are now just into the second year of work. Two areas of research have been targeted: 1) specific immune (especially antibody) responses and 2) non-specific inflammation and adhesion. More precise knowledge of these two areas of research will help elucidate the potential harmful effects of space travel on the immune system, possibly sufficient to create a secondary state of immunodeficiency in astronauts. The results of these experiments are likely to lead to the delineation of functional alterations in antigen presentation, specific immune memory, cytokine regulation of immune responses, cell to cell interactions, and cell to endothelium interactions.

  7. Cholecystitis and nephrotic syndrome complicating Epstein-Barr virus primary infection.

    PubMed

    Rodà, Diana; Huici, Malka; Ricart, Sílvia; Vila, Jordi; Fortuny, Clàudia; Alsina, Laia

    2017-02-01

    Epstein-Barr virus (EBV) infection results in a spectrum of clinical manifestations. The host immune response to EBV plays a key role in the extent and degree of clinical features, which in children under 4 years of age are usually mild, non-specific and self-limiting. A 2-year-old boy in whom no known immune disorder could be found presented with acute acalculous cholecystitis, renal dysfunction with massive proteinuria, ascites, pleural effusion, minimal peripheral oedema and a severe systemic inflammatory response. Improvement occurred after initiation of corticosteroids and antiviral treatment with gancyclovir. In severely symptomatic or complicated EBV infection, a primary immunodeficiency must be suspected. If a primary immunodeficiency has been ruled out, the correct management of severe EBV infection in the immunocompetent host remains controversial.

  8. Dynamics of adaptive and innate immunity in patients treated during primary human immunodeficiency virus infection: results from Maraviroc in HIV Acute Infection (MAIN) randomized clinical trial.

    PubMed

    Ripa, M; Pogliaghi, M; Chiappetta, S; Galli, L; Pensieroso, S; Cavarelli, M; Scarlatti, G; De Biasi, S; Cossarizza, A; De Battista, D; Malnati, M; Lazzarin, A; Nozza, S; Tambussi, G

    2015-09-01

    We evaluated the dynamics of innate and adaptive immunity in patients treated with combined antiretroviral therapy (cART) during primary human immunodeficiency virus infection (PHI), enrolled in a prospective randomized trial (MAIN, EUDRACT 2008-007004-29). After 48 weeks of cART, we documented a reduction in activated B cells and CD8(+) T cells. Natural killer cell and dendritic cell frequencies were measured and a decrease in CD16(+) CD56(dim) with a reciprocal rise in CD56(high) natural killer cells and an increase in myeloid and plasmacytoid dendritic cells were recorded. In conclusion, 48 weeks of cART during PHI showed significant benefits for both innate and adaptive immunity. Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  9. Epistatic interactions between mutations of TACI (TNFRSF13B) and TCF3 result in a severe primary immunodeficiency disorder and systemic lupus erythematosus

    PubMed Central

    Ameratunga, Rohan; Koopmans, Wikke; Woon, See-Tarn; Leung, Euphemia; Lehnert, Klaus; Slade, Charlotte A; Tempany, Jessica C; Enders, Anselm; Steele, Richard; Browett, Peter; Hodgkin, Philip D; Bryant, Vanessa L

    2017-01-01

    Common variable immunodeficiency disorders (CVID) are a group of primary immunodeficiencies where monogenetic causes account for only a fraction of cases. On this evidence, CVID is potentially polygenic and epistatic although there are, as yet, no examples to support this hypothesis. We have identified a non-consanguineous family, who carry the C104R (c.310T>C) mutation of the Transmembrane Activator Calcium-modulator and cyclophilin ligand Interactor (TACI, TNFRSF13B) gene. Variants in TNFRSF13B/TACI are identified in up to 10% of CVID patients, and are associated with, but not solely causative of CVID. The proband is heterozygous for the TNFRSF13B/TACI C104R mutation and meets the Ameratunga et al. diagnostic criteria for CVID and the American College of Rheumatology criteria for systemic lupus erythematosus (SLE). Her son has type 1 diabetes, arthritis, reduced IgG levels and IgA deficiency, but has not inherited the TNFRSF13B/TACI mutation. Her brother, homozygous for the TNFRSF13B/TACI mutation, is in good health despite profound hypogammaglobulinemia and mild cytopenias. We hypothesised that a second unidentified mutation contributed to the symptomatic phenotype of the proband and her son. Whole-exome sequencing of the family revealed a de novo nonsense mutation (T168fsX191) in the Transcription Factor 3 (TCF3) gene encoding the E2A transcription factors, present only in the proband and her son. We demonstrate mutations of TNFRSF13B/TACI impair immunoglobulin isotype switching and antibody production predominantly via T-cell-independent signalling, while mutations of TCF3 impair both T-cell-dependent and -independent pathways of B-cell activation and differentiation. We conclude that epistatic interactions between mutations of the TNFRSF13B/TACI and TCF3 signalling networks lead to the severe CVID-like disorder and SLE in the proband. PMID:29114388

  10. [A first pilot study on the neonatal screening of primary immunodeficiencies in Spain: TRECS and KRECS identify severe T- and B-cell lymphopenia].

    PubMed

    Olbrich, P; de Felipe, B; Delgado-Pecellin, C; Rodero, R; Rojas, P; Aguayo, J; Marquez, J; Casanovas, J; Sánchez, B; Lucena, J M; Ybot-Gonzalez, P; Borte, S; Neth, O

    2014-11-01

    Early diagnosis of primary immunodeficiency such as severe combined immunodeficiency (SCID) and X-linked agammaglobulinemia (XLA) improves outcome of affected infants/children. The measurement of T-cell receptor excision circles (TRECS) and kappa-deleting recombination excision circles (KRECS) can identify neonates with severe T or B-cell lymphopenia. To determine TRECS and KRECS levels from prospectively collected dried blood spot samples (DBS) and to correctly identify severe T and B-cell lymphopenia. Determination of TRECS and KRECS by multiplex PCR from neonates born in two tertiary hospitals in Seville between February 2014 and May 2014. PCR cut-off levels: TRECS<15 copies/μl, KRECS<10 copies/μl, ACTB (β-actin)>1000 copies/μl. Internal (XLA, ataxia telangiectasia) and external (SCID) controls were included. A total of 1068 out of 1088 neonates (mean GA 39 weeks (38-40) and BW 3238g (2930-3520) were enrolled in the study. Mean (median, min/max) copies/μl, were as follows: TRECS 145 (132, 8/503), KRECS 82 (71, 7/381), and ACTB 2838 (2763, 284/7710). Twenty samples (1.87%) were insufficient. Resampling was needed in one neonate (0.09%), subsequently giving a normal result. When using lower cut-offs (TRECS<8 and KRECS<4 copies/μl), all the samples tested were normal and the internal and external controls were correctly identified. This is the first prospective pilot study in Spain using TRECS/KRECS/ACTB-assay, describing the experience and applicability of this method to identify severe lymphopenias. The ideal cut-off remains to be established in our population. Quality of sampling, storage and preparation need to be further improved. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  11. Phenotypic complementation of genetic immunodeficiency by chronic herpesvirus infection.

    PubMed

    MacDuff, Donna A; Reese, Tiffany A; Kimmey, Jacqueline M; Weiss, Leslie A; Song, Christina; Zhang, Xin; Kambal, Amal; Duan, Erning; Carrero, Javier A; Boisson, Bertrand; Laplantine, Emmanuel; Israel, Alain; Picard, Capucine; Colonna, Marco; Edelson, Brian T; Sibley, L David; Stallings, Christina L; Casanova, Jean-Laurent; Iwai, Kazuhiro; Virgin, Herbert W

    2015-01-20

    Variation in the presentation of hereditary immunodeficiencies may be explained by genetic or environmental factors. Patients with mutations in HOIL1 (RBCK1) present with amylopectinosis-associated myopathy with or without hyper-inflammation and immunodeficiency. We report that barrier-raised HOIL-1-deficient mice exhibit amylopectin-like deposits in the myocardium but show minimal signs of hyper-inflammation. However, they show immunodeficiency upon acute infection with Listeria monocytogenes, Toxoplasma gondii or Citrobacter rodentium. Increased susceptibility to Listeria was due to HOIL-1 function in hematopoietic cells and macrophages in production of protective cytokines. In contrast, HOIL-1-deficient mice showed enhanced control of chronic Mycobacterium tuberculosis or murine γ-herpesvirus 68 (MHV68), and these infections conferred a hyper-inflammatory phenotype. Surprisingly, chronic infection with MHV68 complemented the immunodeficiency of HOIL-1, IL-6, Caspase-1 and Caspase-1;Caspase-11-deficient mice following Listeria infection. Thus chronic herpesvirus infection generates signs of auto-inflammation and complements genetic immunodeficiency in mutant mice, highlighting the importance of accounting for the virome in genotype-phenotype studies.

  12. Human immunodeficiency virus (HIV) is highly associated with giant idiopathic esophageal ulcers in acquired immunodeficiency syndrome (AIDS) patients.

    PubMed

    Lv, Bei; Cheng, Xin; Gao, Jackson; Zhao, Hong; Chen, Liping; Wang, Liwei; Huang, Shaoping; Fan, Zhenyu; Zhang, Renfang; Shen, Yinzhong; Li, Lei; Liu, Baochi; Qi, Tangkai; Wang, Jing; Cheng, Jilin

    2016-01-01

    This study aimed to determine whether the human immunodeficiency virus (HIV) exists in giant idiopathic esophageal ulcers in the patients with acquired immune deficiency syndrome (AIDS). 16 AIDS patients with a primary complaint of epigastric discomfort were examined by gastroscopy. Multiple and giant esophageal ulcers were biopsied and analyzed with pathology staining and reverse transcription-polymerase chain reaction (RT-PCR) to determine the potential pathogenic microorganisms, including HIV, cytomegalovirus (CMV) and herpes simplex viruses (HSV). HIV was detected in ulcer samples from 12 out of these 16 patients. Ulcers in 2 patients were infected with CMV and ulcers in another 2 patients were found HSV positive. No obvious cancerous pathological changes were found in these multiple giant esophageal ulcer specimens. HIV may be one of the major causative agents of multiple benign giant esophageal ulcers in AIDS patients.

  13. Feline Immunodeficiency Virus in South America

    PubMed Central

    Teixeira, Bruno M.; Hagiwara, Mitika K.; Cruz, Juliano C. M.; Hosie, Margaret J.

    2012-01-01

    The rapid emergence of AIDS in humans during the period between 1980 and 2000 has led to extensive efforts to understand more fully similar etiologic agents of chronic and progressive acquired immunodeficiency disease in several mammalian species. Lentiviruses that have gene sequence homology with human immunodeficiency virus (HIV) have been found in different species (including sheep, goats, horses, cattle, cats, and several Old World monkey species). Lentiviruses, comprising a genus of the Retroviridae family, cause persistent infection that can lead to varying degrees of morbidity and mortality depending on the virus and the host species involved. Feline immunodeficiency virus (FIV) causes an immune system disease in domestic cats (Felis catus) involving depletion of the CD4+ population of T lymphocytes, increased susceptibility to opportunistic infections, and sometimes death. Viruses related to domestic cat FIV occur also in a variety of nondomestic felids. This is a brief overview of the current state of knowledge of this large and ancient group of viruses (FIVs) in South America. PMID:22590677

  14. Feline immunodeficiency virus in South America.

    PubMed

    Teixeira, Bruno M; Hagiwara, Mitika K; Cruz, Juliano C M; Hosie, Margaret J

    2012-03-01

    The rapid emergence of AIDS in humans during the period between 1980 and 2000 has led to extensive efforts to understand more fully similar etiologic agents of chronic and progressive acquired immunodeficiency disease in several mammalian species. Lentiviruses that have gene sequence homology with human immunodeficiency virus (HIV) have been found in different species (including sheep, goats, horses, cattle, cats, and several Old World monkey species). Lentiviruses, comprising a genus of the Retroviridae family, cause persistent infection that can lead to varying degrees of morbidity and mortality depending on the virus and the host species involved. Feline immunodeficiency virus (FIV) causes an immune system disease in domestic cats (Felis catus) involving depletion of the CD4+ population of T lymphocytes, increased susceptibility to opportunistic infections, and sometimes death. Viruses related to domestic cat FIV occur also in a variety of nondomestic felids. This is a brief overview of the current state of knowledge of this large and ancient group of viruses (FIVs) in South America.

  15. Surface immunoglobulins on blood lymphocytes of normal and immunodeficient persons studied by the mixed antiglobulin method

    PubMed Central

    Litwin, S. D.; Ochs, H.; Pollara, B.

    1973-01-01

    Surface immunoglobulins on human peripheral blood lymphocytes were investigated by the mixed antiglobulin technique—using the single layer mixed antiglobulin method as originally described (SLMA), and a modification employing a double layer of antibody (DLMA). Lymphocytes isolated from the blood of normal individuals had a mean of 7.8 and 18.4 per cent Ig + cells by the SLMA and DLMA techniques respectively. The DLMA data are similar to results obtained by other methods of detecting membrane Igs indicating that the mixed antiglobulin method is comparable in sensitivity. When the total numbers of Ig + cells, obtained by separate κ and λ testing, were compared with results obtained using single anti-light chain antisera, there was no significant difference, suggesting that most positive lymphocytes carry a single variety of light chain. Lymphocytes from the blood of seventeen patients with primary immunodeficiency were analysed. Four patients with variable immunodeficiency and four others with absent serum IgA all had normal surface Igs including α chains. All members of a family having an X-linked immunodeficiency had normal surface Igs including the affected members and a presumed carrier. Four cases of immunodeficiency associated with thymoma proved to have disparate findings. One patient exhibited a selective absence of μ antigens on the membranes of blood lymphocytes of over 2800 tested cells. Two other cases had normal surface Igs while a fourth patient, previously reported, lacked all surface Igs. PMID:4796276

  16. Acquired immunodeficiency syndrome in a patient with no known risk factors: a pathological study.

    PubMed

    Burt, A D; Scott, G; Shiach, C R; Isles, C G

    1984-04-01

    We present the pathological findings in a case of acquired immunodeficiency syndrome (AIDS) in a patient with no known risk factor. Postmortem examination showed klebsiella lung abscess, generalised cytomegalovirus infection, cerebral toxoplasmosis, and a primary cerebral lymphoma. An additional feature was the presence of dilatation of the intrahepatic large bile ducts in association with an atypical distribution of cytomegalovirus. The relation between this case and previously reported cases of AIDS is discussed.

  17. Impaired Akt phosphorylation in B-cells of patients with common variable immunodeficiency.

    PubMed

    Yazdani, Reza; Ganjalikhani-Hakemi, Mazdak; Esmaeili, Mohammad; Abolhassani, Hassan; Vaeli, Shahram; Rezaei, Abbas; Sharifi, Zohre; Azizi, Gholamreza; Rezaei, Nima; Aghamohammadi, Asghar

    2017-02-01

    Common variable immunodeficiency (CVID) is a heterogeneous group of primary immunodeficiency characterized by recurrent infections. We evaluated whether defective PI3K/Akt/FoxO pathway could influence B-cell fate. Determination of B-cell subsets in CVD patients and healthy donors (HDs) were performed using flow cytometry. We evaluated mRNA and protein expression of PI3K, Akt and FoxO using real-time PCR and flow cytometry, respectively. Moreover, phosphorylated Akt (pAkt) expression in B-cells has been measured by flowcytometry. We identified a significant reduction in the percentage of marginal zone like B-cells, memory B-cells (total, switched and unswitched) and plasmablasts in patients, as these decreased B-cell subsets had a significant negative correlation with increased apoptosis in patients. Surprisingly, we identified decreased pAkt expression in B-cells of patients than HDs. We described for the first time impaired pAkt expression in B-cells of CVID patients that had a significant correlation with antibody response to the vaccine and worse clinical complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Human immunodeficiency virus.

    PubMed

    Skinner, Anita

    2016-11-23

    What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The CPD article discussed the importance of human immunodeficiency virus (HIV) testing and diagnosing the condition as early as possible, so that antiretroviral treatment can be initiated and patient outcomes improved.

  19. Performance Analysis of Fuzzy-PID Controller for Blood Glucose Regulation in Type-1 Diabetic Patients.

    PubMed

    Yadav, Jyoti; Rani, Asha; Singh, Vijander

    2016-12-01

    This paper presents Fuzzy-PID (FPID) control scheme for a blood glucose control of type 1 diabetic subjects. A new metaheuristic Cuckoo Search Algorithm (CSA) is utilized to optimize the gains of FPID controller. CSA provides fast convergence and is capable of handling global optimization of continuous nonlinear systems. The proposed controller is an amalgamation of fuzzy logic and optimization which may provide an efficient solution for complex problems like blood glucose control. The task is to maintain normal glucose levels in the shortest possible time with minimum insulin dose. The glucose control is achieved by tuning the PID (Proportional Integral Derivative) and FPID controller with the help of Genetic Algorithm and CSA for comparative analysis. The designed controllers are tested on Bergman minimal model to control the blood glucose level in the facets of parameter uncertainties, meal disturbances and sensor noise. The results reveal that the performance of CSA-FPID controller is superior as compared to other designed controllers.

  20. PID-controller with predictor and auto-tuning algorithm: study of efficiency for thermal plants

    NASA Astrophysics Data System (ADS)

    Kuzishchin, V. F.; Merzlikina, E. I.; Hoang, Van Va

    2017-09-01

    The problem of efficiency estimation of an automatic control system (ACS) with a Smith predictor and PID-algorithm for thermal plants is considered. In order to use the predictor, it is proposed to include an auto-tuning module (ATC) into the controller; the module calculates parameters for a second-order plant module with a time delay. The study was conducted using programmable logical controllers (PLC), one of which performed control, ATC, and predictor functions. A simulation model was used as a control plant, and there were two variants of the model: one of them was built on the basis of a separate PLC, and the other was a physical model of a thermal plant in the form of an electrical heater. Analysis of the efficiency of the ACS with the predictor was carried out for several variants of the second order plant model with time delay, and the analysis was performed on the basis of the comparison of transient processes in the system when the set point was changed and when a disturbance influenced the control plant. The recommendations are given on correction of the PID-algorithm parameters when the predictor is used by means of using the correcting coefficient k for the PID parameters. It is shown that, when the set point is changed, the use of the predictor is effective taking into account the parameters correction with k = 2. When the disturbances influence the plant, the use of the predictor is doubtful, because the transient process is too long. The reason for this is that, in the neighborhood of the zero frequency, the amplitude-frequency characteristic (AFC) of the system with the predictor has an ascent in comparison with the AFC of the system without the predictor.

  1. Toxoplasmic Encephalitis in Patient with Acquired Immunodeficiency Syndrome.

    PubMed

    Lee, Sang-Bok; Lee, Tae-Gyu

    2017-04-01

    Toxoplasmic encephalitis (TE) is an opportunistic infection found in immunocompromised patients and TE related cerebral mass lesion is often reported in acquired immunodeficiency acquired immunodeficiency syndrome (AIDS) patients. However, incidence of TE related AIDS in Korea is still rare and is unfamiliar to neurosurgeons. Differential diagnosis is needed to rule out other brain lesions. A 39-year-old man visited the emergency room with rapid progressive left hemiparesis. Magnetic resonance imaging showed a ring-enhanced mass lesion in his right frontal lobe. Human immunodeficiency virus and Toxoplasma gondii immunoglobulin G were tested positive by a serologic test. We report here a rare case of patient with TE related AIDS.

  2. 21 CFR 610.46 - Human immunodeficiency virus (HIV) “lookback” requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Human immunodeficiency virus (HIV) âlookbackâ... Disease Agents § 610.46 Human immunodeficiency virus (HIV) “lookback” requirements. (a) If you are an... calendar days after a donor tests reactive for evidence of human immunodeficiency virus (HIV) infection...

  3. 21 CFR 610.46 - Human immunodeficiency virus (HIV) “lookback” requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Human immunodeficiency virus (HIV) âlookbackâ... Disease Agents § 610.46 Human immunodeficiency virus (HIV) “lookback” requirements. (a) If you are an... calendar days after a donor tests reactive for evidence of human immunodeficiency virus (HIV) infection...

  4. 21 CFR 610.46 - Human immunodeficiency virus (HIV) “lookback” requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Human immunodeficiency virus (HIV) âlookbackâ... Disease Agents § 610.46 Human immunodeficiency virus (HIV) “lookback” requirements. (a) If you are an... calendar days after a donor tests reactive for evidence of human immunodeficiency virus (HIV) infection...

  5. 21 CFR 610.46 - Human immunodeficiency virus (HIV) “lookback” requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Human immunodeficiency virus (HIV) âlookbackâ... Disease Agents § 610.46 Human immunodeficiency virus (HIV) “lookback” requirements. (a) If you are an... calendar days after a donor tests reactive for evidence of human immunodeficiency virus (HIV) infection...

  6. 21 CFR 610.46 - Human immunodeficiency virus (HIV) “lookback” requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Human immunodeficiency virus (HIV) âlookbackâ... Disease Agents § 610.46 Human immunodeficiency virus (HIV) “lookback” requirements. (a) If you are an... calendar days after a donor tests reactive for evidence of human immunodeficiency virus (HIV) infection...

  7. Influenza Vaccination in Patients with Common Variable Immunodeficiency (CVID).

    PubMed

    Mieves, Jan F; Wittke, Kirsten; Freitag, Helma; Volk, Hans-Dieter; Scheibenbogen, Carmen; Hanitsch, Leif G

    2017-10-05

    Vaccination against influenza in patients with primary antibody deficiency is recommended. Common variable immunodeficiency (CVID) is the most frequent and clinically relevant antibody deficiency disease and is by definition characterized by an impaired vaccination response. The purpose of this review is to present the current knowledge of humoral and cellular vaccine response to influenza in CVID patients. Studies conducted in CVID patients demonstrated an impaired humoral response upon influenza vaccination. Data on cellular immune response are in part conflicting, with two out of three studies showing responses similar to healthy controls. Available data suggest a benefit from influenza vaccination in CVID patients. Therefore, annual influenza vaccination in patients and their close household contacts is recommended.

  8. Primary central nervous system lymphoma in an human immunodeficiency virus-infected patient mimicking bilateral eye sign in brain seen in fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography.

    PubMed

    Kamaleshwaran, Koramadai Karuppusany; Thirugnanam, Rajasekar; Shibu, Deepu; Kalarikal, Radhakrishnan Edathurthy; Shinto, Ajit Sugunan

    2014-04-01

    Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG PET/CT) has proven useful in the diagnosis, staging, and detection of metastasis and posttreatment monitoring of several malignancies in human immunodeficiency virus (HIV)-infected patients. It also has the ability to make the important distinction between malignancy and infection in the evaluation of central nervous system (CNS) lesions, leading to the initiation of the appropriate treatment and precluding the need for invasive biopsy. We report an interesting case of HIV positive 35-year-old woman presented with headache, disorientation, and decreased level of consciousness. She underwent whole body PET/CT which showed multiple lesions in the cerebrum which mimics bilateral eye in brain. A diagnosis of a primary CNS lymphoma was made and patient was started on chemotherapy.

  9. Heterogeneity of envelope molecules expressed on primary human immunodeficiency virus type 1 particles as probed by the binding of neutralizing and nonneutralizing antibodies.

    PubMed

    Poignard, Pascal; Moulard, Maxime; Golez, Edwin; Vivona, Veronique; Franti, Michael; Venturini, Sara; Wang, Meng; Parren, Paul W H I; Burton, Dennis R

    2003-01-01

    Virion capture assays, in which immobilized antibodies (Abs) capture virus particles, have been used to suggest that nonneutralizing Abs bind effectively to human immunodeficiency virus type 1 (HIV-1) primary viruses. Here, we show that virion capture assays, under conditions commonly reported in the literature, give a poor indication of epitope expression on the surface of infectious primary HIV-1. First, estimation of primary HIV-1 capture by p24 measurements shows a very poor correlation with an estimation based on infectivity measurements. Second, virion capture appears to require relatively low Ab affinity for the virion, as shown by the ability of a monoclonal Ab to capture a wild-type and a neutralization escape variant virus equally well. Nevertheless, in a more interpretable competition format, it is shown that nonneutralizing anti-CD4 binding site (CD4bs) Abs compete with a neutralizing anti-CD4bs Ab (b12) for virus capture, suggesting that the nonneutralizing anti-CD4bs Abs are able to bind to the envelope species that is involved in virion capture in these experiments. However, the nonneutralizing anti-CD4bs Abs do not inhibit neutralization by b12 even at considerable excess. This suggests that the nonneutralizing Abs are unable to bind effectively to the envelope species required for virus infectivity. The results were obtained for three different primary virus envelopes. The explanation that we favor is that infectious HIV-1 primary virions can express two forms of gp120, an accessible nonfunctional form and a functional form with limited access. Binding to the nonfunctional form, which needs only to be present at relatively low density on the virion, permits capture but does not lead to neutralization. The expression of a nonfunctional but accessible form of gp120 on virions may contribute to the general failure of HIV-1 infection to elicit cross-neutralizing Abs and may represent a significant problem for vaccines based on viruses or virus

  10. Phenotypic complementation of genetic immunodeficiency by chronic herpesvirus infection

    PubMed Central

    MacDuff, Donna A; Reese, Tiffany A; Kimmey, Jacqueline M; Weiss, Leslie A; Song, Christina; Zhang, Xin; Kambal, Amal; Duan, Erning; Carrero, Javier A; Boisson, Bertrand; Laplantine, Emmanuel; Israel, Alain; Picard, Capucine; Colonna, Marco; Edelson, Brian T; Sibley, L David; Stallings, Christina L; Casanova, Jean-Laurent; Iwai, Kazuhiro; Virgin, Herbert W

    2015-01-01

    Variation in the presentation of hereditary immunodeficiencies may be explained by genetic or environmental factors. Patients with mutations in HOIL1 (RBCK1) present with amylopectinosis-associated myopathy with or without hyper-inflammation and immunodeficiency. We report that barrier-raised HOIL-1-deficient mice exhibit amylopectin-like deposits in the myocardium but show minimal signs of hyper-inflammation. However, they show immunodeficiency upon acute infection with Listeria monocytogenes, Toxoplasma gondii or Citrobacter rodentium. Increased susceptibility to Listeria was due to HOIL-1 function in hematopoietic cells and macrophages in production of protective cytokines. In contrast, HOIL-1-deficient mice showed enhanced control of chronic Mycobacterium tuberculosis or murine γ-herpesvirus 68 (MHV68), and these infections conferred a hyper-inflammatory phenotype. Surprisingly, chronic infection with MHV68 complemented the immunodeficiency of HOIL-1, IL-6, Caspase-1 and Caspase-1;Caspase-11-deficient mice following Listeria infection. Thus chronic herpesvirus infection generates signs of auto-inflammation and complements genetic immunodeficiency in mutant mice, highlighting the importance of accounting for the virome in genotype-phenotype studies. DOI: http://dx.doi.org/10.7554/eLife.04494.001 PMID:25599590

  11. The Role of Faith-Based Organizations in the Education, Support, and Services for Persons Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome.

    PubMed

    Stephens, Teresa M

    2018-03-01

    Faith-based organizations are in a unique position to provide resilience-enhancing efforts for persons living with human immunodeficiency virus/AIDS. Many persons living with human immunodeficiency virus/AIDS report having a strong faith or religious affiliation, with a large percentage attending church services on a regular basis. Faith-based organizations can use these factors to reach out to these individuals and effectively promote health, well-being, education, and support. Faith-based organizations can contribute to the reduction of stigma and isolation for persons living with human immunodeficiency virus/AIDS. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Natural transmission of feline immunodeficiency virus from infected queen to kitten.

    PubMed

    Medeiros, Sheila de Oliveira; Martins, Angelica Nascimento; Dias, Carlos Gabriel Almeida; Tanuri, Amilcar; Brindeiro, Rodrigo de Moraes

    2012-05-25

    Feline immunodeficiency virus (FIV) is a naturally occurring lentivirus that infects cats. The primary mode of transmission occurs through bite wounds, and other routes are difficult to observe in nature. The purpose of this study was to evaluate FIV transmission from queen to kitten in a colony of naturally infected stray cats. With this aim, a queen was monitored over a period of three years. A blood sample was taken to amplify and sequence gag, pol and env regions of the virus from the queen, two kittens and other cats from the colony. Phylogenetic analysis showed evidence of queen to kitten transmission.

  13. [Orofacial clinical manifestations in adult patients with variable common immunodeficiency].

    PubMed

    Chávez-García, Aurora Alejandra; Moreno-Alba, Miguel Ángel; Elizalde-Monroy, Martín; Segura-Méndez, Nora Hilda; Romero-Flores, Jovita; Cambray-Gutiérrez, Julio César; López-Pérez, Patricia; Del Rivero-Hernández, Leonel Gerardo

    2015-01-01

    Common variable immunodeficiency is the primary immunodeficiency (CVID) frequently found in adults. Its prevalence is estimated from 1:25,000 to 75,000 alive newborns; there are variations by ethnic groups, it is estimated about 50-70% in Caucasian patients. Oral cavity lesions are rarely found in adult patients with CVID, there are reports about lesions on pediatric patients mostly caused by infections. To describe the orofacial lesions (oral, maxillofacial and neck area) affecting adults with CVID. A transversal, prospective study was done in patients with CVID attended at Specialties Hospital, CMN SXXI, Mexico City. Patients where examined by the oral and maxillofacial surgeon and clinical findings were reported, then the descriptive analysis of the lesions was done. We evaluated 26 patients, 16 female and 10 males, average age of 38.6 years. In 18/26 patients we found oral lesions on 7 different types. The most frequent was minor salivary glands hiperplasia (19/26),petechiae (12/26) and herpetic ulcers (7/26). In head and neck, we found 4 different lesions, the most common was lymphadenopathy <2cm (4/26). The immunologic alterations associated to CVID favors the development of lesions mainly of infectious and probably autoinmune origin that affects the oral cavity and head and neck area.

  14. Tinea imbricata as a clue to occult immunodeficiency.

    PubMed

    Maroñas Jiménez, Lidia; Monsálvez, Verónica; Gutiérrez García-Rodrigo, Carlota; Postigo Llorente, Concepción

    2014-01-01

    Tinea imbricata (TI) is a geographically restricted dermatophytosis with distinctive clinical and immunologic features. We present a case of TI occurring in a native Brazilian child with previously undiagnosed human immunodeficiency virus infection. Physicians should bear in mind that diagnosis of TI may be a clinical clue to potentially serious underlying immunodeficiency. © 2014 Wiley Periodicals, Inc.

  15. Vaccine-associated Paralytic Poliomyelitis in Immunodeficient Children, Iran, 1995–2008

    PubMed Central

    Shahmahmoodi, Shohreh; Mamishi, Setareh; Aghamohammadi, Asghar; Aghazadeh, Nessa; Tabatabaie, Hamideh; Gooya, Mohammad Mehdi; Zahraei, Seyed Mohsen; Mousavi, Taha; Yousefi, Maryam; Farrokhi, Kobra; Mohammadpour, Masoud; Ashrafi, Mahmoud Reza; Nategh, Rakhshandeh

    2010-01-01

    To determine the prevalence of vaccine-associated paralytic poliomyelitis (VAPP) in immunodeficient infants, we reviewed all documented cases caused by immunodeficiency-associated vaccine-derived polioviruses in Iran from 1995 through 2008. Changing to an inactivated polio vaccine vaccination schedule and introduction of screening of neonates for immunodeficiencies could reduce the risk for VAPP infection. PMID:20587188

  16. Human immunodeficiency virus (HIV) is highly associated with giant idiopathic esophageal ulcers in acquired immunodeficiency syndrome (AIDS) patients

    PubMed Central

    Lv, Bei; Cheng, Xin; Gao, Jackson; Zhao, Hong; Chen, Liping; Wang, Liwei; Huang, Shaoping; Fan, Zhenyu; Zhang, Renfang; Shen, Yinzhong; Li, Lei; Liu, Baochi; Qi, Tangkai; Wang, Jing; Cheng, Jilin

    2016-01-01

    Objective: This study aimed to determine whether the human immunodeficiency virus (HIV) exists in giant idiopathic esophageal ulcers in the patients with acquired immune deficiency syndrome (AIDS). Methods: 16 AIDS patients with a primary complaint of epigastric discomfort were examined by gastroscopy. Multiple and giant esophageal ulcers were biopsied and analyzed with pathology staining and reverse transcription-polymerase chain reaction (RT-PCR) to determine the potential pathogenic microorganisms, including HIV, cytomegalovirus (CMV) and herpes simplex viruses (HSV). Results: HIV was detected in ulcer samples from 12 out of these 16 patients. Ulcers in 2 patients were infected with CMV and ulcers in another 2 patients were found HSV positive. No obvious cancerous pathological changes were found in these multiple giant esophageal ulcer specimens. Conclusion: HIV may be one of the major causative agents of multiple benign giant esophageal ulcers in AIDS patients. PMID:27830031

  17. Evidence for Altered Glutamine Metabolism in Human Immunodeficiency Virus Type 1 Infected Primary Human CD4+ T Cells

    PubMed Central

    Hegedus, Andrea; Kavanagh Williamson, Maia; Khan, Mariam B.; Dias Zeidler, Julianna; Da Poian, Andrea T.; El-Bacha, Tatiana; Struys, Eduard A.

    2017-01-01

    Abstract Glutamine is a conditionally essential amino acid that is an important metabolic resource for proliferating tissues by acting as a proteinogenic amino acid, a nitrogen donor for biosynthetic reactions and as a substrate for the citric acid or tricarboxylic acid cycle. The human immunodeficiency virus type 1 (HIV-1) productively infects activated CD4+ T cells that are known to require glutamine for proliferation and for carrying out effector functions. As a virus, HIV-1 is furthermore entirely dependent on host metabolism to support its replication. In this study, we compared HIV-1 infected with uninfected activated primary human CD4+ T cells with regard to glutamine metabolism. We report that glutamine concentrations are elevated in HIV-1-infected cells and that glutamine is important to support HIV-1 replication, although the latter is closely linked to the glutamine dependency of cell survival. Metabolic tracer experiments showed that entry of glutamine-derived carbon into the citric acid cycle is unaffected by HIV-1 infection, but that there is an increase in the secretion of glutamine-derived glutamic acid from HIV-1-infected cells. Western blotting of key enzymes that metabolize glutamine revealed marked differences in the expression of glutaminase isoforms, KGA and CAG, as well as the PPAT enzyme that targets glutamine-derived nitrogen toward nucleotide synthesis. Altogether, this demonstrates that infection of CD4+ T cells with HIV-1 leads to considerable changes in the cellular glutamine metabolism. PMID:28844150

  18. Evidence for Altered Glutamine Metabolism in Human Immunodeficiency Virus Type 1 Infected Primary Human CD4+ T Cells.

    PubMed

    Hegedus, Andrea; Kavanagh Williamson, Maia; Khan, Mariam B; Dias Zeidler, Julianna; Da Poian, Andrea T; El-Bacha, Tatiana; Struys, Eduard A; Huthoff, Hendrik

    2017-12-01

    Glutamine is a conditionally essential amino acid that is an important metabolic resource for proliferating tissues by acting as a proteinogenic amino acid, a nitrogen donor for biosynthetic reactions and as a substrate for the citric acid or tricarboxylic acid cycle. The human immunodeficiency virus type 1 (HIV-1) productively infects activated CD4 + T cells that are known to require glutamine for proliferation and for carrying out effector functions. As a virus, HIV-1 is furthermore entirely dependent on host metabolism to support its replication. In this study, we compared HIV-1 infected with uninfected activated primary human CD4 + T cells with regard to glutamine metabolism. We report that glutamine concentrations are elevated in HIV-1-infected cells and that glutamine is important to support HIV-1 replication, although the latter is closely linked to the glutamine dependency of cell survival. Metabolic tracer experiments showed that entry of glutamine-derived carbon into the citric acid cycle is unaffected by HIV-1 infection, but that there is an increase in the secretion of glutamine-derived glutamic acid from HIV-1-infected cells. Western blotting of key enzymes that metabolize glutamine revealed marked differences in the expression of glutaminase isoforms, KGA and CAG, as well as the PPAT enzyme that targets glutamine-derived nitrogen toward nucleotide synthesis. Altogether, this demonstrates that infection of CD4 + T cells with HIV-1 leads to considerable changes in the cellular glutamine metabolism.

  19. British Lung Foundation/United Kingdom Primary Immunodeficiency Network Consensus Statement on the Definition, Diagnosis, and Management of Granulomatous-Lymphocytic Interstitial Lung Disease in Common Variable Immunodeficiency Disorders.

    PubMed

    Hurst, John R; Verma, Nisha; Lowe, David; Baxendale, Helen E; Jolles, Stephen; Kelleher, Peter; Longhurst, Hilary J; Patel, Smita Y; Renzoni, Elisabetta A; Sander, Clare R; Avery, Gerard R; Babar, Judith L; Buckland, Matthew S; Burns, Siobhan; Egner, William; Gompels, Mark M; Gordins, Pavels; Haddock, Jamanda A; Hart, Simon P; Hayman, Grant R; Herriot, Richard; Hoyles, Rachel K; Huissoon, Aarnoud P; Jacob, Joseph; Nicholson, Andrew G; Rassl, Doris M; Sargur, Ravishankar B; Savic, Sinisa; Seneviratne, Suranjith L; Sheaff, Michael; Vaitla, Prashantha M; Walters, Gareth I; Whitehouse, Joanna L; Wright, Penny A; Condliffe, Alison M

    A proportion of people living with common variable immunodeficiency disorders develop granulomatous-lymphocytic interstitial lung disease (GLILD). We aimed to develop a consensus statement on the definition, diagnosis, and management of GLILD. All UK specialist centers were contacted and relevant physicians were invited to take part in a 3-round online Delphi process. Responses were graded as Strongly Agree, Tend to Agree, Neither Agree nor Disagree, Tend to Disagree, and Strongly Disagree, scored +1, +0.5, 0, -0.5, and -1, respectively. Agreement was defined as greater than or equal to 80% consensus. Scores are reported as mean ± SD. There was 100% agreement (score, 0.92 ± 0.19) for the following definition: "GLILD is a distinct clinico-radio-pathological ILD occurring in patients with [common variable immunodeficiency disorders], associated with a lymphocytic infiltrate and/or granuloma in the lung, and in whom other conditions have been considered and where possible excluded." There was consensus that the workup of suspected GLILD requires chest computed tomography (CT) (0.98 ± 0.01), lung function tests (eg, gas transfer, 0.94 ± 0.17), bronchoscopy to exclude infection (0.63 ± 0.50), and lung biopsy (0.58 ± 0.40). There was no consensus on whether expectant management following optimization of immunoglobulin therapy was acceptable: 67% agreed, 25% disagreed, score 0.38 ± 0.59; 90% agreed that when treatment was required, first-line treatment should be with corticosteroids alone (score, 0.55 ± 0.51). Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Therapeutic Targeting of CC Ligand 21 or CC Chemokine Receptor 7 Abrogates Pulmonary Fibrosis Induced by the Adoptive Transfer of Human Pulmonary Fibroblasts to Immunodeficient Mice

    PubMed Central

    Pierce, Elizabeth M.; Carpenter, Kristin; Jakubzick, Claudia; Kunkel, Steven L.; Flaherty, Kevin R.; Martinez, Fernando J.; Hogaboam, Cory M.

    2007-01-01

    Idiopathic interstitial pneumonias (IIPs) are a collection of pulmonary fibrotic diseases of unknown etiopathogenesis. CC chemokine receptor 7 (CCR7) is expressed in IIP biopsies and primary fibroblast lines, but its role in pulmonary fibrosis was not previously examined. To study the in vivo role of CCR7 in a novel model of pulmonary fibrosis, 1.0 × 106 primary fibroblasts grown from idiopathic pulmonary fibrosis/usual interstitial pneumonia, nonspecific interstitial pneumonia, or histologically normal biopsies were injected intravenously into C.B-17 severe combined immunodeficiency (SCID)/beige (bg) mice. At days 35 and 63 after idiopathic pulmonary fibrosis/usual interstitial pneumonia fibroblast injection, patchy interstitial fibrosis and increased hydroxyproline were present in the lungs of immunodeficient mice. Adoptively transferred nonspecific interstitial pneumonia fibroblasts caused a more diffuse interstitial fibrosis and increased hydroxyproline levels at both times, but injected normal human fibroblasts did not induce interstitial remodeling changes in C.B-17SCID/bg mice. Systemic therapeutic immunoneutralization of either human CCR7 or CC ligand 21, its ligand, significantly attenuated the pulmonary fibrosis in groups of C.B-17SCID/bg mice that received either type of IIP fibroblasts. Thus, the present study demonstrates that pulmonary fibrosis is initiated by the intravenous introduction of primary human fibroblast lines into immunodeficient mice, and this fibrotic response is dependent on the interaction between CC ligand 21 and CCR7. PMID:17392156

  1. The virus–receptor interaction in the replication of feline immunodeficiency virus (FIV)☆

    PubMed Central

    Willett, Brian J; Hosie, Margaret J

    2013-01-01

    The feline and human immunodeficiency viruses (FIV and HIV) target helper T cells selectively, and in doing so they induce a profound immune dysfunction. The primary determinant of HIV cell tropism is the expression pattern of the primary viral receptor CD4 and co-receptor(s), such as CXCR4 and CCR5. FIV employs a distinct strategy to target helper T cells; a high affinity interaction with CD134 (OX40) is followed by binding of the virus to its sole co-receptor, CXCR4. Recent studies have demonstrated that the way in which FIV interacts with its primary receptor, CD134, alters as infection progresses, changing the cell tropism of the virus. This review examines the contribution of the virus–receptor interaction to replication in vivo as well as the significance of these findings to the development of vaccines and therapeutics. PMID:23992667

  2. Personality Inventory for DSM-5-Short Form (PID-5-SF): Reliability, Factorial Structure, and Relationship With Functional Impairment in Dual Diagnosis Patients.

    PubMed

    Díaz-Batanero, Carmen; Ramírez-López, Juan; Domínguez-Salas, Sara; Fernández-Calderón, Fermín; Lozano, Óscar M

    2017-11-01

    Section III of the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition ( DSM-5) has generated a personality paradigm consisting of 25 personality facets identified in five domains. The developed assessment instrument Personality Inventory for DSM-5 (PID-5) has showed good psychometric properties, but the potential for certain improvements still remain. In this article, a sample of 282 dual diagnosis patients is used to provide evidence of the psychometric properties of the PID-5-Short Form. The mean value of Cronbach's alpha coefficients reached .73 on the facets and .84 for domains and test-retest values ranged between .57 to .83 for facets and .70 to .87 for the domains. Confirmatory factor analyses conducted showed good fit on both models tested: the five correlated factor structure and hierarchical structure of personality traits. The WHODAS 2.0 domains of understanding and communicating, and participating in society, appear to show the strongest relationship with personality facets. In general, the PID-5-Short Form shows adequate psychometric properties for use in dual diagnosis patients.

  3. What motivates use of community-based human immunodeficiency virus testing in rural South Africa?

    PubMed Central

    Upadhya, Devesh; Moll, Anthony P; Brooks, Ralph P; Friedland, Gerald; Shenoi, Sheela V

    2016-01-01

    Despite substantial progress in implementing human immunodeficiency virus testing, challenges remain in achieving widespread uptake particularly in rural resource-limited settings. We sought to understand motivations for human immunodeficiency virus testing in a community-based human immunodeficiency virus testing programme in rural South Africa. We conducted a questionnaire survey in participants undergoing voluntary human immunodeficiency virus testing within an ongoing community-based integrated human immunodeficiency virus/TB intensive case finding programme at congregate rural settings. Participants responded to a six-item non-mutually exclusive motivations survey which included the topics of feeling ill, recent HV exposure, risky lifestyle, illness in a family member, and pregnancy. Among 2068 respondents completing the survey, 1393 (67.4%) were women, median age was 40 years (IQR 19–56), and 1235 (59.7%) were first time testers. Among all testers, 142 (6.9%) were human immunodeficiency virus-positive with median CD4 count 346 (IQR 218–542). Community-based testing for human immunodeficiency virus is acceptable and meets the needs of community members in rural South Africa. Motivations for human immunodeficiency virus testing at the community level are complex and differ according to gender, age, site of community testing, and human immunodeficiency virus status. These differences can be utilised to improve the focus and yield of community-based human immunodeficiency virus screening. PMID:26134323

  4. Ralstonia pickettii-Induced Ataxia in Immunodeficient Mice

    PubMed Central

    Berard, Marion; Medaille, Christine; Simon, Meredith; Serre, Stéphanie; Pritchett-Corning, Kathleen; Dangles-Marie, Virginie

    2009-01-01

    We report here the characterization of an asymmetric ataxia syndrome (head tilt and circling, with death in the most severe cases) demonstrated by profoundly immunodeficient mice housed at the Institut Curie SPF facility. The immune system of the affected mice had been genetically modified so that they were deficient in both B and T cells. Extensive bacteriologic, parasitic, serologic, and histopathologic analysis of the affected animals and their healthy controls led us to identify Ralstonia pickettii as the causative agent of the ataxic syndrome. The outbreak was managed through a test-and-cull process. Even though they also carried Ralstonia pickettii, immunocompetent mice that were kept in the same facility, did not show any of the signs that were expressed by their immunodeficient counterparts. This case highlights the difficulty of maintaining immunocompetent and immunodeficient mice in the same microbiologic unit and the importance of enlarging the spectrum of health monitoring to opportunistic agents when investigating clinical cases in populations of immunocompromised rodents. PMID:19389312

  5. Xenotransplantation in immunodeficient mice to study ovarian follicular development in domestic animals.

    PubMed

    Bols, P E J; Aerts, J M J; Langbeen, A; Goovaerts, I G F; Leroy, J L M R

    2010-04-01

    Nowadays, in vitro study of follicular dynamics of primordial and primary follicular stages is limited because in vitro culture systems for these follicles are lacking, both in domestic animal species and in human. Therefore, additional insights might be generated by grafting ovarian tissue into immunodeficient mice to study activation and maturation of early follicular stages. A considerable amount of data has already been gathered in laboratory animals and through clinical application of human assisted reproduction technologies where live births were reported recently after the use of (cryopreserved) ovarian grafts. However, given that human preantral follicles are difficult to obtain and that there are many similarities between the bovine and human species with regard to ovarian physiology, the bovine model offers exciting additional prospects and is therefore discussed in more detail. This review will focus on recent developments related to preantral follicle and (repeated) ovarian tissue retrieval and xenotransplantation of (bovine) ovarian tissue strips to immunodeficient mice as a model to study preantral follicular dynamics. Different grafting strategies will be discussed as well as the consequences of this procedure on the viability and dynamic behavior of the grafted tissue and follicles. 2010 Elsevier Inc. All rights reserved.

  6. Course of induced infection by Eimeria krijgsmannni in immunocompetent and immunodeficient mice.

    PubMed

    Ono, Yuina; Matsubayashi, Makoto; Kawaguchi, Hiroaki; Tsujio, Masashi; Mizuno, Masanobu; Tanaka, Tetsuya; Masatani, Tatsunori; Matsui, Toshihiro; Matsuo, Tomohide

    2016-01-01

    Recently, we have demonstrated the utility of Eimeria krijgsmanni as a novel mouse eimerian parasite for elucidating the biological diversity. The parasite showed notable infectivity to mice with various levels of immune status and susceptibility to antimicrobial agents including coccidiostat. However, the detailed lifecycle of E. krijgsmanni had not yet been determined and this information was lacking in discussion of previous findings. In the present study, we clarified the morphological characteristics of E. krijgsmanni and its lifecycle in normal mice, and examined the effects in immunodeficient mice and lifecycle stage for challenge infections after the primary inoculation. In immunocompetent mice, the lifecycle consisted of four asexual stages and the sexual sages followed by formation of oocysts during the prepatent periods. Interestingly, the second-generation meronts were detected in all observation periods after the disappearance of the other stages. For the challenge infection of immunodeficient mice, all developmental stages except for the second generation meronts were temporarily vanished. This finding suggests a "rest" or marked delay in development and a "restart" of the promotion toward the next generations. The second generation meronts may play an important role in the lifecycle of E. krijgsmanni.

  7. Human immunity against EBV—lessons from the clinic

    PubMed Central

    2017-01-01

    The mammalian immune system has evolved over many millennia to be best equipped to protect the host from pathogen infection. In many cases, host and pathogen have coevolved, each acquiring sophisticated ways of inducing or protecting from disease. Epstein-Barr virus (EBV) is a human herpes virus that infects >90% of individuals. Despite its ubiquity, infection by EBV is often subclinical; this invariably reflects the necessity of the virus to preserve its host, balanced with sophisticated host immune mechanisms that maintain viral latency. However, EBV infection can result in various, and often fatal, clinical sequelae, including fulminant infectious mononucleosis, hemophagocytic lymphohistiocytosis, lymphoproliferative disease, organomegaly, and/or malignancy. Such clinical outcomes are typically observed in immunosuppressed individuals, with the most extreme cases being Mendelian primary immunodeficiencies (PIDs). Although these conditions are rare, they have provided critical insight into the cellular, biochemical, and molecular requirements for robust and long-lasting immunity against EBV infection. Here, we review the virology of EBV, mechanisms underlying disease pathogenesis in PIDs, and developments in immune cell–mediated therapy to treat disorders associated with or induced by EBV infection. PMID:28108590

  8. AIDS: acquired immunodeficiency syndrome.

    PubMed Central

    Gilmore, N. J.; Beaulieu, R.; Steben, M.; Laverdière, M.

    1983-01-01

    Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Canada. The majority of patients are male homosexuals, although AIDS has also developed in abusers of intravenously administered drugs, Haitian immigrants, individuals with hemophilia, recipients of blood transfusions, prostitutes, and infants, spouses and partners of patients with AIDS. The cause of AIDS is unknown, but the features are consistent with an infectious process. Early diagnosis can be difficult owing to the nonspecific symptoms and signs of the infections and malignant diseases. Therefore, vigilance by physicians is of utmost importance. PMID:6342737

  9. AIDS: acquired immunodeficiency syndrome *

    PubMed Central

    Gilmore, N.J.; Beaulieu, R.; Steben, M.; Laverdière, M.

    1992-01-01

    Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Canada. The majority of patients are male homosexuals, although AIDS has also developed in abusers of intravenously administered drugs, Haitian immigrants, individuals with hemophilia, recipients of blood transfusions, prostitutes, and infants, spouses and partners of patients with AIDS. The cause of AIDS is unknown, but the features are consistent with an infectious process. Early diagnosis can be difficult owing to the nonspecific symptoms and signs of the infections and malignant diseases. Therefore, vigilance by physicians is of the utmost importance. PMID:1544049

  10. Appendectomy in patients with human immunodeficiency virus: Not as bad as we once thought.

    PubMed

    Smith, Michael C; Chung, Paul J; Constable, Yohannes C; Boylan, Matthew R; Alfonso, Antonio E; Sugiyama, Gainosuke

    2017-04-01

    The number of patients living with human immunodeficiency virus and acquired immunodeficiency syndrome is growing due to advances in antiretroviral therapy. Existing literature on appendectomy within this patient population has been limited by small sample sizes. Therefore, we used a large, multiyear, nationwide database to study this topic comprehensively. Using the Nationwide Inpatient Sample, we identified 338,805 patients between 2005 and 2012 who underwent laparoscopic or open appendectomy for acute appendicitis. Interval appendectomies were excluded. We used multivariable adjusted regression models to test differences between patients with human immunodeficiency virus without acquired immunodeficiency syndrome and a reference group, as well as human immunodeficiency virus with acquired immunodeficiency syndrome and a reference group, with regard to duration of stay, hospital charges, in-hospital complications, and in-hospital mortality. Models were adjusted for patient age, sex, race, insurance, socioeconomic status, Elixhauser comorbidity score, and appendix perforation. There were 1,291 (0.38%) patients with human immunodeficiency virus, among which 497 (0.15%) patients had acquired immunodeficiency syndrome. In regression analysis, human immunodeficiency virus alone was not associated with adverse outcomes, while acquired immunodeficiency syndrome alone was associated with longer duration of stay (incidence rate ratio 1.40 [1.37-1.57 95% confidence interval], P < .0001), increased total charges (exponentiated coefficient 1.16 [1.10-1.23 95% confidence interval], P < .0001), and increased risk of postoperative infection (odds ratio 2.12 [1.44-3.13 95% confidence interval], P = .0002). Patients with acquired immunodeficiency syndrome who undergo appendectomy for acute appendicitis are subject to longer and more expensive hospital admissions and have greater rates of postoperative infections while patients with human immunodeficiency virus alone are not

  11. Divergent kinetics of proliferating T cell subsets in simian immunodeficiency virus (SIV) infection: SIV eliminates the "first responder" CD4+ T cells in primary infection.

    PubMed

    Wang, Xiaolei; Xu, Huanbin; Pahar, Bapi; Lackner, Andrew A; Veazey, Ronald S

    2013-06-01

    Although increased lymphocyte turnover in chronic human immunodeficiency virus and simian immunodeficiency virus (SIV) infection has been reported in blood, there is little information on cell turnover in tissues, particularly in primary SIV infection. Here we examined the levels of proliferating T cell subsets in mucosal and peripheral lymphoid tissues of adult macaques throughout SIV infection. To specifically label cells in S-phase division, all animals were inoculated with bromodeoxyuridine 24 h prior to sampling. In healthy macaques, the highest levels of proliferating CD4(+) and CD8(+) T cells were in blood and, to a lesser extent, in spleen. Substantial percentages of proliferating cells were also found in intestinal tissues, including the jejunum, ileum, and colon, but very few proliferating cells were detected in lymph nodes (axillary and mesenteric). Moreover, essentially all proliferating T cells in uninfected animals coexpressed CD95 and many coexpressed CCR5 in the tissues examined. Confocal microscopy also demonstrated that proliferating cells were substantial viral target cells for SIV infection and viral replication. After acute SIV infection, percentages of proliferating CD4(+) and CD8(+) T cells were significantly higher in tissues of chronically infected macaques and macaques with AIDS than in those of the controls. Surprisingly, however, we found that proliferating CD4(+) T cells were selectively decreased in very early infection (8 to 10 days postinoculation [dpi]). In contrast, levels of proliferating CD8(+) T cells rapidly increased after SIV infection, peaked by 13 to 21 dpi, and thereafter remained significantly higher than those in the controls. Taken together, these findings suggest that SIV selectively infects and destroys dividing, nonspecific CD4(+) T cells in acute infection, resulting in homeostatic changes and perhaps continuing loss of replication capacity to respond to nonspecific and, later, SIV-specific antigens.

  12. Novel ZBTB24 Mutation Associated with Immunodeficiency, Centromere Instability, and Facial Anomalies Type-2 Syndrome Identified in a Patient with Very Early Onset Inflammatory Bowel Disease.

    PubMed

    Conrad, Máire A; Dawany, Noor; Sullivan, Kathleen E; Devoto, Marcella; Kelsen, Judith R

    2017-12-01

    Very early onset inflammatory bowel disease, diagnosed in children ≤5 years old, can be the initial presentation of some primary immunodeficiencies. In this study, we describe a 17-month-old boy with recurrent infections, growth failure, facial anomalies, and inflammatory bowel disease. Immune evaluation, whole-exome sequencing, karyotyping, and methylation array were performed to evaluate the child's constellation of symptoms and examination findings. Whole-exome sequencing revealed that the child was homozygous for a novel variant in ZBTB24, the gene associated with immunodeficiency, centromere instability, and facial anomalies type-2 syndrome. This describes the first case of inflammatory bowel disease associated with immunodeficiency, centromere instability, and facial anomalies type-2 syndrome in a child with a novel disease-causing mutation in ZBTB24 found on whole-exome sequencing.

  13. Exclusion of Patients with a Severe T-Cell Defect Improves the Definition of Common Variable Immunodeficiency.

    PubMed

    Bertinchamp, Rémi; Gérard, Laurence; Boutboul, David; Malphettes, Marion; Fieschi, Claire; Oksenhendler, Eric

    In 2014, the European Society for Immune Deficiencies (ESID) revised the common variable immunodeficiency (CVID) diagnosis criteria by incorporating new clinical and biological markers. The new definition appeared more restrictive but had not yet been evaluated in a large cohort of patients. The objective of this study was to evaluate the impact of this new definition in a large cohort of patients with primary hypogammaglobulinemia. Evaluation of 3 different CVID definitions (ESID/Pan-American Group for Immunodeficiency [PAGID] 1999, ESID 2014, DEFI 2015) in 521 patients included in the French DEFI study with a diagnosis of primary hypogammaglobulinemia. Using the ESID/PAGID 1999 definition, 351 patients were classified as CVID. The new ESID 2014 definition excluded 62 (18%) patients. Most of them (n = 56; 90%) had a less severe disease, whereas 6 (10%) presented with a severe disease with major T-cell defect. We propose different criteria (occurrence of opportunistic infection or very low naive CD4+ T-cell count) to define this population with severe T-cell defect. Sixty-two patients fulfilled these criteria, represented 20% of the initial CVID population but accounted for 77% of the deaths, with a 5-year overall survival of 67.6% (95% confidence interval, 51.0-79.6), and were considered as late onset combined immunodeficiency (LOCID). The new ESID definition for CVID still fails to exclude a large number of patients with severe T-cell defect. We propose a new definition (DEFI 2015) that excluded more patients with a T-cell defect and consider these patients as LOCID. This population has a poor outcome and should be considered as a distinct group requiring specific care. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  14. Distribution of immunodeficiency fact files with XML--from Web to WAP.

    PubMed

    Väliaho, Jouni; Riikonen, Pentti; Vihinen, Mauno

    2005-06-26

    Although biomedical information is growing rapidly, it is difficult to find and retrieve validated data especially for rare hereditary diseases. There is an increased need for services capable of integrating and validating information as well as proving it in a logically organized structure. A XML-based language enables creation of open source databases for storage, maintenance and delivery for different platforms. Here we present a new data model called fact file and an XML-based specification Inherited Disease Markup Language (IDML), that were developed to facilitate disease information integration, storage and exchange. The data model was applied to primary immunodeficiencies, but it can be used for any hereditary disease. Fact files integrate biomedical, genetic and clinical information related to hereditary diseases. IDML and fact files were used to build a comprehensive Web and WAP accessible knowledge base ImmunoDeficiency Resource (IDR) available at http://bioinf.uta.fi/idr/. A fact file is a user oriented user interface, which serves as a starting point to explore information on hereditary diseases. The IDML enables the seamless integration and presentation of genetic and disease information resources in the Internet. IDML can be used to build information services for all kinds of inherited diseases. The open source specification and related programs are available at http://bioinf.uta.fi/idml/.

  15. Dynamic Analysis Method for Electromagnetic Artificial Muscle Actuator under PID Control

    NASA Astrophysics Data System (ADS)

    Nakata, Yoshihiro; Ishiguro, Hiroshi; Hirata, Katsuhiro

    We have been studying an interior permanent magnet linear actuator for an artificial muscle. This actuator mainly consists of a mover and stator. The mover is composed of permanent magnets, magnetic cores and a non-magnetic shaft. The stator is composed of 3-phase coils and a back yoke. In this paper, the dynamic analysis method under PID control is proposed employing the 3-D finite element method (3-D FEM) to compute the dynamic response and current response when the positioning control is active. As a conclusion, computed results show good agreement with measured ones of a prototype.

  16. Feedback control system based on a remote operated PID controller implemented using mbed NXP LPC1768 development board

    NASA Astrophysics Data System (ADS)

    Pricop, Emil; Zamfir, Florin; Paraschiv, Nicolae

    2015-11-01

    Process control is a challenging research topic for both academia and industry for a long time. Controllers evolved from the classical SISO approach to modern fuzzy or neuro-fuzzy embedded devices with networking capabilities, however PID algorithms are still used in the most industrial control loops. In this paper, we focus on the implementation of a PID controller using mbed NXP LPC1768 development board. This board integrates a powerful ARM Cortex- M3 core and has networking capabilities. The implemented controller can be remotely operated by using an Internet connection and a standard Web browser. The main advantages of the proposed embedded system are customizability, easy operation and very low power consumption. The experimental results obtained by using a simulated process are analysed and shows that the implementation can be done with success in industrial applications.

  17. Clinical and Immunological Features of Common Variable Immunodeficiency in China

    PubMed Central

    Lin, Lian-Jun; Wang, Yu-Chuan; Liu, Xin-Min

    2015-01-01

    Background: Common variable immunodeficiency (CVID) is one of the most common symptomatic primary immunodeficiency syndromes. The purpose of this article was to broaden our knowledge about CVID for better diagnosis and treatment. Methods: Clinical and immunological features of 40 Chinese patients with CVID were analyzed retrospectively. Results: The median age at onset was 11-year-old (range 4–51 years). The median age at diagnosis was 14.5-year-old (range 5–66 years). The average time of delay in diagnosis was 5.3 years (range 1–41 years). The most common main complaint was fever due to infections (35 cases, 87.5%). Pneumonia (28 cases, 70%) was the most common type of infections. Bronchiectasis was present in 6 patients (15%). Autoimmune disease was detected in 6 cases of CVID, and malignancy in 2 cases. The median total serum levels of IgG, IgA, and IgM at diagnosis were 1.07 g/L, 0.07 g/L, and 0.28 g/L, respectively. The percentages of CD3−/CD10+ B-cells were 1%–3.14%. Conclusions: Infection is the most frequent presentation of CVID. Patients with unexplainable infections should receive further examination including serum immunoglobulin (Ig) and lymphocyte subset analysis. Regular and sufficient substitution with Ig is recommended. PMID:25635425

  18. Screening for long-term poliovirus excretion among children with primary immunodeficiency disorders: preparation for the polio posteradication era in Bangladesh.

    PubMed

    Sazzad, Hossain M S; Rainey, Jeanette J; Kahn, Anna-Lea; Mach, Ondrej; Liyanage, Jayantha B L; Alam, Ahmed Nawsher; Kawser, Choudhury A; Hossain, Asgar; Sutter, Roland; Luby, Stephen P

    2014-11-01

    Persons with primary immune deficiency disorders (PIDD) who receive oral poliovirus vaccine (OPV) may transmit immunodeficiency-associated vaccine-derived polioviruses (iVDPVs) and cause paralytic polio. The objective of this study was to identify children with PIDD in Bangladesh, and estimate the proportion with chronic poliovirus excretion. Patients admitted at 5 teaching hospitals were screened for PIDD according to standardized clinical case definitions. PIDD was confirmed by age-specific quantitative immunoglobulin levels. Stool specimens were collected from patients with confirmed PIDD. From February 2011 through January 2013, approximately 96 000 children were screened, and 53 patients were identified who met the clinical case definition for PIDD. Thirteen patients (24%) had age-specific quantitative immunoglobulins results that confirmed PIDD. Of these, 9 (69%) received OPV 3-106 months before stool specimen collection. Among 11 patients, stool specimens from 1 patient tested positive for polioviruses 34 months after OPV ingestion. However, the poliovirus isolate was not available for genetic sequencing, and a subsequent stool specimen 45 days later was negative. The risk of chronic poliovirus excretion among children with PIDD in Bangladesh seems to be low. The national polio eradication program should incorporate strategies for screening for poliovirus excretion among patients with PIDD. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Predictors of human immunodeficiency virus (HIV) infection in primary care among adults living in developed countries: a systematic review.

    PubMed

    Rumbwere Dube, Benhildah N; Marshall, Tom P; Ryan, Ronan P; Omonijo, Modupe

    2018-06-02

    Early diagnosis of human immunodeficiency virus (HIV) is important because antiretroviral therapies are more effective if infected individuals are diagnosed early. Diagnosis of HIV relies on laboratory testing and determining the demographic and clinical characteristics of undiagnosed HIV-infected patients may be useful in identifying patients for testing. This systematic review aims to identify characteristics of HIV-infected adults prior to diagnosis that could be used in a prediction model for early detection of patients for HIV testing in UK primary care. The population of interest was adults aged ≥ 18 years in developed countries. The exposures were demographic, socio-economic or clinical characteristics associated with the outcome, laboratory confirmed HIV/AIDS infection. Observational studies with a comparator group were included in the systematic review. Electronic searches for articles from January 1995 to April 2016 were conducted on online databases of EMBASE, MEDLINE, The Cochrane Library and grey literature. Two reviewers selected studies for inclusion. A checklist was developed for quality assessment, and a data extraction form was created to collate data from selected studies. Full-text screening of 429 articles identified 17 cohort and case-control studies, from 26,819 retrieved articles. Demographic and socio-economic characteristics associated with HIV infection included age, gender and measures of deprivation. Lifestyle choices identified were drug use, binge-drinking, number of lifetime partners and having a partner with risky behaviour. Eighteen clinical features and comorbid conditions identified in this systematic review are included in the 51 conditions listed in the British HIV Association guidelines. Additional clinical features and comorbid conditions identified but not specified in the guidelines included hyperlipidemia, hypertension, minor trauma and diabetes. This systematic review consolidates existing scientific evidence on

  20. Multicentric Castleman's disease in human immunodeficiency virus infection: two case reports.

    PubMed

    Caroline Ribeiro Sales, Amanda; Romão de Souza Junior, Valter; Iglis de Oliveira, Marta; Azevedo Braga Albuquerque, Claudia; de Barros Campelo Júnior, Evônio; Sérgio Ramos de Araújo, Paulo

    2018-05-05

    Castleman's Disease is a rare B-cell lymphoproliferative disease. It is mostly benign and is characterized by non-neoplastic lymph node hypertrophy, associated with infection by human herpesvirus-8 in people with the human immunodeficiency virus/acquired immunodeficiency syndrome. Although the unicentric or localized form presents as benign, the multifocal form can manifest severe systemic symptoms. We report two unusual cases of men presenting cervical enlarged lymph nodes that were believed to be infectious. The first case is a 41-year-old feoderm man who presented to the Department of Infectious Diseases of the Hospital das Clínicas in May 2015, with irregular fever history (38-39 °C), dyspnea, weight loss (8 kg/1 year), and asthenia with increased cervical lymph nodes of 1-year duration. His immunohistochemical diagnosis presented Castleman's disease in plasmacytic/diffuse form. In the second case, a 35-year-old feoderm man presented at the same hospital with multiple cervical enlarged lymph nodes and histopathological evidence of Castleman's disease associated with human herpesvirus-8. Considering the importance of differential diagnosis of lymphoid disorders, Castleman's disease is a challenging diagnosis in people living with human immunodeficiency virus/acquired immunodeficiency syndrome and can be easily misdiagnosed when lymphoid disorders are present in the human immunodeficiency virus/acquired immunodeficiency syndrome population due to nonspecific symptoms and signs.

  1. ACOG Committee Opinion No. 536: Human immunodeficiency virus and acquired immunodeficiency syndrome and women of color.

    PubMed

    2012-09-01

    In the United States, most new cases of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) occur among women of color (primarily African American and Hispanic women). Most women of color acquire the disease from heterosexual contact, often from a partner who has undisclosed risk factors for HIV infection. Safe sex practices, especially consistent condom use, must be emphasized for all women, including women of color. A combination of testing, education, and brief behavioral interventions can help reduce the rate of HIV infection and its complications among women of color. In addition,biomedical interventions such as early treatment of patients infected with HIV and pre-exposure antiretroviral prophylaxis of high-risk individuals offer promise for future reductions in infections.

  2. Early-onset Evans syndrome, immunodeficiency, and premature immunosenescence associated with tripeptidyl-peptidase II deficiency

    PubMed Central

    Stepensky, Polina; Rensing-Ehl, Anne; Gather, Ruth; Revel-Vilk, Shoshana; Fischer, Ute; Nabhani, Schafiq; Beier, Fabian; Brümmendorf, Tim H.; Fuchs, Sebastian; Zenke, Simon; Firat, Elke; Pessach, Vered Molho; Borkhardt, Arndt; Rakhmanov, Mirzokhid; Keller, Bärbel; Warnatz, Klaus; Eibel, Hermann; Niedermann, Gabriele; Elpeleg, Orly

    2015-01-01

    Autoimmune cytopenia is a frequent manifestation of primary immunodeficiencies. Two siblings presented with Evans syndrome, viral infections, and progressive leukopenia. DNA available from one patient showed a homozygous frameshift mutation in tripeptidyl peptidase II (TPP2) abolishing protein expression. TPP2 is a serine exopeptidase involved in extralysosomal peptide degradation. Its deficiency in mice activates cell death programs and premature senescence. Similar to cells from naïve, uninfected TPP2-deficient mice, patient cells showed increased major histocompatibility complex I expression and most CD8+ T-cells had a senescent CCR7-CD127−CD28−CD57+ phenotype with poor proliferative responses and enhanced staurosporine-induced apoptosis. T-cells showed increased expression of the effector molecules perforin and interferon-γ with high expression of the transcription factor T-bet. Age-associated B-cells with a CD21− CD11c+ phenotype expressing T-bet were increased in humans and mice, combined with antinuclear antibodies. Moreover, markers of senescence were also present in human and murine TPP2-deficient fibroblasts. Telomere lengths were normal in patient fibroblasts and granulocytes, and low normal in lymphocytes, which were compatible with activation of stress-induced rather than replicative senescence programs. TPP2 deficiency is the first primary immunodeficiency linking premature immunosenescence to severe autoimmunity. Determination of senescent lymphocytes should be part of the diagnostic evaluation of children with refractory multilineage cytopenias. PMID:25414442

  3. 78 FR 33848 - Draft Guidance for Industry on Human Immunodeficiency Virus-1 Infection: Developing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-05

    ...] Draft Guidance for Industry on Human Immunodeficiency Virus-1 Infection: Developing Antiretroviral Drugs... entitled ``Human Immunodeficiency Virus-1 Infection: Developing Antiretroviral Drugs for Treatment.'' The... guidance for industry entitled ``Human Immunodeficiency Virus-1 Infection: Developing Antiretroviral Drugs...

  4. Feline immunodeficiency. ABCD guidelines on prevention and management.

    PubMed

    Hosie, Margaret J; Addie, Diane; Belák, Sándor; Boucraut-Baralon, Corine; Egberink, Herman; Frymus, Tadeusz; Gruffydd-Jones, Tim; Hartmann, Katrin; Lloret, Albert; Lutz, Hans; Marsilio, Fulvio; Pennisi, Maria Grazia; Radford, Alan D; Thiry, Etienne; Truyen, Uwe; Horzinek, Marian C

    2009-07-01

    Feline immunodeficiency virus (FIV) is a retrovirus closely related to human immunodeficiency virus. Most felids are susceptible to FIV, but humans are not. Feline immunodeficiency virus is endemic in domestic cat populations worldwide. The virus loses infectivity quickly outside the host and is susceptible to all disinfectants. Feline immunodeficiency virus is transmitted via bites. The risk of transmission is low in households with socially well-adapted cats. Transmission from mother to kittens may occur, especially if the queen is undergoing an acute infection. Cats with FIV are persistently infected in spite of their ability to mount antibody and cell-mediated immune responses. Infected cats generally remain free of clinical signs for several years, and some cats never develop disease, depending on the infecting isolate. Most clinical signs are the consequence of immunodeficiency and secondary infection. Typical manifestations are chronic gingivostomatitis, chronic rhinitis, lymphadenopathy, weight loss and immune-mediated glomerulonephritis. Positive in-practice ELISA results obtained in a low-prevalence or low-risk population should always be confirmed by a laboratory. Western blot is the 'gold standard' laboratory test for FIV serology. PCR-based assays vary in performance. Cats should never be euthanased solely on the basis of an FIV-positive test result. Cats infected with FIV may live as long as uninfected cats, with appropriate management. Asymptomatic FIV-infected cats should be neutered to avoid fighting and virus transmission. Infected cats should receive regular veterinary health checks. They can be housed in the same ward as other patients, but should be kept in individual cages. At present, there is no FIV vaccine commercially available in Europe. Potential benefits and risks of vaccinating FIV-infected cats should be assessed on an individual cat basis. Needles and surgical instruments used on FIV-positive cats may transmit the virus to other cats

  5. Divergent Kinetics of Proliferating T Cell Subsets in Simian Immunodeficiency Virus (SIV) Infection: SIV Eliminates the “First Responder” CD4+ T Cells in Primary Infection

    PubMed Central

    Wang, Xiaolei; Xu, Huanbin; Pahar, Bapi; Lackner, Andrew A.

    2013-01-01

    Although increased lymphocyte turnover in chronic human immunodeficiency virus and simian immunodeficiency virus (SIV) infection has been reported in blood, there is little information on cell turnover in tissues, particularly in primary SIV infection. Here we examined the levels of proliferating T cell subsets in mucosal and peripheral lymphoid tissues of adult macaques throughout SIV infection. To specifically label cells in S-phase division, all animals were inoculated with bromodeoxyuridine 24 h prior to sampling. In healthy macaques, the highest levels of proliferating CD4+ and CD8+ T cells were in blood and, to a lesser extent, in spleen. Substantial percentages of proliferating cells were also found in intestinal tissues, including the jejunum, ileum, and colon, but very few proliferating cells were detected in lymph nodes (axillary and mesenteric). Moreover, essentially all proliferating T cells in uninfected animals coexpressed CD95 and many coexpressed CCR5 in the tissues examined. Confocal microscopy also demonstrated that proliferating cells were substantial viral target cells for SIV infection and viral replication. After acute SIV infection, percentages of proliferating CD4+ and CD8+ T cells were significantly higher in tissues of chronically infected macaques and macaques with AIDS than in those of the controls. Surprisingly, however, we found that proliferating CD4+ T cells were selectively decreased in very early infection (8 to 10 days postinoculation [dpi]). In contrast, levels of proliferating CD8+ T cells rapidly increased after SIV infection, peaked by 13 to 21 dpi, and thereafter remained significantly higher than those in the controls. Taken together, these findings suggest that SIV selectively infects and destroys dividing, nonspecific CD4+ T cells in acute infection, resulting in homeostatic changes and perhaps continuing loss of replication capacity to respond to nonspecific and, later, SIV-specific antigens. PMID:23596288

  6. Profile of the Pediatric Infectious Disease Workforce in 2015.

    PubMed

    Yeh, Sylvia H; Vijayan, Vini; Hahn, Andrea; Ruch-Ross, Holly; Kirkwood, Suzanne; Phillips, Terri Christene; Harrison, Christopher J

    2017-12-22

    Almost 20 years have elapsed since the last workforce survey of pediatric infectious disease (PID) subspecialists was conducted in 1997-1998. The American Academy of Pediatrics Section on Infectious Diseases in collaboration with the Pediatric Infectious Diseases Society sought to assess the status of the current PID workforce. A Web-based survey conducted in 2015 collected data on demographics, practice patterns, and job satisfaction among the PID workforce, and identified factors related to job placement among recent fellowship graduates. Of 946 respondents (48% response rate), 50% were female. The average age was 51 years (range, 29-88 years); 63% were employed by an academic center/hospital, and 85% provided direct patient care; and 18% were not current PID practitioners. Of the 138 (21%) respondents who had completed a PID fellowship within the previous 5 years, 83% applied for <5 PID positions; 43% reported that their first position was created specifically for them; 47% had 1 job offer, and 41% had 2 or 3 job offers; 82% were employed within 6 months; and 74% remained at the institution of their first job. Respondents who were practicing PID full-time or part-time (n = 778) indicated desiring more focused training in immunodeficiencies (31%), transplant-related care (31%), and travel/tropical medicine (28%). Overall, 70% of the respondents would "definitely" or "probably" choose PID again. Most respondents were satisfied with their career choice in PID. Most of the recent fellowship graduates were employed within 6 months after training. We identified potential areas in which the PID community can focus efforts to maintain the pipeline and improve satisfaction among its physicians. © The Author 2017. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. [Acceptability of the opportunistic search for human immunodeficiency virus infection by serology in patients recruited in Primary Care Centres in Spain].

    PubMed

    Puentes Torres, Rafael Carlos; Aguado Taberné, Cristina; Pérula de Torres, Luis Angel; Espejo Espejo, José; Castro Fernández, Cristina; Fransi Galiana, Luís

    2016-01-01

    To assess the acceptability of opportunistic search for human immunodeficiency virus (HIV). Cross-sectional, observational study. Primary Care Centres (PCC) of the Spanish National Health Care System. patients aged 18 to 65 years who had never been tested for HIV, and were having a blood test for other reasons. RECORDED VARIABLES: age, gender, stable partner, educational level, tobacco/alcohol use, reason for blood testing, acceptability of taking the HIV test, reasons for refusing to take the HIV test, and reasons for not having taken an HIV test previously. A descriptive, bivariate, multivariate (logistic regression) statistical analysis was performed. A total of 208 general practitioners (GPs) from 150 health care centres recruited 3,314 patients. Most (93.1%) of patients agreed to take the HIV test (95%CI: 92.2-93.9). Of these patients, 56.9% reported never having had an HIV test before because they considered not to be at risk of infection, whereas 34.8% reported never having been tested for HIV because their doctor had never offered it to them. Of the 6.9% who refused to take the HIV test, 73.9% considered that they were not at risk. According to the logistic regression analysis, acceptability was positively associated to age (higher among between 26 and 35 year olds, OR=1.79; 95%CI: 1.10-2.91) and non-smokers (OR=1.39; 95%CI: 1.01-1.93). Those living in towns with between 10,000 and 50,000 inhabitants showed less acceptance to the test (OR=0.57; 95%CI: 0.40-0.80). The HIV prevalence detected was 0.24% Acceptability of HIV testing is very high among patients having a blood test in primary care settings in Spain. Opportunistic search is cost-effective. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  8. Defect in IgV gene somatic hypermutation in common variable immuno-deficiency syndrome.

    PubMed

    Levy, Y; Gupta, N; Le Deist, F; Garcia, C; Fischer, A; Weill, J C; Reynaud, C A

    1998-10-27

    Common Variable Immuno-Deficiency (CVID) is the most common symptomatic primary antibody-deficiency syndrome, but the basic immunologic defects underlying this syndrome are not well defined. We report here that among eight patients studied (six CVID and two hypogammaglobulinemic patients with recurrent infections), there is in two CVID patients a dramatic reduction in Ig V gene somatic hypermutation with 40-75% of IgG transcripts totally devoid of mutations in the circulating memory B cell compartment. Functional assays of the T cell compartment point to an intrinsic B cell defect in the process of antibody affinity maturation in these two cases.

  9. Frequent transmission of immunodeficiency viruses among bobcats and pumas

    USGS Publications Warehouse

    Franklin, S.P.; Troyer, J.L.; TerWee, J.A.; Lyren, L.M.; Boyce, W.M.; Riley, S.P.D.; Roelke, M.E.; Crooks, K.R.; VandeWoude, S.

    2007-01-01

    With the exception of human immunodeficiency virus (HIV), which emerged in humans after cross-species transmissions of simian immunodeficiency viruses from nonhuman primates, immunodeficiency viruses of the family Lentiviridae represent species-specific viruses that rarely cross species barriers to infect new hosts. Among the Felidae, numerous immunodeficiency-like lentiviruses have been documented, but only a few cross-species transmissions have been recorded, and these have not been perpetuated in the recipient species. Lentivirus seroprevalence was determined for 79 bobcats (Lynx rufus) and 31 pumas (Puma concolor) from well-defined populations in Southern California. Partial genomic sequences were subsequently obtained from 18 and 12 seropositive bobcats and pumas, respectively. Genotypes were analyzed for phylogenic relatedness and genotypic composition among the study set and archived feline lentivirus sequences. This investigation of feline immunodeficiency virus infection in bobcats and pumas of Southern California provides evidence that cross-species infection has occurred frequently among these animals. The data suggest that transmission has occurred in multiple locations and are most consistent with the spread of the virus from bobcats to pumas. Although the ultimate causes remain unknown, these transmission events may occur as a result of puma predation on bobcats, a situation similar to that which fostered transmission of HIV to humans, and likely represent the emergence of a lentivirus with relaxed barriers to cross-species transmission. This unusual observation provides a valuable opportunity to evaluate the ecological, behavioral, and molecular conditions that favor repeated transmissions and persistence of lentivirus between species. Copyright ?? 2007, American Society for Microbiology. All Rights Reserved.

  10. Pain in human immunodeficiency virus disease.

    PubMed

    Newshan, G

    1997-02-01

    To review the prevalence and etiology of pain in persons with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and issues and considerations for pain management in this patient population. Research studies, review articles, and books related to pain in persons with HIV/AIDS. Pain is a common problem for individuals with HIV/AIDS that is often poorly managed and net well documented. Many of these patients have multiple, coexisting illnesses that are painful. Adequate assessment of the underlying cause will help in the treatment or eradication of pain. The management of pain in persons with HIV/AIDS is an important responsibility for oncology nurses because increasing numbers of persons with HIV/AIDS are being treated for neoplastic complications, cytopenias, or being referred to hospice care.

  11. Identification of Patients with RAG Mutations Previously Diagnosed with Common Variable Immunodeficiency Disorders

    PubMed Central

    Buchbinder, David; Baker, Rebecca; Lee, Yu Nee; Ravell, Juan; Zhang, Yu; McElwee, Joshua; Nugent, Diane; Coonrod, Emily M.; Durtschi, Jacob D.; Augustine, Nancy H.; Voelkerding, Karl V.; Csomos, Krisztian; Rosen, Lindsey; Browne, Sarah; Walter, Jolan E.; Notarangelo, Luigi D.; Hill, Harry R.; Kumánovics, Attila

    2015-01-01

    Purpose Combined immunodeficiency (CID) presents a unique challenge to clinicians. Two patients presented with the prior clinical diagnosis of common variable immunodeficiency (CVID) disorder marked by an early age of presentation, opportunistic infections, and persistent lymphopenia. Due to the presence of atypical clinical features, next generation sequencing was applied documenting RAG deficiency in both patients. Methods Two different genetic analysis techniques were applied in these patients including whole exome sequencing in one patient and the use of a gene panel designed to target genes known to cause primary immunodeficiency disorders (PIDD) in a second patient. Sanger dideoxy sequencing was used to confirm RAG1 mutations in both patients. Results Two young adults with a history of recurrent bacterial sinopulmonary infections, viral infections, and autoimmune disease as well as progressive hypogammaglobulinemia, abnormal antibody responses, lymphopenia and a prior diagnosis of CVID disorder were evaluated. Compound heterozygous mutations in RAG1 (1) c256_257delAA, p86VfsX32 and (2) c1835A>G, pH612R were documented in one patient. Compound heterozygous mutations in RAG1 (1) c.1566G>T, p.W522C and (2) c.2689C>T, p. R897X) were documented in a second patient post-mortem following a fatal opportunistic infection. Conclusion Astute clinical judgment in the evaluation of patients with PIDD is necessary. Atypical clinical findings such as early onset, granulomatous disease, or opportunistic infections should support the consideration of atypical forms of late onset CID secondary to RAG deficiency. Next generation sequencing approaches provide powerful tools in the investigation of these patients and may expedite definitive treatments. PMID:25516070

  12. 78 FR 46969 - Human Immunodeficiency Virus Patient-Focused Drug Development and Human Immunodeficiency Virus...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ... for the notice of public meeting entitled ``Human Immunodeficiency Virus (HIV) Patient-Focused Drug Development and HIV Cure Research,'' published in the Federal Register of May 21, 2013 (78 FR 29755). In that... HIV, symptoms experienced because of HIV or its treatment, and issues related to HIV cure research...

  13. Respiratory Infections and Antibiotic Usage in Common Variable Immunodeficiency.

    PubMed

    Sperlich, Johannes M; Grimbacher, Bodo; Workman, Sarita; Haque, Tanzina; Seneviratne, Suranjith L; Burns, Siobhan O; Reiser, Veronika; Vach, Werner; Hurst, John R; Lowe, David M

    Patients with common variable immunodeficiency (CVID) suffer frequent respiratory tract infections despite immunoglobulin replacement and are prescribed significant quantities of antibiotics. The clinical and microbiological nature of these exacerbations, the symptomatic triggers to take antibiotics, and the response to treatment have not been previously investigated. To describe the nature, frequency, treatment, and clinical course of respiratory tract exacerbations in patients with CVID and to describe pathogens isolated during respiratory tract exacerbations. We performed a prospective diary card exercise in 69 patients with CVID recruited from a primary immunodeficiency clinic in the United Kingdom, generating 6210 days of symptom data. We collected microbiology (sputum microscopy and culture, atypical bacterial PCR, and mycobacterial culture) and virology (nasopharyngeal swab multiplex PCR) samples from symptomatic patients with CVID. There were 170 symptomatic exacerbations and 76 exacerbations treated by antibiotics. The strongest symptomatic predictors for commencing antibiotics were cough, shortness of breath, and purulent sputum. There was a median delay of 5 days from the onset of symptoms to commencing antibiotics. Episodes characterized by purulent sputum responded more quickly to antibiotics, whereas sore throat and upper respiratory tract symptoms responded less quickly. A pathogenic virus was isolated in 56% of respiratory exacerbations and a potentially pathogenic bacteria in 33%. Patients with CVID delay and avoid treatment of symptomatic respiratory exacerbations, which could result in structural lung damage. However, viruses are commonly represented and illnesses dominated by upper respiratory tract symptoms respond poorly to antibiotics, suggesting that antibiotic usage could be better targeted. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  14. A novel optimized hybrid fuzzy logic intelligent PID controller for an interconnected multi-area power system with physical constraints and boiler dynamics.

    PubMed

    Gomaa Haroun, A H; Li, Yin-Ya

    2017-11-01

    In the fast developing world nowadays, load frequency control (LFC) is considered to be a most significant role for providing the power supply with good quality in the power system. To deliver a reliable power, LFC system requires highly competent and intelligent control technique. Hence, in this article, a novel hybrid fuzzy logic intelligent proportional-integral-derivative (FLiPID) controller has been proposed for LFC of interconnected multi-area power systems. A four-area interconnected thermal power system incorporated with physical constraints and boiler dynamics is considered and the adjustable parameters of the FLiPID controller are optimized using particle swarm optimization (PSO) scheme employing an integral square error (ISE) criterion. The proposed method has been established to enhance the power system performances as well as to reduce the oscillations of uncertainties due to variations in the system parameters and load perturbations. The supremacy of the suggested method is demonstrated by comparing the simulation results with some recently reported heuristic methods such as fuzzy logic proportional-integral (FLPI) and intelligent proportional-integral-derivative (PID) controllers for the same electrical power system. the investigations showed that the FLiPID controller provides a better dynamic performance and outperform compared to the other approaches in terms of the settling time, and minimum undershoots of the frequency as well as tie-line power flow deviations following a perturbation, in addition to perform appropriate settlement of integral absolute error (IAE). Finally, the sensitivity analysis of the plant is inspected by varying the system parameters and operating load conditions from their nominal values. It is observed that the suggested controller based optimization algorithm is robust and perform satisfactorily with the variations in operating load condition, system parameters and load pattern. Copyright © 2017 ISA. Published by

  15. A Cell Line-Based Neutralization Assay for Primary Human Immunodeficiency Virus Type 1 Isolates That Use either the CCR5 or the CXCR4 Coreceptor

    PubMed Central

    Trkola, Alexandra; Matthews, Jamie; Gordon, Cynthia; Ketas, Tom; Moore, John P.

    1999-01-01

    We describe here a cell line-based assay for the evaluation of human immunodeficiency virus type 1 (HIV-1) neutralization. The assay is based on CEM.NKR cells, transfected to express the HIV-1 coreceptor CCR5 to supplement the endogenous expression of CD4 and the CXCR4 coreceptor. The resulting CEM.NKR-CCR5 cells efficiently replicate primary HIV-1 isolates of both R5 and X4 phenotypes. A comparison of the CEM.NKR-CCR5 cells with mitogen-activated peripheral blood mononuclear cells (PBMC) in neutralization assays with sera from HIV-1-infected individuals or specific anti-HIV-1 monoclonal antibodies shows that the sensitivity of HIV-1 neutralization is similar in the two cell types. The CEM.NKR-CCR5 cell assay, however, is more convenient to perform and eliminates the donor-to-donor variation in HIV-1 replication efficiency, which is one of the principal drawbacks of the PBMC-based neutralization assay. We suggest that this new assay is suitable for the general measurement of HIV-1 neutralization by antibodies. PMID:10516002

  16. Short Communication: Comparative Susceptibility of Rhesus Macaques of Indian and Chinese Origin to Vaginal Simian-Human Immunodeficiency Virus Transmission as Models for HIV Prevention Research.

    PubMed

    Veazey, Ronald S; Ling, Binhua

    2017-12-01

    Historically, Indian rhesus macaques (iRMs) have been preferred for simian immunodeficiency virus (SIV)/HIV prevention, pathogenesis, and treatment studies, yet their supply is limited. Chinese rhesus macaques (cRMs) are currently more available, yet little is known regarding the relative susceptibility of this subspecies to vaginal transmission of SIV or simian-human immunodeficiency virus (SHIV). In this study, we compared the susceptibility of 40 cRMs and 21 iRMs with a single vaginal challenge with SHIVsf162P. Our results showed that cRMs have comparable primary SHIV infection as iRMs, underscoring their equal importance in studies of HIV transmission and prevention.

  17. Surface receptors on neutrophils and monocytes from immunodeficient and normal horses.

    PubMed Central

    Banks, K L; McGuire, T C

    1975-01-01

    Surface receptors on peripheral blood neutrophils and monocytes from normal and immunodeficient horses have been studied. Sheep erythrocytes (SRBC) coated with IgG, IgM, and complement but not IgG(T), readily bound to normal equine monocytes and neutrophils. More than 4000 molecules of IgG were required to sensitize each SRBC for adherence to monocytes, and more than 12,000 molecules were required for adherence to neutrophils. Young horses with a severe combined immunodeficiency had an almost total absence of lymphocytes, but normal numbers of monocytes and neutrophils. The number of receptors for immunoglobulin, complement, and phytolectin on monocytes and neutrophils from immunodeficient animals were similar to those on the cells of normal horses. Although the precursor cells of lymphocytes of horses with combined immunodeficiency appear to be defective, no defect in the other cellular products of the bone marrow were apparent. PMID:1126740

  18. Central nervous system immune activation characterizes primary human immunodeficiency virus 1 infection even in participants with minimal cerebrospinal fluid viral burden.

    PubMed

    Spudich, Serena; Gisslen, Magnus; Hagberg, Lars; Lee, Evelyn; Liegler, Teri; Brew, Bruce; Fuchs, Dietmar; Tambussi, Giuseppe; Cinque, Paola; Hecht, Frederick M; Price, Richard W

    2011-09-01

    Central nervous system (CNS) human immunodeficiency virus (HIV) infection and immune activation lead to brain injury and neurological impairment. Although HIV enters the nervous system soon after transmission, the magnitude of infection and immunoactivation within the CNS during primary HIV infection (PHI) has not been characterized. This cross-sectional study analyzed cerebrospinal fluid (CSF) and blood from 96 participants with PHI and compared them with samples from neuroasymptomatic participants with chronic infection and ≥ 200 or < 200 blood CD4 T cells/μL, and with samples from HIV-seronegative participants with respect to CSF and plasma HIV RNA, CSF to serum albumin ratio, and CSF white blood cell counts (WBC), neopterin levels, and concentrations of chemokines CXCL10 and CCL2. The PHI participants (median 77 days post transmission) had CSF HIV RNA, WBC, neopterin, and CXCL10 concentrations similar to the chronic infection participants but uniquely high albumin ratios. 18 participants had ≤ 100 copies/mL CSF HIV RNA, which was associated with low CSF to plasma HIV ratios and levels of CSF inflammation lower than in other PHI participants but higher than in HIV-seronegative controls. Prominent CNS infection and immune activation is evident during the first months after HIV transmission, though a proportion of PHI patients demonstrate relatively reduced CSF HIV RNA and inflammation during this early period.

  19. New Jersey's Medicaid waiver for acquired immunodeficiency syndrome

    PubMed Central

    Merzel, Cheryl; Crystal, Stephen; Sambamoorthi, Usha; Karus, Daniel; Kurland, Carol

    1992-01-01

    This article contains data from a study of New Jersey's home and community-based Medicaid waiver program for persons with symptomatic human immunodeficiency virus illness. Major findings include lower hospital costs and utilization for waiver participants compared with general Medicaid acquired immunodeficiency syndrome admissions in New Jersey. Average program expenditures were $2,400 per person per month. Based on study findings, it is evident that the waiver program is an important means of providing financial benefits and access to services and that comprehensive case management is a critical factor in assuring program quality. PMID:10120180

  20. Hematopoietic Stem Cell Transplantation for Progressive Combined Immunodeficiency and Lymphoproliferation in Activated PI3K Syndrome Type 1.

    PubMed

    Okano, Tsubasa; Imai, Kohsuke; Tsujita, Yuki; Mitsuiki, Noriko; Yoshida, Kenichi; Kamae, Chikako; Honma, Kenichi; Mitsui-Sekinaka, Kanako; Sekinaka, Yujin; Kato, Tamaki; Hanabusa, Katsuyuki; Endo, Eri; Takashima, Takehiro; Hiroki, Haruka; Yeh, Tzu-Wen; Tanaka, Keisuke; Nagahori, Masakazu; Tsuge, Ikuya; Bando, Yuki; Iwasaki, Fuminori; Shikama, Yoshiaki; Inoue, Masami; Kimoto, Tomiko; Moriguchi, Naohiko; Yuza, Yuki; Kaneko, Takashi; Suzuki, Kyoko; Matsubara, Tomoyo; Maruo, Yoshihiro; Kunitsu, Tomoaki; Waragai, Tomoko; Sano, Hideki; Hashimoto, Yuko; Tasaki, Kazuhiro; Suzuki, Osamu; Shirakawa, Toshihiko; Kato, Motohiro; Uchiyama, Toru; Ishimura, Masataka; Tauchi, Tetsuzo; Yagasaki, Hiroshi; Jou, Shiann-Tarng; Yu, Hsin-Hui; Kanegane, Hirokazu; Kracker, Sven; Durandy, Anne; Kojima, Daiei; Muramatsu, Hideki; Wada, Taizo; Inoue, Yuzaburo; Takada, Hidetoshi; Kojima, Seiji; Ogawa, Seishi; Ohara, Osamu; Nonoyama, Shigeaki; Morio, Tomohiro

    2018-05-17

    Activated phosphatidylinositol-3-OH kinase-delta (PI3Kδ) syndrome type 1 (APDS1) is a recently described primary immunodeficiency syndrome characterized by recurrent respiratory infections, lymphoid hyperplasia, and herpesviridae infections due to germline gain-of-function mutations of PIK3CD. Hematopoietic stem cell transplantation (HSCT) may be considered to ameliorate progressive immunodeficiency and associated malignancy, but appropriate indications, method, and outcomes of HSCT for APDS1 remain undefined. Our objective was to analyze the clinical manifestations, laboratory findings, prognosis, and treatment of APDS1 and explore appropriate indications and methods of HSCT. We retrospectively reviewed the medical records of cohorts undergoing HSCT at collaborating facilities. Thirty-year overall survival was 86.1%, but event-free survival was 39.6%. Life-threatening events, such as severe infections or lymphoproliferation, were frequent in childhood and adolescence, and were common indications for HSCT. Nine patients underwent HSCT with fludarabine-based reduced intensity conditioning (RIC). Seven patients survived after frequent adverse complications and engraftment failure. Most symptoms improved after HSCT. Patients with APDS1 showed variable clinical manifestations. Life-threatening progressive combined immunodeficiency and massive lymphoproliferation were common indications for HSCT. Fludarabine-based RIC-HSCT ameliorated clinical symptoms, but transplant-related complications were frequent, including graft failure. Copyright © 2018. Published by Elsevier Inc.

  1. A robust fractional-order PID controller design based on active queue management for TCP network

    NASA Astrophysics Data System (ADS)

    Hamidian, Hamideh; Beheshti, Mohammad T. H.

    2018-01-01

    In this paper, a robust fractional-order controller is designed to control the congestion in transmission control protocol (TCP) networks with time-varying parameters. Fractional controllers can increase the stability and robustness. Regardless of advantages of fractional controllers, they are still not common in congestion control in TCP networks. The network parameters are time-varying, so the robust stability is important in congestion controller design. Therefore, we focused on the robust controller design. The fractional PID controller is developed based on active queue management (AQM). D-partition technique is used. The most important property of designed controller is the robustness to the time-varying parameters of the TCP network. The vertex quasi-polynomials of the closed-loop characteristic equation are obtained, and the stability boundaries are calculated for each vertex quasi-polynomial. The intersection of all stability regions is insensitive to network parameter variations, and results in robust stability of TCP/AQM system. NS-2 simulations show that the proposed algorithm provides a stable queue length. Moreover, simulations show smaller oscillations of the queue length and less packet drop probability for FPID compared to PI and PID controllers. We can conclude from NS-2 simulations that the average packet loss probability variations are negligible when the network parameters change.

  2. Lessons from the history of the human immunodeficiency virus/acquired immunodeficiency syndrome epidemic among Spanish drug injectors.

    PubMed

    De La Fuente, L; Bravo, M J; Barrio, G; Parras, F; Suárez, M; Rodés, A; Noguer, I

    2003-12-15

    In Spain, approximately 10 years passed between the time when human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) harm-reduction programs should have been developed with sufficient coverage to have an optimum impact on public health (before the HIV/AIDS epidemic's explosion in 1984) and the date of their actual implementation. This delay yielded an enormous cost for the country. The introduction of the virus in drug injector networks during a period of widespread diffusion of heroin injection and the lack of political awareness of the growing problem were 2 important factors that contributed to the important diffusion of the HIV infection among Spanish injection drug users. Lessons can be learned that may be of great interest in countries or territories facing similar challenges now and in the future.

  3. Immunogenicity of NYVAC Prime-Protein Boost Human Immunodeficiency Virus Type 1 Envelope Vaccination and Simian-Human Immunodeficiency Virus Challenge of Nonhuman Primates.

    PubMed

    Saunders, Kevin O; Santra, Sampa; Parks, Robert; Yates, Nicole L; Sutherland, Laura L; Scearce, Richard M; Balachandran, Harikrishnan; Bradley, Todd; Goodman, Derrick; Eaton, Amanda; Stanfield-Oakley, Sherry A; Tartaglia, James; Phogat, Sanjay; Pantaleo, Giuseppe; Esteban, Mariano; Gomez, Carmen E; Perdiguero, Beatriz; Jacobs, Bertram; Kibler, Karen; Korber, Bette; Montefiori, David C; Ferrari, Guido; Vandergrift, Nathan; Liao, Hua-Xin; Tomaras, Georgia D; Haynes, Barton F

    2018-04-15

    A preventive human immunodeficiency virus type 1 (HIV-1) vaccine is an essential part of the strategy to eradicate AIDS. A critical question is whether antibodies that do not neutralize primary isolate (tier 2) HIV-1 strains can protect from infection. In this study, we investigated the ability of an attenuated poxvirus vector (NYVAC) prime-envelope gp120 boost to elicit potentially protective antibody responses in a rhesus macaque model of mucosal simian-human immunodeficiency virus (SHIV) infection. NYVAC vector delivery of a group M consensus envelope, trivalent mosaic envelopes, or a natural clade B isolate B.1059 envelope elicited antibodies that mediated neutralization of tier 1 viruses, cellular cytotoxicity, and phagocytosis. None of the macaques made neutralizing antibodies against the tier 2 SHIV SF162P3 used for mucosal challenge. Significant protection from infection was not observed for the three groups of vaccinated macaques compared to unvaccinated macaques, although binding antibody to HIV-1 Env correlated with decreased viremia after challenge. Thus, NYVAC Env prime-gp120 boost vaccination elicited polyfunctional, nonneutralizing antibody responses with minimal protective activity against tier 2 SHIV mucosal challenge. IMPORTANCE The antibody responses that confer protection against HIV-1 infection remain unknown. Polyfunctional antibody responses correlated with time to infection in previous macaque studies. Determining the ability of vaccines to induce these types of responses is critical for understanding how to improve upon the one efficacious human HIV-1 vaccine trial completed thus far. We characterized the antibody responses induced by a NYVAC-protein vaccine and determined the protective capacity of polyfunctional antibody responses in an R5, tier 2 mucosal SHIV infection model. Copyright © 2018 American Society for Microbiology.

  4. Prevention and treatment of human immunodeficiency virus/acquired immunodeficiency syndrome in resource-limited settings.

    PubMed Central

    Hogan, Daniel R.; Salomon, Joshua A.

    2005-01-01

    Strategies for confronting the epidemic of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) have included a range of different approaches that focus on prevention and treatment. However, debate persists over what levels of emphasis are appropriate for the different components of the global response. This paper presents an overview of this debate and briefly summarizes the evidence on a range of interventions designed to prevent the spread of HIV infection, paying particular attention to voluntary counselling and testing, treatment for sexually transmitted infections and prevention of mother-to-child transmission. We also review the experience with antiretroviral therapy to date in terms of response rates and survival rates, adherence, drug resistance, behavioural change and epidemiological impact. Although various studies have identified strategies with proven effectiveness in reducing the risks of HIV infection and AIDS mortality, considerable uncertainties remain. Successful integration of treatment and prevention of HIV/AIDS will require a balanced approach and rigorous monitoring of the impact of programmes in terms of both individual and population outcomes. PMID:15744406

  5. A Head-to-Head Comparison of the Personality Inventory for DSM-5 (PID-5) With the Personality Diagnostic Questionnaire-4 (PDQ-4) in Predicting the General Level of Personality Pathology Among Community Dwelling Subjects.

    PubMed

    Fossati, Andrea; Somma, Antonella; Borroni, Serena; Maffei, Cesare; Markon, Kristian E; Krueger, Robert F

    2016-02-01

    In order to evaluate if measures of DSM-5 Alternative PD Model domains predicted interview-based scores of general personality pathology when compared to self-report measures of DSM-IV Axis II/DSM-5 Section II PD criteria, 300 Italian community adults were administered the Iowa Personality Disorder Screen (IPDS) interview, the Personality Inventory for DSM-5 (PID-5), and the Personality Diagnostic Questionnaire-4+ (PDQ-4+). Multiple regression analyses showed that the five PID-5 domain scales collectively explained an adequate rate of the variance of the IPDS interview total score. This result was slightly lower than the amount of variance in the IPDS total score explained by the 10 PDQ-4+ scales. The PID-5 traits scales performed better than the PDQ-4+, although the difference was marginal. Hierarchical regression analyses revealed that the PID-5 domain and trait scales provided a moderate, but significant increase in the prediction of the general level of personality pathology above and beyond the PDQ-4+ scales.

  6. "Immune TOR-opathies," a Novel Disease Entity in Clinical Immunology.

    PubMed

    Jung, Sophie; Gámez-Díaz, Laura; Proietti, Michele; Grimbacher, Bodo

    2018-01-01

    Primary immunodeficiencies (PIDs) represent a group of mostly monogenic disorders caused by loss- or gain-of-function mutations in over 340 known genes that lead to abnormalities in the development and/or the function of the immune system. However, mutations in different genes can affect the same cell-signaling pathway and result in overlapping clinical phenotypes. In particular, mutations in the genes encoding for members of the phosphoinositide3-kinase (PI3K)/AKT/mTOR/S6 kinase (S6K) signaling cascade or for molecules interacting with this pathway have been associated with different PIDs that are often characterized by the coexistence of both immune deficiency and autoimmunity. The serine/threonine kinase mechanistic/mammalian target of rapamycin (mTOR), which acts downstream of PI3K and AKT, is emerging as a key regulator of immune responses. It integrates a variety of signals from the microenvironment to control cell growth, proliferation, and metabolism. mTOR plays therefore a central role in the regulation of immune cells' differentiation and functions. Here, we review the different PIDs that share an impairment of the PI3K/AKT/mTOR/S6K pathway and we propose to name them "immune TOR-opathies" by analogy with a group of neurological disorders that has been originally defined by PB Crino and that are due to aberrant mTOR signaling (1). A better understanding of the role played by this complex intracellular cascade in the pathophysiology of "immune TOR-opathies" is crucial to develop targeted therapies.

  7. 50 years of pediatric immunology: progress and future, a clinical perspective.

    PubMed

    Singh, Surjit; Gupta, Anju; Rawat, Amit

    2013-01-08

    Rapidly evolving advances in the field of immunology over the last few decades have impacted the practice of clinical medicine in many ways. In fact, understanding the immunological basis of disease has been pivotal in deciphering the pathogenesis of several disease processes, infective or otherwise. As of today, there is hardly any specialty of medicine which is not influenced by immunology. Pediatric rheumatological disorders, vasculitides, Human Immunodeficiency Virus (HIV) infection, Primary Immunodeficiency Diseases (PIDs) and autoimmune disorders fall under the domain of clinical immunology. This specialty is poised to emerge as a major clinical specialty in our country. The gulf between bench and bedside is narrowing down as our understanding of the complex immunological mechanisms gets better. However, a lot still needs to be done in this field as the morbidity and mortality of some of these conditions is unacceptably high in the Indian setup. A number of medical schools and institutes in the country now have the resources and the wherewithal to develop into specialized centres of clinical immunology. We need to concentrate on training more physicians and pediatricians in this field. The future is bright and the prospects exciting.

  8. Renal disease in the acquired immunodeficiency syndrome in north central Nigeria.

    PubMed

    Agaba, E I; Agaba, P A; Sirisena, N D; Anteyi, E A; Idoko, J A

    2003-01-01

    The brunt of the human immunodeficiency virus infection/the acquired immunodeficiency syndrome is largely borne by communities in sub-Saharan Africa. We describe renal disease in Nigerians with the acquired immunodeficiency syndrome. Consecutive patients with the acquired immunodeficiency syndrome (AIDS) seen in the infections unit of the Jos University Teaching Hospital and a similar group of healthy controls were evaluated for renal disease. Subjects with past history of renal disease, hypovolemia, hypertension, diabetes mellitus and/or a documented fever were excluded from the study. Of the 79 patients with the acquired immunodeficiency syndrome and 57 controls studied, renal disease was present in 41 (51.8%) of the patients in the AIDS group and 7 (12.2%) of controls. While 15 (19%) of the AIDS group had azotemia alone and 20 (25.3%) had proteinuria alone, 6 (7.6%) had azotemia and proteinuria. The mean protein excretion/24 hours was significantly higher in the AIDS group compared to controls, (2.99 +/- 54 g and 0.56 +/- 0.12 g respectively, p = 0.001), while the GFR was significantly higher in controls compared to the study group (103.30 +/- 37.78 and 68.03 +/- 37.55 respectively, p = 0.004). Subjects in the AIDS group with renal disease had a significantly longer duration of illness compared to those without (12.33 +/- 8.67 months and 7.28 +/- 7.78 months respectively, p = 0.008). Age and serum CD4+ cell counts were similar in patients with and without renal disease in the AIDS group. Renal disease is a common complication of acquired immunodeficiency syndrome, the duration of illness being strongly associated with its presence.

  9. Antifungal prophylaxis during neutropenia and immunodeficiency.

    PubMed Central

    Lortholary, O; Dupont, B

    1997-01-01

    Fungal infections represent a major source of morbidity and mortality in patients with almost all types of immunodeficiencies. These infections may be nosocomial (aspergillosis) or community acquired (cryptococcosis), or both (candidiasis). Endemic mycoses such as histoplasmosis, coccidioidomycosis, and penicilliosis may infect many immunocompromised hosts in some geographic areas and thereby create major public health problems. With the wide availability of oral azoles, antifungal prophylactic strategies have been extensively developed. However, only a few well-designed studies involving strict criteria have been performed, mostly in patients with hematological malignancies or AIDS. In these situations, the best dose and duration of administration of the antifungal drug often remain to be determined. In high-risk neutropenic or bone marrow transplant patients, fluconazole is effective for the prevention of superficial and/or systemic candidal infections but is not always able to prolong overall survival and potentially selects less susceptible or resistant Candida spp. Primary prophylaxis against aspergillosis remains investigative. At present, no standard general recommendation for primary antifungal prophylaxis can be proposed for AIDS patients or transplant recipients. However, for persistently immunocompromised patients who previously experienced a noncandidal systemic fungal infection, prolonged suppressive antifungal therapy is often indicated to prevent a relapse. Better strategies for controlling immune deficiencies should also help to avoid some potentially life-threatening deep mycoses. When prescribing antifungal prophylaxis, physicians should be aware of the potential emergence of resistant strains, drug-drug interactions, and the cost. Well-designed, randomized, multicenter clinical trials in high-risk immunocompromised hosts are urgently needed to better define how to prevent severe invasive mycoses. PMID:9227863

  10. Virus-host interaction in feline immunodeficiency virus (FIV) infection.

    PubMed

    Taniwaki, Sueli Akemi; Figueiredo, Andreza Soriano; Araujo, João Pessoa

    2013-12-01

    Feline immunodeficiency virus (FIV) infection has been the focus of several studies because this virus exhibits genetic and pathogenic characteristics that are similar to those of the human immunodeficiency virus (HIV). FIV causes acquired immunodeficiency syndrome (AIDS) in cats, nevertheless, a large fraction of infected cats remain asymptomatic throughout life despite of persistent chronic infection. This slow disease progression may be due to the presence of factors that are involved in the natural resistance to infection and the immune response that is mounted by the animals, as well as due to the adaptation of the virus to the host. Therefore, the study of virus-host interaction is essential to the understanding of the different patterns of disease course and the virus persistence in the host, and to help with the development of effective vaccines and perhaps the cure of FIV and HIV infections. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Antiviral T Cells for Adenovirus in the Pretransplant Period: A Bridge Therapy for Severe Combined Immunodeficiency.

    PubMed

    Miller, Holly K; Hanley, Patrick J; Lang, Haili; Lazarski, Christopher A; Chorvinsky, Elizabeth A; McCormack, Sarah; Roesch, Lauren; Albihani, Shuroug; Dean, Marcus; Hoq, Fahmida; Adams, Roberta H; Bollard, Catherine M; Keller, Michael D

    2018-05-09

    Viral infections can be life threatening in patients with severe combined immunodeficiency (SCID) and other forms of profound primary immunodeficiency disorders both before and after hematopoietic stem cell transplantation (HSCT). Adoptive immunotherapy with virus-specific T cells (VSTs) has been utilized in many patients in the setting of HSCT, but has very rarely been attempted for treatment of viral infections before HSCT. Here we describe the use of VSTs in an infant with RAG1 SCID who had developed disseminated adenovirus which failed to improve on cidofovir. Adenovirus cleared following 2 doses of VSTs and marrow infusion from a matched unrelated donor, without incidence of graft versus host disease. T cell receptor-b sequencing demonstrated expansion of adenovirus-specific T cell fraction of the VSTs, suggesting that infusion facilitated viral clearance. This report suggests that VSTs are likely safe in the pre-HSCT period, and may be a useful bridge therapy for infants with SCID and persistent viral infections. Copyright © 2018 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  12. Comparing immunocompetent and immunodeficient mice as animal models for bone tissue engineering.

    PubMed

    Zhang, Y; Li, X; Chihara, T; Mizoguchi, T; Hori, A; Udagawa, N; Nakamura, H; Hasegawa, H; Taguchi, A; Shinohara, A; Kagami, H

    2015-07-01

    To understand the differences and similarities between immunocompetent and immunodeficient mice as ectopic transplantation animal models for bone tissue engineering. Osteogenic cells from mouse leg bones were cultured, seeded on β-TCP granules, and transplanted onto the backs of either immunocompetent or immunodeficient nude mice. At 1, 2, 4, and 8 weeks postoperatively, samples were harvested and evaluated by hematoxylin-eosin staining, tartrate-resistant acid phosphatase (TRAP) staining, and immunohistochemical staining and quantitative PCR. In immunocompetent mice, inflammatory cell infiltration was evident at 1 week postoperatively and relatively higher expression of TNF-α and IL-4 was observed. In immunodeficient mice, new bone area and the number of TRAP-positive cells were larger at 4 weeks than in immunocompetent mice. The volume of new bone area in immunodeficient mice was reduced by 8 weeks. Bone regeneration was feasible in immunocompetent mice. However, some differences were observed between immunocompetent and immunodeficient mice in the bone regeneration process possibly due to different cytokine expression, which should be considered when utilizing in vivo animal models. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Characterization of a Highly Pathogenic Molecular Clone of Feline Immunodeficiency Virus Clade C

    PubMed Central

    de Rozières, Sohela; Mathiason, Candace K.; Rolston, Matthew R.; Chatterji, Udayan; Hoover, Edward A.; Elder, John H.

    2004-01-01

    We have derived and characterized a highly pathogenic molecular isolate of feline immunodeficiency virus subtype C (FIV-C) CABCpady00C. Clone FIV-C36 was obtained by lambda cloning from cats that developed severe immunodeficiency disease when infected with CABCpady00C (Abbotsford, British Columbia, Canada). Clone FIV-C36 Env is 96% identical to the noninfectious FIV-C isolate sequence deposited in GenBank (FIV-Cgb; GenBank accession number AF474246) (A. Harmache et al.) but is much more divergent in Env when compared to the subgroup A clones Petaluma (34TF10) and FIV-PPR (76 and 78% divergence, respectively). Clone FIV-C36 was able to infect freshly isolated feline peripheral blood mononuclear cells and primary T-cell lines but failed to productively infect CrFK cells, as is typical of FIV field isolates. Two-week-old specific-pathogen-free cats infected with FIV-C36 tissue culture supernatant became PCR positive and developed severe acute immunodeficiency disease similar to that caused by the uncloned CABCpady00C parent. At 4 to 5 weeks postinfection (PI), 3 of 4 animals developed CD4+-T-cell depletion, fever, weight loss, diarrhea, and opportunistic infections, including ulcerative stomatitis and tonsillitis associated with abundant bacterial growth, pneumonia, and pyelonephritis, requiring euthanasia. Histopathology confirmed severe thymic and systemic lymphoid depletion. Interestingly, the dam also became infected with a high viral load at 5 weeks PI of the kittens and developed a similar disease syndrome, requiring euthanasia at 11 weeks PI of the kittens. This constitutes the first report of a replication-competent, infectious, and pathogenic molecular clone of FIV-C. Clone FIV-C36 will facilitate dissection of the pathogenic determinants of FIV. PMID:15308694

  14. Characterization of a highly pathogenic molecular clone of feline immunodeficiency virus clade C.

    PubMed

    de Rozières, Sohela; Mathiason, Candace K; Rolston, Matthew R; Chatterji, Udayan; Hoover, Edward A; Elder, John H

    2004-09-01

    We have derived and characterized a highly pathogenic molecular isolate of feline immunodeficiency virus subtype C (FIV-C) CABCpady00C. Clone FIV-C36 was obtained by lambda cloning from cats that developed severe immunodeficiency disease when infected with CABCpady00C (Abbotsford, British Columbia, Canada). Clone FIV-C36 Env is 96% identical to the noninfectious FIV-C isolate sequence deposited in GenBank (FIV-Cgb; GenBank accession number AF474246) (A. Harmache et al.) but is much more divergent in Env when compared to the subgroup A clones Petaluma (34TF10) and FIV-PPR (76 and 78% divergence, respectively). Clone FIV-C36 was able to infect freshly isolated feline peripheral blood mononuclear cells and primary T-cell lines but failed to productively infect CrFK cells, as is typical of FIV field isolates. Two-week-old specific-pathogen-free cats infected with FIV-C36 tissue culture supernatant became PCR positive and developed severe acute immunodeficiency disease similar to that caused by the uncloned CABCpady00C parent. At 4 to 5 weeks postinfection (PI), 3 of 4 animals developed CD4(+)-T-cell depletion, fever, weight loss, diarrhea, and opportunistic infections, including ulcerative stomatitis and tonsillitis associated with abundant bacterial growth, pneumonia, and pyelonephritis, requiring euthanasia. Histopathology confirmed severe thymic and systemic lymphoid depletion. Interestingly, the dam also became infected with a high viral load at 5 weeks PI of the kittens and developed a similar disease syndrome, requiring euthanasia at 11 weeks PI of the kittens. This constitutes the first report of a replication-competent, infectious, and pathogenic molecular clone of FIV-C. Clone FIV-C36 will facilitate dissection of the pathogenic determinants of FIV.

  15. Nonprogressive and Progressive Primate Immunodeficiency Lentivirus Infections

    PubMed Central

    Brenchley, Jason M.; Silvestri, Guido; Douek, Daniel C.

    2010-01-01

    Natural hosts for simian immunodeficiency virus (SIV)can be, and are often naturally, infected with species-specific SIVs, but do not develop acquired immunodeficiency syndrome (AIDS). These natural hosts maintain high SIV viral loads, but avoid immunodeficiency. Elucidating the mechanisms that allow natural hosts to co-exist with SIV without overt disease may provide crucial information for understanding AIDS pathogenesis. Over the past few years, several key features of natural SIV infections have been described in studies conducted predominantly in sooty mangabeys (SMs), African green monkeys (AGMs), and mandrills. Natural SIV hosts are able to avoid the chronic, generalized immune system activation that is associated with disease progression in HIV-infected individuals and are known to down-modulate the expression of the receptors for SIV. In this perspective we propose that a critical factor that differentiates nonprogressive from progressive HIV or SIV infection is the maintenance of T cell immune competence in the face of a virus that infects and kills CD4+ T cells Elucidation of the mechanisms underlying the preservation of immune function during and after the acute phase of natural SIV infection may lead to the design of novel preventive and therapeutic interventions for treatment of chronic HIV infection. PMID:20620940

  16. Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Older Adults.

    PubMed

    Scott, Jake; Goetz, Matthew Bidwell

    2016-08-01

    Improved survival with combination antiretroviral therapy has led to a dramatic increase in the number of human immunodeficiency virus (HIV)-infected individuals 50 years of age or older such that by 2020 more than 50% of HIV-infected persons in the United States will be above this age. Recent studies confirm that antiretroviral therapy should be offered to all HIV-infected patients regardless of age, symptoms, CD4+ cell count, or HIV viral load. However, when compared with HIV-uninfected populations, even with suppression of measurable HIV replication, older individuals are at greater risk for cardiovascular disease, malignancies, liver disease, and other comorbidities. Published by Elsevier Inc.

  17. Histone deacetylase inhibitors containing a benzamide functional group and a pyridyl cap are preferentially effective human immunodeficiency virus-1 latency-reversing agents in primary resting CD4+ T cells

    PubMed Central

    Gélinas, Céline

    2017-01-01

    Antiretroviral therapy (ART) can control human immunodeficiency virus-1 (HIV-1) replication in infected individuals. Unfortunately, patients remain persistently infected owing to the establishment of latent infection requiring that ART be maintained indefinitely. One strategy being pursued involves the development of latency-reversing agents (LRAs) to eliminate the latent arm of the infection. One class of molecules that has been tested for LRA activity is the epigenetic modulating compounds histone deacetylases inhibitors (HDACis). Previously, initial screening of these molecules typically commenced using established cell models of viral latency, and although certain drugs such as the HDACi suberoylanilide hydroxamic acid demonstrated strong activity in these models, it did not translate to comparable activity with patient samples. Here we developed a primary cell model of viral latency using primary resting CD4+ T cells infected with Vpx-complemented HIV-1 and found that the activation profile using previously described LRAs mimicked that obtained with patient samples. This primary cell model was used to evaluate 94 epigenetic compounds. Not surprisingly, HDACis were found to be the strongest activators. However, within the HDACi class, the most active LRAs with the least pronounced toxicity contained a benzamide functional moiety with a pyridyl cap group, as exemplified by the HDACi chidamide. The results indicate that HDACis with a benzamide moiety and pyridyl cap group should be considered for further drug development in the pursuit of a successful viral clearance strategy. PMID:28113052

  18. Older Americans and AIDS: Transmission Risks and Primary Prevention Research Needs.

    ERIC Educational Resources Information Center

    Catania, Joseph A.; And Others

    1989-01-01

    Growing number of Acquired Immune Deficiency Syndrome (AIDS) cases among older Americans is of increasing concern. In context of primary prevention, reviews findings that bear on modes of human immunodeficiency virus (HIV) transmission (blood transfusions, sexual) among older individuals and knowledge of magnitude of the AIDS problem represented…

  19. The research on visual industrial robot which adopts fuzzy PID control algorithm

    NASA Astrophysics Data System (ADS)

    Feng, Yifei; Lu, Guoping; Yue, Lulin; Jiang, Weifeng; Zhang, Ye

    2017-03-01

    The control system of six degrees of freedom visual industrial robot based on the control mode of multi-axis motion control cards and PC was researched. For the variable, non-linear characteristics of industrial robot`s servo system, adaptive fuzzy PID controller was adopted. It achieved better control effort. In the vision system, a CCD camera was used to acquire signals and send them to video processing card. After processing, PC controls the six joints` motion by motion control cards. By experiment, manipulator can operate with machine tool and vision system to realize the function of grasp, process and verify. It has influence on the manufacturing of the industrial robot.

  20. Comprehensive molecular diagnosis of Epstein-Barr virus-associated lymphoproliferative diseases using next-generation sequencing.

    PubMed

    Ono, Shintaro; Nakayama, Manabu; Kanegane, Hirokazu; Hoshino, Akihiro; Shimodera, Saeko; Shibata, Hirofumi; Fujino, Hisanori; Fujino, Takahiro; Yunomae, Yuta; Okano, Tsubasa; Yamashita, Motoi; Yasumi, Takahiro; Izawa, Kazushi; Takagi, Masatoshi; Imai, Kohsuke; Zhang, Kejian; Marsh, Rebecca; Picard, Capucine; Latour, Sylvain; Ohara, Osamu; Morio, Tomohiro

    2018-05-18

    Epstein-Barr virus (EBV) is associated with several life-threatening diseases, such as lymphoproliferative disease (LPD), particularly in immunocompromised hosts. Some categories of primary immunodeficiency diseases (PIDs) including X-linked lymphoproliferative syndrome (XLP), are characterized by susceptibility and vulnerability to EBV infection. The number of genetically defined PIDs is rapidly increasing, and clinical genetic testing plays an important role in establishing a definitive diagnosis. Whole-exome sequencing is performed for diagnosing rare genetic diseases, but is both expensive and time-consuming. Low-cost, high-throughput gene analysis systems are thus necessary. We developed a comprehensive molecular diagnostic method using a two-step tailed polymerase chain reaction (PCR) and a next-generation sequencing (NGS) platform to detect mutations in 23 candidate genes responsible for XLP or XLP-like diseases. Samples from 19 patients suspected of having EBV-associated LPD were used in this comprehensive molecular diagnosis. Causative gene mutations (involving PRF1 and SH2D1A) were detected in two of the 19 patients studied. This comprehensive diagnosis method effectively detected mutations in all coding exons of 23 genes with sufficient read numbers for each amplicon. This comprehensive molecular diagnostic method using PCR and NGS provides a rapid, accurate, low-cost diagnosis for patients with XLP or XLP-like diseases.

  1. Detection biomarkers of lung cancer using mini-GC-PID system integrated with micro GC column and micro pre-concentrator

    PubMed Central

    2014-01-01

    The survival rate of lung cancer can be significantly improved by monitoring biomarkers in exhaled air that indicate diseases in early stage, so it is very important to develop micro analytical systems which can offer a fast, on-site, real-time detecting biomarkers in exhaled air. In this paper, a mini-gas chromatography (GC)-photo-ionization detector (PID) system integrated with a micro GC column and a micro pre-concentrator was developed for forming an inexpensive, fast, and non-invasive diagnostic tool for lung cancer. This system has very strong concentrate ability owing to its integrated micro pre-concentrator, which make the detection of trace components in exhaled air very easy. In addition, the integrated micro GC column can separate complex mixtures, which overcome low resolution and poor anti-interference ability of other instruments. The results indicated that the mini-GC-PID system can effectively separate and detect the biomarkers at parts-per-billion (ppb) level. PMID:25339856

  2. Recurrent Fevers for the Pediatric Immunologist: It's Not All Immunodeficiency.

    PubMed

    Broderick, Lori

    2016-01-01

    Autoinflammatory diseases are disorders of the innate immune system, characterized by systemic inflammation independent of infection and autoreactive antibodies or antigen-specific T cells. Similar to immunodeficiencies, these immune dysregulatory diseases have unique presentations, genetics, and available therapies. Given the presentation of fevers, rashes, and mucosal symptoms in many of the disorders, the allergist/immunologist is the appropriate medical home for these patients: to appropriately rule out immunodeficiencies, evaluate for allergic disease, and diagnose and treat recurrent fever disorders. However, many practicing physicians are unfamiliar with the clinical presentation, diagnosis, and treatment of autoinflammatory disorders. This review will focus on understanding the signs and symptoms of classic autoinflammatory disorders, introduce newly described monogenic and polygenic disorders, and address the approach to the patient with recurrent fevers to distinguish autoinflammation from immunodeficiency and autoimmunity.

  3. Development of a GA-Fuzzy-Immune PID Controller with Incomplete Derivation for Robot Dexterous Hand

    PubMed Central

    Liu, Xin-hua; Chen, Xiao-hu; Zheng, Xian-hua; Li, Sheng-peng; Wang, Zhong-bin

    2014-01-01

    In order to improve the performance of robot dexterous hand, a controller based on GA-fuzzy-immune PID was designed. The control system of a robot dexterous hand and mathematical model of an index finger were presented. Moreover, immune mechanism was applied to the controller design and an improved approach through integration of GA and fuzzy inference was proposed to realize parameters' optimization. Finally, a simulation example was provided and the designed controller was proved ideal. PMID:25097881

  4. Emergence and Kinetics of Simian Immunodeficiency Virus-Specific CD8+ T Cells in the Intestines of Macaques during Primary Infection

    PubMed Central

    Veazey, Ronald S.; Gauduin, Marie-Claire; Mansfield, Keith G.; Tham, Irene C.; Altman, John D.; Lifson, Jeffrey D.; Lackner, Andrew A.; Johnson, R. Paul

    2001-01-01

    In this report, three Mamu-A*01+ rhesus macaques were examined to compare the emergence of simian immunodeficiency virus (SIV)-specific CD8+ T cells in the intestines and blood in early SIV infection using a major histocompatibility complex class I tetramer complexed with the Gag181–189 peptide. Fourteen days after intravenous inoculation with SIVmac251, large numbers of SIV Gag181–189-specific CD8+ T cells were detected in the intestinal mucosa (3.1 to 11.5% of CD3+ CD8+ lymphocytes) as well as in the blood (3.1 to 13.4%) of all three macaques. By 21 days postinoculation, levels of tetramer-binding cells had dropped in both the intestines and blood. At day 63, however, levels of SIV Gag181–189-specific CD8+ T cells in the intestines had rebounded in all three macaques to levels that were higher (8.6 to 18.7%) than those at day 21. In contrast, percentages of tetramer-binding cells in the peripheral blood remained comparatively stable (2.5 to 4.5%) at this time point. In summary, SIV Gag181–189-specific CD8+ T cells appeared in both the intestinal mucosa and peripheral blood at a comparable rate and magnitude in primary SIV infection. Given that the intestine is a major site of early viral replication as well as the site where most of the total body lymphocyte pool resides, these data indicate that it is also an early and important site of development of antiviral immune responses. PMID:11581423

  5. Immune thrombocytopenic purpura might be an early hematologic manifestation of undiagnosed human immunodeficiency virus infection.

    PubMed

    Lai, Shih-Wei; Lin, Hsien-Feng; Lin, Cheng-Li; Liao, Kuan-Fu

    2017-03-01

    Little research focuses on the association between immune thrombocytopenic purpura and human immunodeficiency virus infection in Taiwan. This study investigated whether immune thrombocytopenic purpura might be an early hematologic manifestation of undiagnosed human immunodeficiency virus infection in Taiwan. We conducted a retrospective population-based cohort study using data of individuals enrolled in Taiwan National Health Insurance Program. There were 5472 subjects aged 1-84 years with a new diagnosis of immune thrombocytopenic purpura as the purpura group since 1998-2010 and 21,887 sex-matched and age-matched, randomly selected subjects without immune thrombocytopenic purpura as the non-purpura group. The incidence of human immunodeficiency virus infection at the end of 2011 was measured in both groups. We used the multivariable Cox proportional hazards regression model to measure the hazard ratio and 95 % confidence interval (CI) for the association between immune thrombocytopenic purpura and human immunodeficiency virus infection. The overall incidence of human immunodeficiency virus infection was 6.47-fold higher in the purpura group than that in the non-purpura group (3.78 vs. 0.58 per 10,000 person-years, 95 % CI 5.83-7.18). After controlling for potential confounding factors, the adjusted HR of human immunodeficiency virus infection was 6.3 (95 % CI 2.58-15.4) for the purpura group, as compared with the non-purpura group. We conclude that individuals with immune thrombocytopenic purpura are 6.47-fold more likely to have human immunodeficiency virus infection than those without immune thrombocytopenic purpura. We suggest not all patients, but only those who have risk factors for human immunodeficiency virus infection should receive testing for undiagnosed human immunodeficiency virus infection when they develop immune thrombocytopenic purpura.

  6. Spatial Analysis of Feline Immunodeficiency Virus Infection in Cougars

    PubMed Central

    Wheeler, David C.; Waller, Lance A.; Biek, Roman

    2010-01-01

    The cougar (Puma concolor) is a large predatory feline found widely in the Americas that is susceptible to feline immunodeficiency virus (FIV), a fast-evolving lentivirus found in wild feline species that is analogous to simian immunodeficiency viruses in wild primates and belongs to the same family of viruses as human immunodeficiency virus. FIV infection in cougars can lead to a weakened immune system that creates opportunities for other infecting agents. FIV prevalence and lineages have been studied previously in several areas in the western United States, but typically without spatially explicit statistical techniques. To describe the distribution of FIV in a sample of cougars located in the northern Rocky Mountain region of North America, we first used kernel density ratio estimation to map the log relative risk of FIV. The risk surface showed a significant cluster of FIV in northwestern Montana. We also used Bayesian cluster models for genetic data to investigate the spatial structure of the feline immunodeficiency virus with virus genetic sequence data. A result of the models was two spatially distinct FIV lineages that aligned considerably with an interstate highway in Montana. Our results suggest that the use of spatial information and models adds novel insight when investigating an infectious animal disease. The results also suggest that the influence of landscape features likely plays an important role in the spatiotemporal spread of an infectious disease within wildlife populations. PMID:21197421

  7. Spatial analysis of feline immunodeficiency virus infection in cougars.

    PubMed

    Wheeler, David C; Waller, Lance A; Biek, Roman

    2010-07-01

    The cougar (Puma concolor) is a large predatory feline found widely in the Americas that is susceptible to feline immunodeficiency virus (FIV), a fast-evolving lentivirus found in wild feline species that is analogous to simian immunodeficiency viruses in wild primates and belongs to the same family of viruses as human immunodeficiency virus. FIV infection in cougars can lead to a weakened immune system that creates opportunities for other infecting agents. FIV prevalence and lineages have been studied previously in several areas in the western United States, but typically without spatially explicit statistical techniques. To describe the distribution of FIV in a sample of cougars located in the northern Rocky Mountain region of North America, we first used kernel density ratio estimation to map the log relative risk of FIV. The risk surface showed a significant cluster of FIV in northwestern Montana. We also used Bayesian cluster models for genetic data to investigate the spatial structure of the feline immunodeficiency virus with virus genetic sequence data. A result of the models was two spatially distinct FIV lineages that aligned considerably with an interstate highway in Montana. Our results suggest that the use of spatial information and models adds novel insight when investigating an infectious animal disease. The results also suggest that the influence of landscape features likely plays an important role in the spatiotemporal spread of an infectious disease within wildlife populations.

  8. Immunodeficiency-related vaccine-derived poliovirus (iVDPV) cases: a systematic review and implications for polio eradication.

    PubMed

    Guo, Jean; Bolivar-Wagers, Sara; Srinivas, Nivedita; Holubar, Marisa; Maldonado, Yvonne

    2015-03-03

    Vaccine-derived polioviruses (VDPVs), strains of poliovirus mutated from the oral polio vaccine, pose a challenge to global polio eradication. Immunodeficiency-related vaccine-derived polioviruses (iVDPVs) are a type of VDPV which may serve as sources of poliovirus reintroduction after the eradication of wild-type poliovirus. This review is a comprehensive update of confirmed iVDPV cases published in the scientific literature from 1962 to 2012, and describes clinically relevant trends in reported iVDPV cases worldwide. We conducted a systematic review of published iVDPV case reports from January 1960 to November 2012 from four databases. We included cases in which the patient had a primary immunodeficiency, and the vaccine virus isolated from the patient either met the sequencing definition of VDPV (>1% divergence for serotypes 1 and 3 and >0.6% for serotype 2) and/or was previously reported as an iVDPV by the World Health Organization. We identified 68 iVDPV cases in 49 manuscripts reported from 25 countries and the Palestinian territories. 62% of case patients were male, 78% presented clinically with acute flaccid paralysis, and 65% were iVDPV2. 57% of cases occurred in patients with predominantly antibody immunodeficiencies, and the overall all-cause mortality rate was greater than 60%. The median age at case detection was 1.4 years [IQR: 0.8, 4.5] and the median duration of shedding was 1.3 years [IQR: 0.7, 2.2]. We identified a poliovirus genome VP1 region mutation rate of 0.72% per year and a higher median percent divergence for iVDPV1 cases. More cases were reported from high income countries, which also had a larger age variation and different distribution of immunodeficiencies compared to upper and lower middle-income countries. Our study describes the incidence and characteristics of global iVDPV cases reported in the literature in the past five decades. It also highlights the regional and economic disparities of reported iVDPV cases. Copyright © 2015

  9. Electrostatic potential of human immunodeficiency virus type 2 and rhesus macaque simian immunodeficiency virus capsid proteins.

    PubMed

    Bozek, Katarzyna; Nakayama, Emi E; Kono, Ken; Shioda, Tatsuo

    2012-01-01

    Human immunodeficiency virus type 2 (HIV-2) and simian immunodeficiency virus isolated from a macaque monkey (SIVmac) are assumed to have originated from simian immunodeficiency virus isolated from sooty mangabey (SIVsm). Despite their close similarity in genome structure, HIV-2 and SIVmac show different sensitivities to TRIM5α, a host restriction factor against retroviruses. The replication of HIV-2 strains is potently restricted by rhesus (Rh) monkey TRIM5α, while that of SIVmac strain 239 (SIVmac239) is not. Viral capsid protein is the determinant of this differential sensitivity to TRIM5α, as the HIV-2 mutant carrying SIVmac239 capsid protein evaded Rh TRIM5α-mediated restriction. However, the molecular determinants of this restriction mechanism are unknown. Electrostatic potential on the protein-binding site is one of the properties regulating protein-protein interactions. In this study, we investigated the electrostatic potential on the interaction surface of capsid protein of HIV-2 strain GH123 and SIVmac239. Although HIV-2 GH123 and SIVmac239 capsid proteins share more than 87% amino acid identity, we observed a large difference between the two molecules with the HIV-2 GH123 molecule having predominantly positive and SIVmac239 predominantly negative electrostatic potential on the surface of the loop between α-helices 4 and 5 (L4/5). As L4/5 is one of the major determinants of Rh TRIM5α sensitivity of these viruses, the present results suggest that the binding site of the Rh TRIM5α may show complementarity to the HIV-2 GH123 capsid surface charge distribution.

  10. High Rates of Subsequent Asymptomatic Sexually Transmitted Infections and Risky Sexual Behavior in Patients Initially Presenting With Primary Human Immunodeficiency Virus-1 Infection.

    PubMed

    Braun, Dominique L; Marzel, Alex; Steffens, Daniela; Schreiber, Peter W; Grube, Christina; Scherrer, Alexandra U; Kouyos, Roger D; Günthard, Huldrych F

    2018-02-10

    Knowledge of the risk factors of individuals with an asymptomatic sexually transmitted infection (STI) is essential for implementation of targeted STI screening strategies. Between June 2015 and January 2017, an STI screening was offered to all participants in the Zurich Primary human immunodeficiency virus (HIV)-1 Infection study. Patients were tested for gonorrhea, chlamydia, syphilis, and hepatitis C virus (HCV). Of 214 participants, 174 (81%) were screened at least once. Most patients were men who have sex with men (MSM) (87.4%). Presenting with a primary HIV infection was associated with higher odds for later risky sexual behavior, as compared with presenting in the chronic phase (odds ratio [OR], 5.58; 95% confidence interval [CI], 3.68-8.8). In total, 79 STIs were detected, reflecting a high period prevalence of 33.3% (58 of 174 patients). Sixty-six percent of patients (52 of 79) were asymptomatic. Most common STIs were chlamydia (50.6%; 40 of 79 patients), gonorrhea (25.3%; 20 of 79), and syphilis (19%; 15 of 79). In a multivariable model, engaging in insertive (OR, 6.48; 95% CI, 1.14-36.76) or both insertive and receptive (4.61; 1.01-20.96) anal intercourse, STI symptoms (3.4; 1.68-6.89), and condomless sex (2.06; 1.14-3.74) were positively correlated with a positive screening result. The hazard of an incident STI increased with the presence of STI symptoms (hazard ratio, 3.03; 95% CI, 1.17-7.84) and any recent drug use (2.63; 1-6.9). A trimonthly STI screening including asymptomatic individuals should be considered in this population, particularly in MSM who report sexual risk behavior. NCT 00537966. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  11. Economic consequences for Medicaid of human immunodeficiency virus infection

    PubMed Central

    Baily, Mary Ann; Bilheimer, Linda; Wooldridge, Judith; well, Kathryn Lang; Greenberg, Warren

    1990-01-01

    Medicaid is currently a major source of financing for health care for those with acquired immunodeficiency syndrome (AIDS) and to a lesser extent, for those with other manifestations of human immunodeficiency virus (HIV) infection. It is likely to become even more important in the future. This article focuses on the structure of Medicaid in the context of the HIV epidemic, covering epidemiological issues, eligibility, service coverage and use, and reimbursement. A simple methodology for estimating HI\\'-related Medicaid costs under alternative assumptions about the future is also explained. PMID:10113503

  12. Neurological complications of human immunodeficiency virus infection.

    PubMed Central

    Kennedy, P. G.

    1988-01-01

    The protean neurological manifestations of human immunodeficiency virus (HIV) infection are reviewed. Both the central nervous system and peripheral nervous system may be affected and many of the complications may occur in individuals with acquired immunodeficiency syndrome (AIDS)-related complex, or who are seropositive for HIV alone as well as those with the established AIDS syndrome. Specific therapy is available for certain of these neurological conditions, but the clinical course in others is untreatable and progressive. Although it seems likely that the pathogenesis of some of these syndromes such as the AIDS-dementia complex are due to the direct effect of HIV on the nervous system, in others the neurological injury probably occurs as a consequence of the immunosuppression which HIV induces, or immune-mediated mechanisms. PMID:3050940

  13. Automatic PID Control Loops Design for Performance Improvement of Cryogenic Turboexpander

    NASA Astrophysics Data System (ADS)

    Joshi, D. M.; Patel, H. K.; Shah, D. K.

    2015-04-01

    Cryogenics field involves temperature below 123 K which is much less than ambient temperature. In addition, many industrially important physical processes—from fulfilling the needs of National Thermonuclear Fusion programs, superconducting magnets to treatment of cutting tools and preservation of blood cells, require extreme low temperature. The low temperature required for liquefaction of common gases can be obtained by several processes. Liquefaction is the process of cooling or refrigerating a gas to a temperature below its critical temperature so that liquid can be formed at some suitable pressure which is below the critical pressure. Helium liquefier is used for the liquefaction process of helium gas. In general, the Helium Refrigerator/Liquefier (HRL) needs turboexpander as expansion machine to produce cooling effect which is further used for the production of liquid helium. Turboexpanders, a high speed device that is supported on gas bearings, are the most critical component in many helium refrigeration systems. A very minor fault in the operation and manufacturing or impurities in the helium gas can destroy the turboexpander. However, since the performance of expanders is dependent on a number of operating parameters and the relations between them are quite complex, the instrumentation and control system design for turboexpander needs special attention. The inefficiency of manual control leads to the need of designing automatic control loops for turboexpander. Proper design and implementation of the control loops plays an important role in the successful operation of the cryogenic turboexpander. The PID control loops has to be implemented with accurate interlocks and logic to enhance the performance of the cryogenic turboexpander. For different normal and off-normal operations, speeds will be different and hence a proper control method for critical rotational speed avoidance is must. This paper presents the design of PID control loops needed for the

  14. Immunization of children with secondary immunodeficiency.

    PubMed

    Esposito, Susanna; Prada, Elisabetta; Lelii, Mara; Castellazzi, Luca

    2015-01-01

    The main causes of secondary immunodeficiency at a pediatric age include infectious diseases (mainly HIV infection), malignancies, haematopoietic stem cell or solid organ transplantation and autoimmune diseases. Children with secondary immunodeficiency have an increased risk of severe infectious diseases that could be prevented by adequate vaccination coverage, but vaccines administration can be associated with reduced immune response and an increased risk of adverse reactions. The immunogenicity of inactivated and recombinant vaccines is comparable to that of healthy children at the moment of vaccination, but it undergoes a progressive decline over time, and in the absence of a booster, the patients remain at risk of developing vaccine-preventable infections. However, the administration of live attenuated viral vaccines is controversial because of the risk of the activation of vaccine viruses. A specific immunization program should be administered according to the clinical and immunological status of each of these conditions to ensure a sustained immune response without any risks to the patients' health.

  15. Immunization of children with secondary immunodeficiency

    PubMed Central

    Esposito, Susanna; Prada, Elisabetta; Lelii, Mara; Castellazzi, Luca

    2015-01-01

    ABSTRACT The main causes of secondary immunodeficiency at a pediatric age include infectious diseases (mainly HIV infection), malignancies, haematopoietic stem cell or solid organ transplantation and autoimmune diseases. Children with secondary immunodeficiency have an increased risk of severe infectious diseases that could be prevented by adequate vaccination coverage, but vaccines administration can be associated with reduced immune response and an increased risk of adverse reactions. The immunogenicity of inactivated and recombinant vaccines is comparable to that of healthy children at the moment of vaccination, but it undergoes a progressive decline over time, and in the absence of a booster, the patients remain at risk of developing vaccine-preventable infections. However, the administration of live attenuated viral vaccines is controversial because of the risk of the activation of vaccine viruses. A specific immunization program should be administered according to the clinical and immunological status of each of these conditions to ensure a sustained immune response without any risks to the patients' health. PMID:26176360

  16. Fc-Mediated Anomalous Biodistribution of Therapeutic Antibodies in Immunodeficient Mouse Models.

    PubMed

    Sharma, Sai Kiran; Chow, Andrew; Monette, Sebastien; Vivier, Delphine; Pourat, Jacob; Edwards, Kimberly J; Dilling, Thomas R; Abdel-Atti, Dalya; Zeglis, Brian M; Poirier, John T; Lewis, Jason S

    2018-04-01

    A critical benchmark in the development of antibody-based therapeutics is demonstration of efficacy in preclinical mouse models of human disease, many of which rely on immunodeficient mice. However, relatively little is known about how the biology of various immunodeficient strains impacts the in vivo fate of these drugs. Here we used immunoPET radiotracers prepared from humanized, chimeric, and murine mAbs against four therapeutic oncologic targets to interrogate their biodistribution in four different strains of immunodeficient mice bearing lung, prostate, and ovarian cancer xenografts. The immunodeficiency status of the mouse host as well as both the biological origin and glycosylation of the antibody contributed significantly to the anomalous biodistribution of therapeutic monoclonal antibodies in an Fc receptor-dependent manner. These findings may have important implications for the preclinical evaluation of Fc-containing therapeutics and highlight a clear need for biodistribution studies in the early stages of antibody drug development. Significance: Fc/FcγR-mediated immunobiology of the experimental host is a key determinant to preclinical in vivo tumor targeting and efficacy of therapeutic antibodies. Cancer Res; 78(7); 1820-32. ©2018 AACR . ©2018 American Association for Cancer Research.

  17. [A place of intravenous immunoglobulins in current clinical practice: Privigen is a novel 10% immunoglobulin].

    PubMed

    Latysheva, T V; Latysheva, E A; Martynova, I A

    2016-01-01

    Intravenous immunoglobulins (IVIGs) were initially designed to treat patients with primary immunodeficiencies (PID). Due to the multidirectional effect of IVIGs on the immune system, a range of nosological entities, in which these agents are successfully administered, is steadily expanding. As of now, IVIGs are successfully used in neurology, rheumatology, hematology, and oncology and they are essential drugs for many patients. In spite of the long experience with IVIGs, their mechanism of action remains unclear, numerous investigations for their clinical introduction are being continued. Therefore, there is a growing need to increase the production of the drugs, which gives rise to the emergence of novel medications, which differ in their composition and manufacture technologies, on the pharmacological market. The 10% intravenous immunoglobulin privigen, the safety and efficacy of which has been proven in foreign practice, is a novel drug on the Russian market.

  18. Envelope residue 375 substitutions in simian–human immunodeficiency viruses enhance CD4 binding and replication in rhesus macaques

    PubMed Central

    Li, Hui; Wang, Shuyi; Kong, Rui; Ding, Wenge; Lee, Fang-Hua; Parker, Zahra; Kim, Eunlim; Learn, Gerald H.; Hahn, Paul; Policicchio, Ben; Brocca-Cofano, Egidio; Deleage, Claire; Hao, Xingpei; Chuang, Gwo-Yu; Gorman, Jason; Gardner, Matthew; Lewis, Mark G.; Hatziioannou, Theodora; Santra, Sampa; Apetrei, Cristian; Pandrea, Ivona; Alam, S. Munir; Liao, Hua-Xin; Shen, Xiaoying; Tomaras, Georgia D.; Farzan, Michael; Chertova, Elena; Keele, Brandon F.; Estes, Jacob D.; Lifson, Jeffrey D.; Doms, Robert W.; Montefiori, David C.; Haynes, Barton F.; Sodroski, Joseph G.; Kwong, Peter D.; Hahn, Beatrice H.; Shaw, George M.

    2016-01-01

    Most simian–human immunodeficiency viruses (SHIVs) bearing envelope (Env) glycoproteins from primary HIV-1 strains fail to infect rhesus macaques (RMs). We hypothesized that inefficient Env binding to rhesus CD4 (rhCD4) limits virus entry and replication and could be enhanced by substituting naturally occurring simian immunodeficiency virus Env residues at position 375, which resides at a critical location in the CD4-binding pocket and is under strong positive evolutionary pressure across the broad spectrum of primate lentiviruses. SHIVs containing primary or transmitted/founder HIV-1 subtype A, B, C, or D Envs with genotypic variants at residue 375 were constructed and analyzed in vitro and in vivo. Bulky hydrophobic or basic amino acids substituted for serine-375 enhanced Env affinity for rhCD4, virus entry into cells bearing rhCD4, and virus replication in primary rhCD4 T cells without appreciably affecting antigenicity or antibody-mediated neutralization sensitivity. Twenty-four RMs inoculated with subtype A, B, C, or D SHIVs all became productively infected with different Env375 variants—S, M, Y, H, W, or F—that were differentially selected in different Env backbones. Notably, SHIVs replicated persistently at titers comparable to HIV-1 in humans and elicited autologous neutralizing antibody responses typical of HIV-1. Seven animals succumbed to AIDS. These findings identify Env–rhCD4 binding as a critical determinant for productive SHIV infection in RMs and validate a novel and generalizable strategy for constructing SHIVs with Env glycoproteins of interest, including those that in humans elicit broadly neutralizing antibodies or bind particular Ig germ-line B-cell receptors. PMID:27247400

  19. Primary intraosseous Kaposi's sarcoma presenting as an asymptomatic periapical radiolucency: a case report.

    PubMed

    Noel, Kenson E; Mardirossian, George; Schneider, Lawrence

    2007-05-01

    Kaposi's sarcoma (KS) is a common mucocutaneous manifestation of acquired immunodeficiency syndrome (AIDS). Primary bone lesions have been reported but are rare. A 38-year-old African-American male who was human immunodeficiency virus (HIV)-positive appeared for the evaluation of an asymptomatic well-defined radiolucency of the mandibular midline discovered on routine radiographic examination. The adjacent central incisors were asymptomatic, nonmobile, and vital. The overlying mucosa and cortical plate were intact. Excision of the lesion revealed a fleshy, pink-red soft tissue mass with a uniform consistency. Histological examination showed a malignant spindle cell neoplasm containing numerous extravasated erythrocytes. The tumor cells exhibited positive immunohistochemical staining for CD31, CD34, and human herpesvirus 8. One year after surgical procedure, the surgical defect showed radiographic evidence of repair and there was no sign of recurrent tumor. This case represents the fourth reported instance of primary intraosseous involvement of the jaws with KS.

  20. Prevalence of Anal Dysplasia in Human Immunodeficiency Virus-Infected Transgender Women.

    PubMed

    Kobayashi, Takaaki; Sigel, Keith; Gaisa, Michael

    2017-11-01

    Although human immunodeficiency virus-infected men who have sex with men are at high risk for anal cancer, little is known about the prevalence of anal dysplasia in human immunodeficiency virus (HIV)-infected transgender women. Our study found that prevalence rates of abnormal anal cytology and histology in HIV-infected transgender women were similar to those in HIV-infected men who have sex with men.

  1. Human immunodeficiency virus/acquired immunodeficiency syndrome and infertility: emerging problems in the era of highly active antiretrovirals.

    PubMed

    Kushnir, Vitaly A; Lewis, William

    2011-09-01

    To review the effects of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in terms of its associated comorbid conditions and the side effects of antiretroviral treatment on fertility. PubMed computer search to identify relevant articles. Research institution. None. None. None. Biological alterations in reproductive physiology may account for subfertility in patients infected with HIV. Psychosocial factors in patients with HIV infection may affect their reproductive desires and outcomes. Antiretroviral medications may have direct toxicity on gametes and embryos. Available evidence indicates that fertility treatments can be a safe option for couples with HIV-discordant infection status, although the potential risk of viral transmission cannot be completely eliminated. Because their potential reproductive desires are increasingly becoming a concern in the health care of young HIV-infected patients, additional data are needed to address the effect of HIV and its treatments on their fertility and reproductive outcomes. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Lack of viral selection in human immunodeficiency virus type 1 mother-to-child transmission with primary infection during late pregnancy and/or breastfeeding.

    PubMed

    Ceballos, Ana; Andreani, Guadalupe; Ripamonti, Chiara; Dilernia, Dario; Mendez, Ramiro; Rabinovich, Roberto D; Cárdenas, Patricia Coll; Zala, Carlos; Cahn, Pedro; Scarlatti, Gabriella; Martínez Peralta, Liliana

    2008-11-01

    Mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV-1) as described for women with an established infection is, in most cases, associated with the transmission of few maternal variants. This study analysed virus variability in four cases of maternal primary infection occurring during pregnancy and/or breastfeeding. Estimated time of seroconversion was at 4 months of pregnancy for one woman (early seroconversion) and during the last months of pregnancy and/or breastfeeding for the remaining three (late seroconversion). The C2V3 envelope region was analysed in samples of mother-child pairs by molecular cloning and sequencing. Comparisons of nucleotide and amino acid sequences as well as phylogenetic analysis were performed. The results showed low variability in the virus population of both mother and child. Maximum-likelihood analysis showed that, in the early pregnancy seroconversion case, a minor viral variant with further evolution in the child was transmitted, which could indicate a selection event in MTCT or a stochastic event, whereas in the late seroconversion cases, the mother's and child's sequences were intermingled, which is compatible with the transmission of multiple viral variants from the mother's major population. These results could be explained by the less pronounced selective pressure exerted by the immune system in the early stages of the mother's infection, which could play a role in MTCT of HIV-1.

  3. Monozygotic twins discordant for common variable immunodeficiency reveal impaired DNA demethylation during naïve-to-memory B-cell transition

    PubMed Central

    Rodríguez-Cortez, Virginia C.; del Pino-Molina, Lucia; Rodríguez-Ubreva, Javier; Ciudad, Laura; Gómez-Cabrero, David; Company, Carlos; Urquiza, José M.; Tegnér, Jesper; Rodríguez-Gallego, Carlos; López-Granados, Eduardo; Ballestar, Esteban

    2015-01-01

    Common variable immunodeficiency (CVID), the most frequent primary immunodeficiency characterized by loss of B-cell function, depends partly on genetic defects, and epigenetic changes are thought to contribute to its aetiology. Here we perform a high-throughput DNA methylation analysis of this disorder using a pair of CVID-discordant MZ twins and show predominant gain of DNA methylation in CVID B cells with respect to those from the healthy sibling in critical B lymphocyte genes, such as PIK3CD, BCL2L1, RPS6KB2, TCF3 and KCNN4. Individual analysis confirms hypermethylation of these genes. Analysis in naive, unswitched and switched memory B cells in a CVID patient cohort shows impaired ability to demethylate and upregulate these genes in transitioning from naive to memory cells in CVID. Our results not only indicate a role for epigenetic alterations in CVID but also identify relevant DNA methylation changes in B cells that could explain the clinical manifestations of CVID individuals. PMID:26081581

  4. State policies and the financing of acquired immunodeficiency syndrome care

    PubMed Central

    Pascal, Anthony; Cvitanic, Marilyn; Bennett, Charles; Gorman, Michael; Serrato, Carl A.

    1989-01-01

    State policies, with respect to the operation of Medicaid programs and the regulation of private health insurance, affect who gets what care, how much is spent, and who ultimately pays. A RAND Corporation study was used to assess States and the District of Columbia in terms of the effects of their Medicaid and health insurance regulations on people with acquired immunodeficiency syndrome and other human immunodeficiency virus-related illnesses. State characteristics are used to explain the individual State policy rankings. PMID:10313357

  5. Cytokine Polymorphisms are Associated with Poor Sleep Maintenance in Adults Living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

    PubMed Central

    Lee, Kathryn A.; Gay, Caryl; Pullinger, Clive R.; Hennessy, Mary Dawn; Zak, Rochelle S.; Aouizerat, Bradley E.

    2014-01-01

    Study Objectives: Cytokine activity and polymorphisms have been associated with sleep outcomes in prior animal and human research. The purpose of this study was to determine whether circulating plasma cytokines and cytokine polymorphisms are associated with the poor sleep maintenance commonly experienced by adults living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Design: Cross-sectional descriptive study. Setting: HIV clinics and community sites in the San Francisco Bay area. Participants: A convenience sample of 289 adults (193 men, 73 women, and 23 transgender) living with HIV/AIDS. Interventions: None. Measurements and Results: A wrist actigraph was worn for 72 h to estimate the percentage of wake after sleep onset (WASO%) and total sleep time (TST), plasma cytokines were analyzed, and genotyping was conducted for 15 candidate genes involved in cytokine signaling: interferon-gamma (IFNG), IFNG receptor 1 (IFNGR1), interleukins (IL1B, IL1R2, IL1R2, IL2, IL4, IL6, IL8, IL10, IL13, IL17A), nuclear factor of kappa light polypeptide gene enhancer in B cells (NFKB1 and NFKB2), and tumor necrosis factor-alpha (TNFA). Controlling for demographic variables such as race and sex, and clinical variables such as CD4+ count and medications, higher WASO% was associated with single nucleotide polymorphisms (SNPs) of IL1R2 rs11674595 and TNFA rs1041981 and less WASO% was associated with IL2 rs2069776. IL1R2 rs11674595 and TNFA rs1041981 were also associated with short sleep duration. Conclusions: This study strengthens the evidence for an association between inflammation and sleep maintenance problems. In this chronic illness population, cytokine polymorphisms associated with wake after sleep onset provide direction for intervention research aimed at comparing anti-inflammatory mechanisms with hypnotic agents for improving sleep maintenance and total sleep time. Citation: Lee KA; Gay C; Pullinger CR; Hennessy MD; Zak RS; Aouizerat BE

  6. Antiviral therapy during primary simian immunodeficiency virus infection fails to prevent acute loss of CD4+ T cells in gut mucosa but enhances their rapid restoration through central memory T cells.

    PubMed

    Verhoeven, David; Sankaran, Sumathi; Silvey, Melanie; Dandekar, Satya

    2008-04-01

    Gut-associated lymphoid tissue (GALT) is an early target of human immunodeficiency virus (HIV) and simian immunodeficiency virus (SIV) and a site for severe CD4+ T-cell depletion. Although antiretroviral therapy (ART) is effective in suppressing HIV replication and restoring CD4+ T cells in peripheral blood, restoration in GALT is delayed. The role of restored CD4+ T-cell help in GALT during ART and its impact on antiviral CD8+ T-cell responses have not been investigated. Using the SIV model, we investigated gut CD4+ T-cell restoration in infected macaques, initiating ART during either the primary stage (1 week postinfection), prior to acute CD4+ cell loss (PSI), or during the chronic stage at 10 weeks postinfection (CSI). ART led to viral suppression in GALT and peripheral blood mononuclear cells of PSI and CSI animals at comparable levels. CSI animals had incomplete CD4+ T-cell restoration in GALT. In PSI animals, ART did not prevent acute CD4+ T-cell loss by 2 weeks postinfection in GALT but supported rapid and complete CD4+ T-cell restoration thereafter. This correlated with an accumulation of central memory CD4+ T cells and better suppression of inflammation. Restoration of CD4+ T cells in GALT correlated with qualitative changes in SIV gag-specific CD8+ T-cell responses, with a dominance of interleukin-2-producing responses in PSI animals, while both CSI macaques and untreated SIV-infected controls were dominated by gamma interferon responses. Thus, central memory CD4+ T-cell levels and qualitative antiviral CD8+ T-cell responses, independent of viral suppression, were the immune correlates of gut mucosal immune restoration during ART.

  7. Identifying HIV/AIDS primary care development needs.

    PubMed

    Foong, Andrew L S; Ng, S F; Lee, Christopher K C

    2005-04-01

    This paper reports a study aimed at identifying the primary health care experiences of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in Malaysia. The rationale behind the study was to enable informed action for developing more responsive and effective primary care. Reports such as from the World Health Organisation forecast sharp escalations in the incidence of HIV/AIDS in Malaysia and the Asia-Pacific region within the next few years. With sparse information on the course of infection on the local population and an understanding of health care needs of those afflicted, health services would be ill-prepared for projected increases. Semi-structured interviews were conducted with a convenience sample of 99 patients attending two major HIV/AIDS clinics in Malaysia. Several gaps in care provision were highlighted, such as with treatment/consultation facilities and availability and accessibility of information. What is also evident is that there are a number of good support services available but not well publicized to those in need of them. That includes health professionals who could be making appropriate referrals. The lack of communications and inter-professional working appears to be part of the problem. The findings provide baseline data and preliminary insights to government and other service providers towards advancing, optimizing and refining existing policies and infrastructure. Although the availability of a number of primary care facilities have been identified, the study indicates the need for more effective co-ordinated efforts with clear leadership to pull together scarce resources towards the aim of some degree of seamless primary care provision. It is suggested that nurses would be well placed for such a role in view of the nature of their education and training that helps prepare them for the multi-faceted role.

  8. The puzzling role of CXCR4 in human immunodeficiency virus infection.

    PubMed

    Vicenzi, Elisa; Liò, Pietro; Poli, Guido

    2013-01-01

    The human immunodeficiency virus type-1 (HIV-1) is the etiological agent of the acquired immunodeficiency syndrome (AIDS), a disease highly lethal in the absence of combination antiretroviral therapy. HIV infects CD4(+) cells of the immune system (T cells, monocyte-macrophages and dendritic cells) via interaction with a universal primary receptor, the CD4 molecule, followed by a mandatory interaction with a second receptor (co-receptor) belonging to the chemokine receptor family. Apart from some rare cases, two chemokine receptors have been evolutionarily selected to accomplish this need for HIV-1: CCR5 and CXCR4. Yet, usage of these two receptors appears to be neither casual nor simply explained by their levels of cell surface expression. While CCR5 use is the universal rule at the start of every infection regardless of the transmission route (blood-related, sexual or mother to child), CXCR4 utilization emerges later in disease coinciding with the immunological deficient phase of infection. Moreover, in most instances CXCR4 use as viral entry co-receptor is associated with maintenance of CCR5 use. Since antiviral agents preventing CCR5 utilization by the virus are already in use, while others targeting either CCR5 or CXCR4 (or both) are under investigation, understanding the biological correlates of this "asymmetrical" utilization of HIV entry co-receptors bears relevance for the clinical choice of which therapeutics should be administered to infected individuals. We will here summarize the basic knowledge and the hypotheses underlying the puzzling and yet unequivocal role of CXCR4 in HIV-1 infection.

  9. Pharmacological inhibition of feline immunodeficiency virus (FIV).

    PubMed

    Mohammadi, Hakimeh; Bienzle, Dorothee

    2012-05-01

    Feline immunodeficiency virus (FIV) is a member of the retroviridae family of viruses and causes an acquired immunodeficiency syndrome (AIDS) in domestic and non-domestic cats worldwide. Genome organization of FIV and clinical characteristics of the disease caused by the virus are similar to those of human immunodeficiency virus (HIV). Both viruses infect T lymphocytes, monocytes and macrophages, and their replication cycle in infected cells is analogous. Due to marked similarity in genomic organization, virus structure, virus replication and disease pathogenesis of FIV and HIV, infection of cats with FIV is a useful tool to study and develop novel drugs and vaccines for HIV. Anti-retroviral drugs studied extensively in HIV infection have targeted different steps of the virus replication cycle: (1) inhibition of virus entry into susceptible cells at the level of attachment to host cell surface receptors and co-receptors; (2) inhibition of fusion of the virus membrane with the cell membrane; (3) blockade of reverse transcription of viral genomic RNA; (4) interruption of nuclear translocation and viral DNA integration into host genomes; (5) prevention of viral transcript processing and nuclear export; and (6) inhibition of virion assembly and maturation. Despite much success of anti-retroviral therapy slowing disease progression in people, similar therapy has not been thoroughly investigated in cats. In this article we review current pharmacological approaches and novel targets for anti-lentiviral therapy, and critically assess potentially suitable applications against FIV infection in cats.

  10. Pharmacological Inhibition of Feline Immunodeficiency Virus (FIV)

    PubMed Central

    Mohammadi, Hakimeh; Bienzle, Dorothee

    2012-01-01

    Feline immunodeficiency virus (FIV) is a member of the retroviridae family of viruses and causes an acquired immunodeficiency syndrome (AIDS) in domestic and non-domestic cats worldwide. Genome organization of FIV and clinical characteristics of the disease caused by the virus are similar to those of human immunodeficiency virus (HIV). Both viruses infect T lymphocytes, monocytes and macrophages, and their replication cycle in infected cells is analogous. Due to marked similarity in genomic organization, virus structure, virus replication and disease pathogenesis of FIV and HIV, infection of cats with FIV is a useful tool to study and develop novel drugs and vaccines for HIV. Anti-retroviral drugs studied extensively in HIV infection have targeted different steps of the virus replication cycle: (1) inhibition of virus entry into susceptible cells at the level of attachment to host cell surface receptors and co-receptors; (2) inhibition of fusion of the virus membrane with the cell membrane; (3) blockade of reverse transcription of viral genomic RNA; (4) interruption of nuclear translocation and viral DNA integration into host genomes; (5) prevention of viral transcript processing and nuclear export; and (6) inhibition of virion assembly and maturation. Despite much success of anti-retroviral therapy slowing disease progression in people, similar therapy has not been thoroughly investigated in cats. In this article we review current pharmacological approaches and novel targets for anti-lentiviral therapy, and critically assess potentially suitable applications against FIV infection in cats. PMID:22754645

  11. Robust PI and PID design for first- and second-order processes with zeros, time-delay and structured uncertainties

    NASA Astrophysics Data System (ADS)

    Parada, M.; Sbarbaro, D.; Borges, R. A.; Peres, P. L. D.

    2017-01-01

    The use of robust design techniques such as the one based on ? and ? for tuning proportional integral (PI) and proportional integral derivative (PID) controllers have been limited to address a small set of processes. This work addresses the problem by considering a wide set of possible plants, both first- and second-order continuous-time systems with time delays and zeros, leading to PI and PID controllers. The use of structured uncertainties to handle neglected dynamics allows to expand the range of processes to be considered. The proposed approach takes into account the robustness of the controller with respect to these structured uncertainties by using the small-gain theorem. In addition, improved performance is sought through the minimisation of an upper bound to the closed-loop system ? norm. A Lyapunov-Krasovskii-type functional is used to obtain delay-dependent design conditions. The controller design is accomplished by means of a convex optimisation procedure formulated using linear matrix inequalities. In order to illustrate the flexibility of the approach, several examples considering recycle compensation, reduced-order controller design and a practical implementation are addressed. Numerical experiments are provided in each case to highlight the main characteristics of the proposed design method.

  12. In Vitro Evaluation of Nonnucleoside Reverse Transcriptase Inhibitors UC-781 and TMC120-R147681 as Human Immunodeficiency Virus Microbicides†

    PubMed Central

    Van Herrewege, Yven; Michiels, Jo; Van Roey, Jens; Fransen, Katrien; Kestens, Luc; Balzarini, Jan; Lewi, Paul; Vanham, Guido; Janssen, Paul

    2004-01-01

    The nonnucleoside reverse transcriptase inhibitors UC-781 and TMC120-R147681 (Dapivirine) effectively prevented human immunodeficiency virus (HIV) infection in cocultures of monocyte-derived dendritic cells and T cells, representing primary targets in sexual transmission. Both drugs had a favorable therapeutic index. A 24-h treatment with 1,000 nM UC-781 or 100 nM TMC120-R147681 prevented cell-free HIV infection, whereas 10-fold-higher concentrations blocked cell-associated HIV. PMID:14693562

  13. High-accuracy resolver-to-digital conversion via phase locked loop based on PID controller

    NASA Astrophysics Data System (ADS)

    Li, Yaoling; Wu, Zhong

    2018-03-01

    The problem of resolver-to-digital conversion (RDC) is transformed into the problem of angle tracking control, and a phase locked loop (PLL) method based on PID controller is proposed in this paper. This controller comprises a typical PI controller plus an incomplete differential which can avoid the amplification of higher-frequency noise components by filtering the phase detection error with a low-pass filter. Compared with conventional ones, the proposed PLL method makes the converter a system of type III and thus the conversion accuracy can be improved. Experimental results demonstrate the effectiveness of the proposed method.

  14. Antibodies Elicited by Multiple Envelope Glycoprotein Immunogens in Primates Neutralize Primary Human Immunodeficiency Viruses (HIV-1) Sensitized by CD4-Mimetic Compounds

    PubMed Central

    Madani, Navid; Princiotto, Amy M.; Easterhoff, David; Bradley, Todd; Luo, Kan; Williams, Wilton B.; Liao, Hua-Xin; Moody, M. Anthony; Phad, Ganesh E.; Vázquez Bernat, Néstor; Melillo, Bruno; Santra, Sampa; Smith, Amos B.; Karlsson Hedestam, Gunilla B.; Haynes, Barton

    2016-01-01

    ABSTRACT The human immunodeficiency virus (HIV-1) envelope glycoproteins (Env) mediate virus entry through a series of complex conformational changes triggered by binding to the receptors CD4 and CCR5/CXCR4. Broadly neutralizing antibodies that recognize conserved Env epitopes are thought to be an important component of a protective immune response. However, to date, HIV-1 Env immunogens that elicit broadly neutralizing antibodies have not been identified, creating hurdles for vaccine development. Small-molecule CD4-mimetic compounds engage the CD4-binding pocket on the gp120 exterior Env and induce Env conformations that are highly sensitive to neutralization by antibodies, including antibodies directed against the conserved Env region that interacts with CCR5/CXCR4. Here, we show that CD4-mimetic compounds sensitize primary HIV-1 to neutralization by antibodies that can be elicited in monkeys and humans within 6 months by several Env vaccine candidates, including gp120 monomers. Monoclonal antibodies directed against the gp120 V2 and V3 variable regions were isolated from the immunized monkeys and humans; these monoclonal antibodies neutralized a primary HIV-1 only when the virus was sensitized by a CD4-mimetic compound. Thus, in addition to their direct antiviral effect, CD4-mimetic compounds dramatically enhance the HIV-1-neutralizing activity of antibodies that can be elicited with currently available immunogens. Used as components of microbicides, the CD4-mimetic compounds might increase the protective efficacy of HIV-1 vaccines. IMPORTANCE Preventing HIV-1 transmission is a high priority for global health. Eliciting antibodies that can neutralize transmitted strains of HIV-1 is difficult, creating problems for the development of an effective vaccine. We found that small-molecule CD4-mimetic compounds sensitize HIV-1 to antibodies that can be elicited in vaccinated humans and monkeys. These results suggest an approach to prevent HIV-1 sexual transmission in

  15. Comparison of Guizotia abyssinica seed extract (birdseed) agar with conventional media for selective identification of Cryptococcus neoformans in patients with acquired immunodeficiency syndrome.

    PubMed Central

    Denning, D W; Stevens, D A; Hamilton, J R

    1990-01-01

    Growth of Cryptococcus neoformans from the sputum of patients with acquired immunodeficiency syndrome may be obscured by oral contamination with Candida albicans on conventional media. We prospectively compared direct plating of sputum and urine onto birdseed agar and compared birdseed agar plating with plating onto Mycosel and Sabouraud dextrose agar cultures. Thirty-two sputum and three urine specimens were compared. C. neoformans was isolated from five specimens. In two specimens, one of sputum and one of urine, C. neoformans was detected only on the birdseed agar plate because of overgrowth on the conventional media by C. albicans. C. neoformans produced dark colonies on birdseed agar, unlike C. albicans, which produces white colonies. The use of birdseed agar as the primary culture medium for sputum and urine specimens from patients with acquired immunodeficiency syndrome increases sensitivity for C. neoformans. Images PMID:2254431

  16. Aphthous vaginal ulceration in two women with acquired immunodeficiency syndrome.

    PubMed

    Schuman, P; Christensen, C; Sobel, J D

    1996-05-01

    Two women with advanced human immunodeficiency virus infection are described who were seen with painful aphthous vaginal ulceration and CD4+ lymphocyte counts < 50 cells/mm3. A chronic rectovaginal fistula developed in one patient. In spite of extensive investigation no underlying cause of the ulceration was discovered. Clinical therapeutic response suggests that corticosteroid therapy may be of value in healing or stabilizing the destructive process. Clinicians should be aware of this complication in human immunodeficiency virus-infected women with severe vaginal pain and unexplained discharge.

  17. Feline immunodeficiency virus OrfA alters gene expression of splicing factors and proteasome-ubiquitination proteins

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sundstrom, Magnus; Chatterji, Udayan; Schaffer, Lana

    2008-02-20

    Expression of the feline immunodeficiency virus (FIV) accessory protein OrfA (or Orf2) is critical for efficient viral replication in lymphocytes, both in vitro and in vivo. OrfA has been reported to exhibit functions in common with the human immunodeficiency virus (HIV) and simian immunodeficiency virus (SIV) accessory proteins Vpr and Tat, although the function of OrfA has not been fully explained. Here, we use microarray analysis to characterize how OrfA modulates the gene expression profile of T-lymphocytes. The primary IL-2-dependent T-cell line 104-C1 was transduced to express OrfA. Functional expression of OrfA was demonstrated by trans complementation of the OrfA-defectivemore » clone, FIV-34TF10. OrfA-expressing cells had a slightly reduced cell proliferation rate but did not exhibit any significant alteration in cell cycle distribution. Reverse-transcribed RNA from cells expressing green fluorescent protein (GFP) or GFP + OrfA were hybridized to Affymetrix HU133 Plus 2.0 microarray chips representing more than 47,000 genome-wide transcripts. By using two statistical approaches, 461 (Rank Products) and 277 (ANOVA) genes were identified as modulated by OrfA expression. The functional relevance of the differentially expressed genes was explored by Ingenuity Pathway Analysis. The analyses revealed alterations in genes critical for RNA post-transcriptional modifications and protein ubiquitination as the two most significant functional outcomes of OrfA expression. In these two groups, several subunits of the spliceosome, cellular splicing factors and family members of the proteasome-ubiquitination system were identified. These findings provide novel information on the versatile function of OrfA during FIV infection and indicate a fine-tuning mechanism of the cellular environment by OrfA to facilitate efficient FIV replication.« less

  18. Clinical utility of the DSM-5 alternative model for borderline personality disorder: Differential diagnostic accuracy of the BFI, SCID-II-PQ, and PID-5.

    PubMed

    Fowler, J Christopher; Madan, Alok; Allen, Jon G; Patriquin, Michelle; Sharp, Carla; Oldham, John M; Frueh, B Christopher

    2018-01-01

    With the publication of DSM 5 alternative model for personality disorders it is critical to assess the components of the model against evidence-based models such as the five factor model and the DSM-IV-TR categorical model. This study explored the relative clinical utility of these models in screening for borderline personality disorder (BPD). Receiver operator characteristics and diagnostic efficiency statistics were calculated for three personality measures to ascertain the relative diagnostic efficiency of each measure. A total of 1653 adult inpatients at a specialist psychiatric hospital completed SCID-II interviews. Sample 1 (n=653) completed the SCID-II interviews, SCID-II Questionnaire (SCID-II-PQ) and the Big Five Inventory (BFI), while Sample 2 (n=1,000) completed the SCID-II interviews, Personality Inventory for DSM5 (PID-5) and the BFI. BFI measure evidenced moderate accuracy for two composites: High Neuroticism+ low agreeableness composite (AUC=0.72, SE=0.01, p<0.001) and High Neuroticism+ Low+Low Conscientiousness (AUC=0.73, SE=0.01, p<0.0001). The SCID-II-PQ evidenced moderate-to-excellent accuracy (AUC=0.86, SE=0.02, p<0.0001) with a good balance of specificity (SP=0.80) and sensitivity (SN=0.78). The PID-5 BPD algorithm (consisting of elevated emotional lability, anxiousness, separation insecurity, hostility, depressivity, impulsivity, and risk taking) evidenced moderate-to-excellent accuracy (AUC=0.87, SE=0.01, p<0.0001) with a good balance of specificity (SP=0.76) and sensitivity (SN=0.81). Findings generally support the use of SCID-II-PQ and PID-5 BPD algorithm for screening purposes. Furthermore, findings support the accuracy of the DSM 5 alternative model Criteria B trait constellation for diagnosing BPD. Limitations of the study include the single inpatient setting and use of two discrete samples to assess PID-5 and SCID-II-PQ. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Immune Reconstitution Reactions in Human Immunodeficiency Virus–Negative Patients

    PubMed Central

    Scharschmidt, Tiffany C.; Amerson, Erin H.; Rosenberg, Oren S.; Jacobs, Richard A.; McCalmont, Timothy H.; Shinkai, Kanade

    2013-01-01

    Background Immune reconstitution inflammatory syndrome (IRIS) is a phenomenon initially described in patients with human immunodeficiency virus. Upon initiation of combination antiretroviral therapy, recovery of cellular immunity triggers inflammation to a preexisting infection or antigen that causes paradoxical worsening of clinical disease. A similar phenomenon can occur in human immunodeficiency virus–negative patients, including pregnant women, neutropenic hosts, solidorgan or stem cell transplant recipients, and patients receiving tumor necrosis factor inhibitors. Observations We report a case of leprosy unmasking and downgrading reaction after stem cell transplantation that highlights some of the challenges inherent to the diagnosis of IRIS, especially in patients without human immunodeficiency virus infection, as well as review the spectrum of previously reported cases of IRIS reactions in this population. Conclusions The mechanism of immune reconstitution reactions is complex and variable, depending on the underlying antigen and the mechanism of immunosuppression or shift in immune status. Use of the term IRIS can aid our recognition of an important phenomenon that occurs in the setting of immunosuppression or shifts in immunity but should not deter us from thinking critically about the distinct processes that underlie this heterogeneous group of conditions. PMID:23324760

  20. Transmission of human immunodeficiency virus from parents to only one dizygotic twin.

    PubMed

    Park, C L; Streicher, H; Rothberg, R

    1987-06-01

    The acquired immunodeficiency syndrome-related complex was identified in a mother and one of her nonidentical twins. Generalized lymphadenopathy was first noted in the infant at age 17 months, and that of the mother was incidentally discovered 6 months later. The father, who had had homosexual contacts before the conception of the twins, appeared to be in good health. No one in the family had constitutional symptoms or showed signs of opportunistic infection. Both parents and the patient had hypergammaglobulinemia, low T-helper-to-suppressor-cell ratio, and positive serum antibody to human immunodeficiency virus. Attempts to isolate the virus from all family members were unsuccessful. The twin brother was in good health with a normal immunologic profile and negative antibody to human immunodeficiency virus.

  1. An unexpected diagnosis of human immunodeficiency virus-2 infection in an overseas visitor: a case report.

    PubMed

    Sohail, Asma; Van Leer, Lyndal; Holmes, Natasha

    2017-03-04

    Human immunodeficiency virus 2 infection is endemic in West Africa but is also found in parts of Europe, North and South America, and India where it is thought to have been introduced secondary to migration and commercial trade ties. It is less common than Human immunodeficiency virus 1, with differences in pathogenicity, lower rates of transmission, longer asymptomatic period and slower progression to acquired immunodeficiency syndrome. Human immunodeficiency virus 2 is also associated with diagnostic challenges given the lack of commercially available diagnostic tests, and management challenges given intrinsic resistance to many anti-retroviral therapies. We describe a case of a 65 year old South Indian female, visiting her family in Australia, who presented with weight loss, pancytopaenia and generalised lymphadenopathy on a background of newly diagnosed congestive cardiac failure. Multiple investigations were performed to elucidate the cause of her presentation, with the eventual unexpected diagnosis of human immunodeficiency virus 2. She was commenced on anti-retroviral treatment and made a remarkable recovery. We describe the challenges associated with diagnosis of human immunodeficiency virus 2 due to lack of commercially available diagnostics, as well as the treatment and management challenges including the fact that human immunodeficiency virus 2 is intrinsically resistant to non-nucleoside reverse transcriptase inhibitors. Human immunodeficiency virus 2 infection should be considered in patients who present with symptoms and signs that do not point towards a clear diagnosis, such as unexplained pancytopaenia or lymphadenopathy, and who have risk factors such as being from an endemic area or having had blood transfusions, especially prior to the commencement of blood-borne virus screening of blood donors.

  2. Practical diagnostic testing for human immunodeficiency virus.

    PubMed Central

    Jackson, J B; Balfour, H H

    1988-01-01

    Since the discovery of human immunodeficiency virus (HIV) as the causative agent of acquired immunodeficiency syndrome in 1983, there has been a proliferation of diagnostic tests. These assays can be used to detect the presence of HIV antibody, HIV antigen, HIV ribonucleic and deoxyribonucleic acids, and HIV reverse transcriptase. Enzyme-linked immunosorbent assays, Western blot, radioimmunoprecipitation assays, indirect immunofluorescence assays, reverse transcriptase assays, and several molecular hybridization techniques are currently available. Enzyme-linked immunosorbent, Western blot, and indirect immunofluorescence assays for HIV antibody are very sensitive, specific, and adaptable to most laboratories. An enzyme-linked immunosorbent assay for HIV antigen is also readily adaptable to most laboratories and will be commercially available soon. While the other assays are more tedious, they are valuable confirmatory tests and are suitable for reference laboratories. The biohazards of performing HIV testing can be minimized with proper biosafety measures. Images PMID:3060241

  3. High field ESR study of the pi-d interaction effect in beta-(BDA-TTP)2MCl4 (M=Fe, Ga)

    NASA Astrophysics Data System (ADS)

    Tokumoto, Takahisa; Vantol, J.; Brunel, L.-C.; Choi, E. S.; Brooks, J. S.; Kaihatsu, T.; Akutsu, H.; Yamada, J.

    2007-03-01

    Novel magnetic organic conductors with pi-d interaction have commanded attention since the discovery of field induced superconductivity. One of them, beta-(BDA-TTP)2FeCl4, has alternating donor molecules and quasi 2D electrical properties. Previous studies of electrical and magnetic properties show an M-I transition at 120K and an AF transition at TN=8.5K, suggesting an exchange interaction between the conduction electrons and the Fe^3+ d-electrons. The properties of beta-(BDA-TTP)2GaCl4 are similar with exception of the absence of the AF transition, which is apparently due to the absence of pi-d exchange interaction. We report angular/temperature dependent 240GHz quasi optical ESR measurements on both compounds to probe the magnetic properties. The Ga compound signals follow the donor molecule structure, and show no magnetic order at any temperature. The Fe compound signals are quite different from the Ga compound, and exhibit AF behavior below TN. The difference of Fe and Ga compounds will be discussed in terms of the interaction between localized and itinerant magnetic moments.

  4. Comparison of Knowledge, Attitudes, and Practices of Educated and Uneducated Adults Regarding Human Immunodeficiency Virus in Karachi, Pakistan

    PubMed Central

    Ahmad, Zainab; Asghar, Mariam; Khan, Alizay Rashid; Arif, Omer; Shah, Syed Hamza; Nadeem, Shahrukh; Waseem, Yamna; Aibani, Rafi; Syed, Ammar salman; Mustafa, Rabia M; Abdulrahman, Zainab; Fatima, Kaneez

    2017-01-01

    Background Despite the high prevalence of human immunodeficiency virus (HIV) in Pakistan, no prior work has been done to specifically highlight the importance of education as a social vaccine against HIV. Therefore, our study focuses on differences in knowledge and practices regarding HIV and acquired immunodeficiency syndrome (AIDS) among educated and uneducated adults. Methodology A cross-sectional study was carried out in which data was collected from all over Karachi. An individual was designated as educated if he had received education above primary school level. Individuals who had studied till primary school or less were considered uneducated. The questionnaire was split into four sections that assessed respondents' demographics, knowledge, attitudes, and practices regarding HIV/AIDS. Chi square test was used as the primary statistical test. Results Out of the 446 adult participants, 235 (52.7%) were educated and 211 (47.3%) were uneducated. Educated participants were significantly more likely to have heard about HIV (183 vs. 39, p < 0.001) and had better knowledge about the symptoms of HIV/AIDS (p < 0.001). Among the participants who knew about AIDS, a greater percentage of uneducated (n = 28, 53%) than educated individuals (n = 68, 37%) believed that people suffering from AIDS should be isolated (p = o.o16) and that HIV can spread through water (40% vs 20% respectively, p < 0.001). Both educated (n = 49, 27%) and uneducated (n = 46, 89%) adults believed that awareness would help prevent the spread of HIV (p = 0.978) and were willing to educate their children about it (p = 0.696). Conclusion Our study revealed a gap in the knowledge about HIV/AIDS between educated and uneducated adults. There is an urgent need for awareness programs that especially reach out to the uneducated masses that are otherwise uninformed about HIV and are under high risk of acquiring HIV. PMID:28706763

  5. A Controlled Study of Funding for Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome as Resource Capacity Building in the Health System in Rwanda

    PubMed Central

    Shepard, Donald S.; Zeng, Wu; Amico, Peter; Rwiyereka, Angelique K.; Avila-Figueroa, Carlos

    2012-01-01

    Because human inmmunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) receives more donor funding globally than that for all other diseases combined, some critics allege this support undermines general health care. This empirical study evaluates the impact of HIV/AIDS funding on the primary health care system in Rwanda. Using a quasi-experimental design, we randomly selected 25 rural health centers (HCs) that started comprehensive HIV/AIDS services from 2002 through 2006 as the intervention group. Matched HCs with no HIV/AIDS services formed the control group. The analysis compared growth in inputs and services between intervention and control HCs with a difference-in-difference analysis in a random-effects model. Intervention HCs performed better than control HCs in most services (seven of nine), although only one of these improvements (Bacille Calmette-Guérin vaccination) reached or approached statistical significance. In conclusion, this six-year controlled study found no adverse effects of the expansion of HIV/AIDS services on non-HIV services among rural health centers in Rwanda. PMID:22556094

  6. A controlled study of funding for human immunodeficiency virus/acquired immunodeficiency syndrome as resource capacity building in the health system in Rwanda.

    PubMed

    Shepard, Donald S; Zeng, Wu; Amico, Peter; Rwiyereka, Angelique K; Avila-Figueroa, Carlos

    2012-05-01

    Because human inmmunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) receives more donor funding globally than that for all other diseases combined, some critics allege this support undermines general health care. This empirical study evaluates the impact of HIV/AIDS funding on the primary health care system in Rwanda. Using a quasi-experimental design, we randomly selected 25 rural health centers (HCs) that started comprehensive HIV/AIDS services from 2002 through 2006 as the intervention group. Matched HCs with no HIV/AIDS services formed the control group. The analysis compared growth in inputs and services between intervention and control HCs with a difference-in-difference analysis in a random-effects model. Intervention HCs performed better than control HCs in most services (seven of nine), although only one of these improvements (Bacille Calmette-Guérin vaccination) reached or approached statistical significance. In conclusion, this six-year controlled study found no adverse effects of the expansion of HIV/AIDS services on non-HIV services among rural health centers in Rwanda.

  7. Neurodevelopmental Impairment among Infants Born to Mothers Infected with Human Immunodeficiency Virus and Uninfected Mothers from Three Peri-Urban Primary Care Clinics in Harare, Zimbabwe

    ERIC Educational Resources Information Center

    Kandawasvika, Gwendoline Q.; Ogundipe, Enitan; Gumbo, Felicity Z.; Kurewa, Edith N.; Mapingure, Munyaradzi P.; Stray-Pedersen, Babill

    2011-01-01

    Aim: The aim of this article is to document the risk of neurodevelopmental impairment (NDI) among infants enrolled in a programme for the prevention of mother-to-child transmission of HIV (human immunodeficiency virus) in Zimbabwe using the Bayley Infant Neurodevelopmental Screener (BINS). Method: We prospectively followed up infants at three…

  8. Feline immunodeficiency virus envelope glycoprotein mediates apoptosis in activated PBMC by a mechanism dependent on gp41 function

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Garg, Himanshu; Joshi, Anjali; Tompkins, Wayne A.

    2004-12-20

    Feline Immunodeficiency Virus (FIV) is a lentivirus that causes immunodeficiency in cats, which parallels HIV-1-induced immunodeficiency in humans. It has been established that HIV envelope (Env) glycoprotein mediates T cell loss via a mechanism that requires CXCR4 binding. The Env glycoprotein of FIV, similar to HIV, requires CXCR4 binding for viral entry, as well as inducing membrane fusion leading to syncytia formation. However, the role of FIV Env in T cell loss and the molecular mechanisms governing this process have not been elucidated. We studied the role of Env glycoprotein in FIV-mediated T cell apoptosis in an in vitro model.more » Our studies demonstrate that membrane-expressed FIV Env induces apoptosis in activated feline peripheral blood mononuclear cells (PBMC) by a mechanism that requires CXCR4 binding, as the process was inhibited by CXCR4 antagonist AMD3100 in a dose-dependent manner. Interestingly, studies regarding the role of CD134, the recently identified primary receptor of FIV, suggest that binding to CD134 may not be important for induction of apoptosis in PBMC. However, inhibiting Env-mediated fusion post CXCR4 binding by FIV gp41-specific fusion inhibitor also inhibited apoptosis. Under similar conditions, a fusion-defective gp41 mutant was unable to induce apoptosis in activated PBMC. Our findings are the first report suggesting the potential of FIV Env to mediate apoptosis in bystander cells by a process that is dependent on gp41 function.« less

  9. Management of a rare presentation of Vogt-Koyanagi-Harada disease in human immunodeficiency virus/acquired immunodeficiency disease syndrome patient.

    PubMed

    Priya, D; Sudharshan, S; Biswas, Jyotirmay

    2017-05-01

    Vogt-Koyanagi-Harada (VKH), a multisystem autoimmune bilateral panuveitis with systemic manifestations, is uncommon in immunocompromised patients such as human immunodeficiency virus (HIV)/acquired immunodeficiency disease syndrome (AIDS). We report a rare presentation of VKH in a 45-year-old HIV-positive female on highly active antiretroviral therapy (HAART) who presented with a history of recurrent panuveitis. A diagnosis of probable VKH was made based on ocular and systemic signs and symptoms. She was treated with topical and systemic steroids with close monitoring of CD4 counts and viral loads. After inflammation control, complicated cataract was managed surgically under perioperative steroid cover. VKH in HIV/AIDS has not been reported earlier. This case shows that significant inflammation can be seen even in HIV/AIDS patients on HAART with VKH in spite of moderate CD4 counts. Management is a challenge considering the systemic risks with long-term use of steroids.

  10. Pediatric allergy and immunology in Brazil.

    PubMed

    Rosario-Filho, Nelson A; Jacob, Cristina M; Sole, Dirceu; Condino-Neto, Antonio; Arruda, Luisa K; Costa-Carvalho, Beatriz; Cocco, Renata R; Camelo-Nunes, Inês; Chong-Neto, Herberto J; Wandalsen, Gustavo F; Castro, Ana P M; Yang, Ariana C; Pastorino, Antonio C; Sarinho, Emanuel S

    2013-06-01

    The subspecialty of pediatric allergy and immunology in Brazil is in its early years and progressing steadily. This review highlights the research developed in the past years aiming to show the characteristics of allergic and immunologic diseases in this vast country. Epidemiologic studies demonstrated the high prevalence of asthma in infants, children, and adolescents. Mortality rates and average annual variation of asthma hospitalization have reduced in all pediatric age groups. Indoor aeroallergen exposure is excessively high and contributes to the high rates of allergy sensitization. Prevalence of food allergy has increased to epidemic levels. Foods (35%), insect stings (30%), and drugs (23%) are the main etiological agents of anaphylaxis in children and adolescents. Molecular diagnosis of primary immunodeficiencies (PID) showed a high incidence of fungal infections including paracoccidioidomycosis in X-linked hyper-IgM syndrome, and the occurrence of BCG adverse reactions or other mycobacterial infections in patients with chronic granulomatous disease. Education in pediatric allergy and immunology is deficient for medical students, but residency programs are effective in training internists and pediatricians for the practice of allergy. The field of PID requires further training. Last, this review is a tribute to Prof. Dr. Charles Naspitz, one of the pioneers of our specialty in Brazil. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  11. Genetics Home Reference: X-linked immunodeficiency with magnesium defect, Epstein-Barr virus infection, and neoplasia

    MedlinePlus

    ... Share: Email Facebook Twitter Home Health Conditions XMEN X-linked immunodeficiency with magnesium defect, Epstein-Barr virus ... Javascript to view the expand/collapse boxes. Description X-linked immunodeficiency with magnesium defect, Epstein-Barr virus ...

  12. Cellular Restriction Factors of Feline Immunodeficiency Virus

    PubMed Central

    Zielonka, Jörg; Münk, Carsten

    2011-01-01

    Lentiviruses are known for their narrow cell- and species-tropisms, which are determined by cellular proteins whose absence or presence either support viral replication (dependency factors, cofactors) or inhibit viral replication (restriction factors). Similar to Human immunodeficiency virus type 1 (HIV-1), the cat lentivirus Feline immunodeficiency virus (FIV) is sensitive to recently discovered cellular restriction factors from non-host species that are able to stop viruses from replicating. Of particular importance are the cellular proteins APOBEC3, TRIM5α and tetherin/BST-2. In general, lentiviruses counteract or escape their species’ own variant of the restriction factor, but are targeted by the orthologous proteins of distantly related species. Most of the knowledge regarding lentiviral restriction factors has been obtained in the HIV-1 system; however, much less is known about their effects on other lentiviruses. We describe here the molecular mechanisms that explain how FIV maintains its replication in feline cells, but is largely prevented from cross-species infections by cellular restriction factors. PMID:22069525

  13. Dysregulation of Innate Lymphoid Cells in Common Variable Immunodeficiency.

    PubMed

    Maglione, Paul J; Cols, Montserrat; Cunningham-Rundles, Charlotte

    2017-10-05

    Common variable immunodeficiency (CVID) is the most prevalent symptomatic primary immune deficiency. With widespread use of immunoglobulin replacement therapy, non-infectious complications, such as autoimmunity, chronic intestinal inflammation, and lung disease, have replaced infections as the major cause of morbidity and mortality in this immune deficiency. The pathogenic mechanisms that underlie the development of these complications in CVID are not known; however, there have been numerous associated laboratory findings. Among the most intriguing of these associations is elevation of interferon signature genes in CVID patients with inflammatory/autoimmune complications, as a similar gene expression profile is found in systemic lupus erythematosus and other chronic inflammatory diseases. Linked with this heightened interferon signature in CVID is an expansion of circulating IFN-γ-producing innate lymphoid cells. Innate lymphoid cells are key regulators of both protective and pathogenic immune responses that have been extensively studied in recent years. Further exploration of innate lymphoid cell biology in CVID may uncover key mechanisms underlying the development of inflammatory complications in these patients and may inspire much needed novel therapeutic approaches.

  14. Dysregulation of Innate Lymphoid Cells in Common Variable Immunodeficiency

    PubMed Central

    Maglione, Paul J.; Cols, Montserrat

    2018-01-01

    Common variable immunodeficiency (CVID) is the most prevalent symptomatic primary immune deficiency. With widespread use of immunoglobulin replacement therapy, non-infectious complications, such as autoimmunity, chronic intestinal inflammation, and lung disease, have replaced infections as the major cause of morbidity and mortality in this immune deficiency. The pathogenic mechanisms that underlie the development of these complications in CVID are not known; however, there have been numerous associated laboratory findings. Among the most intriguing of these associations is elevation of interferon signature genes in CVID patients with inflammatory/autoimmune complications, as a similar gene expression profile is found in systemic lupus erythematosus and other chronic inflammatory diseases. Linked with this heightened interferon signature in CVID is an expansion of circulating IFN-γ-producing innate lymphoid cells. Innate lymphoid cells are key regulators of both protective and pathogenic immune responses that have been extensively studied in recent years. Further exploration of innate lymphoid cell biology in CVID may uncover key mechanisms underlying the development of inflammatory complications in these patients and may inspire much needed novel therapeutic approaches. PMID:28983810

  15. Escape is a more common mechanism than avidity reduction for evasion of CD8+ T cell responses in primary human immunodeficiency virus type 1 infection

    PubMed Central

    2011-01-01

    Background CD8+ T cells play an important role in control of viral replication during acute and early human immunodeficiency virus type 1 (HIV-1) infection, contributing to containment of the acute viral burst and establishment of the prognostically-important persisting viral load. Understanding mechanisms that impair CD8+ T cell-mediated control of HIV replication in primary infection is thus of importance. This study addressed the relative extent to which HIV-specific T cell responses are impacted by viral mutational escape versus reduction in response avidity during the first year of infection. Results 18 patients presenting with symptomatic primary HIV-1 infection, most of whom subsequently established moderate-high persisting viral loads, were studied. HIV-specific T cell responses were mapped in each individual and responses to a subset of optimally-defined CD8+ T cell epitopes were followed from acute infection onwards to determine whether they were escaped or declined in avidity over time. During the first year of infection, sequence variation occurred in/around 26/33 epitopes studied (79%). In 82% of cases of intra-epitopic sequence variation, the mutation was confirmed to confer escape, although T cell responses were subsequently expanded to variant sequences in some cases. In contrast, < 10% of responses to index sequence epitopes declined in functional avidity over the same time-frame, and a similar proportion of responses actually exhibited an increase in functional avidity during this period. Conclusions Escape appears to constitute a much more important means of viral evasion of CD8+ T cell responses in acute and early HIV infection than decline in functional avidity of epitope-specific T cells. These findings support the design of vaccines to elicit T cell responses that are difficult for the virus to escape. PMID:21635736

  16. Performance analysis for bounded persistent disturbances in PD/PID-controlled robotic systems with its experimental demonstrations

    NASA Astrophysics Data System (ADS)

    Kim, Jung Hoon; Hur, Sung-Moon; Oh, Yonghwan

    2018-03-01

    This paper is concerned with performance analysis of proportional-derivative/proportional-integral-derivative (PD/PID) controller for bounded persistent disturbances in a robotic manipulator. Even though the notion of input-to-state stability (ISS) has been widely used to deal with the effect of disturbances in control of a robotic manipulator, the corresponding studies cannot be directly applied to the treatment of persistent disturbances occurred in robotic manipulators. This is because the conventional studies relevant to ISS consider the H∞ performance for robotic systems, which is confined to the treatment of decaying disturbances, i.e. the disturbances those in the L2 space. To deal with the effect of persistent disturbances in robotic systems, we first provide a new treatment of ISS in the L∞ sense because bounded persistent disturbances should be intrinsically regarded as elements of the L∞ space. We next derive state-space representations of trajectory tracking control in the robotic systems which allow us to define the problem formulations more clearly. We then propose a novel control law that has a PD/PID control form, by which the trajectory tracking system satisfies the reformulated ISS. Furthermore, we can obtain a theoretical argument about the L∞ gain from the disturbance to the regulated output through the proposed control law. Finally, experimental studies for a typical 3-degrees of freedom robotic manipulator are given to demonstrate the effectiveness of the method introduced in this paper.

  17. Role of Feline Immunodeficiency Virus in Lymphomagenesis--Going Alone or Colluding?

    PubMed

    Kaye, Sarah; Wang, Wenqi; Miller, Craig; McLuckie, Alicia; Beatty, Julia A; Grant, Chris K; VandeWoude, Sue; Bielefeldt-Ohmann, Helle

    2016-01-01

    Feline immunodeficiency virus (FIV) is a naturally occurring lentivirus of domestic and nondomestic feline species. Infection in domestic cats leads to immune dysfunction via mechanisms similar to those caused by human immunodeficiency virus (HIV) and, as such, is a valuable natural animal model for acquired immunodeficiency syndrome (AIDS) in humans. An association between FIV and an increased incidence of neoplasia has long been recognized, with frequencies of up to 20% in FIV-positive cats recorded in some studies. This is similar to the rate of neoplasia seen in HIV-positive individuals, and in both species neoplasia typically requires several years to arise. The most frequently reported type of neoplasia associated with FIV infection is lymphoma. Here we review the possible mechanisms involved in FIV lymphomagenesis, including the possible involvement of coinfections, notably those with gamma-herpesviruses. © The Author 2016. Published by Oxford University Press on behalf of the Institute for Laboratory Animal Research. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  18. Trajectory following and stabilization control of fully actuated AUV using inverse kinematics and self-tuning fuzzy PID.

    PubMed

    Hammad, Mohanad M; Elshenawy, Ahmed K; El Singaby, M I

    2017-01-01

    In this work a design for self-tuning non-linear Fuzzy Proportional Integral Derivative (FPID) controller is presented to control position and speed of Multiple Input Multiple Output (MIMO) fully-actuated Autonomous Underwater Vehicles (AUV) to follow desired trajectories. Non-linearity that results from the hydrodynamics and the coupled AUV dynamics makes the design of a stable controller a very difficult task. In this study, the control scheme in a simulation environment is validated using dynamic and kinematic equations for the AUV model and hydrodynamic damping equations. An AUV configuration with eight thrusters and an inverse kinematic model from a previous work is utilized in the simulation. In the proposed controller, Mamdani fuzzy rules are used to tune the parameters of the PID. Nonlinear fuzzy Gaussian membership functions are selected to give better performance and response in the non-linear system. A control architecture with two feedback loops is designed such that the inner loop is for velocity control and outer loop is for position control. Several test scenarios are executed to validate the controller performance including different complex trajectories with and without injection of ocean current disturbances. A comparison between the proposed FPID controller and the conventional PID controller is studied and shows that the FPID controller has a faster response to the reference signal and more stable behavior in a disturbed non-linear environment.

  19. Trajectory following and stabilization control of fully actuated AUV using inverse kinematics and self-tuning fuzzy PID

    PubMed Central

    Elshenawy, Ahmed K.; El Singaby, M.I.

    2017-01-01

    In this work a design for self-tuning non-linear Fuzzy Proportional Integral Derivative (FPID) controller is presented to control position and speed of Multiple Input Multiple Output (MIMO) fully-actuated Autonomous Underwater Vehicles (AUV) to follow desired trajectories. Non-linearity that results from the hydrodynamics and the coupled AUV dynamics makes the design of a stable controller a very difficult task. In this study, the control scheme in a simulation environment is validated using dynamic and kinematic equations for the AUV model and hydrodynamic damping equations. An AUV configuration with eight thrusters and an inverse kinematic model from a previous work is utilized in the simulation. In the proposed controller, Mamdani fuzzy rules are used to tune the parameters of the PID. Nonlinear fuzzy Gaussian membership functions are selected to give better performance and response in the non-linear system. A control architecture with two feedback loops is designed such that the inner loop is for velocity control and outer loop is for position control. Several test scenarios are executed to validate the controller performance including different complex trajectories with and without injection of ocean current disturbances. A comparison between the proposed FPID controller and the conventional PID controller is studied and shows that the FPID controller has a faster response to the reference signal and more stable behavior in a disturbed non-linear environment. PMID:28683071

  20. Clinical, laboratory and molecular signs of immunodeficiency in patients with partial oculo-cutaneous albinism

    PubMed Central

    2013-01-01

    Hypopigmentation disorders that are associated with immunodeficiency feature both partial albinism of hair, skin and eyes together with leukocyte defects. These disorders include Chediak Higashi (CHS), Griscelli (GS), Hermansky-Pudlak (HPS) and MAPBP-interacting protein deficiency syndromes. These are heterogeneous autosomal recessive conditions in which the causal genes encode proteins with specific roles in the biogenesis, function and trafficking of secretory lysosomes. In certain specialized cells, these organelles serve as a storage compartment. Impaired secretion of specific effector proteins from that intracellular compartment affects biological activities. In particular, these intracellular granules are essential constituents of melanocytes, platelets, granulocytes, cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells. Thus, abnormalities affect pigmentation, primary hemostasis, blood cell counts and lymphocyte cytotoxic activity against microbial pathogens. Among eight genetically distinct types of HPS, only type 2 is characterized by immunodeficiency. Recently, a new subtype, HPS9, was defined in patients presenting with immunodeficiency and oculocutaneous albinism, associated with mutations in the pallidin-encoding gene, PLDN. Hypopigmentation together with recurrent childhood bacterial or viral infections suggests syndromic albinism. T and NK cell cytotoxicity are generally impaired in patients with these disorders. Specific clinical and biochemical phenotypes can allow differential diagnoses among these disorders before molecular testing. Ocular symptoms, including nystagmus, that are usually evident at birth, are common in patients with HPS2 or CHS. Albinism with short stature is unique to MAPBP-interacting protein (MAPBPIP) deficiency, while hemophagocytic lymphohistiocytosis (HLH) mainly suggests a diagnosis of CHS or GS type 2 (GS2). Neurological disease is a long-term complication of CHS, but is uncommon in other syndromic albinism