Diabetes, mortality and glucose monitoring rates in the TREAT Asia HIV Observational Database Low Intensity Transfer (TAHOD-LITE) study.

OBJECTIVES: Diabetes is a growing cause of morbidity and mortality in people living with HIV (PLHIV) receiving antiretroviral therapy (ART). We investigated the association between fasting plasma glucose (FPG) levels and mortality, and factors associated with FPG monitoring rates in Asia. METHODS: Patients from the Therapeutics Research, Education, and AIDS Training in Asia (TREAT Asia) HIV Observational Database Low Intensity Transfer (TAHOD-LITE) cohort were included in the present study if they had initiated ART. Competing risk and Poisson regression were used to analyse the association between FPG and mortality, and assess risk factors for FPG monitoring rates, respectively. FPG was categorized as diabetes (FPG ≥ 7.0 mmol/L), prediabetes (FPG 5.6-6.9 mmol/L) and normal FPG (FPG < 5.6 mmol/L). RESULTS: In total, 33 232 patients were included in the analysis. Throughout follow-up, 59% had no FPG test available. The incidence rate for diabetes was 13.7 per 1000 person-years in the 4649 patients with normal FPG at ART initiation. Prediabetes [sub-hazard ratio (sHR) 1.32; 95% confidence interval (CI) 1.07-1.64] and diabetes (sHR 1.90; 95% CI 1.52-2.38) were associated with mortality compared to those with normal FPG. FPG monitoring increased from 0.34 to 0.78 tests per person-year from 2012 to 2016 (P < 0.001). Male sex [incidence rate ratio (IRR) 1.08; 95% CI 1.03-1.12], age > 50 years (IRR 1.14; 95% CI 1.09-1.19) compared to ≤ 40 years, and CD4 count ≥ 500 cells/µL (IRR 1.04; 95% CI 1.00-1.09) compared to < 200 cells/µL were associated with increased FPG monitoring. CONCLUSIONS: Diabetes and prediabetes were associated with mortality. FPG monitoring increased over time; however, less than half of our cohort had been tested. Greater resources should be allocated to FPG monitoring for early diabetic treatment and intervention and to optimize survival.

Cardiovascular disease-related mortality and factors associated with cardiovascular events in the TREAT Asia HIV Observational Database (TAHOD).

OBJECTIVES: With aging of the HIV-positive population, cardiovascular disease (CVD) increasingly contributes to morbidity and mortality. We investigated CVD-related and other causes of death (CODs) and factors associated with CVD in a multi-country Asian HIV-positive cohort. METHODS: Patient data from 2003-2017 were obtained from the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD). We included patients on antiretroviral therapy (ART) with > 1 day of follow-up. Cumulative incidences were plotted for CVD-related, AIDS-related, non-AIDS-related, and unknown CODs, and any CVD (i.e. fatal and nonfatal). Competing risk regression was used to assess risk factors of any CVD. RESULTS: Of 8069 patients with a median follow-up of 7.3 years [interquartile range (IQR) 4.4-10.7 years], 378 patients died [incidence rate (IR) 6.2 per 1000 person-years (PY)], and this total included 22 CVD-related deaths (IR 0.36 per 1000 PY). Factors significantly associated with any CVD event (IR 2.2 per 1000 PY) were older age [sub-hazard ratio (sHR) 2.21; 95% confidence interval (CI) 1.36-3.58 for age 41-50 years; sHR 5.52; 95% CI 3.43-8.91 for ≥ 51 years, compared with < 40 years], high blood pressure (sHR 1.62; 95% CI 1.04-2.52), high total cholesterol (sHR 1.89; 95% CI 1.27-2.82), high triglycerides (sHR 1.55; 95% CI 1.02-2.37) and high body mass index (BMI) (sHR 1.66; 95% CI 1.12-2.46). CVD crude IRs were lower in the later ART initiation period and in lower middle- and upper middle-income countries. CONCLUSIONS: The development of fatal and nonfatal CVD events in our cohort was associated with older age, and treatable risk factors such as high blood pressure, triglycerides, total cholesterol and BMI. Lower CVD event rates in middle-income countries may indicate under-diagnosis of CVD in Asian-Pacific resource-limited settings.

Evidence for Triangular D_{3h}

We derive the rotation-vibration spectrum of a 3α+1 neutron(proton) configuration with triangular D_{3h} symmetry by exploiting the properties of the double group D_{3h}^{'} and show evidence for this symmetry to occur in the rotation-vibration spectra of ^{13}C. Our results, based on purely symmetry considerations, provide benchmarks for microscopic calculations of the cluster structure of light nuclei.

Evidence for tetrahedral symmetry in (16)O.

We derive the rotation-vibration spectrum of a 4α configuration with tetrahedral symmetry Td and show evidence for the occurrence of this symmetry in the low-lying spectrum of (16)O. All vibrational states with A, E, and F symmetry appear to have been observed as well as the rotational bands with LP=0+, 3-, 4+, 6+ on the A states and part of the rotational bands built on the E, F states. We derive analytic expressions for the form factors and B(EL) values of the ground-state rotational band and show that the measured values support the tetrahedral symmetry of this band.

Evidence for triangular D3h symmetry in 12C.

We report a measurement of a new high spin Jπ=5- state at 22.4(2) MeV in 12C which fits very well to the predicted (ground state) rotational band of an oblate equilateral triangular spinning top with a D3h symmetry characterized by the sequence 0+, 2+, 3-, 4±, 5- with almost degenerate 4+ and 4- (parity doublet) states. Such a D3h symmetry was observed in triatomic molecules, and it is observed here for the first time in nuclear physics. We discuss a classification of other rotation-vibration bands in 12C such as the (0+) Hoyle band and the (1-) bending mode band and suggest measurements in search of the predicted ("missing") states that may shed new light on clustering in 12C and light nuclei. In particular, the observation (or nonobservation) of the predicted ("missing") states in the Hoyle band will allow us to conclude the geometrical arrangement of the three alpha particles composing the Hoyle state at 7.654 MeV in 12C.

Band structure from random interactions

The anharmonic vibrator and rotor regions in nuclei are investigated in the framework of the interacting boson model using an ensemble of random one- and two-body interactions. We find a predominance of L(P) = 0(+) ground states, as well as strong evidence for the occurrence of both vibrational and rotational band structures. This remarkable result suggests that such band structures represent a far more general (robust) property of the collective model space than is generally thought.

Two-nucleon transfer reactions uphold supersymmetry in atomic nuclei.

The spectroscopic strengths of two-nucleon transfer reactions constitute a stringent test for two-nucleon correlations in the nuclear wave functions. A set of closed analytic expressions for ratios of spectroscopic factors is derived in the framework of nuclear supersymmetry. These ratios are parameter independent and provide a direct test of the wave functions. A comparison between the recently measured 198Hg(d-->,alpha)196Au reaction and the predictions from the nuclear quartet supersymmetry lends further support to the validity of supersymmetry in nuclear physics.

B(E2) upward arrow measurements for radioactive neutron-rich ge isotopes: reaching the N=50 closed shell.

The B(E2;0(+)(1)-->2(+)(1)) values for the radioactive neutron-rich germanium isotopes (78,80)Ge and the closed neutron shell nucleus 82Ge were measured at the HRIBF using Coulomb excitation in inverse kinematics. These data allow a study of the systematic trend between the subshell closures at N=40 and 50. The B(E2) behavior approaching N=50 is similar to the trend observed for heavier isotopic chains. A comparison of the experimental results with a shell model calculation demonstrates persistence of the N=50 shell gap and a strong sensitivity of the B(E2) values to the effective interaction.

On the Elimination of Spurious Modes in Algebraic Models of Molecular Vibrations.

Spurious states arise naturally in the description of molecular vibrational excitations. In the harmonic approximation such states can be projected out from the physical space exactly. This is in general not the case when anharmonic interactions are considered. We show that within the framework of the symmetry, adapted vibron models which include anharmonicities from the outset, these states can be removed in an exact fashion. Copyright 1999 Academic Press.