RESUMEN
Traditional general circulation models, or GCMs-that is, three-dimensional dynamical models with unresolved terms represented in equations with tunable parameters-have been a mainstay of climate research for several decades, and some of the pioneering studies have recently been recognized by a Nobel prize in Physics. Yet, there is considerable debate around their continuing role in the future. Frequently mentioned as limitations of GCMs are the structural error and uncertainty across models with different representations of unresolved scales and the fact that the models are tuned to reproduce certain aspects of the observed Earth. We consider these shortcomings in the context of a future generation of models that may address these issues through substantially higher resolution and detail, or through the use of machine learning techniques to match them better to observations, theory, and process models. It is our contention that calibration, far from being a weakness of models, is an essential element in the simulation of complex systems, and contributes to our understanding of their inner workings. Models can be calibrated to reveal both fine-scale detail and the global response to external perturbations. New methods enable us to articulate and improve the connections between the different levels of abstract representation of climate processes, and our understanding resides in an entire hierarchy of models where GCMs will continue to play a central role for the foreseeable future.
Asunto(s)
Cambio Climático , Clima , Predicción , Simulación por Computador , FísicaRESUMEN
In a prospective cohort of 82 renal transplant recipients, we evaluated the capacity of the cytomegalovirus (CMV) load in whole blood (WB) to predict the plasma CMV load, aiming to identify active CMV infections by using WB samples only and to deduce a WB threshold. Using quantitative real-time PCR, a total of 1,474 WB samples were assayed, of which 279 were positive for CMV, and 140 out of the 276 paired plasma samples tested positive. Thirty (36.6%) patients presented with at least one positive plasma PCR result, and 21 infection episodes (19 patients) required curative treatment (median follow-up time, 12 months). When the plasma CMV load was >500 copies/ml (n = 70), more than 94% (95% confidence interval, 86.0%, 98.4%) of WB samples had >500 copies/ml. Two prediction models were built: log(10) plasma viral load (VL) was calculated as -0.3777 + 0.9342 x log(10) WB VL and as -0.3777 + 0.8563 x log(10) WB VL for patients with and without treatment, respectively. In the validation sample (578 routine samples), 77.2% of the observed and expected plasma viral loads were concordant (95% confidence intervals, 73.5 and 80.5%). According to the model, the plasma viral load was >500 copies/ml when the WB load was >3,170 or >4,000 copies/ml in patients with or without treatment, respectively. WB seems to be an appropriate candidate for routine CMV monitoring of transplant recipients by using a single assay.
Asunto(s)
Sangre/virología , Infecciones por Citomegalovirus/virología , Trasplante de Riñón , Plasma/virología , Reacción en Cadena de la Polimerasa/métodos , Carga Viral/métodos , Adulto , Estudios de Cohortes , Citomegalovirus/aislamiento & purificación , Femenino , Humanos , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
BACKGROUND: Variability of human cytomegalovirus (HCMV) genes counteracting immune responses is poorly investigated in non-cultured clinical strains. OBJECTIVES: In HCMV-infected renal graft recipients, we aimed to (i) investigate the variability of four HCMV immunomodulatory genes, without any culture-related viral selection, (ii) provide evolutionary sequence data, and (iii) study co-existing HCMV variants and their evolution. STUDY DESIGN: UL18, UL40, UL111a and US3 were sequenced in 31 blood samples from 17 patients (8 with sequential samples). Cloning of UL40 PCR products was performed in one donor-positive/recipient-positive (D+/R+) patient's samples. RESULTS: Each patient harboured a unique strain (combination of four genes), however single identical genes were demonstrated among various patients, suggesting recombination events. Sequencing showed in D+/R- recipients, either complete gene stability (four patients) or significant variability (one patient); in three D+/R+ patients, multiple gene variations, possibly linked to super- or co-infections. Cloning evidenced different variants at each time point with an increasing variability over time, illustrating possibly viral reactivations and the subsequent evolution of the variants mixture. CONCLUSION: A noticeable HCMV natural polymorphism was shown, with different evolutive patterns. Moreover, we described the co-evolution of variants mixtures in one patient. Consequences on HCMV infection and graft function deserve further studying.