Space Weathering Effects in Troilite by Simulated Solar-Wind Hydrogen and Helium Ion Irradiation.

Space weathering is a key process in the interpretation of airless planetary surfaces. As we engage new missions to planetary objects with potentially novel surfaces such as 16 Psyche, there is renewed interest in expanding our knowledge of space weathering effects to a wider variety of analog materials, including the physical/chemical effects of solar-wind ions on planetary regoliths. We have experimentally simulated the effects of solar ions on two polished thick sections of meteoritic troilite (FeS) via irradiation with 1 keV hydrogen (H+) and 4 keV helium (He+), to investigate effects resulting from different ion species. We detected depletion of sulfur over the course of each irradiation using in situ X-ray photoelectron spectroscopy. Sulfur depletion rates were surprisingly similar for H+ and He+, interpreted as a function of subsurface ion-activated diffusion. By comparing XPS-derived elemental abundances with SDTrimSP computer simulations, we further quantified sulfur diffusion, sputtering yield, and altered-layer composition with respect to incident-ion fluence, and accounted for the influence of surface oxidation due to atmospheric sample storage. Using scanning electron microscopy, we detected an increase in nanoscale surface roughness resulting from the irradiation, which we quantified using atomic force microscopy. Based on these results, we estimate that an exposure time of order 103 Earth-years is required for troilite on Psyche to reach equilibrium sulfur depletion within the first atomic layer.

Intimidad y soledad en los diálogos: juegos sexuales psicoanalíticos: aproximación desde Bion y Winnicott / Intimacy and solitude in the psychoanalytic dialogues: sexual games: approximation from Bion and Winnicott

Los autores exponen un modelo de trabajo y comprensión de la situación analítica que implica consideraciones técnicas y teóricas. Se postula que el inicio del diálogo con pacientes que presentan anorgasmia primaria, debe ir desde “afuera” hacia “adentro”, desde lo empírico a lo teórico. Se piensa el encuentro sexual en estos casos, como un desafío a la intimidad de ser uno solo con el otro. Un desafío de separación y de ruptura de la simbiosis que se estableció en el encuentro. Conceptualizaciones que aluden a ideas como las de continente-contenido de Bion y de espacio potencial o “capacidad de estar solo” de Winnicott, adquieren particular relevancia en las reflexiones que se despliegan. Se establece una dimensión de la interpretación denominada “presencia”-“ausencia” y se postula la importancia de su consideración en el trabajo técnico.Finalmente se ilustran las propuestas con el caso de una mujer con anorgasmia primaria

The authors present, a model for the work and understanding of the analytic situation, which implies technical and theoretical considerations. It postulates that the beginning of the dialogue with patients that present primary anorgasmia must go from the “outside” towards the “inside”, from empirical to theoretical. Sexual encounters are thought about in these cases as a challenge for the intimacy of being oneself with the other, and also as a challenge for separation and rupture, from the symbiosis established in the encounter. Conceptualizations referring to ideas such as Bion´s container-contained and Winnicott´s “capacity to be alone”, gain particular relevance in the reflections developed here. A dimension of the interpretation entitled “presence-absence” is established, and the importance of its consideration in the technical work is proposed.Finally, this proposal is illustrated with the case of a woman with primary anorgasmia

Contra-reacción terapéutica negativa o el analista incontinente. Reflexiones en torno a los quiebres de la confidencialidad / Negative therapeutic counter-reaction or the incontinent analyst. Reflections on the breaks in confidentiality

El autor comienza el trabajo con una reflexión desde su experiencia, en torno a los quiebres de la confidencialidad, fenómeno frecuente y dañino para el paciente y su entorno. Se señala que la literatura, conceptualiza la confidencialidad como un aspecto inherente y constitutivo del psicoanálisis. Una gran parte de los trabajos anteriores que tratan el tema, se centran en la búsqueda de la psicopatología del terapeuta que efectúa quiebres de la confidencialidad. Se plantea que independiente de la psicología del analista, se trata de una falla técnica que agrede el proceso terapéutico, menoscabando las condiciones necesarias para el progreso del tratamiento y alterando tanto la asociación libre como la atención flotante, esto es, independiente del daño que la infidencia en sí misma pudo producir.Además, se propone una clasificación de los distintos tipos de quiebres de confidencialidad, con el propósito de ordenar este complejo fenómeno

The author begins this paper with a self-reflection, from the perspective of his own experience about the breach of confidentiality, a phenomenon that is common and harmful for the patient and his environment. He points out that the literature conceptualizes confidentiality as an inherent and constitutive aspect of psychoanalysis. Previous papers about this issue had focused mainly on the psychopathology of the therapist who breaks the confidentiality. In this work the author argues that, besides the psychology of the analyst, it is a technical fault that attacks the therapeutic process, undermining the necessary conditions for treatment progress and altering both free association and floating attention, independently of the harm that the misfeasance in itself could produce. Finally, the author proposes a classification scheme of the different types of breaks in confidentiality, in order to organize this complex phenomenon

Secondary electron emission spectra from clean and cesiated Al surfaces: the role of plasmon decay and data analysis for applications.

We report measurements of energy spectra of secondary electrons emitted from clean and cesiated aluminum surfaces under the impact of 130 eV electrons. Measurements show that the decay of bulk and surface plasmons dominates the electron emission. In contrast with theoretical calculations, our experiments indicate that the electron collision cascade inside the solid produced by electrons excited by plasmon decay do not contribute significantly to electron emission. A simple analysis of electron energy distributions measured as a function of Cs surface coverage allows separation of rediffused incident electrons from the continuum background of true secondary electrons. The result shows that yields of rediffused electrons used in several applications may have been significantly overestimated.

Genome-wide pharmacogenetic investigation of a hepatic adverse event without clinical signs of immunopathology suggests an underlying immune pathogenesis.

One of the major goals of pharmacogenetics is to elucidate mechanisms and identify patients at increased risk of adverse events (AEs). To date, however, there have been only a few successful examples of this type of approach. In this paper, we describe a retrospective case-control pharmacogenetic study of an AE of unknown mechanism, characterized by elevated levels of serum alanine aminotransferase (ALAT) during long-term treatment with the oral direct thrombin inhibitor ximelagatran. The study was based on 74 cases and 130 treated controls and included both a genome-wide tag single nucleotide polymorphism and large-scale candidate gene analysis. A strong genetic association between elevated ALAT and the MHC alleles DRB1(*)07 and DQA1(*)02 was discovered and replicated, suggesting a possible immune pathogenesis. Consistent with this hypothesis, immunological studies suggest that ximelagatran may have the ability to act as a contact sensitizer, and hence be able to stimulate an adaptive immune response.

Terapia analítica de la díada madre-hijo y cambio psíquico / The analytic therapy of mother infant dyad

Este trabajo pretende explorar una modalidad de psicoterapia analítica aplicada a la díada madre-hijo, donde el objeto de análisis no es una persona, sino la relación madre-hijo. Este abordaje propone hacer uso tanto de aquello que nos informan las relaciones de objeto contenidas en la transferencia y contratransferencia, como de aquellos elementos vinculares que emergen de la interacción recíproca y que se dan en el contexto del encuadre terapéutico. El reconocimiento y consideración por parte del terapeuta de aquella madre e hijo "reales" pero dinámicamente inconscientes, así como de sus interacciones y representaciones de las mismas, nos conduce de manera integradora hacia la exploración del psiquismo humano donde lo intrapsíquico y lo intersubjetivo se encuentren entrelazados, en una búsqueda permanente de un equilibrio inalcanzable. En concordancia con lo anterior, se formula una aproximación teórico-clínica que se organiza sobre la conjunción de tres pilares teóricos, los cuales guían la presente revisión: la teoría de relaciones objetales, la perspectiva intersubjetiva y los estudios de la interacción temprana madre-bebé. Sobre la base de este desafío epistemológico se estructura esta modalidad de trabajo terapéutico, el cual se ejemplificará a través de un caso clínico que da cuenta de cómo la experiencia de un duelo traumático no elaborado en la madre genera un impacto en el desarrollo del psiquismo del hijo y en el vínculo madre-hijo, llegando a comprometer la organización de las experiencias corporales y relacionales del hijo, afectando el desarrollo del psique-soma y la constelación del self.

These paper explores a modalito of analytical psychotherapy applied to the mother-son dyad, where the analytic object is not a person, but the mother-son relationship. This approach proposes to use a multiplicity of object relations contained in the transference and countertransference to inform us of the linked elements as that they emerge in the reciprocal interaction in the context of the therapeutic frame. The recognition in the consideration from the therapist of the “real” but dynamically unconscious relationship of mother and son, as well as their interactions and self and other representations, lead us to an integrative exploration of the human psyche where intrapsychic and the intersubjective interlace, in a permanent search of an unattainable balance. In concordance with this line of thinking, a theoretical-clinic approach is formulated that is organized on three theoretical pillars: the object relations theory, the intersubjective perspective and the studies of the earlier mother-baby interaction. Based on this epistemological challenge, a new modality of the therapeutic work is structured. It will be exemplified through a clinical case that shows how the experience of a traumatic mourning not elaborated by the mother, generates an impact in the development of the son’s psyche and also on the mother-son bond, which compromises the organization of the body and relational experiences of the son, affecting his the psycho-somatic development and the constitution of the self.

El impacto de la violencia social sobre la estructuración psíquica. Desde la experiencia intrauterina hacia la vinculación madre-hijo / Impact of social violence of psychic structuration. from intrauterine experience to mother-infant linking

Basándose en el supuesto que el paciente re-crea aspectos de su funcionamiento mental en la relación transferencial/contratransferencia, y que es en ese espacio potencial donde se puede acceder creativamente a una comprensión y elaboración de los conflictos, la autora da cuenta detallada de un proceso terapéutico donde ese espacio se pierde por momentos, produciéndose suspensiones de las transacciones transferenciales, y de cómo se trabajó para construirlo con límites más nítidos y con mayor continuidad en la mente. Lo anterior se explicita a través de las vicisitudes propias de un proceso analítico con un niño de siete años de edad, que presenta un trastorno de personalidad limítrofe con estados donde predominan un funcionamiento psicótico y defensas autistas. Se muestra como evoluciona hacia un funcionamiento mental acorde a los logros esperables del proceso de separación-individuación (M. Mahler). A través de material clínico se ilustra como la experiencia traumática (de guerra) de la madre durante el embarazo del paciente, y por ende la experiencia intrauterina estresante del paciente, influyó en la configuración de su estructura psíquica. Donde ciertos comportamientos como el encapsulamiento autista, son comprendidos como un fenómeno patológico defensivo de su vida fetal. Se señala además, que esta actividad defensiva cumple un sentido de refugio psíquico contra experiencias de aniquilamiento. Basándose en este caso clínico y en diversas investigaciones en el ámbito de las neurociencias que dan cuenta de registros de experiencias en el feto durante la vida intrauterina, es que en este trabajo se plantea la necesidad de considerar como un continuo la experiencia intrauterina y la temprana infancia. Se finaliza con una discusión teórica relativa al impacto que puede tener en el feto y en el vínculo madre-hijo un contexto de realidad social de gran violencia. Se explicita el entrecruzamiento entre violencia social, experiencia intrauterina, función de reverie y transmisión inconsciente transgeneracional.

Evaluation of the safety and immunogenicity of a new, heat-treated human rabies immune globulin using a sham, post-exposure prophylaxis of rabies.

A double-blind, controlled, randomized trial was conducted to evaluate the safety and immunogenicity of a new human rabies immune globulin (HTRIG). This product, manufactured by Pasteur Merieux Connaught, PMC, has undergone a heat-treatment step (10 h at 60 degrees C) and removal of mercurothiolate. The corresponding unheated product available from the same manufacturer (human rabies immune globulin, HRIG, IMOGAM RABIES[spr2]) was used for comparison. These two rabies immune globulins (RIGs) were administered either alone or in association with the human diploid cell rabies vaccine (HDCV, IMOVAX[spr2] RABIES, PMC) according to a standard, post-exposure rabies prophylaxis schedule. Sixty-four healthy adults were randomly assigned to four groups of 16 to receive either HRIG/placebo, HTRIG/placebo, HRIG/HDCV or HTRIG/HDCV. RIG was administered at the recommended dose of 20 IU/kg by three intramuscular (i.m.) injections in the gluteus. HDCV or placebo was given on day (D) 0, D3, D7, D14, and D28 into the deltoid by the intramuscular (i.m.) route. Any local reaction from D0 to D3 at the immune globulin injection site, and any systemic reaction from D0 to D42, were monitored by subject diaries. Rabies-neutralizing serum antibody levels were assessed by the rapid fluorescent focus inhibition test (RFFIT) before treatment and on D3, D7, D14, D28, D35, and D42. No serious adverse reactions and, in particular, no allergic-type reactions were reported. The safety profiles of HTRIG and HRIG were similar, except that complaints of pain, or tenderness at the injection site were half as common in the HTRIG group. Most of the local reactions were mild or moderate. After the administration of HTRIG/placebo or HRIG/placebo, 60% of subjects had detectable rabies antibodies levels, but by D42 all titres were below the seroprotective level (i.e. below 0.5 IU/ml). In the groups HTRIG/HDCV and HRIG/HDCV, the antibody titres rose markedly from D7, and reached a maximum value of 19 IU/ml (95% CI, 11 to 38 IU/ml) and 31 IU/ml (95% CI, 20 to 48 IU/ml), respectively, on day 14. All subjects who received RIG and vaccine maintained a protective antibody level from D14 to D42. No significant difference in immunogenicity results between these two groups (HTRIG/HDCV and HRIG/HDCV) was observed, and no interference of immune globulin with vaccine was reported. The safety and immunogenicity profiles of PMC HTRIG appear comparable with the current reference product. The heat-treatment step will enhance the safety by further reducing the probability of virus transmission through immune globulin treatment. The low levels of rabies antibodies obtained by intramuscular administration of either PMC HTRIG or of PMC HRIG support the recommendations that call for local infiltration of wounds with RIG.

Increasing doses of purified influenza virus hemagglutinin and subvirion vaccines enhance antibody responses in the elderly.

The reactogenicities and immunogenicities of two influenza virus vaccines were compared in a placebo-controlled clinical trial among healthy ambulatory persons > or = 65 years old (mean age, 72 years). Volunteers were assigned randomly to receive 15-, 45-, or 135-micrograms doses of monovalent influenza A/Taiwan (H1N1) hemagglutinin (HA) or subvirion (SV) vaccine intramuscularly or a placebo. Increasing doses of SV vaccine were associated with a higher rate of injection site discomfort (P < 0.05; chi-square test for linear trend), but all doses of both vaccines were well tolerated. Increasing the dose of the HA or the SV vaccine resulted in increasingly higher postimmunization levels of serum hemagglutination inhibition and neutralizing antibody levels (P < 0.001; multiple linear regression). Mean serum antibody titers at 1 month increased two- to threefold with a ninefold increase in dose; the frequencies of fourfold or greater rises in titer likewise increased. An increase in the dose of the HA or the SV vaccine also resulted in increased frequencies of rises in immunoglobulin A or G antibody titers in nasal wash specimens. The frequencies increased approximately twofold for each vaccine with a ninefold increase in the dose. These data suggest that increasing the HA vaccine dose is a promising approach to the development of improved influenza virus vaccines for use in elderly people.

Potent inhibition of HIV type 1 infection of mononuclear phagocytes by synthetic peptide analogs of HIV type 1 protease substrates.

The HIV-1 genome encodes a protease that is required for viral processing of the precursor polyproteins Pr55gag and Pr160gag-pol. Interference with this process in human lymphocytes inhibits production of infectious virus. We tested the ability of several protease inhibitors to decrease replication of HIV-1BaL in human monocytes and peritoneal macrophages. The compounds tested are oligopeptide analogs of HIV-1 protease substrates in which the scissile dipeptide has been replaced by a hydroxyethylene isostere. The protease inhibitors were added only once, 1 hr prior to inoculation with virus. Every 3-5 days, half the medium was replaced with fresh medium. Inhibition of virus production was assessed by measuring reverse transcriptase (RT) activity in supernatant medium 14 days after infection. The concentration of drug required to inhibit infection by 50% (IC50) in monocytes ranged from 0.17 to 2.99 microM; IC50 values for peritoneal macrophages ranged from 0.21 to 1.9 microM. The IC50 values for these compounds were 1.1- to 10-fold higher when tested in monocytes compared to their inhibitory effect in lymphocytes, although still potently effective in the dosage range that appeared nontoxic to cells. Cell toxicity was seen only at concentrations greater than 10 microM, and varied among the drugs tested. Immunoblot analysis of two of the drugs (SB205700 and SB108922) confirmed inhibition of polyprotein processing. In control cells, 22% of viral protein pr55 was processed to p24 by 24 hr, and 51% was processed by 48 hr. In cells treated with the protease inhibitors (2 microM), Pr55 processing was inhibited 77% at 24 hr and 89% at 48 hr. Thus, these synthetic peptide analogs potently inhibit productive infection of mononuclear phagocytes by HIV-1. Drugs of this class may be useful for the treatment of HIV-1 infection in humans.

Cellular CD44S as a determinant of human immunodeficiency virus type 1 infection and cellular tropism.

CD4 is the predominant cell membrane protein that binds human immunodeficiency virus type 1 (HIV-1) gp120 and facilitates HIV-1 infection, but other membrane-associated molecules may be involved in determining HIV-1 cellular infection. Our prior work had suggested that CD44, the transmembrane receptor for hyaluronan, might play a role in the infection of mononuclear phagocytes with HIV-1. In the present work, we have used cells of the CD4-positive, CD44-negative human T-lymphoblast cell line Jurkat to study the role of CD44 in HIV-1 infection and tropism. Cells were transfected with cDNA for the standard (S, or hematopoietic) CD44 isoform CD44S or the epithelial isoform CD44E. The resultant lines expressed appropriate CD44S or CD44E mRNA and protein. While the parent Jurkat cells, those transfected with vector alone, and those transfected with CD44E could be productively infected with only the lymphocytotropic strain HIV-1-LAI, cells transfected with CD44S were rendered susceptible to productive infection with the monocytotropic strains HIV-1-BaL and HIV-1-ADA. Also, CD44S-transfected cells displayed higher levels of infection with HIV-1-LAI than did the other transfected Jurkat cells. The transfected cell line cells all had comparable growth rates and expressed similar levels of the membrane antigens CD4, CD7, major histocompatibility complex (MHC) class I, MHC class II, and CD11a, while levels of CD3 were slightly higher in cells transfected with vector alone and in one of the clones transfected with CD44S. Hyaluronan binding was increased in cells transfected with either CD44S or CD44E. Mouse NIH 3T3 fibroblasts transfected with human CD4, human CD44S, or both human CD4 and CD44S displayed the appropriate antigens, but they could not be productively infected with lymphocytotropic or monocytotropic strains of HIV-1. The results indicate that in human leukocytes, CD44S is an important determinant of HIV-1 productive infection and may be involved in viral cellular tropism.

Hospice education about people with AIDS as terminally ill patients: coping with a new epidemic of death.

Hospice care for patients with AIDS often differs from care provided to patients with other terminal illnesses, such as cancer. We designed a seminar series to educate regional hospice staff about these differences and subsequently determined if the educational intervention was associated with improvements in their AIDS-related knowledge, attitudes, or behaviors toward patients with AIDS. Quantitative and qualitative data were collected from seminar participants (n = 63) and a similar comparison group (n = 18) at several time points. Seminar participants significantly improved their AIDS-related behaviors (p.05); and there was a trend toward knowledge improvement. Qualitative data shed light on the quantitative findings. Participants verbalized better understanding of the relatively aggressive care often given to terminally ill patients with AIDS when it enhanced quality of life.

Tuberculous pericarditis in Tanzanian patients with and without HIV infection.

SETTING: Large academic medical center in Tanzania. OBJECTIVES: To determine the etiologies and outcomes of large pericardial effusions in HIV-infected and uninfected patients. DESIGN: Prospective cohort study of patients admitted with new large pericardial effusions, confirmed echocardiographically. Patients had pericardial biopsies and drainage with extensive analysis of tissue and fluid specimens, and were followed with clinical and echocardiographic examinations. RESULTS: Of 28 patients with large pericardial effusions, 19 were infected with HIV-1. 22 had invasive diagnostic procedures: 14 of 14 HIV-infected patients, but only 4 of 8 non-HIV-infected patients, had tuberculous pericarditis (P = 0.01). All but 1 of the HIV-infected patients had strongly positive tuberculin skin tests, and short-term outcomes were similar in the 2 groups. CONCLUSION: TB is the predominant cause of large pericardial effusion in HIV-infected patients in this setting; non-HIV-infected patients are more likely to have other etiologies. These patients were at an early stage of HIV infection and responded well to treatment. In settings where microbiological studies are not routinely available, HIV-infected patients with large pericardial effusions may be treated empirically for tuberculosis and monitored for improvement. If improvement does not follow within 2-4 weeks further studies are indicated. HIV-negative patients should undergo diagnostic evaluation initially.

Neopterin production by HIV-1-infected mononuclear phagocytes.

Neopterin is a pteridine produced by human mononuclear phagocytes, usually in response to interferon-gamma (IFN-gamma) stimulation. Increasing serum levels of neopterin correlate with clinical progression to AIDS in HIV-infected people, but the factors that contribute to these elevated levels are not established. We performed in vitro experiments to investigate the possibility that HIV-1 infection of mononuclear phagocytes directly induces enhanced neopterin production. We found that HIV-1-infected monocytes and peritoneal macrophages produced neopterin in quantities similar to amounts produced by uninfected cells. The HIV-infected cells responded to stimulation with IFN-gamma as well as uninfected cells, with a 6- to 12-fold increase in neopterin production. We conclude that elevated serum levels of neopterin in HIV-infected individuals are not caused by HIV-1 infection of mononuclear phagocytes but may be a result of the normal response to mononuclear phagocytes to increased levels of IFN-gamma.

Immunogenicity and safety of Haemophilus influenzae type b-tetanus protein conjugate vaccine alone or mixed with diphtheria-tetanus-pertussis vaccine in infants.

Haemophilus capsular polysaccharide-tetanus toxoid conjugate (PRP-T) and diphtheria-tetanus-pertussis (DTP) vaccines were administered in a single syringe (group 1) or separate syringes (group 2) to 284 infants at 2, 4, and 6 months of age. Group 1 infants had a slightly greater incidence of local reactions. Systemic reactions were similar. The geometric mean titers of polyribosylribitol phosphate (PRP) serum antibody concentrations after the third dose of PRP-T vaccine were 4.8 and 4.3 micrograms/ml for groups 1 and 2, respectively. Antibody responses to DTP antigens were also similar. The immunogenicity and safety of the PRP-T and DTP vaccines are equivalent when the vaccines are administered in separate syringes or the same syringe to infants.

Hepatitis B vaccination and booster in predialysis patients: a 4-year analysis.

Patients undergoing chronic haemodialysis are at increased risk for infection with hepatitis B virus (HBV), but response to currently available vaccines is suboptimal. We undertook a 4-year prospective study of the efficacy of hepatitis B vaccine in patients with renal insufficiency, who were not yet dialysis-dependent. A booster dose of Recombivax HB was given at 3 or 4 years to those whose antibody levels fell below a predetermined point. Progression to dialysis was associated with poorer initial response to vaccination compared with those remaining dialysis-independent, but response to booster immunization was favourable in both groups. It is concluded that immunization of predialysis patients and subsequent booster vaccine results in a more favourable antibody response than has been seen historically in haemodialysis patients. Local endemicity and cost of vaccine should be considered when determining the best strategy for HBV immunization of patients with chronic renal failure.

Human immunodeficiency virus type 1 infection of human monocytes and macrophages does not alter their ability to generate an oxidative burst.

Human immunodeficiency virus type 1 (HIV-1) infects mononuclear phagocytes, cells that may serve as a reservoir for viral persistence. Infection with HIV-1 leads to progressive compromise of the immune system, resulting in infections with opportunistic pathogens and eventual death. Experiments were designed to determine if in vitro HIV-1 infection of mononuclear phagocytes would diminish their oxidative capabilities, thus decreasing their antimicrobial effectiveness. Blood monocytes and peritoneal macrophages were obtained from uninfected donors and inoculated with a monocytotropic strain of HIV-1. Hydrogen peroxide production and reduction of nitroblue tetrazolium were measured after acute stimulation of cells with PMA or a phagocytic stimulus. Despite vigorous virus production, no difference was seen in oxidative burst between uninfected cells and infected cells or between monocyte-derived and peritoneal macrophages. In conclusion, reduced antimicrobial activity of HIV-infected mononuclear phagocytes is probably not secondary to decreased ability to generate reactive oxygen species.