g , Plotkin, 1999:78, 86, 90, 117, Table 121; Walker, 2004:73–110

g., Plotkin, 1999:78, 86, 90, 117, Table 121; Walker, 2004:73–110). Many of the large, deep, black soil sites are located on resource-rich mainstreams or at trading and cultural centers. For example, richly cultural black soil deposits extend continuously for many miles up and downstream of the Santarem at the mouth of the Tapajos River and several miles inland, both on bluffs INCB024360 mouse and lowlands, a similar distribution obtains on the opposite shore from Santarem, and other large concentrations exist at the northwest Amazon town of Araracuara and the southern

Amazon interfluvial city of Altamira (Eden et al., 1984, Herrera, 1981 and Nimuendaju, 2004:118–164; Smith, 1980). Not surprising in the light of the apparent population density and spread of the major cultural horizons, many sites are in defensive locations. Examples of small, isolated dark soil deposits include the various occupations in caves and rockshelters in Monte Alegre (Roosevelt, 2000 and Roosevelt et al., 1996). The Santarem-age dark

soil component in one of the caves is defended with a palisade. Examples elsewhere include the small late prehistoric site of Maicura on the Puente river in the interfluvial Putumayo basin of the Colombia-Brazil border (Morcote-Rios, 2008), and there many other such modest sites with the soil (Levis et PLX3397 al., 2012 and Smith, 1980:558–560). Not as mysterious as they might seem, Amazonian black soils are the remains of human structures, features, and refuse that accrued at long-term settlements.

Although the soils are sometimes described as undifferentiated refuse, geophysical survey and stratigraphic excavation at many sites reveals rich and varied archeological structuring. The large black soil site at Santarem contains neighborhoods with parallel rows of house Regorafenib mounds rich in fragmentary artifacts and biological remains, next to ceremonial structures and craft production areas (Fig. 12) (Roosevelt, 2007 and Roosevelt, 2014). Surveys and excavations reveal that the cultural black soil deposits extend at least a meter thick over approximately 4 km2 of that site. Contemporary sites in the upper Xingu, also have structures built in the dark-soil refuse. Some settlements of the Amazonian polychrome horizon also are highly-structured black Indian soil deposits. On Marajo, artificial mound villages of the Horizon contained deep black Indian soil deposits between house platforms and cemeteries (Bevan and Roosevelt, 2003, Roosevelt, 1991b, Roosevelt, 2007 and Roosevelt et al.

By the Late Holocene, such changes are global and pervasive in na

By the Late Holocene, such changes are global and pervasive in nature. The deep histories provided by archeology and paleoecology do not detract from our perceptions of the major environmental changes of the post-Industrial world. Instead, they add to them, showing a long-term trend in the increasing influence of humans on our planet, a trajectory that spikes dramatically during the last 100–200 years. They also illustrate the decisions past peoples made when confronted with ecological change or degradation and that these ancient peoples often grappled

with some of the same issues we are confronting PLX3397 purchase today. Archeology alone does not hold the answer to when the Anthropocene began, but it provides valuable insights and raises fundamental questions about defining a geological epoch based on narrowly defined and recent human impacts (e.g., CO2 and nuclear emissions). While E7080 cost debate will continue on the onset, scope, and definition of the Anthropocene, it is clear that Earth’s ecosystems and climate are rapidly deteriorating and that much of this change is due to human activities. As issues such as extinction, habitat loss, pollution, and sea level rise grow increasingly problematic, we need new approaches to help manage and sustain the

biodiversity and ecology of our planet into the future. Archeology, history, and paleobiology offer important perspectives for modern environmental management by documenting how organisms and ecosystems functioned in the past and responded to a range of anthropogenic and climatic changes. Return to pristine “pre-human” or “natural” baselines may be impossible, but archeological records can help define a range of desired future conditions that are key components for restoring and managing ecosystems. As we grapple with the politics of managing the “natural” world, one of the lessons from archeology is that attempts to completely erase people from the natural landscape (Pleistocene rewilding, de-extinction, ADP ribosylation factor etc.) and return to a pre-human baseline are often not realistic and may create new problems that potentially undermine

ecosystem resilience. Given the level of uncertainty involved in managing for future biological and ecological change, we need as much information as possible, and archeology and other historical sciences can play an important role in this endeavor. A key part of this will be making archeological and paleoecological data (plant and animal remains, soils data, artifacts, household and village structure, etc.) more applicable to contemporary issues by bridging the gap between the material record of archeology and modern ecological datasets, an effort often best accomplished by interdisciplinary research teams. This paper was originally presented at the 2013 Society for American Archaeology Annual Meeting in Honolulu, Hawai’i.

7×10−2

and δE=u′*2U−1f−1=5 8m In accordance with laborat

7×10−2

and δE=u′*2U−1f−1=5.8m. In accordance with laboratory experiments by Cenedese et Staurosporine cell line al. (2004), such values of Fr and Ek correspond to a sub-critical (Fr < 1) gravity flow of the eddy (Ek < 0.1) regime. However, the laboratory experiments were done with a plane slope bottom, so the criterion obtained for the eddy regime (Ek < 0.1) cannot be applied to the channelized gravity current unless the channel width is large relative to the gravity current width R.   If the gravity current is frictionally controlled, its width is expressed as R=δE/Sx′R=δE/Sx′, where Sx′   is the downstream slope of the interface ( Darelius & Wåhlin 2007), which in our case can be obtained from the formula Sx  ′ = (BT  x′ + BC  x′)/(B   × H  ). Taking the average for the period of 1–4 days (BTx′ + BCx′   = 2 × 10−4 m2 s−2, B = 0.034 m2 s−1, H = 35.0 m), we obtain Sx′   = 1.7 × 10−4 and R   = 50 km. Since the channel width at the undisturbed level of the interface is ≈ 25 km (see Figure 3), the channel is narrow relative to the potential width of the gravity current, therefore the criterion Ek=(u′*2U−1f−1H−1)2<0.1 does not work – the simulation does not display eddy formation. On the other hand, U f ≈2.5 km should be much smaller than the

channel width (25 km) in order to develop an asymmetry in a channelized gravity current ( Cossu et al. 2010). In addition to equation (2) there are other definitions of the Ekman depth in turbulent flows, e.g. δE = 0.4u*/f (Cushman-Roisin 1994, Perlin et al. 2007). This expression is more likely to correspond selleck screening library to the thickness affected by frictional effects (Umlauf & Arneborg 2009a) and yields substantially larger values for the Ekman depth than the expression δE=u*2/(fU) based on the momentum budget. The Ekman depth δE=u*/fδE=u*/f, averaged over the simulation period of 1–4 days, is estimated at 47 m, which exceeds the dense layer/gravity current thickness (H = 34 m) confirming the frictional control of the current. If entrainment

to the gravity current is ignored (this is justified by the balance of BCx′   + BTx′   and u′*2 shown in Figure 5), the average speed of a geostrophically balanced, transverse interfacial Carbachol jet is vmean = BSx′/2f ( Umlauf & Arneborg 2009b). The latter expression can be used to check whether the simulated jet is geostrophically balanced. The bulk buoyancy and the downstream interfacial slope are estimated as B = 0.035 and 0.033 m s−2 and Sx′ = 1.9 × 10−4 and 1.0 × 10−4 for the respective moments in time of 2 and 4 days, so the estimates of the mean speed of the jet by the above formula are vmean = 0.027 and 0.014 m s−1. The mean values of the jet speed calculated from analytical expression vmean = BSx′/2f were found to be twice as small as the simulated maximum values (cf. Figure 4), which is quite reasonable. Even though the transverse structure of the modelled gravity current in the Słupsk Furrow is found to be similar to that of the Arkona Basin (Arneborg et al.

As the ultrasound exam is performed the fusion system continuousl

As the ultrasound exam is performed the fusion system continuously generates reformatted planes from the reference series matching the oblique imaging planes of the ultrasound transducer. The reformatted planes are displayed either as an overlay or side-by-side with the live ultrasound (Figure 1 and Figure 2). This display enhances

interpretation of ultrasound by enabling a direct comparison with the reference images from the same Baf-A1 solubility dmso view angle. The combined use of different modalities for definitive diagnosis is common. Ultrasound, for instance, is useful to assess indeterminate lesions identified in CT or MRI. A confident diagnosis can be made if a clear correlation can be made between ultrasound and the preceding series. However, if a physician is not confident that ultrasound has found the correct lesion, the case may be further referred to another modality with increased time, cost and potentially mixed results. Fusion imaging enables greater confidence in establishing a clear correlation between modalities by visualizing the same anatomy from the same view angle. Ultrasound is also useful for guiding biopsies for definitive diagnosis. Once again, clear correlation with CT or MRI is required to confidently target a specific lesion. Fusion imaging also has potential as a training Galunisertib cost tool, similarly allowing trainees to better understand

ultrasound in the context of CT or MRI. Fusion imaging

makes use of a tracking system to localize ultrasound transducers and other devices relative to the patient. Optical and electromagnetic systems are available, the latter being most commonly used. Various software tools are also used to bring the reference series into alignment with the tracking system for fusion display [3], [4], [5] and [6]. Research into these tools has been ongoing for approximately 20 years. Clinical implementation of fusion imaging has suffered, however, due to the time required to achieve adequate alignment using traditional methods. Recent advancements in automatic image analysis may potentially reduce this time greatly. Tracking sensors are also incorporated into some interventional devices such as introducers and ablation needles, enabling the display of needle IMP dehydrogenase location as an overlay on live ultrasound images (Fig. 2). This display can be useful for overcoming difficulties in visualizing needles during ultrasound-guided procedures [7]. Such devices may allow procedures to be completed more quickly and with fewer placement attempts, particularly for more complex cases (Fig. 3). Ultrasound fusion imaging can potentially apply to a wide range of specialty disciplines. In neurology, fusion imaging may facilitate the interpretation of vascular imaging, such as for multi-modality characterization of atherosclerosis.

1), 600 mM KCl, 10 mM MgCl2, 2 mM EGTA, 1 mM EDTA, 1% Triton X-10

1), 600 mM KCl, 10 mM MgCl2, 2 mM EGTA, 1 mM EDTA, 1% Triton X-100 and the protease inhibitors described above. The homogenate was centrifuged at 15,800 × g for 10 min at 4 °C, in an Eppendorf centrifuge, the supernatant discarded and the pellet homogenized with the same volume of the high salt medium. The resuspended homogenate was centrifuged as described and the supernatant

was discarded. The Triton-insoluble IF-enriched pellet, containing NF subunits, Vim and GFAP, was dissolved in 1% SDS and protein concentration was determined. The cytoskeletal fraction was prepared as described above. Equal protein concentrations Selumetinib order were loaded onto 10% polyacrylamide gels and analyzed by SDS-PAGE. After drying, the gels were exposed to T-MAT films at − 70 °C with intensifying screens and finally the autoradiograph was obtained. Cytoskeletal proteins were quantified by scanning the films with a Hewlett-Packard Scanjet 6100C scanner and determining optical densities with an Optiquant version 02.00 software (Packard Instrument Company, Meriden, CT 06450 USA). Density values were obtained for the studied proteins. Tissues slices were homogenized in 100 μl of a lysis solution containing 2 mM EDTA, 50 mM Tris–HCl, pH 6.8, 4% (w/v) SDS. For electrophoresis analysis, samples were dissolved in 25% (v/v) of solution containing 40% glycerol, 5% mercaptoethanol, 50 mM Tris–HCl, check details pH 6.8 and boiled for

3 min. Protein homogenate (80 μg) was analyzed by SDS-PAGE and transferred to nitrocellulose membranes (Trans-blot SD semi-dry

transfer cell, BioRad) for 1 h at 15 V in transfer buffer (48 mM Trizma, 39 mM glycine, 20% methanol and 0.25% SDS). The nitrocellulose membranes were washed for 10 min in Tris-buffered saline (TBS; 0.5 M NaCl, 20 mM Trizma, Nitroxoline pH 7.5), followed by 2 h incubation in blocking solution (TBS plus 5% bovine serum albumin and 0.1% Tween 20). After incubation, the blot was washed twice for 5 min with TBS plus 0.05% Tween-20 (T-TBS), and then incubated overnight at 4 °C in blocking solution containing the following antibodies: anti-GFAP (clone G-A-5) diluted 1:500, anti-vimentin (Vim 13–12) diluted 1:400, anti-NF-L (clone NR-4) diluted 1:1000, anti- NF-M (clone clone NN-18) diluted 1:400, anti-NF-H (clone N52) diluted 1:1000, anti-ERK1/2 diluted 1:1000, anti-phosphoERK diluted 1:1000, anti-/JNK diluted 1:1000, anti-phosphoJNK (clone 98F2) diluted 1:1000, anti-p38MAPK (clone A-12) diluted 1:1000, anti-phosphop38MAPK diluted 1:1000, anti-PKAcα diluted 1:1000, anti-PKCaMII diluted 1:500, anti-AKT (clone 2H10) diluted 1:1000, anti-phosphoAKT (clone 244F9) diluted 1:1000, anti-active caspase 3 diluted 1:1000, anti-GSK3β (clone 27C10) diluted 1:1000, anti-phosphoGSK3β, anti-KSP repeats (clone NP1) diluted 1:1000, anti-phoshoNF-LSer55 diluted 1:800, anti-phosphoNF-LSer57 diluted 1:1000 or anti-actin diluted 1:1000.

While the urban district Warnemünde is delimited by its administr

While the urban district Warnemünde is delimited by its administrative boundaries from neighbouring largely rural coastal landscape, these boundaries do not reflect the actual functional relationships along the coast. If the area of Warnemünde included its neighbouring areas, the indicator results would look very different.

Largely accidental boundaries have a strong influence on results, which is a problem for inter-regional and international comparisons based on indicators. Selleck Romidepsin Municipalities, districts, and regions show a pattern of heterogeneous activities and uses rather than a uniform situation. It seems that a heterogeneous study site is more problematic with respect to the application of indicators and the final result will very likely be fuzzier. Therefore, the indicator set should preferably be applied to homogeneous municipalities rather than to larger districts or regions. Several differences in the issue scores between Neringa and Warnemünde result from different sizes and spatial definitions. With all these uncertainties, we think that coastal indicators and especially the SUSTAIN core set are not well suited for international comparisons. The strong variability of assessments carried see more out by different groups for one municipality is present in the end

results even for data aggregated to the pillar level (Fig. 4). This high variability would largely conceal differences between different municipalities, especially on an international level. Comparisons of municipalities within one country will certainly be more reliable, but it has to take into account that the available data for several indicators (e.g. employment rate) do not differentiate on the municipal level but are valid for a region. Municipalities within this region would get the same score for this indicator. Therefore, existing differences between municipalities will not always be sufficiently reflected in the indicator results. Are the indicators and especially the issues able to reflect the state of

sustainable development in municipalities, and does the methodology enable local actors to measure their sustainability Pyruvate dehydrogenase lipoamide kinase isozyme 1 effort? The SUSTAIN partnership (2012b) states that ‘within coastal zones, there are many hundreds of indicators which purport to give information about sustainability but, in reality, none of them do so – because that is not their purpose – as they are, in general, state-of-the-coast indicators.’ The SUSTAIN indicators cover the four pillars of sustainability and are focused on the coast. They can be considered as a step forward, but going through the indicator and issues lists (Table 1) it becomes obvious that most of them have only a weak link to sustainability. However, aggregated to a pillar level they provide insights into the present state of municipalities indicate weaknesses and strengths and, if interpreted correctly, can support decision-making for a more sustainable development.

Nothing Until, very recently This year (2012), I received notic

Nothing. Until, very recently. This year (2012), I received notice from a colleague at the Showa Memorial Institute, National Museum of Nature and Science, Japan, that an intact specimen of S. ramosa had been found in the collection of Emperor Showa (Hirohito)

donated to the museum upon his death and that I had been given permission to dissect it. Stirpulina ramosa is, like all watering pot shells, extraordinarily eccentric but that is a story for another journal. Of interest, however, was the accompanying DAPT datasheet label. The specimen had been collected from Sagami Bay at a depth of 80 m in 1957. That is, from a well-studied locality 55 years previously. Fascinating. But, thinking about the specimen more, I have concluded that I am dealing with the only surviving relict of a probably Tethyan, populous and once species-diverse genus. It is thus a ‘living fossil’. Is it, however, ‘living’? Stirpulina ramosa has never been found alive again since 1957 and is thus probably extinct – possibly at the hand of Man. But, how can we be sure? The answer is that we cannot and it thus seems to me that when extinction is applied to the marine environment and with the exception of large mammals, birds and, possibly, fishes, the word extinct probably has little meaning because we can

never be absolutely certain that this is so. Perhaps a better definition of the status of S. ramosa would Everolimus in vivo be either functionally or biologically dead, since we can only assume that not having been found alive for 55 years it is, at the very least, presumably dead. Thinking about this some more, I reflected on the various representative genera of the Clavagelloidea

that I had examined anatomically over the past 40 years – Humphreyia, Dianadema, Nipponoclava, Kendrickiana and Penicillus. All had been found many, many, years previously and preserved as specimens in museum collections and re-found decades later by me. There are simply no modern specimens. Presumably, therefore, these species are also functionally/biologically dead. In which case, over relatively recent recorded time, the whole watering pot superfamilial clade of bivalves Rebamipide has become to all intents and purposes extinct in our modern seas. In conclusion, therefore, from the limited perspective of my multiple-year involvement with watering pot shells, I reiterate the question posed by Charles Sheppard. That is, just how many decimal places do we need to measure ‘dead’ or ‘extinct’? If my, albeit anecdotal, watering pot evidence is real, then I think that museum taxonomists should be prevailed upon to re-examine, initially, the more specialised species under their curatorial care to identify exactly when the last specimens were collected alive.

Each experiment was repeated at least three times unless stated o

Each experiment was repeated at least three times unless stated otherwise. The statistical significance of the differences between treatments was assessed using t-test and a p value of less than 0.05 was considered significant. We first examined the patterns of AMPK, Akt, mTOR and autophagy activation during 7-day differentiation of hDP-MSC. Osteoblastic differentiation of hDP-MSC was confirmed by a significant increase in alkaline phosphatase activity and the mRNA and/or protein levels of osteogenesis markers osteocalcin, Runx2 and BMP2 (Figs. 1A, B). This was associated with rapid phosphorylation of AMPK and its direct downstream target Raptor, which peaked

at day 1 and then gradually declined (Figs. 1C, D). An inverse activation pattern was observed with mTOR and its substrate S6K, demonstrating an early inhibition at day 1 followed by activation PF-562271 chemical structure from

day CB-839 research buy 3 onwards (Figs. 1C, D). The increase in Akt phosphorylation slightly lagged behind that of AMPK, reaching its maximum at day 3 and remaining high during the rest of the differentiation period (Figs. 1C, D). The conversion of LC3-I to autophagosome-associated LC3-II, as a marker of autophagy, was increased at day 1, but then rapidly declined at later stages of differentiation (Figs. 1C, E). The changes in LC3 conversion were correlated with the extent of autophagic proteolysis, which increased early and declined late during differentiation, as reflected in the reduction and increase, respectively, of the intracellular levels of p62 (Figs. 1C, E), a selective autophagy target [22]. In accordance with the early induction of autophagy, the intracellular concentration of the proautophagic protein beclin-1 reached its maximum 24 h after initiation

of differentiation (Figs. 1C, E). These data demonstrate a complex, time-dependent modulation of AMPK/Akt/mTOR signaling and autophagy during osteogenic differentiation of hDP-MSC, involving early activation of AMPK and transient induction of autophagy, followed by the late activation of Akt and Phosphoglycerate kinase mTOR. We next investigated the role of an early induction of AMPK and autophagy in osteogenic differentiation of hDP-MSC. Autophagy inhibitors bafilomycin, chloroquine and NH4Cl, which prevent autophagolysosome acidification and/or autophagosome–lysosome fusion [23] and [24], all blocked osteogenic differentiation of hDP-MSC, as confirmed by the reduction in alkaline phosphatase activity and expression of osteocalcin and Runx2 (Fig. 2A). Accordingly, the shRNA-mediated knockdown of the autophagy-essential LC3β blocked the increase of osteoblast differentiation markers in hDP-MSC (Figs. 2B, C). The efficiency of LC3β shRNA silencing was confirmed by reduced levels of both LC3-I and LC3-II in differentiating hDP-MSC at day 1 (Fig. 2D).

MERIS; however, is especially adapted to the low reflectance from

MERIS; however, is especially adapted to the low reflectance from water, and due to its 15 narrow bands (10 nm

wide) also has an improved spectral resolution. MERIS 1.2 km resolution is too low to investigate Himmerfjärden, and one can only derive a limited number of water pixels within Himmerfjärden [17]. The 300 m resolution MERIS image shows that one can derive a reasonable amount of water pixels within the bay. One can also apply an adjacency correction that corrects for the high reflectance from land [17] and [26]. The optical properties of a given coastal water body are determined by the optical properties of water itself, phytoplankton, Colored Dissolved Organic Matter (CDOM, also termed humic substances), and Suspended Particulate Matter (SPM, also termed total suspended matter, TSM). Together, these substances determine the color of the sea, and also jointly Sotrastaurin contribute to the attenuation of light in the water body [25]. The light attenuation decreases exponentially with water depth and is a measure of the gradual loss in light intensity, measured as the diffuse attenuation coefficient; Kd(490). The main processes involved in the attenuation of light are absorption and scattering by all optical components in the water.

CDOM, for example mostly absorbs light, especially in the blue part of the visible spectrum. Inorganic suspended matter scatters light more, which increases the water-leaving radiance, and thus is recorded on a satellite image. Phytoplankton absorbs light in the blue and in the

red part of the spectrum, and also scatters light. mTOR inhibitor It is these specific absorption and scattering properties that can be used to derive the concentrations of optical components in the water quantitatively. The ocean color bands in MERIS were carefully chosen in order to be able to derive the light attenuation, chlorophyll a and SPM concentration, as well as Progesterone CDOM [27]. In order to interpret satellite images in the coastal zone correctly, one needs to have a good understanding of the optical properties in the coastal zone. Kratzer and Tett [16] developed an attenuation model for the coastal zone that can act as an ecosystem synthesis of a given coastal area (Fig. 3). The attenuation follows a surface water gradient from the UWWTP at the head of Himmerfjärden bay to Landsort Deep (station BY31), the deepest part of the Baltic Sea (Fig. 2). Hence, the model is 2-dimensional and describes how the attenuation of the three main optical in-water components changes when moving from coastal (source) into open sea waters (sink). The model results highlight the typical optical features of a given coastal area in the Baltic Sea. The optical properties of the open Baltic Sea are clearly dominated by colored dissolved organic matter.

Any association was not observed between the patients who had con

Any association was not observed between the patients who had consistently higher levels of analytes in their sera versus plasma versus culture positivity. There was no correlation between cytokine signatures and the M. tb family (Beijing versus Non-Beijing) identified in the TB patients (P > 0.05, data not shown). Additionally, there was no evidence of significant differences between cytokine signatures and the NTM species identified (P > 0.05, data not shown). However, these results will likely

hold true in future studies with larger sample sizes. In conclusion, serum VEGF-A is the most informative marker for distinguishing active TB from LTBI, and a panel of serum IL-2, IL-9, IL-13, IL-17, TNF-α and sCD40L levels may contribute to more accurate and rapid differential diagnosis between active TB and NTM disease. Serum sCD40L levels and M. tb antigen-specific IFN-γ, TNF-α, and IL-2 responses could be a biomarker associated Torin 1 in vivo with treatment responses when combined with M. tb clearance in sputa cultures. Measurement

of multiple analytes in serum or QFT-IT plasma could speed up diagnosis and may be utilised as a surrogate marker. In addition, it would greatly benefit the development http://www.selleckchem.com/products/pirfenidone.html of diagnostics to differentiate between active TB versus LTBI or active TB versus NTM disease. We thank the study participants who contributed to this work and we appreciate the staff at Severance Hospital in Seoul, South Korea for their assistance. This study was financially supported by the Ministry for Health, Welfare, and Family Affairs, Republic of Korea (Korean Health Technology R&D Project: A101750)

and the National Research Foundation of Korea (2011-0013018). The funding Tyrosine-protein kinase BLK sources had no role in the study process including the design, sample collection, analysis, and interpretation of the results. “
“Streptococcus pneumoniae is a leading cause of infectious death and hospitalization in HIV-infected adults and children in most African countries. 1 and 2 Antiretroviral therapy (ART) leads to a reduction in the incidence of invasive pneumococcal disease (IPD) but the risk remains high. 3, 4, 5 and 6 It is widely proposed that defective T-cell mediated immunity may be responsible for this disease burden, 7, 8 and 9 however, we have recently shown that compared to healthy uninfected children, even minimally symptomatic HIV-infected individuals with preserved CD4+ percentage have an overrepresentation of mature activated B cells, suggestive of immune activation and apoptosis, and low numbers of pneumococcal protein antigen–specific memory B cells. 10 For at least two decades, the peripheral blood CD4+ T cell count or percentage in young children has been used as a correlate of HIV disease progression both as an indicator for the commencement of ART and to monitor its effectiveness when used.