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Patent application title: Method for measuring resistance of a patient HIV-2 to protease inhibitors
Jean-Noel Telles (Paris, FR)
Francoise Brun-Vezinet (Paris, FR)
Diane Descamps (Paris, FR)
Assistance Publique - Hopitaux De Paris
IPC8 Class: AC12Q170FI
USPC Class:
435 5
Class name: Chemistry: molecular biology and microbiology measuring or testing process involving enzymes or micro-organisms; composition or test strip therefore; processes of forming such composition or test strip involving virus or bacteriophage
Publication date: 2009-10-08
Patent application number: 20090253122
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A search method in a biological sample containing an HIV 2 viral strain
for possible resistance of said strain to treatment by an anti-protease
agent, and nucleotide probes for the implementation thereof. According to
methods known per se, the presence of at least one mutation at certain,
specified, particular positions of the proteinic sequence of the protease
of said viral strain from a biological sample taken from a patient
contaminated by HIV 2 is searched. If said mutation is observed, the
existence of a resistance to said anti-protease agent is assumed in the
1. A method for testing, in a biological sample from a patient infected by
HIV-2 containing at least one HIV-2 viral strain, the resistance of said
HIV-2 viral strain to treatment with an antiprotease agent, comprising
investigating the presence of a mutation at position 82 of the protein
sequence of the protease of said viral strain, said mutation having
previously been found to elicit said resistance, and if such a mutation
is found, concluding that a viral strain resistant to said antiprotease
agent is present in the patient in question.
2. The method according to claim 1, wherein:a) the presence of a mutation at position 82 of the protein sequence of the protease of said viral strain in a biological sample taken from a patient infected with HIV-2 is investigated,b) a mutation found in a) which, after cloning in an HIV-2 virus, does not prevent the virus clone obtained from multiplying in culture in the presence of said antiprotease drug is selected, andc) if the mutation is selected at step b), it is concluded that resistance exists to the antiprotease drug referred to in b).
3. The method according to claim 1, wherein the presence of the mutation I82M, in the protein sequence of the protease to said viral strain is investigated and in which said resistance is concluded to exist if said mutation is present.
4. The method according to claim 1, wherein, to detect a mutation of the protein sequence of the protease, a corresponding mutation is sought in the nucleotide sequence of the gene of said protease.
5. The method according to claim 4, wherein said test is carried out using hybridization techniques.
6. The method according to claim 4, wherein said test is carried out using sequencing techniques.
7. The method of claim 4, wherein said mutation in the sequence of the gene corresponds to I82M.
8. The method of claim 7, wherein said mutation corresponds to a codon for position 82, which is ATG, instead of ATA or ATC.
9. The method of claim 1, said method further comprising investigating the presence of at least one additional mutation at one or more of positions 10, 45, 46, 54, 64, 84 and 90 of the protein sequence of the protease of said viral strain.
10. The method of claim 9, wherein the at least one additional mutation is selected from the following mutations: V10I, K45R, I46V, 154M, I64V, I84L and L90M.
11. The method of claim 9, wherein, to detect the at least one additional mutation of the protein sequence of the protease, at least one corresponding mutation is sought in the nucleotide sequence of the gene of said protease.
12. The method of claim 9, wherein said additional mutation is at said position 10.
13. The method of claim 9, wherein said additional mutation is at said position 45.
14. The method of claim 9, wherein said additional mutation is at said position 46.
15. The method of claim 9, wherein said additional mutation is at said position 54.
16. The method of claim 9, wherein said additional mutation is at said position 64.
17. The method of claim 9, wherein said additional mutation is at said position 84.
18. The method of claim 11, wherein said additional mutation corresponds to a condon for position 45, which is AGA, instead of AAA.
19. The method of claim 11, wherein said additional mutation corresponds to a condon for position 54, which is ATG, instead of ATA.
20. The method of claim 11, wherein said additional mutation corresponds to a condon for position 64, which is GTA, instead of ATA.
21. A nucleotide probe usable in the method according to claim 1, comprising, as a minimum sequence, a sequence selected from the group consisting of:a) CCA ATG AACpossibly supplemented by the nucleotide sequence of an adjacent region of the gene of said protease, on either side of the minimum sequence,b) a nucleotide sequence equivalent to a sequence defined in (a), andc) a sequence complementary to a sequence defined in (a) or in (b).
[0001]This is a Division of application Ser. No. 10/865,889 filed Jun. 14,
2004, which in turn is a Division of application Ser. No. 09/980,777
issued as U.S. Pat. No. 6,794,129 B1, which is a National Stage of
Application No. PCT/FR00/01728 filed Jun. 21, 2000. The disclosure of the
prior applications is hereby incorporated by reference herein in its
[0002]The invention relates to a method for testing the resistance of the HIV-2 virus to antiprotease treatment in a patient infected with HIV-2 as well as nucleotide probes usable for such testing.
[0003]Acquired immunodeficiency syndrome (AIDS) is caused by two viruses: HIV-1 and HIV-2. HIV-1 is present throughout the world while HIV-2 is present mainly in western Africa.
[0004]Effective antiviral treatments have been in widespread use since 1996 in developed countries where the virus present is HIV-1. Because of their cost, these treatments cannot be used in developing countries where HIV-2 is present.
[0005]There are three types of antiretroviral treatments: antiprotease (Indinavir, Ritonavir, Saquinavir, Nelfinavir, and Amprenavir), nucleoside reverse transcriptase (RT) inhibitors (Zidovudine, Didanosine, Zalcitabine, Lamivudine, Stavudine, Abacavir, FTC, and Adefovir), and nonnucleoside RT inhibitors (Nevirapine, Delavirdine, and Efavirenz). These treatments are often given in combination; this is known as multiple-drug therapy.
[0006]Antiproteases elicit primary mutations which confer a high degree of resistance but alter the ability of the virus to replicate. Thus, the virus needs to select secondary mutations if it is to be both resistant and able to replicate actively. Also, reverse transcriptase mutations have been described where nucleoside RT inhibitors have been used in combination.
[0007]During treatment with HIV-1 infection, particularly if the levels of drug in the bloodstream are inadequate, viral replication is insufficiently inhibited, or rises above the detection threshold of available viral load techniques (the "viral load" measures the quantity of virus genomes in the bloodstream). Because of the high error rate of reverse transcription, mutations take place in the genes targeted by protease and reverse transcriptase treatment. Certain mutations bring about various degrees of resistance to antivirals. Virologic failure occurs in 20 to 40% of patients treated with current multiple drug regimens.
[0008]If viruses resistant to one or more substances can be shown for a patient before treatment or if the viral load increases again, the best drug combination for treating HIV-1 can be chosen.
[0009]There are currently no published data on mutations in the HIV-2 genome due to the use of antiproteases.
[0010]Antiprotease agents that are active against HIV-1 are also active against HIV-2. However, there are no methods available to assist the clinician in determining resistance to antiprotease drugs in patients infected with HIV-2.
[0011]The amino acid sequence of the HIV-2 protease is known. In the present application, the numbering system for this amino acid sequence can be deduced from that described in Human Retroviruses and Aids, 1997, Los Alamos National Laboratory, Los Alamos, N. Mex., Chapter II, pp. B10 and B11. The first amino acid in the protease sequence, considered to be position 1 in the present application, is the proline in position 86 of the polyprotein PoL in the ROD strain.
[0012]It has now been discovered that antiprotease drugs can bring about mutations in positions 45, 54, 64, 84, and 90 and in positions 10, 46 of the HIV-2 protease and that the mutated viral strains thus appearing are usually resistant to at least one of the antiprotease drugs used.
[0013]Hence, the subject of the present invention is a method for testing resistance of an HIV-2 viral strain to antiprotease treatment.
[0014]In a preliminary testing phase, this is a method wherein:
[0015]a) using known methods, the presence of at least one mutation at one of positions 45, 54, 64, 84, and 90 or one of positions 10, 46 of the protein sequence of the protease of said viral strain in a biological sample taken from a patient infected with HIV-2 is investigated,
[0016]b) of the mutations founds in a), those which, after cloning in an HIV-2 virus, do not prevent the virus clone obtained from multiplying in culture in the presence of said antiprotease drug are selected, and
[0017]c) if at least one mutation is selected at step b), it is concluded that resistance exists to the antiprotease drug referred to in b).
[0018]Of the mutations found in a), those which, when present in a gene cloned in an HIV-2 virus, cause the viral clone not to be significantly prevented from multiplying in the presence of said antiprotease drug are selected. The following procedure may be used to implement step b). The mutations tested are inserted individually into a viral clone by mutagenesis directed by the method described in the article by Kemp et al., J. Virol., 72(6), pp. 5093-5098, 1998. The clones thus obtained are cultured with a "wild-type" (i.e. non-mutated) virus clone as a reference in the presence of the various antiprotease drugs able to act against the HIV-2 virus. By measuring the IC50 with a calorimetric test for example (see above Kemp article), the size of the mutation (minor or major) with the various drugs tested can be determined. Thus, one can select the mutations that allow the virus to multiply in the presence of an antiprotease agent as these mutations give rise to strains resistant to this antiprotease.
[0019]Of course, in the case outlined in c), the future treatment planned for the patient would be a different antiprotease agent from the agent shown to elicit resistance in this patient.
[0020]If step b) did not select a mutation found in step a), it may be concluded that the mutation in question did not elicit resistance by the HIV-2 virus to the antiprotease drug tested for the patient in question.
[0021]Obviously, when step b) identifies a mutation that generates resistance to a given antiprotease drug, step b) of the method described above need not be carried out in the future. In this case, step a) would suffice because the link between the mutation and resistance to the antiprotease drug would be established once and for all; one can go on directly to step c) and conclude that there is resistance to the antiprotease agent studied.
[0022]The invention relates in particular to a method for detecting any resistance of an HIV-2 viral strain to treatment by an antiprotease drug in which the presence of at least one mutation chosen from the following mutations: [0023]K 45 R, I 54 M, I 64 V, I 84 L and L 90 M, or V 10 I, I 46 V, and I 82 M,in the protein sequence of the protease of said viral strain is investigated and in which said resistance is concluded to exist if said mutation or said mutations is or are present.
[0024]The conventional notation in the present application for describing a mutation is as follows: The number indicates the position in the amino acid sequence of the HIV-2 protease. The letter to the left of the number is the amino acid of the wild-type strain in the international classification, with the one-letter code. The letter to the right of the number is the amino acid, in the same classification, resulting from a mutation.
[0025]"Wild-type strain" is understood to be a viral strain that has not mutated after treatment with an antiprotease.
[0026]To identify a mutation in the protein sequence of the protease of the viral strain in question, it is preferable to look for a corresponding mutation in the nucleotide sequence of the gene of said protease. These mutations can be tested on the DNA or the RNA. Of course, in looking for a mutation in the protein sequence by seeking a mutation in the nucleotide sequence, degeneration of the genetic code would be taken into account, namely a given amino acid can be coded by different codons. This mutation assay can be done in the nucleotide sequence by known methods, particularly by hybridization or sequencing techniques.
[0027]In a first embodiment of the invention, a hybridization method using specific probes is implemented to test for the mutation or mutations.
[0028]A particular embodiment using a hybridization method consists of obtaining a polynucleotide containing all or part of the protease gene, and including the sequence of interest corresponding to the region containing the mutation to be assayed. Such a polynucleotide can be obtained in particular by enzymatic amplification. The method used in this case comprises the steps consisting of placing said polynucleotide in contact with a nucleotide probe that is attached or attachable to a solid substrate and is able to hybridize specifically with such a polynucleotide only if the polynucleotide has the mutation studied; then revealing the presence of the polynucleotide attached to the solid substrate by the capture probe, using known methods. For this purpose, the solid substrate can be washed, after which the presence of the polynucleotide, attached to the substrate, is revealed either by a physical method or with an appropriate marker.
[0029]The probe can be attached directly by adsorption or by covalence. It can also be attached indirectly by a ligand/antiligand-type reaction such as the biotin/streptavidin or haptene/antibody pair, with the antiligand attaching to the solid substrate and the ligand to the probe, for example.
[0030]The polynucleotide can also be labeled during the enzymatic amplification stage, for example using a triphosphate nucleoside labeled for the amplification reaction. The labeled nucleotide will be a deoxyribonucleotide in amplification systems generating a DNA, such as PCR, or a ribonucleotide in amplification techniques generating an RNA, such as the TMA or NASBA techniques.
[0031]The polynucleotide can also be labeled after the amplification stage, for example by hybridizing a probe labeled by the sandwich hybridizing technique described in document WO 91/19812.
[0032]A particular method of labeling polynucleotides is described in application FR 98 07870 by the applicant.
[0033]Alternatively, the polynucleotide including all or part of the protease gene can be prepared by enzymatic amplification, elongating primers that have a ligand. The polynucleotide obtained, which will thus contain the ligand, can be attached to the solid substrate by interaction with a corresponding antiligand. The solid substrate to which the polynucleotide is attached is then placed in contact with at least one probe able to attach specifically to the polynucleotide only if it contains the sought-after mutation. If this mutation is present, the probe will be attached to the solid substrate by the hybrid it forms with the polynucleotide, which itself is attached. One need then only reveal the presence of the hybrid so formed by known methods.
[0034]In another embodiment, a hybridization method is used that comprises the steps of enzymatically amplifying all or part of the protease gene using primers carrying a ligand to generate a polynucleotide having at least one ligand, attaching the polynucleotide to a solid substrate by interaction with an antiligand as described above, placing said attached polynucleotide in contact with at least one probe capable of hybridizing specifically therewith, and revealing the hybrid formed, if any. The probe must hybridize only if the polynucleotide contains the sought-after mutation.
[0035]Other detection methods by hybridization may be considered such as that described in Kricka et al., Clinical Chemistry, 45(4), pp. 453-458, 1999 or Keller G. H. et al., DNA Probes, 2nd Ed., Stockton Press, 1993, sections 5 and 6, pp. 173-249.
[0036]The "solid substrate" as used here includes all the materials on which a polynucleotide can be immobilized. Synthetic materials or natural materials, that may be chemically modified, can be used for the solid substrate, particularly polysaccharides such as cellulose-based materials, for example paper, cellulose derivatives such as cellulose acetate and nitrocellulose, or dextran; polymers, copolymers, particularly those based on styrene-type monomers, natural fibers such as cotton, and synthetic fibers such as nylon; minerals such as silica, quartz, glasses, and ceramics; latexes; magnetic particles; metal derivatives; gels; etc. The solid substrate may be in the form of a microtitration plate, a membrane as described in application WO 9412670, a particle, or a biochip.
[0037]"Biochip" is understood to be a solid substrate of small size to which a plurality of polynucleotides are attached at predetermined positions.
[0038]Examples of these biochips are given for example in the publications of G. Ramsay, Nature Biotechnology, 16, pp. 40-44, 1998; F. Ginot, Human Mutation, 10, pp. 1-10, 1997; J. Cheng et al., Molecular Diagnosis, 1(3), pp. 183-200, 1996; T. Livache et al., Nucleic Acids Research, 22(15), pp. 2915-2921, 1994; J. Cheng et al., Nature Biotechnology, 16, pp. 541-546, 1998. The main property of the solid substrate must be to preserve the hybridization properties of the probes on the target and allow a minimum background noise for the detection method. One advantage of biochips is that they simplify the use of numerous probes, taking into account the polymorphism of the virus in areas abutting the sought-after mutation. A biochip for verifying the presence or absence of mutations can be made by the procedure described by Kozal M. et al., Nature Medicine, 2, pp. 753-759, 1996, as a function of alignments of sequences known for different HIV-2 strains.
[0039]A "marker" is understood to be a tracer able to generate a signal. A nonexhaustive list of these tracers includes enzymes producing a detectable signal, for example by colorimetry, fluorescence, or luminescence, such as horseradish peroxidase, alkaline phosphatase, beta-galactosidase, glucose-6-phosphate-dehydrogenase; chromophores such as fluorescent, luminescent, or dye compounds; electron density groups detectable by electron microscopy, or by their electrical properties such as conductivity, by amperometry or voltametry methods, or by impedance measurement; groups detectable by optical methods such as diffraction, surface plasmon resonance, or variation in contact angle, or by physical methods such as atomic force spectroscopy, tunnel effect, etc.; radioactive molecules such as 32P, 35S, or 125I.
[0040]Signal amplification systems can be used as described in document WO/95 08000 and in this case, the preliminary enzymatic amplification reaction may be unnecessary.
[0041]The term "primer" designates an oligonucleotide sequence able to hybridize to a useful nucleic sequence and to serve as a starting point for an enzymatic elongation reaction to produce a nucleic acid fragment complementing a target of interest such as the gene of the protease or part of this gene. The primer has a size of between 5 and 50 nucleotides, particularly between 10 and 30 nucleotides. Preferably, the primers are chosen in the preserved regions of the HIV-2 virus to enable all the viral strains that could be encountered in a patient to be amplified in order to deal with the polymorphism inherent in the HIV-2 virus.
[0042]The probes for demonstrating mutations at positions 45 and/or 54 and/or 64 and/or 84 and/or 90, as well as those showing mutations at positions 10 and/or 46 by hybridizing on all or part of the protease gene of the HIV-2 virus present in a biological sample, are also a subject of the present invention.
[0043]The term "probe" refers to an oligonucleotide sequence able to hybridize specifically with a nucleic acid sequence of interest. Here, since the goal of the present invention is to detect a point mutation on the gene of the HIV-2 protease, the probe must be able to distinguish a point mutation under predetermined hybridization or washing conditions. The size of these probes is between 5 and 40 nucleotides, particularly between 9 and 25 nucleotides. Methods for determining these probes have been described for example in the patent application WO 97/27332. The probe is, for example, constructed such that the position of the mutation to be detected is substantially in the center of the probe.
[0044]The oligonucleotides used as primers or probes can include natural or modified nucleotides such as phosphorothioates, H-phosphonates, alkylphosphorothioates, or analogs of nucleotides containing bases such as inosine or nebularin in the place of the purine or pyrimidine bases present in the A, T, C, G, and U nucleotides.
[0045]These primers or probes can be composed totally or partially of alpha or beta anomerism nucleosides or isomers in the D or L series, or PNA (Nielsen et al., Nucleic Acid Research, 21(2), pp. 197-200, 1993).
[0046]In another embodiment of the invention, the mutation or mutations is/are detected by sequencing all or part of the protease gene.
[0047]The various sequencing methods are well known: In particular, the sequencing methods of Sanger, the sequencing methods using four wells to react the sequences studied with sequencing primers labeled by four different fluorophores (Perkin-Elmer "ABI Prism Dye Primer" procedure), or the method described in U.S. Pat. No. 5,795,722 (Visible Genetics), or the method using labeled nucleotides (Perkin-Elmer "ABI Prism Dye Terminator" procedure) instead of labeled primers can be used. The sequencing methods are described, for example, in Molecular Cloning, A Laboratory Manual, Sambrook, Fritsch, and Maniatis, Cold Spring Harbor Laboratory Press, 1989, Chapter 13.
[0048]In a particular embodiment of the invention, the presence of only one or more given mutations is tested. In another embodiment of the invention, both the mutated nucleotide sequence and the wild-type (non-mutated) nucleotide sequence are tested. If a hybridization method is used, at least two types of probes are defined for each position able to mutate: a probe type specific to the mutated sequence and a probe type specific to the wild-type sequence. Using both these types of probes enables the method to be controlled, since at least one of the two probe types has to react. Another advantage is to reveal the presence of mutated strains and wild-type strains in a given patient, where present.
[0049]Preferably, the target nucleic acid is subjected to a preliminary enzymatic amplification reaction to increase the sensitivity of the test, but it is possible to detect the target nucleic acid directly. The articles by Lewis (1992, Genetic Engineering News, 12, 1-9), and Abramson and Myers (1993, Curr. Opin. Biotechnol., 4, 41-47) give examples of target amplification. The enzymatic amplification technique is, for example, chosen from the NASBA (Nucleic Acid Sequence Based Amplification), TMA (Transcription Mediated Amplification), RT-PCR (Reverse Transcriptase-Polymerase Chain Reaction), SDA (Strand Displacement Amplification), or LCR (Ligase Chain Reaction) techniques.
[0050]Mutant viral strains are detected from a possibly pretreated biologic sample. "Pretreatment" means the various steps by which the sample is treated to make the target nucleic acid, namely the protease gene, accessible, for example lysis, fluidization, concentration, or capture (see for example U.S. Pat. Nos. 5,750,388 and 5,766,849) using methods known of themselves.
[0051]To extract the viral RNA, one may, for example, use the reagent sold by the Boeringher Mannheim Company (High Pure Viral RNA reference 1858882) or the Quiagen kit (Viral RNA reference 29504). Other procedures are described in Maniatis et al., Molecular Cloning: A Laboratory Manual, 2nd Edition, Cold Spring Harbor Laboratory Press, 1989. The biologic sample can be any sample from the human body or possibly a sample enriched by culturing, such as blood, sperm, skin tissue, bronchoalveolar lavage fluid, biopsy, urine, colonies, liquid culture, etc.
[0052]The following examples illustrate the invention.
Example 1
[0053]A study was conducted on three patients infected with HIV-2. Patients 1 and 2 had never received antiproteases. Patient 3 had already received Ritonavir for 8 months, and this treatment had been withdrawn 5 months before the study started. The first sample studied was taken before the beginning of treatment in patients 1 and 2, and 6 weeks after the start of Ritonavir treatment for patient 3. In patients 1 and 2, samples taken 2 and 5 months respectively after the start of treatment were studied. For patient 3, two samples (8 months and 11 months) were analyzed. Treatment consisted of Ritonavir for patient 2 and Ritonavir/Saquinavir for patients 1 and 3, at the recommended doses.
[0054]The plasmas were obtained by centrifuging whole blood at 800 g for 10 minutes and clarified by a second centrifugation at 3000 g for 15 minutes.
[0055]500 microliters of pure plasma were added to 1.5 milliliters of fresh lymphocyte culture stimulated by PHA (106 cells/dish). Viral replication in the supernatant was monitored twice a week by measuring the level of HIV P-24 antigen (ELAVIA Ag I, Sanofi Diagnostics Pasteur). The positive supernatants were stored at -80° C. After ultracentrifugation of 1 milliliter of supernatant (23,500 g for 1 hour), the HIV-2 RNA was extracted by means of the Amplicor HCV Specimen Preparation kit (Roche).
[0056]The protease gene was retrotranscribed from 10 microliters of viral RNA solution and amplified with the Titan One Tube RT-PCR kit (Roche Molecular Diagnostics). Reverse transcription and the first amplification were done with the 3' Prot and 5' RT 3 primers (see below). The reaction at 50° C. for 30 minutes was followed by a denaturing step at 94° C. for 5 minutes then 40 cycles (30 seconds at 94° C., 30 seconds at 55° C., 90 seconds at 68° C.), and finally at 68° C. for 7 minutes. The step PCR stage was done with 5 microliters of the product of the first stage with primers 3' RTD and 5' Prot 2.1, with 5 minutes denaturing at 94° C., followed by 30 cycles (30 seconds at 94° C., followed by 30 cycles at 55° C., and 30 seconds at 72° C.) and finally 10 minutes at 72° C. The primer sequence is the following:
TABLE-US-00001 (SEQ ID NO: 1) 3'Prot: CAGGGGCTGACACCAACAGCACCCCC (SEQ ID NO: 2) 5'RT 3: CCATTTTTTCACAGATCTCTTTTAATGCCTC (SEQ ID NO: 3) 3'RTD: ATGTGGGGGTATTATAAGGATTT (SEQ ID NO: 4) 5'Prot 2.1: GAAAGAAGCCCCGCAACTTC
[0057]The amplification products were purified with the QUIACQUICK PCR purification kit (Quiagen) and sequenced directly with the 3' RTD and 5' Prot 2.1 primers using the ABI Prism Dye Terminator Cycle Sequencing kit (Applied Biosystem). They were analyzed with the Applied Biosystem 377 automatic sequencer and the sequences were aligned with the HIV-2 consensus sequences (subtypes A and B).
[0058]Before treatment, no mutation was detected relative to the HIV-2 A and B consensus sequences.
[0059]After treatment, the following mutations were observed: [0060]position 45: In patients 1 and 2, coexistence of a non-mutated population (lysine; codon AAA) and a mutated population (arginine; codon AGA) were observed, namely the K 45 K/R mutation was observed; [0061]position 54: In patients 1 and 2, replacement of isoleucine (codon ATA) by methionine (codon ATG), namely the I 54 M mutation, was observed; [0062]position 64: A non-mutated population was observed, and a population in which isoleucine (codon ATA) was replaced by a valine (codon GTA), namely mutation I 64 I/V; [0063]position 84: In patient 3, a non-mutated population (isoleucine (codon ATC) and a mutated population with replacement of isoleucine by a leucine (codon CTC) were observed, namely the I 84 I/L mutation; [0064]position 90: In all 3 patients, replacement of leucine (codon CTG) by a methionine (codon ATG) was observed, namely the L 90 M mutation.
[0065]Similarly, the following mutations were observed: [0066]position 10: Replacement of valine (codon GTA) by an isoleucine (codon ATA): i.e. mutation V 10 I when a patient was treated with Ritonavir; [0067]position 46: Replacement of isoleucine (codon ATA) by a valine (codon GTA): i.e. mutation I 46 V when a patient was treated with Ritonavir; and
[0068]position 82: Replacement of isoleucine (codon ATA) by a methionine (codon ATG): i.e. mutation I 82 M when a patient was treated with Indinavir.
Example 2
Example of Probes that can be Used for Detecting Mutations on the HIV-2 Protease Gene
[0069]The probes usable for revealing any mutations according to the invention, using hybridization techniques, can be defined from alignments published by Myers G. et al., 1997, Human Retroviruses and AIDS: A compilation and analysis of nucleic acid and amino acid sequences, Los Alamos National Laboratory, Los Alamos, N. Mex.
[0070]Of course, in addition to the probes expressly defined below, the invention also includes equivalent nucleotide probes, namely probes able to detect the same mutations on the protein sequence of the protease as those detected by the probes defined below, taking into account degeneration in the genetic code, namely the fact that a given amino acid can be coded by different codons.
[0071]Thus, the expression "equivalent nucleotide sequences" means any nucleotide sequences that differ from each other by at least one nucleotide but whose translation leads to the same protein sequence, in other words all nucleotide sequences coding for the same protein sequence.
[0072]Of course, this comment applies to each codon in each probe. Thus, for example, the amino acid in position 53 of HIV-2 protease is a phenylalanine which can be coded either by codon TTT or by codon TTC. The probes corresponding to each of these possibilities are of course part of the invention.
[0073]Depending on the particular hybridization conditions, particularly the temperature and composition of the hybridization and washing buffers, it is possible to define probes that must include at least one of the minimum sequences below, or their complementary sequences. Probes containing these sequences enable mutations to be distinguished in a hybridization process. Of course, analogous probes, obtained in particular by introducing base analogs such as inosine or nebularin in positions where polymorphism due to intrinsic variability of the virus is present lead to a similar result and are also part of the invention.
[0074]These sequences are given in the 5' to 3' direction:
[0075]CCA AAA ATA for a wild-type form of position 45.
[0076]CCA AAA GTA for a wild-type form of position 45.
[0077]CCT AAA ATA for a wild-type form of position 45.
[0078]CCA AGA ATA for a mutated form of position 45.
[0079]CCA AGA GTA for a mutated form of position 45.
[0080]CCT AGA ATA for a mutated form of position 45.
[0081]TTT ATA AAC for a wild-type form of position 54.
[0082]TTT ATA AAT for a wild-type form of position 54.
[0083]TTT ATG AAC for a mutated form of position 54.
[0084]TTT ATG AAT for a mutated form of position 54.
[0085]GAA ATA AAA for a wild-type form of position 64.
[0086]GAA ATA GAA for a wild-type form of position 64.
[0087]GAA GTA AAA for a mutated form of position 64.
[0088]GAA GTA GAA for a mutated form of position 64.
[0089]AAC ATC TTT for a wild-type form of position 84.
[0090]AAC ATT TTT for a wild-type form of position 84.
[0091]AAC CTC TTT for a mutated form of position 84.
[0092]ATT CTG ACA for a wild-type form of position 90.
[0093]ATC CTG ACA for a wild-type form of position 90.
[0094]ATT CTA ACA for a wild-type form of position 90.
[0095]ATC CTA ACA for a wild-type form of position 90.
[0096]ATT ATG ACA for a mutated form of position 90.
[0097]ATC ATG ACA for a mutated form of position 90.
[0099]CCA GTA GTC for a wild-type form of position 10.
[0100]CCA ATA GTC for a mutated form of position 10.
[0101]AAA ATA GTA for a wild-type form of position 46.
[0102]AAA GTA GTA for a mutated form of position 46.
[0103]CCA ATC AAC for a wild-type form of position 82.
[0104]CCA ATA AAC for a wild-type form of position 82.
[0105]CCA ATG AAC for a mutated form of position 82.
[0106]To obtain probes longer than those with the minimum sequences of 9 nucleotides shown above, it is of course necessary to choose additional nucleotides in order to respect the sequence of the adjacent regions on either side of the minimum sequence in the gene of the protease of an HIV-2 strain. These sequences can be obtained from databases.
[0107]For example, the probes indicated below, or their complementary probes, can be used.
[0108](a) Position 45:
[0109]A probe having for example 9 to 25 nucleotides (preferably distributed symmetrically about the mutated codon AGA) whose sequence is included in one of the following sequences:
TABLE-US-00002 ATTACACTCCAAGAATAGTAGGGGG (SEQ ID NO: 5) ATTATAGCCCAAGAATAGTAGGGGG (SEQ ID NO: 6) ATTATAGTCCAAGAATAGTAGGGGG (SEQ ID NO: 7) ATTATACCCCAAGAATAGTAGGGGG (SEQ ID NO: 8) ATTATAGTCCAAGAATAGTAGGAGG (SEQ ID NO: 9) ATTATACCCCAAGAATAGTAGGAGG (SEQ ID NO: 10) can be used.
[0110](b) Position 54:
[0111]A probe having for example 9 to 25 nucleotides (preferably distributed symmetrically about the mutated codon ATG) whose sequence is included in one of the following sequences:
TABLE-US-00003 TAGGGGGATTTATGAACACCAAAGA (SEQ ID NO: 11) TAGGGGGATTCATGAACACCAAAGA (SEQ ID NO: 12) TAGGAGGATTCATGAACACCAAAGA (SEQ ID NO: 13) TAGGAGGGTTCATGAACACCAAAGA (SEQ ID NO: 14) can be used.
[0112](c) Position 64:
[0113]A probe having for example 9 to 25 nucleotides (preferably distributed symmetrically about the mutated codon GTA) whose sequence is included in one of the following sequences:
TABLE-US-00004 AAAATGTAGAAGTAAAAGTACTAAA (SEQ ID NO: 15) AAAATATAGAAGTAAAAGTACTAAA (SEQ ID NO: 16) AAGATGTAGAAGTAAAGGTACTAAA (SEQ ID NO: 17) AAAATGTAGAAGTAGAAGTTCTAAA (SEQ ID NO: 18) AAAATGTAGAAGTAGAAGTCCTGGA (SEQ ID NO: 19) AAAGTGTAGAAGTAAGAGTGCTAAA (SEQ ID NO: 20) can be used.
[0114](d) Position 84:
[0115]A probe having for example 9 to 25 nucleotides (preferably distributed symmetrically about the mutated codon CTC) whose sequence is included in the following sequence:
TABLE-US-00005 CCCCAATCAACCTCTTTGGCAGAAA (SEQ ID NO: 21) can be used.
[0116](e) Position 90:
[0117]A probe having for example 9 to 25 nucleotides (preferably distributed symmetrically about the mutated codon ATG) whose sequence is included in one of the following sequences:
TABLE-US-00006 GCAGAAATATTATGACAGCCTTAGG (SEQ ID NO: 22) GCAGAAATATTATGGCAACCTTAGG (SEQ ID NO: 23) GCAGAAATGTTATGACAGCTTTAGG (SEQ ID NO: 24) GCAGAAATATCATGACAGCCTTGGG (SEQ ID NO: 25) GCAGAAACATTATGACAGCCTTA (SEQ ID NO: 26) can be used.
Sequence CWU
26126DNAArtificial Sequence3' Prot primer 1caggggctga caccaacagc accccc
26231DNAArtificial Sequence5' RT
primer 2ccattttttc acagatctct tttaatgcct c
31323DNAArtificial Sequence3' RTD primer 3atgtgggggt attataagga ttt
23420DNAArtificial Sequence5'
Prot 2.1 primer 4gaaagaagcc ccgcaacttc
20525DNAArtificial SequenceProbe (position 45) 5attacactcc
aagaatagta ggggg
25625DNAArtificial SequenceProbe (position 45) 6attatagccc aagaatagta
ggggg 25725DNAArtificial
SequenceProbe (position 45) 7attatagtcc aagaatagta ggggg
25825DNAArtificial SequenceProbe (position 45)
8attatacccc aagaatagta ggggg
25925DNAArtificial SequenceProbe (position 45) 9attatagtcc aagaatagta
ggagg 251025DNAArtificial
SequenceProbe (position 45) 10attatacccc aagaatagta ggagg
251125DNAArtificial SequenceProbe (position 54)
11tagggggatt tatgaacacc aaaga
251225DNAArtificial SequenceProbe (position 54) 12tagggggatt catgaacacc
aaaga 251325DNAArtificial
SequenceProbe (position 54) 13taggaggatt catgaacacc aaaga
251425DNAArtificial SequenceProbe (position 54)
14taggagggtt catgaacacc aaaga
251525DNAArtificial SequenceProbe (position 64) 15aaaatgtaga agtaaaagta
ctaaa 251625DNAArtificial
SequenceProbe (position 64) 16aaaatataga agtaaaagta ctaaa
251725DNAArtificial SequenceProbe (position 64)
17aagatgtaga agtaaaggta ctaaa
251825DNAArtificial SequenceProbe (position 64) 18aaaatgtaga agtagaagtt
ctaaa 251925DNAArtificial
SequenceProbe (position 64) 19aaaatgtaga agtagaagtc ctgga
252025DNAArtificial SequenceProbe (position 64)
20aaagtgtaga agtaagagtg ctaaa
252125DNAArtificial SequenceProbe (position 84) 21ccccaatcaa cctctttggc
agaaa 252225DNAArtificial
SequenceProbe (position 90) 22gcagaaatat tatgacagcc ttagg
252325DNAArtificial SequenceProbe (position 90)
23gcagaaatat tatggcaacc ttagg
252425DNAArtificial SequenceProbe (position 90) 24gcagaaatgt tatgacagct
ttagg 252525DNAArtificial
SequenceProbe (position 90) 25gcagaaatat catgacagcc ttggg
252623DNAArtificial SequenceProbe (position 90)
26gcagaaacat tatgacagcc tta
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A collection of news and information related to Peter Bourjos published by this site and its partners.
Top Peter Bourjos Articles
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Angels: Rain slightly delays start of Sunday's Angels-Red Sox game
Story | Apr 24, 2011 | 4:33 PMA light rain has been falling on Angel Stadium all Sunday morning, but it started to pick up just before noon, causing the grounds crew to partially roll out the tarp, which was poised to cover the infield. The scheduled...... -
Angels go for three-game sweep of A's; Kendrys Morales examined by foot specialist
Story | Apr 27, 2011 | 4:33 PMThree days ago, the Angels' batters, as former Dodgers Manager Tommy Lasorda once said in a famous rant, couldn't hit water if they fell out of a boat. While getting swept in a four-game series by the Boston Red Sox,...... -
Thursday Morning Coffee: Reapportionment Commission To Meet This Afternoon.
Story | Apr 12, 2012 | 4:22 PMGood Thursday Morning, Fellow Seekers. The Legislative Reapportionment Commission meets at 1 p.m. today to maybe ... possibly ... hope of hopes ... vote on a new map of the 203 state House and 50 state Senate districts. Capitolwire reported...... -
PHILLIES FILES: 3 Phils up for Gold Gloves, including Polly who spoke about his position change
Story | Nov 1, 2011 | 4:24 PMNo more wondering when the Gold Glove winners will be announced. ESPN2 will televise the first-ever Rawlings Gold Glove Awards show at 10 tonight. The one-hour telecast, hosted by Karl Ravech, John Kruk and Barry Larkin, will feature the announcement........ -
Angels bullpen collapses in 6-5 loss; playoff hopes nearly dead
Story | Sep 25, 2011 | 4:33 PMThe Angels bullpen suffered a complete meltdown Sunday, failing to hold a three-run lead in the ninth inning in a loss to the Oakland Athletics, 6-5, in Angel Stadium. Closer Jordan Walden threw away a potential game-ending double-play grounder during....... -
Mark Trumbo and Jeff Mathis in Angels lineup vs. A's
Story | Sep 25, 2011 | 4:33 PMMark Trumbo, who was pulled from Saturday night's game in the seventh inning because of right ankle discomfort, was penciled in to the lineup for Sunday's must-win game against the Oakland Athletics in Angel Stadium. But after the rookie first...... -
Scioscia disputes criticism from Detroit about lineup decisions
Story | Sep 28, 2011 | 4:33 PMSports talk radio in Detroit is abuzz with criticism of Angels Manager Mike Scioscia, who pulled Ervin Santana and Jered Weaver from their scheduled starts against the Texas Rangers on Tuesday and Wednesday and arranged to start five rookies in...... -
Angels face two tough foes: Oakland's Gio Gonzalez, fatigue
Story | Sep 23, 2011 | 9:33 PMThe road-weary Angels will turn to ace Jered Weaver in an effort to keep their slim playoff hopes alive Friday night, but their hitters will also have a difficult obstacle to overcome in Angel Stadium: Oakland left-hander Gio Gonzalez. Gonzalez...... -
Angels lose a game and some ground in Toronto
Story | Sep 22, 2011 | 9:33 PMThe Angels, chasing teams in two separate playoffs races, had a chance to pick up ground in each Thursday in Toronto. The Boston Red Sox, who lead the wild-card race, were idle Thursday. And the Texas Rangers, who lead the...... -
Angels look to end regular-season road campaign on an upbeat
Story | Sep 22, 2011 | 4:33 PMThe Rogers Centre's retractible roof with be open Thursday night when the Angels take the field in Toronto for their final road game of the season. The regular season, that is. Because the Angels begin play just 2 1/2 games...... -
Angels offense heating up during stretch drive
Story | Sep 21, 2011 | 9:33 PMPitching has the Angels knocking on the door to the postseason. Now, Manager Mike Scioscia says, it's up to the offense to carry the team over the threshold. "It's a critical time for us to move forward; getting a couple......


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Running the GT500 at The Nardo Ring in Southern Italy.
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Module 1: Introducing Formative Instructional Practices
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Discover what performance management is and how it can benefit your school
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Learn how to create a root cause analysis, "5 Why's" analysis, and SWOT analysis to analyze data results
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Explore how to define, map, and improve processes using a SIPOC
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Investigate how variance in processes causes waste and how to create standard procedures for reliable, high-quality outcomes
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'Hart of Dixie': 4 Big Questions for Season 2 Premiere
THR highlights some of the top moments from the opener, "I Fall to Pieces."
Are you Team Wade or Team George?
Viewers will have to pick a side when The CW's Southern medical drama Hart of Dixie kicks off its sophomore season Tuesday with an episode that picks up one day after Dr. Zoe Hart's (Rachel Bilson) romantic debacle between the two suitors.
After screening the premiere "I Fall to Pieces" early, The Hollywood Reporter runs down four of the biggest questions for the season two premiere -- and beyond:
[Warning: Light spoilers ahead.]
PHOTOS: The CW's 2012-13 Season: 'Carrie Diaries,' 'Arrow' and 'Cult'
1. Who does Zoe ultimately choose: bad boy Wade (Wilson Bethel) or responsible George (Scott Porter)?
The finale found Zoe in a bind. After succumbing to her feelings for Rammer Jammer bartender (and all-around nuisance, at least in Zoe's eyes) Wade and discovering that "golden boy" George called off his wedding for her, a big decision about which road the former New Yorker will take is imminent. George quickly finds out about her "B-" romp with Wade and as expected, he doesn't have the most positive of reactions. But the two opt to be men about it: As Wade puts it, he has "no interest in being John Wayne with George Tucker" over Zoe. Let's just say, that goes out the window. Zoe's decision doesn't come until the final minutes of the episode, but how she gets to that point is just as important as what she decides.
2. Who is Bluebell newcomer Ruby (guest star Golden Brooks)?
Zoe finally finds a new best friend in Bluebell transplant Ruby Jeffries, but Ruby has more ties to the small town and its residents than meets the eye. (In one key reunion scene, wine plays a role.) Ruby's entry into Zoe's life comes at an opportune time for the doc, as she's been leaning heavily on her best "girlfriend" Lavon (Cress Williams) for guy advice. How exactly does Ruby come into the fold? Zoe treats one of her most difficult patients yet, Ruby's grandfather, who calls Zoe "homewrecker" -- multiple times.
PHOTOS: From Comic to Screen: Behind the Scenes of the CW's 'Arrow'
3. Will we see a new side to Lemon (Jaime King)?
Bluebell residents may be aware that George and Lemon's wedding was called off the night before, but the one person who has the most difficult time moving on is Lemon. While the bulk of the episode focuses on Zoe's struggles in her love life, Lemon makes the bold decision that now is the time for her to start fresh -- which includes moving out of her childhood home, getting a new job at the Rammer Jammer and becoming more independent (see: standing up to her father Brick [Tim Matheson]). So much so that when she attempts to return a wedding gift -- a cake knife -- with Zoe in tow, Bluebell goes into a tizzy, deeming it the town's very first hostage crisis.
4. Is love in the air in Bluebell for Brick?
Brick is getting some notice from the ladies too. Even with the George-Lemon wedding off, a guest from George's side Emily (Mary Paige Keller) is hoping for some quality one-on-one time with the trusted doc in town. But as things often go, Brick is called away to deal with said "hostage crisis."
There are several more moments that stand out in the Hart of Dixie premiere -- including numerous shirtless Wade scenes and worthy one-liners -- but the return effectively wraps up the loose ends from season one. The ultimate question becomes: Will Zoe's decision, revealed at the end of the episode, be satisfying?
Hart of Dixie returns for season two 8 p.m. Tuesday on The CW.
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text: Latest Post: Started By: Rank: Category Barack Obama LegacyBBB Member CommentsR1KRA8'Gestapo' tactics meet senior citizens at Yellowstone By John Macone Newburyport Daily News Posted 153 days ago. Kunectdots"flip-flop"? Is that the same as admitting "My law won't cause you to lose the doctor that you want to keep. The EFFECTS of MY law may cause you to lose the doctor you WANTED to keep? I don't think Obama has EVER given to shakes about his "Legacy". His performance has been to turn this country into what he, and the people who influenced his life, wanted it to be all along. Posted 160 days ago. R1KRA8Barack Obama Legacy - 'flip-flop' * * * Iran warns Obama 'flip-flop' threatens trust By AFP - Agence France Presse Posted 160 days ago. BeRightGet used to it. Hillary is running and will use voter ID laws to get the minority vote. That will be onme of two issues she will run one. The other is I am woman hear me roar. She will win and Bill will be back in the Whitehouse. Better lockdown the interns and get a drycleaner on call to get stains from the dresses. Posted 169 days ago. R1KRA8Obama struggles with debt talk at Ford plant: 'If we don't raise the debt ceiling, we're deadbeats' By Dave Boyer * * * Obama says if Congress does not raise debt ceiling, 'We're deadbeats' (Reuters) Posted 170 days ago. moderationBenghazi investigators gave Hillary Clinton heads-up on findings By Stephen Dinan Issa running out of ammo(options ?) Posted 170 days ago. R1KRA8Benghazi investigators gave Hillary Clinton heads-up on findings By Stephen Dinan Posted 171 days ago. BeRightThis is interesting. I can post this under both Clean Energy and Obama's legacy. I would call the a twofer: Indiana Michigan Power, an operating unit of American Electric Power , has announced it will retire the 500 MW Tanners Creek 4 generating unit along with the other three units at the plant. All four generating units at the plant will be retired by mid-2015. The announcement of the retirement of Unit 4 brings the total of coal-fueled generation that will be retired by AEP to 7,176 MW by early 2016. Posted 171 days ago. luvthesouthObama quote 2009: My healthcare mandate is not a tax. Supreme Court Decision 2012: Obamacare passed into law as a tax. Posted 172 days ago. BeRightWhere is the Presidents leadership on the following problem? Is that he has too many 30ish people in his administration that don't care about the baby boomers: 10,000 people a day will turn 65 for the next 17 years. Adding 30 million to America's senior citizen ranks. In 2026, the Medicare trust fund will be exhausted. By 2021, SS payouts will outstrip money coming in. And in 2033, the SS fund that worked for 75 years will be kaput. Obamacare will cost much more than expected and will strip away at any deficit reductions he claims to be making. What will the community organizer do? Posted 174 days ago. BeRightIt is a shame that we wasted all the stimulus money. Colorado could actually put some of that wasted money to good use now. Posted 175 days ago. luvthesouthnew name for presbo culled from a London newspaper. Ditherer-in-Chief. sounds very english doesn't it. Posted 176 days ago. luvthesouthindecisiveness...thats exactly what we need in a president...and we got it. the fulfillment of the "fad and whim" presidency. Putin is President by proxy. liberals, you have achieved your goal. rejoice. Posted 177 days ago. R1KRA8September 14, 2013 * * * Editorial Do all to avoid a strike in Syria * * * Letter to the Editor It's time to begin impeachment of Obama * * * Posted 177 days ago. ValveguyI guess the Syrian rebels are on their own again as we prop up the rebels and Putin props up Assad. Are we betting on the right horse? What a mess. Posted 179 days ago. R1KRA8Op-Ed Contributor A Plea for Caution From Russia What Putin Has to Say to Americans About Syria By Vladimir V. Putin The New York Times Posted 180 days ago. R1KRA8"This is my last election. After my election I have more flexibility." ~ President Obama "I understand. I will transmit this information to Vladimir." ~ President Medvedev Posted 180 days ago. luvthesouththegreek, you are welcome. frankly i avoid as many public places as i can and when i do, i am usually with my wife. she is the smart one and always has hand sanitizer in her purse. as much as i detest the debit/credit card, i am thankful for it when i think of how nasty our currency must be. i forget exactly what percentage of our paper currency had traces of coke on it during its heyday. maybe that would explain the numbing feeling in my fingers when i counted out bills during that time. :-) Posted 180 days ago. luvthesouthmoderation, yes it is actually. it seems to be an automatic response in many animal species. although i do not recall any pictures of bill emulating that particular lip contortion around hillary. but then again i rarely see images of them together at all. btw this syria "peyton place" is getting more and more bizarre as the time goes on. might be a great time for our President to let biden take over. he can't eff it up too much more...besides, he is always good for a laugh. Posted 180 days ago. Post a Comment |


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dimes |
Lindsay Lohan Accuser -- Actress Was 'Slurring' and REEKED Of Booze
He said, she said. He'll never be able to prove his allegations of boozebreath and slurring unless… -
Surveillance Video Shows Entire Lindsay Lohan Incident
I think I'll wait to see the video before concluding that the guy was sprinting, rather than rely… -
'The Rocketeer' -- Actor Saves 3 Men After Boat Capsizes
He was awesome in The Killing. -
Matt Lauer -- There is NO BEEF with Al Roker
I agree with Ashley. I can't watch Lauer - he skeeves me right out. -
Miley Cyrus -- Intruder With Weapon ARRESTED At Singer's Home
That guy looks like Uncle Fester. -
Drew Carey -- I Feel 'Really Bad' About Bob Barker Situation
I don't think it was Drew's decision, but he may be feeling guilty that he didn't insist on… -
Drew Carey -- I Feel 'Really Bad' About Bob Barker Situation
Not to mention the fact that the show is taped in the Bob Barker Studio at CBS. -
Drew Carey -- I Feel 'Really Bad' About Bob Barker Situation
I have nothing against Drew Carey, but I wonder what a body language expert would make of his video… -
Simon Cowell -- Britney Spears Almost Quit 'X Factor' on Day 1
Yesterday he's bitchomg about a timeslot. Today he's dishing on Spears. What will tomorrow's topic… -
Prince Harry Resurfaces
Boy, you're really getting your money's worth out of those nudie shots.


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Found the same room at a different price? Tell us, and we'll offer to match it.
Directions - Robertson Arms Hotel, Lanarkshire
3 | Visit Scotland Assessed Hotel | Ratings explained |
The Henderson family have lovingly renovated throughout to catapult this wee gem of a hotel into the 21st century.
We have been awarded a Visit Scotland 3 Star Accreditation of which we are rated at the top end. In September 2013 we won the "Best Service Award" in Laterooms.com "Best Kept Secret Awards" and we were delighted to receive a 'highly commended' for "Best Breakfast"
Our en-suite bedrooms are of an extremely high standard with all the facilities you would expect for a very comfortable stay.
Free Wi-Fi is available in all the public areas and most rooms.
The Bistro serves food from mid-day, every day. The Bistro bar has a wood burning stove lit on chilly days and during the summer months the beer garden is a pleasant area for out door dining. The cosy residents snug is super to relax in after a busy day.
Whether your visit is for business or pleasure a warm welcome awaits.
Lovely rooms, friendly service, and superb food make this the perfect base to explore this wonderful part of Scotland.
DirectionsView directions provided by hotelFrom Glasgow follow the M* to Bargeddie, take the A8 as far as Chapelhall then the A73 as far as Carluke. Once at Carluke follow signs for the A721 which will take you to Carnwath. Railway:Carstairs Lanark Carluke Breich Airport:Edinburgh Airport Attractions:Scotlands Theme Park |


text: Notable is the Jansport Big Student Backpack in Chocolate Chip Twilight (pictured) for $59.99. After this mail-in rebate, it falls to $0. With free shipping, that's the lowest total price we could find for this backpack in any pattern by $38. Features include two zippered front stash pockets, S-curve shoulder straps, and more.


text:
Luiz Romagnoli
I've tried it some time ago and I couldn't choose which folder to sync. Does anyone know something about this functionality? Thanks!
SBackup, Simple Backup, is an Open Source, easy to use backup solution intended for desktop use. It can backup any subset of files and folders. All configuration is accessable via Gnome interface. File and paths can be included and excluded … Continue reading
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People always love videos. We've all heard the saying: "A picture is worth a thousand words". Now it has changed slightly: "A video is worth a thousand pictures and words". A video will describe things much better than pictures and … Continue reading
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Pandora FMS is a performance & availability monitoring system, ready for big environments. It uses agents for local monitoring and can do several kinds of remote network monitoring (SNMP v3, TCP checks, remote WMI probes…) Agents works on Linux, Windows, … Continue reading
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I usually use the lshw command as a super-user, but recently i discovered a nice tool which can help me to find out information about the Linux system i am using. This nice command line tool is called ScreenFetch. It … Continue reading
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Hi Guys, Hope you're enjoying the Sunday. Today I've came up with an excellent designing application. Want to become an Interior Home designer for your future or present home? Yes, Wonder, how? Cool, it is very easy i guess. Here … Continue reading
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Percona Server is an enhanced drop-in replacement of MySQL. The latest version Percona Server 5.6 is made available for download with new features and many improvements. In this tutorial let me show you how to install it on Debian 7 … Continue reading
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Hi there, Have you heard about Ninite? No?, Ok no problem. Let me give a short introduction about Ninite. Ninite is a simple but useful utility to ease our all software installation/updation at once. It offers many everyday usage applications … Continue reading
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Collaboration is becoming increasingly important in the modern era to manage, connect and interact with remote employees around the globe. Collaboration tools allows employees to learn from each other, moreover employees will feel that they are part of a family. … Continue reading
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gLabels is a lightweight program for creating labels, barcodes, business cards and media covers for the GNOME desktop environment. It is designed to work with various laser/ink-jet peel-off label and business card sheets that you'll find at most office supply … Continue reading
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BirdFont is a free, Open Source font editor written by Johan Mattsson using Vala programming language. It lets you create vector graphics and export TTF, EOT & SVG fonts. It is available for Windows, Linux, Mac and OpenBSD platforms. Install … Continue reading
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I've tried it some time ago and I couldn't choose which folder to sync. Does anyone know something about this functionality? Thanks!
This is the shortcut of fail2ban:
# ban & send an e-mail with whois report to the destemail.
action_mw = %(banaction)s[name=%(__name__)s, port="%(port)s"]
mail-whois[name=%(__name__)s, dest="%(destemail)s"]
Where you hear this?
Curious about the `action = %(action_mw)s` part, what does this do ?
OSW3 free e per tutti
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Bali Spirit Festival
Purnati Center for the Arts
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Tullan early morning.
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— "Prisoner" from the Stanford Prison Experiment (1971)
(Source: eolithandbone, via x-tammie)
— Jack Kerouac (via owelles)
I wish I could just wash away all the bad things that have ever happened to you. I wish I could leave you cleansed and new once again. I wish I could take away the pain that leaves a heavy burden on your shoulders. I wish I could show you that though the world is cruel, you belong here. You deserve to be here. You deserve to be happy.
(via sunriseismylife)
— George Sand (via observando)
And maybe there are seasons
And maybe they change
And maybe to love is not so strangeThe sounds of the day
Now they hurry away
Now they are gone until tomorrowWhen day will break
And you will wake
And you will rake your hands
Across your eyes and realizeThat it's going to be a day
There is really no way to say no
To the morning


text:
PHILADELPHIA - September 23, 2013 (WPVI) -- A small device is making big news in treating the most serious form of sleep apnea.
That's when someone's breathing is interrupted during their sleep.
If you know someone with heart failure, they could also have "central sleep apnea." A third of those with heart failure have it.
Unlike other sleep apnea types, people with central sleep apnea typically don't snore.
But the brain isn't sending the right signals to keep someone breathing while they sleep. It can be very dangerous, and there haven't been good treatments for it.
Now, there may be a new remedy.
Leslie McGuire says he used to wake up at night gasping for air.
McGuire recalls, "It scares you when you wake up and you go oh my God what's happening."
He has central sleep apnea. A standard C-Pap breathing machine usually won't work.
But it seems a new device called 'remede' (as in 'remedy') is working.
In a test, doctors at 11 hospitals worldwide implanted this pacemaker-like device in 47 patients.
It goes under the collarbone, and a wire runs to the diaphragm.
At night, it signals the diaphragm to breathe.
It cut episodes of not breathing by 80 per cent, and it eased daytime sleepiness.
Dr. William Abraham, the lead researcher at the Ohio State Wexner Medical Center, says, "The beauty of the 'remede' device is that it requires no patient adherence. It's implanted, it's turned on, it's automatic."
Dr. Abraham presented his results at today's session of the 17th annual meeting of the Heart Failure Society of America.
A second round of tests is underway, and is expanding to 25 medical centers.
McGuire says he is happy he was in the first trials - the difference for him was remarkable.
"I wake up now, I've got the energy to get up. I get up and move around - it's just a hundred per cent different," he says.
Most people have obstructive sleep apnea, not central sleep apnea. Snoring is less common with the central type.
However, many other symptoms are similar, such as: abrupt wakening during the night, abnormal breathing, daytime sleepiness, headaches, and difficulty concentrating.
These conditions can lead to many other health problems. If you have any of those symptoms, talk to your healthcare provider about being tested.
The American College of Physicians today issued new recommendations for people with obstructive sleep apnea.
They say patients should lose weight and use continuous positive airway pressure (CPAP) for their first therapy.
"The evidence indicates that intensive weight loss interventions help improve sleep study results and symptoms of OSA," said Dr. Molly Cooke, president of the College of Physicians.
ACP recommends a mandibular advancement device (MAD) as an alternative therapy for patients who prefer it or who can't handle CPAP treatment.
The evidence shows that the incidence of OSA is rising, likely because of the increasing rates of obesity.
lifestyle, healthcheck
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text:
La Velle E. Neal III has covered baseball for the Star Tribune since 1998 (the post-Knoblauch era). Born and raised in Chicago, he grew up following the White Sox and hating the Cubs. He attended both the University of Illinois and Illinois-Chicago and began his baseball writing career at the Kansas City Star. He can be heard occasionally on KFAN radio, lending his great baseball mind to Paul Allen and other hosts. Mark Rosen borrows him occasionally for WCCO-TV.
Darin Mastroianni is slightly injured, and is hitless at Rochester.
Aaron Hicks has a slight knock, and is barely hitting better than Mastroianni.
So the Twins have reinstated Wilkin Ramirez from Class AA New Britain, where he was on a rehab assignment following his battle with concussion symptoms. And he was batting just .172 in seven games.
It shows that the Twins really wanted another player who can play center field. Clete Thomas has played every game there since Hicks was sent down. Cleveland is starting righthanders in all three games of this series, so I'm not sure when Ramirez will start.
On to tonight's game.
I hope this is not taken the wrong way, but can't wait to see Danny Salazar on the mound for the Indians tonight. It's always exciting to see young players with a lot of talent.
Salazar, a 23-year old from Santo Domingo, brings it. Detroit manager Jim Leyland raved last week at how easy Salazar made it look as he hit 98, 99 mph on the radar gun. He has 17 strikeouts in 13.2 innings as he prepares for his third major league start.
The Twins send Andrew Albers out for his home debut and second career start. He sparkled against the Royals last week in his debut, tossing 8.1 scoreless innings. It's a battle of young pitching talents tonight at Target Field.
Ramirez is here and in uniform. The Twins are out on the field for early batting practice. A lot has been made of the Twins not hitting well with runners in scoring position. Should we be surprised at this point of the season?
The Twins don't have a real leadoff hitter. They don't manufacture runs. They don't have a lot of basestealers on the roster. When they are going good they are driving the ball off or over the wall or are capitalizing on opponent's mistakes. They don't string hits together very often. With Willingham back and Colabello getting playing time, the Twins are a little more threatening at the plate.
And, as it has been many times in the past, when Mauer and Morneau are hitting, the Twins are a different team. That's what's happening right now.
Josh Willingham is back in left field after serving as the designated hitter during the Chicago series. Twins manager Ron Gardenhire is confident that Willingham's surgically-repaired knee can handle the duty. That allows Gardy to put Oswaldo Arcia in right field, where he's played more.
Chris Herrmann gets to work with Andrew Albers again as Joe Mauer is the DH tonight.
Gardy said he didn't learn that Jamey Carroll was traded until assistant GM Rob Antony told both of them after Sunday's game. ``That was a little awkward,'' Gardy said. ``Never had that happen before.''
Cleveland (63-55)
1. Michael Bourn, CF
2. Nick Swisher, 1B
3. Jason Kipnis, 2B
4. Asdrubal Cabrera, SS
5. Carlos Santana, DH
6. Yan Gomes, C
7. Michael Brantley, LF
8. Mike Aviles, 3B
9. Drew Stubbs, RF
Twins (52-63)
1. Brian Dozier, 2B
2. Joe Mauer, DH
3. Justin Morneau, 1B
4. Josh Willingham, LF
5. Oswaldo Arcia, RF
6. Trevor Plouffe, 3B
7. Chris Herrmann, C
8. Clete Thomas, CF
9. Pedro Florimon, SS
Pitching: Andrew Albers, LHP
Twins can get to 10 games under .500 for the first time since July 6.
TwinsCentric: Twins don't need more pitching
It's time to let the guys in camp fight it out.
MLB's first replay rulings go in Twins' favor
The Twins became part of baseball history today in Hammond Stadium, when the Blue...
Sano's injury dims optimism of spring training
Miguel Sano's injury cuts like a knife through the optimism of spring training, even...