Multicenter Observational/Exploratory Study Addressed to the Evaluation of the Effectiveness and Safety of Pharmacological Therapy in Opioid-Dependent Patients in Maintenance Therapy in Southern Italy

A multicenter-observational study was performed to assess the effectiveness of rac-methadone, levomethadone, and buprenorphine in opioid-dependent patients in polytherapy in Southern Italy. The primary endpoint was the reduction of urinary positivity to the substances and the maintaining doses. Patients (N = 266, age = 44.80 ± 5.65, male = 79.70%, female = 20.30%) have been recruited. At recruitment, 75% of them were on treatment with rac-methadone, levomethadone, and buprenorphine/naloxone. The patients were grouped into three clusters. The levomethadone patients of Cluster A (N patients = 211), after 180 days, showed stability in urinary methadone posi-tivity, with a marked decrease in heroin −53 ± 4%, cannabinol’s −48 ± 2%, and cocaine −37 ± 6% positivity, with no differences between treatments. A lower QTcF value of 426 ± 8.4 ms was recorded in the levomethadone patients (delta = −19 ms) vs. rac-methadone, at significantly lower doses of levomethadone (−34%, −50.2% in males) (p < 0.05). The Cluster B data were collected from 37 patients, with a high prevalence of comorbidity infections (HIV/HCV/HPV), monitored for 21 months during COVID-19. High doses of levomethadone (58.33 ± 31.58 mg/day) were needed to stabilize those that were negative for opioids and cannabinoids, in contrast to the rac-methadone and buprenorphine/naloxone patients that showed positive toxicology. Eighteen patients of the Cluster C in double diagnosis (major depressive 38.90%, bipolar 27.78%, and schizophrenia 16.67%) were stabilized with high doses of racemate 97.5 ± 8 mg/day, 51.8 ± 5 mg/day of levomethadone (−46.8% vs. rac-methadone; −71% in men), and 2.5 ± 1 mg/day of buprenorphine/naloxone. Three patients in remission were treated with tapering doses of levomethadone. Significantly reduced QTcF values were recorded with levomethadone (delta −32 ms vs. rac-methadone) in the bipolar patients, as well as the schizophrenia patients in remission (delta −45.19 ms vs. rac-methadone). Our patients were safely stabilized. Levomethadone, compared to the racemate, contributes to reducing the illicit use, especially of opioids and cannabinoids at significantly lower doses with cardiovascular safety, which, in bipolar patients, is clinically significant

Safety and Immunogenicity of Conventional Subunit and MF59-adjuvanted Influenza Vaccines in Human Immunodeficiency Virus-1-seropositive Patients

In this study of influenza vaccination, 37 human immunodeficiency virus (HIV)-1-seropositive patients were randomized to receive either a vaccine with a conventional subunit or one adjuvanted with MF59. Blood samples were collected at the time of vaccination, and then 30 and 180 days later, to evaluate immunogenicity, CD4+ T-lymphocyte count and HIV-1 RNA levels. Seroconversion rates against the three viral strains included in the vaccine ranged between 44% and 72% and 53% and 68% for the adjuvanted vaccine and the subunit vaccine, respectively. Other criteria of the European Medicines Evaluation Agency were also met. Vaccination was not associated with serious adverse events. Local and systemic effects were mild and of short duration. CD4+ T-lymphocyte counts and viraemia levels were not negatively affected by vaccination. These results confirmed the safety and immunogenicity of these currently available vaccines in HIV-1-seropositive patients, thus supporting the recommendation for influenza immunization in this high-risk category

Decay and recurrence of non-Gaussian correlations in a quantum many-body system

Gaussian models provide an excellent effective description of many quantum many-body systems ranging from condensed-matter systems1,2 all the way to neutron stars3. Gaussian states are common at equilibrium when the interactions are weak. Recently it was proposed that they can also emerge dynamically from a non-Gaussian initial state evolving under non-interacting dynamics4,5,6,7,8,9,10,11. Here we present the experimental observation of such a dynamical emergence of Gaussian correlations in a quantum many-body system. This non-equilibrium evolution is triggered by abruptly switching off the effective interaction between the observed collective degrees of freedom, while leaving the interactions between the microscopic constituents unchanged. Starting from highly non-Gaussian correlations, consistent with the sine–Gordon model12, we observe a Gaussian state emerging over time as revealed by the decay of the fourth- and sixth-order connected correlations in the quantum field. A description of this dynamics requires a novel mechanism for the emergence of Gaussian correlations, which is relevant for a wide class of quantum many-body systems. In our closed system with non-interacting effective degrees of freedom, we do not expect full thermalization13,14,15,16,17,18,19. This memory of the initial state is confirmed by observing recurrences20 of non-Gaussian correlations

Mechanisms for the emergence of Gaussian correlations

We comprehensively investigate two distinct mechanisms leading to memory loss of non-Gaussian correlations after switching off the interactions in an isolated quantum system undergoing out-of-equilibrium dynamics. The first mechanism is based on spatial scrambling and results in the emergence of locally Gaussian steady states in large systems evolving over long times. The second mechanism, characterized as `canonical transmutation', is based on the mixing of a pair of canonically conjugate fields, one of which initially exhibits non-Gaussian fluctuations while the other is Gaussian and dominates the dynamics, resulting in the emergence of relative Gaussianity even at finite system sizes and times. We evaluate signatures of the occurrence of the two candidate mechanisms in a recent experiment that has observed Gaussification in an atom-chip controlled ultracold gas and elucidate evidence that it is canonical transmutation rather than spatial scrambling that is responsible for Gaussification in the experiment. Both mechanisms are shown to share the common feature that the Gaussian correlations revealed dynamically by the quench are already present though practically inaccessible at the initial time. On the way, we present novel observations based on the experimental data, demonstrating clustering of equilibrium correlations, analyzing the dynamics of full counting statistics, and utilizing tomographic reconstructions of quantum field states. Our work aims at providing an accessible presentation of the potential of atom-chip experiments to explore fundamental aspects of quantum field theories in quantum simulations

Mechanisms for the emergence of Gaussian correlations

We comprehensively investigate two distinct mechanisms leading to memory loss of non-Gaussian correlations after switching off the interactions in an isolated quantum system undergoing out-of-equilibrium dynamics. The first mechanism is based on spatial scrambling and results in the emergence of locally Gaussian steady states in large systems evolving over long times. The second mechanism, characterized as `canonical transmutation', is based on the mixing of a pair of canonically conjugate fields, one of which initially exhibits non-Gaussian fluctuations while the other is Gaussian and dominates the dynamics, resulting in the emergence of relative Gaussianity even at finite system sizes and times. We evaluate signatures of the occurrence of the two candidate mechanisms in a recent experiment that has observed Gaussification in an atom-chip controlled ultracold gas and elucidate evidence that it is canonical transmutation rather than spatial scrambling that is responsible for Gaussification in the experiment. Both mechanisms are shown to share the common feature that the Gaussian correlations revealed dynamically by the quench are already present though practically inaccessible at the initial time. On the way, we present novel observations based on the experimental data, demonstrating clustering of equilibrium correlations, analyzing the dynamics of full counting statistics, and utilizing tomographic reconstructions of quantum field states. Our work aims at providing an accessible presentation of the potential of atom-chip experiments to explore fundamental aspects of quantum field theories in quantum simulations

Epidemiology of HCV genotypes in the area of Lecce

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