A Randomized Trial of Simplified Maintenance Therapy with Abacavir, Lamivudine, and Zidovudine in Human Immunodeficiency Virus Infection

This randomized study evaluated the efficacy and tolerability of continued treatment with protease inhibitor plus nucleoside-analogue combination regimens (n = 79) or a change to the simplified regimen of abacavir-lamivudine-zidovudine (n = 84) in patients with suppressed human immunodeficiency virus type 1 (HIV-1) RNA for ⩾6 months who did not have the reverse transcriptase 215 mutation. After a median follow-up of 84 weeks, virologic failure was 6% in the continuation and 15% in the simplified group (P = .081). Previous zidovudine monotherapy or dual therapy and archived reverse transcriptase resistance mutations in HIV-1 DNA at baseline were significant predictors of failure. Study treatment was discontinued because of adverse events in 20% of the continuation and 7% of the simplified group (P = .021). Simplification to abacavir-lamivudine-zidovudine significantly decreased nonfasting cholesterol and triglyceride levels; however, this switch strategy carries a risk of virologic failure when treatment history or resistance testing suggest the presence of archived resistance mutations to the simplified regime

Indirect Reciprocity, Resource Sharing, and Environmental Risk: Evidence from Field Experiments in Siberia

Integrating information from existing research, qualitative ethnographic interviews, and participant observation, we designed a field experiment that introduces idiosyncratic environmental risk and a voluntary sharing decision into a standard public goods game. Conducted with subsistence resource users in rural villages on the Kamchatka Peninsula in Northeast Siberia, we find evidence consistent with a model of indirect reciprocity and local social norms of helping the needy. When participants are allowed to develop reputations in the experiments, as is the case in most small-scale societies, we find that sharing is increasingly directed toward individuals experiencing hardship, good reputations increase aid, and the pooling of resources through voluntary sharing becomes more effective. We also find high levels of voluntary sharing without a strong commitment device; however, this form of cooperation does not increase contributions to the public good. Our results are consistent with previous experiments and theoretical models, suggesting strategic risks tied to rewards, punishments, and reputations are important. However, unlike studies that focus solely on strategic risks, we find the effects of rewards, punishments, and reputations are altered by the presence of environmental factors. Unexpected changes in resource abundance increase interdependence and may alter the costs and benefits of cooperation, relative to defection. We suggest environmental factors that increase interdependence are critically important to consider when developing and testing theories of cooperatio

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Identification of Key Proteins in Human Epithelial Cells Responding to Bystander Signals From Irradiated Trout Skin

Radiation-induced bystander signaling has been found to occur in live rainbow trout fish (Oncorhynchus mykiss). This article reports identification of key proteomic changes in a bystander reporter cell line (HaCaT) grown in low-dose irradiated tissue-conditioned media (ITCM) from rainbow trout fish. In vitro explant cultures were generated from the skin of fish previously exposed to low doses (0.1 and 0.5 Gy) of X-ray radiation in vivo. The ITCM was harvested from all donor explant cultures and placed on recipient HaCaT cells to observe any change in protein expression caused by the bystander signals. Proteomic methods using 2-dimensional (2D) gel electrophoresis and mass spectroscopy were employed to screen for novel proteins expressed. The proteomic changes measured in HaCaT cells receiving the ITCM revealed that exposure to 0.5 Gy induced an upregulation of annexin A2 and cingulin and a downregulation of Rho-GDI2, F-actin-capping protein subunit beta, microtubule-associated protein RP/EB family member, and 14-3-3 proteins. The 0.1 Gy dose also induced a downregulation of Rho-GDI2, hMMS19, F-actin-capping protein subunit beta, and microtubule-associated protein RP/EB family member proteins. The proteins reported may influence apoptotic signaling, as the results were suggestive of an induction of cell communication, repair mechanisms, and dysregulation of growth signal

What is the evidence for the management of patients along the pathway from the emergency department to acute admission to reduce unplanned attendance and admission? An evidence synthesis

Background Globally, the rate of emergency hospital admissions is increasing. However, little evidence exists to inform the development of interventions to reduce unplanned Emergency Department (ED) attendances and hospital admissions. The objective of this evidence synthesis was to review the evidence for interventions, conducted during the patient’s journey through the ED or acute care setting, to manage people with an exacerbation of a medical condition to reduce unplanned emergency hospital attendance and admissions. Methods A rapid evidence synthesis, using a systematic literature search, was undertaken in the electronic data bases of MEDLINE, EMBASE, CINAHL, the Cochrane Library and Web of Science, for the years 2000–2014. Evidence included in this review was restricted to Randomised Controlled Trials (RCTs) and observational studies (with a control arm) reported in peer-reviewed journals. Studies evaluating interventions for patients with an acute exacerbation of a medical condition in the ED or acute care setting which reported at least one outcome related to ED attendance or unplanned admission were included. Results Thirty papers met our inclusion criteria: 19 intervention studies (14 RCTs) and 11 controlled observational studies. Sixteen studies were set in the ED and 14 were conducted in an acute setting. Two studies (one RCT), set in the ED were effective in reducing ED attendance and hospital admission. Both of these interventions were initiated in the ED and included a post-discharge community component. Paradoxically 3 ED initiated interventions showed an increase in ED re-attendance. Six studies (1 RCT) set in acute care settings were effective in reducing: hospital admission, ED re-attendance or re-admission (two in an observation ward, one in an ED assessment unit and three in which the intervention was conducted within 72 h of admission). Conclusions There is no clear evidence that specific interventions along the patient journey from ED arrival to 72 h after admission benefit ED re-attendance or readmission. Interventions targeted at high-risk patients, particularly the elderly, may reduce ED utilization and warrant future research. Some interventions showing effectiveness in reducing unplanned ED attendances and admissions are delivered by appropriately trained personnel in an environment that allows sufficient time to assess and manage patients

Providing Oral Health Education to Underserved Children and Families within an Interdisciplinary Team

This paper outlines the background literature, needs assessment process, and project activities of a master’s project focused on oral health outcomes through use of an interprofessional team. The project activities were based on recommendations from current literatures, including interprofessional education and teaming, as well as family-centered education to promote positive oral health outcomes for young children and their families. Recommendations for future collaborations and the occupational therapy role within interprofessional oral health care teams are shared

The Lunar Volatile Resources Analysis Package

The presence and abundance of lunar volatiles is an important consideration for ISRU (In Situ Resource Utilisation) since this is likely to be a part of a strategy for supporting long term human exploration of the moon. The Lunar Volatile Resources Analysis Package (L-VRAP) is part of the provisional payload for the ESA European Lander [1] and aims to measure the abundance and chemical/isotopic composition of volatiles from regolith samples and the lunar exosphere

Examining the Links between Multi-Frequency Multibeam Backscatter Data and Sediment Grain Size

Publication history: Accepted - 13 April 2021Acoustic methods are routinely used to provide broad scale information on the geographical distribution of benthic marine habitats and sedimentary environments. Although single-frequency multibeam echosounder surveys have dominated seabed characterisation for decades, multifrequency approaches are now gaining favour in order to capture different frequency responses from the same seabed type. The aim of this study is to develop a robust modelling framework for testing the potential application and value of multifrequency (30, 95, and 300 kHz) multibeam backscatter responses to characterize sediments’ grain size in an area with strong geomorphological gradients and benthic ecological variability. We fit a generalized linear model on a multibeam backscatter and its derivatives to examine the explanatory power of single-frequency and multifrequency models with respect to the mean sediment grain size obtained from the grab samples. A strong and statistically significant (p < 0.05) correlation between the mean backscatter and the absolute values of the mean sediment grain size for the data was noted. The root mean squared error (RMSE) values identified the 30 kHz model as the best performing model responsible for explaining the most variation (84.3%) of the mean grain size at a statistically significant output (p < 0.05) with an adjusted r2 = 0.82. Overall, the single low-frequency sources showed a marginal gain on the multifrequency model, with the 30 kHz model driving the significance of this multifrequency model, and the inclusion of the higher frequencies diminished the level of agreement. We recommend further detailed and sufficient ground-truth data to better predict sediment properties and to discriminate benthic habitats to enhance the reliability of multifrequency backscatter data for the monitoring and management of marine protected areas.This research was funded by the Marine Institute under the Marine Research Programme by the Irish Government Cruise CE19007 Backscatter and Biodiversity of Shelf Sea Habitats (BaBioSSH) survey. Staffing was supported through the Marine Protected Area Monitoring and Management (MarPAMM) project, which is supported by the European Union’s INTERREG VA Programme, managed by the Special EU Programmes Body (SEUPM) with matching funding from the Government of Ireland, the Northern Ireland Executive, and the Scottish Government, as well as the PhD studentship through a Vice Chancellor Research Scholarship of Ulster University (U.K.)