JMIR Res Protoc

BACKGROUND: Effective antiretroviral therapy has greatly reduced HIV-related morbidity and mortality, dramatically changing the demographics of the population of people living with HIV. The majority of people living with HIV in France are well cared for insofar as their HIV infection is concerned but remain at risk for age-associated comorbidities. Their long-term, potentially complex, and growing care needs make the routine, longitudinal assessment of health-related quality of life and other patient-reported outcomes of relevance in the current treatment era. OBJECTIVE: We aim to describe the development of a Web-based electronic patient-reported outcomes system for people living with HIV linked to the ANRS CO3 Aquitaine cohort's data capture and visualization system (ARPEGE) and designed to facilitate the electronic collection of patient-reported data and ultimately promote better patient-physician communication and quality of care (both patient satisfaction and health outcomes). METHODS: Participants who meet the eligibility criteria will be invited to engage with the Web-based electronic patient-reported outcomes system and provided with the information necessary to create a personal patient account. They will then be able to access the electronic patient-reported outcomes system and complete a set of standardized validated questionnaires covering health-related quality of life (World Health Organization's Quality of Life Instrument in HIV infection, named WHOQOL-HIV BREF) and other patient-reported outcomes. The information provided via questionnaires will ultimately be presented in a summary format for clinicians, together with the patient's HIV care history. RESULTS: The prototype of the Web-based electronic patient-reported outcome system will be finalized and the first 2 formative research phases of the study (prototyping and usability testing) will be conducted from December 2017 to May 2018. We describe the sequential processes planned to ensure that the proposed electronic patient-reported outcome system is ready for formal pilot testing, referred to herein as phases 1a and 1b. We also describe the planned pilot-testing designed to evaluate the acceptability and use of the system from the patient's perspective (phase 2). CONCLUSIONS: As the underlying information technology solution, ARPEGE, has being developed in-house, should the feasibility study presented here yield promising results, the panel of services provided via the proposed portal could ultimately be expanded and used to experiment with health-promoting interventions in aging people living with HIV in hospital-based care or adapted for use in other patient populations. TRIAL REGISTRATION: ClinicalTrials.gov NCT03296202; https://clinicaltrials.gov/ct2/show/NCT03296202 (Archived by WebCite at http://www.webcitation.org/6zgOBArps). REGISTERED REPORT IDENTIFIER: RR1-10.2196/9439

Emergence of 3D Printed Dosage Forms: Opportunities and Challenges

The recent introduction of the first FDA approved 3D-printed drug has fuelled interest in 3D printing technology, which is set to revolutionize healthcare. Since its initial use, this rapid prototyping (RP) technology has evolved to such as extent that it is currently being used in a wide range of applications including in tissue engineering, dentistry, construction, automotive and aerospace. However, in the pharmaceutical industry this technology is still in its infancy and its potential yet to be fully explored. This paper presents various 3D printing technologies such as stereolithographic, powder based, selective laser sintering, fused deposition modelling and semi-solid extrusion 3D printing. It also provides a comprehensive review of previous attempts at using 3D printing technologies on the manufacturing dosage forms with a particular focus on oral tablets. Their advantages particularly with adaptability in the pharmaceutical field have been highlighted, including design flexibility and control and manufacture which enables the preparation of dosage forms with complex designs and geometries, multiple actives and tailored release profiles. An insight into the technical challenges facing the different 3D printing technologies such as the formulation and processing parameters is provided. Light is also shed on the different regulatory challenges that need to be overcome for 3D printing to fulfil its real potential in the pharmaceutical industry

Advances and challenges in understanding the role of the lipid raft proteome in human health

INTRODUCTION: Phase separation as a biophysical principle drives the formation of liquid-ordered 'lipid raft' membrane microdomains in cellular membranes, including organelles. Given the critical role of cellular membranes in both compartmentalization and signaling, clarifying the roles of membrane microdomains and their mutual regulation of/by membrane proteins is important in understanding the fundamentals of biology, and has implications for health. Areas covered: This article will consider the evidence for lateral membrane phase separation in model membranes and organellar membranes, critically evaluate the current methods for lipid raft proteomics and discuss the biomedical implications of lipid rafts. Expert commentary: Lipid raft homeostasis is perturbed in numerous chronic conditions; hence, understanding the precise roles and regulation of the lipid raft proteome is important for health and medicine. The current technical challenges in performing lipid raft proteomics can be overcome through well-controlled experimental design and careful interpretation. Together with technical developments in mass spectrometry and microscopy, our understanding of lipid raft biology and function will improve through recognition of the similarity between organelle and plasma membrane lipid rafts and considered integration of published lipid raft proteomics data

Hemoglobin Interlaken in combination with beta thalassemia trait

We report a rare a1 globin gene variant (Hb Interlaken) found in a 63-year-old woman of Italian ancestry living in Buenos Aires Province, Argentina. The variant, a missense mutation at cd15 (GGT &rarr; GAT) causing a Gly &rarr;Asp amino acid substitution and also known as Hb J Oxford, was found in combination with the common thalassemia trait cd 39 (C&rarr;T). The clinical picture of the patient was that of a b-thalassemia trait.&nbsp;我们曾报道在阿根廷布宜诺斯艾利斯一名63岁意大利血统的妇女体内发现罕有的1珠蛋白基因（因特拉肯血红蛋白）变体。研究发现该变体是导致Gly &rarr; Asp氨基酸置的错义突变，也称为Hb J Oxford，与常见的地中海贫血性症cd 39 （C &rarr; T）有关。该患者临床症状与乙型地中海贫血特征相同。</p

Escuchar, hablar, leer y escribir en la EGB

Se reúnen enfoques teóricos, recomendaciones didácticas y propuestas de trabajo en el aula. Se traza un recorrido por aquellos contenidos y estrategias que favorecen el aprendizaje y el desarrollo de las habilidades lingüísticas y comunicativas, las que permiten escuchar, hablar, leer y escribir. En lo que concierne a oralidad, se destaca la importancia de la escucha en el aula y se propone la enseñanza y práctica de la misma como ejercicio de la voluntad y la atención. Además, se señala el valor del habla como discurso compartido, base para cualquier aprendizaje. Se reflexiona sobre la lectoescritura. Se presenta una síntesis de las teorías que tratan la adquisición de la lengua escrita desde una perspectiva interactiva, y se aborda la enseñanza de la escritura en la escuela para lograr una alfabetización avanzada. Y por último, se trata la ortografía.CataluñaBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5; 28014 Madrid; Tel. +34917748000; [email protected]

Mortality and Complication Rates in Adult Trauma Patients Receiving Tranexamic Acid: A Single-center Experience in the Post-CRASH-2 Era.

OBJECTIVES:The CRASH-2 trial demonstrated that tranexamic acid (TXA) in adults with significant traumatic hemorrhage safely reduces mortality. Given that the CRASH-2 trial did not include U.S. sites, our objective was to evaluate patient characteristics, TXA dosing strategies, and the incidence of mortality and adverse events in adult trauma patients receiving TXA at a U.S. Level I trauma center in the post-CRASH-2 era. METHODS:We conducted a retrospective study that included patients aged 18&nbsp;years or older who received TXA after an acute injury from July 2014 to June 2017. We excluded patients who received TXA orally, patients who received TXA for elective surgical procedures or nontrauma indications, patients who received it 8&nbsp;hours or longer after the time of injury, and patients with cardiac arrest at time of emergency department arrival. Trained abstractors collected data from the trauma registry and hospital electronic medical records. Our primary outcome measures were in-hospital death and acute thromboembolic events within 28&nbsp;days from injury. RESULTS:We included 273 patients with a mean (±SD) age of 43.8 (±18.7) &nbsp;years. The mean (±SD) time of administration of TXA from time of injury was 1.55 (±1.2) &nbsp;hours with 229 patients (83.9%) receiving TXA within 3&nbsp;hours. The overall mortality within 28&nbsp;days from injury was 12.8% (95% confidence interval [CI]&nbsp;=&nbsp;8.9% to 16.7%), which was similar compared to that in the CRASH-2 trial (14.5%, 95% CI&nbsp;=&nbsp;13.9% to 15.2%). The incidence of acute thromboembolic events was 6.6% (95% CI&nbsp;=&nbsp;3.7% to 9.5%), which was higher than that in the CRASH-2 trial (2.0%, 95% CI&nbsp;=&nbsp;1.73% to 2.27%). Patients in our cohort also received surgery (64.8% vs. 47.9%) and blood transfusions (74.0% vs. 50.4%) more frequently than those in the CRASH-2 cohort. CONCLUSIONS:Adult trauma patients receiving TXA had similar incidences of death but higher incidences of thromboembolic events compared to the CRASH-2 trial. Variation in patient characteristics, injury severity, TXA dosing, and surgery and transfusion rates could explain these observed differences. Further research is necessary to provide additional insight into the incidence and risk factors of thromboembolic events in TXA use

Mortality and Complication Rates in Adult Trauma Patients Receiving Tranexamic Acid: A Single-center Experience in the Post-CRASH-2 Era.

OBJECTIVES:The CRASH-2 trial demonstrated that tranexamic acid (TXA) in adults with significant traumatic hemorrhage safely reduces mortality. Given that the CRASH-2 trial did not include U.S. sites, our objective was to evaluate patient characteristics, TXA dosing strategies, and the incidence of mortality and adverse events in adult trauma patients receiving TXA at a U.S. Level I trauma center in the post-CRASH-2 era. METHODS:We conducted a retrospective study that included patients aged 18&nbsp;years or older who received TXA after an acute injury from July 2014 to June 2017. We excluded patients who received TXA orally, patients who received TXA for elective surgical procedures or nontrauma indications, patients who received it 8&nbsp;hours or longer after the time of injury, and patients with cardiac arrest at time of emergency department arrival. Trained abstractors collected data from the trauma registry and hospital electronic medical records. Our primary outcome measures were in-hospital death and acute thromboembolic events within 28&nbsp;days from injury. RESULTS:We included 273 patients with a mean (±SD) age of 43.8 (±18.7) &nbsp;years. The mean (±SD) time of administration of TXA from time of injury was 1.55 (±1.2) &nbsp;hours with 229 patients (83.9%) receiving TXA within 3&nbsp;hours. The overall mortality within 28&nbsp;days from injury was 12.8% (95% confidence interval [CI]&nbsp;=&nbsp;8.9% to 16.7%), which was similar compared to that in the CRASH-2 trial (14.5%, 95% CI&nbsp;=&nbsp;13.9% to 15.2%). The incidence of acute thromboembolic events was 6.6% (95% CI&nbsp;=&nbsp;3.7% to 9.5%), which was higher than that in the CRASH-2 trial (2.0%, 95% CI&nbsp;=&nbsp;1.73% to 2.27%). Patients in our cohort also received surgery (64.8% vs. 47.9%) and blood transfusions (74.0% vs. 50.4%) more frequently than those in the CRASH-2 cohort. CONCLUSIONS:Adult trauma patients receiving TXA had similar incidences of death but higher incidences of thromboembolic events compared to the CRASH-2 trial. Variation in patient characteristics, injury severity, TXA dosing, and surgery and transfusion rates could explain these observed differences. Further research is necessary to provide additional insight into the incidence and risk factors of thromboembolic events in TXA use

Application of xylitol in food formulations and benefits for health

Sugar substitution by any sweetener in the food industry is usually made taking into account the calories of the sweetener, the possibility of using it in diets for weight reduction or control, and the degree of similarity between its flavor and the traditional sugar. Among the existent alternative sweeteners, xylitol has attracted the attention of food manufacturers since it has sweetening power similar to sucrose but with lower caloric value, and can be consumed by diabetics. Nowadays, a variety of products containing xylitol in the formulation can be found in the market. Most of them are especially formulated for people with insulin-deficiency. Another important advantage of xylitol ingestion when compared to the traditional sugar is that it promotes several benefits for human health, acting both on the prevention and/or treatment of diseases. Due to these important properties, the use of xylitol in food products is a market in great expansion. The current applications of xylitol in food formulations are summarized in this chapter. The benefits to health promoted by its ingestion are also presented and discussed.(undefined