Efficacy and safety of discontinuing antibiotic treatment for uncomplicated respiratory tract infections when deemed unnecessary. A multicentre, randomized clinical trial in primary care

Antibacterial agent; Antibiotic stewardship; Primary health careAgente antibacteriano; Administración de antibióticos; Atención primaria de saludAgent antibacterià; Administració d'antibiòtics; Atenció primària de salutObjectives To determine the benefits and harms of discontinuing unnecessary antibiotic therapy for uncomplicated respiratory tract infections (RTI) when antibiotics are considered no longer necessary. Methods Multicentre, open-label, randomized controlled clinical trial in primary care centres from 2017 to 2020 (ClinicalTrials.gov, NCT02900820). Adults with RTIs—acute rhinosinusitis, sore throat, influenza or acute bronchitis—who had previously taken any dose of antibiotic for less than 3 days, which physicians no longer deemed necessary were recruited. The patients were randomly assigned in a 1:1 ratio to discontinuing antibiotic therapy or the usual strategy of continuing antibiotic treatment. The primary outcome was the duration of severe symptoms (number of days scoring 5 or 6 on a six-item Likert scale). Secondary outcomes included days with symptoms, moderate symptoms (scores of 3 or 4), antibiotics taken, adverse events, patient satisfaction and complications within the first 3 months. Results A total of 467 patients were randomized, out of which 409 were considered valid for the analysis. The mean (SD) duration of severe symptoms was 3.0 (1.5) days for the patients assigned to discontinuation and 2.8 (1.3) days for those allocated to the control group (mean difference 0.2 days; 95% CI –0.1 to 0.4 days). Patients randomized to the discontinuation group used fewer antibiotics after the baseline visit (52/207 (25.1%) versus 182/202 (90.1%); p 0.001). Patients assigned to antibiotic continuation presented a relative risk of adverse events of 1.47 (95% CI 0.80–2.71), but the need for further health-care contact in the following 3 months was slightly lower (RR 0.61; 95% CI 0.28–1.37). Conclusions Discontinuing antibiotic treatment for uncomplicated RTIs when clinicians consider it unnecessary is safe and notably reduces antibiotic consumption.This work was supported by the Catalan Society of Family Medicine, grant number FAP1601. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. This trial was registered with the ClinicalTrials.gov database (Identifier: NCT02900820)

High frequency resonant experiments in Fe8_8 molecular clusters

Precise resonant experiments on Fe$_{8}$ magnetic clusters have been conducted down to 1.2 K at various tranverse magnetic fields, using a cylindrical resonator cavity with 40 different frequencies between 37 GHz and 110 GHz. All the observed resonances for both single crystal and oriented powder, have been fitted by the eigenstates of the hamiltonian ${\cal H}=-DS_z^2+ES_x^2-g\mu_B{\bf H}\cdot {\bf S}$. We have identified the resonances corresponding to the coherent quantum oscillations for different orientations of spin S = 10.Comment: to appear in Phys.Rev. B (August 2000

A randomised clinical trial to evaluate the effects of Plantago ovata husk in Parkinson patients: changes in levodopa pharmacokinetics and biochemical parameters

P. 296-305Background: Plantago ovata husk therapy could be used in patients with Parkinson disease to reduce the symptoms of gastrointestinal disorders, but it is important to know whether this compound modifies levodopa pharmacokinetics. The maintenance of constant plasma concentrations of levodopa abolishes the clinical fluctuations in parkinsonian patients. The aim of this randomised clinical trial was to establish the influence of the fiber Plantago ovata husk in the pharmacokinetics of levodopa when administered to Parkinson patients well controlled by their oral medication. Methods: To evaluate the effects of this fiber on several biochemical parameters. 18 volunteers participated in the study and received alternatively two treatments (Plantago ovata husk or placebo) with their usual levodopa/carbidopa oral dose. On days 0 (initial situation), 14 and 35 of the study, blood samples were taken to assess levodopa pharmacokinetics and to determine biochemical parameters. Results: Levodopa Cmax was very similar in the initial situation (603.2 ng/ml) and after placebo administration (612.0 ng/ml), being slightly lower (547.8 ng/ml) when Plantago ovata husk was given. AUC was very similar in the three groups: initial situation.- 62.87 μg.min/ml, fiber treatment.- 64.47 μg.min/ml and placebo treatment.- 65.10 μg.min/ml. Fiber reduced significantly the number of peaks observed in the levodopa concentrations, maintaining concentrations more stable. No significant differences were found in total cholesterol, LDL-cholesterol and triglycerides with the administration of Plantago ovata husk. Conclusions: Plantago ovata husk administration caused a smoothing and homogenization of levodopa absorption, providing more stable concentrations and final higher levels, resulting in a great benefit for patients.S

On-line MRI sequences for the evaluation of apple internal quality.

On-line dynamic MRI, which is oriented to industrial grading lines, requires high-speed sequences with motion correction artefacts. In this study two different types of motion correction sequences have been used and have been implemented in real-time (FLASH and UFLARE). They are based on T2* and T2 respectively and their selection depends on the expected contrast effect of the disorder: while watercore enhances bright areas due to higher fluid mobility, internal breakdown potentiates low signal due to texture degradation. For watercore study, five different apple cultivars were used (Normanda-18-, Fuji-35-, Helada-36-, Verde Doncella-54-, Esperiega-75-) along two seasons (2011 and 2012). In total 218 fruits were measured under both, static conditions (20 slices per fruit) and under dynamic conditions (3 repetitions without slice selection). For internal breakdown, Braeburn cultivar has been studied (in total 106 fruits) under both static (20 slices per fruit) and dynamic conditions (3 replicates with slice selection). Metrological aspects such as repeatability of dynamic images and subsequent histogram feature stability become of major interest for further industrial application. Segregation ability among varying degrees of disorder is also analyzed

Pulsational frequencies of the eclipsing delta-Scuti star HD 172189

The eclipsing delta-Scuti star HD 172189 is a probable member of the open cluster IC 4756 and a promising candidate target for the CoRoT mission. The detection of pulsation modes is the first step in the asteroseismological study of the star. Further, the calculation of the orbital parameters of the binary system allows us to make a dynamical determination of the mass of the star, which works as an important constraint to test and calibrate the asteroseismological models. From a detailed frequency analysis of 210 hours of photometric data of HD 172189 obtained from the STEPHI XIII campaign we have identified six pulsation frequencies with a confidence level of 99% and a seventh with a 65% confidence level in the range between 100-300 uHz. In addiction, three eclipses were observed during the campaign, allowing us to improve the determination of the orbital period of the system.Comment: 6 pages, 7 figure

Video-based tasks for emotional processing rehabilitation in schizophrenia

Schizophrenia is a mental disorder characterized by a breakdown of cognitive processes and by a deficit of typi-cal emotional responses. Effectiveness of computerized task has been demonstrated in the field of cognitive rehabilitation. However, current rehabilitation programs based on virtual environments normally focus on higher cognitive functions, not covering social cognition training. This paper presents a set of video-based tasks specifically designed for the rehabilita-tion of emotional processing deficits in patients in early stages of schizophrenia or schizoaffective disorders. These tasks are part of the Mental Health program of Guttmann NeuroPer-sonalTrainer® cognitive tele-rehabilitation platform, and entail innovation both from a clinical and technological per-spective in relation with former traditional therapeutic con-tents

Recent increase of ulcerative lesions caused by Anisakis spp. in cetaceans from the north-east Atlantic

Species of Anisakis typically infect the stomach of cetaceans worldwide, often causing ulcerative lesions that may compromise the host’s health. These nematodes also cause anisakiasis or allergic reactions in humans. To assess the risks of this emerging zoonosis, data on long-term changes in Anisakis infections in cetaceans are necessary. Here, we compare the prevalence and severity of ulcerative lesions caused by Anisakis spp. in five cetacean species stranded along the north-west Spanish coast in 2017–2018 with published data from 1991–1996. Open ulcers were found in 32/ 43 short-beaked common dolphins, Delphinus delphis; 3/5 striped dolphins, Stenella coeruleoalba; 1/7 bottlenose dolphins, Tursiops truncatus; and 1/3 harbour porpoises, Phocoena phocoena mer- idionalis; a single individual of long-finned pilot whale, Globicephala melas, was found unin- fected. In common dolphins, the mean abundance of open ulcers per host was 1.1 (95% confidence interval: 0.8–1.3), with a maximum diameter (mean ± standard deviation) of 25.4 ± 16.9 mm. Stomachs with scars or extensive fibrosis putatively associated with Anisakis were detected in 14 and five animals, respectively. A molecular analysis based on the mitochondrial cytochrome c oxidase II gene using 18 worms from three cetacean species revealed single or mixed infections ofAnisakis simplex sensu stricto and Anisakis pegreffii. Compared with the per- iod 1991–1996, we found a strong increase of prevalence, abundance and extension of ulcerative lesions in most cetacean species. Anisakis populations could have increased in the study area over the last decades, although we cannot rule out that a higher environmental stress has also boosted the pathological effects of these parasites.En prens

Results of the engineering run of the coherent neutrino nucleus interaction experiment (CONNIE)

The CONNIE detector prototype is operating at a distance of 30 m from the core of a 3.8 GWth nuclear reactor with the goal of establishing Charge-Coupled Devices (CCD) as a new technology for the detection of coherent elastic neutrino-nucleus scattering. We report on the results of the engineering run with an active mass of 4 g of silicon. The CCD array is described, and the performance observed during the first year is discussed. A compact passive shield was deployed around the detector, producing an order of magnitude reduction in the background rate. The remaining background observed during the run was stable, and dominated by internal contamination in the detector packaging materials. The in-situ calibration of the detector using X-ray lines from fluorescence demonstrates good stability of the readout system. The event rates with the reactor ON and OFF are compared, and no excess is observed coming from nuclear fission at the power plant. The upper limit for the neutrino event rate is set two orders of magnitude above the expectations for the standard model. The results demonstrate the cryogenic CCD-based detector can be remotely operated at the reactor site with stable noise below2 e RMS and stable background rates. The success of the engineering test provides a clear path for the upgraded 100 g detector to be deployed during 2016.Fil: Aguilar Arevalo, A.. Universidad Nacional Autónoma de México; MéxicoFil: Bertou, Xavier Pierre Louis. Comisión Nacional de Energía Atómica; Argentina. Comisión Nacional de Energía Atómica. Fundación José A. Balseiro; ArgentinaFil: Bonifazi, C.. Universidade Federal do Rio de Janeiro; BrasilFil: Butner, M.. Fermi National Accelerator Laboratory; Estados UnidosFil: Cancelo, G.. Fermi National Accelerator Laboratory; Estados UnidosFil: Castañeda Vazquez, A.. Universidad Nacional Autónoma de México; MéxicoFil: Cervantes Vergara, B.. Universidad Nacional Autónoma de México; MéxicoFil: Chavez, C. R.. Universidad Nacional de Asunción; ParaguayFil: Da Motta, H.. Centro Brasileiro de Pesquisas Físicas; BrasilFil: D'Olivo, J. C.. Universidad Nacional Autónoma de México; MéxicoFil: Dos Anjos, J.. Centro Brasileiro de Pesquisas Físicas; BrasilFil: Estrada, J.. Fermi National Accelerator Laboratory; Estados UnidosFil: Fernández Moroni, Guillermo. Universidad Nacional del Sur. Departamento de Ingeniería Eléctrica y de Computadoras. Instituto ; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ford, R.. Fermi National Accelerator Laboratory; Estados UnidosFil: Foguel, A.. Centro Brasileiro de Pesquisas Físicas; Brasil. Universidade Federal do Rio de Janeiro; BrasilFil: Hernandez Torres, K. P.. Universidad Nacional Autónoma de México; MéxicoFil: Izraelevitch, F.. Fermi National Accelerator Laboratory; Estados UnidosFil: Kavner, A.. University of Michigan; Estados UnidosFil: Kilminster, B.. Universitat Zurich; SuizaFil: Kuk, K.. Fermi National Accelerator Laboratory; Estados UnidosFil: Lima Jr, H. P.. Centro Brasileiro de Pesquisas Físicas; BrasilFil: Makler, M.. Centro Brasileiro de Pesquisas Físicas; BrasilFil: Molina, J.. Universidad Nacional de Asunción; ParaguayFil: Moreno Granados, G.. Universidad Nacional Autónoma de México; MéxicoFil: Moro, Juan Manuel. Universidad Nacional del Sur. Departamento de Ingeniería; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Paolini, Eduardo Emilio. Universidad Nacional del Sur. Departamento de Ingeniería Eléctrica y de Computadoras. Instituto ; ArgentinaFil: Sofo Haro, Miguel Francisco. Comision Nacional de Energia Atomica. Gerencia D/area de Energia Nuclear; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Tiffenberg, Javier Sebastian. Fermi National Accelerator Laboratory; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Trillaud, F.. Universidad Nacional Autónoma de México; MéxicoFil: Wagner, S.. Centro Brasileiro de Pesquisas Físicas; Brasil. Pontificia Universidade Católica do Rio Grande do Sul; Brasi

Prototyping of petalets for the Phase-II Upgrade of the silicon strip tracking detector of the ATLAS Experiment

In the high luminosity era of the Large Hadron Collider, the HL-LHC, the instantaneous luminosity is expected to reach unprecedented values, resulting in about 200 proton-proton interactions in a typical bunch crossing. To cope with the resultant increase in occupancy, bandwidth and radiation damage, the ATLAS Inner Detector will be replaced by an all-silicon system, the Inner Tracker (ITk). The ITk consists of a silicon pixel and a strip detector and exploits the concept of modularity. Prototyping and testing of various strip detector components has been carried out. This paper presents the developments and results obtained with reduced-size structures equivalent to those foreseen to be used in the forward region of the silicon strip detector. Referred to as petalets, these structures are built around a composite sandwich with embedded cooling pipes and electrical tapes for routing the signals and power. Detector modules built using electronic flex boards and silicon strip sensors are glued on both the front and back side surfaces of the carbon structure. Details are given on the assembly, testing and evaluation of several petalets. Measurement results of both mechanical and electrical quantities are shown. Moreover, an outlook is given for improved prototyping plans for large structures.Comment: 22 pages for submission for Journal of Instrumentatio