Observational epidemiological study to identify the clinical profile of naïve patients starting antiretroviral (ARV) therapy in Spain

Purpose of the study: To identify the proportion of patients starting ARV treatment with NNRTIs or with a PI/r and to explore and compare their clinical profile establishing different factors whereby physicians select the initial ARV treatment in a Spanish clinical setting. Methods: An observational study was conducted in two different phases. In Phase I a cross-sectional registration was conducted for patients who initiated ARV treatment in a 6-month period in 65 Spanish hospitals. In Phase II clinical and social-demographic features were collected retrospectively of patients who visited HIV clinics between August and November 2010 who had started ARV treatment containing an NNRTIs or a PI/r in Phase I. Summary of results: In Phase I, 1,687 subjects who initiated ARV treatment were registered, of which 53% started with an NNRTI-based regimen whereas 42% started with a PI/r-based regimen. Two percent of the treatment initiations occurred in a clinical trial. In Phase II, 642 patients were paired consecutively and retrospectively. The group of patients was composed of predominantly male subjects (81% vs 19%). The median time between diagnosis and the start of ARV treatment was 3.6±5.3 years. At the initiation of treatment, 72% of patients had a CD4 count below 350 cells/µl. Although treatment based on NNRTIs in naïve patients is the most frequent option in Spain, the analysis of clinical profiles shows that PI/r-based therapy is more often used than NNRTIs with statistical significance in patients with high viral load, Fig. A (≥100.000 copies/ml) (58% vs 42%; OR:1,75; 95% CI: 1,26–2,43; p<0,01), with CD4 cell counts <200 cells/µl, Fig. B (68% vs 31%; OR: 2,92; 95% CI: 1,99–4,27; p<0,01), and in patients at CDC stage C (65% vs 35%; OR: 2,05; CI: 1,27–3,31; p<0,01). Conclusions: In Spain, HIV is still diagnosed late (as measured by CD4 count<350 cells/µl). Treatment based on NNRTIs are more frequently used in naïve patients, although PIs/r-based regimens play an important role being the preferred option in patients with high viral load (≥100.000 copies/ml) and low CD4 cell count (<200 cells/µl)

Role of floral strips and semi-natural habitats as enhancers of wild bee functional diversity in intensive agricultural landscapes

Los autores de la UAM pertenecen al Terrestrial Ecology Group, Department of EcologyInstalling patches of flowering plants is a commonly used strategy to enhance refuge and food resources for pollinators in intensive agricultural landscapes. Here, we evaluated how floral strips and semi-natural habitats impact the taxonomic and functional diversity of wild bees in intensively farmed sunflower fields. Pan traps were used to assess bee richness and functional diversity at 22 sampling sites (11 sites were positioned in sunflower fields with floral strips, and 11 control sites were adjacent to semi-natural habitats). Five sampling levels were established in each field, positioned at different distances from the flower strip or semi-natural habitat. Wild bee species richness and functional richness were significantly higher inside floral strips and semi-natural habitats compared to sunflower fields. Functional redundancy was significantly higher inside agricultural fields compared to inside floral strips and semi-natural habitats. Sunflower fields with floral strips had lower Rao values compared to sunflower fields adjacent to semi-natural habitats. The community-weighted mean (CWM) of intertegular distance (distance between where wings attach to body) of wild bees was significantly higher in sunflower fields adjacent to semi-natural habitats. In comparison, the CWM of wing length varied across sampling levels in sunflower fields with semi-natural habitats. Our results show it is essential to have semi-natural habitats within intensive agricultural landscapes to ensure the conservation of wild bee diversity, while the installation of floral strips offers a partial substitute to enhance wild bee diversity when semi-natural habitats are scarce or absentFinancial support was provided by the European Union FEDER INTERREG SUDOE Program (SOE1/P5/E0129). CPC was supported by the Estonian Ministry of Education and Research (PSG293) and the European Regional Development Fund (Centre of Excellence EcolChange

Tratamiento quirúrgico en las cifosis congénitas: Revisión de 14 pacientes

Los autores efectúan una revisión de 14 pacientes con cifosis congénita, intervenidos entre los años 1979-1989, con un seguimiento medio de 7 años. La edad media preoperatoria fue de 11 años (todos ellos mayores de 5 años), con una cifosis media de 7 9 . En 6 casos se realizó una artrodesis posterior y en 8 una anterior combinada con una fusión posterior. Inicialmente obtuvieron una corrección media de la curva de 18° con la artrodesis posterior y 20° con la artrodesis combinada. La pérdida postoperatoria final fue de 10° y 8° respectivamente. En un caso, se produjo una pseudoartrosis por fusión corta. Como complicaciones postoperatorias en 5 pacientes, una radiculopatía, una infección superficial y cuatro protusiones de material que requirieron su extracción. Los autores analizan los factores que han podido influir en los resultados obtenidos, comparándolos posteriormente con los conseguidos por otros centros hospitalarios importantes.Fourteen patients with congenital kyphosis treated surgically between 1979- 1989 were reviewed. All had a follow-up of 2 years or more, with an average follow-up of 7 years. The average age at surgery was 11 and the average kyphosis was 79°. Six cases had posterior fusion only and eigth had combined anterior and posterior fusion. The results showed an average correction of the curve at surgery of 18° with posterior arthrodesis and 20° with combined arthrodesis. There was thus an average loss of 10° and 8° respectively from the time of surgery in both types of treatment. Pseudoarthrosis by short fusion ocurred in one case. Other complications after surgery were 1 radiculopathy, one wound infection and four rod protusion (six patients). The factors that have influence in this results were analysed. A comparison from the results of treatment at other medical centers was also carried out

Signatures of arithmetic simplicity in metabolic network architecture

Metabolic networks perform some of the most fundamental functions in living cells, including energy transduction and building block biosynthesis. While these are the best characterized networks in living systems, understanding their evolutionary history and complex wiring constitutes one of the most fascinating open questions in biology, intimately related to the enigma of life's origin itself. Is the evolution of metabolism subject to general principles, beyond the unpredictable accumulation of multiple historical accidents? Here we search for such principles by applying to an artificial chemical universe some of the methodologies developed for the study of genome scale models of cellular metabolism. In particular, we use metabolic flux constraint-based models to exhaustively search for artificial chemistry pathways that can optimally perform an array of elementary metabolic functions. Despite the simplicity of the model employed, we find that the ensuing pathways display a surprisingly rich set of properties, including the existence of autocatalytic cycles and hierarchical modules, the appearance of universally preferable metabolites and reactions, and a logarithmic trend of pathway length as a function of input/output molecule size. Some of these properties can be derived analytically, borrowing methods previously used in cryptography. In addition, by mapping biochemical networks onto a simplified carbon atom reaction backbone, we find that several of the properties predicted by the artificial chemistry model hold for real metabolic networks. These findings suggest that optimality principles and arithmetic simplicity might lie beneath some aspects of biochemical complexity

SUTURA DE B-LYNCH: EXPERIENCIA EN EL DESARROLLO DE UNA NUEVA TÉCNICA QUIRÚRGICA

Antecedentes: La hemorragia postparto (HPP) continúa siendo una de las patologías más prevalentes en la morbimortalidad materna en todo el mundo, especialmente en los países subdesarrollados. Distintos protocolos de manejo y técnicas se han desarrollado en los últimos años para su control. La sutura de B-Lynch surge como una herramienta útil y reproducible. Objetivo: Demostrar los beneficios de la técnica para el control de la HPP. Método: Serie de 5 casos en los que se realizó la sutura de B-Lynch en el Servicio de Obstetricia y Ginecología del Hospital Carlos Van Buren. Se identifican 5 casos en los que se realizó la técnica. Resultados: En los 5 casos se logró exitosamente controlar la HPP y preservar el útero. Una de las pacientes logró un embarazo posterior exitoso. Conclusión: Nuestros resultados permiten afirmar que la técnica de B-Lynch es segura, útil y reproducible en el manejo de la HPP

The solvation and dissociation of 4-benzylaniline hydrochloride in chlorobenzene

A reaction scheme is proposed to account for the liberation of 4-benzylaniline from 4-benzylaniline hydrochloride, using chlorobenzene as a solvent at a temperature of 373 K. Two operational regimes are explored: “closed” reaction conditions correspond to the retention of evolved hydrogen chloride gas within the reaction medium, whereas an “open” system permits gaseous hydrogen chloride to be released from the reaction medium. The solution phase chemistry is analyzed by 1H NMR spectroscopy. Complete liberation of solvated 4-benzylaniline from solid 4-benzylaniline hydrochloride is possible under “open” conditions, with the entropically favored conversion of solvated hydrogen chloride to the gaseous phase thought to be the thermodynamic driver that effectively controls a series of interconnecting equilibria. A kinetic model is proposed to account for the observations of the open system

Nasal Tip Projection and Facial Attractiveness

Objectives/Hypothesis: Six nasal tip projection (NTP) ratios from Goode, Simons, Baum, Powell, and Crumley guide clinical and academic practice on quantifying NTP, but none have been empirically correlated with facial attractiveness. This study's objectives were to determine: 1) if there is a correlation between these ratios and facial attractiveness; and 2) which of the six ratios has the greatest linkage to overall facial attractiveness. Study Design: Basic research study. Methods: There were 300 digital portraits of women (ages 18-25 years) randomly paired and morphed to create 300 synthetic lateral facial images rated by 78 raters in the community. NTP ratios were measured in each portrait. Results: None of the ratios correlated with facial attractiveness. For the Baum, Powell, and Simons ratio, facial attractiveness increased as NTP deviated 1 and 2 standard deviations from the ideal, whereas facial attractiveness decreased as NTP deviated from the Goode and Crumley ideal ratios. The most attractive faces had NTP ratios consistent with previous expert opinion findings. Conclusions: To our knowledge, this is the first study to empirically correlate these six landmark NTP ratios with facial attractiveness. Although there was no correlation with any of the six ratios, the ideal ratios proposed by Goode and Crumley impacted facial aesthetics the most. Although the ideal ratios are useful in establishing rhinoplasty guidelines, they should only be used as a part of the management in achieving an aesthetic face on the whole, as they may not be robust enough to correlate with overall facial attractiveness

Cross-Dimensional Mapping of Number, Length and Brightness by Preschool Children

Human adults in diverse cultures, children, infants, and non-human primates relate number to space, but it is not clear whether this ability reflects a specific and privileged number-space mapping. To investigate this possibility, we tested preschool children in matching tasks where the dimensions of number and length were mapped both to one another and to a third dimension, brightness. Children detected variation on all three dimensions, and they reliably performed mappings between number and length, and partially between brightness and length, but not between number and brightness. Moreover, children showed reliably better mapping of number onto the dimension of length than onto the dimension of brightness. These findings suggest that number establishes a privileged mapping with the dimension of length, and that other dimensions, including brightness, can be mapped onto length, although less efficiently. Children's adeptness at number-length mappings suggests that these two dimensions are intuitively related by the end of the preschool years