Patient-Reported Outcomes in ATLAS and FLAIR Participants on Long-Acting Regimens of Cabotegravir and Rilpivirine Over 48 Weeks

The phase 3 ATLAS and FLAIR studies demonstrated that maintenance with Long-Acting (LA) intramuscular cabotegravir and rilpivirine is non-inferior in efficacy to current antiretroviral (CAR) oral therapy. Both studies utilized Patient-Reported Outcome instruments to measure treatment satisfaction (HIVTSQ) and acceptance (ACCEPT general domain), health status (SF-12), injection tolerability/acceptance (PIN), and treatment preference. In pooled analyses, LA-treated patients (n = 591) demonstrated greater mean improvements from baseline than the CAR group (n = 591) in treatment satisfaction (Week 44, + 3.9 vs. +0.5 HIVTSQs-points; p /= 97% of LA group participants with recorded data preferred LA treatment compared with prior oral therapy. These results further support the potential of a monthly injectable option for people living with HIV seeking an alternative to daily oral treatment

Plan de negocios para implementaci?n de una funeraria ecol?gica para mascotas en la zona 07 de Lima Metropolitana

El objetivo planteado para la presente tesis es la implementaci?n de una funeraria ecol?gica dedicada a la biocremaci?n de mascotas en la zona 7 de Lima Metropolitana y la determinaci?n de su viabilidad. Se identifican dos tendencias importantes a nivel mundial. La primera es el creciente apego de las personas por sus mascotas, resultando en una mayor preocupaci?n por su cuidado, lo que genera el deseo de mantener ese lazo sentimental a?n despu?s de la muerte. La segunda es la conservaci?n del medio ambiente, buscando alternativas ecol?gicas a pr?cticas nocivas como los son la cremaci?n convencional y el entierro. A partir de esto, se propone un m?todo ecol?gico, la hidr?lisis alcalina, como alternativa a la cremaci?n convencional. Adicionalmente, se ofrece la opci?n de comprar una urna biodegradable para disponer de las cenizas de la mascota y dar vida a una nueva planta. Al realizar el estudio de mercado se encontr? una alta intenci?n de compra y se resalt? la importancia del modelo ecol?gico de nuestro servicio. Considerando el uso de canales de marketing directos para alcanzar una participaci?n de mercado adecuada en el primer a?o y analizando los resultados de la evaluaci?n financiera, se determina que el negocio es viable

Genome-wide association analysis of dementia and its clinical endophenotypes reveal novel loci associated with Alzheimer's disease and three causality networks: The GR@ACE project

INTRODUCTION: Large variability among Alzheimer's disease (AD) cases might impact genetic discoveries and complicate dissection of underlying biological pathways. METHODS: Genome Research at Fundacio ACE (GR@ACE) is a genome-wide study of dementia and its clinical endophenotypes, defined based on AD's clinical certainty and vascular burden. We assessed the impact of known AD loci across endophenotypes to generate loci categories. We incorporated gene coexpression data and conducted pathway analysis per category. Finally, to evaluate the effect of heterogeneity in genetic studies, GR@ACE series were meta-analyzed with additional genome-wide association study data sets. RESULTS: We classified known AD loci into three categories, which might reflect the disease clinical heterogeneity. Vascular processes were only detected as a causal mechanism in probable AD. The meta-analysis strategy revealed the ANKRD31-rs4704171 and NDUFAF6-rs10098778 and confirmed SCIMP-rs7225151 and CD33-rs3865444. DISCUSSION: The regulation of vasculature is a prominent causal component of probable AD. GR@ACE meta-analysis revealed novel AD genetic signals, strongly driven by the presence of clinical heterogeneity in the AD series

Postoperative outcomes in oesophagectomy with trainee involvement

BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery

Specific heat of magnetic Ce alloys within a two-component model

We propose a description of the electronic properties of Ce alloys as an inhomogeneous mixture of two components: one containing magnetic Ce ions with an RKKY interaction J H between them, and the other described as a collection of Kondo impurities with exchange interaction J K . Both J H and J K are assumed to depend on a composition parameter X, with a Gaussian distribution around a value X 0 (near to the expectation value of X), related to the experimental composition parameter x of the alloy. When the concentration of the Kondo impurities is large, the specific heat C displays non-Fermi liquid behavior over a wide temperature range. The main qualitative features of C/T as a function of temperature T observed in several Ce alloys are reproduced using simple J H (X) and J K (X) dependences. Copyright Springer-Verlag Berlin/Heidelberg 2004

Surfactant protein secreted by the maturing mouse fetal lung acts as a hormone that signals the initiation of parturition

Parturition is timed to begin only after the developing embryo is sufficiently mature to survive outside the womb. It has been postulated that the signal for the initiation of parturition arises from the fetus although the nature and source of this signal remain obscure. Herein, we provide evidence that this signal originates from the maturing fetal lung. In the mouse, secretion of the major lung surfactant protein, surfactant protein A (SP-A), was first detected in amniotic fluid (AF) at 17 days postcoitum, rising progressively to term (19 days postcoitum). Expression of IL-1β in AF macrophages and activation of NF-κB in the maternal uterus increased with the gestational increase in SP-A. SP-A stimulated IL-1β and NF-κB expression in cultured AF macrophages. Studies using Rosa 26 Lac-Z (B6;129S-Gt(rosa)26Sor) (Lac-Z) mice revealed that fetal AF macrophages migrate to the uterus with the gestational increase in AF SP-A. Intraamniotic (i.a.) injection of SP-A caused preterm delivery of fetuses within 6-24 h. By contrast, injection of an SP-A antibody or NF-κB inhibitor into AF delayed labor by >24 h. We propose that augmented production of SP-A by the fetal lung near term causes activation and migration of fetal AF macrophages to the maternal uterus, where increased production of IL-1β activates NF-κB, leading to labor. We have revealed a response pathway that ties augmented surfactant production by the maturing fetal lung to the initiation of labor. We suggest that SP-A secreted by the fetal lung serves as a hormone of parturition

Chronic exposure to a low dose of ingested petroleum disrupts corticosterone receptor signalling in a tissue-specific manner in the house sparrow (Passer domesticus)

Stress-induced concentrations of glucocorticoid hormones (including corticosterone, CORT) can be suppressed by chronic exposure to a low dose of ingested petroleum. However, endocrine-disrupting chemicals could interfere with CORT signalling beyond the disruption of hormone titres, including effects on receptors in different target tissues. In this study, we examined the effects of 6 weeks of exposure to a petroleum-laced diet (1% oil weight:food weight) on tissue mass and intracellular CORT receptors in liver, fat, muscle and kidney (metabolic tissues), spleen (an immune tissue) and testes (a reproductive tissue). In the laboratory, male house sparrows were fed either a 1% weathered crude oil (n = 12) or a control diet (n = 12); glucocorticoid receptors and mineralocorticoid receptors were quantified using radioligand binding assays. In oil-exposed birds, glucocorticoid receptors were lower in one metabolic tissue (liver), higher in another metabolic tissue (fat) and unchanged in four other tissues (kidney, muscle, spleen and testes) compared with control birds. We saw no differences in mineralocorticoid receptors between groups. We also saw a trend towards reduced mass of the testes in oil-exposed birds compared with controls, but no differences in fat, kidney, liver, muscle or spleen mass between the two groups. This is the first study to examine the effects of petroleum on CORT receptor density in more than one or two target tissues. Given that a chronic low dose of ingested petroleum can affect stress-induced CORT titres as well as receptor density, this demonstrates that oil can act at multiple levels to disrupt an animal’s response to environmental stressors. This also highlights the potential usefulness of the stress response as a bioindicator of chronic crude oil exposure