Significant Reduction of Antibiotic Use in the Community after a Nationwide Campaign in France, 2002–2007

Didier Guillemot and colleagues describe the evaluation of a nationwide programme in France aimed at decreasing unnecessary outpatient prescriptions for antibiotics. The campaign was successful, particularly in reducing prescriptions for children

Gas dynamics in tidal dwarf galaxies : disc formation at z=0

Tidal dwarf galaxies (TDGs) are recycled objects that form within the collisional debris of interacting/merging galaxies. They are expected to be devoid of non-baryonic dark matter, since they can form only from dissipative material ejected from the discs of the progenitor galaxies. We investigate the gas dynamics in a sample of six bona-fide TDGs around three interacting and post-interacting systems: NGC 4694, NGC 5291, and NGC 7252 ("Atoms for Peace"). For NGC 4694 and NGC 5291 we analyse existing HI data from the Very Large Array (VLA), while for NGC 7252 we present new HI observations from the Jansky VLA together with long-slit and integral-field optical spectroscopy. For all six TDGs, the HI emission can be described by rotating disc models. These HI discs, however, have undergone less than a full rotation since the time of the interaction/merger event, raising the question of whether they are in dynamical equilibrium. Assuming that these discs are in equilibrium, the inferred dynamical masses are consistent with the observed baryonic masses, implying that TDGs are devoid of dark matter. This puts constraints on putative "dark discs" (either baryonic or non-baryonic) in the progenitor galaxies. Moreover, TDGs seem to systematically deviate from the baryonic Tully-Fisher relation. These results provide a challenging test for alternative theories like MOND.Peer reviewe

The Atlas3D project -- XIII. Mass and morphology of HI in early-type galaxies as a function of environment

We present the Atlas3D HI survey of 166 nearby early-type galaxies (ETGs) down to M(HI)~10^7 M_sun. We detect HI in ~40% of all ETGs outside the Virgo cluster and in ~10% of all ETGs inside it. This demonstrates that it is common for non-cluster ETGs to host HI. The HI morphology varies from regular discs/rings (the majority of the detections) to unsettled gas distributions. The former are either small discs (M(HI)<10^8 M_sun) confined within the stellar body and sharing the same kinematics of the stars, or large discs/rings (M(HI) up to 5x10^9 M_sun) extending to tens of kpc from the host galaxy and frequently kinematically decoupled from the stars. Neutral hydrogen provides material for star formation in ETGs. Galaxies with central HI exhibit signatures of star formation in ~70% of the cases, ~5 times more frequently than galaxies without central HI. The central ISM is dominated by molecular gas. In ETGs with a small gas disc the conversion of HI into H_2 is as efficient as in spirals. The ETG HI mass function has M*~2x10^9 M_sun and slope=-0.7. ETGs host much less HI than spirals as a family. However, a significant fraction of them is as HI-rich as spirals. The main difference between ETGs and spirals is that the former lack the high-column-density HI typical of the bright stellar disc of the latter. We find an envelope of decreasing M(HI) with increasing environment density. The gas-richest ETGs live in the poorest environments (where star-formation is more common), galaxies in the centre of Virgo have the lowest HI content, and the cluster outskirts are a transition region. We find an HI morphology-density relation. At low environment density HI is mostly distributed on large discs/rings. More disturbed HI morphologies dominate environment densities typical of rich groups, confirming the importance of processes occurring on a galaxy-group scale for the evolution of ETGs.Comment: Accepted for publication on MNRA

Obeticholic acid for the treatment of non-alcoholic steatohepatitis: interim analysis from a multicentre, randomised, placebo-controlled phase 3 trial

Background Non-alcoholic steatohepatitis (NASH) is a common type of chronic liver disease that can lead to cirrhosis. Obeticholic acid, a farnesoid X receptor agonist, has been shown to improve the histological features of NASH. Here we report results from a planned interim analysis of an ongoing, phase 3 study of obeticholic acid for NASH. Methods In this multicentre, randomised, double-blind, placebo-controlled study, adult patients with definite NASH,non-alcoholic fatty liver disease (NAFLD) activity score of at least 4, and fibrosis stages F2–F3, or F1 with at least oneaccompanying comorbidity, were randomly assigned using an interactive web response system in a 1:1:1 ratio to receive oral placebo, obeticholic acid 10 mg, or obeticholic acid 25 mg daily. Patients were excluded if cirrhosis, other chronic liver disease, elevated alcohol consumption, or confounding conditions were present. The primary endpointsfor the month-18 interim analysis were fibrosis improvement (≥1 stage) with no worsening of NASH, or NASH resolution with no worsening of fibrosis, with the study considered successful if either primary endpoint was met. Primary analyses were done by intention to treat, in patients with fibrosis stage F2–F3 who received at least one dose of treatment and reached, or would have reached, the month 18 visit by the prespecified interim analysis cutoff date. The study also evaluated other histological and biochemical markers of NASH and fibrosis, and safety. This study is ongoing, and registered with ClinicalTrials.gov, NCT02548351, and EudraCT, 20150-025601-6. Findings Between Dec 9, 2015, and Oct 26, 2018, 1968 patients with stage F1–F3 fibrosis were enrolled and received at least one dose of study treatment; 931 patients with stage F2–F3 fibrosis were included in the primary analysis (311 in the placebo group, 312 in the obeticholic acid 10 mg group, and 308 in the obeticholic acid 25 mg group). The fibrosis improvement endpoint was achieved by 37 (12%) patients in the placebo group, 55 (18%) in the obeticholic acid 10 mg group (p=0·045), and 71 (23%) in the obeticholic acid 25 mg group (p=0·0002). The NASH resolution endpoint was not met (25 [8%] patients in the placebo group, 35 [11%] in the obeticholic acid 10 mg group [p=0·18], and 36 [12%] in the obeticholic acid 25 mg group [p=0·13]). In the safety population (1968 patients with fibrosis stages F1–F3), the most common adverse event was pruritus (123 [19%] in the placebo group, 183 [28%] in the obeticholic acid 10 mg group, and 336 [51%] in the obeticholic acid 25 mg group); incidence was generally mild to moderate in severity. The overall safety profile was similar to that in previous studies, and incidence of serious adverse events was similar across treatment groups (75 [11%] patients in the placebo group, 72 [11%] in the obeticholic acid 10 mg group, and 93 [14%] in the obeticholic acid 25 mg group). Interpretation Obeticholic acid 25 mg significantly improved fibrosis and key components of NASH disease activity among patients with NASH. The results from this planned interim analysis show clinically significant histological improvement that is reasonably likely to predict clinical benefit. This study is ongoing to assess clinical outcomes