Enabling planetary science across light-years. Ariel Definition Study Report

Ariel, the Atmospheric Remote-sensing Infrared Exoplanet Large-survey, was adopted as the fourth medium-class mission in ESA's Cosmic Vision programme to be launched in 2029. During its 4-year mission, Ariel will study what exoplanets are made of, how they formed and how they evolve, by surveying a diverse sample of about 1000 extrasolar planets, simultaneously in visible and infrared wavelengths. It is the first mission dedicated to measuring the chemical composition and thermal structures of hundreds of transiting exoplanets, enabling planetary science far beyond the boundaries of the Solar System. The payload consists of an off-axis Cassegrain telescope (primary mirror 1100 mm x 730 mm ellipse) and two separate instruments (FGS and AIRS) covering simultaneously 0.5-7.8 micron spectral range. The satellite is best placed into an L2 orbit to maximise the thermal stability and the field of regard. The payload module is passively cooled via a series of V-Groove radiators; the detectors for the AIRS are the only items that require active cooling via an active Ne JT cooler. The Ariel payload is developed by a consortium of more than 50 institutes from 16 ESA countries, which include the UK, France, Italy, Belgium, Poland, Spain, Austria, Denmark, Ireland, Portugal, Czech Republic, Hungary, the Netherlands, Sweden, Norway, Estonia, and a NASA contribution

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

The DUNE far detector vertical drift technology. Technical design report

DUNE is an international experiment dedicated to addressing some of the questions at the forefront of particle physics and astrophysics, including the mystifying preponderance of matter over antimatter in the early universe. The dual-site experiment will employ an intense neutrino beam focused on a near and a far detector as it aims to determine the neutrino mass hierarchy and to make high-precision measurements of the PMNS matrix parameters, including the CP-violating phase. It will also stand ready to observe supernova neutrino bursts, and seeks to observe nucleon decay as a signature of a grand unified theory underlying the standard model. The DUNE far detector implements liquid argon time-projection chamber (LArTPC) technology, and combines the many tens-of-kiloton fiducial mass necessary for rare event searches with the sub-centimeter spatial resolution required to image those events with high precision. The addition of a photon detection system enhances physics capabilities for all DUNE physics drivers and opens prospects for further physics explorations. Given its size, the far detector will be implemented as a set of modules, with LArTPC designs that differ from one another as newer technologies arise. In the vertical drift LArTPC design, a horizontal cathode bisects the detector, creating two stacked drift volumes in which ionization charges drift towards anodes at either the top or bottom. The anodes are composed of perforated PCB layers with conductive strips, enabling reconstruction in 3D. Light-trap-style photon detection modules are placed both on the cryostat's side walls and on the central cathode where they are optically powered. This Technical Design Report describes in detail the technical implementations of each subsystem of this LArTPC that, together with the other far detector modules and the near detector, will enable DUNE to achieve its physics goals

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Inter-University Network for Healthy Aging, Latin America and the Caribbean (RIES-LAC): a university contribution to the Decade of Healthy Aging

La población mundial está envejeciendo1-3, y la región de América Latina y el Caribe (ALC) no es una excepción.4-6 Actualmente, el 8% de la población de ALC tiene más de 65 años, y se estima que esta cifra aumentará al 30%. para 2050,7 Se sabe que el proceso de envejecimiento implica cambios moleculares, fisiológicos, funcionales, psicosociales y sociales.8 Todos envejecemos; La cuestión es envejecer sanamente. Como este no es siempre el caso, la Organización Mundial de la Salud (OMS) declaró el período de 2021 a 2030 como la Década del Envejecimiento Saludable.9 La Década es una colaboración global que involucra a diversos sectores y partes interesadas (gobiernos, sociedad civil, organizaciones internacionales). organizaciones, profesionales, instituciones académicas, los medios de comunicación y el sector privado) para mejorar las vidas de las personas mayores, sus familias y comunidades. La colaboración se centra en cuatro pilares de acción estrechamente interconectados: cambiar la forma en que pensamos, sentimos y actuamos ante la edad y el envejecimiento; garantizar que las comunidades fomenten las capacidades de las personas mayores; proporcionar atención integrada centrada en la persona y servicios primarios de salud que respondan a las personas mayores; y brindar acceso a atención a largo plazo a las personas mayores que la necesiten.9,10 Ante esta situación, ¿qué pueden hacer los académicos de las universidades de ALC? Si nos organizamos y unimos esfuerzos podemos contribuir al Decenio del Envejecimiento Saludable y, en consecuencia, influir en la calidad de vida de las personas mayores. Por lo tanto, a propuesta del Dr. Robinson Cuadros, Presidente del Comité LAC (COMLAT) de la Asociación Internacional de Gerontología y Geriatría (IAGG), el Profesor Iván Palomo, Director del Centro Interuniversitario para el Envejecimiento Saludable de las universidades públicas de Chile , propone ante COMLAT la creación de una Red Interuniversitaria para el Envejecimiento Saludable en ALC (RIES-LAC).The world’s population is aging1-3, and the Latin America and the Caribbean (LAC) region is no exception.4-6 Currently, 8% of the LAC population is over 65 years old, and this number is estimated to increase to 30% by 2050.7 The aging process is known to involve molecular, physiological, functional, psy-chosocial, and social changes.8 We all age; the point is to age healthily. As this is not always the case, the World Health Organization (WHO) declared the period from 2021 to 2030 as the Decade of Healthy Aging.9 The Decade is a global col-laboration involving diverse sectors and stakeholders (governments, civil society, international organizations, professionals, academic institutions, the media, and the private sector) to improve the lives of older people, their families, and com-munities. The collaboration is centered on four closely interconnected pillars of action: changing how we think, feel, and act towards age and aging; ensuring that communities foster the abilities of older people; providing person-centered inte-grated care and primary health services responsive to older people; and providing access to long-term care for older people who need it.9,10 In light of this situation, what can academics from universities in LAC do? If we organize ourselves and unite efforts, we can contribute to the Decade of Healthy Aging and, consequently, influence the quality of life of older people. Therefore, following the proposal of Dr. Robinson Cuadros, President of the LAC Committee (COMLAT) of the International Association of Gerontology and Geriatrics (IAGG), Professor Iván Palomo, Director of the Inter-University Center for Healthy Aging of public universities in Chile, proposes the creation of an Inter-University Network for Healthy Aging in LAC (RIES-LAC) before COMLAT.https://orcid.org/0000-0002-8584-3191https://scholar.google.com/citations?user=ns-9aAgAAAAJ&hl=es&oi=aohttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001337521Revista Internacional - IndexadaS

Poésies castillanes dont, Fernan Perez de Guzman , Coplas de vicios e virtudes ; Inigo Lopez de Mendoza , Proverbios ; Juan de Mena , Labirinto de Fortuna ; Diego del Castillo , Sobre la muerte del rey don Alfonso ; Juan de Mena , Debate de la rason contra la voluntad .

Numérisation effectuée à partir d'un document original.Appartient à l'ensemble documentaire : RegiaAragonRecueil de poésies castillanes du XV e siècle. Les auteurs et les titres (en italique) des oeuvres ont été partiellement identifiés d'après les indications du manuscrit et la tradition littéraire et historiographique ; le premier vers de chaque poème est transcrit. Ce manuscrit contient plusieurs dizaines de poèmes, composés de strophes de 8 vers, rimés et rythmés, qui portent sur des considérations morales chrétiennes : "Diversas virtudes et vicios et ynnos rimados aloores divinos enviados al muy bueno e discreto aluar garcia de sant Maria del conselo del Rey." (f.1) Fernan Perez de Guzman , Coplas de vicios e virtudes : "Diversas virtudes e vicios e ynnos rimados a loores divinos, enviados al muy bueno e discreto Alvar Garçia de Santa Maria, del consejo del rey" (f. 1) ; "Amigo sabio e discreto..." (f. 1-78v) ; Ymnos a los gosos de viestra senora , "Virgen que fuyste criada..." (f. 79-82) ; A la singular virginidat de nuestra señora , "Sy yo mi ynsuficiençia..." (f. 82-83v) ; A nuestra señora , "O sacra esposa del espiritu santo..." (f. 83v-84v) ; Ymno a Nuestra Señora, enbiado al prior de Lupiana fray Estevan de Leon , "La flor que de eterna laude..." (f. 84v-85) ; "Muestrate virgen ser madre..." (f. 85-87) ; A santa Elisabet de Ungria , "Graçias a santa Maria..." (f. 87-88) ; A santo Eugenio. , "De las Españas luzero..." (f. 88r-v) ; Ymno á Sant Gil , "Atenas mas gloriosso..." (f. 89-90) ; A sant Luchas , "Animal del qual nos canta..." (f. 90-91) ; A santa Leocadia ,"Defensora e patrona..." (f. 91-93v) ; Al arcangel sant Miguel , "Prinçipe muy exçellente..." (f. 93v-95) ; Fyn de loores de santos , "Como fizo Bonifaçio..." (f. 95r-v) ; Te Deum laudamus , "A ti alabamos Dios..." (f. 95v-98) ; Pater noster , "Padre nuestro que stas..." (f. 98v-99) ; "Ave, preciosa Maria..." (f. 99v-100) ; Oracion a nuestra señora en fin de toda la obra , "Virgen preçiosa de muy dulçe aspeto..." (f. 100v-101) ; Prologo en las quatro virtudes cardinales, al honorable e noble señor marques de Santillana, conde del Real , "Sy non me engaña el efecto..." (f. 101-111v). Inigo Lopez de Mendoza , Proverbios , avec prologue en prose (f. 113-116) et la glose, "Fijo mio mucho amado..." (f. 117-133 ) . Juan de Mena , Las trecientas ou El Labirinto , "Al muy prepotente don Juan el segundo..." (f. 135-184). Les trois dernières strophes manquent, la strophe 289 a été copiée deux fois, la strophe 288 est manquante. Gomez Manrique , "Carta que enbio Gomes Manrrique con las seguientes coplas a Diego Arias de Avila, contador mayor del rey nuestro señor" (f. 185), prologue en prose (f. 185-186), "De los mares mas perfecto..." (f. 186-194). Mendoza , A su amiga , "Hercules que la serpienta..." (f. 194). Iohan de Duenas , La nao de amor, remetida al rey nuestro señor que Dios aya , "En altas ondas de mar..." (f. 195-198v). Gomez Manrique, Al rey nuestro señor , "Quando Roma conquistava...", (f. 198v-201v). Fernando de la Torre , Testamento del maestre de Santiago , "In Dei nomine por quanto..." (f. 202-204v) : ce texte ne comporte que dix-huit strophes au lieu de vingt. Diego del Castillo , Sobre la muerte del rey don Alfonso , "Avia recogido sus crines doradas..." (f. 205-215). Romance del muy manifico rey don Ferrnando , "En un verde prado syn miedo segura." (f. 215v-216). Juan de Mena, Debate de la rason contra la voluntad , "Canta tu, cristiana musa..." (f. 217-234v) Gomez Manrique : suite du débat de la raison contre la volonté, "Pues este negro morir..." (f. 234v-258v). F. 259-263v : texte en prose, "Disputa que fue fecha en la ciudat de Fes sobre nuestra fe delante del Rey et de sus sabros" (f. 259). F. 259-263v : " Enla ciudat de Fes que es tierra de Moros fue fecha disputa delante de el rey et de rodos sus suabros alfa quis et letrados en el mode segniente ....-.... Et el dicho moro Abraym magaluf se fue en Portogal e se figo christiano e morio en la servicio de dios el qual plega dela querer per donar e anos otros asy mesmo. "Ce manuscrit provient de la bibliothèque des rois Aragonais de Naples . Il a été saisi par Charles VIII en 1495 et apporté au château d'Amboise, puis transféré dans la Librairie royale de Blois . Ce manuscrit est décrit dans l'inventaire du transfert de Blois à Fontainebleau en 1544 : "Ung autre livre en papier en cathelan intitulé cansoniero castiliano, couvert de cuir tanné" (Omont n° 1722) ; et dans le catalogue de la bibliothèque du roi à Paris à la fin du XVI e siècle : "Hymnes en louanges de certaines vertuz et mespris des vices" (Omont n° 2576).Lieu de copie : Castill

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women

Discovering HIV related information by means of association rules and machine learning

Acquired immunodeficiency syndrome (AIDS) is still one of the main health problems worldwide. It is therefore essential to keep making progress in improving the prognosis and quality of life of affected patients. One way to advance along this pathway is to uncover connections between other disorders associated with HIV/AIDS-so that they can be anticipated and possibly mitigated. We propose to achieve this by using Association Rules (ARs). They allow us to represent the dependencies between a number of diseases and other specific diseases. However, classical techniques systematically generate every AR meeting some minimal conditions on data frequency, hence generating a vast amount of uninteresting ARs, which need to be filtered out. The lack of manually annotated ARs has favored unsupervised filtering, even though they produce limited results. In this paper, we propose a semi-supervised system, able to identify relevant ARs among HIV-related diseases with a minimal amount of annotated training data. Our system has been able to extract a good number of relationships between HIV-related diseases that have been previously detected in the literature but are scattered and are often little known. Furthermore, a number of plausible new relationships have shown up which deserve further investigation by qualified medical experts

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization